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At least 1,297 records · Page 72Linked to original sources
PubMed1989

[Planning a replacement for the mandibular condyle based on anthropologic findings].

The sizes of the bilateral capitulum of 467 jaws coming a paleoanthropological collection were evaluated by computer and statistically processed. No essential size differences were found between the right and the left side. Deviations between groups of men and women proved to be significant from a statistical point of view. However, practically, they were found insignificant for composing average jaw capitulum series of five pieces. The data help to design jaw capitulum prostheses and the making of their wax models.

Anthropology↗
PubMed1977

Implants for fixed and removable prostheses.

For those individuals whose oral anatomy contraindicates the use of endosteal implants, there still remains a viable alternative to conventional removable dentures. Both maxillary and mandibular implant dentures of a subperiosteal design will provide a stable implant and a retentive restorative prosthesis. The patient is free from the oral gymnastics required to manipulate such appliances and in the maxilla the dentist is able to eliminate all palatal coverage without compromising the retention of the bridge. The lower subperiosteal implant and the pterygoid extension implant discussed both obtain their stability from accurate fit of the implant substructure to the bone. The implant first becomes more retentive when the periosteum tenaciously reattaches itself to the bone and in turn secures the implant in position (Fig. 13). The restorative procedures follow sound prosthetic prinicples with particular attention on avoiding any impingement of the underlying tissue areas. Implant dentures have truly provided patients a means of exploring alternative treatment modalities other than conventional removable dentures. Literally thousands of patients today are living testimony to the accomplishments of oral implantology when pursued as an exacting science prescribed by colleagues experienced in this revolutionary dental discipline.

Dental Implantation↗
PubMed1994

Restoration of the atrophic, edentulous mandible.

Twenty-five years' experience in treating the atrophic mandible has convinced us that the ramus frame is the finest service we can provide the patient who is afflicted with this condition. Modifications in the design and placement have solved problems encountered with past use of this treatment modality. When one considers the relative comfort and function resulting from a fully-implant-supported prosthesis, the moderate cost of this one-piece custom-fabricated implant, and the fact that the implant and overdenture can be placed in one appointment, we believe that a resurgence will take place in the use of this treatment modality. The patient's ability to have immediate function, although limited to softer foods, is due to the large area of cortical bone supporting the implant. The most appreciative group of patients within our large implant practice consists of those patients who have had this procedure.

Alveolar Bone Loss↗
PubMed2006

Can general dentists produce successful implant overdentures with minimal training?

OBJECTIVES: This study was carried out to determine whether inexperienced dentists can provide two-implant overdentures that are as satisfactory and of the same cost as those provided by experienced prosthodontists. METHODS: Edentulous elders were enrolled in a randomized controlled clinical trial to compare the effects of mandibular conventional and two-implant overdentures on nutrition. They were randomly assigned to groups that were treated by either an experienced prosthodontist or by a newly-graduated dentist with minimal training in implant treatment. Data for this study were obtained during the treatment of the first 140 subjects enrolled. The change in patient ratings of satisfaction after treatment, laboratory costs and the number of unscheduled visits up to 6 months following prosthesis delivery were compared. RESULTS: Satisfaction was significantly higher with implant overdentures than with conventional dentures, but there were no differences in scores for either prosthesis between the groups treated by experienced specialists or new dentists. Furthermore, six of the seven inexperienced dentists reported that they found the mandibular two-implant overdenture easier to provide than the conventional denture. CONCLUSIONS: The results of this study suggest that general dentists can provide successful mandibular two-implant overdentures with minimal training.

Chi-Square Distribution↗
PubMed1991

The transmandibular implant: a 13-year survey of its use.

During the period from August 1976 until July 1989 the transmandibular implant was introduced in a total of 31 oral and maxillofacial surgery departments in the Netherlands and 1,466 patients were treated. This study includes 1,356 treated patients from 28 departments. The treatment course of 1,201 patients (89.6%) was uneventful. Of the 157 complications, 58 related to the anatomic contour of the mandible, 49 to the surgery, 25 to the prosthetic reconstruction, 8 to the psychosocial attitude of the patient, 8 to the use of medication, 5 to trauma, and 4 to the presence of a skin graft. Treatment of the complications included removal of the implant in 44 patients; in 106 patients the complication was treated satisfactorily. In the remaining 7 patients, hypesthesia was present. The reasons for the removal of the 44 implants were infection (11), operative error (5), premature loading of the implant (3), insufficient width of the mandible after a visor osteotomy (1), loss of osseointegration caused by the prosthesis (14), psychological problems (4), trauma (3), drug-related gingival hyperplasia (2), and inexplicable pain (1). The present survey shows a consistent success rate of 96.8%.

Adult↗
PubMed1999

Functional criteria for mandibular implant placement post resection and reconstruction for cancer.

