[The new articulated alveolar bar prosthesis of E. Dolder].
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Denture Retention↗
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Immediate loading implants: a clinical report of 1301 implants.
The purpose of this study is to suggest 4 immediate load of implants techniques that are alternative and/or complementary to the traditional submersion technique. These techniques meet the criteria for implant immobilization during the entire period of osteointegration, and are based on the principles of splinting and load sharing. One hundred fifty-three maxillary and 309 mandibular arches were treated with 1301 implants. Only implants that satisfied the primary retention were immediately loaded with a provisional crown with wings (94), provisional plastic prosthesis (478), provisional plastic prosthesis with metal frame (293), and intraoral welding (436). Facies morphology, type of occlusion, size and function of the tongue, bone density, number, and length of implants appeared to have an influence on the results. Success rates achieved over 21 years are 99.3% with the intraoral welding machine, 98.3% with the provisional plastic prosthesis with metal frame, 97.9% with metal wings, and 88.02% with provisional plastic prosthesis. This last percentage is reflective of the years 1974 to 1984 when only blade-forms and root-forms with unscrewable abutments were available and a provisional plastic prosthesis was the only immobilization technique known. Guidelines are proposed for a treatment plan indicating when and why immediate loading implants can be suggested.
Adolescent↗
Gravity-induced stresses by an obturator prosthesis.
Recontruction after surgical resection of tumors of the maxillae and paranasal sinuses is difficult. In addition to the intermittent forces encountered during function, the prosthesis is subjected to the constant force of gravity. This investigation photoelastically studies the gravity-induced stresses transmitted to the remaining oral structures by various obturator prosthesis framework designs. Frameworks which used I-bar and circumferential retainers with buccal retention were most severe, while the swinglock and light wire retainers were intermediate in generated stress.
Bite Force↗
Obturator prostheses for hemimaxillectomy patients.
Maxillary defects are created by surgical treatment of benign or malignant neoplasms, congenital malformation and by trauma. The size and location of the defects influence the degree of impairment and difficulty in prosthetic rehabilitation. Lack of support, retention, and stability are common prosthodontic treatment problems for patients who have had a maxillectomy. A prosthesis used to close a palatal defect in a dentate or edentulous mouth is referred to as an obturator. The obturator prosthesis is used to restore masticatory function and improve speech, deglutition and cosmetics for maxillary defect patients.
Denture Retention↗
[Defect prosthesis following total upper jaw resection].
Using the method described, a defect prosthesis can be fastened with the help of operatively prepared retention sites and transnasal anchorage after total upper jaw resection. The technical process of manufacture is outlined and the result demonstrated in photographs.
Carcinoma, Squamous Cell↗
Acrylic resin finger prosthesis.
A technique is described for the prosthetic replacement of two fingers using acrylic resin. Retention was obtained using finger rings. The stages of the technique are outlined. Advantages and disadvantages are briefly stated.
Acrylic Resins↗
Early loading of sandblasted, acid-etched implants in the posterior maxilla and mandible: a 1-year follow-up report from a multicenter 3-year prospective study.
PURPOSE: The aim of the present study was to evaluate the concept of an immediate loading protocol in the posterior maxilla and mandible through analysis of implant survival at 1 year. MATERIALS AND METHODS: One year follow-up data of a multicenter study are reported. Eighty-two ITI sandblasted, acid-etched (SLA) implants in 40 patients were loaded between 0 and 11 days after implant placement (mean 4.3 +/- 2.8 days). The restorations consisted of either 2 splinted crowns or a 3-unit fixed prosthesis. All restorations were put into full functional occlusion. Periapical radiographs were evaluated for changes in crestal bone level from baseline to 1 year postloading. Primary stability of the implants was checked initially and before the fitting of the definitive prosthesis. The restorations were evaluated by the practitioners for retention, stability, and esthetics. RESULTS: Three patients' implants were not loaded because of lack of primary stability, and a fourth patient was excluded from the study because of a protocol violation (more than 4 implants were used). All 4 patients were successfully treated outside the protocol. The overall survival rate of the remaining implants at 1 year was 98.8%. The mean bone loss at 1 year was 0.52 +/- 0.98 mm, which is within the reported limits of less than 1 mm (range 0.4 to 1.4 mm) loss in the first year. DISCUSSION AND CONCLUSION: The early results from this study indicate that early and immediate loading of 2 implants in the posterior maxilla and mandible may be suitable in selected patients. On the basis of 1 year of observation, the results appear similar to those achieved with a delayed procedure.
