Hypodontia, ankylosis and infraocclusion: report of a case restored with a fibre-reinforced ceromeric bridge.
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Retained primary molars without permanent successors often undergo progressive infra-occlusion, without predictable exfoliation. Early prophylactic removal, after assessment of root resorption and adjacent periodontal support loss as well as age of onset, is often indicated. This article describes the joint orthodontic-restorative care of such a case and describes an alternative method of restoration using a fibre-reinforced ceromeric bridge. As well as a conservative preparation and good aesthetics, an overlay restoration provided a fully functional occlusion. (+info)
Implant prosthodontic management of anterior partial edentulism: long-term follow-up of a prospective study.
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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)
Two-implant mandibular overdentures: simple to fabricate and easy to wear.
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Success rates for titanium dental implants in the anterior mandible are very high. Because of these success rates, as well as lower costs, it is common to treat edentulous patients with just 2 implants and ball anchors for retention of the overdenture, instead of 4 implants and a bar. In this paper the fabrication of 2-implant overdentures is described. In a controlled clinical trial (to be reported elsewhere), 30 subjects received a 2-implant overdenture for the mandible and a conventional prosthesis for the maxilla. The 30 control patients received conventional complete dentures for both jaws. The stability of the overdentures was excellent, and the lingual dimensions of the denture could be reduced to the level of the mylohyoid line to provide more space for the tongue. In patients with tense labial musculature or a limited amount of attached gingiva, it was important to elevate the shoulder of the implant and ball abutment above the gingival level to avoid peri-implant problems. Significantly fewer visits for adjustment related to post-placement pressure spots were required for mandibular overdentures than for conventional mandibular prostheses. (+info)
Hypohidrotic ectodermal dysplasia: a unique approach to esthetic and prosthetic management: a case report.
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Hypohidrotic ectodermal dysplasia is a rare congenital disease that affects several ectodermal structures. The condition is usually transmitted as an x-linked recessive trait, in which gene is carried by the females and manifested in males. Manifestations of the disease differ in severity and involve teeth, skin, hair, nails and sweat and sebaceous gland. Ectodermal dysplasia is usually a difficult condition to manage. Prosthodontically, because of the typical oral deficiencies, and afflicted individuals are quite young to receive extensive prosthodontic treatment, which restores their appearance and helps them, for the development of positive self-image. This case report describes the management of upper jaw with over denture with copings on existing teeth i.e. two permanent peg shaped centrals as well as lateral incisors. However with adequate of retainer lower denture was provided with a new treatment modality. (+info)
Immediate loading in oral implants. Present situation.
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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 Branemark 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. (+info)
Cleidocranial dysplasia: 2 generations of management.
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Patients with cleidocranial dysplasia (CCD) commonly present with significant dental problems, such as retention of multiple deciduous teeth, impaction or delay in eruption of permanent teeth and, often, the presence of supernumerary teeth. Several approaches have been described for the management of such patients. We report 2 cases illustrating the shift in the management paradigm from edentulation and prosthetic replacement to orthodontically assisted forced eruption and fixed appliance orthodontic treatment combined with orthognathic surgery. (+info)
Low-cost implant overdenture option for patients treated in a predoctoral dental school curriculum.
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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. (+info)
Patient responses to dental implant-retained mandibular overdenture therapy: a 6-year clinical study.
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BACKGROUND: The purpose of this study was to record subjective patient experiences with respect to the surgical placement of dental implants and the functioning of mandibular implant-retained overdentures versus conventional dentures. METHODS: Completely edentulous patients (n = 56) unable to wear a conventional mandibular complete denture were each treated with 4 one-stage titanium plasma sprayed or Sandblasted Large-grit Acid-etched (SLA) screw implants and overdentures retained by a cast bar with extracoronal attachments. Fifty-six patients were subsequently clinically evaluated over a period of up to 6 years. Fifty-three patients responded to questions on their experiences prior to and after treatment with implant retained overdentures. RESULTS: No implants or restorations failed during the observation period. Most of the patients (96%) felt satisfied with their new overdentures, and reported their new dentures fit comfortably. CONCLUSIONS: The use of implants to retain and support the denture improved comfort, giving the patients more self-confidence and improved social interaction, in addition to oral rehabilitation. This study demonstrates rehabilitation of the mandibluar arch with an implant-retained overdenture is a predictable treat- (+info)