Implant‐Supported Prosthetic Rehabilitation of a Patient with Localized Severe Attrition: A Clinical Report

Patients usually adapt to their existing occlusal vertical dimension (OVD). It is essential to resolve each of the problems associated with decreased vertical dimension as a result of attrition. This report describes the multidisciplinary dental treatment of a 40‐year‐old male patient who had severe tooth wear, resulting in reduced vertical dimension. After clinical evaluations, extraoral examination showed a reduction of the lower facial height, drooping, and overclosed commissures. Ten dental implants were placed into the maxillary and mandibular alveolar processes. During the osseointegration period, an interim removable partial denture was made at increased OVD to use in the first stage of rehabilitation. It was used for 3 months as a guide for preparing the definitive restorations. The patient's adaptation to the increased OVD was evaluated. During this period, he was asymptomatic. Following the evaluation period, the provisional fixed restoration was used for 3 months. Then, full‐mouth definitive prostheses supported by a combination of implants and teeth were fabricated to upper and lower jaws. Osseointegration of the implants, peri‐implant mucosa health, prosthesis function, and esthetics were assessed after 1 week and 1, 3, and 6 months. After 3 years of follow‐up, no functional or esthetic difficulties with the implants and restorations were noted.     

Bone healing at a failed implant site in a type II diabetic patient: clinical and histologic evaluations: a case report

Placement of endosseous dental implants in diabetic patients may be compromised because of altered wound healing. Additionally there is no established timetable for implant healing in these patients. A case report is presented that evaluates implant healing at the site of a failed implant after its removal. This report documents bone remodeling in a diabetic patient 6 months after removing the failed implant. The prostheses was delivered within 4 months in the upper arch despite the complications during the healing period.     

口腔种植修复临床效果五年回顾研究

目的:评估柱状种植体应用5年的临床效果。方法:2001年2月至2005年12月植入柱状种植体共931枚,其中Pitt-easy种植体174枚,Frialit-2种植体148枚,Camlog种植体350枚,XiVE种植体176枚,Ankylos种植体45枚,I.M.Z种植体38枚。全部种植体均在2005年12月前完成上部结构修复,其中固定修复456例,活动修复8例,共计464例患者。平均追踪30个月(4-59月)。观察方法为X线检查和临床检查,采用Wheeler存留标准评估,纳入Kaplan-Meier存留曲线统计。结果:种植修复体完成时451例患者对修复效果满意,13例患者对修复体不满意,重做后10例表示满意,3例表示可以接受。随访中有34例患者共46枚种植体确诊为种植体周围炎。有明确记录的共24枚种植体脱落。5年随访累计修复体松动14件,修复体折断8件。据Wheeler存留标准统计5年存留率为95.2%。结论:种植修复患者的满意度高,本组种植体的5年存留率达到95.2%。     

Maxillary antral-nasal inlay autogenous bone graft reconstruction of compromised maxilla: a 12-year retrospective study.

During a 12-year period (1984-1996), 118 maxillary inlay autogenous bone grafts and 248 commercially pure titanium threaded root-form endosseous implants were placed in 54 consecutively treated patients with compromised maxillary bone. In this retrospective clinical study, 3 groups of patients were reviewed, group selection being based on anatomic location and surgical access to the recipient site. Group 1 included patients with bone grafts placed in the antrum floor via an intraoral antrostomy exposure, group 2 included patients with bone grafts placed in the nasal floor via an anterior intraoral nasotomy exposure, and group 3 included patients with bone grafts placed in the antral and nasal floor via an intraoral Le Fort I osteotomy downfracture exposure. Each patient received an implant-supported dental prosthesis. For the combined 3 groups, survival rates were 87% for endosseous implants and 100% for autogenous bone grafts. The success rate for the dental prostheses in the 3 groups was 95%. Sixty-nine dental prostheses functioned a mean of 57.1 months, whereas 3 prostheses required remaking because of implant loss. Of the medical and mechanical risk factors tabulated in this study, current use of nicotine, history of sinusitis, molar site implant placement, and shorter implant lengths had the most influence on implant failure.     

