A method of gauging dental radiographs during treatment planning for dental implants.

J Contemp Dent Pract. 2007;8(6):82-8

Authors: Anil S, Al-Ghamdi HS

AIM: The goal of pre-surgical dental implant treatment planning is to position the optimum number and size of implant fixtures to achieve the best restorative results. The purpose of this article is to describe the use of radiographic imaging software to calibrate and measure anatomical landmarks to overcome inherent distortions associated with dental radiographs. The procedure along with its potential use as an adjunct to radiographic interpretation in routine clinical implant practice is presented. BACKGROUND: Diagnostic imaging is an essential component of implant treatment planning, and a variety of advanced imaging modalities have been recommended to assist the dentist in assessing potential sites for implants. Although technological advances have resulted in new imaging innovations for implant dentistry, dental radiography remains the most widely used tool for determining the quantity and quality of alveolar bone as it is a non-invasive procedure. However, the unreliable magnification factor associated with conventional radiographs remains a major problem when estimating the amount of bone available at the implant site. SUMMARY: This image measurement technique is capable of assessing the bone quantity by measuring the height and width of the alveolar crest for a specified region in a two dimensional plane in any direction related to the visible landmarks in the oral cavity. These measurements can be used by the clinician to select the type of implant and its position. Since there is no additional equipment or cost involved, the technique can be used as an important adjunct in implant practice.

PMID: 17846675 [PubMed - indexed for MEDLINE]

Augmentation in two stages of atrophic alveolar bone prior to dental rehabilitation: a case report.

J Contemp Dent Pract. 2007;8(6):57-63

Authors: Zahrani AA

AIM: The aim of this report is to describe a significantly deficient case of alveolar bone that was managed by alveolar bone augmentation using a technique of distraction osteogensis and onlay bone grafting prior to dental implant placement. BACKGROUND: Injury to the teeth and alveolar ridge of the maxillary anterior region can cause a severe alveolar ridge deficiency resulting in ridge atrophy and maxillary retrognathism. The loss of these teeth and alveolar bone together with fibrotic scar formation can result in adverse changes of the interarch space, occlusal plane, arch relationship, and arch form which complicates rehabilitation and can compromise the esthetic outcome. While implant dentistry has become a new paradigm in oral reconstruction and replacement of missing teeth, ideal implant positioning can be compromised by inadequate alveolar bone in terms of bone height, width, and quality of the bone itself. Correction of osseous deficiencies with ridge augmentation allows ideal implant placement and creates a more natural soft tissue profile which influences crown anatomy and esthetics. REPORT: A 20-year-old female presented with a complaint of poor esthetics resulting from oral injuries incurred in a traffic accident six years previously. In addition to a mandibular parasymphyseal fracture, five maxillary anterior teeth and the most of the alveolar ridge were lost. Clinical examination revealed severe loss of bone in the maxillary anterior region, an absence of a labial sulcus, loss of upper lip support, and a slight over eruption of the mandibular anterior teeth. In preparation for dental implants a distraction osteogenesis surgical procedure was done to lengthen the height of the alveolar ridge. After a three-month healing period, the width of the residual ridge was found to be insufficient for implant placement. To correct this deficiency, a bone graft of a cortiocancellous block was harvested from the chin and fixed to the labial aspect of the ridge. To facilitate revascularization, small perforations were made in the cortical bone of the alveolar ridge at the recipient site before cancellous bone retrieved from the donor site was gently placed between the bone block and the ridge. The patient was then appropriately medicated and healing was uneventful. After three months, the width of the residual ridge was assessed to be adequate for endosseous implants. SUMMARY: The clinical result reported here has shown several procedures may be necessary for the rehabilitation of a trauma patient. Distraction osteogenesis per se may not always satisfactorily improve the anatomical alveolar anatomy but it has advantages over other methods of augmentation. It can improve the height and also expand the soft tissue for further bone grafting. Augmentation of the alveolar bone with an onlay bone graft often provides the desired gain of bone, allows for the ideal placement of dental implants, and improves any discrepancy between the upper and lower arches.

PMID: 17846672 [PubMed - indexed for MEDLINE]

Pre-operative drilling simulation method for dental implant treatment.

Bull Tokyo Dent Coll. 2007 Feb;48(1):27-35

Authors: Arataki T, Furuya Y, Ito T, Miyashita Y, Shimamura I, Yajima Y

The position, depth and direction of implant placement are often planned based on evaluation of radiographs and study casts. Insertion planned in such a manner may not be adequate for precise and safe surgery in some cases due to inadequate working clearance in the oral cavity. In order to obtain high initial stability and ensure osseointegration at the implant-bone interface, careful and precise drilling must be performed at the implant placement site. Therefore, we propose the necessity of evaluating the operability of implant treatment-devices prior to surgery. The amount of handling space needed during implant placement surgery was determined. The results showed that for implants with a length of 7-18 mm, a vertical distance of as much as 50-60 mm was required, depending on the implant platform. These results suggest the necessity of pre-operative drilling simulation in each individual. Handling space was measured with angled heads and probes fabricated on a trial basis for pre-surgical drilling simulation in the oral cavity. We believe that these instruments may be clinically useful in estimating the amount of handling space required prior to surgery and ensuring precise implant placement. Evaluation of the intra-oral environment for handling of treatment devices should be included in the pre-surgical intra-oral evaluation of dental implant cases to avoid changes in treatment planning due to intra-oral interference during the course of surgery.

PMID: 17721064 [PubMed - indexed for MEDLINE]

Facemask therapy with miniplate implant anchorage in a patient with maxillary hypoplasia.

Chin Med J (Engl). 2007 Aug 5;120(15):1372-5

Authors: Zhou YH, Ding P, Lin Y, Qiu LX

PMID: 17711747 [PubMed - indexed for MEDLINE]

Rehabilitation of severely resorbed maxillae with zygomatic implants: an update.

Med Oral Patol Oral Cir Bucal. 2007 May;12(3):E216-20

Authors: Galán Gil S, Peñarrocha Diago M, Balaguer Martínez J, Marti Bowen E

Studies highlight the zygomatic bone as a suitable anatomical structure for implant placements since they cross four corticals. Zygomatic implants were described by Branemark in 1988, since then zygomatic implants are indicated in maxillae with atrophy of the posterior area. They have been used in systemic diseases associated with bone loss in this area, and in patients who have suffered radical surgery for maxillofacial tumors. Computed tomography is recommended before placement in order to discount any pathology of the maxillary sinus. The surgical technique has been slightly modified since its description with procedures such as the sinus slot technique. The success rate obtained by different authors varies between 82% and 100%, indicating this technique as a valid treatment option. The objective of this study was to revise the literature with the aim of updating the subject.

PMID: 17468718 [PubMed - indexed for MEDLINE]

Histological comparison of bone to implant contact in two types of dental implant surfaces: a single case study.