Adult↗
Three-dimensional finite element analysis of the retention of fixed partial dentures.
Four three-dimensional mathematical models were generated, each representing a three-unit fixed partial denture. The second premolar and second molar were used as abutments. Different associations of dental support preparation were tested. A 500-N axial load was applied to the pontic. Strains were analysed for each dental support by means of a three-dimensional finite element analysis technique. The results showed that the greatest strains were observed on the weaker abutment, the premolar. The cervical margin facing the edentulous area is affected most, regardless of the model or the dental support. The greater the dento-prosthetic differential surface between the two dental supports (thus the greater the retention differential) the higher the risk of unsealing.
Bicuspid↗
Properties of a custom-made hinge clasp compared with a conventional circumferential clasp.
The use of the hinge clasp in removable partial denture design, together with the design of a custom-made hinge unit, is discussed in this article. Tests of the retention provided by these custom-made hinge clasps were made, together with conventional clasps, and the results were compared. Six custom-made hinge clasps were constructed and attached to blocks of acrylic resin. The forces required to open these clasps and the effect of wear on the clasps were measured. Six conventional cast clasping units were also constructed and tested. The results indicated that the average force required to open the hinge clasps was 8.13 N (SD 1.99). After a period of simulated wear, the mean value of force required was 7.70 N (SD 2.33) and there was no statistically significant deterioration caused by wear. The mean forces required to withdraw these clasps vertically from a tooth were 30.25 N (SD 6.51) for the conventional clasps and 49.67 N (SD 18.69) for the hinge clasps. It was also found that the hinge clasps had to be withdrawn further from their seated position than the conventional clasps before retention was finally lost. However, neither of these differences were statistically significant.
Dental Clasps↗
A magnetically retained sectional prosthesis for the rehabilitation of the maxillectomy patient.
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Denture Design↗
A longitudinal study on mandibular implants supporting an overdenture: the influence of retention mechanism and anatomic-prosthetic variables on periimplant parameters.
PURPOSE: The aim of this 5-year longitudinal study was to investigate the influence of the retention mechanism for overdenture fixation on the periimplant parameters of mandibular implants. MATERIALS AND METHODS: Ninety edentulous patients, each with two interforaminal implants supporting an overdenture, participated in the study. They had received either a straight or slightly bent round clip bar, a U-shaped rigid bar with or without distal extensions, or single-ball anchors. Anatomic-morphologic and prosthetic variables were assessed related to the implant position and the type of overdenture retention. The degree of mandibular atrophy was determined using cephalometric radiographs. The angle beta between the virtual axis connecting both implants and the mandibular hinge axis was measured on mounted casts. A supporting surface was identified between bent clip bars and U-shaped extension bars. Clinical periimplant parameters were recorded, and changes of the probing attachment level after 5 years were analyzed in 70 patients with respect to the retention device and anatomic-morphologic and prosthetic variables. RESULTS: A significant increase of the Plaque Index was observed after 5 years. The mean clinical attachment loss after 5 years was about 0.2 mm. In more than 50%, beta was small, i.e., < or = 5 degrees. For these implants, loss of clinical attachment was significantly lower. The correlation between attachment loss and beta was weak, while no significant correlation was found with regard to the degree of atrophy and surface. CONCLUSION: In view of the long observation period, it was concluded that the position and retention mechanism of mandibular implants supporting an overdenture have little influence on the long-term stability of the clinical parameters.
Adult↗
[Implants in combination with an overdenture. Indications for the number of implants needed].
Considerations regarding the choice of the number of implants to be placed in combination with an implant-retained overdenture are discussed. Primarily, the characteristics of the chosen retention mechanism should be considered, as well as the magnitude and direction of forces on the implant-bone interface delivered through the suprastructure and implant, and the expected effects on the antagonist denture and/or jaw.
Bone Resorption↗
Attachment, morphology and adherence of human endothelial cells to vascular prosthesis materials under the action of shear stress.
