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Peri-implant soft tissue integration of immediately loaded implants in the posterior macaque mandible: a histomorphometric study

Siar CH, Toh CG, Romanos G, Swaminathan D, Ong AH, Yaacob H, et al.

J. Periodontol., 2003 May;74(5):571-8.

PMID: 12816287

Today, one critical goal in implant placement is the achievement of optimal soft tissue integration. Reports thus far have demonstrated successful soft tissue preservation in delayed loaded implants placed in anterior jaws. The aim of this study was to histomorphometrically examine the soft tissues around immediately loaded implants placed in the macaque posterior mandible.

Matched MeSH terms: Dental Prosthesis, Implant-Supported

Managing complications of radiation therapy in head and neck cancer patients: Part III. Provision of dentures

Rahman RA, Ngeow WC, Chai WL, Ramli R

Singapore Dent J, 2006 Dec;28(1):7-10.

PMID: 17378335

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Pretreatment dental assessment should be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally and, as a result, they succumb to complicated oral adverse effects after radiation therapy. The management of radiation-induced caries, a sequelae of xerostomia has been reviewed in Part II of this series. In this article, the management of difficulty with dentures, another sequelae of xerostomia following radiation therapy is reviewed.

Matched MeSH terms: Dental Prosthesis, Implant-Supported/methods*

Influence of abutment design on clinical status of peri-implant tissues

Taiyeb-Ali TB, Toh CG, Siar CH, Seiz D, Ong ST

Implant Dent, 2009 Oct;18(5):438-46.

PMID: 22129962 DOI: 10.1097/ID.0b013e3181ad8e7a

To compare the clinical soft tissue responses around implant tooth-supported 3-unit bridges using tapered abutments with those using butt-joint abutments.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Edentulous arch treatment with a CAD/CAM screw-retained framework and cemented crowns: a clinical case report

Baig MR, Rajan G, Rajan M

J Oral Implantol, 2009;35(6):295-9.

PMID: 20017646 DOI: 10.1563/AAID-JOI-D-09-00012R1.1

This article describes the rehabilitation of a completely edentulous patient using a milled titanium implant framework and cemented crowns. This combined approach significantly offsets unsuitable implant position, alignment, or angulation, while ensuring the easy retrievability, repair, and maintenance of the prosthesis. Hence, the dual advantage of cemented-retained crowns reproducing appropriate esthetics and function, irrespective of where the screw access openings are located in the substructure, can be obtained, along with the splinting effect and management of soft and hard tissue deficits achievable with a screw-retained framework.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Fulltext Immediate placement and loading of implants in anterior maxilla using an altered screw-retained implant fixed prosthesis

Baig MR, Rajan G

Indian J Dent Res, 2010 Apr-Jun;21(2):311-3.

PMID: 20657109 DOI: 10.4103/0970-9290.66635

This article describes the immediate placement and loading of implants in the aesthetic zone using an implant-retained, fixed prosthesis with a modified design. One section of the implant prosthesis has cemented crowns and the other section is the conventional screw-retained. This combined approach significantly offsets the unsuitable implant position, alignment or angulation, while ensuring the easy retrievability, repair and maintenance of the prosthesis at the same time.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Full-arch metal-resin cement- and screw-retained provisional restoration for immediately loaded implants

Baig MR, Rajan G

J Oral Implantol, 2010;36(3):219-23.

PMID: 20553176 DOI: 10.1563/AAID-JOI-D-09-00048

Abstract This article describes the clinical and laboratory procedures involved in the fabrication of laboratory-processed, provisional, screw-retained, implant-supported maxillary and mandibular fixed complete dentures incorporating a cast metal reinforcement for immediate loading of implants. Precise fit is achieved by intraoral luting of the cast frame to milled abutments. Effective splinting of all implants is attained by the metal substructure and retrievability is provided by the screw-retention of the prosthesis.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Fulltext Fixed rehabilitation of patient with aggressive periodontitis using zygoma implants

Rajan G, Baig MR, Nesan J, Subramanian J

Indian J Dent Res, 2010 Jan-Mar;21(1):125-8.

PMID: 20427922 DOI: 10.4103/0970-9290.62801

Treatment of patients with aggressive periodontitis has always been a challenge to the clinician. Both young and old are known to be affected by this progressive destructive condition of the supporting dental structures. Although dental implants have been offered as a viable treatment alternative for such patients, additional procedures (like bone grafting) and delayed protocols have limited their usage. This case report describes the treatment of a young patient with aggressive periodontitis using a graftless implant solution. Zygoma implants in conjunction with conventional implants were used with immediate loading.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Treatment of a maxillary dento-alveolar defect using an immediately loaded definitive zygoma implant-retained prosthesis with 11-month follow-up: a clinical report

Baig MR, Rajan G

J Oral Implantol, 2010;36(1):31-5.

