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Implant Crowns (implant + crown)

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Medical Sciences	100%

Selected Abstracts

An Analysis of the Effect of a Vent Hole on Excess Cement Expressed at the Crown,Abutment Margin for Cement-Retained Implant Crowns

JOURNAL OF PROSTHODONTICS, Issue 1 2009
Dipan Patel BDS
Abstract Purpose: The labial margins of anterior implant-retained crowns are often positioned subgingivally for a superior esthetic appearance. One of the consequences of subgingival margins is the increased risk of leaving excess cement behind following cementation. This can lead to potential problems, including peri-implant inflammation, soft tissue swelling, soreness, bleeding or suppuration on probing, and bone loss. The purpose of this laboratory study was to investigate the effect of placement, location, and diameter of a vent hole on the amount of cement being expressed at the margin of an anterior implant abutment-retained crown. Materials and Methods: Three implant crown copings were fabricated to fit on the same custom abutment. Three vent diameters (0.75, 1.25, and 1.65 mm) and three locations on the palatal surface of the coping (cervico-palatally, mid-palatally, inciso-palatally) were chosen for vent hole placement. For each test, the coping was cemented onto the abutment under standardized conditions. A preweighed thin coating of cement was applied to the fit surface of the coping. The amount of cement expressed at the margin and vent hole was measured by weight and calculated as a proportion of the amount of cement placed in the coping before seating. The procedure was completed 15 times for each variable. The results were statistically analyzed using univariate ANOVA with post hoc Bonferroni-adjusted independent samples t -tests. Results: The presence of a vent hole influenced the proportion of cement expressed at the coping margin (p < 0.05). The location of a vent hole influenced the proportion of cement expressed at the coping margin (p < 0.05), with the exception of the mid-palatal and inciso-palatal positioning where there was no significant difference (p= 0.61) between groups. The diameter of the vent hole did not significantly influence the proportion of cement expressed at the coping margin (p= 0.096). Conclusions: When using anterior cement-retained implant crowns, the use of a 0.75-mm mid-palatal or inciso-palatal vent hole to minimize the amount of cement expressed at the margin during cementation should be considered. [source]

Astra Tech single-tooth implants: an audit of patient satisfaction and soft tissue form

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2007
R. M. Palmer
Abstract Aim: To investigate patient centred outcomes, soft tissue morphology, and bone levels. Material and Methods: Sixty-six subjects, who had completed treatment for a single implant restoration at least l year previously. Appearance was recorded photographically and bone levels and interdental contact points measured from intra-oral radiographs using a × 7 scale loupe. Subjects completed a satisfaction questionnaire. Results: Subjects were highly satisfied with all aspects of the restoration including the appearance of the soft tissue (median shape/colour score 6 on scale 1,6). Twenty-eight sites in 20 subjects had no contact point between implant crown and adjacent tooth. A normal height papilla was judged to be present in 19 of these sites. These were excluded from the subsequent analysis. In the remaining 46 subjects with contact points the presence (JEMT score 3) or deficiency (score 1/2) of the papilla was significantly related to the distance to the bone level on the adjacent tooth and implant head. Differences were observed between the mesial and distal aspects of the implant restoration. Conclusions: Examining clinicians were more critical of the restorations than the patients. The presence of a complete papilla was associated with a slightly greater distance from contact point to bone level than previously reported. [source]

Single-tooth implant treatment in the anterior region of the maxilla for treatment of tooth loss after trauma: a retrospective clinical and interview study