J Contemp Dent Pract. 2007;8(3):29-36

Authors: Shibli JA, Feres M, de Figueiredo LC, Iezzi G, Piattelli A

AIM: The purpose of this single case study was to evaluate the influence of different implant surfaces on human bone and osseointegration. METHODS AND MATERIALS: A 47-year-old partially edentulous woman received two experimental implants along with conventional implant therapy. Experimental implants placed in the mandibular ramus consisted of machined and anodized surfaces, respectively. After three months of healing, the experimental implants were removed and prepared for ground sectioning and histological analysis. RESULTS: The data demonstrate anodized implant surfaces present a higher percentage of osseointegration when compared to a machined surface in cortical human bone after a healing period of three months. CONCLUSION: This single case study suggests an anodized implant surface results in a higher percentage of bone to implant contact when compared to machined surfaced implants when placed in dense bone tissue. However, further investigations should be conducted.

PMID: 17351679 [PubMed - indexed for MEDLINE]

Retrieval of blade implants with piezosurgery: two clinical cases.

Minerva Stomatol. 2007 Jan-Feb;56(1-2):53-61

Authors: Sivolella S, Berengo M, Fiorot M, Mazzuchin M

In this work an ultrasound device was used to perform an ostectomy for the removal of blade implants in order to save as much bone tissue as possible, so that root form implants might later be inserted. Two patients underwent surgery for the removal of two blade implants (one maxillary, the other mandibular) that were no longer functional. The peri-implant ostectomy was carried out with a piezoelectric surgery device. The instrument demonstrated to be effective and precise during ostectomy, providing an extremely thin cutting line. During the course of the operation and at controls after 7 and 30 days, patients did not show any relevant complications and both still had sufficient alveolar bone to be treated with root form implants. The piezosurgery device proved to be an effective instrument in interventions requiring a significant saving of bone tissue, extreme precision in cutting, and respect of soft tissues.

PMID: 17287707 [PubMed - indexed for MEDLINE]

Short-term success of osseointegrated dental implants in HIV-positive individuals: a prospective study.

J Contemp Dent Pract. 2007 Jan 1;8(1):1-10

Authors: Stevenson GC, Riano PC, Moretti AJ, Nichols CM, Engelmeier RL, Flaitz CM

PURPOSE: Except for the occasional case report, there are no studies evaluating the success rate of osseointegrated dental implants in individuals infected with the human immunodeficiency virus (HIV). This study investigated the short-term clinical outcome of implant placement in a group of HIV-positive and HIV-negative individuals who required complete dentures. METHODS AND MATERIALS: Edentulous subjects were recruited from an HIV-dedicated clinic and a dental school clinic. Two BioHorizons dental implants were placed in the anterior mandible to support an overdenture opposing a maxillary denture. Outcome measurements obtained six months after activation of implants were presence of pain, mobility, soft tissue status, and radiographic bone level. Descriptive statistics were used. RESULTS: Twenty-nine edentulous adults, including 20 HIV-positive subjects (test) and nine HIV-negative subjects (control), participated. The test group had six females, 14 males; 13 Whites, four African-Americans, and three Hispanics with a mean age of 48.9 years (range: 35-59). The mean CD4 count was 467 cells/mm3 (range: 132-948). The control group had six females, three males; seven Whites, and two Hispanics with a mean age of 65.3 years (range: 50-82). Short-term success rate was 100% for both groups. No difference in clinical outcome was found between the groups. CONCLUSION: This study demonstrated dental implants are well tolerated and have predictable outcomes for HIV-infected individuals for the duration of the study and probably over an even longer term.

PMID: 17211499 [PubMed - indexed for MEDLINE]

Delirium during intravenous sedation with midazolam alone and with propofol in dental treatment.

Anesth Prog. 2006;53(3):95-7

Authors: Mohri-Ikuzawa Y, Inada H, Takahashi N, Kohase H, Jinno S, Umino M

A 62-year-old man visited our clinic for dental implantation under intravenous sedation. He demonstrated increased psychomotor activity and incomprehensible verbal contact during intravenous sedation. Although delirium caused by midazolam or propofol in different patients has been reported, the present case represents a delirium that developed from both drugs in the same patient, possibly because of the patient's smaller tolerance to midazolam and propofol.

PMID: 17175823 [PubMed - indexed for MEDLINE]

Digital subtraction technique for evaluation of peri-implant bone change in digital dental imaging.

Bull Tokyo Dent Coll. 2006 May;47(2):57-64

Authors: Wakoh M, Nishikawa K, Otonari T, Yamamoto M, Harada T, Sano T, Yajima Y, Ooguro T

The purpose of this study was to investigate digital subtraction technique in digital dental imaging for implant performance, used to quantitatively evaluate bone change around dental implants. For longitudinal assessment of peri-implant bone change, we applied subtraction technique to digital peri-apical radiographs using a digital dental imaging system in two cases at the upper canine and premolar regions. In both cases, we found two peaks of bone change at the crestal region; we also quantitatively demonstrated a marked change over the first one-month period and approximately three-month period spanning the fourth month to the end of the sixth month following implantation. Digital peri-apical radiography accommodating the digital subtraction program should be re-acknowledged as a reliable modality for assessing amount of bone change at local implantation sites.

PMID: 17167221 [PubMed - indexed for MEDLINE]

Current products and practice: bone anchorage devices in orthodontics.

J Orthod. 2006 Dec;33(4):288-307

Authors: Prabhu J, Cousley RR

Bone anchorage is a promising new field in orthodontics and already a wide variety of bone anchorage devices (BADs) are available commercially. This review aims to assist clinicians by outlining the principles of bone anchorage and the salient features of the available systems, especially those that may influence the choice of a specific BAD for anchorage reinforcement.

PMID: 17142335 [PubMed - indexed for MEDLINE]

Predicting clustered dental implant survival using frailty methods.

J Dent Res. 2006 Dec;85(12):1147-51

Authors: Chuang SK, Cai T

The purpose of this study was to predict future implant survival using information on risk factors and on the survival status of an individual's existing implant(s). We considered a retrospective cohort study with 677 individuals having 2349 implants placed. We proposed to predict the survival probabilities using the Cox proportional hazards frailty model, with three important risk factors: smoking status, timing of placement, and implant staging. For a non-smoking individual with 2 implants placed, an immediate implant and in one stage, the marginal probability that 1 implant would survive 12 months was 85.8% (95%CI: 77%, 91.7%), and the predicted joint probability of surviving for 12 months was 75.1% (95%CI: 62.1%, 84.7%). If 1 implant was placed earlier and had survived for 12 months, then the second implant had an 87.5% (95%CI: 80.3%, 92.4%) chance of surviving 12 months. Such conditional and joint predictions can assist in clinical decision-making for individuals.

PMID: 17122171 [PubMed - indexed for MEDLINE]

Neurosensory disturbances after immediate loading of implants in the anterior mandible: an initial questionnaire approach followed by a psychophysical assessment.

