Treating an edentulous mandible with an implant-supported prosthesis with a shape-memory alloy abutment system.

This clinical report describes a treatment protocol for completely edentulous patients using digital implant planning for an all-on-4 treatment of both the maxilla and mandible as well as the use of a shape-memory alloy retention system to secure a complete-arch restoration to the mandible.

Patient-reported outcome measures (PROMs) and maintenance events in 2-implant-supported mandibular overdenture patients: A 5-year prospective study.

OBJECTIVE: To prospectively evaluate patient-reported outcome measures (PROMs) and treatment outcomes of mandibular two-implant retained overdentures (IOD) in an edentulous geriatric cohort with history of deficient complete dentures (CD). MATERIALS AND METHODS: A total of 103 patients with deficient CD received new optimal CD. After a period of 3 months, 80 of the patients voluntarily received IOD. Outcomes collected at pre-, post-CD/post-IOD treatment annually up to 5 years, included (a) Clinical outcomes: denture-quality (Woelfel's index), complications, and maintenance events, (b) PROMs: patient complaints (maxillary, mandibular functional complaint scores, generic aesthetic complaint scores, frequency, and intensity of complaints) and patient satisfaction, and (c) Maintenance events: technical complications and adverse events. RESULTS: Five-year data were collected from 67 patients (mean age at initiation = 71.3 years, mean observation = 5.9 years) with cumulative implant survival rate = 98.72%. Multiple comparisons for 8 time points showed significant improvements in denture quality and PROMs after new CD and IOD delivery. Further significant improvements were only after IOD delivery in: mandibular denture-quality, mandibular and generic functional complaints, frequency, intensity of complaints, and overall patient satisfaction score. Thereafter, denture-quality and PROMs remained stable. Maintenance events clustered on 1st year and within a minority of patients. Technical complications and overall maintenance events significantly correlated with overall patient satisfaction score at 1st year. CONCLUSIONS: Mandibular IOD was a beneficial treatment option for seniors with history of deficient CD, improving denture-quality, patient satisfaction, and reducing patient complaints up to 5 years. Maintenance events clustered on 1st year, showing no significant impact on long-term patient satisfaction and other PROMs.

A Two-Year Evaluation of a Sloped Marginal Contour Implant System Placed in Healed Sites.

PURPOSE: The purpose of this clinical trial was to evaluate the survival rate, bone remodeling, and soft tissue health around sloped marginal contour implants when placed in healed sites posteriorly in the mouth. MATERIALS AND METHODS: Implants were placed in healed sites at premolar and molar regions. After a 3-month osseointegration period, definitive prostheses were connected. Clinical and radiographic examinations were performed at implant placement and then 1, 3, 6, 12, and 24 months after implant placement. An assessment of implant stability, peri-implant mucosa, level of attached gingivae, occlusion, proximal contact, and marginal bone levels was performed at each respective visit. RESULTS: Fourteen patients were treated and restored with 18 single crowns. The cumulative survival rate was 100% after 2 years. The mean marginal bone remodeling was 0.04 ± 0.26 mm (n = 18). The attached gingival change was +0.33 ± 0.35 mm. CONCLUSION: The 24-month results indicate that the sloped marginal contour implant performed well in posterior healed sites with a 100% survival rate and good marginal bone maintenance.

The use of immediate implant placement for the replacement of a periodontally involved malaligned lateral incisor: a clinical report.

Localized severe chronic periodontitis is often seen in middle-aged patients, particularly when plaque control for malaligned teeth is not satisfactory. While orthodontic treatment can realign such teeth with reduced periodontal support, esthetics may be compromised by gingival recession due to preexisting bone loss and resolution of inflammation after periodontal treatment. This clinical report describes how a malaligned maxillary lateral incisor with severe periodontitis was replaced by an immediately placed implant and implant-supported crown with a good esthetic outcome.

Implant-tissue supported, magnet-retained mandibular overdenture for an edentulous patient with Parkinson's disease: a clinical report.

Degenerative neurologic disorders such as Parkinson's disease are becoming more prevalent as life expectancy is improved. Although the use of an implant-supported overdenture is an acceptable treatment modality, the clinician should recognize the indications and maintenance requirements of different attachment systems for individual patients. The use of a magnetic attachment system in an implant-supported mandibular overdenture for an edentulous patient with Parkinson's disease is presented.

Magnet-retained auricular prosthesis with an implant-supported composite bar: a clinical report.

The use of craniofacial implants to assist in retaining auricular prostheses often requires complex laboratory procedures, involving production of an accurate casting, fitting of a precious alloy bar, and the use of clips. A simplified method for the retention of an auricular prosthesis with a composite bar and magnets is described in this article.

The use of lipiodol in spiral tomography for dental implant imaging.

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

Restorative management of the worn dentition: 4. Generalized toothwear.

This is the final paper of a four part series on the management of worn dentition. The factors affecting the selection of restorative techniques for generalized toothwear, such as pulpal vitality, jaw relationship and occlusal guidance are discussed. The practical steps of oral rehabilitation using fixed prostheses are illustrated with two clinical cases.

Restorative management of the worn dentition: 2. Localized anterior toothwear.

This is the second paper in a four-part series detailing the relative merits of the treatment strategies, clinical techniques and dental materials for the restoration of health, function and aesthetics for the dentition. In this paper the management of wear in the anterior dentition is discussed, using three case studies as illustration.

Cough syrup addiction and rampant caries: a report of two cases.

Sugar-containing syrups such as cough medications have been recognised as potentially cariogenic, especially for chronically sick children suffering from otitis media, seizure disorder, congenital cardiac diseases and asthma. Unfortunately, an increasing number of juveniles are addicted to cough syrups containing centrally-acting drugs and these individuals not only end up with medical and social problems, but also with dental manifestations. This paper addresses the latter problem with the help of two illustrative cases.