DENTAL TRAUMATOLOGY, Issue 3 2003
Lars Andersson
Abstract,,, The aim of this study was to evaluate the results of single-tooth implant treatment in patients where teeth have been lost as a result of trauma. Also, the patients' and professionals' opinions regarding the final outcome of treatment were assessed. Thirty-four patients with 42 lost teeth were evaluated by clinical and radiographic examinations and interviews 2,5 years after treatment. A professional who had not taken part in the treatment evaluated the implant crowns. Central maxillary incisors were the most frequently lost and replaced teeth after trauma (75%) followed by lateral incisors (21%). In patients with incomplete growth, implant treatment was generally postponed until completion of growth. Lack of space was treated by presurgical orthodontics (7%) or by selecting an implant with a reduced diameter (5%). Deficiency of bone was seen in 17% and was treated by bone grafting or local augmentation prior to implant surgery. Patients who had lost two or more teeth after trauma were all subjected to bone grafting. Preservation of roots in the alveolar process seemed to maintain the bone volume enabling better conditions for later implant placement. Forty-one implants (97.6%) were integrated successfully. Complications were few and of minor importance (9.5% before and 12% after cementation of crowns) and could all be managed. No or minimal bone loss was seen. In general, the patients felt that they received good care and that they were well informed about their treatment. Some patients reported that the local anesthesia procedure was not pain-free, but 71% of the patients experienced the treatment as pain-free. For each of the variables (color, shape, height, and size of the crowns), the highest degree of satisfaction was noted in 93,98% of the patients and 91,95% of the single evaluating professional. Given that the patients have finished growth and a careful treatment planning and timing are performed, the functional and esthetical outcome of single-tooth implant treatment today is excellent and can be recommended for replacing tooth losses after trauma in the anterior region of the maxilla. [source]

An Analysis of the Effect of a Vent Hole on Excess Cement Expressed at the Crown,Abutment Margin for Cement-Retained Implant Crowns

Measurements of Tooth Movements in Relation to Single-Implant Restorations during 16 Years: A Case Report

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2005
Torsten Jemt LSD
ABSTRACT Background: Osseointegrated implants behave as ankylotic abutments, and their positions are not affected by dentofacial changes. Purpose: To measure changes in occlusion in relation to single implants in one patient after more than 15 years in function. Materials and Methods: One 25-year-old female was treated with two single implants in the upper central incisor and bicuspid area after trauma. Study casts made prior to treatment (1987) and after 16 years in function (2004) were scanned by means of an optical scanner. Using the palate as the reference, the models were placed in the same coordinate system and analyzed and compared in a computer-aided design (CAD) program. The results of the measurements of the casts were also compared with clinical photographs taken at the time of treatment (1988), after 9 years (1997), and after 16 years (2004) in function. Results: The clinical photographs showed obvious signs of implant infraposition after 9 years. New crowns were made in the incisor region after 15 years (2002), but signs of infraposition were again present at the final examination (2004). Measurements of the casts indicated small tooth movements with a pattern of slight eruption of upper teeth combined with a palatal inclination, mesial drift, and lingual inclination and crowding of the lower anterior teeth. The small measured vertical eruption of the teeth was less than the observed clinical infraposition of the implant crowns, indicating that the vertical position of the palatal may have changed in relation to the implants as well. Conclusion: Obvious dentofacial changes may take place in adult patients. Teeth may adjust for this, and no major problems may arise in the dentate patient. However, because the positions of implants are not affected by dentofacial changes, other patterns of clinical problems can be seen when implant patients present with these changes. The character and frequency of these dentofacial changes that may compromise implant treatment in the long term are not yet known. [source]

Retrievability of implant-retained crowns following cementation

CLINICAL ORAL IMPLANTS RESEARCH, Issue 12 2008
Christian Mehl
Abstract Objectives: The purpose of this study was to assess the retrievability of cemented implant crowns using two different removal devices. The influence of five cement types and two cement application techniques was evaluated. Methods: Forty copings were cast from a CoCr alloy for 40 tapered titanium abutments (5° taper, 4.3 mm diameter, 6 mm height, Camlog, Germany). Twenty copings were modeled as single crowns, whereas 20 copings were modeled with an extension to simulate fixed partial dentures (FPDs). Before cementation, the inner surfaces of the copings were air-abraded (50 ,m Al2O3 particles at 2.5 bars), while the abutments were used as delivered with machined surfaces. Copings were cemented with eugenol-free zinc oxide (Freegenol), zinc phosphate (Harvard), glass ionomer (Ketac Cem), polycarboxylate (Durelon) and so-called self-adhesive resin (RelyX Unicem) cement. Cement was applied in a thin film band of 1 or 3 mm to the cervical margin of the inner surface of the copings, respectively. After cementation, specimens were stored in saline solution for 24 h. The Coronaflex and a standardized custom-made removal device were used to remove the copings from the abutments. Results: Using the same cement, no statistically significant influence with regard to the type of restoration (crown/FDP), cement application mode and device was detected (P>0.05). Therefore, data of specimens cemented with the same cement were pooled. Median attempts to remove the copings were: zinc oxide: 3, self-adhesive resin: 3, zinc phosphate: 5, glass ionomer: 16 and polycarboxylate: 58. Four levels of significance (P<0.0001) were found: (1) zinc oxide/self-adhesive resin; (2) zinc phosphate; (3) glass ionomer; and (4) polycarboxylate. Conclusions: Zinc phosphate and glass ionomer cement might be suitable for a so-called ,semipermanent' (=retrievable) cementation, while polycarboxylate seems to provide the most durable cementation. [source]

Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2005
Rudolf Fürhauser
Abstract Aim: In this study, the reproducibility of a newly developed pink esthetic score (PES) for evaluating soft tissue around single-tooth implant crowns was assessed. The effect of observer specialization was another point of interest. Material and methods: Twenty observers (five prosthodontists, five oral surgeons, five orthodontists and five dental students) were given photographs of 30 single-tooth implant crowns. Seven variables were evaluated vs. a natural reference tooth: mesial papilla, distal papilla, soft-tissue level, soft-tissue contour, alveolar process deficiency, soft-tissue color and texture. Using a 0-1-2 scoring system, 0 being the lowest, 2 being the highest value, the maximum achievable PES was 14. Each observer was requested to make two assessments at an interval of 4 weeks. At the second assessment, the photographs were scored in the reverse order. Results: The mean PES of evaluations at the first assessment (n=600) was 9.46 (±3.81 SD), and 9.24 (±3.8 SD) at the second one. The difference between these two means was not significant statistically (P=0.6379). Implant-related mean PES for single-tooth implants varied from 2.28 to 13.8, with standard deviations between 0.46 and 3.51. Very poor and very esthetic restorations showed the smallest standard deviations. The mean total PES was 10.6 for the prosthodontists, 9.2 for the oral surgeons, 9.9 for the dental students and 7.6 for the orthodontists. Conclusions: The PES reproducibly evaluates peri-implant soft tissue around single-tooth implants. Thus, an objective outcome of different surgical or prosthodontic protocols can be assessed. Orthodontists were clearly more critical than the other observers. Résumé Dans cette étude la reproduction d'un nouveau Score d'Esthétique Rose (PES) pour l'évaluation des tissus mous autour des couronnes d'implants uniques a étéévaluée. L'effet de la spécialisation de l'observateur était un autre point d'intérêt. Vingt observateurs (cinq spécialistes en prothèse, cinq chirurgiens, cinq orthodontistes et cinq étudiants en médecine dentaire) ont reçu des photographies de 30 couronnes sur implant unique. Sept variables ont étéévaluées vs une dent de référence naturelle : papille mésiale, papille distale, niveau du tissu mou, couleur du tissu mou, perte du processus alvéolaire, couleur du tissu mou et texture. En utilisant un système 0,1,2, zéro étant le plus bas et deux étant la plus haute valeur, le score maximum PES était donc de 14. Chaque observateur a reçu comme instruction de réaliser deux évaluations à un intervalle de quatre semaines. A la seconde évaluation les photographies ont étéévaluées dans un ordre inverse. Les PES moyens des évaluations de la première fois (n=600) étaient de 9,46±3,81 et 9,24±3,80 la seconde fois. La différence entre ces deux moyennes n'était pas significative (P=0,6379). Le PS moyen en relation pour les implants sur dent unique variait de 2,28 à 13,8 avec des déviations standards de 0,46 à 3,51. Les restaurations de moindre qualité et les excellentes affichaient les plus petites déviations standards. Le PES total moyen était de 10,6 pour les spécialistes en prothèse, 9,2 pour les chirurgiens, 9,9 pour les étudiants et 7,6 pour les orthodontistes. Le PES évalue donc les tissus mous paraïmplantaires autour des implants uniques. Un aboutissement objectif de différents protocoles chirurgicaux ou prothétiques peut donc être estimé. Les orthodontistes étaient clairement plus critiques que les autres observateurs. Zusammenfassung Ziel: In dieser Arbeit wird die Reproduzierbarkeit eines neu entwickelten Pink Esthetic Index (PES) zur Evaluation vom Weichgewebe um Kronen