Clin Oral Investig. 2006 Dec;10(4):269-77

Authors: Abarca M, van Steenberghe D, Malevez C, De Ridder J, Jacobs R

The aim of the study was to assess past and present neurosensory disturbances using a questionnaire and a psychophysical approach in patients treated with immediate loaded implants in the edentulous anterior mandible. A group of 65 patients (age range 30-84 years, mean 58 years, 30 women) was enrolled. All were treated by means of three immediately loaded implants (Branemark Novum System). A self-designed questionnaire was used for data collection. The response rate was 89%. Of the 58 responders, 33% (n=19) reported neurosensory disturbances after implant surgery. Nine of these patients (mean age 56 years, seven women) participated in an objective evaluation and were subjected to a psychological and several psychophysical tests. At the moment of the evaluation none of the nine patients still had clinical complaints. Psychological testing revealed no statistical differences between the patients, who had previously experienced subjective complaints, and the control group. Two-point discrimination and thermal sensation tests revealed no sensory lesions. The light touch sensation test at the lower lip indicated a more frequent reduction of tactility for the test group (p<or=0.03). Neurosensory disturbances can occur in the anterior region of the mandible after implant surgery.

PMID: 16937108 [PubMed - indexed for MEDLINE]

Multidisciplinary treatment of mandibular prognathism with multiple congenitally missing teeth.

Bull Tokyo Dent Coll. 2006 Feb;47(1):25-31

Authors: Nishimura R, Nojima K, Nishii Y, Hanai J, Arataki T, Uchiyama T, Yamaguchi H

Surgical orthodontic treatment and dental implant therapy were performed on a man (aged 18 years 8 months) with mandibular prognathism and seven congenitally missing teeth: upper canines, first and second premolars and lower right second premolar. After 17 months of preoperative orthodontic treatment at age 20 years 1 month, sagittal split ramus osteotomy was performed using the remaining upper deciduous teeth as an anchor for intermaxillary fixation. In postoperative orthodontic treatment, the remaining deciduous teeth were extracted, and fixture installation was performed. The entire therapy required 4 years to complete (age 22 years 8 months). After completion of orthodontic treatment, superstructures were put in place. This patient had many dental problems, so multidisciplinary care was performed in conjunction with other departments to improve oral function and facial esthetics.

PMID: 16924156 [PubMed - indexed for MEDLINE]

Update in dental implant periapical surgery.

Med Oral Patol Oral Cir Bucal. 2006 Aug;11(5):E429-32

Authors: Pe&#xF1;arrocha Diago M, Boronat López A, Lamas Pelayo J

Implant periapical lesions are infectious-inflammatory alterations surrounding an implant apex, and can be caused by a number of situations--including contamination at instrumentation, overheating of bone, and the prior existence of bone pathology. The diagnosis is based on the clinical manifestations and radiological findings, where a radiotransparency can be seen at periapical level. The lesions are classified according to their evolutive stage as either acute (non-suppurated and suppurated) or chronic (or periapical abscess). The management of implant periapical lesions comprises periapical surgery with curettage and irrigation in the acute phase, or implant extraction when the bone surface is affected and/or primary fixation is lost (chronic phase).

PMID: 16878068 [PubMed - indexed for MEDLINE]

Stress and inflammation as a detrimental combination for peri-implant bone loss.

J Dent Res. 2006 Aug;85(8):711-6

Authors: Heckmann SM, Linke JJ, Graef F, Foitzik Ch, Wichmann MG, Weber HP

The causes of peri-implant bone loss continue to be controversial. To determine the impact of biomechanical stress and inflammation, we investigated a total of 80 interforaminal implants in situ for more than 10 years. Two stress groups, with 14 patients each, were established: a low-stress situation with single-standing implants, and an increased-stress situation with splinted implants. To categorize inflammation, we introduced a Composite Inflammation Score using 4 inflammatory parameters. Peri-implant bone loss was calculated from digital panoramic radiographs. To differentiate between the effects of stress and inflammation, we compared bone loss in both stress groups at equivalent levels of inflammation. With greater Composite Inflammation Score values, a clear discrepancy between single-standing and splinted implants was evident (p = 0.117/0.000, regression analysis; p = 0.135/0.000, analysis of variance; p = 0.002, t tests). While stress and inflammation alone may not necessarily be detrimental factors, the presence of stress heightens peri-implant bone loss significantly as inflammation increases.

PMID: 16861287 [PubMed - indexed for MEDLINE]

Endodontic or dental implant therapy: the factors affecting treatment planning.

J Am Dent Assoc. 2006 Jul;137(7):973-7; quiz 1027-8

Authors: Torabinejad M, Goodacre CJ

BACKGROUND: Clinicians are confronted with difficult choices regarding whether a tooth with pulpal and/or periapical disease should be saved through endodontic treatment or be extracted and replaced with an implant. METHODS: The authors examined publications (research, literature reviews and systematic reviews) related to the factors affecting decision making for patients who have oral diseases or traumatic injuries. RESULTS: The factors to be considered included patient-related issues (systemic and oral health, as well as comfort and treatment perceptions), tooth- and periodontium-related factors (pulpal and periodontal conditions, color characteristics of the teeth, quantity and quality of bone, and soft-tissue anatomy) and treatment-related factors (the potential for procedural complications, required adjunctive procedures and treatment outcomes). CONCLUSIONS: On the basis of survival rates, it appears that more than 95 percent of dental implants and teeth that have undergone endodontic treatment remain functional over time. CLINICAL IMPLICATIONS: Clinicians need to consider carefully several factors before choosing whether to perform endodontic therapy or extract a tooth and place an implant. The result should be high levels of comfort, function, longevity and esthetics for patients.

PMID: 16803823 [PubMed - indexed for MEDLINE]

Low-cost implant overdenture option for patients treated in a predoctoral dental school curriculum.

J Dent Educ. 2006 Jun;70(6):662-6

Authors: McCracken MS, Aponte-Wesson R, O'Neal SJ, Rajdev K

In an effort to make the implant overdenture more affordable for patients, a pricing package at the University of Alabama at Birmingham School of Dentistry was established. This package includes two implants, two dentures (upper and lower), and two implant abutments, all for $975. It is known as the "2-2-2" implant program. One concern regarding the program was whether patients would complete overdenture treatment or simply receive implants at this relatively low cost and have the implants restored outside the school. The purpose of this retrospective chart review was to determine how many patients in 2004 received implants as part of this program and how many of these patients completed overdenture treatment. Other data (age, distance from school, number of teeth at start of treatment, and gender) were collected to identify variables that might be associated with greater likelihood of completing overdenture treatment. In 2004, fifty-one patients received 102 implants as part of this program. Two patients had a failed implant prior to restoration (two of 102 implants), and one patient was referred to graduate prosthodontics for restoration. Of the remaining forty-eight patients, forty-one completed overdenture treatment (85 percent), and seven (15 percent) were lost to follow-up. The mean age of patients receiving this treatment was 60.7 years. The mean distance traveled to the school was 70.7 miles. While no variables showed significant predictive value, point estimates (estimate of the odds ratio) suggest that older patients and patients who travel greater distance to the school were less likely to complete treatment. The low-cost implant overdenture has been an important addition to our curriculum. The majority of patients who receive implants as part of this program complete overdenture treatment.

