Distal extension mandibular removable partial denture connected to an anterior fixed implant-supported prosthesis: a clinical report.

This clinical report demonstrates the possibility of achieving positive results with a removable prosthesis connected to an implant-supported fixed prosthesis. Bone quality and quantity at the implant sites are essential requirements for the success of the treatment. The support of the RPD and its connection with the fixed prosthesis creates stability during chewing activity and allows a functional activity similar to that involving an overdenture. The adoption of an occlusal scheme with subocclusion of the fixed prosthesis contacts compared with those of the removable prosthesis, together with the stress-director system of the RPD can be effective factors that decrease the risk of loss of implant integration. Further long-term follow-up studies with a larger patient population are needed to confirm the clinical and biomechanical validity of the prosthetic solution described in this clinical report.

Mandibular flexure and dental implants: a case report.

The mandibular deformation as a result of jaw movement from rest position has been studied and documented by other authors. Here, we report that there is a possible correlation between this phenomenon and the discomfort experienced by a patient rehabilitated with implant-supported restoration for the mandibular arch during function. The recovery from pain and symptoms was achieved only after splitting the prosthesis into three sections. This case report serves to remind clinicians of the importance of following biological concepts as the key to a successful result.

Single implant-supported crown used as an abutment for a removable cast partial denture: a case report.

This case report describes the use of a single implant as an abutment for a removable cast partial denture. The patient had only anterior teeth remaining in the mandible. One single-stage implant was placed to be used as an abutment for a cast removable partial denture. The periapical X-ray taken 14 months after initial loading showed no bone loss. Clinically, there was no crown loosening, no pocket depth, nor any implant loosening at 14 months. A long-term multicenter study is advocated to evaluate a greater number of patients over a 3- to 5-year time period to evaluate the success fo implant-supported crowns when they are used as partial denture abutments.

The use of transitional implants for immediate fixed temporary prostheses in cases of implant restorations.

While the original Brånemark implant protocol has continued to evolve, the avoidance of implant loading during osseointegration remains a prerequisite with all implant systems. Immediately loaded transitional implants have recently been developed to support the fabrication of a fixed provisional prosthesis that provides implant patients with improved aesthetics and function during the osseointegration period. In this manner, osseointegration can occur free from prosthetic and transmucosal loads. This article describes the use of transitional implants and presents a classification of three different case types.

Processed acrylic resin provisional restoration with lingual cast metal framework.

Fixed provisional prostheses are fabricated to maintain, improve, and/or change oral function and esthetics for varying periods. It is important to know when to provide a provisional prostheses and how to make one so that it will meet the needs of the patient. This article describes a modification of the design of a cast metal reinforced processed acrylic resin provisional restoration for extensive, long-term reconstruction with implants, because some of the treatments rendered to patients require temporization for up to 2 years. This design has been used by the authors since 1991, and has resulted in fewer problems of fracture of the provisional restorations. In addition, removable partial dentures are rarely needed, even when large spans exist between remaining abutments in serial extractions. This procedure also permits performing guided bone regeneration for deficient ridges without the problem of transmucosal loading, while still maintaining the patient's esthetics and function after surgery.

Immediate loading of threaded implants at stage 1 surgery in edentulous arches: ten consecutive case reports with 1- to 5-year data.

Immediate loading of threaded implants with a fixed provisional restoration at stage 1 surgery was evaluated in 10 consecutive patients. The patients selected had to be completely edentulous and have adequate bone for a minimum of 10-mm-long implants. A minimum of 10 implants were placed in each patient's arch. A minimum of five implants were submerged initially for medicolegal reasons and allowed to heal without loading. The remaining implants were loaded the day of stage 1 surgery. Once the provisional restoration was relined, it was cemented or screw retained. A total of 107 implants were placed in these 10 patients; 6 had them placed in the mandible, and 4 in the maxilla. Six patients were treated with Nobel Biocare implants, one with ITI Bonefit implants, two with Astra Tech TiOblast implants, and one with a 31 implant. Sixty-seven of 69 implants that were loaded integrated, and 37 of 38 submerged implants integrated. All 10 patients have been restored with a definitive prosthesis, and all had a fixed provisional prosthesis from stage 1 surgery. The results of this study indicate that immediate loading of multiple implants rigidly splinted around a completely edentulous arch can be a viable treatment modality.

Effect of die spacers on precementation space of complete-coverage restorations.

The authors measured the precementation space achieved in vivo with varying layers of die spacer. Two hundred and ninety-one castings were fabricated in the Advanced Education Program in Prosthodontics at New York University College of Dentistry, New York, New York. Each of four clinician groups applied one layer of Taub Die Hardener and from one to four layers of die spacer to within 0.5 to 1.0 mm of the dies' finishing line. The resultant castings were adjusted using GC Fit-Checker. After final seating of the casting, the Fit-Checker was removed, sectioned buccolingually, and measured using a micrometer at three locations (midocclusally, midaxially, and on the bevel) for a total of 657 readings. Only after data collection were the specimens identified by group. Analysis of variance demonstrated a significance for group and location. Post hoc one-way analysis of variance and Sheffe tests (P < .1) demonstrated that: (1) one or two layers of die spacer demonstrated smaller precementation spaces than three or four layers; (2) the midocclusal precementation space was greater than the midaxial precementation space; (3) on the bevel area where no die spacer was used, the most consistent and minimal precementation space was measured.