Rehabilitation of a maxillectomy case with telescopic crowns: a case report.

Prosthodontic rehabilitation of acquired defects of the maxilla is a challenge in terms of reestablishing oronasal separation. Most of the times these goals are met by means of obturator prosthesis. Preservation of the remaining hard and soft tissues in such patients is very much essential in order to have a good retention, stability and support for the prosthesis. It is very much imperative to fabricate a prosthesis to provide proper function to the patient. Various techniques have been developed to enhance the retention and stability of the prosthesis, some of them being extension of the obturator bulb into the undercuts within the defect, use of magnets, implants etc. Telescopic crowns have been an adjunctive utility to prosthetic dentistry since a very long time. The biomechanics of telescopic crowns aid in providing a good retention and stability to the prosthesis. In the following clinical report a patient with a status of Subtotal Hemi Maxillectomy is presented in whom telescopic copings were incorporated into the cast hollow bulb obturator to enhance the retention and stability of the prosthesis.

Clinical evaluation of early loaded and unloaded implants in edentulous mandible.

OBJECTIVES: The aim of this study is to compare and evaluate the clinical outcome of early loaded and unloaded implants in the interforaminal region of anterior mandible. MATERIALS AND METHODS: Five completely edentulous patients aged between 45 and 65 years were selected satisfying certain criteria. Four implants were placed in 33, 43, 35 and 45 regions; implants in 33 and 43 regions were loaded by a Dolder bar supported overdenture at 7th day. The implants at 35 and 45 regions were connected to 33 and 43 regions, respectively after 4 months. The implants were divided into two groups. Group I consisted of early loaded implants (implants in the region of 33 and 43) and Group II consisted of delayed loaded implants (implants in the region of 35 and 45). The implants were evaluated for various clinical parameters at 2, 4 and 6 month intervals after initial placement. RESULTS: There was significant increase in the bone to implant contact for unloaded implants as compared to early loaded at the end of 6 months of implant placement. There was increased marginal bone loss around early loaded implants as compared to unloaded implants at the end of 6 months. Clinical stability of early loaded implants was lower as compared to the unloaded implants at the end of 6 months. Survival rate for early loaded and unloaded implants was 100% at the end of 6 months with all implants in function. CONCLUSION: Early loading of interforaminal mandibular implants demonstrated a highly acceptable clinical success at the end of 6 months. However, the bone density, marginal bone level and clinical stability were significantly lower for the early loaded implants as compared to unloaded implants.