The effect of bruxism on periodontal sensation in the molar region: A pilot study

STATEMENT OF PROBLEM: Periodontal sensation in individuals with bruxism may differ from that in nonbruxers, as excessive amounts of occlusal force may be applied to the teeth during the night. However, this concept is not adequately addressed in the literature. PURPOSE: The purpose of this study was to investigate the effects of bruxism on periodontal sensation in the molar region. MATERIAL AND METHODS: Fourteen dental school faculty and students lacking objective or subjective abnormalities of stomatognathic function were divided into 2 groups representing nonbruxers (n=7) and bruxers (n=7). Bruxism was confirmed based on the nocturnal electromyography activities of the masseter muscle. Periodontal sensation was assessed based on interocclusal tactile threshold, which refers to the minimal thickness that can be detected between the occlusal surfaces of the teeth. Interocclusal tactile threshold was measured in the first molar region each for the left and right sides by placing variable thicknesses of metal foil and recording the threshold twice daily (morning and afternoon) on 3 separate days. Multivariate ANOVA was performed for bruxism (with or without) as a between-subjects effect, and time of day (morning and afternoon) and side (left and right) as within-subjects effects (alpha=.05) RESULTS: Multivariate ANOVA revealed no significant differences in interocclusal tactile threshold between morning and afternoon or between the left and right sides in either group. The mean (SD) interocclusal tactile threshold for the bruxers was 17.1 (3.9) microm, while that for the nonbruxers was significantly greater at 29.9(5.6) microm (P<.001). CONCLUSIONS: The periodontal sensation in bruxers was increased compared to nonbruxers.     

牙周炎伴高血压患者在龈上洁治术中血压升高的相关因素分析

目的研究牙周炎伴高血压患者在龈上洁治术中血压升高的相关因素,并进一步分析具体原因。 方法收集2019年1—11月就诊于青岛市口腔医院牙周科门诊,且患有慢性牙周炎伴原发性高血压的初诊患者,均通过清晨自行口服降压药血压控制在收缩压（SBP）159 mmHg或舒张压（DBP）99 mmHg以下患者212例。分析比较患者在超声龈上洁治术前和术中血压的变化,并根据术中较术前血压升高（DBP波动≥4 mmHg）进行分组：血压升高组和血压升高不明显组。分析两组之间血压变化与临床相关因素[性别、年龄、心率（HR）、精神紧张、就诊时间（上/下午）]的关系,并进行多因素Logistic回归分析。 结果牙周炎伴高血压患者超声龈上洁治术中的收缩压和舒张压,心率均显著高于术前[SBP_术中 = （133.1 ± 15.0） mmHg、SBP_术前 = （129.7 ± 13.4） mmHg,DBP_术中 = （87.7 ± 10.9） mmHg、DBP_术前 = （83.6 ± 9.6） mmHg,HR_术中 = （77.4 ± 11.3）次/分钟、HR_术前 = （74.2 ± 9.9）次/分钟],差异均有统计学意义（P<0.05）。通过对血压升高组和血压升高不明显组之间临床资料的比较显示：年龄（t = 2.49,P = 0.013）、精神紧张（χ² = 16.27,P<0.001）、就诊时间（上/下午,χ² = 5.87,P<0.001）差异均有统计学意义,而性别差异无统计学意义（t = 1.78,P = 0.181）。多因素Logistic回归分析结果显示,牙周炎伴高血压患者在超声洁治术过程中,年龄（OR = 1.033,95% CI = 1.001 ~ 1.065）、心率加快（OR = 4.073,95% CI = 2.165 ~ 7.661）、精神紧张（OR = 4.260,95% CI = 2.226 ~ 8.152）、下午就诊（OR = 2.376,95% CI = 1.242 ~ 4.545）均是术中血压升高的相关因素（P<0.05）。 结论牙周炎伴高血压患者超声龈上洁治术中血压升高与年龄、心率、精神紧张、就诊时间（上/下午）密切相关,值得临床重点关注。     

