A fixed reconstruction of fully edentulous patients with immediate function using an apically tapered implant design: a retrospective clinical study.

BACKGROUND: Immediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. It is known that implant microtopography (surface) may enhance osseointegration, while implant macrotopography (macrodesign) plays an important role in primary stability in the patient requiring an immediate loading. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of the edentulous subjects treated with narrow and/or regular diameter, which placed and loaded immediately. METHODS: Forty-two consecutive patients received 171 implants, including regular and narrow diameter implants (NDIs). Each jaw, 19 mandibles and 24 maxillae, was treated with a fixed-full arch prosthesis according to the Straumann® Pro Arch concept. The majority (95%) of the restorations were supported by four implants, of which the posterior two implants were tilted. A provisional functional acrylic prosthesis was delivered on the day of surgery. All patients were followed up to 55 months. Cumulative survival rate was determined using Kaplan-Meier analysis. Radiological measurement of marginal bone level was performed. RESULTS: The overall follow-up time for survival rate was up to 55 months. Four implants (3 implants in maxilla, 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 97.7%. Implant survival rate in the axial and tilted implants was not statistically significant. The mean of interproximal marginal bone loss was 0.15 mm after 24 months. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%. CONCLUSIONS: The results of this retrospective pilot study indicated that total edentulous patients requiring an immediate implant placement and loading can be successfully treated with this implant design. The improved mechanical properties of these implants might give a more conservative treatment option for the jaws showing a severe horizontal alveolar bone resorption.

Orthognathic surgery of a patient with oligodontia: alternative technique for intermaxillary fixation.

Oligodontia may cause various problems during orthognathic surgery because it may be difficult to fix the surgical guide splints. The aim of this clinical report was to present an alternative technique for intermaxillary fixation of a patient with oligodontia and facial deformity. A 20-year-old male patient, whose 8 maxillary and 11 mandibular teeth were congenitally missing, was treated using bimaxillary orthognathic surgery. Before the surgical approach, fixed mandibular prosthesis containing pins on the vestibule sides of the crowns was constructed to provide anchorage for intermaxillary splint and to achieve occlusal stability and vertical dimension during the surgery. This prosthesis was also used to hang intraoral elastics during the postoperative orthodontic treatment. At the end of treatment, these pins were cut, composite restoration material was applied to camouflage the places of the pins, and the patient continued to use this prosthesis. The patient gained an appropriate facial aesthetics and oral function using multidisciplinary approach.

Prosthetic rehabilitation of segmental odontomaxillary dysplasia: seven-year follow-up.

Segmental odontomaxillary dysplasia is an uncommon maxillofacial deformity. Clinically, overgrowth and maturation of the maxillary right or left posterior alveolus and the respective gingiva, lack of premolars, delayed eruption of the adjacent teeth, and malformed primary molars are observed. The purpose of this report was to describe the clinical and radiographic findings of a 47-year-old female with segmental odontomaxillary dysplasia and summarize the prosthetic rehabilitation with fixed and removable partial dentures. A 7-year follow-up did not reveal biomechanical or functional problems except the loss of the mandibular left central incisor and wear of the artificial teeth.