In an effort to improve the long-term patency of vascular prostheses several groups now advocate seeding autologous endothelial cells (ECs) onto the lumen of the vessel prior to implantation, a procedure that involves pre-treating the prosthesis material with fibrin, collagen and/or other matrix molecules to promote cell attachment and retention. In this study, we examined the degree to which human umbilical venous endothelial cells (HUVECs) adhered to three materials commonly used polymeric vascular prosthesis that had been coated with the same commercial extra cellular matrix proteins, and after exposure to fluid shear stresses representative of femoro-distal bypass in a cone-and-plate shearing device. We quantified cell number, area of coverage and degree of cell spreading using image analysis techniques. The response of cells that adhered to the surface of each material, and following exposure to fluid shear stress, depended on surface treatment, topology and cell type. Whereas collagen coating improved primary cellular adhesion and coverage significantly, the degree of spreading depended on the underlying surface structure and on the application of the shear stress. In some cases, fewer than 30% of cells remained on the surface after only 1-h exposure to physiological levels of shear stress. The proportion of the surface that was covered by cells also decreased, despite an increase in the degree to which individual cells spread on exposure to shear stress. Moreover, the behaviour of HUVECs was distinct from that of fibroblasts, in that the human ECs were able to adapt to their environment by spreading to a much greater extent in response to shear. The quality of HUVEC attachment, as measured by extent of cell coverage and resistance to fluid shear stress, was greatest on expanded polytetrafluoroethylene samples that had been impregnated with Type I/III collagen.
Blood Vessel Prosthesis↗
Mandibular implant-retained overdenture with magnets: a case report.
Implant-retained overdentures can be a simple treatment option to restore the edentulous mandible. Retention can be achieved via studs, linked bar system or magnets. Success rates using the different retention mechanisms have been reported to be high. However, long-term prospective studies on implant-retained overdentures are limited. This paper reports on a patient who has successfully worn a mandibular implant-retained overdenture with magnets for 12 years.
Aged↗
Converting an implant-supported fixed prosthesis to an overdenture because of fixture loss: a case report.
A patient with a failed implant-supported prosthesis was treated with an immediate interim overdenture. After insertion of a bar modified from the prosthesis substructure, the patient was restored with an implant-supported overdenture. A bar soft liner retention system was used to aid retention and stability of the overdenture.
Dental Implantation, Endosseous↗
Overdentures--when and how.
Implant borne overdentures are a reliable and simple solution to denture retention and stability problems. Such a treatment option requires careful planning and the basis for this is made from the results of clinical trials. An overdenture symposium on this subject was held at Naantali, Finland on 26th August, 1994. The following paper is a summary of the proceedings.
Dental Prosthesis, Implant-Supported↗
The implant-supported milled-bar mandibular overdenture.
Osseointegrated dental implants have been proven successful in the treatment of edentulism. The predictability of the implant-supported prosthesis has also been established. Several techniques have been described for the successful restoration of the edentulous mandible: fixed-detachable prostheses with either the original Brånemark hybrid prosthesis design or conventional implant-supported fixed partial dentures, implant-retained overdentures, and implant-supported overdentures. However, in cases of advanced ridge resorption in which facial tissue support is needed from the flanges of the prosthesis or when a removable type of prosthesis is preferred by the patient, an implant-supported prosthesis is indicated. Electric discharge machining is often used in the fabrication of the bar for an implant-supported overdenture. This procedure is very costly and technique sensitive. An alternative procedure to fabricate a milled-bar implant-supported overdenture is described. This procedure is simple and uses inexpensive equipment and materials. The milled-bar minimizes lateral and rotational displacement. The overdenture incorporates attachments that provide retention, minimizing possible movement along the path of insertion. This type of prosthesis is available to a broad patient population, especially those with advanced ridge resorption, providing an excellent result at a reduced cost. J Prosthodont 2001;10:46-51.
Aged↗
Single-visit hollow obturators for edentulous patients.
A method of fabricating a simple hollow obturator for edentulous patients was described. This procedure can be accomplished in a single office visit using readily available materials. The use of a relatively long-lasting soft reline material for obturators allows stable, comfortable, and effective obturation for many edentulous patients with recently created maxillary defects (Fig. 6). The hollow prosthesis is lightweight and sufficiently flexible to allow relatively simple placement in retentive undercut regions. Direct finger placement of the material insures complete duplication of all desired tissue undercuts. The soft reline material may also serve as a final impression of the defect when fabrication of the definitive prosthesis is undertaken.
Denture, Complete, Immediate↗