Studies of changes in occlusion after the insertion of complete dentures. Part I*

summary The present study aims to investigate changes in the occlusion of complete dentures after their insertion. A total of 85 edentulous patients were provided with new complete dentures. Their individual hinge axes were determined using mechanical axiography and the upper finished dentures were transferred by facebows to Dentatus® articulators. The lower dentures were mounted according to an intraoral central bearing point (CBP) registration and equilibrated in terminal hinge position. An articulator specially modified for measurements in the condylar area was used. The differences between the positions of the condylar balls with CBP registration and those after equilibrating the occlusion were determined. On average, 19 days after insertion, 71 patients took part in a follow-up examination. As in the first session, the terminal hinge position was registered with the CBP method using the apex of the Gothic arch. Thus, the positions of the condylar balls immediately after the new registration could be compared with those in equilibrated in-tercuspation 3 weeks earlier. The differences were found to be 0–5 ± 0–4 mm (0.2–9 mm) in the three axes (sagittal, coronal and horizontal). They are thought to result from settling into the denture bearing tissues and also from neuromuscular adjustment of the masticatory system. Compulsory remounting of complete dentures after insertion is therefore recommended.     

Implant-retained mandibular overdentures versus conventional dentures: 10 years of care and aftercare

PURPOSE: This 10-year prospective, randomized, clinical trial investigated the treatment outcome of edentulous patients treated with mandibular overdentures retained by 2 endosseous implants compared with conventional dentures in patients with or without vestibuloplasty. MATERIALS AND METHODS: One hundred fifty-one edentulous patients (5 groups) with a symphyseal mandibular bone height between 8 and 25 mm participated. Sixty-two patients were treated with an overdenture retained by 2 implants (groups 1 and 3), 59 patients were treated with a conventional denture (groups 2 and 5), and 30 patients were treated with a conventional denture after preprosthetic vestibuloplasty (group 4). Patients who received conventional dentures but preferred implants later on could undergo implant surgery after 1 year of their initial treatment, but were analyzed in their original group. The prosthetic and surgical care and aftercare were scored during a 10-year evaluation period. RESULTS: One hundred thirty-three patients completed the 10-year follow-up evaluations. Forty-four percent of patients treated with conventional dentures switched within 10 years to implant-retained overdentures, versus 16% of the patients who were treated with conventional dentures after vestibuloplasty. On average, a greater time investment and more treatment sessions were needed in patients treated with implant-retained overdentures compared to patients treated with conventional dentures. CONCLUSION: Patients treated with an implant-retained overdenture need more treatment interventions and treatment time than patients treated with conventional dentures.     

In vivo antiplaque efficacy of combined antimicrobial dentifrice and rinse hygiene regimens

PURPOSE: To evaluate using digital plaque image analysis the antiplaque efficacy of oral care regimens including use of antimicrobial toothpaste in combination with antimicrobial mouthrinse. METHODS: 16 subjects completed the study protocol including: (1) initial treatment phase, all subjects used a standard sodium fluoride dentifrice with 2x/day brushing, (2) second treatment phase, subjects were randomized to two treatment groups: stannous fluoride/sodium hexametaphosphate dentifrice or sodium fluoride triclosan/copolymer dentifrice; (3) third treatment phase, the group using stannous fluoride dentifrice rinsed with alcohol-free cetylpyridinium chloride mouthrinse and the group using triclosan dentifrice rinsed with essential oil mouthrinse. During each phase, plaque levels were assessed in the morning before toothbrushing (AM), post-brushing in the morning (PB) and in the afternoon (PM). RESULTS: Stannous fluoride dentifrice was superior to triclosan dentifrice in plaque growth inhibition between toothbrushing. Both mouthrinses provided additional plaque prevention benefits when used with antimicrobial dentifrices. The cetylpyridinium chloride mouthrinse and stannous fluoride dentifrice regimen was particularly effective, building accretive efficacy over time. Average plaque reductions exceeded 50% vs. sodium fluoride dentifrice alone. Chemotherapeutic dentifrices and rinses increase plaque control used alone and particularly in combination. The stannous fluoride-cetylpyridinium chloride regimen showed the greatest benefits.     

