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There are many materials that can be used for direct-placement cores. Although the scientific evidence is incomplete, some materials are better suited to this task than others. This article provides an overview of direct-placement core materials and highlights what clinicians should consider when assessing a new product.
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Severe partial anodontia is relatively rare. This case report describes the 10-year treatment history of a patient with partial anodontia, beginning with removable partial overlay dentures and culminating with fixed implant prostheses.
Many dentists have been reluctant to place dental implants because they have found that most implants are costly and time-consuming to place and have long-term maintenance problems. Most of these problems are caused by using screws to connect the abutment to the implant, the crown to the abutment or both. The use of a screwless implant system and conventional prosthetics, the author contends, can make implant dentistry affordable, versatile and easy to incorporate into all general dental practices.
Many factors influence whether teeth planned for crowns or fixed prosthesis abutments need to be built up. Teeth may now be treated more conservatively with minimal fillers because of the greater strength of current cements, including hybrid ionomers and resins. Teeth planned as fixed prosthesis abutments require more remaining tooth structure and greater buildup strength than those designed for single full crowns. It appears that crown buildup is still necessary, but this procedure is needed less frequently than it was in previous years. Fillers can be used to fill holes left when previous restorations were removed, and are more commonly placed than build-ups.
BACKGROUND: Young permanent molars with developmental enamel defects commonly are treated with stainless steel crowns. However, allergic reactions to nickel and chromium have been reported by some patients. The literature contains no evaluations of alternative treatments. METHODS: In a retrospective study, the authors evaluated the clinical performance of cast gold crowns and tooth-colored composite or ceramic crowns placed on first permanent molars with developmental defects in children 6 to 8 years of age. A total of 41 molars were prepared. After crown preparation, an impression was made, and crowns of cast gold, Artglass (J.F. Jelenko & Co.) composite or Empress (Ivoclar) leucite-containing ceramic were fabricated and clinically evaluated every six months for a period ranging from two to five years postoperatively (mean three years). RESULTS: After two to five years, all crowns were fully retained. The marginal adaptation of 39 of the 41 crowns was rated excellent, and the marginal adaptation of the remaining two crowns (both gold) received acceptable ratings. In two cast gold crowns, the margins were subgingival at cementation; the remaining 39 crowns had supragingival margins at the time of luting. By the end of the second year, all margins were supragingival. All teeth were vital and asymptomatic at all evaluation points. No secondary caries was recorded. Neither gingival inflammation nor loss of vertical dimension was recorded in any case. All crowns were well-accepted by the patients and their parents. CONCLUSIONS: Laboratory-fabricated crowns can be used for the treatment of young permanent molars with developmental defects. CLINICAL IMPLICATIONS: Cast gold, composite or ceramic crowns can be used successfully to treat developmental defects of first permanent molars in children.
BACKGROUND: The methods for evaluating dental implant osseointegration can be limited in their effectiveness. The authors developed a new noninvasive electronic instrument to test implant stability and improve the assessment process. METHODS: Using the new instrument, which was based on impulse testing and fast Fourier transform, or FFT, technology, the authors tested implant stability under real-time clinical conditions. The clinical procedure involved a weekly test of two placed implants, from the first-stage insertion point to the completion of the integration. This longitudinal monitoring spanned eight months. RESULTS: The authors verified clinical implant integration electronically and that it closely matched mathematical predictions. They also observed changes in implant stability during the integration process. CONCLUSIONS: Implant stability can be monitored electronically using FFT testing. A theoretical integration prediction also can be formulated. Like a "dental electrocardiogram," integration is assessed by waveform shape analysis. CLINICAL IMPLICATIONS: Electronic measurement of implant stability may help clinicians noninvasively diagnose the suitability of implants for restoration and aid in postrestorative monitoring.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Attempts have been made at formulating standardized nomenclature for implantology. Although these classification systems have advanced the concept of universal nomenclature in implantology, they can be improved upon. Most of them present terms in glossary form, which can limit their applicability. Others deviate significantly from accepted basic terminology and can be foreign or ambiguous to the average clinician. This article outlines the semiotic approach to language formulation, discusses slight changes to accepted conventional prosthodontic terminology to better encompass implant dentistry, and introduces the shortform and support-retention-connection-prosthesis classification systems.
The Periotest is examined as a possible replacement for outdated, inconsistent dental implant stability diagnosis tools. The Periotest has the advantage of offering reproducible findings by measuring the levels of subclinical mobility using an ultrasonically vibrating probe. The Periotest is successful in assessing the stability status of an implant, but it can detect the quantity of bony osseointegration only in terminal cases. Radiography proved to be a more sensitive method of determining pericervical bone loss; therefore, periapical radiographs in addition to the Periotest device were found to offer the most reliable assessment of an implant's status.
Reverse torque testing has been suggested to reduce the incidence of early loading failures during the first year of loading. However, the variables of bone density at stage II uncovery, the assessment of a small degree of implant rotation, and the effect of implant size and design have not been adequately evaluated. In addition, bone is weakest to shear forces, yet this is the primary force applied with reverse torque testing. This article reviews the benefits and disadvantages of reverse torque testing and suggests early crestal bone loss and failure of implants may be the result of this test, especially in less dense bone types. In addition, a nomenclature of implant failures is introduced to improve the correlation of information in the literature to the failure of implants in clinical practice.
Immediate placement of dental implants into tooth extraction sites is an effective treatment option. When immediate placement procedures are performed with a round implant, a void is often evident between the implant and the orifice of the socket. Previous treatment focused on the use of membranes or special closure techniques to induce bone growth into the void. Anatomically shaped dental implants provide a predictable alternative to previous filling techniques since the anatomical implants decrease or completely fill the void at the socket opening. This article describes a surgical technique developed for the immediate placement of these implants in extraction sites.
Osseointegration is an ongoing histometric process that may vary during clinical function. The implant must be stable at uncovering, which reflects the status of bone-implant interface. The physiology of bone healing associated with endosseous implants suggests that this process occurs between 8 and 12 months, and Periotest values (PTVs) tend to reflect changes in the stability of the bone-implant interface. Stability generally increases gradually from the time of uncovering to an optimal PTV that occurs at a point close to 12 months. This stable interface must remain intact for long-term clinical survival. Rapid development of this optimal PTV is highly desirable in order to prevent premature overloading of the bone-implant interface. The Ankylos implant is a new screw-type implant design in which the thread pitch and length vary to maximize trabecular bone contact. The purpose of this report is to evaluate to 18 months the stability (PTVs) of this implant design. More than 457 implants were placed and followed for a period of 18 months by the multicentered, multidisciplinary Ankylos Implant Clinical Research Group (AICRG). Implant stability (PTVs) was assessed using the Periotest at abutment connection and at 3, 6, 9, 12, and 18 months after uncovering. The Periotest values for all implants rapidly reached an optimal status between uncovering (-3.1 PTVs) and 3 months (-3.4 PTVs). This rapid increase in stability has not previously been reported for other implant designs. The mandibular arch was more negative (-3.8 PTVs) at uncovering as compared with the PTVs for the maxillary arch (-1.7 PTVs). Negative PTVs were recorded (1) as length and diameter increased, (2) as bone density increased, (3) in certain jaw regions, (4) as the number of implants/case increased, and (5) for implants stabile at placement. The Ankylos screw implant design produced rapid stabilization 3 months after uncovering.