STATEMENT OF PROBLEM: Osseointegrated implants used in the mandible post resection and reconstruction for cancer represents a treatment option with the potential for functional improvement and enhanced quality of life. Unfortunately, protocols for their use in this patient population have been empirical and technique-driven with the assumption that they will overcome most, if not all, functional deficits encountered. PURPOSE: The article reviews the salient oral physiologic factors for this group of patients and presents a rational approach and functional criteria for patient selection and implant placement. Other considerations discussed include: timing of implant placement, irradiated and compromised tissues, patient motivation, and tumor prognosis. CONCLUSION: These principles, if followed, may enhance realistic functional outcomes for this patient population.

Dental Implantation, Endosseous↗
PubMed2005

The use of free fibular flap for functional mandibular reconstruction.

PURPOSE: The purpose of this investigation is to document our experience using the free vascularized fibular flap for comprehensive reconstruction of discontinuity defects in the mandible, after combined resections of malignant and aggressive odontogenic tumors, with special emphasis on functional aspect of the reconstruction process. MATERIALS AND METHODS: The study group consisted of consecutive patients treated for reconstruction of discontinuity defects of the mandible, using the fibular vascularized free flap, between 1997-2002. All procedures were performed in the same hospital and by the same surgical team. RESULTS: A total of 13 patients (9 males, 4 females) were treated in our department in a period of 6 years for reconstruction of discontinuity mandibular defects using the free fibula vascularized flap. Wound healing disturbances at the donor site occurred in 4 cases. Two flaps were lost, 1 because of total failure in a patient who was heavily irradiated because of osteosarcoma, the other because of resorption of the bone tissue transfer in a case of total avulsion of the mandible caused by a fall from height. CONCLUSION: Fibula free vascularized flap is a safe and reliable method for comprehensive functional and esthetic mandibular defect reconstruction. Our protocol has a significant impact on preserving the patients quality of life.

Adolescent↗
PubMed1995

Osseointegration and nerve transposition after mandibular resection to treat an ameloblastoma: a case report.

This case report demonstrates the use of osseointegrated implants to replace the mandibular left second premolar and first and second molars removed during a surgical resection of a walnut-sized ameloblastoma. The first-stage surgery was performed 2 years after the oncologic surgery, and it was necessary to laterally reposition the inferior alveolar nerve prior to placement of implants. The patient has been restored to full dental function. There was no occurrence of paresthesia at any time. The treatment plan and the treatment were a collaboration of an oral surgeon, a periodontist, and a restorative dentist, located in Sweden, the United States, and Italy, respectively, and is an indication of what can be accomplished to the benefit of the patient when teamwork is exercised.

Adolescent↗
PubMed1995

Implant-supported restoration of a mandibular reconstruction with an osteocutaneous microvascular free flap: a clinical report.

The microvascular osteocutaneous fibula free flap can provide an esthetic restoration of mandibular discontinuity defects. When the graft is favorably positioned, osseointegrated implants may be placed and a functional restoration completed. When tongue function is not compromised, the patient is able to control saliva and the food bolus and can show excellent speech. This clinical implant-supported fixed prosthodontic restoration shows such treatment.

Bone Transplantation↗
PubMed1995

Periotest measurements and osseointegration of mandibular ITI implants supporting overdentures. A one-year longitudinal study.

The Periotest values of mandibular implants, registered before and after loading by overdentures, were compared. Thirty edentulous patients with 60 Bonefit ITI implants were selected with an average age of 69 years. The Periotest values were measured 1) after a healing period of 3 months and 2) after the overdentures had been worn for a period of 12 months. Periodontal parameters were recorded at both examinations. Furthermore, 17 biopsies of mandibular bone taken from the implant sites during implant surgery were analyzed to assess the bone density. The histomorphometric evaluation was done using a point count method. At the end of the healing period, all registered Periotest values were negative, ranging from -1 to -8 with an average of 4.08. One year later, all measurements showed negative values again, ranging from -2 to -8 with an average of 4.97. The difference was statistically significant. Seventeen biopsies of mandibular bone were evaluated to determine the density. The range of bone density was from 22.4% and 90.9%. There was no correlation found between bone density and Periotest values. However, a significant correlation could be observed between mandibular atrophy and bone density.

Aged↗
PubMedDate not supplied

Endosseous implant and autogenous bone graft reconstruction of mandibular discontinuity: a 12-year longitudinal study of 31 patients.

Surgical, medical, and prosthodontic records of 61 consecutively treated patients with mandibular discontinuity were reviewed retrospectively. All 61 patients had undergone discontinuity reconstruction with autogenous bone grafts; 31 of 61 had also received endosseous dental implants and a dental osseoprosthesis. Of these 31 implant-reconstructed patients, 23 had free autogenous nonvascularized and 8 had vascularized bone grafts. The surgical-prosthetic protocol consisted primarily of secondary, free autogenous nonvascularized bone graft reconstruction and secondary root-form endosseous implant and fixed prosthesis dental reconstruction. Vascularized bone (8 patients) or soft tissue (4 patients) grafts were utilized selectively for severely compromised patients after extensive oncologic resection, avulsive trauma, or after previous radiation treatment. Endosseous implant survival (95.5% in 31 patients), autogenous bone graft success (98.4% in 61 patients), and dental osseoprosthesis success (100% in 31 patients) were favorable. A high incidence (9.1%) of nonfunctioning (sleeping) implants was recorded for this patient population. The need to remove the titanium mesh tray for various reasons (17.6%) and the need to reconstruct soft tissue in the irradiated patient (12%) were noteworthy.

