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Sample records for mandibular implant overdentures

  1. Early Loaded Single Implant Reinforced Mandibular Overdenture.

    PubMed

    Nischal, K; Chowdhary, R

    2016-01-01

    Rehabilitating atrophied mandible with two-implant supported denture is a common treatment modality for implant retained removable overdenture in mandible. This paper aims to design a treatment modality where single implant reinforced overdenture is fabricated for a severely atrophied mandibular ridge with early loading protocol. Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. Midline fracture of the prosthesis is the most common complication related to single implant and two-implant retained mandibular overdentures. To manage such complication, a thin metal mesh is used to reinforce the overdenture and also to make the prostheses lighter and cost effective as compared to conventional cast metal framework. PMID:27403350

  2. Early Loaded Single Implant Reinforced Mandibular Overdenture

    PubMed Central

    Chowdhary, R.

    2016-01-01

    Rehabilitating atrophied mandible with two-implant supported denture is a common treatment modality for implant retained removable overdenture in mandible. This paper aims to design a treatment modality where single implant reinforced overdenture is fabricated for a severely atrophied mandibular ridge with early loading protocol. Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. Midline fracture of the prosthesis is the most common complication related to single implant and two-implant retained mandibular overdentures. To manage such complication, a thin metal mesh is used to reinforce the overdenture and also to make the prostheses lighter and cost effective as compared to conventional cast metal framework. PMID:27403350

  3. Number of implants for mandibular implant overdentures: a systematic review

    PubMed Central

    Lee, Jeong-Yol; Kim, Ha-Young; Bryant, S. Ross

    2012-01-01

    PURPOSE The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction. MATERIALS AND METHODS A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants. RESULTS Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants. CONCLUSION The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants. PMID:23236572

  4. Mini vs. Standard Implants for Mandibular Overdentures: A Randomized Trial.

    PubMed

    de Souza, R F; Ribeiro, A B; Della Vecchia, M P; Costa, L; Cunha, T R; Reis, A C; Albuquerque, R F

    2015-10-01

    A mandibular implant-retained overdenture is considered a first-choice treatment for edentulism. However, some aspects limit the use of standard implants-for example, the width of edentulous ridges, chronic diseases, fear, or costs. This randomized trial compared mandibular overdentures retained by 2 or 4 mini-implants with standard implants, considering oral health-related quality of life (OHRQoL), patient satisfaction, and complications such as lost implant. In sum, 120 edentulous men and women (mean age, 59.5 ± 8.5 y) randomly received 4 mini-implants, 2 mini-implants, or 2 standard implants. Participants provided data regarding OHRQoL and satisfaction until 12 mo. Clinical parameters, including implant survival rate, were also recorded. Both 2 and 4 mini-implants led to better OHRQoL, compared with 2 standard implants. Treatment with 4 mini-implants was more satisfying than 2 standard implants, with 2 mini-implants presenting intermediate results. Implant survival rate was 89%, 82%, and 99% for 4 mini-implants, 2 mini-implants, or 2 standard implants, respectively. Overdentures retained by 4 or 2 mini-implants can achieve OHRQoL and satisfaction at least comparable with that of 2 standard implants. However, the survival rate of mini implants is not as high as that of standard implants (ClinicalTrials.gov NCT01411683). PMID:26294416

  5. Attachment systems for mandibular implant overdentures: a systematic review

    PubMed Central

    Kim, Ha-Young; Lee, Jeong-Yol; Bryant, S. Ross

    2012-01-01

    PURPOSE The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction. MATERIALS AND METHODS A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems. RESULTS Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems. CONCLUSION The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system. PMID:23236571

  6. Two-Year Success Rate of Implant-Retained Mandibular Overdentures by Novice General Dentistry Residents.

    PubMed

    Malmstrom, Hans; Xiao, Jin; Romanos, Georgios; Ren, Yan-Fang

    2015-06-01

    The purpose of the present study was to evaluate the clinical success and patient satisfaction when dental implant-retained mandibular overdentures are placed and restored by novice general dentistry residents. A total of 50 subjects who were dissatisfied with their mandibular complete dentures were enrolled in the study. Two dental implants were placed in the anterior mandible between the mental foramina by novice general dentistry residents under the direct supervision of the principal investigator. The resident attached the denture to the implants 3 to 4 months later using locator attachments. The implant success rate was determined by measuring bone loss, mobility, pocket probing depth, and gingival and plaque indices. Subjects were asked to complete a satisfaction questionnaire with the prosthesis at 3 months, 1 year, and 2 years after overdenture delivery. A total of 100 implants were placed in the 50 study subjects. Of these, 2 implants were lost in 1 subject, and 1 subject died due to unrelated causes. Of the 48 remaining subjects, 45 have had their implants restored with overdentures. The subjects' overall satisfaction with fit and ability to chew hard foods with their mandibular overdentures improved significantly (P < .05) following the denture attachment to the dental implants. We conclude that novice general dentistry residents can successfully place mandibular implants and restore them with overdentures under direct supervision, subsequently enhancing the subjects' satisfaction with their mandibular dentures. PMID:24188137

  7. Simplified Technique for Incorporating a Metal Mesh into Record Bases for Mandibular Implant Overdentures.

    PubMed

    Godoy, Antonio; Siegel, Sharon C

    2015-12-01

    Mandibular implant-retained overdentures have become the standard of care for patients with mandibular complete edentulism. As part of the treatment, the mandibular implant-retained overdenture may require a metal mesh framework to be incorporated to strengthen the denture and avoid fracture of the prosthesis. Integrating the metal mesh framework as part of the acrylic record base and wax occlusion rim before the jaw relation procedure will avoid the distortion of the record base and will minimize the chances of processing errors. A simplified method to incorporate the mesh into the record base and occlusion rim is presented in this technique article. PMID:25659988

  8. Implant Supported Mandibular Overdenture: A Viable Treatment Option for Edentulous Mandible

    PubMed Central

    Lambade, Pravin; Gundawar, Sham

    2014-01-01

    The prosthetic management of the edentulous patient has long been a major challenge. Complete maxillary and mandibular dentures have been the traditional standard of care. However, most of the patients report problems adapting to their mandibular denture due to a lack of comfort, retention, stability and inability to masticate. Implant-supported overdentures have been a common treatment for edentulous patients for the past 20 years and predictably achieve good clinical results. Implant supported overdentures offer many practical advantages over conventional complete dentures and removable partial dentures. These include decreased bone resorption, reduced prosthesis movement, better esthetics, improved tooth position, better occlusion, increased occlusal function and maintenance of the occlusal vertical dimension. This article presents a design and fabrication technique of the implant-retained overdenture that uses four freestanding mandibular implants. PMID:24995252

  9. Effect of cantilever length on stress distribution around implants in mandibular overdentures supported by two and three implants

    PubMed Central

    Ebadian, Behnaz; Mosharraf, Ramin; Khodaeian, Niloufar

    2016-01-01

    Objective: There is no definitive study comparing stress distribution around two versus three implants in implant-retained overdentures with different cantilever length. The purpose of this finite element study was to evaluate stress pattern around the implants of the 2 or 3 implant- supported mandibular overdenture with different cantilevered length. Materials and Methods: The models used in this study were 2 and 3 implant-supported overdenture with bar and clip attachment system on an edentulous mandibular arch. Each model was modified according to cantilever length (0 mm, 7 mm, and 13 mm); thus, 6 models were obtained. The vertical load of 15 and 30 pounds were applied unilaterally to the first molar and 15 pounds to the first premolar, and the stress in bone was analyzed. Results: With increasing cantilever length, no similar stress pattern changes were observed in different areas, but in most instances, an increase in cantilever length did not increase the stress around the implant adjacent to cantilever. Conclusions: Within the limitations of this study, it can be concluded that increasing of cantilever length in mandibular overdentures retained by 2–3 implants did not cause distinct increasing in stress, especially around the implant adjacent to cantilever, it may be helpful to use cantilever in cases of mandibular overdenture supported by splinted implants with insufficient retention and stability. Based on the findings of this study, optimal cantilever length in mandibular overdenture cannot be determined. PMID:27403049

  10. Maintenance requirements associated with mandibular implant overdentures: clinical results after first year of service.

    PubMed

    Bilhan, Hakan; Geckili, Onur; Mumcu, Emre; Bilmenoglu, Caglar

    2011-12-01

    The aim of this clinical study was to evaluate the prosthodontic maintenance requirements during the first year of service of mandibular overdentures supported by interforaminal implants and to assess the influence of attachment type, implant number, and bite force on these requirements. Fifty-nine patients treated with mandibular implant overdentures between the years 2004 and 2009 and appearing in the 12th-month recall were included in this study. The overdentures constituted 4 groups: 2 single interforaminal implants (1 group with locator and 1 group with ball attachments), 3 single interforaminal implants, 3 splinted interforaminal implants (bar), and 4 splinted interforaminal implants (bar). During the examination, prosthetic parameters such as occlusion, tissue adaptation, condition of the retentive mechanism (matrice and patrice), and the condition of the denture-bearing tissues were evaluated and recorded. No statistically significant relation was found between attachment type, bite force values, implant number, and the occurring complications except the need for relining, which was found significantly more in the ball attachments than in other attachment groups (P  =  .03). After 12 months following the overdenture insertion, there seems to be no relation between occurring complications and patient-related factors, such as maximum bite force, age, and gender, as well as factors related to the overdentures such as number and type of attachments. PMID:20932124

  11. Stud attachments for the mandibular implant-retained overdentures: Prosthetic complications. A literature review.

    PubMed

    Daou, Elie E

    2013-04-01

    A plethora of attachment systems for mandibular two-implant overdentures is currently available often without evidence-based support. Technical aspects are now parameters considered when choosing the appropriate attachment. Despite the increasing use of the Locator attachments, studies regarding their properties remain scarce. Peer reviewed articles published in English up to 2011, were identified through a MEDLINE search (Pubmed and Elsevier) and a hand search of relevant textbooks and annual publications. Emphasis was made on the technical complications as well as the loss of retention related to the attachments in implant-retained overdentures, primarily the Locator attachment. The evaluation of the long-term outcome of implant overdentures and complications associated with different attachment systems may provide useful guidelines for the clinician in selecting the type of attachment system and overdenture design. PMID:23960557

  12. Stud attachments for the mandibular implant-retained overdentures: Prosthetic complications. A literature review

    PubMed Central

    Daou, Elie E.

    2013-01-01

    A plethora of attachment systems for mandibular two-implant overdentures is currently available often without evidence-based support. Technical aspects are now parameters considered when choosing the appropriate attachment. Despite the increasing use of the Locator attachments, studies regarding their properties remain scarce. Peer reviewed articles published in English up to 2011, were identified through a MEDLINE search (Pubmed and Elsevier) and a hand search of relevant textbooks and annual publications. Emphasis was made on the technical complications as well as the loss of retention related to the attachments in implant-retained overdentures, primarily the Locator attachment. The evaluation of the long-term outcome of implant overdentures and complications associated with different attachment systems may provide useful guidelines for the clinician in selecting the type of attachment system and overdenture design. PMID:23960557

  13. The effect of flexible acrylic resin on masticatory muscle activity in implant-supported mandibular overdentures: a controlled clinical trial

    PubMed Central

    Ibraheem, Eman Mostafa Ahmed; Nassani, Mohammad Zakaria

    2016-01-01

    Background It is not yet clear from the current literature to what extent masticatory muscle activity is affected by the use of flexible acrylic resin in the construction of implant-supported mandibular overdentures. Objective To compare masticatory muscle activity between patients who were provided with implant-supported mandibular overdentures constructed from flexible acrylic resin and those who were provided with implant-supported mandibular overdentures constructed from heat-cured conventional acrylic resin. Methods In this clinical trial, 12 completely edentulous patients were selected and randomly allocated into two equal treatment groups. Each patient in Group 1 received two implants to support a mandibular overdenture made of conventional acrylic resin. In Group 2, the patients received two implants to support mandibular overdentures constructed from “Versacryl” flexible acrylic resin. The maxillary edentulous arch for patients in both groups was restored by conventional complete dentures. For all patients, masseter and temporalis muscle activity was evaluated using surface electromyography (sEMG). Results The results showed a significant decrease in masticatory muscle activity among patients with implant-supported mandibular overdentures constructed from flexible acrylic resin. Conclusion The use of “Versacryl” flexible acrylic resin in the construction of implant-supported mandibular overdentures resulted in decreased masticatory muscle activity. PMID:26955445

  14. Masticatory efficiency and oral health-related quality of life with implant-retained mandibular overdentures

    PubMed Central

    Sun, Xu; Zhai, Jun-Jiang; Liao, Jian; Teng, Min-Hua; Tian, Ai; Liang, Xing

    2014-01-01

    Objectives: To evaluate masticatory efficiency (ME) and oral health-related quality of life (OHRQoL) in patients rehabilitated with implant-retained mandibular overdentures. Methods: In this randomized controlled clinical trial, 50 edentulous patients visiting the Implant Center and Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China between June 2010 and June 2012 were selected and received 2 implant-retained mandibular overdenture treatments. All patients were rehabilitated with maxillary complete dentures. The ME and OHRQoL were determined both one month before the mandibular complete denture was anchored to the osseointegrated implants, and 6 months after anchoring. Paired t-tests were used to compare means of ME, and oral health impact profile-49 (OHIP-49) domains scores between pre- and post-implant. Linear regression models were utilized to seek correlations between ME and OHIP domains scores. Results: The ME increased from pre- to post-implant retained mandibular overdentures significantly (p<0.001). The total OHIP score and 4 subscales scores were changed significantly from pre- to post-implant; namely, functional limitation, psychological discomfort, physical disability, and physical pain. The total OHIP score, functional limitation, physical disability, and physical pain subscale scores were related to ME. Conclusion: Implant-retained mandibular over dentures can significantly improve patients’ ME and OHRQoL. The improvement in OHRQoL is mainly because of the improved ME. An improved chewing experience, and pain relief also contributes to improvement of OHRQoL. PMID:25316463

  15. Mandibular implant-retained overdenture: finite element analysis of two anchorage systems.

    PubMed

    Menicucci, G; Lorenzetti, M; Pera, P; Preti, G

    1998-01-01

    Transmission of masticatory load in mandibular implant-retained overdentures was evaluated using a three-dimensional finite element model. The reaction forces on the distal edentulous mucosa and the stress on the perimplant bone were compared in overdentures retained either by two ball attachments or by two clips on a bar connecting two implants. In the finite element model, a 35 N load on the first mandibular molar induced a greater reaction force on the distal edentulous ridge mucosa of the nonworking side when the overdenture was anchored by ball attachments than with the clips/bar attachment. Stress on peri-implant bone was greater with the clips/bar attachment than with the ball attachment. PMID:9638007

  16. Clinical evaluation of mandibular implant overdentures via Locator implant attachment and Locator bar attachment

    PubMed Central

    Seo, Yong-Ho; Bae, Eun-Bin; Kim, Jung-Woo; Lee, So-Hyoun; Jeong, Chang-Mo; Jeon, Young-Chan

    2016-01-01

    PURPOSE The aim of this study was to evaluate the clinical findings and patient satisfaction on implant overdenture designed with Locator implant attachment or Locator bar attachment in mandibular edentulous patients. MATERIALS AND METHODS Implant survival rate, marginal bone loss, probing depth, peri-implant inflammation, bleeding, plaque, calculus, complications, and satisfaction were evaluated on sixteen patients who were treated with mandibular overdenture and have used it for at least 1 year (Locator implant attachment: n=8, Locator bar attachment: n=8). RESULTS Marginal bone loss, probing depth, plaque index of the Locator bar attachment group were significantly lower than the Locator implant attachment group (P<.05). There was no significant difference on bleeding, peri-implant inflammation, and patient satisfaction between the two denture types (P>.05). The replacement of the attachment components was the most common complication in both groups. Although there was no correlation between marginal bone loss and plaque index, a significant correlation was found between marginal bone loss and probing depth. CONCLUSION The Locator bar attachment group indicates lesser marginal bone loss and need for maintenance, as compared with the Locator implant attachment group. This may be due to the splinting effect among implants rather than the types of Locator attachment. PMID:27555901

  17. Remodeling of the Mandibular Bone Induced by Overdentures Supported by Different Numbers of Implants.

    PubMed

    Li, Kai; Xin, Haitao; Zhao, Yanfang; Zhang, Zhiyuan; Wu, Yulu

    2016-05-01

    The objective of this study was to investigate the process of mandibular bone remodeling induced by implant-supported overdentures. computed tomography (CT) images were collected from edentulous patients to reconstruct the geometry of the mandibular bone and overdentures supported by implants. Based on the theory of strain energy density (SED), bone remodeling models were established using the user material subroutine (UMAT) in abaqus. The stress distribution in the mandible and bone density change was investigated to determine the effect of implant number on the remodeling of the mandibular bone. The results indicated that the areas where high Mises stress values were observed were mainly situated around the implants. The stress was concentrated in the distal neck region of the distal-most implants. With an increased number of implants, the biting force applied on the dentures was almost all taken up by implants. The stress and bone density in peri-implant bone increased. When the stress reached the threshold of remodeling, the bone density began to decrease. In the posterior mandible area, the stress was well distributed but increased with decreased implant numbers. Changes in bone density were not observed in this area. The computational results were consistent with the clinical data. The results demonstrate that the risk of bone resorption around the distal-most implants increases with increased numbers of implants and that the occlusal force applied to overdentures should be adjusted to be distributed more in the distal areas of the mandible. PMID:26963740

  18. Stress analysis of mandibular two-implant overdenture with different attachment systems.

    PubMed

    Takeshita, Shin; Kanazawa, Manabu; Minakuchi, Shunsuke

    2011-01-01

    This study aimed to investigate the influence of different overdenture attachment systems on the stress generated in peri-implant bone during overdenture dislodgement and loading. Two implants were placed in the canine regions on an acrylic edentulous mandibular model. Four strain gauges were attached to the resin surface adjacent to the left implant. Bar, ball, and magnetic attachments were examined. Three experimental overdentures were fabricated, and the denture parts of the attachment systems were incorporated into the mucosal surface. Retentive forces and strains generated in peri-implant bone during three types of dislodgement (vertical, anterior and posterior) and loading (left first molar region, right first molar region and mid-anterior region) were measured. The bar attachment showed the highest retentive force and reduced strain on posterior dislodgement. The ball attachment demonstrated the largest strain on loading at molar regions. The magnetic attachment showed the smallest retentive force and little strain. PMID:22123019

  19. Strains around distally inclined implants retaining mandibular overdentures with Locator attachments: an in vitro study

    PubMed Central

    Setta, Fathi Abo; Khirallah, Ahmed Samir

    2016-01-01

    PURPOSE The aim of the present study was to evaluate, by means of strain gauge analysis, the effect of different implant angulations on strains around two implants retaining mandibular overdenture with Locator attachments. MATERIALS AND METHODS Four duplicate mandibular acrylic models were constructed. Two implants were inserted in the canine regions using the following degrees of distal inclinations: group I (control); 0°, group II; 10°, group III; 20°, and group IV; 30°. Locator pink attachments were used to connect the overdenture to the implants and Locator red (designed for severely angled implants) was used for group IV (group IVred). For each group, two linear strain gauges were attached at the mesial and distal surfaces of the acrylic resin around each implant. Peri-implant strain was measured on loading and non-loading sides during bilateral and unilateral loading. RESULTS For all groups, the mesial surfaces of the implants at loading and non-loading sides experienced compressive (negative) strains, while the distal implant surfaces showed tensile (positive) strains. Group IV showed the highest strain, followed by group III, group II. Both group I and group IVred showed the lowest strain. The strain gauges at the mesial surface of the loading side recorded the highest strain, and the distal surface at non-loading side showed the lowest strain. Unilateral loading recorded significantly higher strain than bilateral loading. CONCLUSION Peri-implant strains around two implants used to retain mandibular overdentures with Locator attachments increase as distal implant inclination increases, except when red nylon inserts were used. PMID:27141255

  20. Narrow-implant-retained overdenture in an atrophic mandibular ridge: a case report with 6-year follow-up.

    PubMed

    Araujo, Carlos Roberto Garcia; Martins-Junior, Paulo Antonio; Araujo, Roberto Carlos de; Sa, Marcos Augusto de; Wassall, Thomaz; Ferreira, Anderson Jose

    2015-01-01

    When atrophic jaws compromise oral rehabilitation with conventional implants, narrow-diameter implants can be used. This case report describes treatment of an edentulous 75-year-old diabetic woman with a severely resorbed mandibular ridge. Her mandibular dentition was restored with an overdenture supported by 3 narrow implants and 1 mini implant. Her maxillary dentition was restored with a conventional complete denture. A 6-year clinical and radiographic follow-up confirmed that the narrow implants had provided effective stability for the overdenture, providing improvements in phonetics and masticatory ability at a low cost. PMID:26545281

  1. Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

    PubMed Central

    Kim, Ha-Young; Shin, Sang-Wan

    2014-01-01

    PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva

  2. Use of an Implant O-Ring Attachment for the Tooth Supported Mandibular Overdenture: A Clinical Report

    PubMed Central

    Guttal, Satyabodh S.; Tavargeri, Anand K.; Nadiger, Ramesh K.; Thakur, Srinath L.

    2011-01-01

    Retention of a mandibular denture can be achieved by an implant-retained or natural tooth-retained bar and stud attachment in the anterior segment of the mandible. The same design principles holds true for both implant-retained and tooth-retained methods of anchoring the bar and stud attachment. A simple and cost effective treatment for more complex implant overdenture is the concept of conventional tooth-retained overdentures. When few firm teeth still remain in a compromised dentition, preservation of these teeth for overdentures can improve retention and stability. The authors present a clinical report of a patient treated with a mandibular tooth-borne overdenture with bar and O-ring attachment. A splinted bar supported the prosthesis and an O-ring retained the denture. PMID:21769276

  3. Success and survival rates of mandibular overdentures supported by two or four implants: a systematic review.

    PubMed

    Dantas, Isabelle de Sousa; Souza, Mariana Barbosa Câmara de; Morais, Maria Helena de Siqueira Torres; Carreiro, Adriana da Fonte Porto; Barbosa, Gustavo Augusto Seabra

    2014-01-01

    This systematic review evaluated the influence played by the number of implants on the results of rehabilitation treatment with mandibular overdentures on 2 or 4 implants. The literature search was conducted using PubMed, Embase and Cochrane databases. Specific terms were used in performing a search from January 1980 to January 2013. The search strategy was applied by two reviewers who extracted the data and compared the results. Discrepancies were resolved by discussion. Great heterogeneity was seen among the selected studies, in regard to survival rates, prosthesis failure and function rates. A medium degree of quality and methodological consistency was found in one study, and no studies showed a high degree. When considering the prosthesis success rate for 2 implants, there was a variation of 23% to 100%. However, when considering the survival rate, the result was 92% to 100%. For 4 implants, prosthesis survival rates showed less variation, i.e., 97.7% to 100%. Ball attachments were the most common type of abutment for 2 implants; however, there was a higher prevalence of bar abutments for 4 implants. Rehabilitations with 2 implants showed more complications and required more maintenance according to the connection type. Given the limitations of this review, mandibular overdentures with 4 implants showed better results with respect to survival and success rates, especially those with a bar connection. Further studies comparing these two treatment types are necessary to improve the scientific evidence in this area. PMID:24402059

  4. Implant-supported overdenture with prefabricated bar attachment system in mandibular edentulous patient

    PubMed Central

    Ha, Seung-Ryong; Song, Seung-Il; Hong, Seong-Tae; Kim, Gy-Young

    2012-01-01

    Implant-supported overdenture is a reliable treatment option for the patients with edentulous mandible when they have difficulty in using complete dentures. Several options have been used for implant-supported overdenture attachments. Among these, bar attachment system has greater retention and better maintainability than others. SFI-Bar® is prefabricated and can be adjustable at chairside. Therefore, laboratory procedures such as soldering and welding are unnecessary, which leads to fewer errors and lower costs. A 67-year-old female patient presented, complaining of mobility of lower anterior teeth with old denture. She had been wearing complete denture in the maxilla and removable partial denture in the mandible with severe bone loss. After extracting the teeth, two implants were placed in front of mental foramen, and SFI-Bar® was connected. A tube bar was seated to two adapters through large ball joints and fixation screws, connecting each implant. The length of the tube bar was adjusted according to inter-implant distance. Then, a female part was attached to the bar beneath the new denture. This clinical report describes two-implant-supported overdenture using the SFI-Bar® system in a mandibular edentulous patient. PMID:23236580

  5. Mandibular implant-retained overdenture: a clinical trial of two anchorage systems.

    PubMed

    Menicucci, G; Lorenzetti, M; Pera, P; Preti, G

    1998-01-01

    This in-vivo study aimed to investigate the load on the working-side implant and on the edentulous distal mucosa of the nonworking side in a mandibular implant-retained overdenture (MIR-OVD) anchored to 2 implants by either a ball- or a clips-and-bar attachment. Three female patients were provided with duplicate dentures anchored in the 2 ways. Strain on the implant was investigated using a strain-gauged abutment, and load on the mucosa was measured using a suitably placed load cell. Ball attachments appeared to provide greater stability to the MIR-OVD, since load was more evenly distributed onto the distal mucosa of both sides. When the MIR-OVD was bar-anchored, axial load on the working-side abutment increased. PMID:9857597

  6. The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth

    PubMed Central

    Arafa, Khalid A.

    2016-01-01

    Objectives: To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. Methods: A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group received overdentures with cuspless teeth. The rate of implant success was assessed clinically and radiographically at 3, 6, 9, and 12 months. The data were collected by a questionnaire, an observation checklist, and radiography. The data were then analyzed using computerized methods. Results: Overdentures with cusped teeth showed a significant improvement in the clinical criteria, including the absence of clinical implant mobility, pain, and bone resorption, while the clinical criteria for the absence of peri-implant radiolucency were insignificantly different between the 2 groups (p>0.05). There were no significant differences in the clinical evaluations for bone levels at the time of insertion or 3 months after insertions, while significant differences were found at 6, 9, and 12 months after insertion. Conclusion: Overdentures with cusped teeth supported by immediate implants were found superior regarding many clinical criteria than those cuspless counterparts. PMID:26739979

  7. Prospective study of treatment outcome of implant retained mandibular overdenture: Two years follow-up

    PubMed Central

    Arora, Vimal; Kumar, Dinesh; Legha, V. S.; Arun Kumar, K. V.

    2014-01-01

    Aims: The aim of this study is to evaluate the treatment outcome of immediately loaded Implants in the interforaminal region of anterior mandible. Materials and Methods: A total of 15 completely edentulous patients aged between 50 and 70 years were selected satisfying certain inclusion and exclusion criteria. Two implants were placed in 33 and 43 region (B and D location) and the implants were loaded immediately by mandibular overdenture retained with O-ring attachments. The implants were evaluated for various clinical parameters at 6 months, 1 year, 1.5 years, and 2 years intervals after initial placement. Results: There was increased marginal bone loss around implants during the 1st year after that the bone loss was insignificant. Clinical stability of immediately loaded implants was lower initially for 6 months, but improved by the end of 1st year. Survival rate for immediately loaded implants was 96.6% at the end of the period of study. Conclusion: Immediate loading of interforaminal mandibular implants demonstrated a highly acceptable clinical success at the end of 2 years. However, initially the marginal bone level and clinical stability were significantly lower which showed improvement with time. PMID:24963237

  8. Training needs for general dentistry residents to place and restore two-implant-retained mandibular overdentures.

    PubMed

    Malmstrom, Hans; Xiao, Jin; Romanos, Georgios E; Ren, Yan-Fang

    2015-01-01

    Implant therapy is rapidly becoming a standard of care for replacing missing dentition. Predoctoral dental curricula include some training in the implant restorative phase but offer limited exposure to the surgical phase, so it is important for postdoctoral general dentistry residency programs to provide competency training in all phases of implant therapy. The aim of this study was to determine the training needed for general dentistry residents to achieve competence in this area, specifically by defining the number of clinical experiences necessary in both the surgical and prosthetic phases of implant-retained mandibular overdenture construction (IRMOD). Fifteen Advanced Education in General Dentistry (AEGD) residents at one academic dental institution placed two implants in a total of 50 patients with edentulous mandibles and subsequently restored them with IRMOD. The supervising faculty member and the residents evaluated the competency level on a five-point scale after each implant placement and prosthetic case completion. According to the faculty evaluations, the residents achieved surgical competence after placing two implants in four to six cases and prosthetic management competence after restoring two to four cases of IRMOD. All 50 patients were satisfied with the treatment outcomes of IRMOD. This study concluded that general dentistry residents could potentially achieve competence in both the surgical and prosthetic phases of implant therapy while enrolled in an AEGD program. PMID:25576555

  9. Maxillary implant-supported bar overdenture and mandibular implant-retained fixed denture using CAD/CAM technology and 3-D design software: a clinical report.

    PubMed

    Spyropoulou, Panagiota-Eirini; Razzoog, Michael E; Duff, Renée E; Chronaios, Dimitrios; Saglik, Berna; Tarrazzi, Daler E

    2011-06-01

    The implant-supported bar overdenture and the implant-retained fixed complete denture are appropriate treatment choices for patients with inadequate bone volume in the posterior maxilla and mandible, respectively. Computer-aided design/computer-aided manufacturing (CAD/CAM) technology has broadened the scope and application of those treatment options, allowing for prosthodontically-driven implant placement and ideal substructure design for optimal esthetics and biomechanics. This report describes the fabrication of a maxillary implant-supported milled titanium bar with attachments and an overdenture, and a mandibular implant-retained fixed complete denture with milled titanium substructure. PMID:21640235

  10. Implant-supported mandibular overdentures in very old adults: a randomized controlled trial.

    PubMed

    Müller, F; Duvernay, E; Loup, A; Vazquez, L; Herrmann, F R; Schimmel, M

    2013-12-01

    The purpose of this study was (1) to investigate denture satisfaction following the conversion of existing mandibular complete dentures to implant overdentures (IOD) in very old edentulous patients who depend on help for activities of daily living and (2) to evaluate secondary end points, such as functional, structural, nutritional, and patient-centered aspects. For this randomized clinical trial, 2 interforaminal short implants were placed in the intervention group (n = 16, 85.0 ± 6.19 yrs) to retain mandibular IODs; the control group (n = 18, 84.1 ± 5.55 yrs) received conventional relines. During the first year, no implant was lost; however, 2 patients died. IODs proved more stable, and participants in the intervention group demonstrated significantly higher denture satisfaction as well as an increased oral health-related quality of life compared to the control group. Maximum voluntary bite force improved significantly with IODs, yet the chewing efficiency was not different between groups. Masseter muscle thickness increased with IODs, mainly on the preferred chewing side. Body mass index decreased in both groups, but the decline tended to be smaller in the intervention group; blood markers and the Mini Nutritional Assessment did not confirm this tendency. These results indicate that edentulous patients who depend on help for activities of daily living may benefit from IODs even late in life. PMID:24158342

  11. Photoelastic Stress Analysis Surrounding Implant-Supported Prosthesis and Alveolar Ridge on Mandibular Overdentures

    PubMed Central

    da Silva, Dorival Pedroso; Cazal, Claudia; de Almeida, Fernanda Campos Sousa; Dias, Reinaldo Brito e; Ballester, Rafael Yagüe

    2010-01-01

    The purpose of this research was to evaluate the maximum stress around osseointegrated implants and alveolar ridge, in a mandible with left partial resection through a photoelastic mandibular model. The first group consisted of two implants: traditional model (T), implants placed in the position of both canines; fulcrum model (F), implants placed in the position of left canine CL and right lateral incisor LiR. Both models linked through a bar and clips. The second group was consisted of three implants, with implants placed in the position of both canines (CR and CL) and the right lateral incisor (LiR), which composed four groups: (1) model with 3 “O” rings, (2) model 2 ERAs, bar with clips, (3) model 2 ERAs bar without clips; (4) model “O” ring bar and ERA. An axial and an oblique load of 6.8 kgf was applied on a overdenture at the 1st Pm, 2nd Pm, and 1st M. Results showed that the area around the left canine (CL) was practically free of stress; the left lateral incisor (LiL) developed only small tensions, and low stress in all the other cases; the right canine tooth suffered the largest concentrations of stress, mainly with the ERA retention mechanism. PMID:20467562

  12. Effect of attachment type on load distribution to implant abutments and the residual ridge in mandibular implant-supported overdentures

    PubMed Central

    Matsudate, Yoshiki; Abue, Masaru; Hong, Guang; Sasaki, Keiichi

    2015-01-01

    This study aimed to investigate the effect of attachment type on the load transmitted to implants and the residual ridge in a mandibular two-implant-supported overdenture in a model study. Ball attachments, locator attachments, and round-bar attachments were selected and examined. Static and dynamic vertical loads of 100 N were applied in the right first molar region. The load on the implants was measured by piezoelectric three-dimensional force transducers, and the load on the residual ridge beneath the denture base was measured using a tactile sheet sensor. The load on the implants with ball attachments was significantly higher than that with the other two attachments. The load on the residual ridge with round-bar attachments was significantly higher than that with the other two attachments. Our findings indicate that the three-dimensional load on implants and the residual ridge beneath the denture base is significantly associated with the type of attachment used in implant-supported overdentures. PMID:25798201

  13. Two Versus Three Narrow-Diameter Implants with Locator Attachments Supporting Mandibular Overdentures: A Two-Year Prospective Study

    PubMed Central

    El-Sheikh, Ali M.; Shihabuddin, Omar F.; Ghoraba, Sahar M. F.