PMID: 20218868 DOI: 10.1563/AAID-JOI-D-09-00062

This article describes the dental implant-based rehabilitation of a partially edentulous patient with a unilateral maxillary dento-alveolar defect. A screw-retained prosthesis with a modified design was fabricated on zygomatic and regular dental implants. One section of the implant prosthesis has cemented crowns and the other section is conventional screw-retained. The design of the prosthesis overcame the hard and soft tissue deficit and provided the desired esthetics.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Evaluation of splinting implant impression techniques: two dimensional analyses

Tarib NA, Seong TW, Chuen KM, Kun MS, Ahmad M, Kamarudin KH

Eur J Prosthodont Restor Dent, 2012 Mar;20(1):35-9.

PMID: 22474935

This paper aims to evaluate the effect of splinting during implant impression. A master model with two fixtures at the sites of 45 and 47 was used. 20 impressions were made for all four techniques: (A) indirect; (B) direct, unsplinted; (C) direct, splinted; and (D) direct, splinted, sectioned, and re-splinted. Splinting was undertaken with autopolymerizing acrylic resin (AAR). Horizontal distance between fixtures was compared using a digital caliper. The difference in distance were analysed with one-way ANOVA. Group A showed a significantly lowest accuracy among all techniques (p < or = 0.05). There was no significant difference of accuracy among the groups using direct techniques (p > or = 0.05). Group D was more accurate compared to group B and C. We conclude that splinting of impression copings would be beneficial to obtain an accurate impression.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Dimensional profile of oral mucosa around combined tooth-implant-supported bridgework in macaque mandible

Siar CH, Toh CG, Ali TB, Seiz D, Ong ST

Clin Oral Implants Res, 2012 Apr;23(4):438-46.

PMID: 21435011 DOI: 10.1111/j.1600-0501.2010.02145.x

A stable oral mucosa is crucial for long-term survival and biofunctionality of implants. Most of this evidence is derived from clinical and animal studies based solely on implant-supported prosthesis. Much less is known about the dimensions and relationships of this soft tissue complex investing tooth-implant-supported bridgework (TISB). The aim here was to obtain experimental evidence on the dimensional characteristics of oral mucosa around TISB with two different abutment designs.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Metal-ceramic screw-retained implant fixed partial denture with intraoral luted framework to improve passive fit

Baig MR, Gunaseelan R

J Oral Implantol, 2012 Apr;38(2):149-53.

PMID: 20932151 DOI: 10.1563/AAID-JOI-D-09-00089

Passive fit of a long-span screw-retained implant prosthesis is an important criteria for the success of the restoration. This article describes a technique for fabricating a ceramometal implant fixed dental prosthesis (FDP) for a long-span partially edentulous situation by altering the conventional screw-retained design. The possibility of a passive fit is maximized by intraoral luting of the cast frame to milled abutments, and the potential framework distortion during fabrication is compensated to a major extent. Retrievability is ensured by screw retention of the prosthesis to the implants. Compared with conventional porcelain fused to metal screw-retained FDP, this prosthesis is relatively inexpensive to fabricate.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Zygomatic implant-retained fixed complete denture for an elderly patient

Baig MR, Rajan G, Yunus N

Gerodontology, 2012 Jun;29(2):e1140-5.

PMID: 21615782 DOI: 10.1111/j.1741-2358.2010.00433.x

Dental rehabilitation of a completely edentulous geriatric patient has always been a challenge to the clinician, especially in treating those with higher expectations and demands. Treatment duration and the amount of residual alveolar bone available are often important considerations when planning for dental implant-based fixed treatment for these patients. With the introduction of zygomatic implants, a graftless alternative solution has emerged for deficient maxillary bone with provision for immediate loading. This article describes the treatment of a completely edentulous elderly patient using zygomatic implants in conjunction with conventional implants. The implants were immediately loaded using a definitive acrylic resin fixed denture reinforced with a cast metal framework, to provide function and aesthetics.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Finite element analysis of different surgical approaches in various occlusal loading locations for zygomatic implant placement for the treatment of atrophic maxillae

Ishak MI, Abdul Kadir MR, Sulaiman E, Abu Kasim NH

Int J Oral Maxillofac Surg, 2012 Sep;41(9):1077-89.