Efficiency of immediately loaded mandibular full-arch implant restorations

Background: The concept of immediately loading dental implants in fully edentulous patients offers patients many benefits, including the ability to eat post placement and improved comfort during healing. This approach may also minimize the number of patient visits when compared with the traditional approach of implant placement and healing over a 3‐ to 4‐month healing period. Purpose: The aim of this study was to compare the number of treatment visits for patients undergoing traditional implant placement and healing with that of patients receiving immediate implant loading prior to construction of the definitive prostheses. Materials and Methods: This case series evaluated two patient groups. Group 1 consisted of seven patients who were edentulous in the mandible. After implant placement, the implants were covered by oral mucosa during 3 to 4 months of healing. During this time patients wore relined mandibular dentures. Group 2 consisted of seven patients who had their implants immediately loaded with fixed prostheses on the day of implant placement. Results: The implants in both groups were integrated successfully; however, the number of patient visits between implant placement and construction of the definitive prostheses was 38 in the conventionally loaded group and 1 in the immediately loaded group. Conclusions: The group with immediate loading required significantly fewer postoperative visits compared with the conventionally loaded group.     

功能性颌骨重建61例临床分析

目的:评价采用多种骨瓣进行功能性颌骨重建的临床效果。方法:61例颌骨缺损患者,首先应用多种骨瓣重建颌骨的连续性,然后植入骨结合种植体,利用种植义齿重建患者的咀嚼和发音功能。61例患者中,男39例,女22例,平均年龄48岁(20～61岁)。游离髂骨瓣32例,血管化腓骨瓣21例,单纯牵引成骨重建颌骨7例,其他骨瓣1例。共植入种植体247颗。种植固定义齿修复29例,种植体支持的活动义齿修复32例。结果:种植义齿修复完成后平均追踪49个月(6～114个月),种植体脱落6颗。1例患者在修复完成2年后因肿瘤复发死亡(含4颗种植体,不计入存活种植体)。至最后复查,共237颗种植体仍在行使功能,累计5年存活率为95.95%。结论:应用游离髂骨瓣、血管化腓骨瓣重建颌骨的连续性后,植入骨结合种植体,能够有效地重建患者的咀嚼、发音功能,近期效果满意。     

Dental implants in geriatric patients: a retrospective study of 47 cases

PURPOSE: To determine the overall success of dental implants placed in geriatric patients. PATIENTS: Dental implants were placed in 47 geriatric patients who were 79 or more years of age at the time of the procedure. The study group was composed of 27 men and 20 women, with a median age of 89 years and a range of 79 to 99 years of age at the time of implant surgery. A total of 73 dental implants were placed in the maxilla and 87 dental implants placed in the mandible. All implants were restored with fixed implant-supported prostheses or removable implant-supported prostheses. Eleven of the patients underwent maxillary sinus augmentation with porous hydroxyapatite and platelet-rich plasma. Seven patients had their implants immediately loaded. RESULTS: A total of 160 dental implants were placed in the 47 geriatric patients. One hundred fifty-nine integrated successfully. In the case of the failed implant, the site was grafted and another implant was placed 5 months subsequent to the initial failure. This replacement implant integrated and has been in function for 6 months. The survival rate for dental implants placed in the maxilla was 99% and in the mandible was 100% in our geriatric population. CONCLUSION: Treatment with dental implants can be predictable and safe for the rapidly growing geriatric population. Geriatric patients who are medically stable are suitable candidates for osseointegrated implant surgery, which facilitates oral function, comfort, and quality of life. A review of the 47 geriatric patients treated supports the conclusion that dental implants can be successfully placed and restored with fixed implant-supported or removable implant-supported prostheses.     