    2012-01-01

    Purpose. To compare treatment outcome (survival rate, condition of hard and soft peri-implant tissues) and prosthodontic maintenance requirements of two versus three narrow-diameter bone level implants with Locator attachments supporting mandibular overdentures. Materials and Methods. Twenty completely edentulous patients with atrophic mandibles were treated. Ten patients (Group A) were treated with overdentures supported by two narrow (3.3-mm diameter) implants (Straumann AG, Basel, Switzerland) and ten patients (Group B) were treated with overdentures supported by three narrow implants. Locator (Zest Anchors, USA) attachments were used for prosthetic anchorage. Standardized clinical and radiographic parameters (survival rate, plaque index, calculus index, gingival index, bleeding index, probing depth and marginal bone loss) were evaluated at the time of the completion of the prosthetic treatment (baseline) and after 6, 12 and 24 months of functional loading. Prosthodontic maintenance requirements were also scored. Results. Only one implant was lost (Group B) during the healing period. There were no significant differences with regards to any of the studied clinical and radiographic parameters between the two groups (P > 0.05). Few prosthetic complications were recorded. Conclusions. No need to insert more than two narrow-diameter bone level implants with Locator attachments in cases of atrophic mandible to support an overdenture, however, long-term prospective studies are required to support this notion. PMID:22754570

  14. Comparison of marginal bone loss and patient satisfaction in single and double-implant assisted mandibular overdenture by immediate loading

    PubMed Central

    Khoshhal, Masume; Ebrahimzadeh, Zahra

    2015-01-01

    PURPOSE The purpose of this study was to compare the coronal bone level and patient satisfaction in 1-implant and 2-implant assisted mandibular overdentures. MATERIALS AND METHODS Twenty patients who had maladaptive mandibular dentures were treated in this study. Patients were randomly divided into two groups. The first group received 1 implant (Simple line II, Implantium, South Korea) in their mandibular midline and the second group received 2 implants in their B and D regions (according to Misch's category). If the primary stability of each implant was at least 60 ISQ, ball attachment was placed and denture relined with soft liner. After 6 weeks, retentive cap incorporated with hard acrylic resin. In the 6 and 12 months recalls, periapical digital radiograph were made and visual analogue scale questionnaires were used to record patient satisfaction. The Friedman test was done for comparing the presurgical and postsurgical parameters in each group and the U-Mann Whitney test (P<.05) was done for comparison of post-treatment results between the two groups. RESULTS All implants achieved sufficient primary stability to be immediately loaded. Patient satisfaction was high, and there were no significant differences between two groups (P>.05). In addition, mean marginal bone loss was 0.6 ± 0.67 mm in the first group and 0.6 ± 0.51 mm in the second group, after 12 month. Mean marginal bone loss showed no significant differences between two groups. CONCLUSION This preliminary one-year result indicated that mandibular overdentures anchored to a single implant can be a safe and cost-effective method as a starting step for implant-overdenture treatment. PMID:26140170

  15. A Prospective Study of Early Loaded Single Implant-Retained Mandibular Overdentures: Preliminary One-Year Results

    PubMed Central

    El-Sheikh, Ali M.; Shihabuddin, Omar F.; Ghoraba, Sahar M. F.

    2012-01-01

    Purpose. To investigate the predictability of simplifying mandibular overdenture treatment using one-stage surgery and early prosthetic loading of a single implant. Materials and Methods. Twenty edentulous patients with problematic existing mandibular dentures were treated. A single implant with a chemically modified surface (SLActive, Straumann AG, Basel, Switzerland) was placed into the mandibular midline. The patients were recalled at 3, 6 and 12 months. Clinical assessments and marginal bone loss using standardized radiographs were recorded. All complications, failures and maintenance were noted. Visual analog-scale questionnaires were used to record patient satisfaction in five categories. ANOVA was used to determine differences between means of marginal bone loss and different categories of patient staisfaction (P = 0.05). Results. The 20 early loaded implants were all surviving at the 12-month recall. All implants showed less than 1 mm of marginal bone loss by the end of the 1-year with a significant increase during the follow-up period. Few prosthetic problems were reported. Patient satisfaction was high with a significant increase in all comfort and functional parameters. Conclusions. These preliminary 1-year results indicate that early loading of a single chemically modified surface implant used to retain a mucosa-borne mandibular overdenture is a safe, reliable, and cost-effective treatment. PMID:22505895

  16. Locators versus magnetic attachment effect on peri-implant tissue health of immediate loaded two implants retaining a mandibular overdenture: a 1-year randomised trial.

    PubMed

    Elsyad, M A; Mahanna, F F; Elshahat, M A; Elshoukouki, A H

    2016-04-01

    This study aimed to evaluate peri-implant tissue health of immediate loaded two implants retaining a mandibular overdenture with either magnetic or locator attachment. Thirty two completely edentulous patients (20 males/12 females) were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible using flapless surgical technique. Mandibular overdentures were immediately connected to the implants with either magnetic (group I, GI) or locator (group II, GII) attachments. Peri-implant tissue health was evaluated clinically in terms of plaque scores (PI), bleeding scores (BI), probing depth (PD), implant stability (ISQ) and interleukin-1-β (IL-1b) concentrations in peri-implant sulcular fluid. PI, BI and PD were measured at mesial, distal, buccal and lingual surfaces of each implant. Radiographic evaluation was performed in terms of vertical (VBL) and horizontal (HBLO) alveolar bone loss. Evaluations were performed 2 weeks (T0), 6 months (T1) and 12 months (T2) after overdenture insertion. Plague scores, PD, IL-1b, VBL and HBLO increased significantly with time. ISQ decreased significantly with time. BI showed no significant differences between observation times. GI recorded significant higher PI, ISQ and IL-1b at T2 compared to GII. GII recorded significant higher VBL than GI at T2 only. For HBLO, no significant differences between groups were noted. VBL and HBLO showed a significant positive correlation with PD. Locator attachments for immediate loaded implants retaining mandibular overdentures are associated with decreased plaque accumulation, decreased implant stability, decreased interleukin-1β concentration in peri-implant crevicular fluid and increased per-implant vertical bone loss compared to magnetic attachments after 1 year. PMID:26549496

  17. Rehabilitation of resorbed mandibular ridges using mini implant retained overdentures: A case series with 3 year follow-up.

    PubMed

    Kumari, Pooja; Verma, Mahesh; Sainia, Vikrant; Gupta, Rekha; Gill, Shubhra

    2016-01-01

    With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases. PMID:27141177

  18. The Effect of Inter-Implant Distance on Retention and Resistance to Dislodging Forces for Mandibular Implant-Tissue-Supported Overdentures

    PubMed Central

    Tabatabaian, Farhad; Saboury, Abolfazl; Sobhani, Zahra Sadat; Petropoulos, Vicki C

    2014-01-01

    Objectives: The effect of inter-implant distance on retention and resistance of implant-tissue-supported overdentures is lacking in the literature. An in vitro study was performed to evaluate this effect for mandibular implant-tissue-supported overdentures retained by two ball attachments. Materials and Methods: An acrylic cast of an edentulous mandible was fabricated. Three pairs of implants were symmetrically placed at both sides of the midline. The inter-implant distance was 10, 25, and 35 millimeters in positions A, B and C, respectively. A framework simulating the overdenture was fabricated on the cast. Six attachment housings were placed within the overdenture. For each sample, two ball abutments were screwed onto the implant pairs and two pink nylon inserts were seated in their respective attachment housings. The samples were tested in three groups of 15 (A, B, and C). The testing machine applied tensile dislodging forces and peak loads were measured in three directions: vertical, oblique, and anterior-posterior. A one-way ANOVA followed by Tukey’s HSD was used to determine groups that were significantly different. Tests were carried out at 0.05 level of significance. Results: Peak loads for the anterior-posteriorly directed dislodging forces were significantly the highest for group C (P<0.05); 21.25 N±3.05 N, while there were no statistically significant differences among groups with vertically and obliquely directed forces (P>0.05). Conclusion: Inter-implant distance did not affect the vertical retention and oblique resistance of mandibular implant-tissue-supported overdentures; however, it affected anterior-posterior resistance. PMID:25628676

  19. Evaluation of stress distribution of implant-retained mandibular overdenture with different vertical restorative spaces: A finite element analysis

    PubMed Central

    Ebadian, Behnaz; Farzin, Mahmoud; Talebi, Saeid; Khodaeian, Niloufar

    2012-01-01

    Background: Available restorative space and bar height is an important factor in stress distribution of implant-supported overdentures. The purpose of this study was to evaluate the effect of different vertical restorative spaces and different bar heights on the stress distribution around implants by 3D finite element analysis. Materials and Methods: 3D finite element models were developed from mandibular overdentures with two implants in the interforaminal region. In these models, four different bar heights from gingival crest (0.5, 1, 1.5, 2 mm) with 15 mm occlusal plane height and three different occlusal plane heights from gingival crest (9, 12, 15 mm) with 2 mm bar height were analyzed. A vertical unilateral and a bilateral load of 150 N were applied to the central occlusal fossa of the first molar and the stress of bone around implant was analyzed by finite element analysis. Results: By increasing vertical restorative space, the maximum stress values around implants were found to be decreased in unilateral loading models but slightly increased in bilateral loading cases. By increasing bar height from gingival crest, the maximum stress values around implants were found to be increased in unilateral loading models but slightly decreased in bilateral loading cases. In unilateral loading models, maximum stress was found in a model with 9 mm occlusal plane height and 1.5 mm bar height (6.254 MPa), but in bilateral loading cases, maximum stress was found in a model with 15 mm occlusal plane height and 0.5 mm bar height (3.482 MPa). Conclusion: The reduction of bar height and increase in the thickness of acrylic resin base in implant-supported overdentures are biomechanically favorable and may result in less stress in periimplant bone. PMID:23559952

  20. Use of SIG device to accurately place permanent miniature dental implants to retain mandibular overdenture. A case report.

    PubMed

    Sussman, Harold I; Goodridge, Opal F

    2006-01-01

    A case of mini-dental implant insertion for retention of a mandibular overdenture in a hospitalized patient has been documented. The additional use of the SIG (drill guide) directional device in the implant placement protocol gave the practitioner more confidence and resulted in the proper alignment of the three ball-top, one-piece fixtures. The three implants were inserted exactly 1 cm apart and parallel to each other. The distal fixtures were approximately 1 cm away from the mental foramina, thereby eliminating the risk of lip paresthesia. Keeper caps were placed in the denture's intaglio after one month. The keeper caps allowed for proper retention of the overdenture. The caps also enabled the patient to easily insert and withdraw his denture, even though he displayed limited manual dexterity. The tissue response was excellent, and oral hygiene was made easier with adequate spacing of the exposed ball-tops. The overall experience for both the operator and the patient was very positive. General dentists should be able to readily master this technique and add it to their armamentarium for the benefit of all their patients. PMID:17036584

  1. Full mouth rehabilitation of a patient with mandibular implant screw retained Fp-3 prosthesis opposing maxillary acrylic removable over-denture

    PubMed Central

    Jain, Ashish R.; Nallaswamy, Deepak; Ariga, Padma; Philip, Jacob Mathew

    2013-01-01

    A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid denture is fixed on implants while the posterior part of the denture is extended and cantilevered from implants. This article presents the fabrication of a maxillary over-denture opposing mandibular implant retained hybrid prosthesis. A total of four implants were placed in the mandibular arch. Castable abutments were used to produce the optimal angulations. Framework was waxed, cast recovered, and the fit was refined until the framework seated passively on the master cast. The mandibular denture teeth were waxed to the hybrid framework, and a final wax try-in was performed to verify and correct maxillomandibular relations before processing. The prosthesis was inserted after verification of occlusion, retention, and stability. The rehabilitation of edentulous patients with hybrid dentures has been observed to achieve greater masticatory function and psychological satisfaction than with conventional over-dentures. Producing a passive-fitting substructure for a fixed removable screw retained hybrid prosthesis is arguably one of the most technically complex tasks in implant dentistry. The technique presented may not initially produce a perfectly passive framework, but use of disclosing media and adjusting the internal aspect of the casting can result in non-binding, fully seated prostheses. PMID:24015016

  2. FEM Analysis of Mandibular Prosthetic Overdenture Supported by Dental Implants: Evaluation of Different Retention Methods

    PubMed Central

    Cicciù, M.; Cervino, G.; Bramanti, E.; Lauritano, F.; Lo Gudice, G.; Scappaticci, L.; Rapparini, A.; Guglielmino, E.; Risitano, G.

    2015-01-01

    Prosthetic rehabilitation of total edentulous jaws patients is today a common technique that clinicians approach in their daily practice. The use of dental implants for replacing missing teeth is going to be a safe technique and the implant-prosthetic materials give the possibility of having long-term clinical success. Aim of this work is to evaluate the mechanical features of three different prosthetic retention systems. By applying engineering systems of investigations like FEM and von Mises analyses, how the dental implant material holds out against the masticatory strength during the chewing cycles has been investigated. Three common dental implant overdenture retention systems have been investigated. The ball attachment system, the locator system, and the common dental abutment have been processed by Ansys Workbench 15.0 and underwent FEM and von Mises investigations. The elastic features of the materials used in the study have been taken from recent literature data. Results revealed different response for both types of device, although locator system showed better results for all conditions of loading. The data of this virtual model show all the features of different prosthetic retention systems under the masticatory load. Clinicians should find the better prosthetic solution related to the patients clinical condition in order to obtain long-term results. PMID:26798405

  3. FEM Analysis of Mandibular Prosthetic Overdenture Supported by Dental Implants: Evaluation of Different Retention Methods.

    PubMed

    Cicciù, M; Cervino, G; Bramanti, E; Lauritano, F; Lo Gudice, G; Scappaticci, L; Rapparini, A; Guglielmino, E; Risitano, G

    2015-01-01

    Prosthetic rehabilitation of total edentulous jaws patients is today a common technique that clinicians approach in their daily practice. The use of dental implants for replacing missing teeth is going to be a safe technique and the implant-prosthetic materials give the possibility of having long-term clinical success. Aim of this work is to evaluate the mechanical features of three different prosthetic retention systems. By applying engineering systems of investigations like FEM and von Mises analyses, how the dental implant material holds out against the masticatory strength during the chewing cycles has been investigated. Three common dental implant overdenture retention systems have been investigated. The ball attachment system, the locator system, and the common dental abutment have been processed by Ansys Workbench 15.0 and underwent FEM and von Mises investigations. The elastic features of the materials used in the study have been taken from recent literature data. Results revealed different response for both types of device, although locator system showed better results for all conditions of loading. The data of this virtual model show all the features of different prosthetic retention systems under the masticatory load. Clinicians should find the better prosthetic solution related to the patients clinical condition in order to obtain long-term results. PMID:26798405

  4. A finite element analysis of stress distribution in the bone, around the implant supporting a mandibular overdenture with ball/o ring and magnetic attachment.

    PubMed

    John, Jins; Rangarajan, V; Savadi, Ravindra C; Satheesh Kumar, K S; Satheesh Kumar, Preeti

    2012-03-01

    Today implant dentistry has made great inroads into the treatment modalities that are available in treating an edentulous patient. Popularity of a two implant retained overdenture has created a necessity to examine the various attachment systems being used and the stresses that are transmitted to the alveolar bone. Hence a Three dimensional Finite Element Analysis was done to analyze the stress distribution in the mandibular bone with implant-supported overdenture having Ball/O-ring and Magnet attachments of different diameters. A segment of the anterior region of the mandible was modeled with implant and the overdenture. Four different models were generated having Ball/O-Ring and Magnet Attachments. Forces of 10 N, 35 N and 70 N were applied from the horizontal, vertical and oblique directions respectively and the stress distribution studied. It was concluded that the greatest stress concentrations were seen at the crest of the cortical bone and could be reduced by using smaller sized attachments for implant supported-overdenture. PMID:23450217

  5. Effects of Mucosal Thickness on the Stress Distribution and Denture Stability of Mandibular Implant-Supported Overdentures with Unsplinted Attachments In Vitro

    PubMed Central

    Haruta, Asuka; Matsushita, Yasuyuki; Tsukiyama, Yoshihiro; Sawae, Yoshinori; Sakai, Nobuo; Koyano, Kiyoshi

    2011-01-01

    The aim of this study was to compare the effects of mucosal thickness on the stress pattern around implants and movement of implant-supported overdentures with ball/female and three different types of magnetic attachments. After insertion of two root-form implants into a mandibular model, the surface of the model was covered with a 1.5- or 3-mm layer of impression material to simulate the oral mucosa, and removable overdentures were fabricated on each model. A 50-N vertical force was applied to the right first molar, and the resultant stress distribution and denture movement were measured. In the 1.5-mm mucosal model, the magnetic attachments showed significantly lower bending moments than did the ball attachment. The denture base displacement was the lowest on a magnetic attachment. In this study, use of magnetic attachments could be advantageous for mandibular implant-supported overdentures based on lower stress and better denture stability especially in the thin mucosal model. PMID:21799705

  6. Comparison of single-standing or connected implants on stress distribution in bone of mandibular overdentures: a two-dimensional finite element analysis.

    PubMed

    Tabata, Lucas Fernando; Assunção, Wirley Gonçalves; Barão, Valentim Adelino Ricardo; Gomes, Erica Alves; Delben, Juliana Aparecida; de Sousa, Edson Antônio Capello; Rocha, Eduardo Passos

    2010-05-01

    This study aimed to compare the influence of single-standing or connected implants on stress distribution in bone of mandibular overdentures by means of two-dimensional finite element analysis. Two finite element models were designed using software (ANSYS) for 2 situations: bar-clip (BC) group-model of an edentulous mandible supporting an overdenture over 2 connected implants with BC system, and o'ring (OR) group-model of an edentulous mandible supporting an overdenture over 2 single-standing implants with OR abutments. Axial loads (100 N) were applied on either central (L1) or lateral (L2) regions of the models. Stress distribution was concentrated mostly in the cortical bone surrounding the implants. When comparing the groups, BC (L1, 52.0 MPa and L2, 74.2 MPa) showed lower first principal stress values on supporting tissue than OR (L1, 78.4 MPa and L2, 76.7 MPa). Connected implants with BC attachment were more favorable on stress distribution over peri-implant-supporting tissue for both loading conditions. PMID:20485031

  7. Implant overdenture using Konus telescope on one-piece implant: a case report.

    PubMed

    Ohkubo, Chikahiro; Kobayashi, Mariko; Okamoto, Naoko; Hosoi, Toshio; Kurtz, Kenneth S; Murata, Toshiyuki

    2009-12-01

    An implant-retained Konus (tapered double crown) telescopic complete overdenture was fabricated for a mandibular edentulous patient. The Konus telescopic overdenture coping crowns and framework assembly were cast with commercially pure (CP) titanium, joined using laser welding and placed on four one-piece implants. Sufficient retention and stability were obtained using this method. PMID:20158062

  8. A quality-of-life comparison between self-aligning and ball attachment systems for 2-implant-retained mandibular overdentures.

    PubMed

    Bilhan, Hakan; Geckili, Onur; Sulun, Tonguc; Bilgin, Tayfun

    2011-03-01

    The aim of this study was to evaluate the self-aligning overdenture attachment system by comparing its oral health-related quality of life (OHRQL) with a traditionally used ball attachment system. In this randomized, within-subject crossover trial, 25 edentulous subjects each received 2 mandibular implants, and were then assigned to receive either self-aligning or traditional ball attachments. After 3 months, all subjects were switched to the second attachment type. The OHRQL was evaluated for both of the treatments using the short form of the Oral Health Impact Profile (OHIP-14). A subanalysis among subjects with below-average space available for attachment placement was also performed. Wilcoxon signed-rank test was used to compare differences between groups. Scores on the OHIP-14 physical disability domain were significantly better for the self-aligning attachment system (P  =  .049). Among subjects with below-average attachment space, functional limitation, psychological discomfort, physical disability, psychological disability, and total OHIP-14, scores were significantly better for the self-aligning attachment system (P  =  .041, P  =  .047, P  =  .048, P  =  .026, and P  =  .005, respectively). The self-aligning attachment system for 2-implant-retained mandibular overdentures is equal or superior to traditional ball attachments in all domains of the OHIP-14. PMID:20662674

  9. Effect of Implant Height Differences on Different Attachment Types and Peri-Implant Bone in Mandibular Two-Implant Overdentures: 3D Finite Element Study.

    PubMed

    Ozan, Oguz; Ramoglu, Serhat

    2015-06-01

    Implant-supported overdentures with self-aligning attachment systems are preferred to improve the stability and retention of complete dentures. The positioning of the implant attachments is a very important aspect of two-implant overdentures in obtaining better stress distribution. Therefore, the objective of this study was to compare two different attachment systems in a two-implant overdenture by evaluating the stress distributions in peri-implant bone and stresses on the attachments with positioning at different height levels using the 3D FEA method. Six models with ball attachments and 6 models with locator attachments-totaling 12 models (including 2 controls)-with the left implant positioned unilaterally at different height levels were subjected to 3 loading conditions (anterior, right posterior, and left posterior). Data for Von Misses stresses were produced numerically, color coded, and compared among the models for attachments and peri-implant cortical bone. The configurations in which implants presented 3 mm height differences in the bone level showed the most successful results in the peri-implant bone. When stresses on the attachments were compared, greater stress values were obtained from the ball attachments. As a conclusion, the configurations with a considerable (3 mm) height difference between quadrants of the mandible in the anterior segment showed the most successful results in the peri-implant bone. On the contrary, peak stress values around the implant observed from the models with less (1 mm) bone height difference may require leveling of the bone during surgery. However, these findings should be corroborated with clinical studies. PMID:24471769

  10. Replacing worn overdenture abutments of an unknown implant system by using laser welding: a clinical report.

    PubMed

    Mohunta, Vrinda V; Stevenson, James A; Lee, Damian J

    2014-09-01

    This clinical report describes a procedure for replacing worn ball abutments with low-profile resilient abutments by using laser welding when the implant system for a mandibular implant-supported overdenture could not be identified. PMID:24836281

  11. Impact of Platelet-Rich Plasma on Bone Height Changes around Platform Switched Implants Supporting Mandibular Overdentures in Controlled Diabetic Patients

    PubMed Central

    Ibraheem, Eman Mostafa Ahmed; Eldeen, Amany Mohy

    2015-01-01

    BACKGROUND: The platform switching concept was recently introduced to implant dentistry involving the reduction of restoration abutment diameter with respect to the diameter of dental implant. Long-term follow-up around these implants showed higher levels of bone preservation and proper stress distribution and improved esthetics. AIM: The aim of the present study was to evaluate the changes in bone height by means of radiographic examination around platform switched implant supporting mandibular overdentures in controlled diabetic patients. SUBJECTS AND METHODS: Fourteen male complete edentulous patients were selected and enrolled in a follow-up study plan. Split mouth technique was applied; one side implant chosen randomly with Platelet-rich-plasma (PRP) and the other without PRP, bone height changes was assessed by Cone Beam Computed Tomography (CBCT) radiographic examination after 3 months, 6 months, 9 months and 1 year later. RESULTS: There was increase in bone height loss in both sides but with no statistical significance difference between the two sides after 3 months, 6 months, 9 months and 1 year respectively. CONCLUSION: The result of this article satisfied the patients both esthetically and functionally with recorded increase in bone height loss. PMID:27275316

  12. Short-term post-operative pain and discomfort following insertion of mini-implants for retaining mandibular overdentures: a randomized controlled trial.

    PubMed

    Ribeiro, A B; Della Vecchia, M P; Cunha, T R; Sorgini, D B; Dos Reis, A C; Muglia, V A; de Albuquerque, R F; de Souza, R F

    2015-08-01

    The retention of removable dentures by mini-implants is a relatively recent treatment modality and may lead to minimal post-operative trauma. This study compared post-operative pain and discomfort following the insertion of mini-implants (two or four) or two standard-size implants for the retention of mandibular overdentures. One hundred and twenty edentulous participants (mean age 59.5 ± 8.5 years) were randomly allocated into three groups according to received treatment: (GI) four mini-implants, (GII) two mini-implants or (GIII) two standard implants. Seven days after implant insertion, patients answered questions (100-mm VAS) relating to pain, swelling, and discomfort with chewing, speech and hygiene, considering their experiences during the 1st and 6th day. Groups were compared by two-way anova (α = 0.05). All participants (GI: 38; GII: 42; GIII: 40) were analysed after 7 days. At the 6th day, GI felt significantly higher pain than GII and GIII. GI also reported more difficulty in performing oral hygiene practices than GIII during the 1st day. There was no significant difference between groups for the other questions and periods. No participant suffered unexpected side effects. The use of four mini-implants induces more intense post-operative pain at the 6th day than the insertion of two mini- or conventional fixtures, as well as more difficult oral hygiene on the 1st day. Clinicaltrials.gov, NCT01411683; FAPESP, 2011/00688-7 and 2011/23347-0. PMID:25765784

  13. A randomised clinical trial on the influence of splinted and unsplinted oral implants in mandibular overdenture therapy. A 3-year report.

    PubMed

    Naert, I E; Gizani, S; Vuylsteke, M; van Steenberghe, D

    1997-06-01

    A randomised clinical trial was performed to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. Furthermore, patient satisfaction was evaluated for different attachment systems retaining the overdenture. Thirty-six edentulous patients were randomised into three groups of equal size and treated with either magnets, ball attachments or straight bars (reference group). After 3 years of observation no implants were lost in any of the groups. Besides, no statistically significant differences were noted for the peri-implant outcome. Although the bar group presented the highest retention force, the general satisfaction of the patients in the three groups did not differ. The patients with bar retentions showed less prosthetic complications of the retention elements but more at the level of the denture-supporting mucosa. Finally, the clinical outcome of all groups confirms that overdenture treatment demands regular controls with limited time intervals. PMID:9552823

  14. Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws

    PubMed Central

    2014-01-01

    PURPOSE To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results. PMID:25177466

  15. Tissue-supported dental implant prosthesis (overdenture): the search for the ideal protocol. A literature review

    PubMed Central

    Laurito, Domenica; Lamazza, Luca; Spink, Michael J.; De Biase, Alberto

    2012-01-01

    Summary Aims The success of maxillary and mandibular tissue supported implant prostheses varies in the literature, and the ideal protocol may be elusive from given the numerous studies. The oral rehabilitation option is an alternative to conventional dentures and should improve function, satisfaction, and retention. The purpose of this review article is to clarify these questions. Methods The search of literature reviews English non-anecdotal implant overdentures articles from 1991 to 2011. Results The results display an aggregate comprehensive list of categorical variables from the literature review. Overall success of maxillary and mandibular implant overdenture was respectively, 86.6% and 95.8%. Conclusion The literature indicates that the implant overdenture prosthesis provides predictable results – enhanced stability, function and a high-degree of satisfaction compared to conventional removable dentures. PMID:22783448

  16. Mandibular Overdenture Retained by Magnetic Assembly: A Clinical tip.

    PubMed

    Anupam, Purwar; Anandakrishna, G N; Vibha, Shetty; Suma, Janya; Shally, Khanna

    2014-12-01

    The preservation of remaining root structure and alveolar bone covering them with denture has been used since many years. Tooth-retained overdentures transfer occlusal forces to the alveolar bone through the periodontal ligament of the retained tooth roots and thereby prevent bone resorption. Applications of magnets in overdenture technique has been widely used in dentistry in the field of prosthodontics, as they can be manufactured in small dimensions as retentive devices for complete denture, removable partial dentures, obturators and maxillofacial prosthesis. This article presents a simple and efficient method of fabrication of mandibular over denture retained by magnets in a patient whose mandibular residual ridge is severely resorbed with few remaining teeth and maxillary conventional removable partial denture. Mandibular over denture retained by magnets assembly consist of magnet and coping with keeper on remaining tooth structure to rehabilitate the patient since magnetic attachments can provide support, stability and retention. PMID:26199541

  17. Two Years Retrospective Evaluation of Overdenture Retained by Symphyseal Single Implant Using Two Types of Attachments

    PubMed Central

    Ismail, Hussien Abdelfattah; Mahrous, Ahmed I; Banasr, Fahad H; Soliman, Tarek A; Baraka, Yasser

    2015-01-01

    Background: This study was aimed to evaluate complete mandibular overdentures retained by a symphyseal single implant using ball and magnet attachments in both clinical and radiographic evaluation. Materials and Methods: Ten dental press fit titanium implants were installed in the lower jaws of completely edentulous patients according to two-stage surgical protocol. For each patient, one implant was installed in the symphyseal midline region, and left submerged and unloaded for 4 months. The patients were then divided into two equal groups. The first group received mandibular overdentures retained by ball and socket attachment. The second group received mandibular overdentures retained by magnet attachment. Both groups were supplied with conventional maxillary complete dentures. All patients were evaluated immediately after denture insertion, 6 months, and 12 months and after 24 months of overdenture insertion. Results: The study showed insignificant difference regarding the clinical condition and the marginal bone height changes in both groups during the follow-up period. Conclusion: Single implant retained overdenture with ball and socket or magnetic attachments was easy in construction, required less home care to maintain gingival health and give satisfactory clinical results. PMID:26124591

  18. A Sequential Approach to Implant-Supported Overdentures.

    PubMed

    Kosinski, Timothy

    2016-03-01

    Fabrication of implant-supported maxillary or mandibular overdentures can seem to be difficult procedures. Many things could go wrong and/or unnoticed until the fabrication has been completed. Implants must be correctly surgically placed in viable bone at the proper angulation and spacing within an arch. The type of attachment must be considered and future treatment of the appliance should be simple and efficient. The appliance must function not only initially but also for many years to come. The author has found the use of the GPS attachment to be an ideal tool to achieve the goals of retention and stability. Careful planning is the most important part of this process, and understanding the benefits and risks of creating overdentures should be well understood by the dentists. By sequentially planning and treating these types of cases, the patient is able to function reasonably during the stages of implant healing. The final prosthesis is created and remaining teeth that held the transitional appliance in place are remove on the day of final seating. This is an excellent simplified retentive system option for those patients who are anxious about losing their teeth, even those teeth that are diseased and ugly. PMID:27039540

  19. Effect of neutral zone technique on marginal bone loss around implant-supported overdentures

    PubMed Central

    Darwish, Mahmoud; Nassani, Mohammad Zakaria; Baroudi, Kusai

    2015-01-01

    Aim: The aim of this study was to compare changes in marginal bone height around immediately loaded implants supporting a mandibular overdenture constructed according to the neutral zone technique with changes around overdentures constructed according to the conventional methods. Materials and Methods: Twelve completely edentulous male patients were randomly allocated to two equal groups of patients. Patients in the first group received conventionally constructed complete dentures and patients in the second group received complete dentures constructed using the neutral zone record. All the patients received two single-piece titanium implants placed bilaterally in the mandibular canine regions using flapless surgery, which were then immediately loaded by the dentures. Marginal bone height was radiographically evaluated at baseline and 6, 12, and 18 months after implant loading. Results: There was a significant loss in marginal bone height around the supporting implants in each study group. However, no significant differences in marginal bone height were recorded between the study groups over the observation period (P > 0.05). Conclusion: Marginal bone height changes induced by overdentures constructed with neutral zone technique on immediately loaded implants are not different from those changes induced by overdentures constructed with a conventional method. PMID:26942118

  20. Comparison of stress distribution between complete denture and implant-retained overdenture-2D FEA.

    PubMed

    Assunção, W G; Tabata, L F; Barão, V A R; Rocha, E P

    2008-10-01

    The aim of this study was to compare the stress distribution induced by posterior functional loads on conventional complete dentures and implant-retained overdentures with different attachment systems using a two-dimentional Finite Element Analysis (FEA-2D). Three models representative of edentulous mandible were constructed on AutoCAD software; Group A (control), a model of edentulous mandible supporting a complete denture; Group B, a model of edentulous mandible supporting an overdenture over two splinted implants connected with the bar-clip system; Group C, a model of edentulous mandible supporting an overdenture over two unsplinted implants with the O-ring system. Evaluation was conducted on Ansys software, with a vertical force of 100 N applied on the mandibular left first molar. When the stress was evaluated in supporting tissues, groups B (51.0 MPa) and C (52.6 MPa) demonstrated higher stress values than group A (10.1 MPa). Within the limits of this study, it may be concluded that the use of an attachment system increased stress values; furthermore, the use of splinted implants associated with the bar-clip attachment system favoured a lower stress distribution over the supporting tissue than the unsplinted implants with an O-ring abutment to retain the mandibular overdenture. PMID:18482352

  1. The effect of implant number and position on the stress behavior of mandibular implant retained overdentures: A three-dimensional finite element analysis.