安氏Ⅱ类错(骀)合并下颌后缩青少年吞咽运动研究

目的 通过对安氏Ⅱ类下颌后缩青少年吞咽时肌肉肌电图和下颌运动描记图进行研究,探索下颌后缩对患者吞咽功能的影响.方法 对29名安氏Ⅱ类下颌后缩青少年(安氏Ⅱ类组)与28名安氏Ⅰ类青少年(对照组)进行吞咽时颞肌前束、咬肌、颏肌肌电幅值及下颌运动范围进行测量,对比两组差异.结果 研究所得的计量数据以(中位数M上(Q25),下(Q75)四分位数)表示.1.安氏Ⅱ类组右侧颞肌前束肌电幅值(3.2(1.7,4.4) μV)小于对照组(5.0(2.7,12.9)μV),双侧咬肌肌电幅值(右3.2(2.2,5.7) μV/左3.1(1.9,4.8)μV)小于对照组(右5.6(3.1,9.7)μV/左4.7(2.6,9.8)μV),双侧颏肌肌电幅值(右22.1(15.2,40.1)μV/左21.9(13.1,36.9) μV)大于对照组(右13.7(7.3,20.7)μV/左10.8(7.0,22.8) μV).2.安氏Ⅱ类组吞咽颌位垂直向偏离(1.2(0.3,2.0)mm)大于对照组(0.5(0.2,1.0) mm)、冠状向偏离(0.4(0.2,0.7)mm)大于对照组(0.2(0.1,0.3)mm),矢状向偏离(-0.4(-1.1,0.3)mm)比对照组(0.1(-0.1,0.4)mm)更为偏前.吞咽过程中下颌垂直向位移(1.6(1.1,3.0) mm)大于对照组(1.0(0.5,1.6) mm),冠状向位移(0.3(0.1,0.8) mm)大于对照组(0.1(0.0,0.2) mm),矢状向位移(-0.4(-1.8,0.5)mm)比对照组(0.0(-0.3,0.4)mm)向前更多.结论 相比于安氏Ⅰ类患者,安氏Ⅱ类下颌后缩青少年中异常吞咽及唇功能不全比例更高.     

Soft tissue facial angles in individuals with ectodermal dysplasia: A three-dimensional noninvasive study.

OBJECTIVE: To supply quantitative information about the facial soft tissues of patients with hypohidrotic ectodermal dysplasia. DESIGN: Prospective assessment. SETTING: National meetings of hypohidrotic ectodermal dysplasia patients and families. PATIENTS AND MAIN OUTCOME MEASURES: Facial and mandibular corpus convexities in the horizontal plane; facial convexity in the sagittal plane; interlabial, naso-labial, nasal convexity, and left and right soft tissue gonial angles were calculated from the three-dimensional coordinates of 11 soft tissue facial landmarks obtained in 18 male and 17 female hypohidrotic ectodermal dysplasia patients aged 3 to 41 years and in 504 reference healthy individuals. In addition, z-scores were computed and the patients were grouped by cluster analysis. RESULTS: Male and female z-scores did not differ. In the pooled group, facial convexities in the horizontal and sagittal planes were significantly (Student's t, p < .01) increased (flatter) in hypohidrotic ectodermal dysplasia patients, compared with normal controls. The naso-labial angle was significantly reduced (more acute). Upper and lower facial convexity and mandibular corpus convexity in the horizontal plane deviated less from the norm with increasing age. Facial convexity in the horizontal and sagittal planes, soft tissue gonial angles, and naso-labial and interlabial angles deviated less from the norm with increasing number of teeth present in the mouth. Cluster analysis identified three homogeneous groups, all characterized by a peculiar facial phenotype. Modifications in facial convexity and gonial and interlabial angles differentiated each cluster. CONCLUSIONS: Patients with hypohidrotic ectodermal dysplasia had flatter faces in the horizontal and sagittal planes than normal controls had. Cluster analysis revealed patterned differences in facial phenotype.     