PMID: 16741134 [PubMed - indexed for MEDLINE]

Bone apposition to titanium implants biocoated with recombinant human bone morphogenetic protein-2 (rhBMP-2). A pilot study in dogs.

Clin Oral Investig. 2006 Sep;10(3):217-24

Authors: Becker J, Kirsch A, Schwarz F, Chatzinikolaidou M, Rothamel D, Lekovic V, Laub M, Jennissen HP

The aim of the present study was to investigate bone formation to recombinant human bone morphogenetic protein-2 (rhBMP-2)-biocoated and rhBMP-2-nonbiocoated titanium implants after implantation in dogs. Implantation of sand-blasted and acid-etched (C), chromosulfuric acid surface-enhanced (CSA), and rhBMP-2-biocoated CSA [BMP-A: noncovalently immobilized rhBMP-2 (596 ng/cm(2)), BMP-B: covalently immobilized rhBMP-2 (819 ng/cm(2))] implants was performed in both the mandible and tibia of dogs. After 4 weeks of healing, the percentage of direct bone to implant contact (BIC) and the induced bone density (BD) at a distance of less than and greater than 1 mm adjacent to each implant was assessed. Histomorphometric analysis of implants inserted in the mandible and tibia revealed that BIC values appeared to be highest in the BMP-B group, followed by BMP-A, CSA, and C. BD as measured at a distance of <1 mm revealed obvious differences between groups: BMP-B>BMP-A>CSA>C. However, no differences between groups were observed at a distance of >1 mm. Within the limits of the present study, it may be concluded that rhBMP-2 immobilized by covalent and noncovalent methods on CSA-treated implant surfaces seemed to be stable and promoted direct bone apposition in a concentration-dependent manner.

PMID: 16683108 [PubMed - indexed for MEDLINE]

Implant-supported anterior tooth restoration.

Keio J Med. 2006 Mar;55(1):23-8

Authors: Hartmann HJ, Steup A

Various options are available for restoring anterior teeth. Their choice is dictated by the severity of infection of the teeth to be extracted and the pocket depth. Immediate single-stage implant placement proved to be the least traumatic option, which best preserved the soft tissue. A differential use of surgical and prosthodontic techniques is indispensable to account for conditions in the individual case. Given an adequate amount of hard tissue, soft tissue contours can be expected to return to normal.Immediate implants combined with a soft tissue support have been found to ensure that the depth of even larger pockets is stable for years.

PMID: 16636646 [PubMed - indexed for MEDLINE]

Peri-implant inflammation defined by the implant-abutment interface.

J Dent Res. 2006 May;85(5):473-8

Authors: Broggini N, McManus LM, Hermann JS, Medina R, Schenk RK, Buser D, Cochran DL

An implant-abutment interface at the alveolar bone crest is associated with sustained peri-implant inflammation; however, whether magnitude of inflammation is proportionally dependent upon interface position remains unknown. This study compared the distribution and density of inflammatory cells surrounding implants with a supracrestal, crestal, or subcrestal implant-abutment interface. All implants developed a similar pattern of peri-implant inflammation: neutrophilic polymorphonuclear leukocytes (neutrophils) maximally accumulated at or immediately coronal to the interface. However, peri-implant neutrophil accrual increased progressively as the implant-abutment interface depth increased, i.e., subcrestal interfaces promoted a significantly greater maximum density of neutrophils than did supracrestal interfaces (10,512 +/- 691 vs. 2398 +/- 1077 neutrophils/mm(2)). Moreover, inflammatory cell accumulation below the original bone crest was significantly correlated with bone loss. Thus, the implant-abutment interface dictates the intensity and location of peri-implant inflammatory cell accumulation, a potential contributing component in the extent of implant-associated alveolar bone loss.

PMID: 16632764 [PubMed - indexed for MEDLINE]

The 'mini'-implant has arrived.

J Am Dent Assoc. 2006 Mar;137(3):387-90

Authors: Christensen GJ

There is no question that dental implants have been the most influential change in dentistry during the last half-century. In general, they are well-proven and highly useful. However, the diameter of standard implants (approximately 3.75 mm), along with the frequent need to graft bone to allow for their placement, have limited their use for those who most need implants. The introduction, approval and continuing observation of success of smaller-diameter mini-implants have stimulated use of implants in situations in which standard-sized implants could not have been used without grafting. The result has been more patients who have been served successfully at reduced cost with minimized pain and trauma--patients who could not have been treated with implants otherwise. Continuing research is needed for further verification of the acceptability of mini-implants.

PMID: 16570473 [PubMed - indexed for MEDLINE]

Response from the AAP.

J Am Dent Assoc. 2006 Mar;137(3):296, 298; author reply 298, 300

Authors: Krebs KA

PMID: 16570462 [PubMed - indexed for MEDLINE]

Compressive osteotomes for expansion and maxilla sinus floor lifting.

Med Oral Patol Oral Cir Bucal. 2006 Jan;11(1):E52-5

Authors: Calvo-Guirado JL, Saez-Yuguero R, Pardo-Zamora G

AIM: The aim of this article is to assess the efficiency of the technique for the posterior alveolar expansion and elevation of the upper maxillary alveolar ridge through the use of compressive osteotomes (Quirurgical Bontempi, Espa&#xF1;a) which have been specifically designed for Osseotite NT and Osseotite NT Certain of 3i implants (Implants Innovations, USA). MATERIALS AND METHODS: 24 adult patients (16 female and 12 male), who were selected according to Albrektsson's inclusion and exclusion criteria, took part in the study. All the patients presented bone deficiency in the width and height of the upper maxilla. 48 Osseotite implants were performed (four Osseotite Standard; six Osseotite NT; 38 NT Certain (3i, Implants Innovations, CA, USA)). Implant diameters were 4 mm in 44 cases and 5 mm in 4 cases with lengths varying between 11.5 (n = 4) and 13 mm (n = 44). The alveolar ridges of the 24 patients had initial widths from 1.5 mm to 5 mm and heights between 5 and 13 mm. Results: The data obtained were analysed using the SPSS 11.0 program. In the 48 areas treated with immediate implants, an increase in bone height of 6.75 mm -/+ 1.25 mm was achieved. In the case of the alveolar expansion for the 48 implants, the average was 3.2 mm -/+ 0.15 mm. CONCLUSIONS: The technique for alveolar expansion and elevation of the upper maxilla with compressive osseotomes can lead to a 100% success rate after a 9-month follow-up of the implants and insertion of prostheses. It is a highly predictable surgical procedure which allows implants to be performed at the same time as surgery, thus reducing the number of such interventions while recovering aesthetic and functional losses in the patient.