    PubMed

    Topkaya, Tolga; Solmaz, Murat Yavuz

    2015-07-16

    The present study evaluated the effects of ball anchor abutment attached to implants with a 4.30 mm diameter and 11 mm insert length on stress distribution in a patient without any remaining teeth in the lower jaw. In the study, the stress analysis was performed for five different configurations (2 with 4 implant-supported and 3 with 2 implant-supported) and three different loading types using ANSYS Workbench software. The stresses measured in the 4 implant-supported models were lower compared to the stresses measured in the 2 implant-supported models. The stresses on the implants intensified on the cervical region of the implants. When the effects of the loading sites on the stress were examined, the loading on the first molar tooth produced the highest stresses on the implants. PMID:25862522

  2. Immediate loading on mandibular edentulous patient with SFI Bar® overdenture

    PubMed Central

    Kim, Ha-Young; Kim, Ryan Jin-Young; Qadeer, Sarah; Jeong, Chang-Mo; Shin, Sang-Wan

    2011-01-01

    Despite the greater retention and low maintenance of bar attachment system, the longer clinical time and increased number of visits were the assignments to overcome in bar attachment system. This case report describes SFI-Bar® (Cendres et Métaux, Biel/Bienne, Switzerland) to be solve those problems. A 65-year-old female, who had severely absorbed mandible, hoped to wear a stable mandibular denture without pain. As soon as two implants were placed on mandible, a tube bar was connected to two adaptors connected to each implant. The length of the tube bar was adjusted considering inter implant distance, and reconnected to the adaptors. Finally a female part was seated beneath the denture. This case report showed that a satisfactory clinical result was achieved by delivering bar overdenture immediately after implant placement without laboratory procedure. PMID:21503194

  3. An analysis of the implant-supported overdenture in the edentulous mandible.

    PubMed

    Chen, K-W; Lin, T-M; Liu, P-R; Ramp, L C; Lin, H-J; Wu, C-T; Pan, Y-H

    2013-01-01

    This investigation examined the cumulative survival rate of the implant-supported overdenture using two types of attachments in patients treated at Show Chwan Memorial Hospital Implant Center from 1992 to 2006. Fifty-one patients (30 men and 21 women) were treated with mandibular implant-supported overdentures. Attachment systems used were the Hader bar with bilateral, cast ERA attachments (Group A, 31 patients with 15 men and 16 women, 134 implants) and the Hader bar with bilateral, distal extension cantilevers (Group B, 20 patients with 15 men and 5 women, 85 implants). Two hundred and four implants remained at the end of the follow-up period. Among failed implants, 10 implants were in Group A (failure rate: 10/134 = 7·5%), whereas five implants were in Group B (failure rate: 5/85 = 5·9%). Sixty-six point seven per cent (10/15) of failed implants were placed in the distal anterior mandible, and 33·3% (5/15) were placed in the middle anterior mandible. Survival was also examined with respect to condition of the opposing arch. Patients wearing a maxillary removable partial denture had the highest implant failure rate (5/51 = 9·8%), whereas the failure rate of the maxillary complete denture group was only 5·7%. The most frequent need for maintenance was wear over patrix component of ERA or Hader clip (n = 56). Eight patients experienced connector fracture between ERA and Hader bar, and one experienced distal extension cantilever fracture. The implant-supported overdenture can be an effective and reliable alternative to the conventional complete mandibular denture. Fewer prosthetic complications were seen in overdentures retained with distal extension cantilever attachments. PMID:23121231

  4. Comparison of Three Attachments in Implant-Tissue Supported Overdentures: An In Vitro Study

    PubMed Central

    Tabatabaian, F.; Alaie, F.; Seyedan, K.

    2010-01-01

    Objective: Retention and resistance of the implant-tissue supported overdenture may be affected by the type of attachment. The aim of this research was to compare the retention and resistance of Nobel Biocare Ball (NBB), Nobel Biocare Bar and Clip (NBBC) and Sterngold ERA Red (ERAR) attachments on an implant-tissue supported overdenture model. Materials and Methods: The attachment samples were divided into 3 groups of NBB, NBBC, and ERAR (5 samples in each group). Two parallel Nobel Biocare Branemark implants were placed symmetrically at the symphysis region of a mandibular test model. A metallic overdenture was fabricated precisely adapted to the model and attached to a Zwick testing machine (crosshead speed of 51 mm/min). Dislodging tensile forces were applied in three vertical, oblique, anterior-posterior directions and two situations, at the beginning and after 100 times of insertion/removal of the overdenture, for each sample. The maximum dislodging force was measured. A One-way ANOVA test was employed followed by Tukey’s test. Results: ERAR was the most retentive and resistant in both situations. NBB and NBBC showed the same anterior-posterior resistance at the beginning. All test groups represented a large amount of retention and resistance loss after the insertion/removal of the overdenture, while NBBC showed a higher loss of anterior-posterior resistance than NB. Conclusion: A highest level of retention and resistance was seen in ERAR. The retention and resistance were affected by the wear of attachments. PMID:21998784

  5. Prosthetic implant treatment of the edentulous maxilla with overdenture.

    PubMed

    Inversini, M

    2006-10-01

    The literature concerning the success of prosthetic implant treatment with maxillary overdenture is reviewed, and variables affecting treatment from the implant and prosthetic standpoint are analysed. Guidelines for the fabrication of maxillary overimplants comparable to those for mandibular overimplants are still lacking, as are evidence-based prosthetic design concepts. Individual methods and techniques have been described, but evaluation standards for the outcome of maxillary prosthetic-implant treatment are lacking or individually interpreted. The biomechanics involved in the proposed system are described, together with the advantages of telescopic crowns for the retention of removable partial prosthesis supported by maxillary implants. The positive influence, in terms of long-term prognosis, of the perio-protective design of removable partial prostheses supported by maxillary overimplants is also discussed. The proposed system not only provides stability, support and retention for removable partial prostheses supported by maxillary implants, but also enables implant survival rates to be improved, both for biomechanical reasons and due to improved oral hygiene. The simplification of fabrication procedures, repair, rebasing and re-operating also reduce the cost of follow-up and improve the cost/benefit ratio. However, additional studies are needed to clarify the number and most appropriate distribution of implants, as well as the most favourable prosthetic designs for maxillary overimplants. PMID:17268392

  6. Prosthetic management of the atrophic mandible using endosseous implants and overdentures: a six year review.

    PubMed

    Chan, M F; Johnston, C; Howell, R A; Cawood, J I

    1995-11-11

    This paper presents the treatment results and experiences gained from a retrospective study of patients treated with the IMZ osseo-integrated implant system and mandibular overdentures. Patients experiencing problems wearing conventional dentures were assessed by the implant team and 65 cases were treated with 154 endosseous implants placed in the edentulous mandible. Two to four implants were placed in each case and in addition some patients have had augmentation of the mandible with hydroxyapatite. The definitive mandibular prostheses were supported by both implants and the residual ridges. A variety of retention systems were utilised, which included different types of bar and clip, stud attachments, and magnets. The patients have been followed up regularly and evaluated after periods of between one and six years. Six implants have failed over this time resulting in a success rate of over 96%. Most patients expressed a high degree of satisfaction with their new overdentures. There was, however, a considerable burden of maintenance care required for the patient group examined. The findings demonstrate that implant retained overdentures offer a highly effective means of oral rehabilitation for the atrophic mandible, restoring both oral function and facial form. PMID:7495628

  7. Attachment systems for implant retained overdentures: a literature review.

    PubMed

    Trakas, Theodoros; Michalakis, Konstantinos; Kang, Kiho; Hirayama, Hiroshi

    2006-03-01

    This article presents a comparison between different attachment systems used to retain and support maxillary and mandibular overdentures in completely edentulous patients. A literature review based on a MEDLINE search limited to English-language articles published from 1988 to the present was performed, and a large number of attachments available in the dental market were reviewed with regard to several factors, including: (1) implant survival rate, (2) marginal bone loss, (3) soft tissue complications, (4) retention, (5) stress distribution, (6) space requirements, (7) maintenance complications, and (8) patient satisfaction. These factors are considered essential for the successful outcome and good long-term prognosis of the prostheses. Selection criteria previously published in the literature are discussed as well. Product names and manufacturers are mentioned only if related to attachment systems, as they are cited in the original articles. PMID:16569958

  8. A finite element study on stress distribution of two different attachment designs under implant supported overdenture

    PubMed Central

    El-Anwar, Mohamed I.; Yousief, Salah A.; Soliman, Tarek A.; Saleh, Mahmoud M.; Omar, Wael S.

    2015-01-01

    Objective This study aimed to evaluate stress patterns generated within implant-supported mandibular overdentures retained by two different attachment types: ball and socket and locator attachments. Materials and methods Commercial CAD/CAM and finite element analysis software packages were utilized to construct two 3D finite element models for the two attachment types. Unilateral masticatory compressive loads of 50, 100, and 150 N were applied vertically to the overdentures, parallel to the longitudinal axes of the implants. Loads were directed toward the central fossa in the molar region of each overdenture, that linear static analysis was carried out to find the generated stresses and deformation on each part of the studied model. Results According to FEA results the ball attachment neck is highly stressed in comparison to the locator one. On the other hand mucosa and cortical bone received less stresses under ball and socket attachment. Conclusions Locator and ball and socket attachments induce equivalent stresses on bone surrounding implants. Locator attachment performance was superior to that of the ball and socket attachment in the implants, nylon caps, and overdenture. Locator attachments are highly recommended and can increase the interval between successive maintenance sessions. PMID:26644755

  9. Preliminary In Vitro Study on O-Ring Wear in Mini-Implant-Retained Overdentures.

    PubMed

    Chaves, Carolina Andrade; Souza, Raphael Freitas; Cunha, Tatiana Ramirez; Vecchia, Maria Paula; Ribeiro, Adriana Barbosa; Bruniera, João Felipe; Silva-Sousa, Yara Teresinha

    2016-01-01

    This preliminary in vitro study evaluated the simulated retention force of O-rings used for mini-implant overdenture treatment and the effect of mechanical fatigue corresponding to 6 months of wear. A mandibular overdenture analog device was attached to two mini-implants and underwent a tensile strength test before and after the application of insertion-removal and simulated masticatory cycles. Insertion-removal cycles led to a retention loss of 24%, whereas masticatory cycles did not influence retention. Micro-CT scans showed minor deformation following mechanical cycling, but the changes were milder than those observed in similar clinical specimens. Both experimental loading methods led to physical changes in the O-rings, which explains in part the similar clinically observed wear. PMID:27479342

  10. Biomaterial aspects: A key factor in the longevity of implant overdenture attachment systems

    PubMed Central

    Daou, Elie E.

    2015-01-01

    Background: New attachment systems are released for mandibular two-implant overdentures often without evidence-based support. Biomaterial aspects are now the parameters considered when choosing the appropriate attachment. Studies regarding their properties remain scarce. Purpose: The purpose of this review was to help the clinician in selrcting the most adapted stud attachments according evidence-based dentistry. Materials and Methods: An electronic search was conducted using specific databases (PubMed, Medline, and Elsevier libraries). Peer-reviewed articles published in English up to July 2014 were identified. Emphasis was given on the biomaterial aspects and technical complications. No hand search was added. Results: The electronic search generated 115 full-text papers, of which 84 papers were included in the review. The majority were clinical and in vitro studies. Some review articles were also considered. Papers reported survival and failures of overdenture connection systems. Emphasis was laid on attachment deformation. Conclusion: Implant overdentures long-term follow-up studies may provide useful guidelines for the clinician in selecting the type of attachment system and overdenture design. Locator attachments are more and more used, with lesser complications reported. PMID:26312224

  11. Implant-supported overdentures: the ZAAG attachment system.

    PubMed

    Davidoff, S R

    1997-11-01

    It has been amply demonstrated during the last decade that there are significant advantages to implant-supported overdentures beyond conventional complete dentures. Several attachment systems exist for connecting the overdenture to the implants, and practically all of them present notable benefits to the patients. This article discusses the use of the Zest Anchor Advanced Generation (ZAAG). This system, an outgrowth from the original Zest attachment, uses both individual implant attachments and bar attachments, and is compatible with all major implant systems. In addition to the retention, stability, and resiliency the ZAAG implant attachment system provides, it has the advantage of placing the resistance force of the attachment close to the implant body. PMID:9533347

  12. Implant-supported overdentures: a longitudinal prospective study.

    PubMed

    Bergendal, T; Engquist, B

    1998-01-01

    The aim of this study was to evaluate the clinical function and long-term prognosis of overdentures retained by a small number of implants in the maxilla and mandible using one of two different attachment systems. Included in the study were all patients referred to specialty clinics in Jönköping and Linköping, Sweden, during the treatment period who needed an overdenture and could be provided with a minimum number of two bilaterally-placed implants. Excluded were patients with bone-grafted jaws, irradiated cancer patients, heavy bruxers, and patients who had lost a fixed prosthesis because of implant losses. The patients were randomly assigned to receive one retentive system, either a round 2-mm-diameter bar with clips or ball attachments (Nobel Biocare). Eighteen overdentures were placed in maxillae and 32 in mandibles, supported by a total of 115 Brånemark implants. Of the implants placed, 86.1% were continuously osseointegrated. The cumulative implant survival rates after 7 years of loading were 75.4% in the maxillae and 100% in the mandibles. There was no difference in implant survival rate between the attachment systems. Patients with implant losses were characterized by severely resorbed maxillary ridges and inferior bone quality, together with unfavorable loading circumstances such as short implants combined with long leverages. Complications and prosthetic adjustments were mostly resolved early and easily. PMID:9581412

  13. Stress distributions in maxillary bone surrounding overdenture implants with different overdenture attachments.

    PubMed

    Chun, H-J; Park, D-N; Han, C-H; Heo, S-J; Heo, M-S; Koak, J-Y

    2005-03-01

    In this study, effects of different overdenture attachments on the stress distributions in the maxillary bone surrounding the overdenture implants are studied. Four different types of attachment are considered. They are rigid Dalbo Stud, movable Dalbo Stress Broken, movable Dalro, and movable O-ring attachments. Three-dimensional finite element analysis was conducted with commercial package to obtain the stress distributions in the maxillary bone. Varying the attachment types and angle of inclination of load, the stress distributions in the portions of compact bone and trabecular bone were monitored separately. The analysis was conducted by assuming two different boundary conditions at the interface between cap and overdenture abutment in order to evaluate influence of interface boundary condition on stress distribution in the maxillary bone. They were perfect bonding condition and contact with friction at the interfaces. However, it is preferable to assume perfect bond condition at the interface for rigid type attachment systems and contact with friction at the interface for movable type attachment systems. From the numerical results, it was found that the load transfer mechanism of the implant system is altered significantly by the types of the overdenture attachment and also special care must be taken to assign proper boundary conditions at the interface for the analysis. The movable type Dalro attachment generated the highest maximum effective stress in the maxillary bone among the models under the same inclined loading condition for contact with friction. The rigid type Dalbo Stud attachment generated the smallest maximum effective stress in the maxillary bone among the models under the same inclined loading condition for perfect bonding condition. PMID:15707430

  14. A Partial Palatal Coverage Overdenture Retained by Zygomatic Implants.

    PubMed

    Schweitzer, Daniel M; Bloom, Mitchell J; Mancia, Gregorio O

    2015-12-01

    Prosthodontic rehabilitation of an atrophic edentulous maxilla can be challenging and is further complicated when multiple risk factors are present. Fixed prostheses require multiple implants for support/retention organized in biomechanically favorable positions in order to afford a good prognosis. Such suitable implant arrangements in an atrophic edentulous ridge can often be difficult to achieve. Removable prostheses require fewer implants for a favorable prognosis and can furthermore take advantage of the additional anatomical structures for support/retention. This clinical treatment will describe the fabrication of a partial palatal coverage overdenture retained by zygomatic implants. PMID:26215793

  15. Does a mandibular overdenture improve nutrient intake and markers of nutritional status better than conventional complete denture? A systematic review and meta-analysis

    PubMed Central

    Yamazaki, Toru; Martiniuk, Alexandra LC; Irie, Koichiro; Sokejima, Shigeru; Lee, Crystal Man Ying

    2016-01-01

    Objectives The need for denture treatment in public health will increase as the population ages. However, the impact of dentures on nutrition, particularly overdenture treatment, remains unclear although the physical and psychological effects are known. We investigated whether treatment with a mandibular implant supported overdenture improves nutrient intake and markers of nutritional status better than a conventional complete denture in edentulous patients. Design Systematic review and meta-analysis. Methods Medline, EMBASE and the Cochrane Central Register of Controlled Trials were searched for eligible studies published up to April 2016. We included studies which compared the treatment effect of an overdenture to conventional denture on nutrition, in which primary outcomes included changes in intake of macronutrients and/or micronutrients and/or indicators of nutritional status. Two reviewers independently evaluated eligible studies and assessed the risk of bias. We used a fixed effects model to estimate the weighted mean difference (WMD) and 95% CI for change in body mass index (BMI), albumin and serum vitamin B12 between overdenture and conventional denture 6 months after treatment. Results Of 108 eligible studies, 8 studies involving 901 participants were included in the narrative appraisal. Four studies reported changes in markers of nutritional status and nutrient intake after treatment with a prosthetic, regardless of type. In a meta-analysis of 322 participants aged 65 years or older from three studies, pooled analysis suggested no significant difference in change in BMI between an overdenture and conventional denture 6 months after treatment (WMD=−0.18 kg/m2 (95% CI −0.52 to 0.16)), and no significant difference in change in albumin or vitamin B12 between the two treatments. Conclusions The modifying effect of overdenture treatment on nutritional status might be limited. Further studies are needed to evaluate the effectiveness and efficacy of

  16. Mechanical response comparison in an implant overdenture retained by ball attachments on conventional regular and mini dental implants: a finite element analysis.

    PubMed

    Chang, Shih-Hao; Huang, Shiang-Rung; Huang, Shao-Fu; Lin, Chun-Li

    2016-06-01

    This study investigates the bone/implant mechanical responses in an implant overdenture retained by ball attachments on two conventional regular dental implants (RDI) and four mini dental implants (MDI) using finite element (FE) analysis. Two FE models of overdentures retained by RDIs and MDIs for a mandibular edentulous patient with validation within 6% variation errors were constructed by integrating CT images and CAD system. Bone grafting resulted in 2 mm thickness at the buccal side constructed for the RDIs-supported model to mimic the bone augmentation condition for the atrophic alveolar ridge. Nonlinear hyperelastic material and frictional contact element were used to simulate characteristic of the ball attachment-retained overdentures. The results showed that a denture supported by MDIs presented higher surrounding bone strains than those supported by RDIs under different load conditions. Maximum bone micro strains were up to 6437/2987 and 13323/5856 for MDIs/RDIs under single centric and lateral contacts, respectively. Corresponding values were 4429/2579 and 9557/5774 under multi- centric and lateral contacts, respectively. Bone micro strains increased 2.06 and 1.96-folds under single contact, 2.16 and 2.24-folds under multiple contacts for MDIs and RDIs when lateral to axial loads were compared. The maximum RDIs and MDIs implant stresses in all simulated cases were found by far lower than their yield strength. Overdentures retained using ball attachments on MDIs in poor edentulous bone structure increase the surrounding bone strain over the critical value, thereby damaging the bone when compared to the RDIs. Eliminating the occlusal single contact and oblique load of an implant-retained overdenture reduces the risk for failure. PMID:26212887

  17. Rehabilitation with implant-supported overdentures in total edentulous patients: A review

    PubMed Central

    Segura-Andrés, Gustavo; Faus-López, Joan; Agustín-Panadero, Rubén

    2013-01-01

    Objectives: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. Material and methods: We performed a Medline search and review of pertinent articles on the mentioned subject from 1986 to 2011. As a searching strategy, we used the following words: implant-supported overdentures, attachment systems, Locator attachment, cantilever, fixed prosthesis. Results and conclusions: Implant-supported overdentures constitute an accurate and predictable treatment option and achieve a higher patients’ satisfaction. This type of treatment constitutes a cheaper treatment than fixed prostheses and in some patients, with loss of lip support or with an interoclusal space larger than 15 mm, the choice of implant-supported overdentures seems to prevent future aesthetic or phonetic problems. Key words:Overdentures, implant occlusion, implant rehabilitation, total edentulous rehabilitation, fixed prosthesis. PMID:24455093

  18. Finite element analysis to compare complete denture and implant-retained overdentures with different attachment systems.

    PubMed

    Barão, Valentim Adelino Ricardo; Assunção, Wirley Gonçalves; Tabata, Lucas Fernando; Delben, Juliana Aparecida; Gomes, Erica Alves; de Sousa, Edson Antonio Capello; Rocha, Eduardo Passos

    2009-07-01

    This finite element analysis compared stress distribution on complete dentures and implant-retained overdentures with different attachment systems. Four models of edentulous mandible were constructed: group A (control), complete denture; group B, overdenture retained by 2 splinted implants with bar-clip system; group C, overdenture retained by 2 unsplinted implants with o'ring system; and group D, overdenture retained by 2 splinted implants with bar-clip and 2 distally placed o'ring system. Evaluation was performed on Ansys software, with 100-N vertical load applied on central incisive teeth. The lowest maximum general stress value (in megapascal) was observed in group A (64.305) followed by groups C (119.006), D (258.650), and B (349.873). The same trend occurred in supporting tissues with the highest stress value for cortical bone. Unsplinted implants associated with the o'ring attachment system showed the lowest maximum stress values among all overdenture groups. Furthermore, o'ring system also improved stress distribution when associated with bar-clip system. PMID:19553853

  19. Telescopic Overdenture and Implant Supported Fixed Partial Denture: A Pragmatic Treatment Approach

    PubMed Central

    Dede, Doğu Ömür; Cenk Durmuşlar, M.; Şahın, Onur; Köroğlu, Ayşegül; İşısağ, Özer

    2015-01-01

    This case report presents a patient who had been rehabilitated with a telescopic overdenture and implant supported fixed partial denture (ISFPD). The treatment process was as follows: (1) fabricating telescopic crowns and overdenture prosthesis for the lower jaw and a temporary complete denture for the upper jaw, (2) using the temporary denture as diagnostic and surgical guide to optimize dental implant placement, and (3) fabricating ISFPD for the upper jaw. Using the patient's existing or temporary denture not only serves as an alternative surgical guide to calibrate the dental implant locations but also helps to finish the restoration at desired dimension, size, and anatomic form. PMID:26106491

  20. Retrospective Analysis of Implant Overdenture Treatment in the Advanced Prosthodontic Clinic at the University of Illinois at Chicago.

    PubMed

    Marinis, Aristotelis; Afshari, Fatemeh S; Yuan, Judy Chia-Chun; Lee, Damian J; Syros, George; Knoernschild, Kent L; Campbell, Stephen D; Sukotjo, Cortino

    2016-02-01

    The aim of the present retrospective study was to evaluate the clinical outcomes of implant-supported overdenture treatment provided by prosthodontic specialty residents. Twenty-three patients with 25 implant-supported overdentures (IODs) participated in the study. Seventy-four implants were placed by periodontic, prosthodontics, or oral and maxillofacial surgery students. All prostheses were fabricated in the advanced prosthodontics clinic at University of Illinois at Chicago. The condition of the peri-implant soft tissue, implants, and prostheses were evaluated. Complications and any maintenance were documented. Patients completed an oral health impact profile-14 and semantic differential scale questionnaires. Statistical analyses were performed using SPSS statistical software. Twenty mandibular and 5 maxillary IODs were evaluated. Ninety-seven percent of the attachments were locators (Zest Anchors) and 3% ball attachments. None of the implants had lost osseointegration, but 14 implants (19%) had developed marginal bone loss in one-third of the implant length or more. Fourteen (19%) implants had developed dehiscence, which ranged from 1 to 4 mm. A variation in the width of the keratinized tissue, gingival, plaque, and calculus index was observed. There was a statistically significant relationship between the presence of plaque and the bleeding on probing on the buccal aspect of implants (P = .012). The incidence of dehiscence was significantly higher on the midfacial when the keratinized tissue was less than 2 mm (P < .0001). The majority of the complications were prosthetic in nature, such as broken denture teeth (74%) and worn or loose matrices (35%). Debris was observed in 19% of the locator abutments, and 36% of the overdentures were not stable in application of anterior force. Patients were compliant with oral hygiene protocols and their chewing ability was high (mean = 8.0). The overall experience was pleasant (mean = 7.5); the treatment provided good

  1. The incomprehensible success of the implant stabilised overdenture in the edentulous mandible: a literature review on transfer of chewing forces to bone surrounding implants.

    PubMed

    Chao, Y L; Meijer, H J; Van Oort, R P; Versteegh, P A

    1995-12-01

    The approach of implant stabilised overdentures has become one of the routine treatment modalities for compromised edentulous ridges. The purpose of this literature review is to analyze survival rates of loaded implants, occlusal forces and stress distributions of implant stabilised overdentures in edentulous mandibles and of fixed loaded implants at least over a medium-term period. which is comparable with fixed prostheses. Patients with implant stabilised overdentures and with fixed bridges on implants generate similar occlusal forces. The number of implants under a prosthetic construction seems to have less influence on stress distribution than design of the superstructure and related direction of forces. PMID:8603169

  2. Improving masticatory performance, bite force, nutritional state and patient's satisfaction with implant overdentures: a systematic review of the literature.

    PubMed

    Boven, G C; Raghoebar, G M; Vissink, A; Meijer, H J A

    2015-03-01

    Oral function with removable dentures is improved when dental implants are used for support. A variety of methods is used to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state. A systematic review describing the outcome of the various methods to assess patients' appreciation has not been reported. The objective is to systematically review the literature on the possible methods to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state of patients with removable dentures and to describe the outcome of these. Medline, Embase and The Cochrane Central Register of Controlled Trials were searched (last search July 1, 2014). The search was completed by hand to identify eligible studies. Two reviewers independently assessed the articles. Articles should be written in English. Study design should be prospective. The outcome should be any assessment of function/satisfaction before and at least 1 year after treatment. Study population should consist of fully edentulous subjects. Treatment should be placement of any kind of root-form implant(s) to support a mandibular and/or maxillary overdenture. Fifty-three of 920 found articles fulfilled the inclusion criteria. A variety of methods was used to measure oral function; mostly follow-up was 1 year. Most studies included mandibular overdentures, three studies included maxillary overdentures. Implant-supported dentures were accompanied by high patient's satisfaction with regard to denture comfort, but this high satisfaction was not always accompanied by improvement in general quality of life (QoL) and/or health-related QoL. Bite force improved, masseter thickness increased and muscle activity in rest decreased. Patients could chew better and eat more tough foods. No changes were seen in dietary intake, BMI and blood markers. Improvements reported after 1 year apparently decreased slightly with time, at least on the long run. Treating

  3. Comparison of retention and release periods for implant overdenture attachments.

    PubMed

    Petropoulos, V C; Smith, W; Kousvelari, E

    1997-01-01

    The aim of this study was to compare the retention and release periods of the Nobel Biocare bar and clip (NBC), Nobel Biocare ball (NB), Zest anchor (ZA), Zest magnet (ZM), and Sterngold ERA (SE) attachments on an implant-retained overdenture model. The attachments were tested using two permanently placed Brånemark implants on a test model that was attached to an Instron machine (cross-head speed 50.8 mm/minute). Each attachment had one part embedded in a denture-like housing, and the other part screwed into the implants. Dislodging tensile forces were applied to the housings in two directions simulating function: vertical and oblique. Eight tests were done in two directions with three samples of each attachment. The dislodging forces generated measurements of the peak load, break load, and displacement at peak load and break load. Release periods were calculated using displacements between the peak load and break load and the cross-head speed. Results showed the NBC to be significantly most retentive for the break load when subjected to vertical and oblique forces with mean values and standard deviations of 2104.5 +/- 506.7 g and 1958.1 +/- 165.4 g, respectively. Next most retentive was the SE, followed by the ZA and NB. The ZM was significantly least retentive (127.8 +/- 7.0 g and 143.5 +/- 19.7 g). For the release period, results showed the NBC to have significantly the fastest release period for vertical and oblique forces (1.86 x 10(-3) and 7.35 x 10(-4) minutes). The ZM significantly had the slowest release period for those forces (3.02 x 10(-2) and 2.35 x 10(-2) minutes). The data suggested that the NBC could be selected when a higher degree of retention and fast release period are desired. The next most retentive was the SE; ZM was the least retentive and had the slowest release period. PMID:9109267

  4. Implant-supported obturator overdenture for extensive maxillary resection patient: a clinical report.

    PubMed

    Leles, Cláudio Rodrigues; Leles, José Luiz Rodrigues; de Paula Souza, Carlos; Martins, Rafael Ragonezi; Mendonça, Elismauro Francisco

    2010-04-01

    This clinical report presents an implant-retained obturator overdenture solution for a Prosthodontic Diagnostic Index Class IV maxillectomy patient with a large oronasal communication and severe facial asymmetry, loss of upper lip and midfacial support, severe impairment of mastication, deglutition, phonetics, and speech intelligibility. Due to insufficient bone support to provide satisfactory zygomaticus implant anchorage, conventional implants were placed in the body of the left zygomatic arch and in the right maxillary tuberosity. Using a modified impression technique, a cobalt-chromium alloy framework with three overdenture attachments was constructed to retain a complete maxillary obturator. Patient-reported functional and quality of life measure outcomes were dramatically improved after treatment and at the two-year follow-up. PMID:20040025

  5. Repair of a fractured implant overdenture gold bar: A clinical and laboratory technique report

    PubMed Central

    Vohra, Fahim; Al Fawaz, Amani

    2013-01-01

    This clinical report explains a convenient, efficient, yet effective alternative for management of fractured substructure cast bars for implant-retained overdentures. The technique allows the fracture to be repaired at low cost and short time without remaking the substructure and the denture and further allowing the patient to keep their denture. The report sketches the clinical and laboratory procedures involved in the repair. PMID:24926222

  6. Comparison of immediate complete denture, tooth and implant-supported overdenture on vertical dimension and muscle activity

    PubMed Central

    Shah, Farhan Khalid; Gebreel, Ashraf; Elshokouki, Ali hamed; Habib, Ahmed Ali

    2012-01-01

    PURPOSE To compare the changes in the occlusal vertical dimension, activity of masseter muscles and biting force after insertion of immediate denture constructed with conventional, tooth-supported and Implant-supported immediate mandibular complete denture. MATERIALS AND METHODS Patients were selected and treatment was carried out with all the three different concepts i.e, immediate denture constructed with conventional (Group A), tooth-supported (Group B) and Implant-supported (Group C) immediate mandibular complete dentures. Parameters of evaluation and comparison were occlusal vertical dimension measured by radiograph (at three different time intervals), Masseter muscle electromyographic (EMG) measurement by EMG analysis (at three different positions of jaws) and bite force measured by force transducer (at two different time intervals). The obtained data were statistically analyzed by using ANOVA-F test at 5% level of significance. If the F test was significant, Least Significant Difference test was performed to test further significant differences between variables. RESULTS Comparison between mean differences in occlusal vertical dimension for tested groups showed that it was only statistically significant at 1 year after immediate dentures insertion. Comparison between mean differences in wavelet packet coefficients of the electromyographic signals of masseter muscles for tested groups was not significant at rest position, but significant at initial contact position and maximum voluntary clench position. Comparison between mean differences in maximum biting force for tested groups was not statistically significant at 5% level of significance. CONCLUSION Immediate complete overdentures whether tooth or implant supported prosthesis is recommended than totally mucosal supported prosthesis. PMID:22737309

  7. Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year

    PubMed Central

    GARGARI, M.; PRETE, V.; PUJIA, M.; CERUSO, F. M.