PMID: 22575179 DOI: 10.1016/j.ijom.2012.04.010

The aim of this study was to compare two different types of surgical approaches, intrasinus and extramaxillary, for the placement of zygomatic implants to treat atrophic maxillae. A computational finite element simulation was used to analyze the strength of implant anchorage for both approaches in various occlusal loading locations. Three-dimensional models of the craniofacial structures surrounding a region of interest, soft tissue and framework were developed using computed tomography image datasets. The implants were modelled using computer-aided design software. The bone was assumed to be linear isotropic with a stiffness of 13.4 GPa, and the implants were assumed to be made of titanium with a stiffness of 110 GPa. Masseter forces of 300 N were applied at the zygomatic arch, and occlusal loads of 150 N were applied vertically onto the framework surface at different locations. The intrasinus approach demonstrated more satisfactory results and could be a viable treatment option. The extramaxillary approach could also be recommended as a reasonable treatment option, provided some improvements are made to address the cantilever effects seen with that approach.

Matched MeSH terms: Dental Prosthesis, Implant-Supported

Cementum status in natural teeth opposing implant-borne bridgework in Macaca fascicularis

Siar CH, Pua CK, Toh CG, Romanos G, Ng KH

Oral Surg Oral Med Oral Pathol Oral Radiol, 2012 Nov;114(5 Suppl):S46-53.

PMID: 23083955 DOI: 10.1016/j.tripleo.2011.07.049

The objective of this study was to investigate the cementum status in natural teeth opposing implant-supported bridgework.

Matched MeSH terms: Dental Prosthesis, Implant-Supported/adverse effects*

Finite element analysis of zygomatic implants in intrasinus and extramaxillary approaches for prosthetic rehabilitation in severely atrophic maxillae

Ishak MI, Kadir MR, Sulaiman E, Kasim NH

Int J Oral Maxillofac Implants, 2013 May-Jun;28(3):e151-60.

PMID: 23748334 DOI: 10.11607/jomi.2304

To compare the extramaxillary approach with the widely used intrasinus approach via finite element method.

Matched MeSH terms: Dental Prosthesis, Implant-Supported/methods*

A comparative study on complete and implant retained denture treatments: a biomechanics perspective

Chen J, Ahmad R, Suenaga H, Li W, Swain M, Li Q

J Biomech, 2015 Feb 5;48(3):512-9.

PMID: 25560272 DOI: 10.1016/j.jbiomech.2014.11.043

Although implant-retained overdenture allows edentulous patients to take higher occlusal forces than the conventional complete dentures, the biomechanical influences have not been explored yet. Clinically, there is limited knowledge and means for predicting localized bone remodelling after denture treatment with and without implant support. By using finite element (FE) analysis, this article provides an in-silico approach to exploring the treatment effects on the oral mucosa and potential resorption of residual ridge under three different denture configurations in a patient-specific manner. Based on cone beam computerized tomography (CBCT) scans, a 3D heterogeneous FE model was created; and the supportive tissue, mucosa, was characterized as a hyperelastic material. A measured occlusal load (63N) was applied onto three virtual models, namely complete denture, two and four implant-retained overdentures. Clinically, the bone resorption was measured after one year in the two implant-retained overdenture treatment. Despite the improved stability and enhanced masticatory function, the implant-retained overdentures demonstrated higher hydrostatic stress in mucosa (43.6kPa and 39.9kPa for two and four implants) at the posterior ends of the mandible due to the cantilever effect, than the complete denture (33.4kPa). Hydrostatic pressure in the mucosa signifies a critical indicator and can be correlated with clinically measured bone resorption, pointing to severer mandibular ridge resorption posteriorly with implant-retained overdentures. This study provides a biomechanical basis for denture treatment planning to improve long-term outcomes with minimal residual ridge resorption.

Matched MeSH terms: Dental Prosthesis, Implant-Supported/instrumentation*

Fulltext Maxillomandibular relationship record for complete arch/mouth implant restorations using putty-elastomeric occlusion rim at healing abutment level

Patil PG, Nimbalkar-Patil S

Contemp Clin Dent, 2015 Jul-Sep;6(3):318-20.

PMID: 26321828 DOI: 10.4103/0976-237X.161869

Recording of the maxillomandibular relationship (MMR) in implant complete arch restorations usually necessitates removal of the healing abutments to attach the record bases, which makes the procedures tedious and time-consuming.

Matched MeSH terms: Dental Prosthesis, Implant-Supported

Fulltext Outcomes of placing short implants in the posterior mandible: a preliminary randomized controlled trial

Al-Hashedi AA, Taiyeb-Ali TB, Yunus N

Aust Dent J, 2016 06;61(2):208-18.

