Complications after use of elastomeric pressure-indicating media at 24-hour follow-up visit for immediate maxillary complete removable dental prosthesis: A clinical report.

Various pressure-indicating media are available to assess the adaptation of the intaglio surface of a removable dental prosthesis at the insertion and follow-up appointments. This clinical report describes the use of an elastomer that entered the maxillary sinus through an undetected oroantral communication at the 24-hour follow-up for an immediate maxillary complete removable dental prosthesis. A Caldwell-Luc sinusotomy procedure was required to remove the material, and the patient required over 1 year of healing time before his reported symptoms resolved.

Case report: a patient who had not removed her lower denture for 54 years.

BACKGROUND: A 71-year-old female presented with a left submandibular space abscess. This was found to be due to large accumulations of calculus on the lingual flanges of her lower denture ulcerating the floor of the mouth. She had not taken the prosthesis out since it was provided as an immediate denture after extractions 54 years previously. At presentation she could not take her denture out as the calculus locked the denture under lingual undercuts. The denture was sectioned in the midline to remove it and the submandibular abscess was drained via a neck incision. FINDINGS: Prior to removal the denture was remarkably stable and she had enjoyed a long period of problem free denture wearing and had had exceptional value from it. There was also surprisingly little mandibular alveolar bone resorption. CONCLUSION: The case demonstrates what may happen if a lower denture is not taken out for over half a century. The calculus on the lingual flanges provided both stability and retention for the denture, and it appeared to have protected the ridge from resorption. While the calculus may have provided some surprising benefits to her lower denture it ultimately led to a serious infection.

Immediate loading of implants in the maxilla: survival and bone loss after at least 2 years in function.

PURPOSE: To compare survival and peri-implant bone loss around immediately loaded surface-enhanced implants in the maxilla supporting single crowns (SCs), fixed partial dentures (FPDs), and fixed full-arch dentures (FFDs). MATERIALS AND METHODS: The study included all subjects referred for implant treatment in the maxilla followed by immediate loading between November 2004 and 2007 with at least 2 years of follow-up. Smokers were excluded. Implant survival and bone loss were assessed by a calibrated external examiner who compared digital periapical radiographs taken during recall visits with baseline radiographs (day of loading = day after implant placement). An implant was considered successful when bone loss did not exceed 1 mm. Survival of implants supporting SCs, FPDs, and FFDs was compared using the log-rank test. A linear mixed-effect model analysis was used to evaluate bone loss because of clustering of implants in patients. RESULTS: Three hundred six implants were placed in 55 patients (31 women, 24 men; mean age, 57.5 ± 11.4 years; range, 19 to 77 years) and followed for a mean of 35 ± 10.2 months (range, 24 to 58 months). One implant failed, resulting in an overall survival rate of 99.7% on the implant level and 98.2% on the patient level. No statistically significant differences were observed in the survival rates for SCs (100%), FPDs (98%), and FFDs (100%). The overall mean bone loss was 0.27 ± 0.37 mm (range, 0.00 to 2.55 mm) and was not influenced by the prosthetic reconstruction. CONCLUSION: Immediate loading of fluoride-modified implants in the maxilla is a predictable and reliable treatment option with high survival rates and limited peri-implant bone loss after 2 years. No statistically significant differences were found between implants supporting SCs, FPDs, and FFDs.

Early loading of implants with fixed dental prostheses in edentulous mandibles: 4.5-year clinical results from a prospective study.

