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Linear tomography's clinical accuracy and validity for presurgical dental implant analysis.

Accurate assessment of alveolar ridge morphology and inferior alveolar canal location is critical in the presurgical planning phase for dental implant therapy. This study examined the accuracy and validity of linear tomography in the presurgical assessment of potential mandibular implant sites. Seven subjects (six oral and maxillofacial surgeons and one oral radiologist) traced the mandibular cortical bone and inferior alveolar canal on linear tomographic images taken from five mandibles on five separate occasions over 5 weeks. Tracings and the sectioned mandibles were scanned into a computer and assessed for eight measurement criteria. Statistically significant findings were present for intraobserver variability, interobserver variability, and differences between the perceived and actual anatomic structures within the assessed plane of section. These findings demonstrate that the inherent dimensional instability of linear tomography severely limits its diagnostic and clinical role in preoperative implant site assessment.

Alveolar Process↗

Aesthetic enhancement of anterior dental implants with the use of tapered osteotomes and soft tissue manipulation.

An adequate bone base is usually a prerequisite for functionally and aesthetically optimal reconstruction of the soft tissue architecture around a dental implant. In patients with sufficient bone height but insufficient bone width as a result of tooth loss, a jaw enlargement technique with osteotomes combined with soft tissue manipulation may be utilized to facilitate proper implant placement while concomitantly optimizing the aesthetics of the final implant prosthesis. The learning objective of this article is to familiarize the reader with the principles of ridge expansion with tapered osteotomes combined with periodontal plastic soft tissue surgery to aid in proper implant placement and enhance the aesthetic result of the final prosthesis.

Alveolar Ridge Augmentation↗

Distraction osteogenesis for augmenting the deficient alveolar ridge in preparation for dental implant placement: a case report.

Distraction osteogenesis is a process in which new bone is created in a defect of the alveolar ridge by stretching existing bone. The process was originally developed by a Russian orthopedist, Gavriel Ilizarov, for the correction of long-bone deformities. It was later adapted to the maxillofacial skeleton and alveolar ridge. Distraction osteogenesis involves surgically creating a mobile bone segment to which a distraction device is attached. By controlled movement, the bone segment, along with the soft tissues overlying it, are transported into a new position. After a suitable healing period, the distraction device is removed and dental implants can be placed. A case report is presented describing the use of alveolar distraction to augment a vertically deficient alveolar ridge.

Adult↗

Clinicoanatomic examination of the fibula: anatomic basis for dental implant placement.

The advantages of the free vascularized fibular flap include its ability to be shaped with relative ease and to be grafted at the same time tumors are resected, with consequent reduction in operation time. In addition, few complications occur at donor sites. However, a large, systematic, and detailed investigation of clinicoanatomic problems of the fibula has not been performed. Therefore, in the present study, the fibula was examined morphologically and morphometrically, with special attention to regions important in the placement of dental implants. Eighty fibulae obtained from cadavers of 41 Japanese individuals aged 46 to 92 years (mean, 72.7 years) were fixed with 70% alcohol after infusion of about 6 liters of 10% formalin via the femoral artery. Morphometric examination showed the nutrient foramen was located posteriorly in 85.0% of sections, the maximal width of fibular cross sections was 13.1 mm, and the maximal cortical thickness of fibular cross sections was 4.1 mm.

Aged↗

Dental implant jurisprudence: avoiding the legal failures.

The law measures the quality of dentistry by the "standard of care" as defined by the courts. The ultimate judges of the facts in a malpractice suit are usually juries made up mostly of lay people. Ignorance of the legal requirements for dentistry, and specifically dental implants, unnecessarily exposes today's dental health care provider to such suits. However, with a reasonable understanding of the legal issues and requirements surrounding the standard of care, a dentist may avoid becoming embroiled in a malpractice claim.

Dental Implants↗

Effects of dental implant surfaces on the expression of bone sialoprotein in cells derived from human mandibular bone.

BACKGROUND: Protein adsorption is believed to be the first event that takes place after contact of natural tissue with an artificial surface. Bone sialoprotein (BSP) is one of the major noncollagenous proteins in the extracellular matrix of bone. The expression of BSP coincides with initial bone mineralization and is believed to be a center of crystallization for hydroxyapatite formation. MATERIAL/METHODS: We used a variety of four differently designed dental implant surfaces (SLA, CPT, ANOX, TICER) to investigate the effects on the development of adult human mandibular bone at days 5, 10, 15, 20, and 25 in vitro. The time course of the expression of BSP and labeling of fibroblasts was visualized immunohistochemically. The distribution patterns of cells were determined semiquantitatively on both the surface and the tissue-implant borderline. RESULTS: BSP immunoresponse increased from day 5 before decreasing after day 15 in vitro. The distribution of BSP-expressing cells changed during that time. Cell counts revealed that the time course of the settlement of cells depended on the design of the surface of the implant. The design of the border of the implant affected both the cell distribution patterns and the survivals of cells to a higher degree than did the design of the implant surface. CONCLUSIONS: Investigation of novel biomaterials for bone engineering represents an essential area for the design of tissue-engineering strategies. The hydroxyapatite-based implant material TICER could be a good scaffold to guide and promote the regeneration of bone tissue.

Adult↗

Parameters affecting the stress distribution around LTI carbon and aluminum oxide dental implants.

Three-dimensional finite element stress analysis was used to study the effects that implant neck geometry and the tissue properties at the implant-bone interface have on the stress distribution around free-standing blade- and post-type LTI carbon and aluminum oxide dental implants. Implants having neck flares of 13 degrees and 26 degrees were studied. In addition, to simulate fibrous encapsulation of the implant as opposed to a direct bone apposition retention mechanism, a soft tissue interposing layer between implant and bone was also modeled. The results of the study indicate that a reduction in neck flare from 26 degrees to 13 degrees was a positive design change for blade- and post-type LTI carbon implants and blade-type aluminum oxide implant but not for post-type aluminum oxide implant. The results of the study indicate the presence of fibrous tissue surrounding the implants may be indicative of a failing system and may be the result of either hypophysiological stress (aluminum oxide implants) or hyperphysiological stress (LTI carbon implants).

Aluminum↗

Bone graft augmentation and dental implant treatment in a patient with osteogenesis imperfecta: review of the literature with a case report.

This case report with a review of the literature describes a patient with osteogenesis imperfecta who was treated with dental implants. To our knowledge, only one case report has been published in the English dental literature describing implant treatment in the osteogenesis imperfecta patient. The uncertainty in treatment confronted by all clinicians is the density of bone, which is essential for implant survival.

Adult↗