Implant-supported mandibular telescopic prostheses in oral cancer patients: an up to 9-year retrospective study

PURPOSE: The aim of this retrospective study was to present the results of implant-supported telescopic prostheses in the mandible after removal of malignant tumors. MATERIALS AND METHODS: Between 1991 and 2000, 24 patients with squamous cell carcinoma (16 irradiated, eight nonirradiated) underwent mandibular rehabilitation with implant-supported telescopic prostheses. A total of 111 dental implants were placed. Treatment complications were observed. The cumulative survival rates of the implants and prostheses were evaluated by lifetable analysis. RESULTS: Within a mean follow-up period of 30 months (1 to 108 months), only three implants failed. All other implants are still in function. Of 24 patients, 23 were satisfied with their implant-supported telescopic restorations. Soft tissue, implant, or prosthetic complications occurred very rarely. The cumulative implant survival rate was about 97% and the cumulative prosthesis survival rate was about 95% at 9 years. CONCLUSION: Implants and implant-supported telescopic maxillofacial prostheses can successfully remain in function over a long period. Increased implant and prosthetic complications should not be expected. Therefore, telescopic implant attachments seem to be very useful as a treatment option for prosthetic restoration of the mandible in tumor patients.     

口腔种植修复临床效果十年回顾研究

目的评估骨结合种植体应用10年的临床效果。方法1994年8月至2004年8月在北京大学口腔医学院·口腔医院口腔种植中心植入的骨结合种植体共5590枚,其中Branemark种植体161枚,Frialit-2种植体1436枚,IMZ种植体1012枚,Ankylos种植体767枚,Camlog种植体2189枚,Komet种植体25枚。全部种植体均在2004年8月前完成上部结构修复,其中固定修复2314例,活动修复315例,共计2629例患者。平均追踪77·2个月(7~121个月)。观察方法为X线检查和临床检查,采用Wheeler存留标准评估,纳入Kaplan-Meier存留曲线统计。结果种植修复体完成时2624例患者对修复效果满意,5例患者对修复体不满意,重作后4例表示满意,1例表示可以接受。随访中有105例患者共178枚种植体确诊为种植体周围炎。有明确记录的共68枚种植体脱落。10年随访累计修复体松动21件,修复体折断4件,烤瓷冠崩瓷51件。据Wheeler存留标准统计10年存留率为96·7%。结论种植修复患者的满意度高,本组种植体的10年存留率达到96·7%。     

Retrospective cohort study of the clinical performance of 1-stage dental implants

PURPOSE: To evaluate long-term clinical performance of 1-stage dental implant prostheses at a single clinic, emphasizing clinical and demographic characteristics that affect implant survival. MATERIALS AND METHODS: Dental records of all 308 patients (674 implants) treated with 1-stage implants at Mayo Clinic from October 1993 through May 2000 were reviewed from implant placement to last visit. Exposure and outcome variables affecting performance were collected separately to control bias in the data collection process. Additional confounding factors (age and sex) were adjusted with the stratified Cox proportional hazards model. Implant survival was determined by means of a Kaplan-Meier survival estimate. The log-rank test was used to determine the role of clinical and demographic variables in implant survival. The relative risk associated with the possible effect of clinical and demographic variables on implant survival was estimated with the Cox proportional hazards model. RESULTS: The implant survival rate (n = 654 implants) was 97% (mean +/- SD follow-up, 21.0 +/- 18.8 months; range, 1 to 78 months). Performance bias was limited because nearly all patients were treated by 1 prosthodontist. Two implants failed after loading (6 and 9 months). The incidence of complications was less than 4%. Among the implant failures, use of heterogeneous bone graft was associated with 4.8 times more failures than was use of autogenous bone graft (P = .04). After augmentation, delaying implant placement for 5 to 6 months resulted in 8.6 times more failures than the rate after earlier placement (P < .001). DISCUSSION: Retrospective review of the clinical performance of a 1-stage dental implant system yielded a 97% survival rate, with no failures noted after 13 months. Prosthetic complications were low, especially for fixed implant prostheses. CONCLUSION: Clinical performance of 1-stage dental implant prostheses between 1993 and 2000 demonstrated a high level of predictability.     

