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At least 1,261 records · Page 70Linked to original sources
PubMed1999

The role of orthognathic surgery in the treatment of severe dentoalveolar extrusion.

BACKGROUND: When mandibular molars are not replaced after extraction, the long-term problem of inadequate interarch space for either a fixed or removable prosthesis can occur. In the past, practitioners needed to decide whether to shorten the teeth, extract the supererupted maxillary molars to recapture space or leave the area unrestored. The authors present another option. CASE DESCRIPTION: A 61-year-old man was referred to a periodontist by his general dentist for placement of mandibular implants in the posterior sextant. Extreme supereruption of the maxillary dentoalveolar segment prevented restoration of the opposing edentulous area. An oral and maxillofacial surgeon performed a segmental osteotomy of the posterior right maxilla to gain needed interarch space. After the osteotomy was stabilized, the periodontist placed implants that were subsequently restored with a fixed prosthesis. CLINICAL IMPLICATIONS: The role of orthognathic surgery in treatment planning should not be overlooked in the comprehensive management of severe extrusion. It offers patients the opportunity to gain both function and esthetics that might otherwise be impossible.

Ambulatory Surgical Procedures↗
PubMed1996

Non-submerged osseointegrated dental implants with ball attachments supporting overdentures in patients with mandibular alveolar ridge atrophy. A short-term follow-up.

Non-submerged, hollow screw ITI-Bonefit dental implants with ball attachments supporting overdentures were used as alternative treatment to combined vestibulo-lingual-plasty with free split-thickness skin graft and removable dentures in 40 consecutive patients with mandibular alveolar ridge atrophy. One hundred and fifty-six non-sub-merged fixtures were installed. Ball attachments were mounted on the fixtures and implant-supported overdentures inserted 3-4 months after fixture installation. The observation period after implant activation and prosthesis insertion varied from 1 to 3 years with a median observation period of 2 years. The overall success rate of individual implants was 99%(155/156). The prosthesis function rate was 100%(40/40). The 1-year success rate of individual implants was 99%(155/156) with a prosthesis function rate of 100%(40/40). No persistent surgical, periodontic or prosthodontic complications were observed. The results indicate that non-submerged osseointegrated ITI-Bonefit dental implants with ball attachments supporting overdentures can be a successful alternative to combined vestibulo-lingual-plasty with free split-thickness skin graft and removable dentures, and as successful as the use of submerged dental implants.

Aged↗
PubMed2001

Displacement of the mandible in a child with congenital unilateral temporomandibular joint ankylosis treated with two-stage condylar replacement: a long-term study with the aid of roentgen stereometric analysis.

OBJECTIVE: To monitor mandibular displacement in three dimensions with a high degree of accuracy before, during, and after treatment. DESIGN: Prospective roentgen stereometric analysis from age 3 years 7 months to age 13 years 8 months. SETTING: Center for Craniofacial Anomalies and Department of Maxillofacial Surgery, Malmö University Hospital, Malmö, Sweden. PATIENT: Girl with unilateral congenital temporomandibular joint (TMJ) ankylosis and marked facial asymmetry. INTERVENTIONS: Epipharyngeal inspection at age 2 years 6 months and insertion of implants under general anesthesia. Resection of the affected right condyle at age 5 years 4 months, replacement of the ramus-condyle complex with a custom made titanium prosthesis at age 5 years 5 months, and replacement of the artificial condyle by a costochondral graft at age 9 years 7 months. Roentgen examinations were performed at intervals from age 3 years 7 months to age 13 years 8 months. Body length was measured annually. MAIN OUTCOME MEASURES: Stereo roentgenograms were digitized by the Department of Orthopedic Surgery, Malmö University Hospital. RESULTS: Unexpected lowering of the mandible occurred before treatment. Each procedure had a distinct effect on the direction of mandibular displacement. There was little or no pathological involvement of the functional matrix. Growth of the costochondral graft exceeded growth of the unaffected TMJ. Anterior displacement as well as rotation and tilting of the mandible to the unaffected side accelerated after the age of body peak height velocity. CONCLUSIONS: Accurate monitoring of mandibular displacement may contribute to a rationale for clinicians' decision on treatment protocol and reveal compensatory differential growth.

Adolescent↗
PubMed1998

Tripodal mandibular subperiosteal implant: basic sciences, operational procedures, and clinical data.