PMID: 25966305 DOI: 10.1111/adj.12337

BACKGROUND: Short dental implants can be an alternative to bone augmentation procedures at sites of reduced alveolar bone. Most studies on short implants are retrospective or multicentre reports that lack controlled and consistent comparison between different systems. This study aimed to compare clinical and radiographic outcomes of short implants in two different systems in the posterior mandible.

METHODS: Twenty patients with two adjacent missing posterior teeth were recruited. Patients were assigned equally and randomly into two groups; Bicon(®) (6 or 8 mm) and Ankylos(®) (8 mm) implants. A two-stage surgical approach and single crowns were used for implant placement and loading. Outcomes included peri-implant clinical parameters, implant stability (Periotest values; PTVs) and peri-implant bone changes, which were assessed at baseline, 2, 6 and 12 months post-loading.

RESULTS: No implant loss was encountered up to 12 months post-loading. No significant difference in the clinical or radiographic parameters was observed except for PTVs (p < 0.05) that was lower in Ankylos(®) implants.

CONCLUSIONS: The use of short dental implants was associated with excellent 12 months clinical and radiographic outcomes. Ankylos(®) and Bicon(®) implants demonstrated similar peri-implant soft tissue and alveolar bone changes. However, Ankylos(®) implants demonstrated better implant stability at all evaluation intervals.

Matched MeSH terms: Dental Prosthesis, Implant-Supported*

Impact of mandibular implant prostheses on the oral health-related quality of life in partially and completely edentulous patients

Yunus N, Masood M, Saub R, Al-Hashedi AA, Taiyeb Ali TB, Thomason JM

Clin Oral Implants Res, 2016 Jul;27(7):904-9.

PMID: 26173463 DOI: 10.1111/clr.12657

OBJECTIVE: To assess the oral health-related quality of life (OHRQoL) of patients provided with mandibular implant fixed partial prostheses (IFPP) for rehabilitation of two adjacent missing posterior teeth and complete denture patients provided with mandibular implant-supported overdenture (ISOD). The response to change in OHRQoL with implant prostheses was additionally compared.

MATERIAL AND METHODS: In this prospective study, 20 IFPP (mean age 47.0; SD 12.9 years) and 28 ISOD (mean age 61.5; SD 9.1 years) patients received 2 mandibular implants. Metal ceramic nonsplinted fixed prostheses were provided in IFPP group, while in ISOD group, the mandibular overdentures were retained by nonsplinted attachments. Patients rated their oral health-related quality of life using OHIP-14 Malaysian version at baseline (T0), 2-3 months (T1) and 1 year (T2) postimplant treatment. Mean OHIP-14 for total and domain scores between groups and intervals was analysed using repeated-measures ANOVA and t-test. Mann-Whitney and Wilcoxon signed-rank tests were used for the comparison of mean score change and effect size, while the association between pre- and post-treatment scores was determined using multivariate linear regression modelling.

RESULTS: The total OHIP and domain scores before implant treatment were significantly higher (lower OHRQoL) in IFPP than in ISOD groups, except for physical pain where this domain showed similar impact in both groups. Postimplant scores between groups at T1 and T2 showed no significant difference. The mean score changes at T0-T1 and T0-T2 for total OHIP-14 and domains were significantly greater in IFPP except in the domains of physical pain and disability which showed no difference. Large effect size (ES) was observed for total OHIP-14 in IFPP while moderate in ISOD. Improved OHRQoL was dependent on the treatment group and pretreatment score.

CONCLUSION: Improvement in OHRQoL occurred following both mandibular implant-supported overdentures and implant fixed partial prostheses.

Matched MeSH terms: Dental Prosthesis, Implant-Supported

A Simple Technique for Accurate Transfer of Secondary Copings in a Tooth-Supported Telescopic Prosthesis

Shankargouda SB, Sidhu P, Kardalkar S, Desai PM

J Prosthodont, 2017 Feb;26(2):168-171.

PMID: 26479878 DOI: 10.1111/jopr.12385

Residual ridge resorption is a rapid, progressive, irreversible, and inevitable process of bone resorption. Long-standing teeth and implants have been shown to have maintained the bone around them without resorption. Thus, overdenture therapy has been proven to be beneficial in situations where few remaining teeth are present. In addition to the various advantages seen with tooth-supported telescopic overdentures, a few shortcomings can also be expected, including unseating of the overdenture, increased bulk of the prosthesis, secondary caries, etc. The precise transfer of the secondary telescopic copings to maintain the spatial relationship, without any micromovement, remains the most critical step in ensuring the success of the tooth-supported telescopic prosthesis. Thus, a simple and innovative technique of splinting the secondary copings was devised to prevent distortion and micromovement and maintain its spatial relationship.

Matched MeSH terms: Dental Prosthesis, Implant-Supported/methods*

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