Single-tooth replacement in the aesthetic zone with immediate provisionalization: fourteen consecutive case reports.

The concept of osseointegration has been the subject of numerous investigations since it was originally introduced by Brånemark. Researchers have attempted to further define and modify the surgical protocol for implant therapy, and have altered the length of healing, implant design, and the time of fixture placement in attempts to improve the efficacy and predictability of this restorative modality. This article demonstrates the use of an immediate placement procedure for restoring single teeth in the aesthetic zone, focusing on the maintenance of the hard and soft tissues in the region.

Ten-year results for Brånemark implants immediately loaded with fixed prostheses at implant placement.

This investigation was initiated to develop a method to provide patients with a fixed provisional prosthesis placed at the time of implant placement. Sixty-three standard 3.75-mm Nobel Biocare implants of varying lengths were placed into mandibular sites in 10 patients and followed for up to 10 years. Twenty-eight implants were immediately loaded at implant placement, providing support for fixed provisional prostheses, while 35 adjacent implants were allowed to heal submerged and stress-free. Following a 3-month healing period, the submerged implants were exposed and definitive reconstruction was accomplished. All 10 prostheses supported by 28 implants placed into immediate function at the time of implant placement were successful during the 3-month healing period. Of these 28 implants placed into immediate function, 4 ultimately failed. Of the 35 submerged implants, all are osseointegrated and in function to date. Life-table analysis demonstrates an overall 10-year survival rate of 93.4% for all implants. The 10-year life-table analysis of survival is 84.7% for immediately loaded implants and 100% for submerged implants. Statistical analysis of the submerged versus immediately loaded implants demonstrates failure rates for immediately loaded implants to be significantly higher (P = .022 by the log rank test). These data demonstrate that although mandibular implants can be successfully placed into immediate function in the short term to support fixed provisional prostheses, long-term prognosis is guarded for those implants placed into immediate function distal to the incisor region.

Bone formation and osseointegration stimulated by rhBMP-2 following subantral augmentation procedures in nonhuman primates.

The purpose of this study was to evaluate bone formation and osseointegration using titanium dental implants in the subantral space following surgical implantation of recombinant human bone morphogenetic protein-2 (rhBMP-2). In each of four cynomolgus monkeys, one subantral site was treated with rhBMP-2 (0.19 mg per implant) in an absorbable collagen sponge (ACS). The contralateral site was treated with vehicle in ACS (control). Three months later, two screw-type titanium dental implants were placed into each augmented sinus, and one additional implant was placed immediately anterior to the sinus. Thus, each animal had three experimental sites: rhBMP-2, control, and nonsinus. Animals were sacrificed after an additional 3 months, and block sections were harvested and prepared for histometric analysis. Analysis of variance and t tests were used to evaluate differences between experimental conditions. Mean (+/- SD) vertical bone gain was significantly greater in rhBMP-2 than in control sites (6.0 +/- 0.3 versus 2.6 +/- 0.3 mm; P < .002). Bone density in rhBMP-2 sites averaged 14.4 +/- 2.9% versus 13.9 +/- 4.6% and 14.1 +/- 3.6% for control and nonsinus sites, respectively, without significant differences between experimental conditions. Bone-implant contact in rhBMP-2 sites (41.4 +/- 7.7%) was not significantly different from that in control (38.9 +/- 12.4%) and nonsinus sites (46.8 +/- 10.6%). The present study provides evidence for considerable vertical bone gain in the subantral space following surgical implantation of rhBMP-2, thus allowing placement of dental implants. The newly formed bone appears to be of similar quality and to be as suitable for osseointegration as the residual bone in this nonhuman primate model. Thus, surgical implantation of rhBMP-2 appears to have clinical utility and may provide a realistic alternative to autogenous bone grafts for subantral augmentation procedures.

Implant marketing: cost effective implant dentistry.

The application of the KAL-Technique to the field of implant dentistry allows both patients and dental practices to benefit. It is an exciting advance that decreases frustration and stress in providing implant procedures and lowers overall costs. Professionals using the KAL-Technique report significant predictability in achieving passive framework fit. They are also lowering overall cost of implant cases, which increases the number of patients who can accept implant treatment. It has been well established that the more individuals in a practice that receive implants, the more referrals a practice will gain. This is because implant patients find tremendous advances in the quality of life, and do not hesitate to tell others who can take advantage of this opportunity. Implant dentistry is one of the fastest growing fields in dentistry today. While some other areas of dentistry begin to decline in volume and need, implant dentistry provides the opportunity to keep practices strong and to insure long-term success.

Immediate fixed interim prostheses supported by two-stage threaded implants: methodology and results.

Restoring patients with implant-supported fixed-detachable bridges according to the protocol established by Brånemark necessitates a period of several months when complete dentures must be worn to allow for a stress-free healing period of the implants. For many patients, especially when they still have some natural teeth remaining, this is unacceptable. An approach was developed that overcomes these limitations, offering an alternative to the transitional removable approach. Five or six Nobelpharma fixtures were placed between and two additional fixtures were placed distolingual to the foramina. Abutments were connected at implant insertion to these two fixtures and to one fixture in the symphyseal region. The remaining fixtures were allowed to heal in the conventional manner. A previously constructed mandibular denture was converted to a fixed bridge supported by these three implants. This method was successfully applied in seven patients who were reconstructed with mandibular fixed-detachable bridges without ever wearing a removable prosthesis. The overall, long-term implant therapy was not adversely affected by this technique.