Cases reported "Jaw, Edentulous"

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1/54. New ways of designing suprastructures for fixed implant-supported prostheses.

    The replacement of lost teeth and tooth-bearing tissues with implant-supported prostheses often forced both dentist and technician to choose removable overdentures because they were the only treatment modality possible. By means of a clinical case, this article demonstrates a new approach in framework design that not only expands the limitations of conventional ceramometal implant prostheses, but also eliminates a great number of the hazards that cause implant failure with a new type of suprastructure. The technique enables both the clinician and the technician to apply all of the esthetic possibilities of tooth-supported metal ceramic crown and bridge techniques. This technique combines screw and cementation retention without changing the original treatment protocol. A new casting technique introduced by Sonntag and a new specially developed alloy was used. Essentially, the reconstructive body has been broken down into a screw-retained soft tissue/bone-replacing part using a one-piece casting technique, and a crown-replacing part to be provisionally cemented with a large variety of new possibilities.
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ranking = 1
keywords = bone
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2/54. Use of crestal bone for augmentation of extremely knife-edged alveolar ridges prior to implant placement: report of 3 cases.

    A technique is presented for interforaminal lateral augmentation of mandibles with adequate bone height, but extremely knife-edged mandibular alveolar ridges (Class IV of Cawood and Howell's classification of residual ridges), in which the crestal portion of the knife-edged ridge is used as grafting material. Following an osteotomy and rotation of the grafts by 180 degrees, the grafts were fixed to the residual ridge below the osteotomy line by means of miniscrews. All grafts showed only mild resorption after a healing period of 3 months, and it was possible to place 4 implants in the now sufficiently wide host region.
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ranking = 5
keywords = bone
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3/54. Treatment of a patient with severe osteoporosis and chronic polyarthritis with fixed implant-supported prosthesis: a case report.

    This article reports the treatment and 5-year follow-up of an 80-year-old female with a history of severe osteoporosis and chronic polyarthritis. Treatment included methotrixate disodium and acemetacin. After the last tooth was removed from the mandible, the patient was successfully treated with a fixed mandibular prosthesis supported by 6 implants placed between the mental foramina. The implants have remained osseointegrated, and peri-implant smears have been negative for bacterial colonization. Radiographic follow-up examination has revealed bone loss that is slightly greater than expected. This article focuses on the placement of implants in a patient receiving medication for chronic polyarthritis and osteoporosis.
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ranking = 1
keywords = bone
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4/54. Three-dimensional CT scan analysis for implant-supported fixed prostheses.

    Rapid technological advances in dental implantology, computer imaging, and dental radiography in combination with traditional prosthetic concepts offer today's clinicians unprecedented possibilities in diagnosis and treatment planning. This article presents information on the use of three-dimensional computed tomography scan analysis to determine the quality (density), quantity, and location of bone to establish the most effective implant placement. In addition, this article analyzes the correlation of prosthodontic, periodontic, and technological concepts necessary for completion of a maxillary and mandibular fixed, full-mouth rehabilitation.
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ranking = 1
keywords = bone
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5/54. Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible.

    mandibular fractures can occur with the insertion of endosseous implants. Four patients whose mandibles were fractured with the removal or insertion of mandibular endosseous implants are described. Three of the patients required an autogenous bone graft to repair the fracture, and 1 patient was managed with a reconstruction plate. Strategies for prevention and treatment of this uncommon complication are discussed.
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ranking = 1
keywords = bone
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6/54. Fixed implant rehabilitation of the edentulous maxilla: clinical guidelines and case reports. Part II.