    2013-01-01

    SUMMARY Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. Objective The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Methods Forty-three patients were selected from the out patient clinic, Department of Dentistry “Fra G.B. Orsenigo Ospedale San Pietro F.B.F.”, Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. Discussion and Result The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn’t difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. Conclusions The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven’t difficulty in removal and insertion of the denture and in oral hygiene. They haven’t in both groups problems related to fractures. PMID:23741602

  8. Single dental implant retained mandibular complete dentures – influence of the loading protocol: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Over the years, there has been a strong consensus in dentistry that at least two implants are required to retain a complete mandibular denture. It has been shown in several clinical trials that one single median implant can retain a mandibular overdenture sufficiently well for up to 5 years without implant failures, when delayed loading was used. However, other trials have reported conflicting results with in part considerable failure rates when immediate loading was applied. Therefore it is the purpose of the current randomized clinical trial to test the hypothesis that immediate loading of a single mandibular midline implant with an overdenture will result in a comparable clinical outcome as using the standard protocol of delayed loading. Methods/design This prospective nine-center randomized controlled clinical trial is still ongoing. The final patient will complete the trial in 2016. In total, 180 edentulous patients between 60 and 89 years with sufficient complete dentures will receive one median implant in the edentulous mandible, which will retain the existing complete denture using a ball attachment. Loading of the median implant is either immediately after implant placement (experimental group) or delayed by 3 months of submerged healing at second-stage surgery (control group). Follow-up of patients will be performed for 24 months after implant loading. The primary outcome measure is non-inferiority of implant success rate of the experimental group compared to the control group. The secondary outcome measures encompass clinical, technical and subjective variables. The study was funded by the Deutsche Forschungsgemeinschaft (German research foundation, KE 477/8-1). Discussion This multi-center clinical trial will give information on the ability of a single median implant to retain a complete mandibular denture when immediately loaded. If viable, this treatment option will strongly improve everyday dental practice. Trial registration The trial

  9. Effect of simulated masticatory loading on the retention of stud attachments for implant overdentures.

    PubMed

    Abi Nader, S; de Souza, R F; Fortin, D; De Koninck, L; Fromentin, O; Albuquerque Junior, R F

    2011-03-01

    This study assessed the effect of simulated mastication on the retention of two stud attachment systems for 2-implants overdentures. Sixteen specimens, each simulating an edentulous ridge with implants and an overdenture were divided into two groups, according to the attachment system: Group I (Nobel Biocare ball-socket attachments) and Group II (Locator attachments). Retention forces were measured before and after 400,000 simulated masticatory loads in a customised device. Data were compared by two-way anova followed by Bonferroni test (α = 0·05). Group I presented significantly lower retention forces (Newtons) than Group II at baseline (10·6 ± 3·6 and 66·4 ± 16·0, respectively). However, differences were not significant after 400,000 loads (7·9 ± 4·3 and 21·6 ± 17·0). The number of cycles did not influence the measurements in Group I, whereas a non-linear descending curve was found for Group II. It was concluded that simulated mastication resulted in minor changes for the ball attachment tested. Nevertheless, it reduced the retention of Locator attachments to 40% of the baseline values, what suggests that mastication is a major factor associated with maintenance needs for this system. PMID:20819139

  10. Maxillary Overdentures Supported by Four Splinted Direct Metal Laser Sintering Implants: A 3-Year Prospective Clinical Study

    PubMed Central

    Mangano, Francesco; Shibli, Jamil Awad; Anil, Sukumaran

    2014-01-01

    Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results. PMID:25580124

  11. The Effects of Denture Cleansing Solutions on the Retention of Attachments of Implant Supported Overdentures

    PubMed Central

    Derafshi, Reza; Mohaghegh, Mina; Saki, Maryam; Safari, Anahita; Rabee Haghighi, Mohammad

    2015-01-01

    Statement of the Problem Implant-retained overdenture can improve the stability of dentures and prevent bone loss. Overdenture-wearing patients need special hygiene care. Purpose The aim of this study was to evaluate the effects of various denture cleansers on the retention of Dio orange O-rings. Method and Materials In this experimental study, 40 Dio orange O-rings were divided into 4 groups (10 O-rings each) and each group was soaked for equivalent of 6 months in the following solutions: 5.25% NaOCl (1:10 dilution), Corega cleanser tabs, Professional cleanser tabs and water (as the control group). After 6 months, O-rings were tested for 2inch/minutes of tensile force. The peak load-to-dislodgement was recorded. Data were imported to SPSS18 and were analyzed by One-Way ANOVA and Tukey HSD test (p≤ 0.05). Results Denture cleansing solutions have significant effects on the reduction of retentive value of O-rings (p≤ 0.001). Corega tabs caused the reduction of 15.7% (9.91±0.53 N) in the retentive value of O-rings and Professional tabs caused 15% (10.00±0.86 N). NaOCl caused significant decrease (48%) in retentive value of O-rings (6.10±0.91 N in comparison with the control group (11.76±1 N). Conclusion This in-vitro study demonstrated that the retention of O-rings was affected when soaked in cleansing solutions. NaOCl caused more reduction in retentive value compared to effervescent cleansers and would not be recommended for cleansing O-rings. These results should be interpreted clinically and the role of other factors in the retention of O-rings should be considered in order to recommend the best cleanser for O-ring overdentures. PMID:26106638

  12. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  13. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  14. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  15. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  16. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  17. Stress-strain distribution at bone-implant interface of two splinted overdenture systems using 3D finite element analysis

    PubMed Central

    2013-01-01

    PURPOSE This study was accomplished to assess the biomechanical state of different retaining methods of bar implant-overdenture. MATERIALS AND METHODS Two 3D finite element models were designed. The first model included implant overdenture retained by Hader-clip attachment, while the second model included two extracoronal resilient attachment (ERA) studs added distally to Hader splint bar. A non-linear frictional contact type was assumed between overdentures and mucosa to represent sliding and rotational movements among different attachment components. A 200 N was applied at the molar region unilaterally and perpendicular to the occlusal plane. Additionally, the mandible was restrained at their ramus ends. The maximum equivalent stress and strain (von Mises) were recorded and analyzed at the bone-implant interface level. RESULTS The values of von Mises stress and strain of the first model at bone-implant interface were higher than their counterparts of the second model. Stress concentration and high value of strain were recognized surrounding implant of the unloaded side in both models. CONCLUSION There were different patterns of stress-strain distribution at bone-implant interface between the studied attachment designs. Hader bar-clip attachment showed better biomechanical behavior than adding ERA studs distal to hader bar. PMID:24049576

  18. Clinical outcome of double crown-retained implant overdentures with zirconia primary crowns

    PubMed Central

    Buergers, Ralf; Ziebolz, Dirk; Roediger, Matthias

    2015-01-01

    PURPOSE This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: 5.9 ± 2.2 years), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required. PMID:26330981

  19. Implant overdenture using a locator bar system by drill and tapping technique in a mandible edentulous patient: a case report

    PubMed Central

    Kim, Min-Su; Yoon, Mi-Jung; Huh, Jung-Bo; Jeon, Young-Chan

    2012-01-01

    Various options have been introduced for the selection of implant overdenture attachments. Attachment wear due to the repeated insertion and removal of dentures has caused problems such as decreased retention and the requirement for suprastructure remanufacturing. In these cases, a Locator bar system was applied using the drill and tapping technique to achieve total retrievability. In a 55-year-old female patient who showed three degrees of mobility in most of her teeth due to severe alveolar bone loss, a complete denture in the maxilla and an implant supported type overdenture in the mandible were planned after extracting all the remaining teeth. Six implants were placed from canine region to the distal molar region, and the locator was connected to the milled bar using the drill and tapping technique. For a 61-year-old female edentulous patient who complained of poor retention with old denture, a complete denture in the maxilla and an implant-tissue supported type overdenture in the mandible were planned. Four implants were placed in front of mental foramen, and the Locator was also connected to the Hader bar using the drill and tapping technique. With this technique, female parts can be easily replaced, and retention can be continuously maintained. PMID:22737318

  20. Implant overdenture using a locator bar system by drill and tapping technique in a mandible edentulous patient: a case report.

    PubMed

    Kim, Min-Su; Yoon, Mi-Jung; Huh, Jung-Bo; Jeon, Young-Chan; Jeong, Chang-Mo

    2012-05-01

    Various options have been introduced for the selection of implant overdenture attachments. Attachment wear due to the repeated insertion and removal of dentures has caused problems such as decreased retention and the requirement for suprastructure remanufacturing. In these cases, a Locator bar system was applied using the drill and tapping technique to achieve total retrievability. In a 55-year-old female patient who showed three degrees of mobility in most of her teeth due to severe alveolar bone loss, a complete denture in the maxilla and an implant supported type overdenture in the mandible were planned after extracting all the remaining teeth. Six implants were placed from canine region to the distal molar region, and the locator was connected to the milled bar using the drill and tapping technique. For a 61-year-old female edentulous patient who complained of poor retention with old denture, a complete denture in the maxilla and an implant-tissue supported type overdenture in the mandible were planned. Four implants were placed in front of mental foramen, and the Locator was also connected to the Hader bar using the drill and tapping technique. With this technique, female parts can be easily replaced, and retention can be continuously maintained. PMID:22737318

  1. Immediate implant placement in posterior areas: the mandibular arch.

    PubMed

    Fugazzotto, Paul A; Hains, Frederick O

    2012-01-01

    When contemplating removal of a premolar or molar and its immediate replacement with an implant-supported prosthesis, the feasibility of other potentially less "aggressive" treatment approaches must first be considered. Treatment decisions must be made in the context of an appropriate definition of therapeutic success. Replacement of hopeless mandibular molars with implant restorations has undergone significant evolution since the introduction of osseointegrated implants some 30 years ago. Over the past decade, various treatment approaches have been advocated. This article discusses these approaches and other considerations needed for implant placement at the time of mandibular molar extraction. PMID:22908599

  2. Frenectomy with anterior lingual sulcoplasty for an implant-supported overdenture: A clinical report.

    PubMed

    Perri de Carvalho, Paulo Sergio; Janjacomo, Luiz Antonio; Ponzoni, Daniela

    2016-04-01

    This clinical report describes the deepening of a patient's anterior mandibular lingual sulcus in combination with frenectomy and the use of an acrylic resin guiding device fixed to an osseointegrated dental implant to maintain the patency of the new sulcular depth. PMID:26723097

  3. Split-Framework in Mandibular Implant-Supported Prosthesis

    PubMed Central

    2015-01-01

    During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient's discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities. PMID:26770841

  4. An in vitro investigation into retention strength and fatigue resistance of various designs of tooth/implant supported overdentures.

    PubMed

    Fatalla, Abdalbseet A; Song, Ke; Du, Tianfeng; Cao, Yingguang

    2012-02-01

    Previously, the choice of prosthetic implant-retained overdentures has depended on data from previous studies about the retention-fatigue strength of the attachment system selected. Little or no data have been available on the correlation between the attachment system selected and the overdenture support configuration. The purpose of the present study was to evaluate the retention force and fatigue resistance of three attachment systems and four support designs of overdenture prosthesis. Four lower edentulous acrylic models were prepared and eight combinations of attachments groups were investigated in the study. These included: O-Rings with mini-dental implants (MDIs), Dalbo elliptic with Dalbo Rotex and fabricated flexible acrylic attachments with both MDI and Dalbo Rotex. The study was divided into four test groups: groups A and B, controls, and groups C and D, experimental groups. Control group A contained three overdenture supports: two free standing MDIs in the canine region and at the midline, and one simulated tooth root with Dalbo Rotex screwed in. Control group B contained four overdenture support foundations: two free standing MDIs in the right canine region and the first premolar region, and two simulated tooth roots with Dalbo Rotex screwed in at the same MDI position, but on the left side of the model. Experimental group C contained three overdenture support foundations: two free standing MDIs in the canine region and at the midline, and one simulated tooth root with MDI screwed in. Experimental group D contained four overdenture support foundations: two free standing MDIs in the right canine region and the first premolar region, and two simulated tooth roots with MDIs screwed in at the same MDI position, but on the left side of the model. Each group was further divided into two subgroups according to attachment type used. Five samples were prepared for each group. Retention force (N) values were recorded initially (0 cycles) and after 360, 720, 1440

  5. Effect of different mucosa thickness and resiliency on stress distribution of implant-retained overdentures-2D FEA.

    PubMed

    Barão, Valentim Adelino Ricardo; Assunção, Wirley Gonçalves; Tabata, Lucas Fernando; de Sousa, Edson Antonio Capello; Rocha, Eduardo Passos

    2008-11-01

    The study aimed to evaluate the effect of different mucosa thickness and resiliency on stress distribution of implant-retained overdentures using a two-dimensional finite element analysis. Models were used in order to simulate two situations. In group A, model represented an edentulous mandible supporting an overdenture retained by two-splinted-implants connected with bar-clip system while in group B, model simulated an edentulous mandible supporting an overdenture retained by two-splinted-implants connected with bar-clip system associated with two-distally placed o'ring system. In each group, mucosa assumed three characteristics of thickness (1, 3 and 5 mm) in the resiliencies: hard, resilient and soft, respectively. Evaluation was performed on Ansys software. Group A showed higher stress values regardless of the mucosa characteristics. Overall, stress decreased at the supporting tissues as mucosa thickness and resiliency increased. Regarding supporting tissues, cortical bone showed the highest stress values. The use of bar-clip attachment system with distally placed o'ring attachment design optimized the stress distribution. PMID:18783845

  6. Microbiological aspects of human mandibular subperiosteal dental implants.

    PubMed

    Rams, Thomas E; Balkin, Burton E; Roberts, Thomas W; Molzan, Arthur K

    2013-12-01

    Clinical, microbiological, and biochemical features of human mandibular subperiosteal dental implants exhibiting peri-implantitis were compared with those experiencing long-term peri-implant health. After evaluation of clinical parameters, submucosal plaque samples were obtained from permucosal implant abutment posts exhibiting probing depths ≥5 mm and bleeding on probing in subjects with peri-implantitis (n = 3) and from posts with peri-implant health in subjects with long-term subperiosteal implant health (n = 8). The microbial specimens were transported in VMGA III and plated onto enriched Brucella blood agar and Hammond's selective medium with anaerobic incubation, and onto selective TSBV with 5% CO2 incubation. Total anaerobic viable counts and selected bacterial species were identified using established phenotypic methods and criteria. In vitro resistance to doxycycline (2 μg/mL), amoxicillin (2 μg/mL), or metronidazole (4 μg/mL) was recorded per subject when bacterial pathogen growth was noted on antibiotic-supplemented isolation plates. Interleukin (IL)-1β levels were measured with an enzyme-linked immunosorbent assay in peri-implant crevicular fluid samples from 5 study subjects. Significantly higher Plaque Index scores, higher total anaerobic viable counts, more red complex species, and lower proportions of gram-positive facultative viridans streptococci and Actinomyces species were detected on peri-implantitis-affected subperiosteal implants as compared with subperiosteal implants with long-term peri-implant health. No in vitro resistance to the 3 test antibiotic breakpoint concentrations studied was found, except a Fusobacterium nucleatum strain resistant to doxycycline at 2 μg/mL from 1 peri-implantitis subject. Subperiosteal implants with peri-implantitis tended to yield higher peri-implant crevicular fluid IL-1β levels. The level of peri-implant supramucosal plaque control and the composition of the peri-implant submucosal microbiome may be

  7. Performance of attachments used in implant-supported overdentures: review of trends in the literature.

    PubMed

    Lee, Damian J

    2013-02-01

    The purpose of this review is to examine the performance of attachments used in implant-supported overdenture (IOD) in both clinical and in vitro settings and report the compiled findings, comparisons, and trends in the research literature. Articles published in PubMed on IOD attachment systems and performance were reviewed. Non-original articles were excluded. For each article included, the type of study, number of implants, number of attachment systems, and study outcome were recorded. Of the 283 articles found, 158 met the inclusion criteria. Ninety-four articles were clinical studies and 64 articles were in vitro studies. Studies on retention were the most common for in vitro studies, and four or more attachment systems were compared in most articles with significant differences in outcome. A clinical outcome of one attachment system was most common for clinical studies, while most studies had neutral outcomes overall. Ball attachment was the most commonly tested IOD attachment system. The trend in the literature showed that there is a large discrepancy between the study designs and outcomes between the clinical and the in vitro studies for IOD. Further clinical studies that can validate in vitro research should be encouraged to address this discrepancy between the two areas. PMID:23509021

  8. Performance of attachments used in implant-supported overdentures: review of trends in the literature

    PubMed Central

    2013-01-01

    The purpose of this review is to examine the performance of attachments used in implant-supported overdenture (IOD) in both clinical and in vitro settings and report the compiled findings, comparisons, and trends in the research literature. Articles published in PubMed on IOD attachment systems and performance were reviewed. Non-original articles were excluded. For each article included, the type of study, number of implants, number of attachment systems, and study outcome were recorded. Of the 283 articles found, 158 met the inclusion criteria. Ninety-four articles were clinical studies and 64 articles were in vitro studies. Studies on retention were the most common for in vitro studies, and four or more attachment systems were compared in most articles with significant differences in outcome. A clinical outcome of one attachment system was most common for clinical studies, while most studies had neutral outcomes overall. Ball attachment was the most commonly tested IOD attachment system. The trend in the literature showed that there is a large discrepancy between the study designs and outcomes between the clinical and the in vitro studies for IOD. Further clinical studies that can validate in vitro research should be encouraged to address this discrepancy between the two areas. PMID:23509021

  9. Testing the retention of attachments for implant overdentures - validation of an original force measurement system.

    PubMed

    Fromentin, O; Lassauzay, C; Abi Nader, S; Feine, J; de Albuquerque Junior, R F

    2010-01-01

    The aim of this study was to validate an original portable device to measure attachment retention of implant overdentures both in the lab and in clinical settings. The device was built with a digital force measurement gauge (Imada) secured to a vertical wheel stand associated with a customized support to hold and position the denture in adjustable angulations. Sixteen matrix and patrix cylindrical stud attachments (Locator) were randomly assigned as in vitro test specimens. Attachment abutments were secured in an implant analogue hung to the digital force gauge or to the load cell of a traction machine used as the gold standard (Instron Universal Testing Machine). Matrices were secured in a denture duplicate attached to the customized support, permitting reproducibility of their position on both pulling devices. Attachment retention in the axial direction was evaluated by measuring maximum dislodging force or peak load during five consecutive linear dislodgments of each attachment on both devices. After a wear simulation, retention was measured again at several time periods. The peak load measurements with the customized Imada device were similar to those obtained with the gold standard Instron machine. These findings suggest that the proposed portable device can provide accurate information on the retentive properties of attachment systems for removable dental prostheses. PMID:19912482

  10. Finite element analysis on stress distribution of maxillary implant-retained overdentures depending on the Bar attachment design and palatal coverage

    PubMed Central

    2016-01-01

    PURPOSE The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-retained overdenture. MATERIALS AND METHODS Maxillary implant-retained overdentures with 4 implants placed in the anterior region of edentulous maxilla were converted into a 3-D numerical model, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional finite element analysis. RESULTS In all experimental models, the highest stress was concentrated on the most distal implant and implant supporting bone on loaded side. The stress at the most distal implant-supporting bone was concentrated on the cortical bone. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant and implant supporting bone on loaded side. CONCLUSION It could be suggested that when making maxillary implant retained overdenture, using Hader bar instead of milled bar and full palatal coverage rather than partial palatal coverage are more beneficial in distributing the stress that is applied on implant supporting bone. PMID:27141251

  11. Comparison of changes in retentive force of three stud attachments for implant overdentures

    PubMed Central

    Kim, Su-Min; Choi, Jae-Won; Jeon, Young-Chan; Jeong, Chang-Mo; Yun, Mi-Jung; Lee, So-Hyoun

    2015-01-01

    PURPOSE The aim of this study was to compare the changes in retentive force of stud attachments for implant overdentures by in vitro 2-year-wear simulation. MATERIALS AND METHODS Three commercially available attachment systems were investigated: Kerator blue, O-ring red, and EZ lock. Two implant fixtures were embedded in parallel in each custom base mounting. Five pairs of each attachment system were tested. A universal testing machine was used to measure the retentive force during 2500 insertion and removal cycles. Surface changes on the components were evaluated by scanning electron microscopy (SEM). A Kruskal-Wallis test, followed by Pairwise comparison, was used to compare the retentive force between the groups, and to determine groups that were significantly different (α<.05). RESULTS A comparison of the initial retentive force revealed the highest value for Kerator, followed by the O-ring and EZ lock attachments. However, no significant difference was detected between Kerator and O-ring (P>.05). After 2500 insertion and removal cycles, the highest retention loss was recorded for O-ring, and no significant difference between Kerator and EZ lock (P>.05). Also, Kerator showed the highest retentive force, followed by EZ lock and O-ring, after 2500 cycles (P<.05). Based on SEM analysis, the polymeric components in O-ring and Kerator were observed to exhibit surface wear and deformation. CONCLUSION After 2500 insertion and removal cycles, all attachments exhibited significant loss in retention. Mechanism of retention loss can only be partially explained by surface changes. PMID:26330977

  12. Interforaminal hemorrhage during anterior mandibular implant placement: An overview.

    PubMed

    Kusum, Chandan Kumar; Mody, Pranav V; Indrajeet; Nooji, Deviprasad; Rao, Suhas K; Wankhade, Bhushan Ganesh

    2015-01-01

    Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement. PMID:26288617

  13. Interforaminal hemorrhage during anterior mandibular implant placement: An overview

    PubMed Central

    Kusum, Chandan Kumar; Mody, Pranav V.; Indrajeet; Nooji, Deviprasad; Rao, Suhas K.; Wankhade, Bhushan Ganesh

    2015-01-01

    Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement. PMID:26288617

  14. Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: Retrospective study of a cohort of edentulous patients

    PubMed Central

    Selva-Otaolaurruchi, Eduardo J.; Montero, Javier; Sola-Ruiz, Fernanda

    2015-01-01

    Background This work aims to confirm if implant-supported overdentures are a good treatment option for edentulous patients and offer an improvement in quality of life compared with traditional complete prostheses (dentures). Material and Methods This retrospective clinical descriptive study included three evaluation groups: validation group (n=57); control group of patients with complete removeable prostheses (n=56); study group of patients with implant-supported overdentures retained with the Locator® system (n=80). The study also validated the Oral Health Impact Profile-20 questionnaire. Individual protocols were created that included socio-demographic data, the Oral Health Impact Profile-20 (OHIP-20) questionnaire and Oral Satisfaction Scale (OSS). Descriptive and bivariate statistical analysis was carried out applying χ², Pearson, Kruskal-Wallis, and Student t tests, transferring data into SPSS-Windows® software from a Microsoft® Excel spreadsheet. Results The OHIP-20 proved to be a valid instrument and provided reliable assessment of health-related quality of life among both the Spanish general population and edentulous patients. The control and study groups proved comparable, showing socio-demographic homogeneity. For patients with overdentures retained by means of the Locator® system, these restorations had significantly lower impact on quality of life (19 vs 33), both generally and for each individual questionnaire item, and much higher satisfaction with the state of their oral cavities (8.3 vs 5.3) than patients wearing dentures; both sets of data showed a direct linear relationship, so that as the level of impact on quality of life increased, perceived oral satisfaction worsened. Conclusions Patients rehabilitated with implant supported overdentures retained by the Locator® system, presented significantly lower levels of impact on their quality of life and significantly higher oral satisfaction than patients with conventional complete prostheses

  15. Split-frame implant prosthesis designed to compensate for mandibular flexure: a clinical report.

    PubMed

    Paez, Carmen Yamily; Barco, Thomas; Roushdy, Sally; Andres, Carl

    2003-04-01

    When an edentulous mandible is restored with 4 or more implants connected by a metal bar and retained with screws, mandibular flexure may cause screw loosening and unnecessary stresses and strains on the prosthesis and implants. Separating the prosthesis at the midline can relieve these stresses and strains. This article describes the separation of a hybrid mandibular denture at the midline. PMID:12690344

  16. Stress distribution patterns of implant supported overdentures-analog versus finite element analysis: A comparative in-vitro study

    PubMed Central

    Satpathy, Soumyadev; Babu, C. L. Satish; Shetty, Shilpa; Raj, Bharat

    2015-01-01

    Aims and Objectives: The aim of this study was to asses & compare the load transfer characteristics of Ball/O-ring and Bar/Clip attachment systems in implant supported overdentures using analog and finite element analysis models. Methodology: For the analog part of the study, castable bar was used for the bar and clip attachment and a metallic housing with a rubber O-ring component was used for the ball/O-ring attachment. The stress on the implant surface was measured using the strain-gauge technique. For the finite element analysis, the model were fabricated and load applications were done in a similar manner as in analog study. Results: The difference between both the attachment systems was found to be statistically significant (P<0.001). Conclusion: Ball/O-ring attachment system transmitted lesser amount of stresses to the implants on the non-loading side, as compared to the Bar-Clip attachment system. When overall stress distribution is compared, the Bar-Clip attachment seems to perform better than the Ball/O-ring attachment, because the force was distributed better. PMID:26929521

  17. The evaluation of selected attachment systems for implant-retained overdenture based on retention characteristics analysis.

    PubMed

    Chladek, Grzegorz; Wrzuś-Wieliński, Marcin

    2010-01-01

    The results of mechanical characteristics of attachments used for retaining and stabilizing overdenture have been analysed. Two commercially used attachments (a ball attachment and a bar attachment) and elastic frictional attachments designed by the research team with Professor Chladek as the leader have been investigated. The diagrams of force-displacement characteristics have been registered. Retention forces (F(R)) have been determined and total work (W(T)) disconnecting the attachments has been calculated on the basis of these diagrams. The analysis of total work corresponding to different types of attachments made it possible to distinguish some characteristic areas which illustrate specific features of particular designs. It has been revealed that determining the retention force allows us to compare only the attachments which work on similar bases. In order to conduct a purely objective comparison of the efficiency of different designs, it is necessary to analyze complete force-displacement characteristics as well as to determine on this basis the subsequent phases of separating the parts of attachments and to find the value of the work which in fact determines their quality. The comparison of selected commercially used designs and the presented elastic frictional attachments (taking into account the criterion of work) gives clear evidence that the introduced design of attachment enables us to create very good conditions of retaining overdenture. PMID:21247057

  18. Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report

    PubMed Central

    Agustín-Panadero, Rubén; Peñarrocha-Oltra, David; Gomar-Vercher, Sonia; Ferreiroa, Alberto

    2015-01-01

    This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene. PMID:26140179

  19. Comparison of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible--a computed tomography-based three-dimensional finite element analysis.

    PubMed

    Barão, V A R; Delben, J A; Lima, J; Cabral, T; Assunção, W G

    2013-04-26

    A finite element analysis was used to compare the effect of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible. Four models of an human mandible were constructed. In the OR (O'ring) group, the mandible was restored with an overdenture retained by four unsplinted implants with O'ring attachment; in the BC (bar-clip) -C and BC groups, the mandibles were restored with overdentures retained by four splinted implants with bar-clip anchor associated or not with two distally placed cantilevers, respectively; in the FD (fixed denture) group, the mandible was restored with a fixed full-arch four-implant-supported prosthesis. Models were supported by the masticatory muscles and temporomandibular joints. A 100-N oblique load was applied on the left first molar. Von Mises (σvM), maximum (σmax) and minimum (σmin) principal stresses (in MPa) analyses were obtained. BC-C group exhibited the highest stress values (σvM=398.8, σmax=580.5 and σmin=-455.2) while FD group showed the lowest one (σvM=128.9, σmax=185.9 and σmin=-172.1). Within overdenture groups, the use of unsplinted implants reduced the stress level in the implant/prosthetic components (59.4% for σvM, 66.2% for σmax and 57.7% for σmin versus BC-C group) and supporting tissues (maximum stress reduction of 72% and 79.5% for σmax, and 15.7% and 85.7% for σmin on the cortical and trabecular bones, respectively). Cortical bone exhibited greater stress concentration than the trabecular bone for all groups. The use of fixed implant dentures and removable dentures retained by unsplinted implants to rehabilitate edentulous mandible reduced the stresses in the periimplant bone tissue, mucosa and implant/prosthetic components. PMID:23518207

  20. Implant supported overdenture in the patients with history of radio and chemotherapy for the prostate malignancy

    PubMed Central

    Aeran, Himanshu; Nautiyal, Vijay; Kumar, Varun; Uniyal, Shashank

    2015-01-01

    The success of dental implants in patients that have undergone chemo and radiotherapy for a region other than head and neck remain unclear, although some local and systemic factors could be contraindications to dental implant treatment. As there are very few absolute medical contraindications to dental implant treatment, but a number of conditions may increase the risk of treatment failure or complications. The case report describes the successful survival of dental implants placed in maxilla and mandible of a patient who had undergone radio and chemotherapy for prostate cancer. PMID:27390497

  1. Physical and metallurgical considerations of failures of soldered bars in bar attachment systems for implant overdentures: a review of the literature.

    PubMed

    Waddell, J Neil; Payne, Alan G T; Swain, Michael V

    2006-10-01

    The purpose of this literature review was to identify the etiological factors of failure of soldered bars in bar attachment systems for removable implant overdentures. A search of MEDLINE using the key words "bar attachment systems" was performed of English language peer-reviewed journals published between 1975 and 2005. Clinical studies of implant overdentures with prosthodontic maintenance complications of bar attachment systems were identified to establish the perceived etiology of failure. A further search of MEDLINE using the key words "solder joint" was also performed of the fixed prosthodontic literature to identify specific factors affecting the strength, fatigue resistance, and quality of gold solder joints used for bar attachment systems. The first search on bar attachment systems produced evidence of low failure rates of interabutment bars, but higher failure rates of bars where distal cantilever extensions were used. There were no explanations or descriptions of the nature of those failures in the clinical studies reviewed. The second search on fixed prosthodontic literature identified multiple factors that could potentially relate to the failed solder joints with bar attachments. Two potential sites of failure in bar attachments with distal cantilevers were identified, and a simple estimate of the tensile stresses at the solder joints was performed. The values found are comparable to the fatigue failure stresses reported in the searched literature. PMID:17052473

  2. A 5-year perspective on a removable overdenture appliance for a patient with osteonecrosis of the jaw, a mandibular resection, and rampant caries.

    PubMed

    Login, Gary R

    2016-08-01

    A 78-year-old man with a history osteonecrosis of the jaw and 2 subsequent surgeries to repair a fractured mandible had a condition that contraindicates most dentoalveolar procedures to restore his failing dentition. A Snap-On-Smile overdenture restored his opportunity for natural speech, occlusal function, and esthetics. PMID:26996932

  3. Fabrication of a maxillary implant-supported overdenture retained by two cemented bars: a clinical report.

    PubMed

    Uludag, Bulent; Sahin, Volkan; Celik, Gozde

    2007-05-01

    Parallel placement of 2 separate bars may be indicated in patients where bone is available in the posterior part of the maxilla. Bars and stud attachments are the primary attachment systems compatible with the majority of the implant systems currently available; however, treatment planning in certain situations may be challenging due to the component available with the implant system used. This report describes the fabrication of a cemented bar design for use in situations when the components of the implant system are inadequate for fabrication of a screw-retained bar. PMID:17547940

  4. Interforaminal implant placement in oral cancer patients: during ablative surgery or delayed? A 5-year retrospective study.

    PubMed

    Mizbah, K; Dings, J P; Kaanders, J H A M; van den Hoogen, F J A; Koole, R; Meijer, G J; Merkx, M A W

    2013-05-01

    In a retrospective study, two mandibular prosthetic rehabilitation strategies supported by implants in oral cancer patients were evaluated: implants placed in the non-resected edentulous symphyseal area during ablative surgery (DAS implants); or at a later stage (postponed (P) implants). Medical files of patients from two head-neck oncology groups from 2000 to 2005 were screened for study inclusion. DAS protocol was used in one group and P protocol in the other. After a 5 year follow-up of 261 edentulous patients with oral cancer in the second group, P implants were placed in 27 patients to support an overdenture. Of the 249 edentulous patients in the first group, 82 patients were given an implant supported overdenture using the DAS implant protocol. Regarding implant loss, no statistically significant differences were seen between the DAS and P implants. In the DAS group, more patients benefited from an implant-supported lower overdenture (39 versus 11%, respectively), and they received their overdenture on average 20.0 months sooner (sd=11.01, p<0.001) after ablative surgery. 17.1% of DAS implants and 4.6% of P implants were never loaded due to tumour and patient related factors including unfavourable implant soft tissue, tumour recurrence near the implant, or radiotherapy induced trismus. PMID:23102901

  5. Mandibular reconstruction using free vascularized iliac crest grafts and dental implants

    PubMed Central

    MOLDOVAN, IULIU; JUNCAR, MIHAI; DINU, CRISTIAN; ONISOR-GLIGOR, FLORIN; ROTAR, HORATIU; BRAN, SIMION; BACIUT, GRIGORE

    2015-01-01

    Background and aim The mandible is frequently affected by tumor masses present in the oral cavity and is included in the tumor ablation procedure, with major functional and esthetic consequences for the patient. A method of high current interest in mandibular reconstruction is based on the use of free vascularized iliac crest grafts, followed by reconstruction using dental implants. Methods This study presents the case of four patients benefiting from this treatment method, and monitors the treatment stages and their clinical evolution after mandibular reconstruction and dental implant placement. Results The postoperative evolution of the patients was favorable, with the integration of the iliac crest grafts and dental implants. After prosthetic loading, the masticatory as well as the esthetic function of the patients was restored to a standard close to the initial one. Conclusions This mandibular reconstruction method proved to be effective, with a high degree of reliability and a significant improvement of the patients’ quality of life. PMID:26609275

  6. Mandibular reconstruction with vascularized fibula flap and osseointegrated implants: a clinical report.

    PubMed

    Khatami, Amir H; Toljanic, Joseph A; Kleinman, Alejandro

    2010-01-01

    Primary and secondary reconstruction of mandibular discontinuity defects with vascularized flap is currently the standard of care in many institutions. The most commonly used donor site for such flaps is fibula. Fibula provides enough bone length, allows 2-team approach, and has low donor site morbidity and abundant periosteal blood supply. The placement of endosseous implants in the vascularized fibula flap also facilitates functional dental rehabilitation. This clinical report describes the prosthetic rehabilitation and the complications of 2 mandibular discontinuity defects treated with vascularized fibula flap and implant-supported fixed prosthesis. PMID:20545535

  7. Experimental and numerical predictions of Biomet(®) alloplastic implant in a cadaveric mandibular ramus.

    PubMed

    Mesnard, M; Ramos, A

    2016-05-01

    The purpose of this study was to evaluate experimentally the behaviors of an intact and an implanted cadaveric ramus, to compare and analyze load mechanism transfers between two validated finite element models. The intact, clean cadaveric ramus was instrumented with four rosettes and loaded with the temporal reaction load. Next, the Biomet microfixation implant was fixed to the same cadaveric mandibular ramus after resection. The mandibular ramus was reconstructed from computed tomographic images, and two finite element models were developed. The experimental results for the mandibular ramus present a linear behavior of up to 300 N load in the condyle, with the Biomet implant influencing strain distribution; the maximum influence was near the implant (rosette #4) and approximately 59%. The experimental and numerical results present a good correlation, with the best correlation in the intact ramus condition, where R(2) reaches 0.935 and the slope of the regression line is 1.045. The numerical results show that screw #1 is the most critical, with maximum principal strains in the bone around 21,000 με, indicating possible bone fatigue and fracture. The experimental results show that the Biomet temporomandibular joint mandibular ramus implant changes the load transfer in the ramus, compared to the intact ramus, with its strain-shielding effect. The numerical results demonstrate that only three screws are important for the Biomet TMJ fixation. These results indicate that including two proximal screws should reduce stresses in the first screws and strains in the bone. PMID:27017105

  8. Force Transfer and Stress Distribution in an Implant-Supported Overdenture Retained with a Hader Bar Attachment: A Finite Element Analysis

    PubMed Central

    Satheesh Kumar, Preeti; Satheesh, Kumar K. S.; John, Jins; Patil, Geetha; Patel, Ruchi

    2013-01-01

    Background and Objectives. A key factor for the long-term function of a dental implant is the manner in which stresses are transferred to the surrounding bone. The effect of adding a stiffener to the tissue side of the Hader bar helps to reduce the transmission of the stresses to the alveolar bone. But the ideal thickness of the stiffener to be attached to the bar is a subject of much debate. This study aims to analyze the force transfer and stress distribution of an implant-supported overdenture with a Hader bar attachment. The stiffener of the bar attachments was varied and the stress distribution to the bone around the implant was studied. Methods. A CT scan of edentulous mandible was used and three models with 1, 2, and 3 mm thick stiffeners were created and subjected to loads of emulating the masticatory forces. These different models were analyzed by the Finite Element Software (Ansys, Version 8.0) using von Mises stress analysis. Results. The results showed that the maximum stress concentration was seen in the neck of the implant for models A and B. In model C the maximum stress concentration was in the bar attachment making it the model with the best stress distribution, as far as implant failures are concerned. Conclusion. The implant with Hader bar attachment with a 3 mm stiffener is the best in terms of stress distribution, where the stress is concentrated at the bar and stiffener regions. PMID:24459589

  9. Overdentures on Implants for Better Quality of Life Among the Fully Edentulous Patients - Case Reports.

    PubMed

    Nikolovska, Julijana; Petrovski, Dragan; Petricevic, Nikola; Kapusevska, Biljana; Korunoska-Stevkovska, Vesna

    2015-01-01

    Global aging population has brought several challenges for their medical systems and total edentulism is one of them. The fabrication of removable acrylic dentures seems to be a simple and cheap treatment solution, but a majority of patients is not satisfied with their functional instability, causing limited diets, mouth soreness, speech and psycho-social problems etc. The results in many studies indicate an impact of oral conditions associated with the full denture wearing on oral-health related quality of life, especially in lower jaw. The reason for improper denture retention could be alveolar ridge bone resorption and numerous studies about this problem are plausible. Bone resorption in lower jaw may turn the alveolar ridge into a flabby soft tissue which is unable to sustain proper denture retention. The implant-retained prosthesis is an alternative treatment option in these situations. Implants will provide retention, stability, function and aesthetics and they are not so expensive solution. The aim of this article is to show solving of retention problems of a lower denture in two different clinical cases using implants and without any special technology. PMID:27442389

  10. Alternative to the inferior alveolar nerve block anesthesia when placing mandibular dental implants posterior to the mental foramen.