PMID: 16388295 [PubMed - indexed for MEDLINE]

Bone grafting simultaneous to implant placement. Presentation of a case.

Med Oral Patol Oral Cir Bucal. 2005 Nov-Dec;10(5):444-7

Authors: Pe&#xF1;arrocha-Diago M, Gómez-Adrián MD, García-Mira B, Ivorra-Sais M

Bone defects at mandibular alveolar crest level complicate the placement of dental implants in the ideal location. Surgical reconstruction using autologous bone grafts allows implant fixation in an esthetic and functional manner. We describe a patient with large mandibular bone loss secondary to periodontal inflammatory processes. Reconstruction of the mandibular alveolar process was carried out using onlay block bone grafts harvested from the mandible. The grafts were stabilized by positioning the dental implants through them--a procedure that moreover afforded good primary implant fixation. After two years of follow-up the clinical and radiological outcome is good. In the lower jaw, where bone regeneration is complicated, we were able to achieve good results in this patient--minimizing the corresponding waiting time by grafting and placing the implants in the same surgical step.

PMID: 16264379 [PubMed - indexed for MEDLINE]

Advanced restorative techniques.

Br Dent J. 1999 Dec 11;187(11):593-600

Authors: Howe L, Palmer P, Barrett V

Many alternative techniques are available to ensure the best possible outcome for an implant restoration.

PMID: 16163276 [PubMed - indexed for MEDLINE]

Application of oral implants to the general dental practice.

J Am Dent Assoc. 2005 Aug;136(8):1092-100; quiz 1165-6

Authors: Stanford CM

BACKGROUND: The use of dental implants has become a management strategy for replacing missing teeth. As new implant surface technologies develop and prosthetic options increase, the field of dental implantology continues to change. General dentists con sidering the use of this treatment modality in their practices should understand the vital role treatment planning plays in achieving predictable outcomes. OVERVIEW: This article reviews specific issues the general dentist typically faces when considering patients for single-tooth, partially-edentulous-arch and full-arch tooth replacement using dental implants. The author analyzes patient-based assessments, as well as diagnostic criteria and steps, to help practitioners predict patient-specific issues that may signal complications. He also discusses approaches for resolving complications. The article emphasizes the importance of careful evaluation in predicting patient-specific issues that can lead to gingival recession and suggests approaches to manage these situations. CONCLUSIONS AND CLINICAL IMPLICATIONS: Dental implants have become an increasingly common treatment option for missing dentition. Because innovations in implant surfaces continue to promote faster bone growth with better predictability, general dentists should be aware of the importance of treatment planning, assessment and teamwork in achieving successful outcomes.

PMID: 16161363 [PubMed - indexed for MEDLINE]

Response shift masks the treatment impact on patient reported outcomes (PROs): the example of individual quality of life in edentulous patients.

Health Qual Life Outcomes. 2005;3:55

Authors: Ring L, H&#xF6;fer S, Heuston F, Harris D, O'Boyle CA

BACKGROUND: Quality of life (QoL) is now established as an important outcome for evaluating the impact of disease, and for assessing the efficacy of treatments. However, individuals change with time and the basis on which they make a QoL judgement may also change, a phenomenon increasingly referred to as response shift. Here, the individual may change his or her internal standards, values, and/or conceptualization on the target construct as a result of external factors such as a treatment or a change in health status. This has important implications for assessing the effects of treatments as a change in QoL may reflect a response shift, a treatment effect, or a complex combination of both. In this study, we used an individualised quality of life (IQoL) measure, the SEIQoL, together with a then-test to determine whether response shift would influence the measurement of treatment efficacy in edentulous patients. METHODS: Data are reported here for the first phase of a randomised controlled clinical trial designed to assess the impact, on IQoL, of implant supported dentures compared with high quality conventional dentures. IQoL was measured using the SEIQoL-DW in 117 patients (mean age 64.8; 32% male) at baseline (T1) and 3 months (T2) after receiving high quality conventional dentures. The work was carried out in dental teaching hospitals in Dublin and Belfast. RESULTS: Unadjusted SEIQoL index scores revealed no significant impact of treatment at three months (baseline: 75.0; 3 months: 73.2, p = .33, n.s.). However, the then-test at 3 months revealed that patients retrospectively rated their baseline IQoL as significantly lower (P < .001) than they had rated it at the time (then-test baseline: 69.2). Comparison of the 3 month scores with this readjusted baseline indicated a significant treatment effect (then-test baseline: 69.2; 3 months: 73.2, p = 0.016). 81% of patients nominated at least one different IQoL domain at 3 months. CONCLUSION: The positive impact of denture treatment for edentulous patients on IQoL was seen only when response shifts were taken into consideration. The nature of the response shifts was highly complex but the data indicated a degree of re-conceptualization and reprioritisation. Assessment of the impact of treatments using patient-generated reports must take account of the adaptive nature of patients.

PMID: 16146573 [PubMed - indexed for MEDLINE]

Immediate loading of two single tooth implants in the maxilla: preliminary results after one year.

J Contemp Dent Pract. 2005 Aug 15;6(3):148-57

Authors: Nuzzolese E

This clinical report describes the traumatic avulsion of the left maxillary central and lateral incisors with minimal tissue trauma, followed by placement of provisional restorations of two root-form implants in a 14-year old female patient. Ten days following the avulsion, implant therapy was performed with Summers osteotomes and flapless technique using a root-form 3i osseotite NT. Angulated abutments and acrylic provisional crowns were placed. No occlusal contact was detected. An impression was made 30 days after implant insertion and ceramic restorations were placed 3 months later. No significant soft tissue contraction was observed during the provisional period. The patient exhibited no clinical or radiologic complications for 8 months after loading. In carefully selected under-aged patients implant therapy and immediate loading in the anterior maxilla for traumatic tooth avulsion may prove to be valuable to avoid soft tissue contraction, alveolar bone resorption, and positive esthetic/psychological response.

PMID: 16127484 [PubMed - indexed for MEDLINE]

Cost-effectiveness of mandibular two-implant overdentures and conventional dentures in the edentulous elderly.

J Dent Res. 2005 Sep;84(9):794-9

Authors: Heydecke G, Penrod JR, Takanashi Y, Lund JP, Feine JS, Thomason JM

Implementation of new therapies is usually governed by financial considerations, so efficacy studies should also include cost comparisons. The cost and effectiveness of mandibular conventional dentures (CD, n = 30) and two-implant overdentures (IOD, n = 30) were compared in elderly subjects. Effectiveness (Oral Health Impact Profile, OHIP-20) and cost were measured up to one year post-treatment. Data for subsequent years were estimated by the Delphi method. Using an average life expectancy of 17.9 years, the equalized annual costs (in Canadian dollars) were dollar 399 for CD and dollar 625 for IOD (p < 0.001), and the equalized annual values for the outcome (OHIP-20) were 47.0 for CD and 31.3 for IOD treatment (p < 0.05). These values translate into a yearly additional cost for IOD treatment of dollar 14.41 per OHIP-20 point. These results are key to the implementation of programs to provide this form of therapy for edentulous adults.