不同材质的义齿基托对修复效果影响的分析

目的：应用复制义齿技术制作不同材质基托,研究义齿基托材料对义齿功能发挥的影响。方法选取符合纳入标准的多数牙缺失的患者,采用复制义齿技术制作不同基托材质(纯钛、钴铬合金和树脂基托)的义齿各10件。分别对3组义齿修复体进行重量等指标的比较观察,评价固位力等初戴效果。结果经过实际测量,在义齿重量方面,上颌的纯钛组与钴铬组有明显差异（P<0.05）。从患者评价方面,初戴时大多数患者感觉纯钛组义齿异物感小,固位好,质轻;金属基托从异物感和语言方面似乎更适应患者的心理要求。结论由于解剖位置和金属材料特性的原因,口腔修复材料选择时需要考虑义齿的修复效果,并不完全取决于材料的密度。     

Occlusal contacts of edentulous patients with mandibular hybrid dentures opposing maxillary complete dentures.

The purpose of this study was to evaluate differences between the occlusal contacts of edentulous patients with mandibular implant-supported hybrid dentures opposing maxillary complete dentures and those of patients with conventional maxillary and mandibular complete dentures. Six parameters related to occlusion were measured in the 2 groups (n = 40 for each group) using pressure-sensitive film. The mean values generated by each test group for each parameter were compared using a t test. Pearson's correlation coefficients between occlusal force, age, and time in function were examined. Occlusal force and area in the implant denture wearers were larger than those in the conventional denture wearers. No significant difference was seen in occlusal force balance between the left and right sides. The center of occlusal load in the implant denture wearers was more anterior. The maxillary denture may become more unstable in implant denture wearers. It is suggested that the stability and retention of a maxillary denture be checked and the occlusion be adjusted more frequently in the hybrid denture wearer than in the conventional denture wearer.     

Adjunctive effects to non-surgical periodontal therapy of systemic metronidazole and amoxycillin alone and combined. A placebo controlled study

BACKGROUND AND AIM: Several studies have reported adjunctive benefits to scaling and root planing (SRP) of systemic amoxycillin and metronidazole in the treatment of periodontal diseases. To date no comparisons have been made of these antimicrobials alone or in combination. The aim of this study was to compare the adjunctive benefits to SRP of amoxycillin and metronidazole alone and combined. METHODS: 66 subjects <46 years of age with advanced chronic periodontal disease participated in this randomised, double blind, 4 parallel treatment group designed study. All subjects received quadrant SRP and then were prescribed amoxycillin capsules (250 mg) and metronidazole tablets (200 mg) (AM) or lactate capsules and metronidazole (PM) or amoxycillin and calcium lactate tablets (AP) or lactate and calcium lactate (PP). All medication was 3 of each per day for 7 days. Subgingival plaque samples were obtained and probing depth (PD), loss of attachment (LOA), bleeding on probing (BOP), suppuration (SUPP) and plaque (DEP) were recorded pre-treatment, 1, 3 and 6 months post-treatment. RESULTS: Final group sizes were: AM=15, PM=16, AP=16 and PP=15. PD improved in all groups. Treatment effects were highly significantly different and always greatest in the AM and least in the PP groups. Benefits of PM and AP over PP were also noted. LOA improved in all groups and showed the same highly significant treatment differences, again favouring AM. BOP improved in all groups, particularly in AM compared to the other groups. SUPP improved in all groups and was virtually eradicated in AM with differences among treatments highly significant. DEP changed little in any group and there were no significant differences among groups. Microbiological data showed significant differences in favour of AM compared to PP and PM for total aerobes and anaerobes at 1 month. P. intermedia counts were always lower in active groups compared to PP and reached significance for AM and AP at 1 month and AM and PM at 3 months. CONCLUSION: The significant differences among treatment groups and the overall trend in the data, in line with other studies, support the considerable adjunctive benefits to SRP of amoxycillin and metronidazole combined in the treatment of advanced chronic periodontal disease.     