AIM: The purpose of this study was to evaluate the survival and success of early-loaded implants placed in the intraforaminal area of the edentulous mandible, and the survival of the implant-supported fixed dental prostheses (FDP). MATERIAL AND METHODS: Thirty-seven patients (18.9% male, mean age 64.5 years) with edentulous lower jaws were treated with implant-supported FDPs in the mandible. One hundred and eighty-five screw-type implants were placed in the intraforaminal area of the symphysis (five implants per patient). Immediately after implant placement, a framework was fabricated and the FDP was manufactured on the framework. Within 2 weeks, the implants were rigidly connected and loaded with the implant-retained FDP. RESULTS: During the 1-8-year observation period (mean 4.5 years), a total of 32 implant-retained complications occurred. Nineteen implants were lost in 10 patients, resulting in a cumulative survival of 89.7%. Nine implants in five patients did not osseointegrate. Although these implants were not removed, because stability within the connective tissue was acceptable and inflammation was absent, they were recorded as unsuccessful. Consequently, the cumulative success declined to 84.9%. Four implants in three patients had clinical signs of periimplantitis (2.2% of all implants). Denture-related complications included one complete failure, when one FDP had to be removed after the last of five implants had been replaced. Furthermore, 10 fractures of the framework occurred in six patients, three FDPs had to be adapted or modified, and the facing of the FDP had to be repaired 16 times in 11 patients. CONCLUSION: Although one-stage early-loaded implants functioned well for most patients with edentulous mandibles, immediate loading is associated with a larger number of implant-related complications than in other studies investigating delayed loading. Because of the substantial prosthetic complications and aftercare, this procedure cannot be generally recommended.

A drug-free oral hydrogel wound dressing for pain management in immediate denture patients.

This article evaluated a drug-free oral hydrogel wound dressing composed entirely of natural food ingredients for its ability to relieve pain in immediate denture patients. Evaluation occurred at a 24-hour postoperative appointment. For this crossover study, 44 patients who were taking oral narcotics evaluated their discomfort (using a scale of 0-10) at 1, 3, 5, and 10 minutes after denture insertion with no topical treatment and again after SockIt! Oral Pain Gel was applied to the dentures. The gel provided statistically significant pain relief at all time points beyond that provided by oral narcotic alone (p < 0.0001).

Oromandibular dystonia following dental treatment: case reports and discussion.

Oromandibular dystonia (OMD) is a movement disorder characterised by involuntary, repetitive, and patterned muscle contractions of varying severity, affecting the jaws, tongue, face, and pharynx. It is most commonly idiopathic or medication-induced, but peripheral trauma sometimes precedes the condition. There have been several reports of OMD following dental treatment, and this paper discusses two cases which occurred following extractions and full dentures.

Radiographic changes around immediately restored dental implants in periodontally susceptible patients: 1-year results.

PURPOSE: There is little information available about radiographic bone changes around immediately restored implants in periodontally compromised patients. The aims of this study were to evaluate the effect of immediate restoration on radiographic bone changes and to compare radiographic changes between arches and between healed and extraction sites in periodontally susceptible patients. MATERIALS AND METHODS: Patients received periodontal treatment. "All in one" implant surgery was then performed: Hopeless teeth were extracted, debridement around remaining adjacent teeth was performed, implants were inserted guided by a surgical stent, and a prefabricated screwed provisional restoration was immediately delivered on selected implants. Periapical radiographs using a parallelism appliance were taken at implant surgery and 6 and 12 months postsurgery. The distance between the alveolar crest and the implant shoulder was measured at the mesial and distal aspect of each implant. Bone changes were compared between immediately restored, submerged, and nonrestored implants; between arches; and between healed and extraction sites. RESULTS: Nineteen patients received 74 implants. Twelve implants in 4 patients failed within the first 6 months. Mean bone changes (+/- SE) between baseline and 12 months ranged between -1.19 +/- 0.19 mm and -1.88 +/- 0.3 mm. No difference was found between restored versus nonrestored sites or between maxillary and mandibular sites. Bone loss was slightly higher in healed sites. CONCLUSIONS: First-year bone changes around immediately restored dental implants in periodontally susceptible patients were slightly higher than most reports in the literature. This indicates a potential influence of periodontal disease on the success rate of dental implants.

The radiographic bone loss pattern adjacent to immediately placed, immediately loaded implants.

