Treatment of Hemi‐Mandibulectomy Defect with Implant‐Supported Telescopic Removable Prosthesis. A Clinical Report

Excision of head and neck tumors (benign or malignant) often leads to large segmental resections of the mandible. The following clinical report describes the oral rehabilitation of a 60‐year‐old Caucasian man after partial mandibulectomy due to primary oral leiomyosarcoma. Treatment consisted of a free fibula flap and an implant‐supported telescopic removable prosthesis.     

Long‐Term Follow‐Up of CeraOne™ Single‐Implant Restorations: An 18‐Year Follow‐Up Study Based on a Prospective Patient Cohort

Background: Knowledge on long‐term clinical performance of more than 5 years on the single‐implant CeraOne? (Nobel Biocare AB, Gothenburg, Sweden) concept is limited. Purpose: The aim of this study is to report the long‐term clinical performance of the first CeraOne single‐implant restorations, installed 17 to 19 years ago. Materials and Methods: The group comprised 57 patients provided with 65 CeraOne single‐tooth restorations. Sixty‐two all‐ceramic and three metal‐ceramic crowns were cemented between 1989 and 1991. Patients were followed up clinically and with intraoral radiographs at placement, after 1, 5, and between 17 and 19 years after placement. Results: Data were available for altogether 48 patients, followed up on an average time of 18 years. Excluding deceased patients (n = 2) and failed implant patients (n = 2), only five patients were lost to follow‐up (8.8%). Two implants failed, resulting in an 18‐year implant cumulative success rate (CSR) of 96.8%, and altogether eight original single‐crown restorations were replaced (CSR 83.8%). The most common reason for crown replacement was infra‐position of the implant crown (n = 3). Many of the remaining original crowns showed various signs of implant crown infraposition at the termination of the study. In general, the soft tissue at the restorations was assessed to be healthy and comparable with the gingiva at the adjacent natural teeth. Bone levels were on an average stable with only few patients exhibiting bone loss of more than 2 mm during 18 years in function. Conclusion: This long‐term follow‐up study of single‐implant restorations shows encouraging results with few implant failures and minimal bone loss over an 18‐year period. Original single‐crown restorations were replaced more frequently, because of, for example, implant crown infraposition and veneer fractures. The CeraOne concept proved to be a highly predictable and safe prosthodontic treatment.     

A 30‐Year Follow‐Up of a Patient with Mandibular Complete‐Arch Fixed Implant‐Supported Prosthesis on 4 Implants: A Clinical Report

Mandibular complete‐arch fixed implant‐supported prostheses are recognized as one of the earliest and most popular prostheses in implant dentistry. This prosthesis was the main focus in the early era of osseointegration. Despite its widespread popularity, few clinical reports have described long‐term follow‐up greater than 10 years for this type of prosthesis. This report describes a 30‐year follow‐up of a patient who underwent treatment for a mandibular complete‐arch fixed implant‐supported prosthesis with 4 machined surfaced implants, opposing a maxillary complete denture. This report documents a variety of photographs and radiographs taken over a period of 30 years to compare bone levels at various stages of care and maintenance, including de novo bone formation underneath the distal cantilevers due to functional loading. The biologic and biomechanical response to this treatment protocol and long‐term clinical observations and prosthodontic outcome and maintenance needs are also addressed.     

Three Tumor Patients with Total Maxillectomy Rehabilitated with Implant‐Supported Frameworks and Maxillary Obturators: A Follow‐Up Report

Background: Few reports are available on treatment using implant‐supported frameworks with maxillary obturators after total maxillectomy on tumor patients. Purpose: To describe, evaluate, and report the clinical and radiographic performance of implant‐supported frameworks and maxillary obturators after maxillectomy during the first years of function. Materials and Methods: Three patients with cancer in the maxillary region treated by total maxillectomy were rehabilitated. Seventeen dental and two craniofacial implants were installed, and the patients each received implant‐supported, screw‐retained, three‐unit frameworks with a U‐shaped bar and obturators retained by four magnetic attachments. Clinical and radiographic data were collected up to 7 years of follow‐up. Results: The frequency of complications was low. Two craniofacial implants and one dental implant were loose and removed at abutment connection. No implants were lost after framework connection, and the mean marginal bone loss was small. Conclusion: Within the limitations of this report, dental implants are useful for rehabilitation of total maxillectomy patients, and a three‐unit, screw‐retained, implant‐supported framework with maxillary obturator retained by magnetic attachment is a successful treatment concept for this patient group.     

Management of a Fractured Multiunit Maxillary Implant‐Supported Fixed Prosthesis with Stripped Abutment Screws Using a Hybrid Cement‐Retained and Screw‐Retained Design: A 5‐Year Follow‐Up Clinical Report

Fracture and loosening of implant‐supported prostheses (ISPs) are complications encountered in routine dental practice. In the present report, management of a fractured maxillary full‐arch cement‐retained (CR) fixed dental prosthesis supported by six implants is presented. Due to stripped screws, complications were encountered that prevented the retrieval of two of the six abutment screws, which was managed by using a hybrid retention approach, whereby a single full‐arch CR and screw‐retained (SR) ISP was used. The techniques used to successfully retrieve four of the abutment screws are described. The final retention design involved a combination of three CR and three SR restorations, which offers the advantages of both retention designs.