    Fixed prosthetic implant reconstruction of the edentulous maxilla demands skill and state-of-the-art techniques of both the surgeon and the restorative dentist. As discussed in Part I (Implant Dent. 1999;8: 186-193), accurate diagnosis and treatment planning are essential to successful, predictable clinical results. How and where implants are placed have a lasting impact on the quality and prognosis of the final restoration. A series of clinical guidelines and considerations is reviewed with illustrative clinical treatment protocols of edentulous maxillae of unfavorable anatomy including attendant prosthetic difficulties. This article addresses the fixed implant rehabilitation of edentulous maxillas with inadequate posterior bone and favorable arch position, inadequate posterior bone and unfavorable arch position, and inadequate anterior and posterior bone and unfavorable arch position.
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ranking = 3
keywords = bone
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7/54. Reconstruction of severely resorbed atrophic maxillae and management with transitional implants.

    The reconstruction of the severely resorbed maxilla requires complex surgical treatment sequencing. Often, multiple grafting procedures are required either before or in conjunction with implant placement. Regardless of the surgical modality, the grafting procedures and the placement of implants in poor quality bone require undisturbed healing during which no pressure is placed on the grafted implant ridge. The use of transitional implants allows the surgeon to provide stable temporary prostheses throughout the healing phase, while preventing pressure from being placed on the grafted or implant reconstructed ridge throughout the maturation. These transitional implant-supported temporaries allow the implant team to maintain vertical dimension, and they provide the patient with the benefits of implant-supported restorations during the time leading up to final prosthetic reconstruction.
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ranking = 1
keywords = bone
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8/54. Immediate loading of titanium hexed screw-type implants in the edentulous patient: case report.

    Histologic and histomorphometric studies in both animals and humans have shown that more rapid and greater bone-to-implant contact can be achieved with implants that incorporate certain surface characteristics compared with the original machined-surface implants. Such findings are significant because various implant designs may allow the fixtures to sufficiently resist functional loading sooner than originally thought. The case report presented here indicates that immediate loading of hexed titanium screw-type implants in the anterior mandible can lead to successful osseointegration and clinical outcome. The number of implants placed, their distribution, and the type of rigid connection are critical considerations for immediate loading. A bone height that can accommodate dental implants > or = 10 mm long is recommended. Biomechanically, the implants to be immediately loaded must be stable and resistant to macromovement to ensure good osseointegration.
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ranking = 2
keywords = bone
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9/54. Treatment of micrognathia with edentulous maxilla by sagittal split mandibular osteotomy and a subperiosteal implant immobilized with transmaxillary screws.

    Micrognathia complicated by edentulous maxilla was treated by performing sagittal-split mandibular osteotomy and immobilizing a subperiosteal implant using transmaxillary screws. The patient was a 42-year-old man who had a birdlike facial deformity caused by significant hypoplasia of the mandible. He also demonstrated significant malocclusion attributable to micrognathia and edentulous maxilla caused by resorption of the alveolar bone. These conditions impaired his mastication and articulation, making it impossible for him to eat regular food or carry out normal conversation. A subperiosteal implant was placed on the edentulous maxilla, and was rigidly immobilized to the maxilla using five transmaxillary screws. A prosthesis was then attached to the implant, and by using the implant as the point of reference and the anchor, the mandible was moved forward by sagittal-split mandibular osteotomy. Intermaxillary fixation was subsequently performed. The postoperative course has been favorable, and his facial complexion has improved significantly. One and a half years after his surgery, there has been no sign of complications or malocclusion caused by mandibular retraction. He is now able to eat regular food and speak normally.
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ranking = 1
keywords = bone
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10/54. Computer analysis of titanium implants in atrophic arch and poor quality bone: a case report.

    The oral implantologist usually uses a panoramic radiograph for the evaluation of bone tissue around implants. The development of computed tomography combined with computer software has allowed for the bone-to-implant interface to be illustrated in greater detail with cross-sectional and pseudo-color images. An implant patient has titanium fixtures in an atrophic arch and poor quality bone four years after implantation. The implants were loaded with fixed metal/resin restorations seven days after surgery. Integration of the implants and the anatomic structures near the implant sites are described with an imaging technique.
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ranking = 7
keywords = bone
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