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Implant Surgery (implant + surgery)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Implant Dentistry	34%
Dermatology	5%

Kinds of Implant Surgery

cochlear implant surgery

Selected Abstracts

ORIGINAL RESEARCH,HISTORY: Nikolaj A. Bogoraz (1874,1952): Pioneer of Phalloplasty and Penile Implant Surgery

THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2005
Dirk Schultheiss MD
ABSTRACT Phalloplasty and penile implants are outstanding pioneering procedures introduced in 1936 by the Russian surgeon Nikolaj A. Bogoraz and are thus of eminent interest to the urological and plastic surgeon. This article from the history of medicine will discuss his biography and scientific achievements during the first half of the 20th century. [source]

Management of Cerebrospinal Fluid Leakage From Cochleostomy During Cochlear Implant Surgery

THE LARYNGOSCOPE, Issue 11 2006
Christopher T. Wootten MD
Abstract Objectives: The objectives of this retrospective review were to determine the incidence of cerebrospinal fluid (CSF) otorrhea from the cochleostomy during cochlear implant surgery, to recognize patients at risk, and to determine the appropriate preoperative, postoperative and intraoperative management. Methods: A chart review from two cochlear implant centers was performed to determine the incidence of CSF otorrhea, patients at risk, and appropriate management. Results: The incidence of CSF gusher is low, encountered in approximately 1% of patients undergoing cochlear implant surgery, and is seen in equal incidence in children and adults in our series. Preoperative imaging was predictive in only 50% of cases. Mechanisms for otorrhea in specific cochlear malformations and in those in which no apparent malformation exists are discussed. Successful implantation is expected in most cases. Intraoperative management may require complete packing of the middle ear space in addition to the cochleostomy to control CSF leak. Lumbar drain is rarely necessary. Outpatient management is possible in the majority of cases. Vaccination and antibiotic prophylaxis is essential. Conclusions: CSF otorrhea can be encountered in cochlear malformations and in cochleas without apparent malformation. Successful implantation without short-term or long-term complications is expected. [source]

The Potential Risk of Carotid Injury in Cochlear Implant Surgery

THE LARYNGOSCOPE, Issue 2 2002
B. R. Gastman MD
Abstract Background The advent of cochlear implantation has revolutionized the options afforded to the deaf population. With the increase in the prevalence of this procedure have come larger experiences in the associated technical challenges and complications. Results We present the evaluation and management of a patient with an unusual complication of improper placement of the implant electrode into the carotid canal and its management. We discuss the anatomy of the carotid artery and its proximity to the cochlea to emphasize the potential risk to this large vessel. Conclusions Damage to the carotid canal and the carotid artery is a potential risk of cochlear implant surgery. When available, we recommend intraoperative electrical testing of the cochlear implant be performed. If there is doubt as to the placement of the electrode, a radiograph should be obtained before the patient is taken out of the operating room to avoid this complication. [source]

Ultracision: An Alternative to Electrocautery in Revision Cochlear Implant Surgery

THE LARYNGOSCOPE, Issue 1 2002
Roland Laszig MD
No abstract is available for this article. [source]

Tissue Engineering Research in Oral Implant Surgery

ARTIFICIAL ORGANS, Issue 3 2001
Minoru Ueda
Abstract: In this article, we introduce some of the more extensively evaluated technologies using concepts of tissue engineering. We report on hard tissue engineering and soft tissue engineering and their utility for dental implant therapy. For hard tissue engineering, we evaluated human recombinant bone morphogenetic protein-2 and marrow mesenchymal stem cells using a model of sinus augmentation procedure in rabbit. We also describe distraction osteogenesis as another category for hard tissue engineering. In addition, we evaluate soft tissue management using cultured epithelial grafting for soft tissue engineering. The results of our tissue regeneration materials and methods in this study are positive. When the tissue engineering materials are used in clinics in the future, implant surgery could be the leading field. [source]