    PubMed

    Heller, A A; Shankland, W E

    2001-01-01

    Local anesthesia block of the inferior alveolar nerve is routinely taught throughout dental education. This commonly used technique eliminates all somatosensory perception of the mandible, mandibular teeth, floor of the mouth, ipsilateral tongue, and all but the lateral (buccal) gingivae. Generally, the dentist or surgeon desires these structures to be anesthetized. However, in the placement of mandibular implants, it may be useful for the patient to be able to sense when the inferior alveolar nerve is in danger of being damaged, possibly producing permanent paresthesia. In this article, the technique of mandibular infiltration prior to mandibular implant placement in the mandible is discussed. PMID:12500871

  11. Telescopic overdenture for oral rehabilitation of ectodermal dysplasia patient

    PubMed Central

    Gupta, Charu; Verma, Mahesh; Gupta, Rekha; Gill, Shubhra

    2015-01-01

    Reduced number of teeth with underdeveloped alveolar ridges poses a greatest prosthetic challenge in rehabilitation of ectodermal dysplasia patients (ED). Furthermore, surgical risks and financial constraints may preclude the implant supported prosthesis, the most desirable treatment option in an adult ED patient. Long edentulous span does not permit fixed dental prosthesis (FDP) as well. Telescopic denture by incorporating the best of both fixed and removable prosthesis can be a viable treatment alternative for ED patients with compromised dentition and limited finances. A 21-year-old young girl presented with chief complaint of esthetics and mastication due to missing upper and lower teeth. A provisional diagnosis of ED was made based on familial history, physical, and oral examination. This clinical report describes management of an adult ED patient by means of telescopic overdenture prosthesis in mandibular arch and FDP in maxillary arch which restored esthetics, function, and social confidence of the patient in a cost effective manner. PMID:26604583

  12. Shear bond strength comparison of implant-retained overdenture attachment pickup materials.

    PubMed

    Cayouette, Monica J; Barnes, Logan; Vuthiganon, Jompobe; McPherson, Karen

    2016-01-01

    This study evaluated the shear bond strength (SBS) of 4 different retentive materials for the chairside pickup of dental implant attachments. Shear force was applied to determine the SBS of each material to denture acrylic resin. The difference between SBSs of polymethyl methacrylate and UBAR (claimed to bond to metal) to metal housings was also evaluated. There were no statistically significant differences among the SBSs of Jet Denture Repair Acrylic, EZ PickUp, and UBAR, but Quick Up had an SBS that was significantly lower than that of the other 3 materials. In addition, UBAR had a higher SBS to metal housings than did processed polymethyl methacrylate. PMID:27367633

  13. An Alternative Technique for Fabrication of Frameworks in an Immediate Loading Implant Fixed Mandibular Prosthesis

    PubMed Central

    Paleari, André Gustavo; Presoto, Cristina Dupim; Vasconcelos, Juliano Alencar; Nunes Reis, José Maurício dos Santos; Pinelli, Lígia Antunes Pereira; Tavares da Silva, Regina Helena Barbosa; Quishida, Cristiane Campos Costa

    2015-01-01

    The oral rehabilitation of edentulous patients with immediate loading has become a safe procedure with high predictability. The success is related to immediate fabrication of a passive fit framework to attach the implants. Based on these considerations, this case report shows an alternative technique for mandibular rehabilitation using implants immediately loaded, where the framework was fabricated using cylinders with internal reinforcement and precast pieces, electrowelding, and conventional welding providing esthetics and function to the patient in a short period of time. PMID:25628899

  14. Rehabilitation of a patient with mandibular resection using osteointegrated implants: a case report.

    PubMed

    Murat, Sema; Gurbuz, Ayhan; Kamburoglu, Kivanc

    2013-10-01

    This case report details a 65-year-old male patient who underwent mandibular resection and radiotherapy as treatment for squamous cell carcinoma of the right mandible. The patient was rehabilitated with an implant-supported fixed partial denture and a maxillary occlusal ramp. The patient has been wearing his prosthesis for 2 years with no complaints. PMID:21942399

  15. Experimental findings on customized mandibular implants in Göttingen minipigs - a pilot study.

    PubMed

    Markwardt, J; Sembdner, P; Lesche, R; Jung, R; Spekl, K; Mai, R; Schulz, M C; Reitemeier, B

    2014-01-01

    Reconstructing continuity defects of the mandible is still challenging for surgeons. The currently applied conventional titanium bridging plates have considerable rates of complications. Now, a new technology enables an individual shape-identical creation of a mandibular implant in a form-board design by the method of LaserCUSING using pure titanium. This technology has been successfully performed in previous examinations to individually reconstruct mandibular continuity defects. This pilot study evaluated the surgical procedure in 10 female Göttingen mini pigs. First, a computed tomography scan from a mini pig cranium was performed. A three-dimensional model of the mandible was designed by data conversion. Based on the data, a customized mandibular implant resembling the natural shape was virtually created and manufactured. Then, a continuity defect of the left mandible was created in a standardized way. The implants were inserted into the defect and the wounds were allowed to heal for 21, 35, 56 and 180 days. During the healing period, no signs of inflammation or infection were observed. After the sacrifice of the minipigs the mandibles were resected. Histological microsections using Donath's sawing and grinding technique were manufactured and stained with Masson Goldner trichrome staining. The histomorphological results showed a pronounced ossification at the outer and inner surface of the implants. This animal study describes a promising approach to optimize customized implants for the application in humans. PMID:24189298

  16. Mandibular fracture after endosseous implant placement in conjunction with inferior alveolar nerve transposition: a patient treatment report.

    PubMed

    Kan, J Y; Lozada, J L; Boyne, P J; Goodacre, C J; Rungcharassaeng, K

    1997-01-01

    A patient with a severely atrophic right posterior mandible had three endosseous implants placed in conjunction with transposition of the inferior alveolar nerve. Three weeks following implant placement surgery, the patient experienced a spontaneous fracture of the mandible involving the two anterior implants. The two implants were removed, and the fracture was treated with open reduction and fixation with titanium mesh. The fracture healed, and the posterior implant integrated. This report suggests that the buccolingual and superior-inferior position of the mandibular canal can increase the possibility of mandibular fracture by increasing the size of the buccal cortical plate that is removed to expose the nerve during surgery. PMID:9337027

  17. Assessment of mandibular posterior regional landmarks using cone-beam computed tomography in dental implant surgery.

    PubMed

    de Souza, Lílian Azevedo; Souza Picorelli Assis, Neuza Maria; Ribeiro, Rosangela Almeida; Pires Carvalho, Antônio Carlos; Devito, Karina Lopes

    2016-05-01

    The aim of this study has been to evaluate and correlate the anatomical features of the posterior mandibular region (submandibular fossa depth, bone height and thickness, and mandibular canal corticalization) to improve accident prevention and allow safe planning in implantology. Four parasagittal sections of cone-beam computed tomography (CBCT) from 100 patients were bilaterally analyzed. Linear measurements of the submandibular fossa depth, bone height and thickness were performed. The submandibular fossa was also classified into non-influential undercuts and influential undercuts for implant placement. Mandibular canal corticalization was also evaluated and classified according to the visualization. Data on patient age and gender were also collected. Forty-one scans (41%) were from male patients, and 59 (59%) were from female patients. Patient age ranged between 18 and 84 years, with an average age of 51.37 years. The submandibular fossa depth and implant bone thickness had a significant effect on the variability of the sample (46.1% and 22.3%, respectively). The submandibular fossa depth was quite variable, and the highest values were observed in the posterior regions. In 18.27% of the cases, the presence of the fossa directly influenced implant placement, considering a bone height of 10mm (standard implant). A significant correlation was observed between fossa depth and bone thickness. Thus, greater attention should be paid to thick ridges; although thick ridges are favorable, they may be associated with deeper submandibular fossae. The mandibular canal was the most influential anatomical structure in the premolar region due to the reduced bone height in this region and the greater difficulty in viewing the canal, and the submandibular fossa was the most influential structure in the molar region due to lower bone height leading up to the fossa and the greater fossa depth in this region. Therefore, CBCT is an important tool for assessing the mandibular region

  18. Evaluation of Hi-Tec Implant Restoration in Mandibular First Molar Region- A Prospective Clinical Study

    PubMed Central

    Sreeram, Roopa Rani. S.; Prasad, L Krishna; Chakravarthi, P Srinivas; Devi, Naga Neelima; Sreeram, Sanjay Krishna

    2015-01-01

    Background and Aims Missing teeth lead to loss of structural balance, inefficient function, poor aesthetics and psychological effects on human beings, which needs restoration for normal contour, function and aesthetics. Several natural or synthetic substitutes are being used for replacement of missing tooth since centuries. Implants are the latest modality of replacement. So, the study was aimed to assess clinical success rate of Hi-Tec implant; which is economical and new in market. Results of the study will help clinician for appropriate implant selection. Materials and Methods The study included 10 patients from 19 to 31 years and needed restoration of missing mandibular first molar. Restoration had done using Hi Tec Single-tooth implants with metal-ceramic single crown prosthesis after three months of osseointegration. The implants were evaluated clinically (bleeding on probing, probing depth, implant mobility- periotest) and radiographically (marginal bone loss and peri-implant radiolucency) for six years. The observers were blinded for the duration of the study to prevent bias. Results All the patients had uneventful post-surgical healing. No bleeding on probing, Implant mobility, peri-implant radiolucency with minimal marginal bone loss and constant probing depths were observed well within the normal range during follow-up periods. Conclusion Two stage single-tooth Hi Tec implant restoration can be used as a successful treatment modality for replacing mandibular first molar in an economic way. However, these results were obtained after 6 years of follow up with a smaller sample size, so long term multi center studies with a larger sample size is recommended for the predictability of success rate conclusively. PMID:26436053

  19. Mandibular implant-supported fixed dental prosthesis with a modified design: a clinical report.

    PubMed

    Tourah, Anita; Moshaverinia, Alireza; Chee, Winston W

    2014-02-01

    This clinical report describes the rehabilitation of a patient with a mandibular implant-supported fixed dental prosthesis. Because of the limited restorative space available in the posterior mandible and in considering the higher wear rate of acrylic resin in comparison with titanium when it opposes metal ceramic restorations, the treatment used a milled titanium bar with acrylic resin denture teeth, which replaced the anterior teeth with milled titanium for the posterior occluding surfaces. PMID:24262946

  20. "Rules of 10"--guidelines for successful planning and treatment of mandibular edentulism using dental implants.

    PubMed

    Cooper, Lyndon F; Limmer, Bryan M; Gates, W Day

    2012-05-01

    The three "Rules of 10" for treatment planning dental implant therapy in the edentulous mandible are designed to improve the success of both the endosseous implants and the prosthesis. These "rules" acknowledge and provide a method to control the mechanical environment, addressing factors affecting implant and prosthesis longevity, including magnitude of forces, resistance of the prosthesis against these forces, and the biology of bone and its ability to respond to loading environments. The rules specify that for any IRO or ISFP, there must be a minimum of 10 mm of alveolar dimension (inferior/superior) and a minimum of 10 mm of interocclusal (restorative) dimension measured from the soft-tissue ridge crest to the occlusal plane. Additionally, for an ISFP, the anterior/posterior distribution of implants must be greater than 10 mm. This article provides support in the literature for these rules and illustrates their application in the treatment of mandibular edentulism. PMID:22616215

  1. Does crown/implant ratio influence the survival and marginal bone level of short single implants in the mandibular molar? A preliminary investigation consisting of 12 patients.

    PubMed

    Ghariani, L; Segaan, L; Rayyan, M M; Galli, S; Jimbo, R; Ibrahim, A

    2016-02-01

    Crown/implant (C/I) ratio has been proven to not affect the survival of the implants; however, it is also a fact that no evidence exists with regard to the use of single short implants in the mandibular molar. The aim of this study was to determine whether the crown/implant ratios of single implant-supported fixed restorations on implants of 6-8 mm in the mandibular molar have an impact on the implant survival and marginal bone maintenance. Twelve short dental implants (6-8 mm) were installed and restored with single crowns, loaded after 3 months of healing. The restorations were divided according to crown-to-implant ratio into two groups: Group 1: C/I < 2.0 and Group 2: C/I ≧ 2.0. Alveolar bone loss was measured using CBCT scan, taken at the implant placement and after 12 months follow-up from loading. Reduced implant/crown ratio shown no statistic significant differences on implant survival and the alveolar bone level compared with recommended implant/crown ratio. Within the limitation of this study, it can be concluded that reduced C/I ratio could be used as a substitute for recommended C/I ratio in severely mandibular atrophic residual alveolar ridges. PMID:26333185

  2. Design and finite element analysis of a novel sliding rod microscrew implantation device for mandibular prognathism

    PubMed Central

    Li, Yanfeng; Lv, Yuan; Lu, Yongjin; Zeng, Pan; Zeng, Xianglong; Guo, Xiaoqian; Han, Weili

    2015-01-01

    Tooth distalization is an effective approach for mandibular prognathism. Current distalization devices are bulky and clinically complicated. Here, we designed a novel molar distalization device by using a sliding rod and a microscrew and performed a mechanical analysis and finite element model (FEM) analysis of force distribution and displacement of the upper canine, first and second premolar and first molar. A 2D FEM was constructed using the Beam3 element and a 3D FEM was constructed of the mandibular teeth, the periodontal membrane, and the alveolar bones using the UG software. The upper first molar was divided into 12 points on the dental surface to facilitate stress analysis. Force analysis using the ANSYS WORKBECNH revealed that, both horizontally and vertically, the traction force causing distalization of the first molar decreased when the spring coil moved down the L shaped sliding rod. The 3D FEM force analysis revealed distomedial displacement of the upper first molar when the sliding rod microscrew implantation device caused distalization of the molar. These findings support further exploration for the use of the sliding rod microscrew implants as an anchorage for group distal movement of the teeth of patients with mandibular prognathism. PMID:26379860

  3. Correction of the occlusal and functional sequelae of mandibular condyle fractures using orthodontic mini-implant molar intrusion.

    PubMed

    Cousley, Richard R J; Gibbons, Andrew J

    2014-09-01

    We report on the non-surgical management of an adult female whose bilateral mandibular condylar fractures had resulted in a clockwise (posterior) mandibular rotation, limitation of mandibular movements and increased occlusal loading on the molar teeth. She refused maxillary surgery and was treated with a minimally-invasive approach, involving orthodontic fixed appliances and mini-implant intrusion of the maxillary molar teeth. This provided both occlusal and functional improvements, including a significant increase in the inter-incisal distance, which were stable after one year of retention. PMID:24521751

  4. Change in the width of the mandibular body from 6 to 23 years of age: an implant study.

    PubMed

    Işeri, H; Solow, B

    2000-06-01

    After the ossification of the mandibular symphysis, shortly after birth, changes in mandibular width would be expected to occur only by surface apposition or resorption on the buccal surfaces of the left and right mandibular halves. However, evidence for an opening hinge movement of the two mandibular halves around a vertical axis located in the region of the mandibular symphysis was recently found in longitudinal studies of 29 subjects with unilateral implant markers in the mandible. These subjects were followed from 8.5 to 15.5 years of age (Korn and Baumrind, 1990; Baumrind and Korn, 1992). The aim of the present investigation was to examine whether the presence of such an age-related increase in mandibular body width could be confirmed in a sample with bilateral implant markers in the mandible. The sample comprised 10 subjects (3F, 7M) from the files of another longitudinal study with implant markers (Björk, 1968). A total of 122 pairs of annual lateral and postero-anterior (p-a) cephalometric records were available, covering longitudinal observation periods ranging from 8 to 16 years within an age interval of between 6 and 23 years. The width between a right and left side mandibular implant marker was measured with digital callipers on all p-a radiographs. Each measurement was corrected mathematically for various sources of radiographic enlargement. A small, but statistically significant increase in the distance between the right and left implant markers, i.e. in the bilateral width of the mandibular body, was observed in all subjects. The total increase in width in each subject ranged from 0.7 to 1.7 mm for the various periods of observation (P < or = 0.01). For the 12-year period from 6 to 18 years, the average total increase was 1.6 mm (P < or = 0.001, SD = 0.42), i.e. 0.13 mm/year. After this age there was no systematic trend. The mechanism for this increase in width is unknown. It is suggested that during postnatal growth, an increasing load from the

  5. Nonunion of mandibular midline osteotomy after tumor surgery and radiation repaired by endosseous implants.

    PubMed

    Taub, Daniel; Tursun, Ramzey; Gold, Lionel; Jamal, Basem T

    2010-04-01

    Nonunion of the mandible after microvascular flap reconstruction of defects resulting from tumor surgery is a known but rare complication, occurring in 5% of cases. When nonunion results with the use of microvascular flaps, rigid internal fixation, and radiotherapy, other options to treat the nonunion carry a greater risk of osteomyelitis, osteoradionecrosis, and/or persistent nonunion. Although endosseous implants have been reported to cause mandibular fracture in some cases, our case proposes and supports the use of implants for immobilization and/or prevention of nonunion of the mandible in patients who have a high probability of this complication developing, thereby avoiding plating across the nonunion site with the risk of plate exposure and osteoradionecrosis. This technique permitted a good quality of life in our patient during the healing period. He was able to masticate and phonate properly when compared with other treatment options that would have required external and/or intermaxillary fixation devices. PMID:20044192

  6. Replacement of mandibular central incisors with implant-supported crowns: a case report.

    PubMed

    Bäumer, Daniel; Zuhr, Otto; Hürzeler, Markus

    2016-01-01

    Anterior teeth are often affected by accidental dental trauma and may eventually be lost. When the neighboring teeth are unharmed, implant-supported crowns are often the preferred treatment choice. When not only the teeth but also the supporting hard and soft tissue has been lost, surgical reconstruction may be needed. However, in combined horizontal and vertical class III defects, the available augmentation techniques are often not predictable. In this case report, two neighboring mandibular central incisors were replaced by two implants after soft and hard tissue augmentation with the cortical bone plate method. The interdental soft tissue was reconstructed with remarkable success, making this an example of what can be achieved in cases such as this. PMID:27092347

  7. Systematic Review and Meta-Analysis on Incidence of Altered Sensation of Mandibular Implant Surgery.

    PubMed

    Lin, Chia-Shu; Wu, Shih-Yun; Huang, Hsin-Yi; Lai, Yu-Lin

    2016-01-01

    Altered sensation (including paresthesia, dysesthesia and hypoesthesia) after mandibular implant surgery may indicate transient or permanent injury of the inferior alveolar nerve and the mental branch, and considerably lower patients' satisfaction about the therapy. Previous studies have shown a great degree of variability on the incidence of altered sensation. We here reported the incidence of altered sensation after mandibular implant surgery based on a meta-analysis of 26 articles published between 1990.1.1 and 2016.1.1. Study quality and risk of bias was assessed and the studies with a lower score were excluded in the meta-analysis. Data synthesis was performed using the logistic-normal random-effect model. The meta-analyses revealed that the short-term (10 days after implant placement) and long-term (1 year after implant placement) incidence was 13% (95% CI, 6%-25%) and 3% (95% CI, 1%-7%), respectively. (2) For the patients who initially reported altered sensation, 80% (95% CI, 52%-94%) of them would return to normal sensation within 6 months after surgery, and 91% (95% CI, 78%-96%) of them would return to normal sensation one year after surgery. We concluded that dentist-patient communication about the risk of altered sensation is critical to treatment planning, since the short-term incidence of altered sensation is substantial (13%). When a patient reports altered sensation, regular assessment for 6 months would help tracing the changes of symptoms. In terms of long-term follow-up (1 year after surgery), the incidence is much lower (3%) and most patients (91%) would return to normal sensation. PMID:27100832

  8. Systematic Review and Meta-Analysis on Incidence of Altered Sensation of Mandibular Implant Surgery

    PubMed Central

    Lin, Chia-Shu; Wu, Shih-Yun; Huang, Hsin-Yi; Lai, Yu-Lin

    2016-01-01

    Altered sensation (including paresthesia, dysesthesia and hypoesthesia) after mandibular implant surgery may indicate transient or permanent injury of the inferior alveolar nerve and the mental branch, and considerably lower patients’ satisfaction about the therapy. Previous studies have shown a great degree of variability on the incidence of altered sensation. We here reported the incidence of altered sensation after mandibular implant surgery based on a meta-analysis of 26 articles published between 1990.1.1 and 2016.1.1. Study quality and risk of bias was assessed and the studies with a lower score were excluded in the meta-analysis. Data synthesis was performed using the logistic-normal random-effect model. The meta-analyses revealed that the short-term (10 days after implant placement) and long-term (1 year after implant placement) incidence was 13% (95% CI, 6%-25%) and 3% (95% CI, 1%-7%), respectively. (2) For the patients who initially reported altered sensation, 80% (95% CI, 52%-94%) of them would return to normal sensation within 6 months after surgery, and 91% (95% CI, 78%-96%) of them would return to normal sensation one year after surgery. We concluded that dentist-patient communication about the risk of altered sensation is critical to treatment planning, since the short-term incidence of altered sensation is substantial (13%). When a patient reports altered sensation, regular assessment for 6 months would help tracing the changes of symptoms. In terms of long-term follow-up (1 year after surgery), the incidence is much lower (3%) and most patients (91%) would return to normal sensation. PMID:27100832

  9. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

    PubMed Central

    Gander, Thomas; Grätz, Klaus; Rostetter, Claudio; Zweifel, Daniel; Bredell, Marius

    2015-01-01

    ABSTRACT Objectives Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and Methods We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula) transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units (HU). Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test. Results Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001). There was a statistical significant increase in bone density in cortical (P < 0.001) and cancellous (P = 0.004) bone. Conclusions Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time. PMID:26539286

  10. A comparative study on complete and implant retained denture treatments: a biomechanics perspective.

    PubMed

    Chen, Junning; Ahmad, Rohana; Suenaga, Hanako; Li, Wei; Swain, Michael; Li, Qing

    2015-02-01

    Although implant-retained overdenture allows edentulous patients to take higher occlusal forces than the conventional complete dentures, the biomechanical influences have not been explored yet. Clinically, there is limited knowledge and means for predicting localized bone remodelling after denture treatment with and without implant support. By using finite element (FE) analysis, this article provides an in-silico approach to exploring the treatment effects on the oral mucosa and potential resorption of residual ridge under three different denture configurations in a patient-specific manner. Based on cone beam computerized tomography (CBCT) scans, a 3D heterogeneous FE model was created; and the supportive tissue, mucosa, was characterized as a hyperelastic material. A measured occlusal load (63N) was applied onto three virtual models, namely complete denture, two and four implant-retained overdentures. Clinically, the bone resorption was measured after one year in the two implant-retained overdenture treatment. Despite the improved stability and enhanced masticatory function, the implant-retained overdentures demonstrated higher hydrostatic stress in mucosa (43.6kPa and 39.9kPa for two and four implants) at the posterior ends of the mandible due to the cantilever effect, than the complete denture (33.4kPa). Hydrostatic pressure in the mucosa signifies a critical indicator and can be correlated with clinically measured bone resorption, pointing to severer mandibular ridge resorption posteriorly with implant-retained overdentures. This study provides a biomechanical basis for denture treatment planning to improve long-term outcomes with minimal residual ridge resorption. PMID:25560272

  11. Implant-supported fixed restoration of post-traumatic mandibular defect accompanied with skin grafting: A clinical report

    PubMed Central

    Noh, Kwantae; Choi, Woo-Jin

    2013-01-01

    Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with post-traumatic mandibular defect. A split-thickness skin graft was performed prior to implant placement and prefabricated acrylic stent was placed to hold the graft in place. The esthetic and functional demands of the patient were fulfilled by implant-supported screw-retained fixed prosthesis using CAD-CAM technology. PMID:23508120

  12. BIOMECHANICAL ANALYSIS OF THE STRESSES GENERATED BY DIFFERENT DISOCCLUSION PATTERNS IN AN IMPLANT-SUPPORTED MANDIBULAR COMPLETE DENTURE

    PubMed Central

    Greco, Gustavo Diniz; Jansen, Wellington Corrêa; Landre, Janis; Seraidarian, Paulo Isaías

    2009-01-01

    Objectives: This study evaluated by three-dimensional finite element analysis the tensions generated by different disocclusion patterns (canine guide and bilateral balanced occlusion) in an implant-supported mandibular complete denture. Material and Methods: A three-dimensional model of implant-supported mandibular complete denture was fabricated according to the Brånemark protocol. A 5-element 3.75 x 13-mm screw-shape dental implant system was modeled for this study. The implants were located in the intermental foramen region with 3-mm-high prosthetic components joined by a nickel-chromium framework with 12-mm bilateral cantilever covered by acrylic resin and 12 acrylic denture teeth. SolidWorks® software was used before and after processing the simulations. The mechanical properties of the components were inserted in the model and a 15 N load was established in fixed points, in each one of the simulations. Data were collected in the entire nickel-chromium framework. The results were displayed three-dimensionally as color graphic scales. Results: The canine guide generated greater tensions in the region of the first implant, while the bilateral balanced occlusion generated great tensions in the entire metallic framework. The maximum tension found in the simulation of the bilateral balanced occlusion was 3.22 fold higher than the one found in the simulation of the disocclusion in canine guide. Conclusion: The pattern of disocclusion in canine guide is the ideal for implant-supported mandibular complete denture. PMID:19936535

  13. Removable partial overdentures with mechanical (precision) attachments.

    PubMed

    Mensor, M C

    1990-10-01

    Mechanical attachments for overdentures have been available in various forms for over a century. The explosive interest in osseointegration and the effort on the part of the profession to avoid the complete denture as a treatment modality has stirred the interest in positive retentive elements for overdentures represented by the mechanical stud and bar attachments. The cited references provide a resource as a trouble-free guide in the selection and use of the various stud and bar attachment systems. The clinical examples show a pattern of application not generally discussed by the manufacturers, illustrating the simplicity of use with the options for all attachments including magnets. The discussion on magnets comes from 9 years of clinical experience. Rare earth magnets provide excellent adjunct retention, and their assembly follows the same protocol and complexity as stud attachment systems. All magnets, at the present state of the art, have a corrosion potential with the exception of the Laser Sealed Units (Golden Dental, Golden, CO). Finally, the mechanics of the attachment overdenture serves as an excellent training field for the osseointegrated prosthesis, be it the classic Brånemark (Nobelpharma USA, Chicago, IL) restorative or the implant overdenture concept. PMID:2227040

  14. Mandibular reconstruction using autologous iliac bone and titanium mesh reinforced by laser welding for implant placement.

    PubMed

    Yamashita, Yoshio; Yamaguchi, Yoshimasa; Tsuji, Mitsuhiro; Shigematsu, Masahito; Goto, Masaaki

    2008-01-01

    Segmental mandibulectomy is a treatment option for benign and malignant neoplasms of the mandible. Although reconstructing the mandible of a patient with a missing segment is difficult, it is essential to improve the postoperative course of the patient. Mandibular reconstruction using titanium mesh is a useful technique for dental implant placement because the morphology of the mandible can be easily reproduced. However, fitting titanium mesh to the remaining mandible is not an easy task during surgery. The present report introduces a method in which a 3-dimensional skull model fabricated by means of stereolithography is prepared, based on computerized tomography (CT) scans, to construct a titanium mesh cage matching the shape of the mandible, preoperatively. Furthermore, the load-bearing area of the titanium mesh cage is reinforced by laser welding another layer of titanium mesh to reduce the incidence of metal fatigue during jaw movement. PMID:19216287

  15. 3D finite element analysis of immediate loading of single wide versus double implants for replacing mandibular molar

    PubMed Central

    Desai, Shrikar R.; Karthikeyan, I.; Gaddale, Reetika

    2013-01-01

    Purpose: The purpose of this finite element study was to compare the stresses, strains, and displacements of double versus single implant in immediate loading for replacing mandibular molar. Materials and Methods: Two 3D FEM (finite element method) models were made to simulate implant designs. The first model used 5-mm-wide diameter implant to support a single molar crown. The second model used 3.75-3.75 double implant design. Anisotropic properties were assigned to bone model. Each model was analyzed with single force magnitude (100 N) in vertical axis. Results: This FEM study suggested that micromotion can be controlled better for double implants compared to single wide-diameter implants. The Von Mises stress for double implant showed 74.44% stress reduction compared to that of 5-mm implant. The Von Mises elastic strain was reduced by 61% for double implant compared to 5-mm implant. Conclusion: Within the limitations of the study, when the mesiodistal space for artificial tooth is more than 12.5 mm, under immediate loading, the double implant support should be considered. PMID:24554890

  16. Mandibular remodeling measured on cephalograms. 1. Osseous changes relative to superimposition on metallic implants.

    PubMed

    Baumrind, S; Ben-Bassat, Y; Korn, E L; Bravo, L A; Curry, S

    1992-08-01

    We report the results of a study aimed at quantifying remodeling of mandibular surfaces in a sample of growing children who represent those usually treated by orthodontists in the mixed and early adult dentition. The sample, 31 patients with metallic implants of the Björk-type, was monitored at annual intervals between 8 1/2 and 15 1/2 years of age. (Maxillary remodeling changes for the sample have been reported earlier.) The present article reports findings concerning changes at condyle, gonion, menton, pogonion, and point B as identified on lateral cephalograms. Data are reported in the Frankfort plane frame of reference with the cephalograms from different time points superimposed on the metallic implants. Mean displacement at condyle was larger than that at any other landmark and was similar in magnitude and direction to the observations of Björk when the difference in orientation of the vertical axis in the two studies is taken into account. The mean displacement of gonion was in an upward and backward direction at an angle of approximately 45 degrees to the Frankfort plane. Mean displacements at menton and pogonion were in a downward and backward direction but were very small. Mean displacement at point B was somewhat greater than that of menton and gonion, oriented in an upward and backward direction. Individual variation for most of the parameters measured was sufficiently large to warrant the inference that caution should be used when mean values are applied to the analysis of individual cases. PMID:1636630

  17. The Value of SPECT/CT in Monitoring Prefabricated Tissue-Engineered Bone and Orthotopic rhBMP-2 Implants for Mandibular Reconstruction.