A tripodal mandibular subperiosteal dental implant is a three piece cast metal framework that fits on the residual ridge beneath the periosteum and provides support for a dental prosthesis by means of posts or other mechanisms protruding through the oral mucosa. This implant is indicated in patients with advanced atrophy of the mandible where the unstable alveolar bone has completely disappeared, leaving in place the more stable basal bone with specific anatomical contours. The authors present their experience of 317 cases carried out in three different centers related to this implant modality and underline the importance of the basic anatomic, physiologic, and medical knowledge required to optimize the results.

Adult↗
PubMed2003

[Functional implantation reconstruction of acquired jaw defects after tumor resection].

OBJECTIVE: Partial or full defects of jawbone following tumor resection frequently lead to a loss of mastication, an impaired speech function and a severe deformity of appearance. To improve the life quality of such patients, implantation or bone grafting-combined implantation was utilized to functionally reconstruct the jaw defects. METHODS: 1. Fragmental or full mandibular defects were reconstructed by vascularized or non-vascularized bone grafts in combination with immediate or delayed implants. 2. The unilateral maxillary defect with an edentulous counter-side was rehabilitated by a prosthesis secured on implants placed on the healthy side. 3. For bilateral maxillary defect, implants were placed in the zygmatic bone or augmented zygmatic bone to support a prosthesis with magnetic retention. RESULTS: 64 jaw defects (10 in maxilla; 54 in mandible) were reconstructed by three different methods to restore the appearance and functions. The longest follow-up period was 12 years and the shortest 5 year, only 6 implants were lost due to failure of osseointegration. The implant survival rate for the maxillary defects was 97.5%, for the mandibular defects with vascularized bone grafts was 97.1%, and with non-vascularized bone grafts was 97.7%. CONCLUSIONS: Implants-borne prosthesis is an applicable technique in restoration of maxillary defects. In case of insufficient zygomatic thickness, bone augmentation is often needed prior to implantation. As for the mandibular reconstruction, bone grafting in combination with implantation is an ideal method. Compared to non-vascularized bone grafting, the vascularized method is much more suitable for bone grafting beds with poor blood supply. From the practical point of view, non-vascularized bone graft in combination with implantation is more practicable. The reduced off-body time of bone grafts from donor to recipient site keeps most of osteoblasts vital and enables simultaneous implants to achieve osseointegration. This confirms the osteogenesis, osteoconduction and osteoinduction of bone autografts.

Adolescent↗
PubMed1990

[A clinical study of the extentional labiobuccal lingual flange complete denture].

In this study, 26 mandibular edentulous patients with severe atrophy alveolar ridge were treated by the extensional labiobucco-lingual flange complete denture prosthesis that were made by way of expanding the impression in which the external oblique ridge area, the genial tubercles, mental protuberance and more sublingual area are partially included. The results show that in retention, stability and support are better than the conventional lower complete denture. The masticatory efficiency, the bite force and the denture bearing area are much improved. There is no significant change in the height of the mandibular alveolar ridge between the conventional dentures and the extensional flange dentures after about one year. This method is easy to be used, no surgical operation is needed.

Aged↗
PubMed2005

Bone remodeling in immediately loaded and unloaded titanium dental implants: a histologic and histomorphometric study in humans.

Remodeling is thought to prevent microdamage accumulation caused by repetitive loading and to increase the fatigue life of bone. The bone remodeling rate (BRR) is the period of time needed for new bone to replace the existing bone and to allow for the adaptation of bone to its environment. BRR is expressed as a percentage or volume of new bone within a specific time period. The aim of the present study was to evaluate bone remodeling events on submerged and immediately loaded dental implants. Twelve patients with edentulous mandibles participated in this study. All patients were rehabilitated with fixed mandibular prostheses, with 10 dental implants per patient. An additional implant was inserted in the most distal posterior mandibular jaw region. In 6 patients, these additional implants were loaded with a fixed provisional prosthesis the same day of the implant surgery and loaded. In the other 6 patients, the additional implants were left submerged and not loaded. After 6 months, all the additional implants were retrieved with a trephine. The percentage of woven and lamellar bone, number of osteoclasts and osteoblasts, and percentage of bone labeled by tetracycline at 0.5 mm and 2 mm from the implant surface were evaluated. The percentage of lamellar bone, number of osteoblasts, and percentage of bone tetracycline labeling was significantly higher in the loaded implants than in the unloaded implants (P =.0001). Also in the loaded implants, the percentage of woven and lamellar bone, number of osteoclasts and osteoblasts, and percentage of bone tetracycline labeling was significantly higher at 0.5 mm than at 2 mm from the implant surface (P =.0001). No such differences were found in unloaded implants (P =.377). In conclusion, we found that (1) loading appeared to stimulate bone remodeling at the interface, (2) a higher percentage of lamellar bone was found in loaded implants, (3) the percentage of bone labeling was higher at the interface of loaded implants, (4) no differences were found in the BRRs between immediately loaded and unloaded implants, and (5) immediate loading had not interfered on the lamellar bone formation at the interface and had not produced formation of woven bone at the interface.