auf Einzelzahnimplantaten untersucht. Zusätzlich interessierte der Einfluss des Spezialisierungsgrades eines Untersuchers. Material und Methoden: Man gab zwanzig Untersuchern (5 Prothetiker, 5 Oralchirurgen, 5 Orthodonten und 5 Zahnmedizinstudenten) Fotoaufnahmen von 30 Kronen auf Einzelzahnimplantaten. Sie hatten 7 Variabeln gegenüber einem natürlichen Referenzzahn zu beurteilen: mesiale Papille, distale Papille, Niveau der Weichgewebe, Form der Weichgewebe, Defizit an Alveolarkamm, Farbe und Struktur der Weichgewebe. Man definierte eine Bewertungsskala 0-1-2, wobei 0 für den schlechtesten und 2 für den besten Wert stehen, so dass man einen maximalen PES von 14 erreichen konnte. Jeder Untersucher war angehalten, im Abstand von 4 Wochen zwei Beurteilungen durchzuführen. Anlässlich des zweiten Untersuchungstermins wurden die Fotoaufnahmen in ungekehrter Reihenfolge beurteilt. Resultate: Der mittlere PES bei den Untersuchungen im ersten Umgang (n=600) betrug 9.46 (±3.81 SD) und 9.24 (±3.8 SD) im zweiten Umgang. Der Unterschied zwischen diesen zwei Mittelwerten war statistisch nicht signifikant (P=0.6379). Der mittlere implantatspezifische PES für die Einzelzahnimplantate variierte zwischen 2.28 und 13.8 mit Standardabweichungen zwischen 0.46 und 3.51. Sehr schlechte und sehr schöne Rekonstruktionen zeigten die kleinesten Standardabweichungen. Der mittlere Gesamt-PES war bei den Prothetikern 10.6, bei den Oralchirurgen 9.2, bei den Zahnmedizinstudenten 9.9 und bei den Orthodonten 7.6. Zusammenfassung: Der Pink Esthetic Index untersucht die periimplantären Weichgewebe um Einzelzahnimplantate und wird auf seine Reproduzierbarkeit überprüft. Damit kann man die Ergebnisse von verschiedenen chirurgischen und prothetischen Protokollen objektivieren. Die Orthodonten waren deutlich kritischer bei ihrer Beurteilung als die anderen Behandler. Resumen Intencion: En este estudio se valoró la reproductibilidad de una nueva Valor de Rosado Estético (PES) para evaluar el tejido blando alrededor de coronas de implantes unitarios. El efecto de la especialización del observador fue otro punto de interés. Material y metodos: Se entregó a veinte observadores (5 prostodoncistas, 5 cirujanos orales, 5 ortodoncistas y 5 estudiantes dentales) fotografías de 30 coronas de implantes unitarios. Se evaluaron 7 variables frente a dientes naturales de referencia: papila mesial, papila distal, nivel de tejido blando, contorno de tejido blando, deficiencia del proceso alveolar, color y textura del tejido blando. Usando un sistema de puntuación de 0-1-2, siendo 0 el valor más bajo, 2 el valor más alto, el PES más alto alcanzable era de 14. Se solicitó a cada observador que llevara a cabo dos valoraciones en un intervalo de 4 semanas. En la segunda valoración las fotografías se valoraron en orden inverso. Resultados: El PES medio de evaluaciones a la primera valoración (n=600) fue 9.46 (±3.81 SD) y 9.24 (±3.8 SD) en la segunda. La diferencia entre estas dos medias no fue estadísticamente significativo (P=0.6379). El PES medio relacionado al implante para implantes unitarios varió desde 2.28 a 13.8 con desviaciones estándar entre 0.46 y 3.51. Las restauraciones más pobres y más estéticas mostraron las desviaciones estándar más bajas. El PES total fue de 10.6 para los prostodoncistas, 9.2 para los cirujanos orales, 9.9 para los estudiantes dentales y 7.6 para los ortodoncistas. Conclusiones: Las Puntuaciones de Estética Rosa evalúa reproduciblemente el tejido blando periimplantario alrededor de implantes unitarios. De este modo, se puede valorar un resultado objetivo de diferentes protocolos quirúrgicos o prostodónticos. Los ortodoncistas fueron claramente más críticos que los otros observadores. [source]