Minimally Invasive Flapless Implant Surgery: A Prospective Multicenter Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2005
ODhc, William Becker DDS
ABSTRACT Background: Placement of implants with a minimally invasive flapless approach has the potential to minimize crestal bone loss, soft tissue inflammation, and probing depth adjacent to implants and to minimize surgical time. Purpose: The aim of this multicenter study was to evaluate implant placement using a minimally invasive one-stage flapless technique up to 2 years. Materials and Methods: Fifty-seven patients ranging in age from 24 to 86 years were recruited from three clinical centers (Tucson, AZ, USA; Tel Aviv, Israel; Göteborg, Sweden). Seventy-nine implants were placed. A small, sharp-tipped guiding drill was used to create a precise, minimally invasive initial penetration through the mucosa and into bone (Nobel Biocare, Yorba, Linda, CA, USA). Implants were placed according to the manufacturer's instructions, with minimal countersinking. The parameters evaluated were total surgical time, implant survival, bone quality and quantity, implant position by tooth type, depth from mucosal margin to bone crest, implant length, probing depth, inflammation, and crestal bone changes. At 2 years, for 79 implants placed in 57 patients, the cumulative success rate using a minimally invasive flapless method was 98.7%, indicating the loss of 1 implant. Changes in crestal bone for 77 baseline and follow-up measurements were insignificant (radiograph 1: mean 0.7 mm, SD 0.5 mm, range 2.8 mm, minimum 0.2 mm, maximum 3.0 mm; radiograph 2: mean 0.8 mm, SD 0.5 mm, range 3.4 mm, minimum 0.12 mm, maximum 3.5 mm). Using descriptive statistics for 78 patients (one implant lost), mean changes for probing depth and inflammation were clinically insignificant. The average time for implant placement was 28 minutes (minimum 10 minutes, maximum 60 minutes, SD 13.1 minutes). Average depth from mucosal margin to bone was 3.3 mm (SD 0.7 mm, minimum 2 mm, maximum 5 mm, range 3 mm). Thirty-two implants were placed in maxillae and 47 in mandibles. Conclusions: The results of this study demonstrate that following diagnostic treatment planning criteria, flapless surgery using a minimally invasive technique is a predictable procedure. The benefits of this procedure are lessened surgical time; minimal changes in crestal bone levels, probing depth, and inflammation; perceived minimized bleeding; and lessened postoperative discomfort. [source]

Titanium allergy in dental implant patients: a clinical study on 1500 consecutive patients

CLINICAL ORAL IMPLANTS RESEARCH, Issue 8 2008
Alberto Sicilia
Abstract Background: In dentistry, allergic reactions to Ti implants have not been studied, nor considered by professionals. Placing permanent metal dental implants in allergic patients can provoke type IV or I reactions. Several symptoms have been described, from skin rashes and implant failure, to non-specific immune suppression. Objective: Our objective was to evaluate the presence of titanium allergy by the anamnesis and examination of patients, together with the selective use of cutaneous and epicutaneous testing, in patients treated with or intending to receive dental implants of such material. Material and methods: Thirty-five subjects out of 1500 implant patients treated and/or examined (2002,2004) were selected for Ti allergy analysis. Sixteen presented allergic symptoms after implant placement or unexplained implant failures [allergy compatible response group (ACRG)], while 19 had a history of other allergies, or were heavily Ti exposed during implant surgeries or had explained implant failures [predisposing factors group (PFG)]. Thirty-five controls were randomly selected (CG) in the Allergy Centre. Cutaneous and epicutaneous tests were carried out. Results: Nine out of the 1500 patients displayed positive (+) reactions to Ti allergy tests (0.6%): eight in the ACRG (50%), one in the PFG (5.3%)(P=0.009) and zero in the control group. Five positives were unexplained implant failures (five out of eight). Conclusions: Ti allergy can be detected in dental implant patients, even though its estimated prevalence is low (0.6%). A significantly higher risk of positive allergic reaction was found in patients showing post-op allergy compatible response (ACRG), in which cases allergy tests could be recommended. [source]

Bone replacement following dental trauma prior to implant surgery , present status

DENTAL TRAUMATOLOGY, Issue 1 2009
Mats Hallman
Although autogenous bone grafts is considered the ,gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has increased. Today, a substantial number of biomaterials are available on the market, but only a few are well documented. The user should be aware that these biomaterials have different properties: resorbable or non-resorbable, time of resorption and resorption mechanism. The purpose of this review is to describe the function of various bone substitutes and indications for their use in reconstructive implant surgery and to give an overview of the current situation. [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]

Review of the Liposuction, Abdominoplasty, and Face-Lift Mortality and Morbidity Risk Literature