Adult↗
PubMed1989

[Evaluation of the degree of restoration of function with fixed molar bridges].

The purpose of this study was to determine the degree of restoration of masticatory function with fixed molar bridges. Evaluations were made of the deep temperature of the masseter muscle, masticatory performance and occlusal contacts (duration, force distribution, area and number of contacts). Criteria were established for the parameters above mention in 30 normal subjects. Fixed bridges were placed in 10 patients with missing only the mandibular first molar. Measurements were carried out both prior to and after placement of the prosthesis. The following results were obtained. 1. The deep temperature of the masseter muscle patients recovered in 30 days after prosthesis. 2. The total number of contact points and contact area increased after placement by 30 days. 3. The duration of occlusal contacts increased up to 30 days after placement. 4. The force distribution of occlusal contacts decreased for a time but recovered as the normal subjects after 30 days. 5. The masticatory performance was restored immediately after the placement and showed no change by 45 days.

Body Temperature↗
PubMedDate not supplied

Clinical application of narrow Brånemark System implants for single-tooth restorations.

Replacing small, single incisors with implants can be esthetically challenging and difficult because of the limited amount of bone. In this investigation, 3.0-mm-diameter implants were used to support 30 single maxillary and mandibular incisors in 21 patients. The implants have been in function for 3 to 7 years, and 29 are still stable. Only 2 complications in the mandibular incisor region have occurred; 1 implant fractured (after 5 years of function) and 1 prosthesis was replaced. The overall success rate is 96.7%. The favorable results and esthetic appearance achieved suggest that replacing small incisors where light occlusal forces are present with narrower implants is a feasible treatment option.

Adolescent↗
PubMed2000

A comparison of the early postoperative care required by patients treated with single and two stage surgical techniques for the provision of Brånemark implant supported mandibular overdentures.

Patients who underwent a single stage surgical procedure to place two Brånemark implants to stabilise complete mandibular overdentures with bar attachments, required no more postoperative follow-up visits before definitive prosthesis construction than patients who had their implants placed at two separate surgical stages. However, the visits of the single stage group, occurred over a shorter time-scale and more attention was required to tighten or replace their healing abutments.

Aged↗
PubMedDate not supplied

Implant placement and restoration following bone marrow transplantation for chronic leukemia: a case report.

Bone marrow transplantation is used with increasing frequency to treat various hematologic diseases, particularly the leukemias. A case involving dental implant therapy in a woman who had undergone successful allogeneic bone marrow transplantation for treatment of chronic myelogenous leukemia is presented to illustrate specific considerations in treatment planning, surgical management, and overall prosthetic rehabilitation. Five mandibular endosseous implants were placed in November 1991 and subsequently restored with a fixed detachable prosthesis. The patient experienced no complications related to the implants or prosthesis during the 3 years after restoration.

Adult↗
PubMed1993

Osseointegrated dental implants with ball attachments supporting overdentures in patients with mandibular alveolar ridge atrophy.

Brånemark dental implants with ball attachments supporting overdentures were used as alternative treatment to combined lingual-vestibuloplasty with free split-thickness skin graft and removable dentures in 25 consecutive patients with mandibular alveolar ridge atrophy. Ninety-three fixtures were placed. Ball attachments were mounted on the fixtures, and implant-supported overdentures were inserted 3 to 4 months after fixture placement. The observation period after implant activation and prosthesis insertion varied from 12 to 27 months with a median observation period of 18 months. The overall success rate of individual implants was 97% (90/93). The prosthesis function rate was 100% (25/25). The 1-year success rate of individual implants was 98% (91/93) with a prosthesis function rate of 100% (25/25). No persistent surgical or prosthodontic complications were observed. Preliminary results indicate that osseointegrated Brånemark dental implants with ball attachments supporting overdentures can be a successful alternative to combined lingual-vestibuloplasty with free split-thickness skin graft and removal dentures in patients with denture problems related to mandibular alveolar ridge atrophy.