Implant treatment of patients with edentulous jaws: a 20-year follow-up

Background: Implant‐supported prostheses are today often used in rehabilitation of partially or totally edentulous patients. Both patients and the dental profession often regard implant treatment as successful in a life perspective. Therefore, studies with a long‐term follow‐up are important. Purpose: The aim was to investigate the outcome of implant treatment with fixed prostheses in edentulous jaws after 20 years, with special reference to survival rate of implants and prostheses and frequency of peri‐implantitis. Materials and Methods: The patient material was a group of patients treated in the early 1980s. The original patient group comprised the first 48 consecutive patients treated with implant‐supported prostheses at Umeå University. All patients were edentulous in one or two jaws. The patients had a mean age at the implant insertion of 54.3 years (range 40–74). At the planning of this study 20 years after treatment, 19 of the 48 patients were found to be deceased. Of the 29 patients still alive, 21 patients with altogether 23 implant‐supported prostheses could be examined clinically and radiographically. All patients were treated ad modum Brånemark® (Nobel Biocare AB, Göteborg, Sweden) with a two‐stage surgical procedure. The implants had a turned surface. Abutment connections were performed 3 to 4 months after fixture insertion in the mandible, and after a minimum of 6 months in the maxilla. The prostheses were fabricated with a framework of gold alloy and acrylic artificial teeth. Results: The 21 patients (with 23 implant prostheses) examined had at the time of treatment got 123 implants (27 in the upper jaw and 96 in the lower jaw) inserted. Only one of these implants had been lost (about 2 years after loading) giving a survival rate of 99.2%. Very small changes occurred in the marginal bone level. Between the 1 and 20‐year examinations, the mean bone loss was 0.53 mm and the mean bone level at the final examination was 2.33 mm below the reference point. Conclusions: This follow‐up over two decades of implant‐supported prostheses demonstrates a very good prognosis for the treatment performed. The frequencies of peri‐implantitis, implant failures, or other complications were very small, and the original treatment concept with a two‐stage surgery and a turned surface of the implants will obviously give very good results.     

Immediate placement and implant loading for expedited patient care: a patient report

This patient report concerns etiologic factors leading to a failed natural dentition, masticatory function, and poor dental esthetics in a 30-year-old woman. The surgical and restorative treatment provided for the patient was designed to address her dental phobia, location of residence, and debilitated oral condition. While the following case report details an example of the clinical success that can be achieved through advances in dental implant treatment, the most satisfying event was not necessarily the procedure itself, but the profound change that the generosity of the osseointegration community has made on the life of a needy individual. Through the active leadership of the Osseointegration Foundation Charitable Grant Program, the patient, whose complex treatment is described here, was able to take advantage of treatment that otherwise would not have been available to her. This complex treatment was enabled by the Osseointegration Foundation and other caring donors.     

引导骨再生膜技术在上颌前牙缺失伴重度骨缺损中的应用

目的：评价引导骨再生技术（GBR）在上颌前牙缺失伴重度骨缺损的种植修复效果。方法：选择30例上颌前牙缺失伴重度骨缺损患者,植入Xive种植体62枚,在骨缺损区植入Bio-Oss骨粉,Bio-Gide膜覆盖,重建牙槽骨的高度和宽度;8-10个月后二期手术,术后6周种植修复。结果：62枚种植的Xive种植体,观察最长48个月,最短12个月,种植体存留率100%。结论：骨再生引导膜技术（GBR）在上颌前牙缺失伴重度骨缺损中的临床应用效果稳定,有效。     

In vivo comparison of force development with various materials of implant-supported prostheses