DERMATOLOGIC SURGERY, Issue 7 2005
Robert A. Yoho MD
Background The statistical discrepancies that exist in the mortality and morbidity risk literature are such that surgeons and patients cannot accurately assess the true risk rates associated with plastic surgery procedures. Objectives and Methods To review any relevant literature published to date in which the risk rates from liposuction, abdominoplasty, and rhytidectomy are cited and to reassess these figures alongside those published for both elective and emergency general surgeries. Results and Conclusion Despite the lack of reliable, comprehensive reporting of deaths and complications resulting from cosmetic surgeries, published data demonstrate that the risks associated with liposuction and rhytidectomy compare favorably with those from most general surgical procedures. In contrast, the morbidity and mortality rates from abdominoplasty remain unacceptably high. A significant lack of literature documenting cosmetic breast implant surgery and blepharoplasty risks is observed, which should be of concern to both patients and physicians. Liposuction and face-lift surgery data generally show that surgical centers are statistically safer than hospital operating rooms, although the data have not been standardized for the patients' American Society of Anesthesiologists (ASA) risk class, the health of the patient prior to surgery. General anesthesia may carry a risk roughly equivalent to or perhaps greater than cosmetic surgery, although, again, ASA class variables confound clear comparison between studies. Recent anesthesia literature refutes the many claims that general anesthesia risks are now remote: a landmark study that surveyed the entire scholarly literature showed a mortality rate of 1 in 13,000, roughly similar to overall cosmetic surgery mortality risks. Moreover, a prolonged operating time has been repeatedly implicated in other surgical literature to be related to morbidity and mortality. The latter certainly has relevance to cosmetic surgery. [source]

Regional audit: Perioperative management of MRSA orthopaedic patients in the Oxford region

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2004
N. Aslam
Summary Aim:, Methicillin resistant staphylococcus aureus (MRSA) colonisation or infection is of particular importance in patients undergoing operations involving implanteable materials, such as in orthopaedic surgery. An audit of the perioperative management of orthopaedic patients in the Oxford region was carried out to assess the level of clinician awareness and the uniformity of current guidelines between hospitals. Methods:, A postal questionnaire was designed for asking information on various aspects of perioperative management of MRSA patients and was sent to each hospital. Results:, Responses were obtained from nine of 10 hospitals in the region. The average response rate for each hospital was 75%, and the overall individual response rate was 67.5% (27/40). Seventy-eight per cent of respondents knew that there was a pre-admission screening policy. Fifteen per cent were unaware of any MRSA policy. Forty-four per cent indicated that teicoplanin was used for prophylaxis in implant surgery whilst 44% used vancomycin. Eighteen per cent believed that cefuroxime was used for prophylaxis. Forty-eight per cent of hospitals had an MRSA-free zone for orthopaedic patients. Conclusion:, This study indicates a lack of uniformity in the perioperative management of MRSA-positive patients in the region and a lack of awareness of both MRSA guidelines and their implementation. Uniformity of MRSA guidelines is necessary to allow better clinician awareness and compliance, especially in surgical trainees who are travelling between different training hospitals in the region. Implementation of such a policy with re-audit of subsequent awareness and compliance is proposed. [source]

Recombinant human bone morphogenetic protein-7 in maxillary sinus floor elevation surgery in 3 patients compared to autogenous bone grafts

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2000
A clinical pilot study
Abstract Background/Aims: This pilot study was designed to determine the clinical bone formation ability of a human recombinant DNA bone morphogenetic protein-7, also referred to as Osteogenic Protein-1 [OP-1] combined with a collagen carrier, implanted in the maxillary sinus of 3 patients. The results were compared with a group of 3 patients treated with sinus floor elevation and autogenous bonegrafts. Methods: 6 consecutive patients, 4 female and 2 male, between 48 and 57 years of age were treated by means of sinus floor elevation for insufficient bone height in the posterior maxilla for implant surgery. 3 patients, 2 female and 1 male, were treated with OP-1 attached to a collagen device. In these patients, 4 maxillary sinus grafting procedures according to Tatum's method were carried out. 1 g of collagen carrier containing 2.5 mg rhOP-1 mixed with 3 ml of saline was placed between the bony floor and the elevated mucosal lining of the most caudal part of the maxillary sinus, in order to increase the vertical bone dimension to place dental implants of a sufficient length. The 3 other patients, also 2 female and 1 male, with a total of 5 sinus sites, were treated with sinus floor elevation and autogenous iliac crest bonegrafts. After 6 months, during dental implant preparation, bone cores were taken for histology. Thus, clinical, radiological and histological results of the 2 groups of 3 patients were compared. Results: 6 months after sinus grafting with OP-1, in 1 male, well-vascularized bonelike tissue of good quality was observed clinically. This could be confirmed by histology. In the second, female, patient no bone formation was observed at all. A cyst-like granular tissue mass, without purulent content, was removed. In the 3rd, female, patient, who received bilateral sinus grafts, some bonelike formation was seen, however it showed flexible tissue which led to the decision that at 6 months after the sinus grafting, the implant placement had to be postponed. In all 5 autogenous grafted sinuses a bone appearance similar to normal maxillary bone was observed clinically as well as histologically and dental implants could be placed six months after sinus floor elevation surgery. Conclusions: These findings indicate that the OP-1 device has the potential for initiating bone formation in the human maxillary sinus within 6 months after a sinus floor elevation operation. However, the various findings in these 3 patients indicate that the behaviour of the material is at this moment insufficiently predictable, in this indication area. Further investigation is indicated before OP-1 can be successfully used instead of the "gold standard" autogenous bone graft. [source]

