[Agenesis of upper lateral incisors treated with unit implants].
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Provision of replacement complete dentures for an increasingly elderly population presents problems for the dentist. Reduced adaptability in the older person leads to difficulty in learning to use new appliances unless existing skills can be employed. It is therefore helpful to reproduce familiar features of a patient's old appliances, especially if these have been used for some years. This paper describes a method of treatment that provides both clinician and laboratory with the ability to achieve this objective, while retaining freedom to eliminate clinically-identified faults in the old appliances in the process of provision of the new. The technique depends on the substitution of conventional wax-rimmed record blocks with wax replicas of the old appliances. These replica record blocks lend themselves to any - major or minor - alteration during occlusion recording. They also incorporate a rigid baseplate and function as special trays.
The accuracy of a replication system for biostereometric analysis of denture tooth wear was examined. The differences observed were less than 0.32 per cent which serves to illustrate the degree of accuracy of this technique.
The loss of a maxillary incisor is traditionally treated with a three-unit bridge. The progress made in dental implantology since the demonstration of osseointegration by Brånemark and al. allows the overall replacement of the missing tooth. Furthermore, the use of osseointegrated implants makes the replacement of a single maxillary incisor reliable and aesthetic, even in cases of moderate gingival and bone recession. In respect of the rules set forth by Brånemark and al., it is essential to make a wax-up and a surgical stents. For anterior teeth, the single tooth abutment marketed by Nobelpharma allows the aesthetic margins of the prosthesis to be placed in a sub-gingival position. Once this component is positioned on the fixture, the achievement of the prosthesis is practically identical to traditional metal ceramic crown. The abutment is maintained on the fixture by a screw which can be easily removed and avoids an excess of subgingival cement. Nonetheless, its diameter means that it is reserved for relatively wide teeth. This type of treatment involves the development of a reliable and proven surgical planning for bone grafts, especially in cases of facial traumatism.
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Sixty-two ceramic implants (Frialit) were installed in 53 patients with agenesia or loss of single teeth due to traumata or infection. Sixty-three per cent of the implants were operated in immediately after tooth extraction, whereas the rest were installed in a healed bony alveolar ridge. Eighty-five per cent of the implants were replacements for maxillary incisors. The average observation period was 4 years. During this period 10 implants were removed due to lack of osseointegration. Seven of these implants were lost in the healing period, the remaining 3 were removed after installation of the suprastructure. Eighty-four percent of the implants were successful after 4 years. Trauma in the maxillary region have caused fracture of the implants in 5 patients. Such incidents create therapeutic problems difficult to solve satisfactorily.
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Spectrophotometric measurements were done on Vita shade guides. Three shade guides were spectrally analysed. A model was developed for a standard shade guide that can be used repeatedly employing reflectance spectroradiometers.
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A specially designed Branemark prosthetic component incorporates the features of an abutment cylinder and gold coping to permit fabrication of an aesthetically pleasing single-tooth restoration for osseointegrated jaw-bone fixtures.
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