Summary  The purpose of this study was to measure axial loading, generating bending moments on fibre reinforced composite (FRC) implant prostheses using strain-gauged customized abutment in vivo . Bending moments of conventional implant prosthetic material were also measured and the data were compared with those for FRC. Three unit fixed dental prostheses were made for two dental implant fixtures, which had been functioning properly for more than one year using Tescera^TM ATL^TM, porcelain fused to metal and gold as occlusal material. Three patients participated in this study; two patients had two implants on one side of the mandible and one had two implants on both sides of the mandible. Five sets of fixed dental prostheses were fabricated for each material and these were cemented with Temp-bond^® on strain-gauged customized abutments, which were screwed into the underlying implant fixtures. Axial loadings and bending moments were measured when a patient bit the experimental fixed dental prosthesis. anova and the Tukey HSD test (α = 0·05) were used for statistical analysis. There were no significant differences in normalized bending moments among the three different implant prosthetic materials. Within the limitations of this study, Tescera^TM ATL^TM generated bending moments similar to conventional implant prosthetic materials such as gold and porcelain.     

Evaluating the clinical performance of the Osseotite implant: defining prosthetic predictability

A 5-year prospective, multicenter study is in progress at four private dental practices to determine the cumulative implant survival rate and prosthetic outcome when using the Osseotite dental implant in posterior maxillary and mandibular areas. An interim evaluation after 34.4 months of study progress is presented. A total of 219 Osseotite implants were placed in 74 patients (34 women and 40 men with a mean age of 57.8 +/- 15.2 years) using a conventional two-stage surgical protocol and 3- to 6-month healing time. Subsequently, patients were restored with fixed or removable restorations. Nineteen of the 74 patients reported smoking an average of 13.2 cigarettes per day. Restorative treatments included 40 single-unit restorations; 53 splinted 2-, 3-, 4-, and 5-unit implant-supported maxillary and mandibular prostheses; 4 full-arch fixed maxillary prostheses; 1 mandibular fixed/detachable hybrid prosthesis; and 1 mandibular overdenture. The mean time from implant placement to second stage surgery was 6.2 +/- 2.0 months; from restoration and implant loading to the most recent follow-up evaluation was 20.9 +/- 6.8 months. Of the 219 implants placed, three posterior maxillary implants developed infections and were removed prior to second stage surgery. No implant failures occurred at second stage surgery or after implant loading. Using the Kaplan-Meier method, the cumulative implant survival rate was 100% for anterior implants and 98.4% for posterior implants at 28.5 +/- 5.7 months. The cumulative postloading implant survival rate was 100% for both anterior and posterior implants. The results of this study indicate that the Osseotite dental implant achieved a high rate of integration that remained stable during nearly 2 years of implant function. In addition, because no postloading implant failures have occurred, the Osseotite implant has provided a high level of prosthetic predictability.     

Immediate loading with mini dental implants in the fully edentulous mandible

The use of immediate loaded prostheses is not recommended for at least 2 weeks to prevent implants from premature loading. In addition, immediate removable prostheses are negated for at least 4 weeks at the site of guided bone regeneration or bone graft. However, patients are often not pleased with limited diets and the unaesthetic appearance during the healing period without a denture between implant placement and final prosthesis. Mini dental implants provide stable and esthetic temporary prostheses immediately after implant placement and bone grafts. The use of mini dental implants is simple and cost effective because the patient's old denture is used as a provisional prosthesis. This article shows the success of 27 mini dental implants that were placed for 11 mandibular fully edentulous patients.     