Preoperative radiologic planning of implant surgery in compromised patients

PERIODONTOLOGY 2000, Issue 1 2003
Reinhilde Jacobs
No abstract is available for this article. [source]

Computer-assisted implantology: historical background and potential outcomes,a review

THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 2 2008
Abbas Azari
Abstract Background The accurate transfer of preoperatively determined implant positions to the patient mouth is very beneficial to the dental practitioner as well as patients. The objective of this paper was to review the gradual development of computer-assisted implant surgery. Methods All of the major data sources including unpublished data in the internet are considered Results and Conclusions Computer-assisted/-guided/-aided implantology has been founded to overcome the errors encountered during implant osteotomies and to position the implants more precisely. The protocols followed by this sophisticated technique are based upon the advocated concept of prosthetic-driven implantology and CT-scan analysis recently approved. Although several attempts have been made to improve this approach more and more, little has been done regarding the patient's demands, including cost. The inherent complexity of the techniques and materials utilized necessitates several degrees of training before attempting treatment and must be taken into account. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Incidence and indications for revision cochlear implant surgery in adults and children,

THE LARYNGOSCOPE, Issue 1 2009
Kevin D. Brown MD
Abstract Objectives/Hypothesis: To identify the incidence of and common causes for cochlear implant revision. Study Design: Retrospective case series. Methods: Operative records were reviewed for all cases of revision cochlear implantation from 1992 to 2006. The causes for reimplantation were classified as hard device failure, soft device failure, exposure/infection, receiver/stimulator migration, and electrode migration. Manufacturers' failure analysis of explanted devices was likewise determined. Results: Eight hundred and six cochlear implants were performed during the study period including 44 (5.5%) revision procedures. The revision rate was 7.3% for children and 3.8% for adults and reached statistical significant difference. The most common reasons for revision were device failure (78%; 55% hard failure, 23% soft failure) followed by electrode migration (9%) and receiver/stimulator migration (7%). Manufacturers' analysis of failed devices revealed loss of hermetic seal and cracked cases to be the most common causes of failure. Bench analysis of 5/10 explanted devices that were soft failures demonstrated identifiable device defects. Conclusions: Revision cochlear implant surgery is an infrequent occurrence. Its incidence appears to be higher in children than in adults, although in this series does not appear to be due to increased wound complications, infections, or trauma. Explanted implants that have soft failure as the etiology may have demonstrable defects on bench testing. Laryngoscope, 119:152,157, 2009 [source]

Management of Cerebrospinal Fluid Leakage From Cochleostomy During Cochlear Implant Surgery

Central Effects of Residual Hearing: Implications for Choice of Ear for Cochlear Implantation,

THE LARYNGOSCOPE, Issue 10 2004
Howard W. Francis MD
Abstract Objectives/Hypothesis: The study tested the hypothesis that among patients with similar levels of residual hearing in the nonimplanted ear, speech perception outcome is the same whether or not the implanted ear has profound or severe levels of hearing loss. Study Design: Retrospective. Methods: Levels of hearing loss in postlingually deafened adults who had cochlear implantation at Johns Hopkins University (Baltimore, MD) between 1991 and 2002 were classified according to pure-tone averages as bilateral severe (n = 20), severe-profound (severe in one ear and profound in the other) (n = 23), and bilateral profound (n = 43). There was no significant difference in the age at onset and duration of deafness among the three patient groups. Individuals in the bilateral severe and severe-profound groups had comparable levels of severe hearing loss in their nonimplanted ears, whereas those in severe-profound and bilateral profound groups had comparable levels of profound hearing loss in their implanted ears. Speech perception performance was evaluated using words from the Consonant Nucleus Consonant word list, Hearing in Noise Test sentences in quiet, and Central Institute for the Deaf sentences through recorded presentation at 70 dB sound pressure level (SPL). Results: Despite the profound hearing loss of the implanted ear in the asymmetrical group, there was no significant difference in mean speech perception scores compared with the bilateral severe group within the first year after implant surgery. By comparison, the bilateral profound group had lower speech perception results compared with patients with residual hearing in one or both ears. Conclusion: The study results suggest that implantation of the profoundly deafened ear does not diminish the functional advantage conferred by residual hearing in a patient with asymmetrical hearing loss. Therefore, the central auditory pathway may be the site at which persistent auditory function has its most beneficial effects. [source]