Aged↗
PubMedDate not supplied

Radiographic study of changes in the mandibular condyle after implant prosthodontic rehabilitation.

PURPOSE: The aim of this follow-up investigation was to assess the influence of clinical variables after implant prosthodontic rehabilitation in patients without temporomandibular disorders on alterations of condylar morphology as seen radiographically. MATERIALS AND METHODS: In 167 patients, the condylar findings of flattening, erosion, osteophytes, and sclerosis were scored according to severity on rotational panoramic radiographs. Findings were followed up on images taken before and on average 5 years after implant prosthodontic rehabilitation. Changes were analyzed in relation to age, gender, initial radiologic status, and occlusal support pre- and posttreatment, according to Eichner groups, by logistic regression analysis. RESULTS: The majority of patients did not show structural alterations over the follow-up period, regardless of whether the condyle was already affected at the outset of the investigation. Condyles unaffected at the time of the first radiograph made up the majority of increases in radiographic score. Flattening and sclerosis were cumulative, whereas erosions and osteophytes had a more transient character. There was no influence of the mentioned clinical or radiographic findings on the development of changes. CONCLUSION: Over the investigated period, the incidence of all four noted findings doubled. However, the statistical methods employed could not detect any influence of patient variables or the insertion of implant-retained prosthodontics on the development of condylar changes in this specific patient group. Both assertions reflect the complexity of the topic.

Adult↗
PubMed1998

Treatment outcomes with mandibular removable partial dentures: a population-based study of patient satisfaction.

STATEMENT OF PROBLEM: Little is known about the outcomes of treatment with mandibular removable partial dentures provided by dentists in private dental practice. PURPOSE: This study examined 15 aspects of patient satisfaction and explored the factors found to be associated with dissatisfaction. MATERIAL AND METHODS: A questionnaire was mailed to people whose dental insurance claims included CPT Code 5214 within the last 5 years. A composite measure of treatment outcome was created by combining the responses to the 15 satisfaction items, and 10 factors were then tested statistically to determine their relationship to dissatisfaction. RESULTS: A majority of the respondents were satisfied with the prosthesis, but a substantial amount of dissatisfaction existed. Dissatisfaction was greater when there was no previous wearing experience or when there was an opposing maxillary removable partial denture. Respondents under the age of 60 expressed more dissatisfaction than did those over the age of 60, and subjects with lower levels of general health also reported less satisfaction. One third of the respondents believed their prosthesis required adjustment or replacement, and one fourth said the removable partial denture had caused a problem with the natural teeth. CONCLUSION: A majority of survey respondents treated with a mandibular removable partial denture in private dental practice were satisfied with the prosthesis, but a substantial amount of dissatisfaction existed. Dissatisfaction was related to age, health, prior experience with a prosthesis, and the type of opposing dentition.

Denture, Partial, Removable↗
PubMed1994

Restoration of inadequate occlusal face height by using resin bonded to etched metal removable prosthesis.

The resin bonded to etched metal casting of a removable partial denture was used anteriorly in combination with posterior acrylic resin teeth to restore patients with mandibular overclosure. The procedure is simple, esthetic, conservative, inexpensive, and not time-consuming. Patients maintained their new occlusal facial height with normal functional activity. The remaining natural teeth showed no signs of changes in 6 months in either opposing tooth structure or the periodontium.

Dental Occlusion↗
PubMed1998

A combined approach to benign but advanced mandibular tumor.

Mandibular tumors such as ameloblastoma or fibrous dysplasia frequently follow a relentless course despite the fact that they are pathologically benign. Patients suffered from multiple recurrences and repeated surgery, and might still lose their masticatory function. To solve the above problems, a new combined approach--segmental mandibulectomy, free fibular flap reconstruction and primary osseointegration--was applied to three cases of aggressive mandibular tumors. The pathology spectrum included an enormous ameloblastoma, a fibrous dysplasia and a multiple recurrent ameloblastoma. Fixed partial prosthesis were loaded 6 months after the procedure. There were no detectable recurrence after 30 months' follow-up. The patients regained their facial contour, dental occlusion and masticatory function in a relatively short period of time. Segmental mandibulectomy lessens the likelihood of recurrence, free fibular flap transfer restores the dental articulation function and facial contour, and immediate osseointegration has further enhanced the masticatory function. This combined approach thus improves the patients' satisfaction and ensure their social interactions. It is justified for some selected aggressive mandibular tumors.

Adolescent↗