Retrospective cohort clinical investigation of a dental implant with a narrow diameter and short length for the partial rehabilitation of extremely atrophic jaws.

We investigated the short-term clinical outcomes of narrow-diameter short-length implants for the fixed-prosthetic partial rehabilitation of extremely resorbed jaws. Twenty-three patients requiring partial rehabilitations with narrow-platform short-length implants in any jaw were included in this study. In total, 30 implants 3.3 mm in diameter and 7 (n = 15 implants) or 8.5 (n = 15 implants) mm in length were inserted. The primary outcome measure was implant cumulative survival rate (CSR); the secondary outcome measures were marginal bone resorption at 1 and 3 years and the incidence of biologic and mechanical complications. Five patients (21.7%) with six implants (20%) were lost to follow-up. Two implants failed in two patients, yielding a CSR at 3 years of follow-up of 93.4%. The average (standard deviation) marginal bone resorption was 1.34 mm (0.95 mm) after the first year and 1.38 mm (0.78 mm) after the third year. Biologic complications occurred in three patients; mechanical complications occurred in three patients. Despite the limitations of the study, our findings show that the use of new narrow-diameter short-length implants for the rehabilitation of extremely atrophic regions is viable in the short-term, and can be considered a treatment alternative in extremely resorbed jaws.

TMJ vibrations in asymptomatic patients using old and new complete dentures.

PURPOSE: The aim of this study was to assess the presence of temporomandibular joint (TMJ) noises in subjects with severe bone resorption, who have worn the same complete dentures for over 10 years, and 5 months after treatment with increments of acrylic resin on the occlusal surface after having new dentures in place. METHODS: After applying the research diagnostic criteria (RDC)/temporomandibular disorder (TMD) questionnaire, 20 asymptomatic subjects were assessed before and 5 months after the new dentures were put in place. Joint vibrations were assessed by the Sono Pak program by selecting the vibrations that occurred during the opening and closing cycle. RESULTS: The means of the results revealed a nonnormal distribution and were submitted to Kruskal-Wallis statistical analysis (p < 0.05). The vibration means were of low intensity (< or =9.96 Hz). After rehabilitation, there was a reduction in the vibrations (< or =5.2 Hz) statistically significant only at the end of mouth opening with the old dentures when compared with the other cycles. CONCLUSION: The intensity and number of occurrences of joint vibrations were reduced after 5 months of wearing new dentures.

Análisis vectorial del proceso de distracción osteogénica por transporte óseo mandibular: un análisis tridimensional de elementos finitos / Vectorial analysis of the osteogenesis distraction process by mandibular bone transport: a three-dimensional finite element analysis

Uno de los factores determinantes del éxito de la técnica de transporte óseo mandibular es el análisis prequirúrgico de los vectores de distracción, por la probabilidad de generar alteraciones en la relación del disco de transporte y el atracadero; lo anterior disminuye la calidad de la reconstrucción, desencadenando en configuraciones mandibulares asimétricas y mandíbulas difíciles de rehabilitar desde el punto de vista protésico.

The use of overdentures in children with cleft lip and palate: a report of two cases.

The treatment of children with cleft lip and palate is complex. Advances in primary surgery and the advent of alveolar bone grafting have resulted in the reduction of prosthetic intervention. However, in patients where surgery is contraindicated or has been unsuccessful, an alternative treatment is required. Overdentures are a simple, conservative and reversible non-surgical alternative for children with cleft lip and palate. We present two cases with severe complete bilateral cleft lip and palate that were managed in this way.

Longitudinal follow-up of osseointegrated implants in patients with resected jaws.

PURPOSE: To investigate the effects of bone grafting and radiotherapy on implant survival rates. MATERIALS AND METHODS: This follow-up study involved 36 patients with 180 implants who were treated between January 1989 and December 2000 by prosthodontic rehabilitation using osseointegrated implants following jaw resection. They comprised 20 patients with malignant tumors, 12 with benign tumors, and 2 patients each with osteomyelitis and cysts. RESULTS: A total of 15 implants (11 in the maxilla and 4 in the mandible) were removed for various reasons during the follow-up study. Implant survival rates were calculated using the Kaplan-Meier method; the overall survival rate for the 180 implants was 88.6%. Specific implant survival rates were as follows: in residual bone, 73.8% for the maxilla and 95.2% for the mandible; in grafted bone, 80% for the maxilla and 94.1% for the mandible; in irradiated bone, 79.7%; and in nonirradiated bone, 93.5%. DISCUSSION: Radiotherapy, a dose of 30 Gy, was performed in patients with malignant tumors but not in patients with benign tumors, cysts, or osteomyelitis. No differences were found in the results for implants placed due to jaw resection for malignant tumors and those for implants placed due to benign tumors, cysts, or osteomyelitis. Implants lost varied in length from 7 to 18 mm. Among these, loss was more frequent with shorter implants (lengths to 10 mm). CONCLUSION: The clinical results obtained in the present study compare favorably with those obtained by others. However, jaw reconstruction and rehabilitation should not be performed by the oral surgeon alone; oral and maxillofacial function should be restored using a team approach in close cooperation with specialists in prosthodontics and periodontics to improve the result of implant treatment.

Masticatory function in patients with congenital and acquired maxillofacial defects.

Ninety-eight patients who received prosthodontic treatment for maxillofacial defects were examined clinically and by means of questionnaires and registration of chewing efficiency and occlusal force. Although 30% of the patients stated that they could chew soft food, and one third could not chew the test food (almonds), only 14% said they had a poor chewing ability. The mean occlusal force was small (80 N) but the individual variation was great (median 49 N, maximum 327 N). Despite major defects and poor functional test results, most patients were remarkably well-adapted to their situation and to maxillofacial prosthodontic rehabilitation. Severe signs and symptoms of temporomandibular disorders were rare.

The role of a hospital-based dental implant center.

The role of a hospital-based implant center with dental and medical specialists working as a team is discussed. Advantages to the team include the availability of sophisticated hospital equipment and facilities. Referring dentists are encouraged to participate in and/or observe treatment performed at the implant center. Four cases treated by an implant team within a hospital environment are presented.

Prosthesis serviceability for acquired jaw defects.

Patients with acquired jaw defects treated with prostheses present variable prosthesis longevity due to variable factors that influence the tissue foundation anatomically and physiologically supporting the prosthesis. Prosthesis serviceability is unpredictable or limited in longevity. Multiple prostheses and sequential prostheses interrelated are often indicated to effectively rehabilitate patients with acquired jaw defects.