Surgical simulation of Class III edentulous patient using a 3D craniofacial model: report of a case.
A case of edentulous prognathism in a 46-year-old Japanese male is presented. We described the outcome of the patient who underwent simultaneous sagittal splitting ramus osteotomy of the edentulous mandible, interpositional bone graft of severely atrophic edentulous jaws, and delayed placement of titanium implants for reconstruction. We highly recommend performing a surgical simulation using a craniofacial model of the patient's anatomy created using CT image data. The procedure provides almost ideal maxillary and mandibular contours. (+info)
The contribution of imaging and digitised data to mandibular reconstruction and implant stabilised occlusal rehabilitation: a case report.
Different methods are recommended for the surgical reconstruction of the resected mandible. The advantages for implant stabilised prostheses in restoring the occlusion are recognised but few papers provide adequate data to identify the successful outcome of treatment. The literature is reviewed and the advantages of imaging together with the use of digitised data is highlighted by a case requiring rehabilitation with enhanced planning methods. (+info)
Changing paradigms in implant dentistry.
This review focuses on five paradigms of implant dentistry which have undergone considerable modifications in recent years. An attempt was made to select and include all the relevant citations of the past 10 years. These five paradigms document the debate in the clinical and scientific community and include the aspects of (1) smooth vs. rough implant surfaces, (2) submerged vs. non-submerged implant installation techniques, (3) mixed tooth-implant vs. solely implant-supported reconstructions, (4) morse-taper abutment fixation vs. butt-joint interfaces, and (5) titanium abutments vs. esthetic abutments in clinical situations where esthetics is of primary concern. (+info)
Occlusal stability in implant prosthodontics -- clinical factors to consider before implant placement.
The success of any prosthetic design depends on proper management of the occlusion. The clinical variables influencing occlusal stability must be determined and considered in the design of the final prosthesis. This paper outlines some of these variables. (+info)
A multi-centre study of Osseotite implants supporting mandibular restorations: a 3-year report.
This multi-centre study evaluated the performance of the Osseotite implant in the mandibular arch. Osseotite implants (n = 688) were placed in 172 patients; 43.5% were placed in the anterior mandible and 66.5% in the posterior mandible. Fifteen per cent of the implants were placed in soft bone, 56.9% in normal bone and 28.1% in dense bone. During placement, 49.9% of the implants were identified as having a tight fit, 48.6% a firm fit and 1.5% a loose fit. About one-third of the implants (32.4%) were short (10 mm in length or less). After 36 months, only 5 implants had been lost, for a cumulative survival rate of 99.3%. The 3-year results of this study indicate a high degree of predictability with placement of Osseotite implants in the mandibular arch. (+info)
Implant prosthodontic management of anterior partial edentulism: long-term follow-up of a prospective study.
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.
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)
A 5-year prospective study of implant-supported single-tooth replacements.
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)