    PubMed

    Zhou, Miao; Peng, Xin; Mao, Chi; Tian, Jia-he; Zhang, Shu-wen; Xu, Fang; Tu, Jing-jing; Liu, Sheng; Hu, Min; Yu, Guang-yan

    2015-01-01

    Bone tissue engineering shows good prospects for mandibular reconstruction. In recent studies, prefabricated tissue-engineered bone (PTEB) by recombinant human bone morphogenetic proteins (rhBMPs) applied in vivo has found to be an effective alternative for autologous bone grafts. However, the optimal time to transfer PTEB for mandibular reconstruction is still not elucidated. Thus, here in an animal experiment of rhesus monkey, the suitable transferring time for PTEB to reconstruct mandibular defects was evaluated by 99mTc-MDP SPECT/CT, and its value in monitoring orthotopic rhBMP-2 implants for mandibular reconstruction was also evaluated. The result of SPECT/CT showed higher 99mTc-MDP uptake, indicating osteoinductivity, in rhBMP-2 incorporated demineralized freeze-dried bone allograft (DFDBA) and coralline hydroxyapatite (CHA) implants than those without BMP stimulation. 99mTc-MDP uptake of rhBMP-2 implant peaked at 8 weeks following implantation while CT showed the density of these implants increased after 13 weeks' prefabrication. Histology confirmed that mandibular defects were repaired successfully with PTEB or orthotopically rhBMP-2 incorporated CHA implants, in accordance with SPECT/CT findings. Collectively, data shows 99mTc-MDP SPECT/CT is a sensitive and noninvasive tool to monitor osteoinductivity and bone regeneration of PTEB and orthotopic implants. The PTEB achieved peak osteoinductivity and bone density at 8 to 13 weeks following ectopic implantation, which would serve as a recommendable time frame for its transfer to mandibular reconstruction. PMID:26340447

  18. The Value of SPECT/CT in Monitoring Prefabricated Tissue-Engineered Bone and Orthotopic rhBMP-2 Implants for Mandibular Reconstruction

    PubMed Central

    Zhou, Miao; Peng, Xin; Mao, Chi; Tian, Jia-he; Zhang, Shu-wen; Xu, Fang; Tu, Jing-jing; Liu, Sheng; Hu, Min; Yu, Guang-yan

    2015-01-01

    Bone tissue engineering shows good prospects for mandibular reconstruction. In recent studies, prefabricated tissue-engineered bone (PTEB) by recombinant human bone morphogenetic proteins (rhBMPs) applied in vivo has found to be an effective alternative for autologous bone grafts. However, the optimal time to transfer PTEB for mandibular reconstruction is still not elucidated. Thus, here in an animal experiment of rhesus monkey, the suitable transferring time for PTEB to reconstruct mandibular defects was evaluated by 99mTc-MDP SPECT/CT, and its value in monitoring orthotopic rhBMP-2 implants for mandibular reconstruction was also evaluated. The result of SPECT/CT showed higher 99mTc-MDP uptake, indicating osteoinductivity, in rhBMP-2 incorporated demineralized freeze-dried bone allograft (DFDBA) and coralline hydroxyapatite (CHA) implants than those without BMP stimulation. 99mTc-MDP uptake of rhBMP-2 implant peaked at 8 weeks following implantation while CT showed the density of these implants increased after 13 weeks’ prefabrication. Histology confirmed that mandibular defects were repaired successfully with PTEB or orthotopically rhBMP-2 incorporated CHA implants, in accordance with SPECT/CT findings. Collectively, data shows 99mTc-MDP SPECT/CT is a sensitive and noninvasive tool to monitor osteoinductivity and bone regeneration of PTEB and orthotopic implants. The PTEB achieved peak osteoinductivity and bone density at 8 to 13 weeks following ectopic implantation, which would serve as a recommendable time frame for its transfer to mandibular reconstruction. PMID:26340447

  19. [Mandibular bone tissue regeneration after the introduction of the implantation system performed on the basis of carbon composite material].

    PubMed

    Chetvertnykh, V A; Loginova, N P; Astashina, N B; Rogozhnikov, G I; Rapekta, S I

    2013-01-01

    The purpose of this study was to investigate the processes of regeneration of bone tissue after the introduction of new implant systems. In the experiment, performed on 10 male pigs of Landras breed aged 50-55 days and weighing 17-18.5 kg, the time course of histological changes was studied in the area of mandibular regeneration after the formation of tissue defect and the introduction of the implant of a proposed construction. Morphological analysis of the experimental results 90, 180 and 270 days after the operation demonstrated the process of reparative regeneration of damaged bone along implant-bone block boundaries. Bone repair proceeded through the stage of formation of the woven bone with its progressive substitution by the lamellar bone, with the maintenance of the shape, size and symmetry of the damaged organ. PMID:23805619

  20. Influence of ridge inclination and implant localization on the association of mandibular Kennedy class I removable partial denture.

    PubMed

    Cunha, Lígia Del' Arco Pignatta; Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; Falcón-Antenucci, Rosse Mary; Goiato, Marcelo Coelho

    2011-05-01

    The aim of this study was to evaluate the tendency of displacement of the supporting structures of the distal extension removable partial denture (DERPD) associated to the implant with different inclinations of alveolar ridge and implant localizations through a two-dimensional finite-element method. Sixteen mandibular models were fabricated, presenting horizontal, distally descending, distally ascending, or descending-ascending ridges. All models presented the left canine and were rehabilitated with conventional DERPD or implant-retained prosthesis with the ERA system. The models were obtained by the AutoCAD software and transferred to the finite-element software ANSYS 9.0 for analysis. A force of 50 N was applied on the cusp tips of the teeth, with 5 points of loading of 10 N. The results were visualized by displacement maps. For all ridge inclinations, the assembly of the DERPD with distal plate retained by an anterior implant exhibited the lowest requisition of the supporting structures. The highest tendency of displacement occurred in the model with distally ascending ridge with incisal rest. It was concluded that the association of the implant decreased the displacement of the DERPD, and the anterior positioning of the implant associated to the DERPD with the distal plate preserved the supporting structures for all ridges. PMID:21558932

  1. All-on-4 concept implantation for mandibular rehabilitation of an edentulous patient with Parkinson disease: A clinical report.

    PubMed

    Liu, Fang-Chun; Su, Wei-Chia; You, Chia-Hsun; Wu, Aaron Yu-Jen

    2015-12-01

    Parkinson disease (PD) is a progressive neurologic disorder. Compromised voluntary and involuntary muscle control of the orofacial-pharyngeal muscles of patients with PD may lead to difficulty in mastication, dysphagia, and tremor of the mouth and chin. All of these problems represent major challenges for the clinician with respect to the oral rehabilitation. This clinical report describes the use of the All-on-4 concept implantation for mandibular rehabilitation with a fixed detachable dental prosthesis in an edentulous patient with PD. The treatment steps, outcome, and limitations are discussed. PMID:26409584

  2. A 4-year follow-up of two complete mandibular implant-supported removable prostheses in a patient with severe rheumatoid polyarthritis: case report.

    PubMed

    Ella, Bruno; Lasserre, Jean-François; Blanchard, Jean-Pierre; Fricain, Jean Christophe

    2011-01-01

    Rheumatoid polyarthritis is a systemic autoimmune disease characterized by chronic synovitis and bone damage associated with significant functional disability and morbidity. This case report describes a 4-year follow-up of a 56-year-old female receiving polymedication for severe rheumatoid polyarthritis and osteoporosis with a fully edentulous maxilla treated with two osseointegrated implants supporting a removable mandibular prosthesis. No practitioner wanted to use implants to stabilize her mandibular prosthesis because of the health risks involved. This report encourages the dental practitioner to be familiar with the symptoms and oral manifestations of rheumatoid polyarthritis in order to help manage this disease when patients lose all of their teeth. PMID:21483874

  3. Mandibular remodeling measured on cephalograms: 2. A comparison of information from implant and anatomic best-fit superimpositions.

    PubMed

    Baumrind, S; Ben-Bassat, Y; Korn, E L; Bravo, L A; Curry, S

    1992-09-01

    This study quantifies the differences in the perceived pattern of mandibular remodeling when two different methods are used to superimpose roentgenographic images of the mandible. Lateral cephalograms for a group of subjects with metallic implants of the Björk type were superimposed twice; first on the metallic implants and then independently on mandibular anatomic structures according to a common "best fit" rule. In this article, we compare the between-superimposition differences in the perceived displacements of condyle, gonion, menton, pogonion, and Point B. Mean differences between the two superimpositional techniques were smaller than had been anticipated. For the 7-year time interval between 8.5 and 15.5 years, the largest mean differences between methods were 2.70 mm in the horizontal direction at condyle, 1.90 mm in the vertical direction at condyle, and 1.52 mm in the vertical direction at gonion. None of the other between-superimposition differences had a mean value in excess of 1 mm. The individual case variability between the two methods was, however, quite considerable, a finding that we believe has bearing on the confidence that can be placed in individual case analyses in clinical orthodontics. A preliminary attempt has been made to represent and discuss the magnitude of this problem. PMID:1510047

  4. Finite element analysis of dental implant loading on atrophic and non-atrophic cancellous and cortical mandibular bone - a feasibility study.

    PubMed

    Marcián, Petr; Borák, Libor; Valášek, Jiří; Kaiser, Jozef; Florian, Zdeněk; Wolff, Jan

    2014-12-18

    The first aim of this study was to assess displacements and micro-strain induced on different grades of atrophic cortical and trabecular mandibular bone by axially loaded dental implants using finite element analysis (FEA). The second aim was to assess the micro-strain induced by different implant geometries and the levels of bone-to-implant contact (BIC) on the surrounding bone. Six mandibular bone segments demonstrating different grades of mandibular bone atrophy and various bone volume fractions (from 0.149 to 0.471) were imaged using a micro-CT device. The acquired bone STL models and implant (Brånemark, Straumann, Ankylos) were merged into a three-dimensional finite elements structure. The mean displacement value for all implants was 3.1 ±1.2 µm. Displacements were lower in the group with a strong BIC. The results indicated that the maximum strain values of cortical and cancellous bone increased with lower bone density. Strain distribution is the first and foremost dependent on the shape of bone and architecture of cancellous bone. The geometry of the implant, thread patterns, grade of bone atrophy and BIC all affect the displacement and micro-strain on the mandible bone. Preoperative finite element analysis could offer improved predictability in the long-term outlook of dental implant restorations. PMID:25468296

  5. Evaluation of immediately loaded dental implants bioactivated with platelet-rich plasma placed in the mandibular posterior region: A clinico-radiographic study

    PubMed Central

    Anand, Ullas; Mehta, D. S.

    2012-01-01

    Background and Objectives: The purpose of the present study was to clinically and radiographically assess the soft and hard tissue changes around the immediately loaded single tooth implants bioactivated with platelet-rich plasma (PRP), placed in the mandibular posterior region. Materials and Methods: A total of 11 patients having single tooth edentulous space in the mandibular posterior region were selected. An endosseous implant was placed after clinical and radiographic examination in each selected site using single stage surgical approach. The patients were followed up at 3, 6, 9, and at 12 months of post implant insertion. The patients were subjected to recording of clinical parameters like modified plaque index, modified gingival index, probing depth, and clinical implant mobility scale. Radiographs made at different intervals were subjected to assessment of bone level mesial and distal to each implant using computer assisted image analysis. Results: Scores for clinical parameters were minimal and comparable. The probing depth around the implant was measured during the follow-up period and the changes observed were statistically non-significant. None of the implants were clinically mobile during the follow-up period. Radiographically, the peri-implant bone resorption both on mesial and distal sides was within normal limit after one year of immediate loading. Finally, the overall success rate for the immediately loaded bioactivated implant placed in the mandibular posterior region was recorded as 100%. Interpretation and Conclusion: The use of platelet-rich plasma may lead to improved early bone apposition around the implant; and thus, results in increased rate of osseointegration. Single stage implant procedure with the adjunctive use of PRP enhances the ability of peri-implant healing tissue to create favorable soft and hard tissue relationships. It also gives the added advantage of psychological boost for the patient by getting fixed replacement of tooth

  6. Role of implant configurations supporting three-unit fixed partial denture on mandibular bone response: biological-data-based finite element study.

    PubMed

    Yoda, N; Liao, Z; Chen, J; Sasaki, K; Swain, M; Li, Q

    2016-09-01

    Implant-supported fixed partial denture with cantilever extension can transfer the excessive load to the bone around implants and stress/strain concentration potentially leading to bone resorption. This study investigated the effects of implant configurations supporting three-unit fixed partial denture (FPD) on the stress and strain distribution in the peri-implant bone by combining clinically measured time-dependent loading data and finite element (FE) analysis. A 3-dimensional mandibular model was constructed based on computed tomography (CT) images. Four different configurations of implants supporting 3-unit FPDs, namely three implant-supported FPD, conventional three-unit bridge FPD, distal cantilever FPD and mesial cantilever FPD, were modelled. The FPDs were virtually inserted to the molar area in the mandibular FE models. The FPDs were loaded according to time-dependent in vivo-measured 3-dimensional loading data during chewing. The von Mises stress (VMS) and equivalent strain (EQS) in peri-implant bone regions were evaluated as mechanical stimuli. During the chewing cycles, the regions near implant necks and bottom apexes experienced high VMS and EQS than the middle regions in all implant-supported FPD configurations. Higher VMS and EQS values were also observed at the implant neck region adjacent to the cantilever extension in the cantilevered configurations. The patient-specific dynamic loading data and CT-based reconstruction of full 3D mandibular allowed us to model the biomechanical responses more realistically. The results provided data for clinical assessment of implant configuration to improve longevity and reliability of the implant-supported FPD restoration. PMID:27224022

  7. Immediate functional loading of an implant-supported fixed prosthesis at the time of ablative surgery and mandibular reconstruction for squamous cell carcinoma.

    PubMed

    Odin, Guillaume; Balaguer, Thierry; Savoldelli, Charles; Scortecci, Gérard

    2010-01-01

    The authors describe a case of squamous cell carcinoma of the oral cavity managed by ablative surgery, mandibular reconstruction with a fibula free flap, and implant placement during the same session. Immediate functional implant loading, respecting the principles of basal implantology, was performed 48 hours later using a highly rigid, screw-secured fixed prosthesis that served as an external fixator for the implants and grafted bone. Implant loading before external beam radiotherapy improves flap stability, bone consolidation, and quality of life. Functional and esthetic outcomes were evaluated 2 years after radiotherapy was completed. PMID:20553177

  8. Comprehensive Comparison of the 5-Year Results of All-on-4 Mandibular Implant Systems With Acrylic and Ceramic Suprastructures.

    PubMed

    Ayna, Mustafa; Gülses, Aydin; Açil, Yahya

    2015-12-01

    The objective of the present study was to evaluate the comprehensive 5-year results of fixed mandibular dentures fabricated from metal-acrylic or metal-ceramics according to the All-on-4 protocol. Twenty-seven patients who received immediately loaded All-on-4 fixed mandibular dentures in 2006 were included in the study, and they were evaluated up to 5 years after denture integration. Endpoints were chosen in accordance with the 2007 Pisa consensus and included bone resorption, the Oral Health Impact Profile (OHIP), the sulcus fluid flow rate (SFFR), and prosthodontic complications. The initial situation in both groups was largely identical. Bone loss remained under 2 mm after 5 years in all implants and showed no group difference. The SFFR showed a gradual increase in both groups, and acrylic-bearing implants showed a substantially and significantly higher flow rate from the third year onward. The subjective improvement as expressed by the OHIP score was immediate and dramatic, and it showed no group differences. All acrylic restorations showed some extent of abrasion, and veneer fractures occurred in 4 patients (28.6%). Besides a single fracture of a fixation screw, there were no prosthetic complications in patients with ceramic suprastructures. According to bone loss and subjective outcome, acrylic and ceramic suprastructures appeared to be equivalent after 5 years; however, sulcus flow and prosthodontic complications suggest that the economic advantage of acrylic dentures may be specious. The rational choice of implant suprastructures requires comprehensive, long-term observation. Short-term economic benefits might be cancelled out in the long term. PMID:24712706

  9. Five years follow-up of implant-prosthetic rehabilitation on a patient after mandibular ameloblastoma removal and ridge reconstruction by fibula graft and bone distraction

    PubMed Central

    Oteri, Giacomo; Ponte, Francesco Saverio De; Pisano, Michele; Cicciù, Marco

    2012-01-01

    This case report presents a combination of surgical and prosthetic solutions applied to a case of oral implant rehabilitation in post-oncologic reconstructed mandible. Bone resection due to surgical treatment of large mandibular neoplasm can cause long-span defects. Currently, mandibular fibula free flap graft is widely considered as a reliable technique for restoring this kind of defect. It restores the continuity of removed segment and re-establishes the contour of the lower jaw. However, the limited height of grafted fibula does not allow the insertion of regular length implants, therefore favouring vertical distraction osteogenesis as an important treatment choice. This report presents a patient affected by extensive mandibular ameloblastoma who underwent surgical reconstruction by fibula free flap because of partial mandibular resection. Guided distraction osteoneogenesis technique was applied to grafted bone, in order to obtain adequate bone height and to realize a prosthetically guided placement of 8 fixtures. After osseointegration, the patient was rehabilitated with a full arch, screw-retained prosthetic restoration. At five-years follow up, excellent integration of grafted tissue, steady levels of bone around the fixtures and healthy peri-implant tissues were reported. PMID:22623943

  10. Effect of the additional installation of implants in the posterior region on the prognosis of treatment in the edentulous mandibular jaw.

    PubMed

    Miyamoto, Youji; Fujisawa, Kenji; Takechi, Masaaki; Momota, Yukihiro; Yuasa, Tetsuya; Tatehara, Seiko; Nagayama, Masaru; Yamauchi, Eiji

    2003-12-01

    The aim of this study was to elucidate the effect of the additional installation of implants in the posterior region on the prognosis of treatment in the edentulous mandibular jaw. Fifteen patients who had received implants (Brånemark system, Nobel Biocare, Gotebörg, Sweden) in the edentulous mandible and completed a 1-year follow-up after the fitting of implant-anchored fixed prostheses were selected. In seven patients (Group A), four or five implants were installed between the mental foramina, and in eight patients (Group P), one or two implants, one on each side, were installed in the posterior regions in addition to the implants between the foramina. All implants of both groups achieved osseointegration. In Group A, there was no implant loss after loading. Six implants were lost in five patients of Group P within 1 year after loading. All of them were located in the posterior region. To elucidate whether or not the failure rate of the implants in the posterior region of Group P after loading was especially high, the failures were also compared with 89 implants, which were installed in the posterior region of the mandibles to support implant-anchored fixed partial prosthesis, during the same period (Group C). The cumulative survival rate of the implants of Group P was 60%, while that of the implants of Group C was 100% (P<0.001). When the survival rates of posterior implants with the same length of the two groups were compared, there were significant differences for the 7- and 10-mm-length implants only. These data demonstrate that the posterior implants in Group P are at greater risk. Deformation of the mandible due to jaw movement was thought to be the most likely cause of the implant loss. Therefore, when such modified treatment is chosen, it should be performed with meticulous attention. PMID:15015949

  11. Patients With Transmandibular Implants Are at Risk for Severe Complications When Becoming Frail.

    PubMed

    Hoeksema, Arie R; Raghoebar, Gerry M; Vissink, Arjan; Visser, Anita

    2015-08-01

    Early in the implant era, transmandibular implant systems were used for retention of implant-retained mandibular overdentures in the severely resorbed mandible. These transmandibular systems require very thorough aftercare, especially when patients become frail and dependent on care. As a result, oral care often receives less attention in frail elderly patients or the patient cannot maintain the needed level of oral care. Care providers often are unfamiliar with the level of oral care needed to preserve transmandibular implants in good condition. This case series describes the risk for severe complications, including chronic pain and fracture of the mandible, in frail elderly patients who were unable to maintain oral care at the desired level and whose caregivers did not provide the needed level of oral care. PMID:25865719

  12. Mandibular reconstruction with a prefabricated free vascularized fibula and implant-supported prosthesis based on fully three-dimensional virtual planning.

    PubMed

    Freudlsperger, Christian; Bodem, Jens Philipp; Engel, Eva; Hoffmann, Jürgen

    2014-05-01

    Because optimal reconstruction of maxillofacial defects requires functional rehabilitation, the current study demonstrates the successful secondary reconstruction of a large mandibular continuity defect using a fully digitally planned prefabricated free vascularized fibula with immediate implant-supported prosthodontic restoration. A 56-year-old man presented with a large mandibular continuity defect after resection of an enlarged squamous cell carcinoma arising from the floor of the mouth. For secondary reconstruction, the shape of the neomandible and implant position for support of the lower prosthesis were planned virtually. The combined cutting and drilling guide was printed in 3 dimensions. In a 2-step surgical approach, first, the implants were inserted into the fibula and covered with a split-thickness skin graft to form a neogingiva. In a second operation, the fibula was harvested, osteotomized, and fixed with the denture on the preinserted implants. The fibula was placed to its final position guided by the occlusion. Using three-dimensional virtual backward planning, it was feasible to perform a mandibular reconstruction with immediate prosthetic rehabilitation. PMID:24670276

  13. Influence of implant inclination associated with mandibular class I removable partial denture.

    PubMed

    de Freitas Santos, Ciandrus Moraes; Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; de Moraes, Sandra Lúcia Dantas; Falcón-Antenucci, Rosse Mary

    2011-03-01

    The aim of this study was to use two-dimensional finite element method to evaluate the displacement and stress distribution transmitted by a distal extension removable partial denture (DERPD) associated with an implant placed at different inclinations (0, 5, 15, and 30 degrees) in the second molar region of the edentulous mandible ridge. Six hemimandibular models were created: model A, only with the presence of the natural tooth 33; model B, similar to model A, with the presence of a conventional DERPD replacing the missing teeth; model C, similar to the previous model, with a straight implant (0 degrees) in the distal region of the ridge, under the denture base; model D, similar to model C, with the implant angled at 5 degrees in the mesial direction; model E, similar to model C, with the implant angled at 15 degrees in the mesial direction; and model F, similar to ME, with the implant angled at 30 degrees in the mesial direction. The models were created with the use of the AutoCAD 2000 program (Autodesk, Inc, San Rafael, CA) and processed for finite element analysis by the ANSYS 8.0 program (Swanson Analysis Systems, Houston, PA). The force applied was vertical of 50 N on each cusp tip. The results showed that the introduction of the RPD overloaded the supporting structures of the RPD and that the introduction of the implant helped to relieve the stresses of the mucosa alveolar, cortical bone, and trabecular bone. The best stress distribution occurred in model D with the implant angled at 5 degrees. The use of an implant as a support decreased the displacement of alveolar mucosa for all inclinations simulated. The stress distribution transmitted by the DERPD to the supporting structures was improved by the use of straight or slightly inclined implants. According to the displacement analysis and von Mises stress, it could be expected that straight or slightly inclined implants do not represent biomechanical risks to use. PMID:21415633

  14. Location of the Mandibular Canal and Thickness of the Occlusal Cortical Bone at Dental Implant Sites in the Lower Second Premolar and First Molar

    PubMed Central

    Huang, Heng-Li; Fuh, Lih-Jyh; Li, Rou-Wei; Wu, Jay; Tsai, Ming-Tzu; Shen, Yen-Wen; Tu, Ming-Gene

    2013-01-01

    The objective of this study was to evaluate the location of the mandibular canal and the thickness of the occlusal cortical bone at dental implant sites in the lower second premolar and lower first molar by using dental cone-beam computed tomography (CBCT). Seventy-nine sites (47 second premolar and 32 first molar sites) were identified in the dental CBCT examinations of 47 patients. In this study, 4 parameters were measured: (1) MC—the distance from the mandibular canal to the upper border of the mandible; (2) CD—the distance from the mandibular canal to the buccal border of the mandible; (3) MD—the distance from the mandibular canal to the lingual border of the mandible; (4) TC—the thickness of the cortical bone at the occlusal side. A statistical analysis was employed to compare the size and differences between these 4 parameters at the lower second premolar and lower first molar. Regarding the MC and MD, the experimental results showed no statistical difference between the first molar and second premolar. However, the TC for the second premolar was greater than that of the first molar. Thus, careful consideration is necessary in choosing the size of and operation type for dental implants. PMID:24302975

  15. The use of phentolamine mesylate to evaluate mandibular nerve damage following implant placement.

    PubMed

    Froum, Stuart J; Froum, Scott H; Malamed, Stanley F

    2010-09-01

    High success rates and long-term predictability of implant therapy have been well documented in the literature. However, complications in implant treatment can arise and include sensory disturbances, especially in the posterior mandible in areas close to the inferior alveolar nerve. Treatment efficacy of sensory disturbances caused by implant placement in this area relies on the expeditious diagnosis of an induced paresthesia. Recently, phentolamine mesylate has been introduced as a reversal agent of local anesthesia with the ability to decrease the requisite time for a patient to return to normal sensation. This article introduces a method for faster detection of a potential paresthesia induced by implant placement in the posterior mandible. PMID:20879205

  16. Metastatic Breast Cancer in Medication-Related Osteonecrosis Around Mandibular Implants

    PubMed Central

    Favia, Gianfranco; Tempesta, Angela; Limongelli, Luisa; Crincoli, Vito; Piattelli, Adriano; Maiorano, Eugenio

    2015-01-01

    Patient: Female, 66 Final Diagnosis: Breast cancer metastasis in medication-related osteonecrosis of the jaw Symptoms: — Medication: — Clinical Procedure: Clinical and radiological examination • surgical treatment Specialty: Dentistry Objective: Rare co-existance of disease or pathology Background: Many authors have considered dental implants to be unrelated to increased risk of medication-related osteonecrosis of the jaw (MRONJ). Nevertheless, more recently, more cases of peri-implant MRONJ (PI-MRONJ) have been described, thus becoming a challenging health problem. Also, metastatic cancer deposits are not infrequently found at peri-implant sites and this may represent an additional complication for such treatments. We present the case of a breast cancer patient with PI-MRONJ, presenting a clinically and radiologically undetected metastasis within the necrotic bone, and highlight the necessity of an accurate histopathological analysis. Case Report: A 66-year-old female patient, who had received intravenous bisphosphonates for bone breast cancer metastases, came to our attention for a non-implant surgery-triggered PI-MRONJ. After surgical resection of the necrotic bone, conventional and immunohistochemical examinations were performed, which showed breast cancer deposits within the necrotic bone. Conclusions: Cancer patients with metastatic disease, who are undergoing bisphosphonate treatment, may develop unusual complications, including MRONJ, which is a site at risk for hosting additional metastatic deposits that may be clinically and radiologically overlooked. Such risk is increased by previous or concomitant implant procedures. Consequently, clinicians should be prudent when performing implant surgery in cancer patients with advanced-stage disease and consider the possible occurrence of peri-implant metastases while planning adequate treatments in such patients. PMID:26371774

  17. Influence of the overall stiffness of a load-bearing porous titanium implant on bone ingrowth in critical-size mandibular bone defects in sheep.

    PubMed

    Schouman, T; Schmitt, M; Adam, C; Dubois, G; Rouch, P

    2016-06-01

    The aim of this work was to assess the influence of reduction of the apparent mechanical properties of fully load-bearing porous titanium implants used in mandibular bone defects. Segmental 18mm long bone defects were created bilaterally in the lower jaws of adult ewes. One group of 6 ewes (group A) was treated with load-bearing 'rigid' (high stiffness) porous implants on the right side, and with control on the left side. A second group of 6 ewes (group B) was treated with 'flexible' porous and control implants exhibiting apparent mechanical properties ten times lower than the rigid implants. The mechanical behavior of the reconstructed hemi-mandibles was assessed by cantilever testing and bone ingrowth into the segmental defects was assessed by BV/TV measurement within the implant using micro-CT 12 weeks after implantation. A significantly higher rigidity was identified for porous implants compared with control implants at the anterior interface in group B. BV/TV of porous implants was significantly higher than that of control implants in group A. BV/TV differences were significant between porous and control implants in group B and were homogeneous along the main axis. Significantly higher BV/TV was identified in most sub-volumes of group B porous implants compared with group A. This work highlights the critical importance of the tuning of scaffolds to promote bone ingrowth with reference to the local strains occurring within the porous scaffold, which in this application was achieved using fully load-bearing low-stiffness porous titanium implants. PMID:26999620

  18. Posterior implants for distal extension removable prostheses: a retrospective study.

    PubMed

    Mitrani, Ricardo; Brudvik, James S; Phillips, Keith M

    2003-08-01

    Common complaints associated with the Kennedy Class I (bilateral free end) and Class II (unilateral free end) removable partial denture situations are lack of stability, minimal retention, and unesthetic retentive clasping. Some of the same complaints have been reported for implant overdentures with only anterior implants. Starting in 1995, 10 of these patients were treated at the University of Washington with posterior osseointegrated implants to provide stability and/or retention of the removable prostheses, eliminating the need for clasps when possible. This article describes implant alternatives and prosthesis designs and presents a follow-up clinical evaluation of at least 1 year consisting of patient satisfaction, radiographic examination, and soft tissue health. Two groups were evaluated. Group 1 included patients whose implants were used as vertical stops for mandibular distal extension prostheses. Care was taken to ensure that the implants were not loaded laterally by creating a single-point contact at the center of a modified healing abutment. In these cases, sufficient retention was available from the anterior teeth and/or implant abutments. Group 2 included patients whose implants required retention because of lack of adequate tooth abutments. In those cases, a resilient type of attachment was used, which allowed for a small divergence from the path of insertion. Results indicated consistent increased satisfaction in all patients, minimal component wear, no radiographic evidence of excessive bone loss, and stable peri-implant soft tissues. PMID:12956479

  19. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  20. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  1. Comparative stress distribution of implant-retained mandibular ball-supported and bar-supported overlay dentures: a finite element analysis.

    PubMed

    Vafaei, Fariborz; Khoshhal, Masoumeh; Bayat-Movahed, Saeed; Ahangary, Ahmad Hassan; Firooz, Farnaz; Izady, Alireza; Rakhshan, Vahid

    2011-08-01

    Implant-retained mandibular ball-supported and bar-supported overlay dentures are the two most common treatment options for the edentulous mandible. The superior option in terms of strain distribution should be determined. The three-dimensional model of mandible (based on computerized tomography scan) and its overlying implant-retained bar-supported and ball-supported overlay dentures were simulated using SolidWorks, NURBS, and ANSYS Workbench. Loads A (60 N) and B (60 N) were exerted, respectively, in protrusive and laterotrusive motions, on second molar mesial, first molar mesial, and first premolar. The strain distribution patterns were assessed on (1) implant tissue, (2) first implant-bone, and (3) second implant-bone interfaces. Protrusive: Strain was mostly detected in the apical of the fixtures and least in the cervical when bar design was used. On the nonworking side, however, strain was higher in the cervical and lower in the apical compared with the working side implant. Laterotrusive: The strain values were closely similar in the two designs. It seems that both designs are acceptable in terms of stress distribution, although a superior pattern is associated with the application of bar design in protrusive motion. PMID:20712443

  2. Periodontal considerations of the removable partial overdenture.

    PubMed

    Gomes, B C; Renner, R P

    1990-10-01

    1. An overdenture, whether complete or partial, is an excellent mode of treatment in the mutilated dentition for the preservation of the residual ridge. 2. Selection of patients for an overdenture should be based on past history of dental neglect, the status of the teeth and their periodontium, including present oral hygiene status, and patient motivation. The patients with a history of dental neglect, poor oral hygiene, and lack of motivation in having the teeth and the periodontium restored to health as well as strict compliance to a home-care regimen and recall schedule are not good candidates for treatment with an overdenture. 3. The choice of teeth or roots to serve as overdenture abutments must include their periodontal evaluation, which should consist of a detailed periodontal examination, diagnosis, prognosis, and treatment when this is indicated, including chemical protection (fluoride gel) and an oral hygiene regimen tailored to individual needs. 4. The knowledge and expertise in the selection and implementation of appropriate periodontal treatment modalities is of paramount importance in restoring optimum periodontal health to the overdenture abutments before overdenture fabrication. 5. The maintenance phase of the overdenture abutments as well as of the existing natural teeth is of critical importance in the preservation of health of these abutments and teeth. This maintenance phase should consist of periodic recalls based on individual needs; a detailed periodontal evaluation, including patient's motivation and status of oral hygiene and denture hygiene; and detection of caries. If necessary, appropriate periodontal and/or restorative therapy should be performed, and oral hygiene measures reinforced. This will ensure longevity of both abutment teeth or roots and of the existing natural teeth resulting in a long-term success of an overdenture. 6. Because there is evidence of high incidence of periodontal disease and dental caries in overdenture wearers

  3. Therapeutical attitudes in tooth supported overdentures with ball attachements. Case report.

    PubMed

    Țâncu, A M; Melescanu Imre, M; Preoteasa, C T; Preoteasa, E

    2014-01-01

    Tooth supported overdenture with ball attachments has a number of advantages in prosthetics, but presents some difficulties as well, which sometimes make impossible the use of these anchoring systems; these difficulties should be well known. In this regard we present a suggestive case. It is the case of a patient, aged 57, who came for treatment, suffering from subtotal maxillary and mandibular edentulism (present 11 and 21, respectively 33 and 43), previously having an overdenture prosthesis on natural teeth, with special systems - ball attachment type, dissatisfied with the treatment (due to repeated fractures and functional intolerance to dentures). Clinical examination revealed an increase of the vertical dimension of occlusion and reduced prosthetic space at a correct, functional DVO value, aspects that were explaining the patient's reported complaints. As a therapeutic approach, having into consideration the balance conditions that were favorable for complete dentures and the large ball attachments volume, which did not allow keeping them at a functional DVO at any of the jaws, and the relatively young age of the patient, it was decided to remove the ball attachments and to keep the teeth for a simple overdenture, both to the maxillar and the mandible, over coronary reduced teeth, enough to allow the denture thickness at a functional DVO. Good end result of prosthetics, with stable, functional dentures, which were well tolerated and offered satisfaction to the patient, have led to an increased quality of life. PMID:27057258

  4. Therapeutical attitudes in tooth supported overdentures with ball attachements. Case report

    PubMed Central

    Țâncu, AM; Melescanu Imre, M; Preoteasa, CT; Preoteasa, E

    2014-01-01

    Tooth supported overdenture with ball attachments has a number of advantages in prosthetics, but presents some difficulties as well, which sometimes make impossible the use of these anchoring systems; these difficulties should be well known. In this regard we present a suggestive case. It is the case of a patient, aged 57, who came for treatment, suffering from subtotal maxillary and mandibular edentulism (present 11 and 21, respectively 33 and 43), previously having an overdenture prosthesis on natural teeth, with special systems – ball attachment type, dissatisfied with the treatment (due to repeated fractures and functional intolerance to dentures). Clinical examination revealed an increase of the vertical dimension of occlusion and reduced prosthetic space at a correct, functional DVO value, aspects that were explaining the patient’s reported complaints. As a therapeutic approach, having into consideration the balance conditions that were favorable for complete dentures and the large ball attachments volume, which did not allow keeping them at a functional DVO at any of the jaws, and the relatively young age of the patient, it was decided to remove the ball attachments and to keep the teeth for a simple overdenture, both to the maxillar and the mandible, over coronary reduced teeth, enough to allow the denture thickness at a functional DVO. Good end result of prosthetics, with stable, functional dentures, which were well tolerated and offered satisfaction to the patient, have led to an increased quality of life. PMID:27057258

  5. Effects of Length and Inclination of Implants on Terminal Abutment Teeth and Implants in Mandibular CL1 Removable Partial Denture Assessed by Three-Dimensional Finite Element Analysis

    PubMed Central

    Fayaz, Amir; Geramy, Alahyar; Memari, Yeganeh

    2015-01-01

    Objectives: This study sought to assess the effects of length and inclination of implants on stress distribution in an implant and terminal abutment teeth in an implant assisted-removable partial denture (RPD) using three-dimensional (3D) finite element analysis (FEA). Materials and Methods: In this in vitro study, a 3D finite element model of a partially dentate mandible with a distal extension RPD (DERPD) and dental implants was designed to analyze stress distribution in bone around terminal abutment teeth (first premolar) and implants with different lengths (7 and 10 mm) and angles (0°, 10° and 15°). Results: Stress in the periodontal ligament (PDL) of the first premolar teeth ranged between 0.133 MPa in 10mm implants with 15° angle and 0.248 MPa in 7mm implants with 0° angle. The minimum stress was noted in implants with 10mm length with 0° angle (19.33 MPa) while maximum stress (25.78 MPa) was found in implants with 10mm length and 15° angle. In implants with 7 mm length, with an increase in implant angle, the stress on implants gradually increased. In implants with 10 mm length, increasing the implant angle gradually increased the stress on implants. Conclusion: Not only the length of implant but also the angle of implantation are important to minimize stress on implants. The results showed that vertical implant placement results in lower stress on implants and by increasing the angle, distribution of stress gradually increases.

