Immediate implant placement on removal of the natural tooth: retrospective analysis of 1,081 implants.

Conventional implant therapy dictates a period of 1 to 2 years from the start of treatment to the completion of the restoration. In contrast, immediate implant placement has resulted in the initiation of prosthetic treatment in as little as 3 to 6 months with the additional benefit of reducing alveolar bone resorption, patient morbidity, and expense. This article reports on the criteria for immediate implant placement into an extraction socket, as well as a reliable technique and a retrospective analysis of 1,081 implants placed immediately into extraction sockets. Of the 1,081 implants placed, 35% were followed for 1 year, 46% were followed for 2 to 5 years, and 19% for 5 to 11 years postloading. The criteria for success were complete stability and no further bone loss than had appeared at the second stage surgery and on the day of restoration. The overall survival rate in this current study is 95%.

Therapy for a patient with oligodontia: case report.

Oligodontia, the congenital absence of numerous teeth, presents many problems for both patient and therapist. Chief among these is the sequence and timing of orthodontic therapy, implant placement, and restorative dentistry. The absence of teeth can pose not only functional but psychosocial problems for young people. This report details a young woman who was diagnosed with oligodontia at age 9, treated using a multidisciplinary approach, and followed for 12 years.

A multidisciplinary approach to the treatment of oligodontia: case report.

The treatment of young people with implants requires advanced planning and coordination of many different specialities within dentistry. Timing and sequence of therapy will often decide the success or failure of treatment. Congenital absence of many teeth (oligodontia) associated with or without syndromes poses not only functional but also psychosocial problems for young people. A case is presented in which orthodontist, restorative dentist, and periodontist evaluated and performed the necessary therapy for a young person who at the age of 9 was diagnosed with oligodontia/l. Nine implants were placed: 13 years, 8 months in the mandible and 15 years, 6 months in the maxilla. All implants were restored as single teeth. The patient was followed until age 20.

The diagnosis and management of vertical defects within the furcation.

This article describes two common varieties of osseous lesions within the furcation--hemifurcal and crescent-intrafurcal defects--and their appropriate management. Although hemifurcal lesions are difficult to assess both radiographically and clinically, once they are diagnosed, they can be readily resolvable using a self-regeneration procedure or an osseous graft. Crescent-intrafurcal defects are more common than hemifurcal lesions and can be discerned more easily on radiographs than clinically. The treatment of a crescent-intrafurcal defect focuses on minimizing the vertical component. Self-regeneration or osseous grafting is considered an appropriate treatment course.

The role of orthodontics in periodontics and restorative dentistry.

Uprighting and extrusion are two movements that are used to aid in the treatment of difficult periodontal and restorative problems. Simple appliances can be used to alter tooth position, enhancing either the periodontal therapy, restorative dentistry, or both. Treatment time can be limited to 3 to 6 months.

Achieving ideal esthetics in osseointegrated prostheses. Part II. The single unit.

There are several advantages to the CeraOne single-tooth abutment. It seats directly onto the fixture, forming a nonrotating joint. A new type of gold alloy screw that can be tightened to 32 N/cm is used. In addition, the restoration is constructed on a prefabricated ceramic cap onto which porcelain is directly baked. A case report illustrates the technique and the highly esthetic results of such single-tooth replacement.

Periodontal preparation of the adult patient prior to orthodontics.

Evaluation of periodontal status and proposed orthodontic therapy must be made prior to initiating tooth movement. Teeth with a compromised periodontium can be treated. Prior to initiation of orthodontic therapy, it may be necessary to perform periodontal surgery for pocket elimination or reduction, to perform mucogingival surgery, or to correct gross occlusal discrepancies.

The analgesic efficacy of suprofen in periodontal and oral surgical pain.

Suprofen is a new, orally effective nonsteroidal antiinflammatory analgesic of the propionic acid chemical class. Three separate single-dose studies were performed to evaluate the efficacy of suprofen in acute pain associated with periodontal surgery and removal of impacted third molars. Study medications were: A--suprofen 200 mg, codeine 60 mg, propoxyphene HCl 65 mg, and placebo; B--suprofen 400 mg and 200 mg, aspirin 650 mg, and placebo; C--suprofen 400 mg and 200 mg, aspirin 650 mg with codeine 60 mg, aspirin 650 mg alone, and placebo. Analgesic and side effect data were collected over a 6-hour period after patients medicated for moderate to severe pain. All studies were randomized, double-blinded, and parallel-group in design. Suprofen was significantly more effective than codeine 60 mg, propoxyphene HCl 65 mg, and aspirin 650 mg. Suprofen 400 mg appeared to be clinically more effective than the aspirin-codeine combination and the difference was statistically significant for most of the analgesic variables. Of the 224 patients who received suprofen in the 3 studies, 16 reported drowsiness and 1 reported constipation.

Double-blind evaluation of suprofen and aspirin in the treatment of periodontal pain.

A double-blind, randomized, parallel group, placebo-controlled study was carried out to compare the safety and efficacy of single doses of suprofen (200 mg and 400 mg) with aspirin (650 mg) and placebo in relieving pain. In patients with pain resulting from periodontal surgery, a single dose of suprofen 200 or 400 mg was significantly better than placebo in reducing pain intensity and providing pain relief. The superiority of both doses of suprofen over placebo was demonstrated in every parameter in which pain intensity or pain relief was calculated. In addition, both doses of suprofen were better than, or at least equivalent to, aspirin 650 mg in every efficacy measure including the patients' overall acceptability of treatment.

An evaluation of root resections. A ten-year study.

A study was undertaken to evaluate the long term results of root resections. Records of 100 patients who had undergone root resections 10 years prior to the study were reviewed. Although the immediate postoperative results were gratifying, they were not always lasting. Eighty-four per cent of the failures occurred after 5 years. Most failures were in the mandibular arch and derived from reasons other than inflammatory periodontal disease. Suggestions are made as to how to improve the prognosis of resected teeth.

Orthodontic procedures that improve the periodontal prognosis.

Osseous defects not amenable to conventional resective or regenerative osseous surgery alone may respond to a combination of orthodontic and periodontal techniques. Two orthodontic procedures-correction of mesially tipped teeth and forced eruption-have been described that may enhance the periodontal prognosis. Each procedure is accomplished with use of sectional orthodontic appliances and each requires a short time for treatment. Beneficial results include improvement of the crown-to-root ratio, reception of the forces of occlusion in the long axis of the tooth, and reduction or elimination of infrabony defects.