Restoring soft and hard dental tissues using a removable implant prosthesis with digital imaging for optimum dental esthetics: a clinical report

Currently, most dental implants are placed in the esthetic zone with a delayed surgical protocol. This delay can result in loss of both soft and hard oral tissues following the healing period, necessitating guided tissue regeneration, distraction osteogenesis, or bone expansion and grafting procedures either prior to or at the time of implant placement. If a delayed placement protocol is used, or if grafting procedures are ineffectual, the prosthetic phase of implant dentistry must restore the missing structures artistically and functionally to integrate with the patient's existing dentition. This article presents the option of using a removable implant prosthesis for an esthetic anterior restoration of soft and hard tissues. A computer-assisted camera was used to record speaking, smiling, and active facial positions, with digital imaging to achieve realism for tooth position during the prosthetic phase. The captured patient images with the esthetic setups were transmitted by e-mail for direct viewing by both dentist and dental technician prior to case completion. These images were viewed as reference files during laboratory construction of the prosthesis to achieve the desired esthetic and functional results.     

Computer-guided implant planning using a preexisting removable partial dental prosthesis

Converting a conventional removable partial dental prosthesis (RPDP) into an implant-assisted removable partial dental prosthesis (IARPDP) may be facilitated by using data from the intaglio surface of the RPDP for proper implant placement. This procedure can be done by connecting the data from the intaglio surface of the RPDP to the residual ridge data of the cone beam computed tomography scan with implant planning software. However, although a misplaced implant under an RPDP can cause various complications, as yet, no technique has connected the information on a patient’s existing RPDP to the implant planning software. This article presents computer-guided implant planning, using a patient’s existing RPDP.     

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天然牙联合种植体支持可摘局部义齿修复多数牙缺失,可以解决KennedyⅠ、Ⅱ类牙列缺损（特别是有多数牙齿的缺失）情况下,可摘局部义齿在固位、稳定、支持方面存在的问题。同时,这类修复方法也可作为由于患者骨组织或经济原因不能行固定种植义齿修复的一个很好的选择。然而,有关这类修复的基础研究与临床报道比较少,且仍缺乏系统性。本文从生物力学及临床设计须注意的问题两个方面对此进行初步的阐述。     

Rehabilitation of a missing ear with an implant retained auricular prosthesis

Burns can leave a patient with a severely debilitating disability even after treatment. The objectives of burn rehabilitation are to minimize the adverse effects caused by the injury while rehabilitating the patient''s physical and psychological well-being, maximizing social integration. Long-term success of maxillofacial prostheses mainly depends on the retention. Extra oral implant retained prostheses have proved to be a predictable treatment option for maxillofacial rehabilitation. Replacement of a severely deformed external ear with burned tissues may be satisfactorily accomplished by a cosmetic prosthesis anchored by implants integrated in the skull. The use of such implants is now a well-recognized method for creating a stable result in maxillofacial rehabilitation. This case report describes a safe, simple and economical method for the rehabilitation of a patient with missing right auricle using an implant supported silicone prosthesis. The implant was placed in the mastoid region of the temporal bone. Reconstruction of the ear was done with auricular silicone prosthesis, retained using magnets incorporated in an autopolymerizing resin shim to decrease the weight of the prosthesis on a single implant. This method eliminates the need of tedious laboratory procedures and exact casting and fitting requirements of a metal substructure while minimizing the overall weight and cost of the prosthesis while maintaining adequate support, esthetics and retention of the prosthesis.     

Conversion of a partial removable dental prosthesis from Kennedy class II to class III using a dental implant and semiprecision attachments

This article presents a design to convert a partial removable dental prosthesis (PRDP) from Kennedy class II to class III using a dental implant. Incorporating semiprecision attachments, this design provides desired esthetics, phonetics, and function.     

The use of lipiodol in spiral tomography for dental implant imaging

Preoperative radiographic assessment is mandatory for the meticulous treatment planning and successful placement of implants. The precise topographical evaluation of selected implant sites, apart from the most straightforward cases, requires tomographic examination with the use of diagnostic radiographic templates. The incorporation of various radiopaque materials such as barium sulphate and lead foil as radiographic markers had not been entirely satisfactory. A new contrast medium, Lipiodol ethiodized oil (Laboratoire Guerbet, Paris, France), can easily be mixed with the monomer of autopolymerizing acrylic resin. The resultant acrylic template has several advantages. The tomographic images (Scanora; Soredex Orion Corporation, Helsinki, Finland) are radiographically homogenous and show the contour of the future prosthesis, the angulation of the planned implant, and the thickness of the soft tissue. In addition, the radiopaque template is optically transparent (with a slight yellow tint), which facilitates good visibility of surgical sites when the template is modified to become the surgical guide for implant placement. This transparent template can be further modified for implant position registration at the time of surgery. Because this multipurpose template is simple to construct and inexpensive, it can be recommended for routine use in implant dentistry.     