  6. Determining optimal surface roughness of TiO(2) blasted titanium implant material for attachment, proliferation and differentiation of cells derived from human mandibular alveolar bone.

    PubMed

    Mustafa, K; Wennerberg, A; Wroblewski, J; Hultenby, K; Lopez, B S; Arvidson, K

    2001-10-01

    In the complex process of bone formation at the implant-tissue interface, implant surface roughness is an important factor modulating osteoblastic function. In this study, primary cultures of osteoblast-like cells, derived from human mandibular bone, were used. The aim was to examine the effect of varying surface roughness of titanium implant material on cellular attachment, proliferation and differentiation. A recognized method of increasing surface roughness and enlarging the surface area of titanium implants is by blasting with titanium dioxide particles: the four specimen types in the study comprised surfaces which were machine-turned only, or blasted after turning, with 63-90 microm, 106-180 microm, or 180-300 microm TiO(2) particles, respectively. The specimens were analyzed by scanning electron microscopy and confocal laser scanning. The turned samples had the smoothest surfaces: average height deviation (S(a)) of 0.20 microm. The roughest were those blasted with 180-300 microm particles, S(a) value 1.38 microm. Blasting with intermediate particle sizes yielded S(a) values of 0.72 microm and 1.30 microm, respectively. Cell profile areas were measured using a semiautomatic interactive image analyzer. Figures were expressed as percentage of attachment. DNA synthesis was estimated by measuring the amount of [(3)H]-thymidine incorporation into trichloroacetic acid (TCA) insoluble cell precipitates. The specific activity of alkaline phosphatase was assayed using p-nitrophenylphosphate as a substrate. The ability of the cells to synthesize osteocalcin was investigated in serum-free culture medium using the ELSA-OST-NAT immunoradiometric kit. After 3 h of culture, the percentage of cellular attachment did not differ significantly between specimens blasted with 180-300 micromparticles and the turned specimens. All blasted surfaces showed significantly higher [(3)H]-thymidine incorporation than the turned surfaces (P<0.05), with the highest on the surfaces blasted

  7. Reconstruction of Mandibular Defects

    PubMed Central

    Chim, Harvey; Salgado, Christopher J.; Mardini, Samir; Chen, Hung-Chi

    2010-01-01

    Defects requiring reconstruction in the mandible are commonly encountered and may result from resection of benign or malignant lesions, trauma, or osteoradionecrosis. Mandibular defects can be classified according to location and extent, as well as involvement of mucosa, skin, and tongue. Vascularized bone flaps, in general, provide the best functional and aesthetic outcome, with the fibula flap remaining the gold standard for mandible reconstruction. In this review, we discuss classification and approach to reconstruction of mandibular defects. We also elaborate upon four commonly used free osteocutaneous flaps, inclusive of fibula, iliac crest, scapula, and radial forearm. Finally, we discuss indications and use of osseointegrated implants as well as recent advances in mandibular reconstruction. PMID:22550439

  8. Biomechanical analysis of alveolar bone stress around implants with different thread designs and pitches in the mandibular molar area.

    PubMed

    Lan, Ting-Hsun; Du, Je-Kang; Pan, Chin-Yun; Lee, Huey-Er; Chung, Wei-Hao

    2012-04-01

    Threaded implants have been shown to play an important role in increasing mechanical osseointegration. The aim of this study was to determine bone stress distribution when using different types of implant thread pitches and designs. Five 3D finite element models were constructed to simulate bone stresses induced in implant bodies with two types of thread form: triangular ("Tri" prefix) and trapezoidal ("Trap" prefix). The former had thread pitches of 0.8, 1.2, and 1.6 mm, while the latter had thread pitches of 1.2 and 1.6 mm. A biting load of 143 N was applied vertically and obliquely to the occlusal central fossa of the crown. The main effects of each level of the three factors investigated (loading type, pitch, and thread form) in terms of the stress value were computed for all models. Results indicated that the loading type was the main factor of influence on the peak compressive stress of the alveolar bone. Optimal thread pitch was 1.2 mm for a triangular-thread implant, and a trapezoidal-threaded implant with thread pitch of 1.6 mm had the lowest stress value among trapezoidal-threaded implants. This study concluded that each thread form has its unique optimal thread pitch with regard to lower concentration of bone stress. Clinically, this study suggests that in biomechanical consideration, thread pitch exceeding 0.8 mm is more appropriate for a screwed implant. For clinical cases that require greater bone-implant interface, trapezoidal-threaded implants with thread pitch of 1.6 mm provide greater primary stability and lower concentration of bone stress under different loading directions. PMID:21301903

  9. Attachment fixation of the overdenture: part II.

    PubMed

    Mensor, M C

    1978-01-01

    Many attachment systems of the bar or stud type increase the stability of an overdenture. When selecting an attachment it is essential to consider the skill of the dentist-laboratory team as well as the dexterity of the patient and to use the easiest system that will still improve stabilization. Generally simplicity in design, ease of maintenance, and minimum leverage should be paramount considerations in selection. Use of a guide such as the EM Gauge and of the EM Attachment Selector significantly reduces the confusion in selecting attachments and increases the working armamentarium for stabilizing an overdenture. PMID:340660

  10. Mandibular fracture as a complication of inferior alveolar nerve transposition and placement of endosseous implants: a case report.

    PubMed

    Karlis, Vasiliki; Bae, Richard D; Glickman, Robert S

    2003-01-01

    Placement of endosseous implants and inferior alveolar nerve transposition is a treatment option for patients with an edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal. Complications associated with these procedures include infection, prolonged neurosensory disturbances, and/or pathologic fracture. This report presents the surgical management of a patient with a mandible fracture after inferior alveolar nerve transposition with concurrent placement of two endosseous implants. PMID:14560480

  11. Removable partial overdentures for the irradiated patient

    SciTech Connect

    Rosenberg, S.W. )

    1990-10-01

    Patients who have received radiotherapy to the head and neck area must avoid dental extractions and seek simplicity in treatment and home care follow-up. For partially edentulous patients, removable partial overdenture therapy can fulfill these goals while maintaining the high level of function and aesthetics desired by patients.11 references.

  12. Laser micro-grooved, Arginine-Glycine-Apspartic acid (RGD) coated dental implants, a 5 years radiographic follow-up

    PubMed Central

    Alkhodary, Mohamed Ahmed

    2014-01-01

    Objectives This work has utilized laser direct writing to produce 10 microns wide uniform grooves on the surface of custom made titanium (Ti-6Al-4V) dental implants, and the tri-peptide RGD coating to produce a micromechanical and a chemical union with the tissues around the implant crest module and minimize crestal bone loss. The aim of this study was to follow these implants radiographically after five years of service under a mandibular overdenture. Methodology Standardized digital periapical radiographs and the computer software “Image J” were used to evaluate the bone density profile and vertical bone loss along the mesial and distal sides of the implants used in this study. Results The results of this study demonstrated less vertical bone loss and higher bone density profiles next to the laser microgrooved implants coated with the RGD than those only having the laser micro-grooves. Conclusion The RGD coating has improved the bone density profile and reduced the vertical bone loss around the studied dental implants. However, further studies are needed to compare the effects of the laser micro-grooves versus other uniform or non uniform surface features; also, the RGD coating should be compared to other biomimetic surface coating materials. PMID:25780355

  13. Irradiation autogenous mandibular grafts in primary reconstructions

    SciTech Connect

    Hamaker, R.C.

    1981-07-01

    The procedure, irradiated mandibular autografts, for primary reconstruction, is presented with an immediate success rate of 88%. Eight cases have undergone primary mandibular reconstruction with the tumorous mandible irradiated to 10,000 rads in a single dose. The longest follow-up is 2 3/4 years. The autograft has proven to be an ideal implant. Major resections of the mandible in conjunction with large myocutaneous flaps have been reconstructed utilizing this implant.

  14. The contribution of imaging and digitised data to mandibular reconstruction and implant stabilised occlusal rehabilitation: a case report.

    PubMed

    Watson, R M; Coward, T J; Clark, R K; Grindrod, S

    2001-03-24

    Different methods are recommended for the surgical reconstruction of the resected mandible. The advantages for implant stabilised prostheses in restoring the occlusion are recognised but few papers provide adequate data to identify the successful outcome of treatment. The literature is reviewed and the advantages of imaging together with the use of digitised data is highlighted by a case requiring rehabilitation with enhanced planning methods. PMID:11325155

  15. Early and immediate loading protocols for overdentures in completely edentulous maxillas: a comprehensive review of clinical trials.

    PubMed

    Alfadda, Sara Abdulaziz

    2014-01-01

    A comprehensive review was conducted to answer the question 'Does the immediate loading of dental implants with an overdenture in the maxilla provide predictable clinical and psychological outcomes?' Detailed search strategies were used to identify pertinent articles in English that were published between 1975 and August 2013 and indexed in PubMed, MEDLINE, Embase, The Cochrane Central Register of Controlled Trials, and a personal library; in addition, relevant journals were manually searched. Only randomized controlled clinical trials (RCTs), controlled clinical trials (CCTs), and prospective studies with a follow-up period of at least one year, all involving 10 or more adult participants, were considered. Six prospective studies reporting on outcomes of up to 2 years were included, five of which employed a bar-retained overdenture, and one of which used a ball attachment as a retention mechanism. Short term reports demonstrate that immediate/early loading of dental implants with a maxillary overdenture is a predictable treatment approach and results in favorable implant/prosthesis survival, soft tissue health, and patient satisfaction outcomes. However, for a definitive conclusion, well-designed long-term trials are required to establish a consensus on treatment planning, longevity, long-term complications and maintenance, cost-effectiveness, and patients-mediated outcomes. PMID:25825112

  16. Costal Grafting in Mandibular Reconstruction

    PubMed Central

    Bourlet, Jerôme; Château, Joseph; Jacquemart, Mathieu; Dufour, Clémence; Mojallal, Ali; Gleizal, Arnaud

    2015-01-01

    Background: Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery, and free fibular flap is the gold standard for this indication. However, there are alternatives; nonvascular bone grafting is one of them, and we present the costal grafting for mandibular reconstruction, a classic technique that is reliable, efficient, and produced less morbidity than the technique of using composite free flaps. Method: A 9-year retrospective review of 54 patients treated surgically for mandibular reconstruction was performed. The criterion mainly analyzed was graft survival. The surgical technique was described in detail. Results: A total of 54 patients with mandibular bone defect were identified. Five symphysis, 46 corpus, and 20 ramus defects were considered. These patients underwent reconstruction by costal grafting, and the engrafting was successful in 92.6% of cases. Dental rehabilitation with dental implants was realized in 70% of cases. Conclusions: The approach described in this article allowed the authors to obtain good results with costal grafting for mandibular reconstruction and dental rehabilitation. Costal grafting is a good alternative for fibula free flap in specific indications. Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery. Since the 1980s, the gold standard for these defects is the use of free fibular flap.1 In some cases, this technique is contradicted; the surgeon then has several possibilities for the use of free osteomyocutaneous flaps (iliac crest, scapula, and serrato-costal flaps).2–8 PMID:26893990

  17. Cemented and screw-retained implant-supported single-tooth restorations in the molar mandibular region: A retrospective comparison study after an observation period of 1 to 4 years

    PubMed Central

    Peñarrocha-Diago, Miguel; Pradíes, Guillermo; Sola-Ruiz, María-Fernanda; Agustín-Panadero, Rubén

    2015-01-01

    Objectives: The aim of this study was to evaluate the survival and compare the appearance of different mechanical and biological complications, in screw-retained and cemented-retained single-tooth implant-supported restorations localized in the molar mandibular region, over a period of 1 to 4 years. Material and Methods: A retrospective study was carried out with a total of eighty implant-supported restorations, which were placed in eighty patients for prosthetic rehabilitation of a mandibular molar. Forty patients were rehabilitated with a cemented-retained restoration and the other forty with a screw-retained restoration. The presence of the following complications was recorded for both types of prostheses: Fractures of the ceramic veneering, loosening screws, mucositis and peri-implantitis. Debonding of the restoration was analyzed in the cemented-retained restoration group. The clinical survival of crowns was analyzed with a Kaplan-Meier test and the clinical complications were compared, using a Student t test and Log-rank test. Results: 27 patients registered some complication. The average rate of complications was 37,5% for cemented-retained restorations and 30% for screw-retained restorations. The complications more common in the cemented-retained restoration were the presence of mucositis (14,87%), while in the screw-retained restorations was the loosening screw (20%). Student t test and Log-Rank test found significant differences (p=0,001) between the screw loosening and presence of mucositis. Conclusions: The cemented-retained restorations seem to prevent screw loosening, but the presence of cement seem to increase the complications around the soft tissues, however in the screw-retained restorations the presence of mucositis and peri-implantitis are lower than cemented-retained restorations. The incidence of fracture of ceramic veneering was similar in both groups. Key words:Screw-retained restorations, cemented-retained restorations, screw loosening

  18. An overview of U.S. predoctoral dental implant programs and their directors.

    PubMed

    Barwacz, Christopher A; Avila-Ortiz, Gustavo; Allareddy, Veerasathpurush; Tamegnon, Monelle; Hoogeveen, Kaitlin

    2015-03-01

    The aim of this study was to provide an overview of current predoctoral implant programs in the United States, including curricular characteristics and clinical practices regarding implant therapy education and program directors' characteristics. An electronic survey was sent to predoctoral implant program directors of all 64 accredited U.S. dental schools; 52 of the 60 eligible programs responded, for a response rate of 87%. The responding program directors were primarily affiliated with either prosthodontics departments (44%) or restorative dentistry departments (40%). Structurally, 80.8% of the responding schools integrate their implant programs into the third year of the curriculum. Clinical implant therapy exercises reported were simulation exercises without direct patient care (90.4% of responding schools) and direct patient care under supervision (94.2%). The most frequently taught restorative modalities are posterior single-tooth implant crown (96.2%), mandibular implant-retained overdenture (88.5%), and anterior implant-supported single crown (61.5%). A majority (74.5%) of responding programs utilize analog surgical guide planning, while 25.5% reported use of digital guided surgery planning software. All schools in the Northwest and 66.7% in the South Central regions utilize custom abutments as the primary abutment design, while a majority of schools in the North Central (62.5%), Northeast (53.8%), Southwest (66.7%), and Southeast (80%) regions use stock abutments (p=0.02). Regional differences were significant with regard to fixation modality, with all the Northwest programs using screw retention and 90% of Southeast and 87.5% of North Central programs using cement retention (p=0.002). This study demonstrated that while institutions share program director and curricular similarities, clinical practices and modalities vary significantly by region. PMID:25729020

  19. Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.

    PubMed

    Frake, Paul C; Goodman, Joseph F; Joshi, Arjun S

    2015-01-01

    The investigators of this study hypothesized that fractures of the mandibular condyle can be repaired using short-segment intramedullary implants and purely endoscopic surgical technique, using a basic science, human cadaver model in an academic center. Endoscopic instrumentation was used through a transoral mucosal incision to place intramedullary implants of 2 cm in length into osteotomized mandibular condyles. The surgical maneuvers that required to insert these implants, including condyle positioning, reaming, implant insertion, and seating of the mandibular ramus, are described herein. Primary outcome was considered as successful completion of the procedure. Ten cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg-type implant and screwing a threaded implant into the condylar head were possible. The inferior portion of the implant remained exposed, and the ramus of the mandible was manipulated into position on the implant using retraction at the sigmoid notch. The results of this study suggest that purely endoscopic repair of fractures of the mandibular condyle is possible by using short-segment intramedullary titanium implants and a transoral endoscopic approach without the need for facial incisions or punctures. The biomechanical advantages of these intramedullary implants, including improved strength and resistance to mechanical failure compared with miniplates, have been recently established. The combination of improved implant design and purely endoscopic technique may allow for improved fixation and reduced surgical- and implant-related morbidity in the treatment of condylar fractures. PMID:25534058

  20. Biodynamics of attachments used in overdentures: experimental analysis with photoelasticity.

    PubMed

    Labaig, C; Marco, R; Fons, A; Selva, E J

    1997-03-01

    Treatment with overdentures is an alternative to conventional complete prostheses. Different types of attachments can be placed in natural teeth that act as retainers for overdentures. The photoelastic relationship between the design of the attachment and the distribution of occlusal forces among the abutment teeth and the distal alveolar ridges was examined. The results were used to develop a classification for clinical cases so that the correct attachment design can be selected. PMID:9452685

  1. Short implants: are they a viable option in implant dentistry?

    PubMed

    Schwartz, Steven Richard

    2015-04-01

    Short-length implants (<10 mm) can be used effectively in atrophic maxillae or mandibles even with crown/implant ratios that previously would have been considered excessive. Short implants can support either single or multiple units and can be used for fixed prostheses or overdentures. The use of short-length implants may avoid the need for complicated bone augmentation procedures, thus allowing patients who were either unwilling or unable for financial or medical reasons to undergo these advanced grafting techniques to be adequately treated. PMID:25835796

  2. Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in Relation with Dental Implantology

    PubMed Central

    Wang, Hom-Lay; Sabalys, Gintautas

    2010-01-01

    ABSTRACT Objectives It is critical to determine the location and configuration of the mandibular canal and related vital structures during the implant treatment. The purpose of the present study was to review the literature concerning the mandibular canal and inferior alveolar neurovascular bundle anatomical variations related to the implant surgery. Material and Methods Literature was selected through the search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular canal, inferior alveolar nerve, and inferior alveolar neurovascular bundle. The search was restricted to English language articles, published from 1973 to November 2009. Additionally, a manual search in the major anatomy, dental implant, prosthetic and periodontal journals and books were performed. Results In total, 46 literature sources were obtained and morphological aspects and variations of the anatomy related to implant treatment in posterior mandible were presented as two entities: intraosseous mandibular canal and associated inferior alveolar neurovascular bundle. Conclusions A review of morphological aspects and variations of the anatomy related to mandibular canal and mandibular vital structures are very important especially in implant therapy since inferior alveolar neurovascular bundle exists in different locations and possesses many variations. Individual, gender, age, race, assessing technique used and degree of edentulous alveolar bone atrophy largely influence these variations. It suggests that osteotomies in implant dentistry should not be developed in the posterior mandible until the position of the mandibular canal is established. PMID:24421958

  3. The reverse zygomatic implant: a new implant for maxillofacial reconstruction.

    PubMed

    Dawood, Andrew; Collier, Jonathan; Darwood, Alastair; Tanner, Susan

    2015-01-01

    This case report describes the rehabilitation of a patient who had been treated with a hemimaxillectomy, reconstruction with a latissimus dorsi vascularized free flap, and radiotherapy for carcinoma of the sinus some years previously. Limited jaw opening, difficult access through the flap to the bony site, and the very small amount of bone available in which to anchor the implant inspired the development and use of a new "reverse zygomatic" implant. For this treatment, site preparation and implant insertion were accomplished using an extraoral approach. The implant was used along with two other conventional zygomatic implants to provide support for a milled titanium bar and overdenture to rehabilitate the maxilla. Two years later, the patient continues to enjoy a healthy reconstruction. The reverse zygomatic implant appears to show promise as a useful addition to the implant armamentarium for the treatment of the patient undergoing maxillectomy. PMID:26574864

  4. Implant success lies in complications management: A report of two cases.

    PubMed

    Rani, Sapna; Devi, Jyoti; Verma, Mahesh

    2016-01-01

    At present, implant supported or retained prostheses are considered as a first therapeutic alternative for patients. Although the success rate of dental implants is very high, no treatment is without complications; same applies to implants also. Implant failure can be due to biological factors, i.e., loss of osseointegration or due to technical complications. This case report presents implant complications involving both factors along with the management of these cases. In implant supported overdenture patient, loss of implant on the right side and implant body fracture of the left side implant is reported and in another patient abutment screw fracture and its management is reported. PMID:27307672

  5. Implant success lies in complications management: A report of two cases

    PubMed Central

    Rani, Sapna; Devi, Jyoti; Verma, Mahesh

    2016-01-01

    At present, implant supported or retained prostheses are considered as a first therapeutic alternative for patients. Although the success rate of dental implants is very high, no treatment is without complications; same applies to implants also. Implant failure can be due to biological factors, i.e., loss of osseointegration or due to technical complications. This case report presents implant complications involving both factors along with the management of these cases. In implant supported overdenture patient, loss of implant on the right side and implant body fracture of the left side implant is reported and in another patient abutment screw fracture and its management is reported. PMID:27307672

  6. Mandibular bone repair by implantation of rhBMP-2 in a slow release carrier of polylactic acid--an experimental study in rats.

    PubMed

    Schliephake, Henning; Weich, Herbert A; Dullin, Christian; Gruber, Rudolf; Frahse, Sarah

    2008-01-01

    The aim of the present study was to test the hypothesis that human recombinant bone morphogenic protein 2 (rhBMP-2) implanted in a slow release carrier of polylactic acid (PLA) can repair a non-healing defect in the rat mandible and maintain the thickness of an augmented volume. p-DL-lactic acid discs were produced and loaded with 48 and 96 microg rhBMP-2 and inserted into non-healing defects of the mandible of 45 Wistar rats. Fifteen rats received implants with 96 microg rhBMP-2 (Group 2), 48 microg rhBMP-2 (Group 1) and blank implants without BMP (Group 0) each on one side of the mandible. Unfilled defects of the same size on the contralateral sides of the mandibles served as empty controls. After 6, 13 and 26 weeks, implants of each group were retrieved from five animals each and submitted to flat panel detector computed tomography. Bone formation and thickness of augmentation was assessed by computer-assisted histomorphometry. In Group 2 significantly more bone was produced than in Group 1. Implants of Group 1 induced significantly more bone than the blank controls only after 6 weeks, whereas the difference was not significant after 13 and 26 weeks. Differences between Group 2 and Group 1 were clearly significant after 26 weeks. The thickness of bone tissue was maintained in Group 2 whereas it decreased in Group 1 and was negligible in Group 0. It is concluded that the PLA implants with 96 microg rhBMP-2 were able to bridge a non-healing defect in the rat mandible and maintained the thickness of an augmented volume. However, continuous supply of osteogenic signals appears to be required to compensate for adverse effects during polymer degradation. PMID:17936352

  7. Splinted mandibular protraction appliance.

    PubMed

    Jena, Ashok Kumar; Singh, Satinder Pal

    2015-03-01

    Advancement of mandible rather than tooth movement is an ideal treatment for the correction of Class II malocclusion resulting from mandibular retrusion. In growing patients, forward repositioning of mandible by mandibular repositioning appliances is considered as a treatment of choice. Correction of mandibular retrusion by the conventional mandibular protraction appliances (MPAs) is mainly due to dento-alveolar changes and by altering the design of original MPAs, these limitations were minimized. The modified design enhanced the mandibular growth and contributed for the better skeletal correction of Class II malocclusion as compared to the conventional MPAs. This article highlights the design and fabrication of a splinted MPA for the correction of Class II malocclusion due to mandibular retrusion and also describes a patient managed by this appliance. PMID:25821367

  8. Splinted mandibular protraction appliance

    PubMed Central

    Jena, Ashok Kumar; Singh, Satinder Pal

    2015-01-01

    Advancement of mandible rather than tooth movement is an ideal treatment for the correction of Class II malocclusion resulting from mandibular retrusion. In growing patients, forward repositioning of mandible by mandibular repositioning appliances is considered as a treatment of choice. Correction of mandibular retrusion by the conventional mandibular protraction appliances (MPAs) is mainly due to dento-alveolar changes and by altering the design of original MPAs, these limitations were minimized. The modified design enhanced the mandibular growth and contributed for the better skeletal correction of Class II malocclusion as compared to the conventional MPAs. This article highlights the design and fabrication of a splinted MPA for the correction of Class II malocclusion due to mandibular retrusion and also describes a patient managed by this appliance. PMID:25821367

  9. Simultaneous Bimaxillary Surgery and Mandibular Reconstruction With a 3-Dimensional Printed Titanium Implant Fabricated by Electron Beam Melting: A Preliminary Mechanical Testing of the Printed Mandible.

    PubMed

    Lee, Ui-Lyong; Kwon, Jae-Sung; Woo, Su-Heon; Choi, Young-Jun

    2016-07-01

    A woman presented with a long history of mandibular defects posterior to the left lower first premolar caused by inadequate reconstruction after removal of a tumor on the left side of the mandible. In the frontal view, extreme facial asymmetry was apparent. The dental midline of the mandible was deviated 10 mm to the left compared with the dental midline of the maxilla, and all maxillary teeth were inclined to the left owing to dental compensation. There was an 8-mm maxillary occlusal cant relative to the maxillary first molar. Bimaxillary surgery using computer-assisted designed and computer-assisted manufactured devices without an intermediate occlusal splint was performed to align the maxilla and mandible at the correct position, and reconstructive surgery for the mandible using a 3-dimensional printed titanium mandible was concurrently performed. In particular, during the virtual mandible design, 2 abutments that enabled the prosthetic restoration were included in the mandible using a computer-assisted design program. This report describes the successful functional and esthetic reconstruction of the mandible using electron beam melting technology, an alternative technique for reconstruction of mandibles that did not undergo radiation therapy. PMID:27060494

  10. Enhanced bone healing using collagen-hydroxyapatite scaffold implantation in the treatment of a large multiloculated mandibular aneurysmal bone cyst in a thoroughbred filly.

    PubMed

    David, Florent; Levingstone, Tanya J; Schneeweiss, Wilfried; de Swarte, Marie; Jahns, Hanne; Gleeson, John P; O'Brien, Fergal J

    2015-10-01

    An unmet need remains for a bone graft substitute material that is biocompatible, biodegradable and capable of promoting osteogenesis safely in vivo. The aim of this study was to investigate the use of a novel collagen-hydroxyapatite (CHA) bone graft substitute in the clinical treatment of a mandibular bone cyst in a young horse and to assess its potential to enhance repair of the affected bone. A 2 year-old thoroughbred filly, presenting with a multilobulated aneurysmal bone cyst, was treated using the CHA scaffold. Post-operative clinical follow-up was carried out at 2 weeks and 3, 6 and 14 months. Cortical thickening in the affected area was observed from computed tomography (CT) examination as early as 3 months post-surgery. At 14 months, reduced enlargement of the operated mandible was observed, with no fluid-filled area. The expansile cavity was occupied by moderately dense mineralized tissue and fat and the compact bone was remodelled, with a clearer definition between cortex and medulla observed. This report demonstrates the promotion of enhanced bone repair following application of the CHA scaffold material in this craniomaxillofacial indication, and thus the potential of this material for translation to human applications. PMID:25712436

  11. Pathological mandibular fracture: A severe complication of periimplantitis.

    PubMed

    Naval-Gías, Luis; Rodriguez-Campo, Francisco; Naval-Parra, Beatriz; Sastre-Pérez, Jesús

    2015-04-01

    Nowadays, dental implant treatment is a very common option for patients even in medical compromised conditons. Some complications related to them have been described. Periimplantitis (PI) is one of the biggest concerns complications of these kind of treatments, probably has a multifactorial aethiology. Usually the consequences of PI are the loss of the implants and prostheses, expenses of money and time for dentists and patients. Very often PI implies the necesity of repeating the treatment . Pathological mandibular fracture due to PI is a severe but infrequent complication after dental implant treatment, especially after PI. In this study we present three cases of mandibular pathologic fractures among patients with different medical and dental records but similar management: two of them had been treated years ago of oral squamous cell carcinoma with surgery and radiotherapy, the other patient received oral bisphosphonates for osteoporosis some years after implantation. We analized the causes, consequences and posible prevention of these fractures as well as the special features of this kind of mandibular fractures and the different existing treatments. Key words:Periimplantitis, pathological mandibular fracture, mandibular atrophy, bicortical implants. PMID:26155355

  12. Pathological mandibular fracture: A severe complication of periimplantitis

    PubMed Central

    Rodriguez-Campo, Francisco; Naval-Parra, Beatriz; Sastre-Pérez, Jesús

    2015-01-01

    Nowadays, dental implant treatment is a very common option for patients even in medical compromised conditons. Some complications related to them have been described. Periimplantitis (PI) is one of the biggest concerns complications of these kind of treatments, probably has a multifactorial aethiology. Usually the consequences of PI are the loss of the implants and prostheses, expenses of money and time for dentists and patients. Very often PI implies the necesity of repeating the treatment . Pathological mandibular fracture due to PI is a severe but infrequent complication after dental implant treatment, especially after PI. In this study we present three cases of mandibular pathologic fractures among patients with different medical and dental records but similar management: two of them had been treated years ago of oral squamous cell carcinoma with surgery and radiotherapy, the other patient received oral bisphosphonates for osteoporosis some years after implantation. We analized the causes, consequences and posible prevention of these fractures as well as the special features of this kind of mandibular fractures and the different existing treatments. Key words:Periimplantitis, pathological mandibular fracture, mandibular atrophy, bicortical implants. PMID:26155355

  13. Implants and all-ceramic restorations in a patient treated for aggressive periodontitis: a case report

    PubMed Central

    Hong, Jin-Sun; Yeo, In-Sung; Kim, Sung-Hun; Lee, Jai-Bong; Han, Jung-Suk

    2010-01-01

    A 23-year-old female with aggressive periodontitis was treated using dental implants and LAVA system. The severely compromised teeth were extracted irrespective of initial conservative periodontal treatment. An implant-supported overdenture with 4 implants was fabricated for the maxilla and all-ceramic restorations for the mandible. Esthetic and functional goals were achieved with team approach involving periodontists and prosthodontists. This case report describes a treatment procedure for a generalized aggressive periodontitis patient with severe bone resorption. PMID:21165277

  14. Lower lip numbness due to the mandibular canal narrowing after dental reimplantation: A case report

    PubMed Central

    Shamloo, Nafiseh; Safi, Yaser; Fathpour, Kamyar; Yaghmaei, Masood; Bahemmat, Nika

    2015-01-01

    Mandibular canal is the most important anatomical landmark in the body of mandible which always must be considered for implant surgery in posterior mandibular region. Damage to vessels and inferior alveolar nerve that passes through the mandibular canal can cause problems such as hemorrhage and neurosensory disturbances. Damage to the mandibular canal can occur during implant surgery. Depending on the severity of injuries, it would result in temporary or permanent neurosensory disturbances. We have reported a case that mandibular canal narrowing occurred following implant surgery and resulted in anesthetic and hypoesthetic areas in the lower lip. Patient had a history of implant surgery in the region of teeth numbered 30 and numbered 31. The inserted implant failed after 6 years, and reimplantation was done in this area, but due to lower lip numbness in the right side, the second implant was removed, and another implant was inserted in the region of the tooth numbered 32. After 2 years, right lower lip numbness was reported again by the patient. Cone beam computed tomography images showed canal narrowing in the region of the tooth numbered 31 where the second implant was inserted. It seems that the main cause for anesthesia and hypoesthesia in this patient is canal narrowing due to damage during implant replacement and removal. PMID:26288630