PURPOSE: The purpose of this study was to evaluate radiographic bone levels adjacent to implants placed in fresh extraction sockets (ESs) and immediately loaded with a fixed full-arch provisional restoration compared to bone levels adjacent to implants placed in native bone (NB) under the same restorative conditions. MATERIALS AND METHODS: Patients with a hopeless maxillary and/or mandibular dentition had their remaining teeth extracted and 6 to 8 implants placed and restored within 72 hours. Radiographs were obtained at time 0, 3 to 6 months, and annually for 5 years. The radiographs were digitized, and the bone level changes were measured using a computer-assisted method. RESULTS: A total of 139 implants, 42 ES and 97 NB, placed in 17 patients were evaluated. The overall results indicated that for all implants (ES + NB), 0.60+/-0.71 mm of bone was lost after 6 months; 1.17 +/-0.59 mm of bone was lost after 18 months; 0.87+/-0.76 mm bone was lost after 36 months; and 1.35 +/-0.42 mm of bone was lost after 60 months. When stratifying for NB versus ES implants, it was found that for NB implants, 0.75+/- 0.21 mm of bone was lost after 6 months; 1.31 +/- 0.91 mm of bone was lost after 12 months; 1.07+/-0.21 mm of bone was lost after 36 months; and 1.45 +/- 0.49 mm of bone was lost after 54 months. For ES implants, 0.14 +/-0.33 mm of bone was lost after 6 months; 1.02 +/-0.27 mm of bone was lost after 12 months; 0.86+/-0.42 mm of bone was lost after 36 months; and 1.30 +/-0.48 mm of bone was lost after 54 months. CONCLUSION: The combination of ES and NB implants can be immediately loaded with a fixed full-arch prosthesis and remain stable for greater than 5 years. The bone loss adjacent to these implants is similar to that seen surrounding those placed and restored using traditional protocols.

Immediate complete dentures.

When dentists treat patients for immediate complete dentures, they assume responsibility not only for the clinical and laboratory techniques unique to immediate complete denture fabrication, but also the responsibility for informing their patients about their treatment options, instructing their patients in the care of their oral tissues and dentures, and for continuing maintenance of the immediate dentures. Immediate dentures can be a traumatic introduction to complete dentures if patients are not informed fully about the complexity of the clinical and laboratory procedures, the need for immediate denture maintenance, and the costs associated with immediate denture treatment. The importance of 8 to 12 months of continuing care for immediate denture patients must be explained to patients and the dangers of neglecting continuing care must be emphasized.

Differences two years after tooth extraction in mandibular bone reduction in patients treated with immediate overdentures or with immediate complete dentures.

In a randomized controlled clinical trial, 74 patients who required immediate dentures were randomly treated with immediate overdentures on two lower canines or with immediate complete dentures. Mandibular bone reduction was measured by use of oblique lateral cephalometric radiographs made at baseline and the results compared with those of one year and two years after denture treatment. Analysis of the data showed that the average bone reduction in the lower canine regions in the first year was 0.9 mm in the immediate-overdenture group and 1.8 mm in the immediate complete-denture group. In the posterior parts of the mandible, the bone reductions were, respectively, 0.7 mm and 1.9 mm. The differences were statistically significant in all measured regions. During the second year, no significant differences in bone reduction were found. The sums of differences in the first two years were significant in all regions except the molar region, preserving the initial difference. Retention of roots of canines beneath a mandibular denture in immediate denture patients, even when they were in poor condition, reduced the collapse of the alveolar processes in all regions of the mandible.

Longitudinal electromyographic study of chewing patterns in complete-denture wearers.

A longitudinal electromyographic study of the anterior temporal and masseter activity during habitual chewing of apple was performed on 21 subjects provided with immediate complete dentures. At the pretreatment stage, when the patients having an anterior residual dentition were chewing, the peak mean voltages showed low values (range, 48 to 58 microV). After denture placement, there was a further decrease of the temporal activity that persisted to the 6-month stage. After the dentures were relined, a significant increase in chewing force of the temporal muscles was noted at the 1-year stage. During the second year, when no corrections of the dentures were made, the temporal activity decreased below the pretreatment level. The masseter muscle chewing activity generally showed no significant changes during the 2-year observation period. The mean durations of the chewing strokes and chewing cycles were longer than values reported in dentate samples and generally displayed no significant changes during the 2-year period.