Morphological differences in the temporomandibular joints in asymmetrical prognathism patients

OBJECTIVE: To investigate the morphology of the temporomandibular joints (TMJ) in skeletal asymmetry with prognathism. DESIGN: Three-group observational clinical study. SETTING AND SAMPLE POPULATION: University setting. Thirty-five patients undergoing orthognathic surgery without signs and symptoms of TMJ disorder were assigned to three groups (right deviation, n = 11; left deviation, n = 14; and non-deviation; n = 10) based on anteroposterior cephalometric analysis. OUTCOME MEASURE: Positional and morphological differences of the TMJs were evaluated using a total of 70 bilateral sagittal TMJ magnetic resonance images. RESULTS: In both the right and left deviation groups, the TMJ on the deviated side showed a significantly steeper eminence than that on the non-deviated side (p < 0.05). The anterior joint space was narrower on the deviated side than on the non-deviated side whereas the posterior joint space did not differ markedly, indicating an anterior position of the condyle in the glenoid fossa of the TMJ on the deviated side. Disk displacement comparisons revealed no significant differences between left and right sides in the symmetry or asymmetry group. CONCLUSION: Asymmetrical prognathism patients exhibit significant morphological differences between the right and left TMJs concerning the slope of the articular eminence, which correspond to facial asymmetry.     

Patient response to variations in denture technique. Part III: Five-year subjective evaluation.

Dentures were constructed for 64 patients by two different techniques. One technique, designated as "complex," involved more complicated procedures such as a true hinge axis location, balanced occlusion, dentures remounted on an articulator after processing with new interocclusal records, and occlusal corrections made on the articulator. The "standard" technique involved an arbitrary mounting of the maxillary cast on the articulator, arranging the occlusion with centric relation coincident with centric occlusion but without a balanced occlusion, and making occlusal corrections in the mouth. Subjective evaluations were made for each of the 64 patients at initial placement of the dentures and for all active patients at five yearly recall visits following placement. The evaluation method was designed to determine clinical differences between the dentures made by the two techniques. At the end of 5 years, the data obtained at five yearly recall visits were subjected to statistical testing. These tests were performed to determine if the technique by which the dentures were made had any effect on the performance of the dentures that could be detected clinically. The results of the test showed that there was no significant difference between dentures made using two denture techniques that could be detected by subjective means.     

An improved transpalatal bar design. Part I. Comparison of moments and forces delivered by two bar designs for symmetrical molar derotation

Moments and forces delivered during symmetrical derotation of upper molars by 10 Goshgarian-type (GTPB) and 10 Zachrisson-type transpalatal bars (ZTPB) were measured in laboratory experiments using a computer-based strain gauge. The bar passivity in sagittal, transverse, and vertical planes was first assessed at the measurement apparatus. Then each end of the 20 passive bars was symmetrically activated by 10 mm in the sagittal plane using a template. The activated bars were placed into lingual attachments of the measuring apparatus, and three consecutive measurement steps were done for each bar. Measurements were made when the attachments were at 0 degrees, 5 degrees, and 10 degrees of deactivation. The mesiodistal (sagittal) forces, the horizontal forces, and the moments of rotation at the right and left attachments were measured at each step. The horizontal forces and the moments of rotation of the two designs had statistically significant differences. Greater moments of rotation were produced by the GTPB. The ZTPB produced significantly lower contractive horizontal forces than did the GTPB at 5 degrees and 10 degrees of deactivation.     