Adolescent↗
PubMed1996

Forty years of experience with subperiosteal implant dentures in 41 edentulous patients.

Forty-one complete mandibular subperiosteal implant-supported and retained dentures were consecutively inserted between 1952 and 1971, and patients were monitored through 1992. After variables and methods of follow-up were described, the implants were divided into three categories: 14 (34%) nonfunctional implants, 9 (22%) functioning implants, and 18 (44%) functional implants prematurely terminated by death or cause unrelated to implant condition. Five percent of the implants failed by 5 years, 22% failed by 10 years, 34% failed by 20 years, and none failed after 20 years. Nine implants were still functioning 21 to 36 years after insertion, of which five were functioning for more than 30 years. The implants that were developed later were notably superior to earlier implants. The results of this review could be interpreted to suggest consideration of mandibular subperiosteal implants for selected patients, particularly those with resorbed mandibles.

Adult↗
PubMed2005

Fabrication of a surgical template for implant/bar-retained mandibular overdentures.

To achieve long-term success with an implant-retained overdenture, application of force in the path of insertion of the prosthesis has been recommended. This implies that the retentive matrices and the implants are positioned parallel to each other and to the path of insertion of the prosthesis. This article describes a technique for the fabrication of a surgical template for an implant-retained overdenture in the mandible. Adherence to the guidelines proposed in this article will lead to optimal implant placement in a consistent and repeatable manner.

Dental Implants↗
PubMed1991

[Preprosthetic orthodontic preparation and Brånemark implants].

The patient presented an important bone loss in the edentulous area 21 to 23. The 11 had a temporary crown and a removable prosthesis has replaced the anterior missing teeth. The orthodontic treatment of this class II division 1 was to be undertaken in order to reduce the maxillary proalveolie and to line up the mandibular incisors. The difficulty of the orthodontic treatment was due to the importance of the anterior edentulous area which did not allow a continuous multiring treatment but a bilateral one and a succession of anterior removable prosthesis as anchoring points. The temporary crowns on osseointegrated fixtures replacing 22 and 23 were used to obtain the final orthodontic movements needed in the orthodontic preprosthetic treatment. However, if the fixtures had been placed at the beginning of the treatment in order to use them among other anchoring points, the complete orthodontic treatment would have been faster and much easier. At that time, our major handicap was to determine the ideal position of the fixtures which would allow the orthodontic application as well as a successful cosmetic fixed prosthesis. The use of scanner, three dimensional reconstruction Scanlam, surgical stents and fixed prosthesis with inlay cores would have brought the solution to this problem. Today, the use of osseointegrated fixtures can be applied in much more complex orthodontic movements.

Adult↗
PubMed2000

Treatment of micrognathia with edentulous maxilla by sagittal split mandibular osteotomy and a subperiosteal implant immobilized with transmaxillary screws.

Micrognathia complicated by edentulous maxilla was treated by performing sagittal-split mandibular osteotomy and immobilizing a subperiosteal implant using transmaxillary screws. The patient was a 42-year-old man who had a birdlike facial deformity caused by significant hypoplasia of the mandible. He also demonstrated significant malocclusion attributable to micrognathia and edentulous maxilla caused by resorption of the alveolar bone. These conditions impaired his mastication and articulation, making it impossible for him to eat regular food or carry out normal conversation. A subperiosteal implant was placed on the edentulous maxilla, and was rigidly immobilized to the maxilla using five transmaxillary screws. A prosthesis was then attached to the implant, and by using the implant as the point of reference and the anchor, the mandible was moved forward by sagittal-split mandibular osteotomy. Intermaxillary fixation was subsequently performed. The postoperative course has been favorable, and his facial complexion has improved significantly. One and a half years after his surgery, there has been no sign of complications or malocclusion caused by mandibular retraction. He is now able to eat regular food and speak normally.

Adult↗
PubMed2002

Osteoporosis: the effect on mandibular bone resorption and therapeutic possibilities by means of implant prostheses.

In recent years, considerable attention has been given to the interrelationship between the outbreak of a systemic process of reduction in the bone mass and the possibility of a significant resorption of the alveolar bone. The degree of alveolar bone loss increases with age, and this may be related, at least in part, to the systemic conditions that also encourage the development of osteoporosis. Although numerous studies have documented the possible role of osteoporosis as a deteriorating factor in both tooth loss and mandibular bone resorption, this article underlines how the morphostructural evolution of the edentulous mandible is primarily correlated to mechanical factors as a result of modifications to its function. We will also take into consideration the therapeutic advantages provided by prosthetic rehabilitation on osseointegrated implants, in terms of reinstatement of the loading conditions through patterns of propagation of mechanical forces that are similar to physiologic ones.

Alveolar Bone Loss↗