Immediate Postextractive Dental Implant Placement with Immediate Loading on Four Implants for Mandibular‐Full‐Arch Rehabilitation: A Retrospective Analysis

Background: To date, only few studies have reported on the clinical outcomes of immediate postextraction implant placement and immediate loading. Purpose: The purpose of this retrospective study was to report the results of immediately loading four implants placed in fresh extraction sockets in the mandible after a follow‐up of 24 months. Materials and Methods: Between January 2001 and January 2009, 50 patients (28 women and 22 men, average age 54 years), had 347 teeth extracted and a total of 200 dental implants placed in the mandible. The patients received a provisional fixed bridge the same day and a permanent one 3 months later. Clinical checkups were performed after 1, 2, 3, 6, 12, and 24 months. Marginal bone measurements were made in intraoral radiographs taken 1 day after surgery and after 1 year. A questionnaire was used to evaluate self‐perceived factors related to comfort, aesthetics, and function. Results: All bridges were stable and no implant failures were recorded during the follow‐up, giving a survival rate of 100%, at 2 years. The marginal bone loss amounted to 1.33 ± 0.36 mm after 1 year and 1.48 ± 0.39 mm after 2 years. Ten patients showed prosthetic complications with the provisional bridge, but all the definitive prostheses remained stable throughout the study period without any complications. The patients reported satisfaction with the treatment. Conclusions: The present retrospective study showed that immediate loading of four implants immediately placed in extraction sockets is a valid treatment modality for the totally edentulous mandible.     

全牙列缺失口腔种植的即刻修复

为保证种植体初期稳定性,形成良好的骨整合,通常需在种植体植入后3～6个月再延期修复近年来,越来越多的文献报道了全牙列缺失即刻修复的病例,且取得了良好的临床效果。但是,对全牙列缺失的即刻修复尚存一些争议。本文在回顾近年文献的同时结合本课题组的研究结果,对上下颌牙列缺失即刻修复进行评估,并提出相关论点。     

部分牙缺失种植即刻功能负荷的临床探讨

目的:对部分牙缺失种植即刻功能负荷进行临床探讨。方法:将NobelBiocare种植体植入颌骨内,种植体植入扭力必须达到35Ncm以上。选择永久基台接在种植体上,用一定的扭力拧紧基台,基台水平印模,按常规制作和即刻戴上临时塑料修复体。6周后再印模,制作和戴上烤瓷修复体。结果:36例65枚种植体中,下颌22例41枚种植体,上颌14例24枚种植体,修复后成功率为98.5%。结论:部分牙缺失种植即刻功能负荷初步临床结果是满意的,其长期效果有待进一步的观察。     

Transition from Failing Dentition to Full‐Arch Fixed Implant‐Supported Prosthesis with a Staged Approach Using Removable Partial Dentures: A Case Series

The present retrospective case series is aimed at evaluating a staged approach using a removable partial denture (RPD) as an interim prosthesis in treatment to correct a failing dentition until such time as a full‐arch fixed implant‐supported prosthesis may be inserted. Eight patients, who had undergone maxillary full‐arch rehabilitation with dental implants due to poor prognosis of their dentitions, were analyzed. All treatment included initial periodontal therapy and a strategic order of extraction of hopeless teeth. An RPD supported by selected teeth rehabilitated the compromised arch during implant osseointegration. These remaining teeth were extracted prior to definitive prosthesis delivery. Advantages and drawbacks of this technique were also recorded for the cases presented. Among the advantages provided by the staged approach are simplicity of fabrication, low cost, and ease of insertion. Additionally, RPD tooth support prevented contact between the interim prosthesis and healing abutments, promoting implant osseointegration. The main drawbacks were interference with speech and limited esthetic results. Implant survival rate was 100% within a follow‐up of at least 1 year. The use of RPDs as interim prostheses allowed for the accomplishment of the analyzed rehabilitation treatments. It is a simple treatment alternative for patients with a low smile line.     

A Novel Approach for Converting a Mandibular Complete Denture to a Fixed Interim,Screw‐Retained Implant Prostheses: A Case Report

For most of the last century, conventional complete dentures have been the standard of care and the most common treatment for edentulous patients. Technological advancements in fabrication techniques may significantly reduce the number of office visits required to fabricate complete dentures. Immediate occlusal loading with mandibular full arch prostheses has been extensively researched and is now one of the standards of care for edentulous patients. A clinical technique for converting a mandibular immediate complete denture to an interim full arch, screw‐retained fixed prosthesis with novel implant restorative components for immediate loading on four implants is described.     