单侧后牙反者髁突侧向运动轨迹的研究

目的通过记录单侧后牙反者与正常者下颌侧向运动时髁突在三雏方向上的运动轨迹。探讨单侧后牙反者髁交侧向运动轨迹的特征。揭示其与正常之间的差异。方法正常15例,单侧后牙反7例．应用计算机化的髁突运动轨迹描记仅(computer-Aide,Axiography,CADlAX)Ⅰ型以及分析软件(Gamma Dental Sofrware for Windows 2．3．2．22。GDSW)记录下颌做左右侧向运动时髁突在水平面及矢状面上的运动轨迹。结果实验组侧向运动中非工作侧矢状向最大位移量王著小于正常对照组。工作侧髁突向后运动的幅度大于正常对照组。结论单侧后牙反者髁突侧向运动轨迹形态与正常有明显差异。其两侧关节囊、韧带松驰。     

Comparative studies on check-bite and central-bearing-point method for the remounting of complete dentures

summary Thirty-six complete dentures were remounted both with check-bite as well as central-bearing-point (CBP) registration. The mandibular or denture position was registered in the condylar area three times with each method. Two independent operators carried out the registrations. One half of patients had their occlusion equilibrated according to the check-bite registration, the other half in the central-bearing-point position. After individual determination of the hinge axis the upper dentures were mounted by a face-bow transfer into a Dentatus® articulator. A total of six registrations was performed and repeatedly compared in the condylar area in three dimensions using a computer supported measuring device. The reproducibility of the check-bite registration was 0.37 ±0.33 mm, with a maximum of 1.77 mm. For the central-bearing-point method this was 0.29±0.26 mm with a maximum of 1.56 mm. The mean difference in condylar position between both methods was 0.66±0.55 mm with a maximum of 4.02 mm. A third independent operator re-examined 30 of the patients 2–3 weeks after the remounting and evaluated the adaptation to the new dentures. Those patients whose dentures were equilibrated with the central-bearing-point method tended to cope better with their dentures and suffered on average from fewer pressure spots.     

Recording sagittal condylar angles using a mandibular facebow

summary The aim of this study was to determine the average sagittal condylar inclination angles of dentate subjects using a mandibular facebow with pencil tracing styli, to relate these angles to values assigned to articulators, and to assess the repeatability accuracy of drawing a tangent to a traced curve. The right and left sagittal condylar inclination angles of 103 subjects were recorded using a mandibular facebow with pencil tracing styli which marked a graph card during protrusive excursions. Tangents to the tracings were measured with a protractor allowing assessment of reproducibility. The mean left and right sagittal condylar inclination angles were 32° and 31.5°, respectively, with no significant differences ( P =0.609). Individual right and left measurements within each group showed significant differences ( P = 0.0000). The mean of the tangents drawn through three sagittal condylar angle tracings by 10 operators was 33.3°, and the mean of 10 tangents drawn through the same three tracings by one of the authors was 32.9°, with no significant difference ( P = 0.634). The average sagittal condylar inclination angles found in this study are in agreement with those reported in the literature. In fixed sagittal condylar angle articulators 30° appear to be an appropriate setting. The reproducibility of this method of recording sagittal condylar inclination angles was found to be accurate for the individual operator and between operators.     

牙科放大镜在金瓷冠唇侧龈边缘适合性研究中的应用

目的：本研究旨在探讨牙科放大镜辅助临床牙体预备后对金瓷冠唇侧龈边缘适合性的影响。方法：随机选择20位待拔除双侧上颌第一前磨牙的正畸患者共40颗牙分成两组。实验组：配戴牙科放大镜预备右侧上颌第一前磨牙;对照组：常规预备左侧上颌第一前磨牙。硅胶取模后拔除并保存、制作金瓷冠、在离体牙上试戴、粘固、沿牙体长轴片切。在光学体式显微镜和扫描电镜下测量唇侧龈边缘差异值后统计学分析。结果：实验组金瓷冠唇侧垂直边缘差异值和绝对边缘差异值明显小于对照组,有显著性差异（P〈0.01）。实验组金瓷冠唇侧水平边缘差异值与对照组比较,无显著性差异（P〉0.05）。结论：牙科放大镜辅助临床牙体预备对提高金瓷冠唇侧龈边缘适合性是有效的。     