PMID: 16109986 [PubMed - indexed for MEDLINE]

Clinical and radiographic behaviour of 290 dental implants with a surface treated with hydrofluoric acid and passivated with hydrofluoric and nitric acid: early loading results after 2 years.

Med Oral Patol Oral Cir Bucal. 2005 Aug-Oct;10(4):355-61

Authors: Mart&#xED;nez-González JM, Barona-Dorado C, Cano-Sánchez J, Flórez-Rodríguez M, Cantero-Alvarez M

OBJECTIVE: This work presents the results of clinical and radiological behaviour, for 2 years, of 290 implants treated with a first etching with HF and a second etching with HF and HNO3 acids and that were loaded 8 weeks after insertion. EXPERIMENTAL DESIGN: It is a prospective study on 290 implants placed in 56 patients with an age range from 28 to 81. The selection was previously made through radiological study with panoramic and tomographic radiographs, followed by the implantological treatment with prosthetic loading and clinical (15 days, 1, 3 , 6, 12, 18 and 24 months) and radiological control (12 and 24 months). RESULTS: During the healing period, 11 implants failed, resulting in a CSR of 96.21%. After prostheses placement at 2 months, 4 implants were retired, successfully remaining 275 implants. CONCLUSIONS: The following and favourable results after the prosthetic loading of 179 implants (CSR of 98.56%), attest that early loading may and must be applied, after rigorous planning and case selection.

PMID: 16056190 [PubMed - indexed for MEDLINE]

Preprosthetic and implantological surgery in patients with severe maxillary atrophy.

Med Oral Patol Oral Cir Bucal. 2005 Aug-Oct;10(4):343-54

Authors: Gonz&#xE1;lez-García R, Naval-Gías L, Muñoz-Guerra MF, Sastre-Pérez J, Rodríguez-Campo FJ, Gil-Díez-Usandizaga JL

AIMS: To evaluate the success of the osseointegration of dental implants in patients with severe maxillary atrophy after sinus lift augmentation and onlay graft surgery with autologous bone grafts. DESIGN: A descriptive and analytic study of 27 patients with severe maxillary atrophy and partial or total edentulism, after 4 years follow-up. All cases underwent to autologous bone graft sinus lift augmentation with or without onlay grafts in the anterior maxillae. After this, reconstruction with osseointegrated implants was performed. RESULTS: After the follow-up period, 89.1% of implants were osseointegrated and loaded. Anterior iliac crest bone graft provides good results with respect to implant osseointegration. The achievement of two surgical procedures for bone grafts surgery and implants surgery, separated 2 or more months, provides better results for osseointegration in comparison to a sole surgical procedure (p<0.01). CONCLUSIONS: Implants survival predictability is greater when a second surgical procedure is performed, once bone grafts have experimented an appropriate consolidation. The use of onlay graft and sinus lift augmentation techniques is useful in the resolution of complex problems such as the severe maxillary atrophy.

PMID: 16056189 [PubMed - indexed for MEDLINE]

Immediate loading in oral implants. Present situation.

Med Oral Patol Oral Cir Bucal. 2005;10 Suppl 2:E143-53

Authors: Uribe R, Peñarrocha M, Balaguer J, Fulgueiras N

The earliest antecedents of immediate loading were introduced by Ledermann in 1979. He placed overdenture in four interforaminal implants on the same day the surgery was carried out. In the original implantological protocol of Brånemark the immediate loading did not appear indicated, currently, it is being presented as a predictable alternative in several studies. We revised different articles on immediate loading from 1997 to 2002. We analysed different variables and concluded that immediate loading produces a success rate in posterior maxilla similar to the differed loading (90-100%). The characteristics of the implant, favourable to immediate loading, are: screw-shaped, with a rough surface, sand blasted and acid etching processed and a minimum length of 10 mm. The initial stability and a micro movement of the implant, inferior to 150 microm and a marginal to the insertion equal or superior to 32 N/cm are defined as a proper osseous. The bruxism stands out as an adverse factor according to several authors.

PMID: 15995575 [PubMed - indexed for MEDLINE]

Pain and inflammation in 41 patients following the placement of 131 dental implants.

Med Oral Patol Oral Cir Bucal. 2005 May-Jul;10(3):258-63

Authors: Gonz&#xE1;lez-Santana H, Peñarrocha-Diago M, Guarinos-Carbó J, Balaguer-Martínez J

AIMS: To study pain and swelling in the first week after dental implant placement. MATERIAL AND METHODS: A total of 131 implants were placed in 41 patients (17 males and 24 females) under local anesthesia. Pain was scored by means of a verbal and visual analog scale (VAS), while swelling was evaluated by a verbal scale. RESULTS: Most patients who experienced pain reported the latter to be slight, with a peak intensity 6 hours after the operation in 41.5% of cases. A significant relation was observed between pain and the number of implants placed. Swelling was moderate in most patients who reported pain -- peak intensity of inflammation being recorded after 48 hours in 48.8% of cases. A significant association was observed between swelling and older patients, the placement of more than four dental implants, and operations in which sinus lift or bone regeneration procedures were carried out. Swelling was greater in patients with implants positioned in the posterior sector versus those placed in the anterior zone, and in those located at free extreme or totally edentulous patients, versus those placed in interdental spaces. CONCLUSIONS: Following implant placement, pain tends to be mild, with moderate inflammation. The latter is seen to be greater in older patients, in subjects receiving a larger number of implants, and in interventions involving regenerative techniques.

PMID: 15876971 [PubMed - indexed for MEDLINE]

Implant rehabilitation of the atrophic upper jaw: a review of the literature since 1999.

Med Oral Patol Oral Cir Bucal. 2005;10 Suppl 1:E45-56

Authors: Sorní M, Guarinós J, García O, Peñarrocha M

The severely resorbed maxilla presents serious limitations for conventional implant placement. As a result, different techniques have been developed in the last two decades, with variable results. The most significant approaches comprise the placement of implants in anatomical abutments, elevation of the sinus floor, and reconstructive surgery with bone grafting. The present study reviews the most important articles on the management of the atrophic upper jaw published in the literature since 1999.

PMID: 15800467 [PubMed - indexed for MEDLINE]

Initial subgingival colonization of 'pristine' pockets.

