Delirium during intravenous sedation with midazolam alone and with propofol in dental treatment.
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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. (+info)
Rationale for socket preservation after extraction of a single-rooted tooth when planning for future implant placement.
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After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. These changes are usually clinically significant and can make placement of a conventional bridge or an implant-supported crown difficult. If bone resorption is significant enough, then placement of an implant may become extremely challenging. Postextraction maintenance of the alveolar ridge minimizes residual ridge resorption and, thus, allows placement of an implant that satisfies esthetic and functional criteria. Recent advances in bone grafting materials and techniques allow the dentist to place implants in sites that were considered compromised in the past. This article focuses on the healing pattern of sockets, with and without the use of regenerative materials, and the rationale for preserving the dimensions of the extraction socket. Histologic and clinical evidence is reviewed to provide an in-depth understanding of the logic behind and value of socket preservation. (+info)
Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skeletal class-III conditions: review of the literature and report of a case.
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BACKGROUND: Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. METHODS: Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skeletal class-III conditions due to cleft palate are described. RESULTS: A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. CONCLUSION: Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients. (+info)
Retrieval of blade implants with piezosurgery: two clinical cases.
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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. (+info)
Rehabilitation of severely resorbed maxillae with zygomatic implants: an update.
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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. (+info)
Development of new drug delivery system for implant bone augmentation using a basic fibroblast growth factor-gelatin hydrogel complex.
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This study sought to clarify the effectiveness of bFGF-gelatin hydrogel complex on bone regeneration around implants for the development of a new drug delivery system for bone augmentation. Twenty-four titanium implants (03.3 mmX 10 mm) were placed into edentulous areas of the mandibles of four beagle dogs with the upper four screw threads exposed at buccal side. bFGF-gelatin hydrogel complex with 0, 0.1, 1, 10, 100 microg bFGF or autogenous bone (as control) then filled the bone defect site to cover the exposed screw threads. After eight weeks, tissue specimens including implants were evaluated histologically and histomorphometrically. Histological observation showed new bone formation around exposed screw threads in the groups with 1, 10, 100 microg bFGF and autogenous bone-a striking contrast to the groups with contents of 0 and 0.1 microg bFGF. These results thus suggested that bFGF-gelatin hydrogel complex using an optimum amount of bFGF was useful for bone augmentation around implants. (+info)
Pre-operative drilling simulation method for dental implant treatment.
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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. (+info)
Removable partial denture on osseointegrated implants and natural teeth.
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Implants have been designed to provide edentulous patients with fixed prostheses or overdentures. Recently, implant-supported fixed partial prostheses and single crowns have become successful treatment alternatives to removable and fixed partial dentures. However, few researchers have examined "removable partial dentures on implants and natural teeth". In this article, we report two patients fitted with "removable partial dentures on implants and natural teeth". The patients were satisfied with their dentures in terms of function and aesthetics. Regular follow-up visits revealed that the periodontal and peri-implant conditions were stable. There was no evidence of excessive intrusion or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. Since the average duration of observation was about 38 months, further follow-up examinations are necessary to determine whether these dentures remain stable long-term. (+info)