Full Arch Restoration with Computer-Assisted Implant Surgery and Immediate Loading in Edentulous Ridges with Dental Fresh Extraction Sockets. One Year Results of 10 Consecutively Treated Patients

There is a growing need for patients to be rehabilitated with a fixed, implant-supported prosthesis immediately after surgery. The present study aims to describe the results of a modified prosthetic and surgical protocol of computer-assisted implant insertion and immediate loading in edentulous jaws with extraction sockets. Ten patients were consecutively treated with a modified computer assisted implant surgery protocol and screw-retained provisional metal-acrylic prosthesis prepared ahead of surgery and delivered immediately. Overall, 60 implants (Nobel Replace Tapered Groovy) were inserted, of which 22 were inserted in fresh extraction sockets. Definitive prosthesis was delivered after 6–12 months. Outcome measures were radiographic marginal bone-level changes, survival of implants, and patient satisfaction. The follow-up period was of at least 12 months. All the patients felt comfortable and none withdrew from the study. No implants were lost, resulting in a cumulative survival rate of 100 %. Radiological estimation showed a mean peri-implant marginal bone loss of 1.4 ± 0.3 mm. No other complications, biological or mechanical, were recorded. In all cases, patients appeared to be very satisfied with the aesthetic and function. Within the limitations of this study, our data seem to validate this surgical and prosthetic protocol with valid functional and aesthetic results when applied in selected cases.     

Retrieval Technique for Full‐Arch Implant‐Supported Fixed Prosthesis: A Clinical Report

In the event of the loss of an implant and to take advantage of the preexisting structures, a rescue procedure that allows continuous use of the original fixed restoration during the restoration of the tripod support at the implant level can be used. When nonphysiological occlusion forces are avoided, the success rate of this rescue procedure is very similar to any other rehabilitation made following a conventional protocol. Furthermore, the fact that the patient has already adapted to the prosthesis position and its vertical dimension results in easier functional adaptation in the postoperative period and, consequently, greater comfort.     

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.     

Immediate Occlusal Loading of Osseotite® Implants in Mandibular Edentulous Patients: A Prospective Observational Report with 18-Month Data

PURPOSE: To evaluate the efficacy of treatment consisting of placement and immediate occlusal loading of implants in 27 patients with edentulous mandibles. MATERIALS AND METHODS: Twenty-seven patients were treated in two private practice settings. One hundred fifty-one implants were placed and immediately occlusally loaded with fixed implant prostheses (15 cement-retained, 12 screw-retained) on the day of implant placement. The implant-retained prostheses were inserted within 5 hours of implant placement. Patients were followed for at least 18 months. The required criteria for immediate occlusal loading was primary implant stability of at least 30 Ncm of insertion torque. The implant prostheses were removed at least 12 months post-placement and the implants were evaluated for primary clinical stability and radiographic bone apposition to implants. RESULTS: At the 12-month follow-up appointments, cumulative survival rates of 98.0% and 100% were recorded for implants and prostheses, respectively. Three implants failed within 3 months. All other implants were clinically successful. CONCLUSIONS: Immediate occlusal loading of multiple, splinted mandibular implants is an effective treatment when implants are stable at insertion and are rigidly splinted with implant-retained prostheses.     

Immediate Loading of Mandibular Overdentures Supported by One‐Piece,Direct Metal Laser Sintering Mini‐Implants: A Short‐Term Prospective Clinical Study

Background: Only a few studies have dealt with immediately loaded, unsplinted mini‐implants supporting ball attachment–retained mandibular overdentures (ODs). The aim of this study is to evaluate treatment outcomes of ball attachment–retained mandibular ODs supported by one‐piece, unsplinted, immediately loaded, direct metal laser sintering (DMLS) mini‐implants. Methods: Over a 4‐year period (2009 to 2012), all patients referred to the Dental Clinic, University of Varese, and to a private practice for treatment with mandibular ODs were considered for inclusion in this study. Each patient received three or four DMLS mini‐implants. Immediately after implant placement, a mandibular OD was connected to the implants. At each annual follow‐up session, clinical and radiographic parameters were assessed, including the following outcome measures: 1) implant failures; 2) peri‐implant marginal bone loss; and 3) complications. Statistical analysis was conducted using a life‐table analysis. Results: A total of 231 one‐piece DMLS mini‐implants were inserted in 62 patients. After 4 years of loading, six implants failed, giving an overall cumulative survival rate of 96.9%. The mean distance between the implant shoulder and the first visible bone‐to‐implant contact was 0.38 ± 0.25 and 0.62 ± 0.20 mm at the 1‐ and 4‐year follow‐up examinations, respectively. An incidence of 6.0% of biologic complications was reported; prosthetic complications were more frequent (12.9%). Conclusions: Within the limits of this study, it can be concluded that the immediate loading of one‐piece, unsplinted, DMLS titanium mini‐implants by means of ball attachment–supported mandibular ODs is a successful treatment procedure. Long‐term follow‐up studies are needed to confirm these results.