Molar restorations supported by 2 implants: an alternative to wide implants.
(17/218)
The single-tooth restoration has become one of the most widely used procedures in implant dentistry. Improvements to the abutment implant interface design, wider implant platforms and the increased use of cemented restorations have greatly enhanced this procedure. Nonetheless, limitations in the volume of underlying bone and heavy occlusal loads, with or without parafunctional habits, still contribute to occasional disappointments in restoration stability. The use of 2 implants to restore a molar has been shown to eliminate problems associated with bone volume and prosthetic stability. One of the most significant barriers to the widespread use of this concept has been the limitation of the size of implants and their associated prosthetic components. This paper presents the use of 2 implants to replace a single molar using implants and prosthetic components in the Astra Tech Dental Implant System. (+info)
The use of an osseointegrated implant for orthodontic anchorage to a Class II Div 1 malocclusion.
(18/218)
This case report describes the use of an osseointegrated implant to maximize anchorage in a 24-year-old female orthodontic patient with an Angle Class II, Division 1 malocclusion. Preadjusted edgewise appliance therapy was performed by extraction of only the maxillary first premolars. The osseointegrated implant was placed in the median-sagittal region of the hard palate for maximum orthodontic anchorage and connected to maxillary first molar bands via a transpalatal arch. Total treatment time was 2 years and 8 months. Cephalometric superimposition revealed the achievement of maximum molar anchorage in the maxilla, resulting in satisfactory occlusal and facial improvements. Histological analysis of the implant-bone interface demonstrated that the fixture was successfully osseointegrated. In conclusion, the osseointegrated implant placed in the median-sagittal palate was shown to be an effective orthodontic system that can be used clinically as a rigid intraoral anchorage. (+info)
Mental nerve function after inferior alveolar nerve transposition for placement of dental implants.
(19/218)
BACKGROUND: One option for successful placement of dental implants in an atrophic posterior mandible without injury to the inferior alveolar nerve (IAN) is to transpose or lateralize the nerve. This procedure carries the risk of numbness along the distribution of the nerve, the complication that the procedure is undertaken to avoid in the first place. The purpose of the present study was to assess mental nerve function after transposition of the IAN. METHOD: We determined the outcomes of 20 IAN transposition procedures in 12 consecutive patients at the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia. The study included objective testing of sensory nerve function as well as subjective assessment by the participants. RESULTS: All subjects reported initial transient sensory disturbance. Objective testing after a minimum of 6 months revealed that, for each patient, affected sites had the same level of sensation as unoperated areas. Eighty percent of the patients said that the lower lip and chin felt normal. The others said that these structures did not feel exactly normal but that the difference was of no consequence. CLINICAL SIGNIFICANCE: It is concluded that IAN transposition can be safely and predictably performed with low risk to the mental nerve sensibility. (+info)
Implant prosthodontic management of anterior partial edentulism: long-term follow-up of a prospective study.
(20/218)
OBJECTIVE: This paper reports on the long-term outcome of patients with Kennedy Class IV partial edentulism treated in the Implant Prosthodontic Unit (IPU) at the University of Toronto, Toronto, Ontario. METHODS: The information for this paper was gathered from the charts of the first 30 consecutive, partially edentulous patients treated at the IPU. These patients all had Class IV edentulism and formed part of the original prospective clinical studies that were initiated in 1983. The patients' dental history suggested maladaptive experiences with traditional removable prostheses or a reluctance to have intact or quasi-intact teeth prepared as retainers for fixed prostheses. Fifteen men and 15 women treated with 94 Br nemark dental implants, supporting 34 prostheses, were followed until June 2000 (25 patients) or until they were lost to follow-up (5 patients). The multiple missing teeth occurred in 19 maxillae and 15 mandibles. RESULTS: The original prosthodontic treatments were intended to result in 33 fixed partial prostheses and 1 overdenture. At the time of this report, 25 patients with 86 implants supporting 31 fixed prostheses and 3 overdentures had been followed for an average of 12 years (range 7 16 years). The overall survival of implants was 92%. The difference between men (94%) and women (89%) was not statistically significant. CONCLUSIONS: This report is an interim update on an ongoing long-term prospective study. The results so far demonstrate a high survival rate for Br nemark implants supporting tissue-integrated prostheses for the management of anterior partial edentulism. (+info)
Outcomes of implant prosthodontic treatment in older adults.