可摘式美学牙龈修复体在上颌前份种植义齿中的应用

目的 介绍一种改善上颌前份种植义齿美学效果的新方法。方法 54例上颌前牙缺失的患者接受了种植义齿修复后，其中的8例患者存在有基台外露，义齿牙冠过长和牙间楔状间隙显著等影响美观的临床表现，作者利用丙烯酸树脂制作精确吸附固位的可摘式人工牙龈修复体来恢复种植义齿的牙冠及牙周组织的解剖学形态。结果 经过2年的随访观察，未见牙龈退缩与种植体周围炎的发生，人工牙龈修复体理想地纠正了上述患者种植义齿的美学缺陷。结论 本方法简单，经济，实用，可有效地增强上颌前份种植义齿修复后的美学与功能。     

Development of gingival esthetics in the edentulous patient prior to dental implant placement using a flangeless removable prosthesis: a case report

Development of gingival contours found in healthy natural dentitions enhances the esthetic results achieved with implant-supported fixed prostheses. However, this endeavor is frequently difficult to achieve, especially in the completely edentulous patient. Edentulous patients with optimal hard and soft tissue can be treated with a specially designed removable prosthesis that will develop gingival contours prior to implant placement. By means of a transitional complete removable prosthesis with ovate pontics and no labial flange, a natural-looking soft tissue profile can be developed prior to dental implant placement. A minimally invasive tissue punch surgical technique is used to place the implants, which are immediately restored with a 1-piece, cross-arch, provisional fixed prosthesis. This article presents the prosthodontic and surgical protocols utilized to improve the appearance of the definitive implant rehabilitation.     

牙周炎患者种植义齿修复的几点思考

牙周病是牙齿缺失的主要原因之一,严重影响患者的生活质量。受余留牙条件的限制,常规修复很难达到理想的修复效果,近年来种植修复为其提供了更为安全有效的修复方案。然而,天然牙的牙周致病菌亦会对种植体周围组织产生破坏作用,增加种植失败的风险。因此,除对牙周病患者进行系统完善的治疗外,选择合适的种植修复方案和保证长期的牙周及种植体维护更是提高种植修复长期成功率的关键因素。本文将就其相关问题进行讨论。     

Provisionalization for a single cementable dental implant restoration

This article presents a procedure for refining margins of provisional implant crowns. This procedure uses an analog of the implant and abutment. This procedure allows functional and esthetic considerations such as emergence profiles, symmetry, diastemas, embrasures, size, contours, position, angulation, and relation to other teeth to be evaluated.     

The role of the dental technician in fabricating the single-stage implant prosthesis

With the initiation of the concept of osseointegration, the use of dental implants has become a predictable and frequently used addition to comprehensive planning and treatment of edentulous patients. Implantology poses challenges for the dental laboratory not present in any other existing specialty. Single-stage implant surgery represents such an innovation.     

个别前牙缺失改良可摘义齿修复

常规的可摘局部义齿修复，有时因个别前牙缺失，也要戴一块大基托在舌(腭)侧，这样就造成了患者异物感很强，部分患者甚至难以适应。近6年来，笔者采用改良可摘义齿修复个别前牙缺失，收到了良好的效果。     

激光辅助凝血在美学区种植修复中的应用

目的探讨上前牙美学区域种植修复中激光辅助凝血的临床应用及疗效。 方法2011年12月至2014年10月,收治上前牙美学区域牙位缺失患者24例,埋植式植入种植体5个月后接受二期手术,随机分为激光照射组（12例）和非照射组（12例）。照射组采用激光辅助凝血,非照射组采用常规缝合止血。术后印模制作及佩戴临时冠,1~ 3个月后制作终义齿,临床观察6~ 34个月。记录制取印模、终义齿时间,用红色美学指数（PES）计分标准进行计分,并对患者满意度进行调查。 结果24例均成功完成种植义齿修复,激光照射组制作终义齿时间为（10.25 ± 1.14）d,非照射组制作终义齿时间为（26.08 ± 3.55）d,差异具有统计学意义（t=-13.871,P= 0.000）。照射组PES得分最高14分,最低7分,中位数为12.5;非照射组PES得分最高11分,最低7分,中位数为7.0;差异具有统计学意义（Z= 3.341,P= 0.001）。 结论激光辅助凝血促进种植体周围软组织修复,缩短临时及永久修复时间,美学区域行种植修复能够获得良好的临床效果。