This report involves the retrospective evaluation of ITI implants placed by a group of 12 clinicians located throughout the United States. Of the 174 single implants placed in 129 patients, 151 ...implants (86.8%) were placed in posterior regions, and 23 were placed in anterior regions; 54.6% of the implants had a length of 10 mm or less. Ninety-two implants were restored with a screw-retained crown, and 82 were restored with a cemented crown (in function 6 months or longer). The survival rate at 6 months was 97.7%. Occlusal screw loosening had an 8.7% occurrence rate (no repeated loosening), and solid conical abutment loosening had a 3.6% occurrence rate (all in one patient). Significant radiographic bone loss was observed on 2.3% of the implants. Data suggest that ITI implants can be a satisfactory choice for posterior single tooth restorations.
This study measures the amount of torque that can be applied to the heads of implant screws via hand-held drivers and wrenches in a simulated clinical setting.
Sixty second-year dental students ...applied their maximum controlled torque to the head of a hex instrument attached to a Tonichi torque gauge mounted in a mannequin. The torque values obtained were recorded, and a mean torque value was calculated RESULTS; The mean torque value obtained in this study was 11.55 N.cm.
Small-diameter, 10 N.cm gold screws can be adequately tightened with manufacturer-supplied instrumentation. Larger screws requiring more than 10 N.cm of torque cannot be tightened manually using currently available hand-held screwdrivers and hand wrenches.
It is a great challenge for the clinician to choose a methodology, abutment design, and type of restoration in order to achieve optimal results and avoid complications in implant rehabilitations in ...the aesthetic zone. The great variety of materials that are coming in contact with the soft tissues (acrylic, base alloy, gold, titanium, zirconia, and recently lithium disilicate) further complicate the decision-making, and as they show different soft tissue response and color, they seem to affect the final result, especially in patients with thin biotype.
This chapter will focus on the methodology of the prosthetically driven single implant placement, especially in demanding aesthetic cases, on today’s knowledge of the biology of different materials and abutment selection (customized vs. prefabricated abutments, screw vs cement retained) and provide some clinical guidelines to achieve optimum aesthetic results. Finally, new approaches regarding “immediate abutment placement,” “intermediate abutment placement,” and digital technology for impression in combination with prefabricated CAD lithium disilicate blocks will be discussed with the help of clinical case presentations.
An implant‐supported restoration can be inserted onto an implant by either attaching it to the implants with screws or cementing it onto abutments that have been secured by screws. There are ...advantages and disadvantages to each procedure, and the decision of whether to screw retain or cement a restoration is often dependent on the implant position and clinician preference. Screw retention requires a screw‐access hole to be made through the restoration that is normally restored with composite resin once the restoration is in place. Screw‐retained restorations can be secured to implants with as little as 4 mm of space from the platform of the implant to the opposing teeth. In a cement‐retained restoration there is no screw‐access hole that may interfere with occlusal stops or excursive movements. Incomplete removal of cement may result in peri‐implant inflammation, soft‐tissue swelling, bleeding and/or suppuration and eventual resorption of peri‐implant bone.
The digital information age has made knowledge plentiful. With just a “click” of a mouse, our patients can take an active role in their own dental health. How wonderful it would be if knowledge were ...the only requirement needed. Proper processing of newly learned knowledge is needed to form an action plan or the knowledge helps with nothing. Keeping up with the latest products in the dental field is a full-time job in and of itself. These different options change the demands of our patients, making our job of knowing, with a certain accuracy, all of the products as well as the options and possible implications of the dental care that we choose for that particular patient.
Since the mere action of telling a patient what is needed in their particular case is not just “selling” a product, but we are actually asking them to invest in our expertise in the procedure. So we owe it to our patients to know which product is the best for their particular case but also how that product works, what is the preparation design needed for that product and what are the limitations of it. Knowing all of this is necessary to know what is needed to get the best possible result and make for a happy patient and doctor and technician. A treatment plan is anything said prior to doing the treatment. Once the treatment has been completed, everything which is then said, is an excuse. If a dental professional offers a patient a treatment option and does not know how the product will react in that patient’s particular scenario, a disservice is done to all involved.
To evaluate the outcome of immediately loaded cross-arch bridges 4 months after loading. A second aim was to compare survival rates of implants placed in healed versus fresh extraction sites.
In ...total, 105 consecutive patients about to have their mandibles rendered fully edentulous (mean extractions per patient: 6.1 teeth) received four to six implants each (total number = 448), which were immediately placed in healed sites (266 implants, 59%) or fresh sockets (182 implants: 41%). Immediate loading of provisional prostheses was performed and all patients were followed-up for 4 months. The success criteria included prosthesis success, assessment of individual implant stability and complications.
No patient dropped out and all 105 patients received definitive fixed prostheses after four months of loading. The overall implant survival rate after four months was 98.2%. Eight implants were lost in eight patients (8%). Four of them were inserted in fresh extraction sockets (2.2%) and four in healed sites (1.5%). No significant difference (P = 0.4990) was found for implants placed into healed sites versus fresh extraction sites. No complications were reported.
Immediate implant placement and loading resulted in high implant as well as prosthetic survival rates. Placement in healed or fresh extraction bone sites did not influence implant survival.
Restauraciones protésicas sobre implantes Jorge Alberto Arismendi-Echavarria
Revista de la Facultad de Odontología Universidad de Antioquia,
06/1998, Letnik:
10, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Implant-supported restoration is an additional choice in Restoratile DentiStry. .4 Multi-professional team can offer adequate solutions to the patient. The lack of a structure like-ligament implies ...very special considerations about hiomechanics when you work implant-supported restorations. The main one is to avoid occlusal overload but a clear understanding of what constitutes occlusal overload is not available and, given all of the parameters in volved, likely, never will he. Then, the clinical judgment is the choice. The amount of prosthetic abutments in the market permit us to make aesthetic and functional restorations, including single tooth restorations, partially edentulous and complete edentulous restorations, with different techniques (both screw-retained or cemented restorations) and different materials like acrylic or porcelain teeth according with the patient needs.
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