  15. Autotransplantation of Mandibular Third Molar: A Case Report

    PubMed Central

    Ravi kumar, Pabbati; Jyothi, Mandava; Sirisha, Kantheti; Racca, Khushboo; Uma, Chalasani

    2012-01-01

    Autogenous transplantation is a feasible, fast, and economical option for the treatment of nonsalvageable teeth when a suitable donor tooth is available. This paper presents successful autotransplantation of a mature mandibular left third molar (38) without anatomical variances is used to replace a mandibular left second molar (37). The mandibular second molar was nonrestorable due to extensive root caries and resorption of distal root. After extraction of mandibular second and third molars, root canal therapy was done for the third molar extraorally, and the tooth was reimplanted into the extracted socket of second molar site. After one year, clinical and radiographic examination revealed satisfactory outcome with no signs or symptoms suggestive of pathology. In selected cases, autogenous tooth transplantation, even after complete root formation of the donor tooth, may be considered as a practical treatment alternative to conventional prosthetic rehabilitation or implant treatment. PMID:23346422

  16. Lower molar and incisor displacement associated with mandibular remodeling.

    PubMed

    Baumrind, S; Bravo, L A; Ben-Bassat, Y; Curry, S; Korn, E L

    1997-01-01

    The purpose of this study was to quantify the amount of alveolar modeling at the apices of the mandibular incisor and first molar specifically associated with appositional and resorptive changes on the lower border of the mandible during growth and treatment. Cephalometric data from superimpositions on anterior cranial base, mandibular implants of the Björk type, and anatomical "best fit" of mandibular border structures were integrated using a recently developed strategy, which is described. Data were available at annual intervals between 8.5 and 15.5 years for a previously described sample of approximately 30 children with implants. The average magnitudes of the changes at the root apices of the mandibular first molar and central incisor associated with modeling/remodeling of the mandibular border and symphysis were unexpectedly small. At the molar apex, mean values approximated zero in both anteroposterior and vertical directions. At the incisor apex, mean values approximated zero in the anteroposterior direction and averaged less than 0.15 mm/year in the vertical direction. Standard deviations were roughly equal for the molar and the incisor in both the anteroposterior and vertical directions. Dental displacement associated with surface modeling plays a smaller role in final tooth position in the mandible than in the maxilla. It may also be reasonably inferred that anatomical best-fit superimpositions made in the absence of implants give a more complete picture of hard tissue turnover in the mandible than they do in the maxilla. PMID:9107373

  17. Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery

    PubMed Central

    (Bhattacharya), Sampa Ray; Majumdar, Dibyendu; Singh, Dilip K.; Islam, M. D. Rabiul; Ray, Pradip K.; Saha, Nilanjana

    2015-01-01

    Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis. PMID:25821361

  18. An unusual case of implant failure.

    PubMed

    Verhoeven, J Willem; Cune, Marco S; van Es, Robert J J

    2007-01-01

    A 67-year-old woman was referred with a rapidly progressing swelling in the left canine region of the edentulous mandible. Nine months earlier, 2 permucosal implants had been placed in her atrophic anterior mandible. A few weeks after implant placement, an inoperable carcinoma of the lung had been diagnosed. This tumor was treated with a combination of chemotherapy and radiotherapy. After 3 months, the implants were provided with a Dolder bar supporting an overdenture. Subsequently, progressive inflammation developed around the left implant and removal of the implant was necessary. When progressive swelling of the mucosa developed at the previous implant site, the patient was referred to an oral and maxillofacial surgeon. The swelling measured 35 mm in diameter and was biopsied. It was diagnosed as a metastasis of the lung carcinoma to the mandible. The tumor of the jaw was treated with local radiotherapy. PMID:17319363

  19. Treatment options for the replacement of missing mandibular incisors.

    PubMed

    Fleigel, Jeffrey D; Salmon, Cade A; Piper, James M

    2011-07-01

    The replacement of a mandibular incisor is a dental treatment warranting special consideration. Some of the challenges associated with the anterior mandible are limited space, challenging surrounding anatomy, and tough esthetic requirements. Proper diagnosis and treatment planning may require a multidisciplinary approach to successfully meet the demands of replacing a missing tooth in this sextant. Several treatment options currently exist for mandibular incisor replacement. These options include (1) resin-bonded fixed dental prostheses (RBFDPs), (2) orthodontic treatment, (3) full-veneer fixed dental prostheses (FDPs), (4) dental implants for single-tooth replacement, (5) possible extraction of one or more incisors and restoration with implant-supported FDPs, (6) possible extraction of one or more teeth and restoration with FDPs from #22 to 27, (7) possible extraction of one or more teeth and restoration with removable dental prostheses (RDPs). This manuscript outlines the various treatment options for the replacement of mandibular incisors and discusses benefits and drawbacks of each. PMID:21631631

  20. Telescopic overdenture: Perio-prostho concern for advanced periodontitis

    PubMed Central

    Goswami, Roma; Mahajan, Puneet; Siwach, Amit; Gupta, Ankur

    2013-01-01

    The crown- and sleeve-coping denture is a removable prosthesis that is supported by both selectively retained teeth and the residual ridge or mucosa. It is a versatile and successful means of achieving long-term restoration of a partially edentulous jaw. Insertion and removal of the denture and routine oral hygiene are easy to perform. The beneficial results of this form of treatment can be considered for a wide variety of clinical applications for the severely advanced periodontitis case. This paper presents a case report on the prosthetic rehabilitation of a partially edentulous patient with a telescopic overdenture for the mandible and complete denture for the maxilla. PMID:24124317

  1. Multiple mandibular fractures. Treatment outlines.

    PubMed

    Elia, Giovanni; Franco, Elena; Clauser, Luigi C

    2016-02-01

    Multiple mandibular comminuted fractures usually occur in high energy traumas. The authors describe the management and treatment of multiple mandibular fractures in a young patient after a suicide attempt. PMID:26862697

  2. Neonatal Mandibular Distraction Osteogenesis

    PubMed Central

    Flores, Roberto L.

    2014-01-01

    Mandibular distraction has revolutionized the treatment of Robin sequence associated with severe airway obstruction. The distraction technique remains the only intervention that directly corrects mandibular hypoplasia and the retropositioned tongue, providing efficient relief of airway stenosis. Multiple studies have demonstrated the efficacy of distraction in avoiding tracheostomy and decreasing the severity airway obstruction in this patient population. The benefit to avoiding tracheostomy and relieving airway obstruction is superior to that of tongue–lip adhesion. It is, therefore, not surprising that mandibular distraction has become the first-line intervention at many centers for the surgical treatment of Robin sequence. The complication profile associated with mandibular distraction appears low; the most common complication is infection, which can be treated by antibiotics alone. The severity of airway obstruction can be quantified by polysomnogram: This tool has become one of the most widely used objective metrics in the Robin sequence population. Therefore indications for surgery, timing of palatoplasty and long-term assessment of airway function should be performed in conjunction with sleep study analysis. The effects of mandibular lengthening on feeding difficulty in Robin sequence patient remains a topic of controversy. Studies have demonstrated conflicting results: This can be an area of future study. Agreed-upon indications for surgery and definitive protocols of care have yet to be formulized; future research should focus on achieving these goals. Such studies would require agreed-upon terminology for Robin sequence, an increase in comparative and prospective analysis, and the use of quantifiable metrics of clinical results. PMID:25383055

  3. Neonatal mandibular distraction osteogenesis.

    PubMed

    Flores, Roberto L

    2014-11-01

    Mandibular distraction has revolutionized the treatment of Robin sequence associated with severe airway obstruction. The distraction technique remains the only intervention that directly corrects mandibular hypoplasia and the retropositioned tongue, providing efficient relief of airway stenosis. Multiple studies have demonstrated the efficacy of distraction in avoiding tracheostomy and decreasing the severity airway obstruction in this patient population. The benefit to avoiding tracheostomy and relieving airway obstruction is superior to that of tongue-lip adhesion. It is, therefore, not surprising that mandibular distraction has become the first-line intervention at many centers for the surgical treatment of Robin sequence. The complication profile associated with mandibular distraction appears low; the most common complication is infection, which can be treated by antibiotics alone. The severity of airway obstruction can be quantified by polysomnogram: This tool has become one of the most widely used objective metrics in the Robin sequence population. Therefore indications for surgery, timing of palatoplasty and long-term assessment of airway function should be performed in conjunction with sleep study analysis. The effects of mandibular lengthening on feeding difficulty in Robin sequence patient remains a topic of controversy. Studies have demonstrated conflicting results: This can be an area of future study. Agreed-upon indications for surgery and definitive protocols of care have yet to be formulized; future research should focus on achieving these goals. Such studies would require agreed-upon terminology for Robin sequence, an increase in comparative and prospective analysis, and the use of quantifiable metrics of clinical results. PMID:25383055

  4. [Lingual mandibular osteonecrosis].

    PubMed

    de Visscher, J G A M; Dietvorst, D P; van der Meij, E H

    2013-04-01

    A 47-year-old man was referred to an oral and maxillofacial surgeon by his dentist because ofa painful ulcer with exposed bone at the lingual side of teeth 47 and 48. The lesion was diagnosed as lingual mandibular osteonecrosis. Characteristics of lingual mandibular osteonecrosis are exposed bone in the molar area and sequestration. The disorder can appear spontaneously or following damage to the mucous membrane. Treatment options are surgical smoothening of exposed bone, surgical removal of necrotic bone and awaiting spontaneous sequestration. PMID:23654048

  5. Measuring mandibular motions

    NASA Technical Reports Server (NTRS)

    Dimeff, J.; Rositano, S.; Taylor, R. C.

    1977-01-01

    Mandibular motion along three axes is measured by three motion transducers on floating yoke that rests against mandible. System includes electronics to provide variety of outputs for data display and processing. Head frame is strapped to test subject's skull to provide fixed point of reference for transducers.

  6. Mandibular fibular graft reconstruction with CAD/CAM technology: A clinical report and literature review.

    PubMed

    Mehra, Mamta; Somohano, Tanya; Choi, Mijin

    2016-01-01

    This clinical report describes the treatment of a partially dentate patient who presented with dental implants placed in a reconstructed fibula graft in the mandible. A complete mouth rehabilitation with a maxillary complete denture and a mandibular implant-supported fixed complete denture was fabricated with computer-aided design and computer-aided machining technology. PMID:26372630

  7. Mandibular incisive canal in relation to periapical surgery

    PubMed Central

    Bilginaylar, Kani; Orhan, Kaan; Uyanik, Lokman Onur

    2016-01-01

    The aim of the present paper is to emphasize the importance of the mandibular interforaminal neurovascular bundle with a case and make a warning to dentists and surgeons during oral and maxillofacial surgeries, such as implant replacement, bone harvesting, genioplasty, open reduction of a mandibular fracture, and cyst enucleations at this region. In this paper, we present a 58-year-old male who referred with pain and a tingling sensation on the left lower lip. After radiographical, extraoral and intraoral examinations, findings indicated the lesion to be a cyst which was related with a periapical lesion of the canine tooth and extracted socket of first premolar tooth. After removal of a cyst, the mandibular incisive nerve was documented which was in relation to cyst cavity. PMID:27041907

  8. Mandibular third molar autotransplantation--literature review with clinical cases.

    PubMed

    Mendes, Rui Amaral; Rocha, Germano

    2004-12-01

    Autotransplantation of mandibular third molars in a precocious phase of development is indicated when a substitute for adjacent compromised or missing molars is needed, and when mesial movements of the posterior teeth, the resultant loss of space, and overeruption of opposing teeth and consequent changes in the occlusion must be avoided. Provided that the apices of the mandibular third molar are immature, the immediate replacement of a lost or compromised tooth usually ensures a good outcome. Transplantation of third molars helps to maintain alveolar bone and enables endosseous implantation without requiring bone regeneration. We present examples of transplantation of mandibular third molars and review the factors that affect the success or failure of this procedure, such as atraumatic extraction and adequate immobilization of the transplanted tooth and root development after transplantation. Sex or age seem to have no effect on the final outcome. PMID:15588551

  9. Anterior mandibular ameloblastoma

    PubMed Central

    Bhandarwar, Ajay H.; Bakhshi, Girish D.; Borisa, Ashok D.; Wagh, Amol; Kapoor, Rajat; Kori, Channabasappa G.

    2012-01-01

    Ameloblastoma is a benign odontogenic tumor. These are usually asymptomatic until a large size is attained. Ameloblastoma has tendency to spread locally and has a high recurrence rate. Majority of ameloblastomas (80%) arise from the mandible. Ameloblastoma arising from anterior mandibular region (symphysis-menti) is rare. Very few cases of midline anterior ameloblastomas are reported in the literature. They often require wide local excision. Reconstruction of mandible in these cases is challenging. We present a case of mandibular ameloblastoma arising from symphysis-menti. Patient underwent wide surgical excision of the tumor followed by immediate reconstruction using free fibular vascular flap, stabilized with titanium reconstructive plates. A brief case report ands review of literature is presented. PMID:24765429

  10. Bilateral Mandibular Paramolars

    PubMed Central

    Dhull, Rachita Singh; Panda, Swagatika; Acharya, Sonu; Yadav, Shweta; Mohanty, Gatha

    2014-01-01

    ABSTRACT Supernumerary tooth is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. They can cause a variety of complications in the develo­ping dentition. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. Here is the presentation of a case of unusual location of supernumerary teeth located in between mandibular first and second molar region bilaterally. How to cite this article: Dhull KS, Dhull RS, Panda S, Acharya S, Yadav S, Mohanty G. Bilateral Mandibular Paramolars. Int J Clin Pediatr Dent 2014;7(1):40-42. PMID:25206236

  11. Assessment of a method for the prediction of mandibular rotation.

    PubMed

    Lee, R S; Daniel, F J; Swartz, M; Baumrind, S; Korn, E L

    1987-05-01

    A new method to predict mandibular rotation developed by Skieller and co-workers on a sample of 21 implant subjects with extreme growth patterns has been tested against an alternative sample of 25 implant patients with generally similar mean values, but with less extreme facial patterns. The method, which had been highly successful in retrospectively predicting changes in the sample of extreme subjects, was much less successful in predicting individual patterns of mandibular rotation in the new, less extreme sample. The observation of a large difference in the strength of the predictions for these two samples, even though their mean values were quite similar, should serve to increase our awareness of the complexity of the problem of predicting growth patterns in individual cases. PMID:3472458

  12. Mandibular Advancement Splints.

    PubMed

    Bamagoos, Ahmad A; Sutherland, Kate; Cistulli, Peter A

    2016-09-01

    Although mandibular advancement splints (MAS) are not as efficacious as continuous positive airway pressure (CPAP) in reducing obstructive respiratory events, patient adherence and preference are greater than CPAP. Additionally, the effectiveness of both treatments on general health outcomes, cognitive function, and quality of life appears to be equivalent. The main barrier for the implementation of MAS treatment in clinical practice is the interindividual variability in response to MAS treatment. Several prediction tools have been proposed to enhance patient selection for MAS treatment. Phenotyping obstructive sleep apnea patients may reveal patient characteristics that enable the prediction of response to MAS treatment. PMID:27542880

  13. Experience with Mandibular Reconstruction Using Transport-Disc-Distraction Osteogenesis

    PubMed Central

    Pingarrón-Martín, Lorena; Otero, T. González; Gallo, L.J. Arias

    2014-01-01

    The goal of transport-disc-distraction osteogenesis (TDDO) is to restore bone continuity by using in-situ bone. It may be useful following trauma, gunshot injuries, or tumor ablation, especially when there may be contraindications at the donor site or for prolonged surgery. To the best of the authors' knowledge, this is the first time TDDO has been used for mandibular reconstruction reporting additional procedures, which include osseointegrated dental implants rehabilitation and orthognathic surgery. A retrospective study is performed analyzing all mandibular reconstruction cases that may be suitable for distraction from January 2006 to December 2011. A thorough description of the documented cases includes details about sex, gender, complications, duration of hospitalization, etiology, size, and location of the defect. Eight cases of mandibular reconstruction were included. Six cases correspond to mandibular ameloblastoma. The remaining two cases were mandibular gunshot comminuted fractures. Range of the defects was from 45 to 60 mm. Length of the transport disc was 15 to 20 mm. Protocolized technique consisted of 5 days of latency period, 19 to 45 days of activation term (average 30 days), and 8 to 12 weeks for consolidation. Mean distraction length achieved was 40.45 mm. We can conclude that TDDO is an alternative to conventional and more invasive procedures, when we face severe segmental mandibular defects reconstruction. It shows the potential to restore a better anatomical bone regeneration, also providing soft tissues and reducing donor-site morbidity. Patients' education and awareness about the proper use of the transport-disc-distraction device is important to optimize functional outcomes. PMID:26000082

  14. ITI implants and Dolder bars in the treatment of large traumatic defect of mandible: a clinical report.

    PubMed

    Aydin, Murat; Yilmaz, Ayşe; Kâtiboğlu, Bülent; Tunç, Elif Pak

    2004-12-01

    The development of more sophisticated implant techniques to produce satisfying results improves the precise planning of both the surgical phase of the implantation and the following prosthetic rehabilitation. Ball and bar attachments are the main retainer systems for implant-bearing overdentures to achieve a successful treatment in the partial or full edentulism. In this clinical report, a 23-year-old male patient, presented with a large traumatic defect in the anterior mandible, was treated with ITI implant and ITI Dolder bar combinations. The reason to prefer this kind of treatment depends on the highest retention capacity and cleaning facilities of the system. PMID:15522058

  15. Anatomy of Mandibular Vital Structures. Part II: Mandibular Incisive Canal, Mental Foramen and Associated Neurovascular Bundles in Relation with Dental Implantology

    PubMed Central

    Wang, Hom-Lay; Sabalys, Gintautas

    2010-01-01

    ABSTRACT Objectives The purpose of the present study was to review the literature of how to identify the mental foramen, mandibular incisive canal and associated neurovascular bundles during implant surgery and how to detect and avoid the damage of these vital structures during implant therapy. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular incisive canal, mental foramen, mental nerve, anterior mental loop. The search was restricted to English language articles, published from 1979 to November 2009. Additionally, a manual search in the major anatomy, dental implant, and periodontal journals and books was performed. Results In total, 47 literature sources were obtained and reviewed. The morphology and variations of the mandibular incisive canal, mental foramen and associated neurovascular bundles were presented as two entities. It suggested that clinicians should carefully assess these vital structures to avoid nerve/artery damage. Conclusions The mandibular incisive canal, mental foramen and associated neurovascular bundles exist in different locations and possess many variations. Individual, gender, age, race, assessing technique used and degree of edentulous alveolar bone atrophy largely influence these variations. It suggests that the clinicians should carefully identify these anatomical landmarks, by analyzing all influencing factors, prior to their implant surgical operation. PMID:24421959

  16. Implant-connected versus tooth-connected implant-supported partial dentures: 2-year clinical and radiographic comparative evaluation.

    PubMed

    Mostafa, Tamer Mohamed; El-Sheikh, Mohamed M; Abd El-Fattah, Fadel

    2015-01-01

    The purpose of this study was to clinically and radiographically compare implant-connected and tooth-connected implant-supported fixed-detachable mandibular partial dentures. Twenty partially edentulous patients (age range: 25 to 50 years) with mandibular Kennedy Class II configurations were equally divided into two groups receiving a three-unit, fixed-detachable, screw-retained partial denture. Group 1 comprised patients with unilateral missing mandibular molars and premolars. Two implants were placed at the mandibular first premolar and first molar areas. Group 2 comprised patients with missing mandibular molars and second premolars. An implant was placed at the mandibular first molar area, the first premolar was prepared, and a coping was cemented to the tooth with permanent cement. Each case was evaluated clinically and radiographically at baseline (partial denture insertion) and after 6, 12, and 24 months. Data were collected and statistically analyzed using repeated-measures one-way and two-way analysis of variance tests. There was no statistically significant difference between the two groups (P > .05). The implant-tooth-supported prosthesis provided an equally predictable treatment option compared to the totally implant-supported prosthesis in terms of implant survival and loss of marginal bone. PMID:25909533

  17. Effect of bar cross-section geometry on stress distribution in overdenture-retaining system simulating horizontal misfit and bone loss.

    PubMed

    Spazzin, Aloísio Oro; Costa, Ana Rosa; Correr, Américo Bortolazzo; Consani, Rafael Leonardo Xediek; Correr-Sobrinho, Lourenço; dos Santos, Mateus Bertolini Fernandes

    2013-08-01

    This study evaluated the influence of cross-section geometry of the bar framework on the distribution of static stresses in an overdenture-retaining bar system simulating horizontal misfit and bone loss. Three-dimensional FE models were created including two titanium implants and three cross-section geometries (circular, ovoid or Hader) of bar framework placed in the anterior part of a severely resorbed jaw. One model with 1.4-mm vertical loss of the peri-implant tissue was also created. The models set were exported to mechanical simulation software, where horizontal displacement (10, 50 or 100 μm) was applied simulating the settling of the framework, which suffered shrinkage during the laboratory procedures. The bar material used for the bar framework was a cobalt--chromium alloy. For evaluation of bone loss effect, only the 50-μm horizontal misfit was simulated. Data were qualitatively and quantitatively evaluated using von Mises stress for the mechanical part and maximum principal stress and μ-strain for peri-implant bone tissue given by the software. Stresses were concentrated along the bar and in the join between the bar and cylinder. In the peri-implant bone tissue, the μ-strain was higher in the cervical third. Higher stress levels and μ-strain were found for the models using the Hader bar. The bone loss simulated presented considerable increase on maximum principal stresses and μ-strain in the peri-implant bone tissue. In addition, for the amplification of the horizontal misfit, the higher complexity of the bar cross-section geometry and bone loss increases the levels of static stresses in the peri-implant bone tissue. PMID:23791086

  18. Biomechanical load analysis of cantilevered implant systems.

    PubMed

    Osier, J F

    1991-01-01

    Historically, dental implants have been placed in areas where quality bone exists. The maxillary sinus areas and mandibular canal proximities have been avoided. From these placements, various cantilevered prosthetic applications have emerged. This analysis uses static engineering principles to define the loads (i.e., forces) placed upon the implants. These principles make use of Newton's first and third laws of mechanics by summing the forces and moments to zero. These summations then generate mathematical equations and their algebraic solutions. Three implant systems are analyzed. The first is a two-implant system. The second is a three-implant cross-arch stabilized system usually found in mandibular replacements of lower full dentures. The third is a five-implant system which is identical to the three-implant cantilevered system but which uses implants in the first molar area, thereby negating the cantilevered load magnification of the three-implant design. These analyses demonstrate that, in a cantilevered application, the implant closest to the point of load application (usually the most posterior implant) takes the largest compressive load. Implants opposite the load application (generally the anterior implant) are in tension. These loads on the implants are normally magnified over the biting force and can easily reach 2 1/2 to five times the biting load. PMID:1942131

  19. Dental student perceptions of predoctoral implant education and plans for providing implant treatment.

    PubMed

    Yuan, Judy Chia-Chun; Kaste, Linda M; Lee, Damian J; Harlow, Rand F; Knoernschild, Kent L; Campbell, Stephen D; Sukotjo, Cortino

    2011-06-01

    This study aims to identify dental students' perceptions of pre-patient care laboratory exercises (PCLEs) and clinical experiences that influence their future plans for providing implant care. One of two questionnaires was administered to dental student classes at one dental school (D2: Survey 1; D3 and D4: Survey 2). Future plans as graduates to provide implant diagnosis and treatment planning (DxTP), restoration of single-tooth implants (STIs), and implant-retained overdentures (IODs) were cross-sectionally assessed along with potential influences such as PCLE, clinical experiences, gender, and class. The majority of students planned to provide implant services after graduation (DxTP 68.9 percent; STI 61.2 percent; IOD 62.1 percent). Bivariately, males reflected more preparedness from PCLEs than females (p=.002) and the D2 students more than D3 and D4 students (p<.001). Multivariate models revealed the perceived preparedness from PCLEs generally had the strongest association with future plans for performing implant therapy. However, this varied by gender and class. These findings indicate that PCLEs are important for their influence on students' future plans to provide implant therapy. However, further studies are needed to validate actual PCLEs and clinical implant practices (both longitudinally and for other schools) and to determine educational interventions to optimize the provision of implant care. PMID:21642520

  20. Enhancing the zone of keratinized tissue around implants

    PubMed Central

    Narayan, Sarita Joshi; Singh, Pranav Kumar; Mohammed, Shammas; Patel, R. K. V.

    2015-01-01

    Presence or absence of a minimal zone of keratinized tissue around dental implants has been a matter of controversy. However, a consensus exists that a thick zone of keratinized zone around implants provides a prosthetic friendly environment, facilitates precise prosthetic procedures, allows oral hygiene maintenance, resists recession, and enhances esthetic blending. The aim of the present case series was to increase the zone of keratinized soft tissue around dental implants supporting overdentures. Three different surgical techniques modified palatal roll technique with and without apical positioning and connective tissue graft (CTG) were used to achieve this goal. There was a significant gain of keratinized soft tissue with all the three techniques, which remained stable over a period of 6 months. Modified palatal roll technique with and without apical positioning and CTG are simpler surgical techniques, which can be successfully and predictably used for increasing the zone of keratinized tissue around implants. PMID:26929509

  1. Indirect method of base adaptation against supporting element of tooth root for a partial overdenture prosthesis.

    PubMed

    Oh, Won-suk; Park, Ju-mi

    2014-08-01

    The base of a partial overdenture prosthesis should be fitted intraorally against the supporting element of a tooth root. Chairside relining is a common method; however, an autopolymerizing acrylic resin presents high porosity when polymerized intraorally. This article describes an indirect method where an impression is made with a silicone occlusion registration material to create a replica of the supporting elements of the residual ridge and the tooth root in a high-viscosity polyvinyl siloxane impression material. PMID:24412183

  2. Management of mandibular angle fracture.

    PubMed

    Braasch, Daniel Cameron; Abubaker, A Omar

    2013-11-01

    Fractures through the angle of the mandible are one of the most common facial fractures. The management of such fractures has been controversial, however. This controversy is related to the anatomic relations and complex biomechanical aspects of the mandibular angle. The debate has become even more heated since the evolution of rigid fixation and the ability to provide adequate stability of the fractured segments. This article provides an overview of the special anatomic and biomechanical features of the mandibular angle and their impact on the management of these fractures. PMID:24183373

  3. Bilateral molariform mandibular second premolars.

    PubMed

    Acharya, Sonu; Kumar Mandal, Pradip; Ghosh, Chiranjit

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots. PMID:25685564

  4. Overwhelming hypercalcaemia in mandibular ameloblastoma.

    PubMed

    Lo, Tom Edward Ngo; Villafuerte, Cesar Vincent; Acampado, Laura Trajano

    2014-01-01

    Ameloblastoma is considered to be a benign odontogenic tumour of epithelial in origin that is slow growing but recurrent and invasive in nature. Some of its features have been sources of debate among experts regarding its benign or malignant character. We report a case of a 20-year-old Filipino woman with right mandibular ameloblastoma presenting with overwhelming hypercalcaemia. Work ups for hypercalcaemia eventually revealed tumoral hypercalcaemia, which was initially controlled with intravenous bisphosphanate. The patient eventually underwent tumour excision and mandibular reconstruction, which totally corrected hypercalcaemia. This case will highlight the rare association of hypercalcaemia among patients with ameloblastoma. PMID:25326561

  5. The position of the mandibular canal and histologic feature of the inferior alveolar nerve.

    PubMed

    Kilic, C; Kamburoğlu, K; Ozen, T; Balcioglu, H A; Kurt, B; Kutoglu, T; Ozan, H

    2010-01-01

    The inferior alveolar nerve is the one of the large branches of the mandibular division of the trigeminal nerve. It is vulnerable during surgical procedures of the mandible. Despite its importance, no anatomical and histological examination has been conducted to provide a detailed cross-sectional morphology of the mandibular canal according to dental status. Therefore, the present study aimed to identify the position of the mandibular canal through direct measurement and to determine the branches of the inferior alveolar nerve through histologic examination. The area between the anterior margin of the third molar and the anterior margin of the second premolar of dentulous, partially dentulous, and edentulous hemimandible specimens (n = 49) from 26 human cadavers was serially sectioned into seven segments, and specific distances were measured using digital calipers. Following this, 5-microm cross-sections were prepared along the mandibular canal and mental foramen, and examined by fluorescence microscopy. The mandibular canal was located at a mean distance of 10.52 mm above the inferior margin of the mandible. The mean maximum diameters of the mandibular canal, inferior alveolar nerve, inferior alveolar artery, and inferior alveolar vein were 2.52, 1.84, 0.42, and 0.58 mm, respectively. This study found that the inferior alveolar nerve often gives rise to several branches at each level (range 0-3). To minimize the risk of injury, knowledge of the small branches of the nerve and of the detailed findings regarding the position of the mandibular canal reported here should be considered when planning mandibular surgery, especially during implant placement. PMID:19918867

  6. A Clinical Study of Mandibular Angle Fracture

    PubMed Central

    Yoon, Wook-Jae; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Lim, Kyung-Seop; Shin, Seung-Min; Kim, Cheol-Man

    2014-01-01

    Purpose: To establish management protocol for mandibular angle fracture, we describe pertinent factors including cause, impacted third molar and recent treatment tendency. Methods: We examined the records of 62 patients who had unilateral mandibular angle fracture. Sixty patients who had open reduction surgery were examined at postoperative weeks 1, 4, 8, 12, and 28. Results: Left mandibular angle fracture is frequent in younger males. Presence of the mandibular third molar can increase fracture risk. Because of attached muscle, favorable fractures occurred primarily in the mandibular angle area. Conclusion: Extracting the mandibular third molar can prevent angle fractures, and open reduction with only one plate adaptation is generally the proper treatment method for mandibular angle fracture. PMID:27489834

  7. Pediatric maxillary and mandibular tumors.

    PubMed

    Trosman, Samuel J; Krakovitz, Paul R

    2015-02-01

    Pediatric maxillary and mandibular tumors offer considerable challenges to otolaryngologists, oral surgeons, pathologists, and radiologists alike. Because of the close proximity to vital structures, appropriate steps toward a definitive diagnosis and treatment plan are of paramount importance. This article reviews the most common causes of pediatric jaw masses and discusses diagnostic and therapeutic considerations and recommendations. PMID:25442129

  8. Mandibular development in Australopithecus robustus.

    PubMed

    Cofran, Zachary

    2014-07-01

    Australopithecus robustus has a distinct mandibular anatomy, with a broad and deep corpus and a tall, relatively upright ramus. How this anatomy arose through development is unknown, as gross mandibular size and shape change have not been thoroughly examined quantitatively in this species. Herein, I investigate A. robustus mandibular growth by comparing its ontogenetic series with a sample of recent humans, examining age-related size variation in 28 linear measurements. Resampling is used to compare the amount of proportional size change occurring between tooth eruption stages in the small and fragmentary A. robustus sample, with that of a more complete human skeletal population. Ontogenetic allometry of corpus robusticity is also assessed with least squares regression. Results show that nearly all measurements experience greater average increase in A. robustus than in humans. Most notably, A. robustus corpus breadth undergoes a spurt of growth before eruption of M1 , likely due in part to delayed resorption of the ramus root on the lateral corpus. Between the occlusion of M1 and M2 , nearly all dimensions experience greater proportional size change in A. robustus. Nested resampling analysis affirms that this pattern of growth differences between species is biologically significant, and not a mere byproduct of the fossil sample size. Some species differences are likely a function of postcanine megadontia in A. robustus, although the causes of other differences are less clear. This study demonstrates an important role of the postnatal period for mandibular shape development in this species. PMID:24820665

  9. Analysis and evaluation of relative positions of mandibular third molar and mandibular canal impacts

    PubMed Central

    Kim, Hang-Gul

    2014-01-01

    Objectives This study used cone-beam computed tomography (CBCT) images to categorize the relationships between the mandibular canal and the roots and investigated the prevalence of nerve damage. Materials and Methods Through CBCT images, contact and three-dimensional positional relationships between the roots of the mandibular third molar and the mandibular canal were investigated. With this data, prevalence of nerve damage according to the presence of contact and three-dimensional positional relationships was studied. Other factors that affected the prevalence of nerve damage were also investigated. Results When the mandibular third molar and the mandibular canal were shown to have direct contact in CBCT images, the prevalence of nerve damage was higher than in other cases. Also, in cases where the mandibular canal was horizontally lingual to the mandibular third molar and the mandibular canal was vertically at the cervical level of the mandibular third molar, the prevalence of nerve damage was higher than in opposite cases. The percentage of mandibular canal contact with the roots of the mandibular third molar was higher when the mandibular canal was horizontally lingual to the mandibular third molar. Finally, the prevalence of nerve damage was higher when the diameter of the mandibular canal lumen suddenly decreased at the contact area between the mandibular canal and the roots, as shown in CBCT images. Conclusion The three-dimensional relationship of the mandibular third molar and the mandibular canal can help predict nerve damage and can guide patient expectations of the possibility and extent of nerve damage. PMID:25551092

  10. A Posterior Lingual Sulcoplasty in Implant Therapy: A Case History Report.

    PubMed

    Perri de Carvalho, Paulo Sergio; Janjacomo, Luiz Antonio; Ponzoni, Daniela

    2016-01-01

    This case history report describes the deepening of a patient's posterior mandibular lingual sulcus in combination with an acrylic resin guiding device fixed to an osseointegrated dental implant to maintain the patency of the new sulcular depth. PMID:26929959