Dynamic study of miniplates by finite element method

Three-dimensional analysis by means of the finite element method was made of displacement and principal stress at various parts of plates and bone fragments. The plates were 4 Champy, AO, Luhr, Steinh?user 4-hole, short miniplates (Plates 1,2,3, and 4) and Plate 5, which was the same as the others except that it was made of titanium. To all of these plates loads were applied in the directions of the Y and Z axes on the free(right)ends. The plates were fixed in place by means of screw holes 1 and 2 in the left ends. In addition, various kind of osteosynthesis were performed on 2 bone fragments with Plate 1. The left ends of these fragments were fixed in place, and loads were applied to the free(right)ends in the Y and Z axes. 1) When load was applied in the direction of the Y axis, displacements along the Y and X axes were greatest in the case of Plate 5 and next greatest in Plate 1. Displacement along the Z axis was greatest in Plate 3 and next greatest in Plate 5. Displacement along the X axis was least in Plate 3 and displacement along Y and Z axes were least in Plate 4. 2) When load was applied in the direction of the Z axis, displacements along the all axes were greatest in Plate 5, next greatest in Plate 1, and least in Plate 4. 3) In all plates, when load was applied in the direction of the Y axis, maximum principal stresses occured above the region between screw holes 2 and 3. Minimum principal stress, however, concentrated below the area between screw holes 2 and 3 in all models. 4) In all plate models, when loads was applied in the direction of the Z axis, maximum principal stresses concentrated in the outer central part of each plate in the region between the vicinity of the right edge of screw hole 2 and the vicinity of the left edge of screw hole 3. Minimum principal stress, on the outer hand, concentrated in the inner middle region of the plate in a zone corresponding to that in which maximum principal stress concentrated.(ABSTRACT TRUNCATED AT 400 WORDS)     

Provisional implants for immediate restoration of partially edentulous jaws: a clinical study

PURPOSE: The aim of this study was to evaluate the use of provisional implants, which can provide patients with provisional fixed partial dentures during the healing time of augmentation procedures and/or during the osseointegration period of definitive implants until delivery of the definitive prosthesis. MATERIALS AND METHODS: Thirty-one patients were consecutively included in the study. Eighteen patients (group A, primary simultaneous group) were initially treated simultaneously with provisional and definitive implants and provided with 18 interim fixed partial dentures. Thirteen patients (group B) received provisional implants in a staggered procedure. In the first stage of group B patients (augmentation phase), provisional implants were placed to bridge the augmentation phase and for anchoring 13 interim fixed partial dentures. In the second stage (secondary simultaneous group), patients of group B received provisional implants to bridge the osseointegration phase for simultaneously placed definitive implants by further use of 13 interim fixed partial dentures. All patients were followed from provisional implant and definitive implant placement to delivery of the definitive prosthesis. Loss of provisional implants and interim fixed partial dentures was noted, and stability of provisional implants was evaluated using the Periotest device. The procedures of immediate rehabilitation with fixed partial dentures using provisional implants were subjectively rated by patients with regard to satisfaction, treatment period, and acceptance. RESULTS: In 31 patients, 44 provisional fixed partial dentures were supported by 98 provisional implants. No provisional implant loss in group A or group B-second stage was observed. Only 3 (3%) provisional implants were lost in group B-first stage during the augmentation phase. Incidence (90.8% versus 9.2%) and stability (Periotest values: 8.6 +/- 3.9 versus 4.8 +/- 2.7) of provisional implants differed significantly between maxilla and mandible (P < .01). All interim fixed partial dentures (n = 44) remained in place for the intended time period but in 3 cases with provisional implant loss they were shortened. No definitive implant loss (n = 94, survival: 100%) and especially no implant loss in cases of maxillary sinus augmentation was seen. The items rated showed high satisfaction and good acceptance of the intensive surgical and prosthodontic program. CONCLUSION: This clinical review showed that (1) provisional implants can successfully provide patients with a fixed partial denture for immediate rehabilitation to bridge the osseointegration or augmentation phase, even in cases with an initially compromised bone situation and (2) although treatment is elaborate, the selected patients decided on a fixed interim rehabilitation with provisional implants rather than on a removable solution.