(21/218)
Older adults are expected to account for an increasingly disproportionate number of individuals needing oral implant prostheses. However, this biotechnology was initially studied for predominantly middle-aged edentulous patients, not elderly people. High rates of success and minimal crestal bone loss have been reported for oral implants mainly in this group. The results of studies at the University of Toronto now clearly support earlier reports that older adults respond to oral implants in the same manner as younger adults, despite their tendency for systemic illness, including osteoporosis. However, unfavourable jawbone quantity and quality, particularly atrophy of the maxilla, impaired implant success. Furthermore, placement of implants in sites that had been edentulous for shorter periods was associated with greater crestal bone loss, a finding that may have implications for younger adults undergoing such treatment. The major decision-making challenge in managing depleted dentitions and complete edentulism in an aging society now lies in differentiating the treatment outcomes, especially patient-mediated assessments (including economic analyses), of the various prosthodontic options available for older adults. (+info)
Implant prosthodontics in medically challenged patients: the University of Toronto experience.
(22/218)
A series of prospective studies started in the mid-1980s at the University of Toronto have provided evidence of the efficacy and effectiveness of implants in the treatment of the fully and partially edentulous patients. These studies have focused primarily on treatment outcomes at the surgical and prosthodontic levels, with an overall failure rate of 7.7% over a 20-year period. Because a considerable proportion of these failures (4.2%) occurred before insertion of the prosthesis, and because osseointegration is essentially a wound-healing process, factors that interfere with healing, including systemic conditions, may contribute to implant failure. This paper reviews studies on the impact of selected systemic conditions, including osteoporosis, cardiovascular diseases, diabetes mellitus, and hypothyroidism, as well as smoking behaviour, on the success or survival of oral implants in patients treated in the Implant Prosthodontic Unit at the University of Toronto. (+info)
A 5-year prospective study of implant-supported single-tooth replacements.
(23/218)
OBJECTIVE: Because osseointegration has been successful in the management of completely edentulous patients, it is tempting to extrapolate these results and infer the success of single-tooth replacement. Yet there are major clinical differences between edentulous and partially edentulous patients. This prospective study is a follow-up to one started at the University of Toronto in 1986. The purpose of this study was to continue longitudinal assessment of implant-supported single-tooth replacements. METHODS: The original study comprised 42 consecutively treated patients with a total of 49 implants. The patient group consisted of all University of Toronto patients treated with single Br nemark implants whose treatment had been completed more than 5 years previously (i.e., before 1994). No exclusion criteria applied. One implant was not osseointegrated at the time of stage 2 surgery, and 6 patients with reportedly successful osseointegrated implants were not available for recall. For the preparation of this report, 30 of the remaining 42 implants were assessed during recall examinations. Assessment of success was based on published criteria. In addition, soft-tissue appearance, implant immobility, occlusal contacts in centric occlusion and excursions, proximal contacts, tightness of crown and abutment screws, and patients' responses on satisfaction questionnaires were evaluated. RESULTS: The criteria defining success of treatment in implant prosthodontics were met by all 30 of the single-tooth implants, which had been in place for 5 or more years. Each implant was immobile, and each had a mean vertical bone reduction of less than 0.2 mm annually. CONCLUSION: Stable long-term results can be achieved with single Branemark implant-supported crowns. (+info)
Implant prosthodontic management of posterior partial edentulism: long-term follow-up of a prospective study.
(24/218)
OBJECTIVE: This paper reports on the long-term outcome of implant-supported posterior-zone prostheses in the first 35 consecutive, partially edentulous patients treated in the Implant Prosthodontic Unit (IPU) at the University of Toronto, Toronto, Ontario. METHODS: A total of 106 Branemark dental implants were placed in 46 posterior edentulous spans in 35 patients for the management of multiple missing teeth; the patients were followed prospectively. Treatment planning principles involved a minimum of 2 or 3 implants at each edentulous site and scrupulous occlusal prosthodontic designs. RESULTS: The overall survival of posterior implants was 94%. No factors in the patients' history adversely affected implant survival. CONCLUSIONS: This clinical update suggests that the use of Branemark implants in the rehabilitation of patients who are partially edentulous in the posterior zone is highly effective and that survival of the implants is excellent. (+info)