20例上颌无牙颌种植固定修复的临床疗效观察

目的 回顾性分析上颌无牙颌患者行种植固定修复恢复牙列缺失的临床疗效。方法 回顾分析2017年—2020年在南京医科大学附属口腔医院行上颌无牙颌种植固定修复的20例患者，共植入109枚植体，观察比较术后即刻及随访过程中种植体存留率及边缘骨吸收情况；通过OHIP EDENT(Oral Health Impact Profile EDENT)问卷、视觉模拟评分法（VAS）评估牙列缺失修复的临床效果，应用SPSS软件进行描述性统计分析。结果 在随访期间，109枚种植体中有3枚因骨结合失败而被取出，种植体存留率为97.24%。植体周边缘骨吸收（MBL）约0.74 mm/年，OHIP EDENT问卷平均得分为8.00，VAS平均得分为9.15。结论 上颌无牙颌种植固定修复短期临床效果稳定，患者满意度较高。     

Immediately loaded implants supporting fixed prostheses in the edentulous maxilla: a preliminary clinical and radiologic report

PURPOSE: To evaluate the survival rate of immediately loaded ITI sand-blasted, large-grit, acid-etched (SLA) solid-screw dental implants in the edentulous maxilla after 8 months of loading. MATERIALS AND METHODS: Twenty-eight patients (mean age 63 years) with edentulous maxillae each received 6 implants and 1 implant-supported fixed provisional prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patient received a definitive, screw-retained, implant-supported fixed prosthesis. A total of 168 implants were placed. Clinical parameters were registered after 1 month of loading with the implant-supported fixed prostheses as well as 8 months after implant placement. Radiologic examinations and assessments were made at implant placement and after 8 months. RESULTS: The mean marginal bone level at implant placement was 1.6 mm (range 0 to 5.1; SD 1.1) apical of the reference point (the implant shoulder). The mean marginal bone level at the 8-month follow-up was 3.2 mm (range 0.4 to 5.9; SD 1.1) apical of the reference point. Three implants failed during the healing period. DISCUSSION: The improved results in the present study might be a result of the positive effect of splinting the implants immediately after placement. CONCLUSION: ITI SLA solid-screw implants immediately loaded (ie, loaded within 24 hours of placement) and supporting fixed prostheses had successful survival rates after 8 months. The present results constitute a solid baseline for future follow-up studies.     

上颌窦内提升术种植修复上颌后牙缺失的临床观察

目的:评价上颌窦内提升术并同期植入种植体在上颌后牙区缺失修复中的应用效果。方法:2008年至2010年共完成上颌窦内提升术并同期植入种植体临床病例20例。男12例,女8例,年龄18-65岁。术前CT示:牙槽嵴顶至上颌窦底距离为5-8mm,行上颌窦内提升术,平均提升上颌窦底高度3.8mm(2-5mm),共植入38枚种植体,种植体植入6个月后完成义齿修复。结果:所有患者术后未出现上颌窦炎症,一例术中窦膜穿孔,将种植窝放入明胶海绵,同期植入种植体完成种植手术,术后3天术区疼痛,无其他明显症状。38枚种植体平均负载18个月,种植体稳定,行使功能良好,未见明显骨吸收。结论:对于骨高度不足的患者,行上颌窦内提升术,并同期植入种植体的方法可靠,具有好的疗效,可扩大种植牙的适应症范围。     

Cantilever fixed prostheses utilizing dental implants: a 10-year retrospective analysis.

OBJECTIVE: The dental literature has been unclear about long-term success of fixed cantilever prostheses supported by dental implants. The disappointing results reported when cantilever fixed partial dentures (FPDs) are supported with natural teeth are not directly applicable to implant cantilever FPDs. This article reports on 10 years of implant-retained fixed prostheses primarily in the maxillary arch using the ITI dental implant system. METHOD AND MATERIALS: Sixty cantilever prostheses using 115 ITI dental implants on 36 patients were placed and monitored over a 10-year period. RESULTS: No implant fractures, abutment fractures, porcelain fractures, prosthesis fractures, soft tissue recession, or radiographic bone loss were recorded. All 60 cantilevered prostheses remain in satisfactory function. CONCLUSION: Positive, long-term results, using implant-retained cantilever FPDs can be achieved by: (1) using a rough surface implant of 4.1 mm or greater; (2) using an implant/abutment design that reduces stacked moving parts and reduces the implant-to-crowns ratio; and (3) using a cementable prosthesis design that eliminates the need for occlusal screw retention.