J Dent Res. 2005 Apr;84(4):340-4

Authors: Quirynen M, Vogels R, Pauwels M, Haffajee AD, Socransky SS, Uzel NG, van Steenberghe D

The treatment of periodontitis/peri-implantitis involves the reduction/eradication of periopathogens. After therapy, beneficial and pathogenic species recolonize the subgingival area. The dynamics of recolonization and especially the role of the supragingival environment in this process are still not well-understood. This prospective, split-mouth study followed the early colonization of 'pristine' pockets created during implant surgery (16 partially edentulous patients), to record the time needed before a complex subgingival flora could be established with the supragingival area as the single source. Four subgingival plaque samples were taken from shallow and medium pockets around implants (test), and neighboring teeth (undisturbed microbiota as reference) 1, 2, and 4 wks after abutment connection. Checkerboard DNA-DNA hybridization and culture data revealed a complex microbiota (including several pathogenic species) in the pristine pockets within a wk, with a minimal increase in counts up to 4 wks. Analysis of these data demonstrated that, even with the supragingival environment as the single source for colonizing bacteria, a complex subgingival microbiota can develop within 1 wk.

PMID: 15790740 [PubMed - indexed for MEDLINE]

For the dental patient. Dental implants. An option for replacing missing teeth.

J Am Dent Assoc. 2005 Feb;136(2):255

Authors: ,

PMID: 15786584 [PubMed - indexed for MEDLINE]

Combined cephalometric and stent planning for palatal implants.

J Orthod. 2005 Mar;32(1):20-5

Authors: Cousley RR, Parberry DJ

Several aspects of palatal implant usage are technique sensitive. In particular, problems during the insertion stage may compromise implant osseo-integration, or its subsequent ease of handling and effectiveness. This paper describes a systematic approach to combined cephalometric and model planning, and subsequent stent fabrication for Orthosystem palatal implants. The authors recommend this protocol in order to optimize three-dimensional control of implant positioning, and to both simplify and standardize the insertion stage.

PMID: 15784938 [PubMed - indexed for MEDLINE]

Reimbursement for dental implants: dispelling some popular myths.

J Am Dent Assoc. 2005 Feb;136(2):210-1

Authors: Anderson MH

BACKGROUND AND OVERVIEW: Dental implants are being placed with increasing regularity. Many dentists do not take advantage of insurance coverages for this treatment because they are under the impression that no aspect of implant therapy is covered. This article discusses a number of insurance benefits that may be available to dental patients but not readily apparent to treating dentists and their staff members. CONCLUSIONS AND PRACTICE IMPLICATIONS: Some dentists and patients may assume incorrectly that a dental insurance plan does not reimburse for any implant therapy when, in fact, there may be some benefit available for at least a portion of the treatment. In addition, some dentists and patients may not consider implant therapy even when it is the preferred treatment option because of the assumed lack of reimbursement. Knowing that some reimbursement is available may make the difference in the patient's accepting the best treatment for his or her condition. Furthermore, since an increasing number of patients now make some contribution toward their dental insurance plan premiums, they deserve to know their options and to receive appropriate benefits.

PMID: 15782526 [PubMed - indexed for MEDLINE]

Evaluation of the implantation position of mini-screws for orthodontic treatment in the maxillary molar area by a micro CT.

Bull Tokyo Dent Coll. 2004 Aug;45(3):165-72

Authors: Ishii T, Nojima K, Nishii Y, Takaki T, Yamaguchi H

The interalveolar septum between the upper first molar and the second premolar of the separated human maxillary bone was three-dimensionally observed by micro CT to evaluate the appropriate mini-screw type implant placement position by considering the relationship between the tooth roots and the maxillary sinus. After taking micro CTs of 5 human maxillary bones, horizontally sectioned images of the interalveolar septum area 2, 4, 6, 8, 10, and 12 mm deep from the crest of the alveolar ridge were reconstructed by three-dimensional reconstruction software. The bucco-lingual and mesio-distal lengths and area in each sectioned interalveolar septum were measured using digital image measurement software. Using the results, the interalveolar septum area between the upper first molar and the second premolar approximately 6-8 mm deep from the alveolar crest in the tooth root apical direction was determined to be the safest position for mini-screw implantation. Furthermore, lateral implantation from the palatal side was deduced to be the safest approach.

PMID: 15779459 [PubMed - indexed for MEDLINE]

Histomorphometric evaluation of new bone formation in diabetic rats submitted to insertion of temporary implants.

Braz Dent J. 2004;15(2):87-92

Authors: Ottoni CE, Chopard RP

This study aimed to quantify new bone formation in the femurs of diabetic Wistar rats. Over an eight-week period, MTI-MP implants were evaluated in control rats and in diabetic rats. At several points during this period, various markers for bone deposit were introduced. The material was observed under fluorescent light microscopy. New bone formation in periosteal and cortical regions linked to the implant did not vary significantly between the groups. However, there were significant differences in total new bone formation in the medullar canal and in bone/implant contact area in the medullar portion. Bone deposits attached to the surface of the temporary implants demonstrated that they are biocompatible and capable of osseointegration.

PMID: 15776188 [PubMed - indexed for MEDLINE]

Case report: restoration of edentulous mandible with 4 BOI implants in an immediate load procedure.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2004 Dec;148(2):195-8

Authors: Ihde S, Eber M

Dental implants for insertion from the lateral aspects of the jaw bone have been described repeatedly, since 1972. Long term results have been reported. Due to their design, BOI-Implants (basal osseointegration) can be installed even in those cases, where the vertical bone supply is reduced. This applies to the distal areas of the maxilla and the mandible. Furthermore, BOI-implants allow immediate loading as long as a balanced masticatory function can be achieved and maintained. This paper reports on the steps taken to install a full lower bridge in 4 BOI-implants and restoration in a patient with a circular bridge. The bridge was made from CoCr-Alloy and covered with acrylic resin. This treatment technique reduces costs and treatment time by about 50% compared to conventional techniques.

PMID: 15744373 [PubMed - indexed for MEDLINE]

Implants in anatomical buttresses of the upper jaw.

Med Oral Patol Oral Cir Bucal. 2005 Mar-Apr;10(2):163-8

Authors: Sorn&#xED; M, Guarinos J, Peñarrocha M

The skull presents a series of dense bony buttresses that conform a protective frame around the different craniofacial cavities. The middle third portion presents two anterior buttresses (frontomaxillary and frontozygomatic) and a posterior buttress (pterygomaxillary). In certain situations these structural supports allow the rehabilitation of free upper extremities in atrophic jaws by positioning parasinusal angulated implants--thereby avoiding the need for more complex reconstruction techniques such as sinus lifting or autografting procedures. The present study presents a review of the literature on implant insertion in anatomical buttresses of the upper jaw.

PMID: 15735549 [PubMed - indexed for MEDLINE]

Immediate loading of dental implants in the edentulous mandible.

