Control of peri-implant inflammation.

The long-term success of osseointegrated implants depends on the health and integrity of surrounding peri-implant tissues. Proper maintenance around the implants is critical, but may be difficult for some patients. An implant system that allows for the replacement of the intramobile element and cleaning or replacement of the transmucosal implant extension may provide a method of ensuring reliable periodontal health.

A review of the intraosseous course of the nerves of the mandible.

A review of the literature revealed that a common feature of all human mandibles is a large nerve (inferior alveolar nerve, IAN) between the mandibular and mental foramina. This nerve sends branches directly to the teeth or contributes a variable number of branches to a plexus of nerves which does the same. The plexus originates from a separate nerve that enters the mandibular foramen. The nerve plexus has been demonstrated by dissections and not by radiology. The buccal-lingual and superior-inferior positions of the IAN were not consistent among mandibles. The intramandibular IAN frequently ran a concave curve with a posterior segment descending as it progressed anteriorly and an anterior segment that ascended to the mental foramen. A bony canal was not always observed between the mandibular and mental foramina. The canal frequently lacked definite walls, especially near the mental foramen. Bilateral symmetry (location of the canal in each half of the mandible) was common, whereas duplications of the canal were rare. Nutrient canals and other branches of the mandibular nerve have been observed within the mandible. These may have been confused for the IAN or may contribute to the plexus of nerves.

Dental implant reconstruction after endodontic failure: report of case.

Avulsion of natural teeth caused by trauma may present an unusual problem for the general practitioner. Endodontic therapy and replantation of the tooth into the socket have a relatively low long-term prognosis because of internal or external root resorption. Dental implants can provide proper support and function for missing teeth with excellent esthetic results without preparation of natural dentition. In this case report, an implant system is used to restore an anterior space created by the loss of endodontically treated central and lateral incisors.

Hydroxyapatite-augmented sites as receptors for replacement implants.

Implant failures can arise from a variety of conditions. Damage to the tissue structures at surgical placement, inadvertent stress distribution to the marginal bone, unfavorable arch relationships between the maxilla and mandible, occlusal trauma, inadequate prosthetic design, and improper oral hygiene are but a few of the problems that can result in ultimate damage and loss. The use of hydroxyapatite to restore bone contour and health can allow for replacement of a dental implant reconstruction. This paper will describe the use of porous hydroxyapatite to create proper bone morphology for the placement of IMZ osteointegrated dental implants in an edentulous maxilla and a mandibular distal edentulous area. Both cases are followed from the removal of previously placed blade-type implants to the reconstruction by use of the IMZ osteointegrated system within the hydroxyapatite-contoured ridges.

Two cases of incompatibility to carbon-coated subperiosteal implants.

Two cases of clinical incompatibility of carbon-coated subperiosteal implants are presented. The clinical history and the microscopic features of biopsy material of each case are reviewed. The histologic appearance of tissue from both cases presented scattered particles of carbon surrounded by lymphocytes, macrophages, plasma cells, and tissue eosinophils. Active phagocytosis and Russell's bodies were seen. Large masses of carbon were surrounded by connective tissue. The clinical and microscopic findings suggest an immunologic rejection of the implant-coating material.