J Am Dent Assoc. 2004 Nov;135(11):1543-9; quiz 1621-2

Authors: Castellon P, Blatz MB, Block MS, Finger IM, Rogers B

BACKGROUND: The authors review the literature regarding immediate implant loading in the anterior edentulous mandible, demonstrate the technique they currently use, review preliminary results and present an illustrative case. MATERIALS AND METHODS: The authors conducted a literature search using PUBMED and Ovid databases. They considered for review 31 articles in English from 1969 to 2003 that pertained to immediate loading of the anterior mandible. The authors developed a technique to provide a bar-supported prosthesis on the day of surgery. They treated five patients and followed them up for at least six months. The preliminary results are presented. RESULTS: This literature review demonstrated that immediate loading of anterior mandibular implants is an acceptable method, with predictable results. This case series demonstrates the potential for delivering a final bar on the day of surgery, based on the current evidence and clinical application. CONCLUSIONS AND PRACTICE IMPLICATIONS: The method described provides patients with immediate prosthetic restorations and a decreased treatment time compared with that for the traditional two-stage implant approach.

PMID: 15622658 [PubMed - indexed for MEDLINE]

Frailty approach for the analysis of clustered failure time observations in dental research.

J Dent Res. 2005 Jan;84(1):54-8

Authors: Chuang SK, Cai T, Douglass CW, Wei LJ, Dodson TB

Because dental implant failure patterns tend to cluster within subjects, we hypothesized that the risk of implant failure varies among subjects. To address this hypothesis in the setting of clustered, correlated observations, we considered a retrospective cohort study where we identified a cohort having at least one implant placed. The cohort was composed of 677 patients who had 2349 implants placed. To test the hypothesis, we applied an innovative analytic method, i.e., the Cox proportional hazards model with frailty, to account for correlation within subjects and the heterogeneity of risk, i.e., frailty, among subjects for implant failure. Consistent with our hypothesis, risk for implant failure among subjects varied to a statistically significantly degree (p=0.041). In addition, the risk for implant failure is significantly associated with several factors, including tobacco use, implant length, immediate implant placement, staging, well size, and proximity of adjacent implants or teeth.

PMID: 15615876 [PubMed - indexed for MEDLINE]

Periimplantitis.

Med Oral Patol Oral Cir Bucal. 2004;9 Suppl:69-74; 63-9

Authors: S&#xE1;nchez-Gárces MA, Gay-Escoda C

Orodental rehabilitation through the use of implants offers very high success rates. In this paper, we describe some of the complications involved with this technique, such as periimplant disease and, within this category, periimplantitis, an inflammatory reaction in which there is a loss of the bony support of the implant accompanied by inflammation. The aetiology of the disease is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, the poor alignment of implant components, external morphology and excessive mechanical load. The microorganisms most commonly associated with implant failure are spirochetes and mobile forms of Gram-negative anaerobes, unless the origin is the result of simple mechanical overload. Diagnosis is based on changes of colour in the gum, bleeding and probing depth of periimplant pockets, suppuration, x-ray and gradual loss of bone height around the tooth. Treatment will differ depending upon whether it is a case of mucositis or periimplantitis. Therapeutic objectives focus on correcting technical defects by means of surgery and decontamination techniques (abrasion with carbon particles, citric acid solution, topical tetracycline application and laser surgery). This study also presents a microbiological study of periimplantitis conducted by the Barcelona School of Dentistry that determined that the antibiotic therapy proven to be most efficacious in the antibiogram was the association of amoxycillin and clavulanic acid.

PMID: 15580138 [PubMed - indexed for MEDLINE]

For the dental patient. Missing a tooth? A single-tooth implant may be for you.

J Am Dent Assoc. 2004 Oct;135(10):1499

Authors:

PMID: 15551992 [PubMed - indexed for MEDLINE]

[Clinical observation on reimplanting the upper inversely impacted incisor after extraction]

Shanghai Kou Qiang Yi Xue. 2004 Aug;13(4):296

Authors: Xie JZ

In order to determine the feasibility of reimplantation of upper inversely impacted incisor, we enlarged the interdental distance by orthodontic appliance, then replanted the impacted incisor after extraction. 13 of 15 cases had good results. It was a good method to replant inverse impacted incisor after extraction which avoid extracting the tooth simply.

PMID: 15349670 [PubMed - indexed for MEDLINE]

Implantology and the severely resorbed edentulous mandible.

Crit Rev Oral Biol Med. 2004;15(4):240-8

Authors: Stellingsma C, Vissink A, Meijer HJ, Kuiper C, Raghoebar GM

Patients with a severely resorbed edentulous mandible often suffer from problems with the lower denture. These problems include: insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. Dental implants have been shown to provide a reliable basis for fixed and removable prostheses. This has resulted in a drastic change in the treatment concepts for management of the severely resorbed edentulous mandible. Reconstructive, pre-prosthetic surgery has changed from surgery aimed to provide a sufficient osseous and mucosal support for a conventional denture into surgery aimed to provide a sufficient bone volume enabling implants to be placed at the most optimal positions from a prosthetic point of view. The aim of this paper is to review critically the literature on procedures related to the severely resorbed edentulous mandible and dental implant treatment. The study includes the transmandibular implant, (short) endosseous implants, and reconstructive procedures such as distraction osteogenesis, augmentation of the mandibular ridge with autogenous bone, and bone substitutes followed by the placement of implants. The number of patients participating in a study, the follow-up period, the design of the study, the degree of mandibular resorption, and the survival rate of the dental implants all are considered evaluation parameters. Although numerous studies have described the outcome results of dental implants in the edentulous mandible, there have been few prospective studies designed as randomized clinical trials that compare different treatment modalities to restore the severely resorbed mandible. Therefore, it is not yet possible to select an evidence-based treatment modality. Future research has to be focused on long-term, detailed follow-up clinical trials before scientifically based decisions in treating these patients can be made. This will contribute to a higher level of care in this field.

PMID: 15284188 [PubMed - indexed for MEDLINE]

An eight-year follow-up to a randomized clinical trial of participant satisfaction with three types of mandibular implant-retained overdentures.

J Dent Res. 2004 Aug;83(8):630-3

Authors: Timmerman R, Stoker GT, Wismeijer D, Oosterveld P, Vermeeren JI, van Waas MA

Studies have shown that mandibular implant overdentures significantly increase satisfaction and quality of life of edentulous elders. Improved chewing ability appears to have a positive impact on nutritional state. Therefore, it is important to determine the best design of this prosthesis over the long term. In this randomized controlled trial, three groups of edentulous participants with atrophic mandibles wore 3 types of implant overdentures. During an eight-year follow-up, only seven of the 110 participants had dropped out of this study. Almost all participants were still satisfied with their overdentures. Participant satisfaction concerning retention and stability of the mandibular overdenture had decreased significantly in the two-implant ball attachment group, whereas the opinion of participants in the single- and triple-bar groups was still at the same level. The long-term results suggest that a mandibular overdenture retained by 2 implants with a single bar may be the best treatment strategy for edentulous people with atrophic ridges.

PMID: 15271972 [PubMed - indexed for MEDLINE]