The Potential Risk of Carotid Injury in Cochlear Implant Surgery

Tissue Engineering Research in Oral Implant Surgery

Outcomes of dental implants placed in a surgical training programme

AUSTRALIAN DENTAL JOURNAL, Issue 4 2009
LP Smith
Abstract Background:, This study evaluates surgical outcomes and survival rates of implants placed in a multidisciplinary implant teaching programme. Methods:, A retrospective review of all implant surgery performed over a 6-year period by accredited oral and maxillofacial surgery trainees at the Royal Dental Hospital of Melbourne was undertaken. Patients were reviewed for a minimum of 6 months post-implant placement. Implant survival was defined as those implants which were not removed, were clinically integrated as assessed by torque testing and in an appropriate position to receive a subsequent prosthesis. Kaplan-Meier analysis was used to assess overall survival and univariate factors affecting survival. Multivariate analysis used Cox proportional hazards models. Results:, Over 6 years, 127 patients were treated. Follow-up data were present for 105 patients with 236 implants placed. Survival of implants at 1 and 5 years was 94 per cent and 92.8 per cent, respectively. The only univariate and multivariate factor which affected implant survival was perioperative bone grafting. All failed implants were single stage. Other factors such as patient age, smoking status, implant site, anaesthetic type, immediate or delayed placement, implant length and diameter, and medical comorbidities did not significantly affect implant survival. Conclusions:, A satisfactory implant survival rate was found in a tertiary teaching centre. Perioperative bone grafting significantly increased the risk of implant failure. [source]

Fibrin glue for preventing immediate postoperative hypotony following glaucoma drainage implant surgery

ACTA OPHTHALMOLOGICA, Issue 3 2006
Juha Välimäki
Abstract. Purpose:,To prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant (GDI) surgery. Methods:,A total of 42 eyes of 34 consecutive patients with refractory glaucoma requiring single-plate Molteno implantation were retrospectively reviewed. Peritubular filtration was checked intraoperatively in all filtered eyes. Fibrin glue was used over the scleral flap intraoperatively in every eye with peritubular leakage. All Molteno tubes were completely closed with an absorbable ligature. Results:,Peritubular filtration was detected in 11 eyes of 11 patients. All 11 eyes maintained intraocular pressure (IOP) ,,16 mmHg in the immediate postoperative phase. The mean IOP on the first postoperative day was 30.5 ± 10 mmHg. After an average follow-up of 6 months, the mean IOP in these 11 eyes was 19.1 ± 6 mmHg. No complications or Seidel-positive aqueous leak were observed during the follow-up period. Conclusions:,Results suggest that intraoperative use of fibrin glue is a viable option for reducing peritubular filtration and preventing immediate postoperative hypotony after GDI surgery. [source]

Localized erosive pustular dermatosis of the scalp at the site of a cochlear implant: successful treatment with topical tacrolimus

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2009
A. V. Marzano
Summary Erosive pustular dermatosis of the scalp (EPDS) is a rare form of nonmicrobial pustulosis mainly occurring in elderly patients with long-term sun damage to the skin. Clinically, it is characterized by pustular lesions that progressively merge into erosive and crusted areas over the scalp. The histology of EPDS is nonspecific, and its pathophysiology remains undetermined, with various types of local trauma possibly acting as the triggering factor. We describe a 24-year-old woman who developed EPDS after cochlear implant surgery for profound sensorineural hearing loss. We speculate that either the cutaneous surgery during cochlear implantation or the skin inflammation that commonly occurs near the magnet might have triggered the disorder. It is of note that the patient's skin lesions healed completely after treatment with topical tacrolimus, a relatively novel immunosuppressive molecule. Thus, topical tacrolimus may be indicated as a therapeutic alternative to the widely used steroids for this disease, mainly to avoid steroid-related cutaneous atrophy. [source]

Modular Preoperative Planning Software for Computer-Aided Oral Implantology and the Application of a Novel Stereolithographic Template: A Pilot Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2010
Xiaojun Chen PhD
ABSTRACT Purpose: In the field of oral implantology, there is a trend toward computer-aided implant surgery, especially the application of computerized tomography (CT)-derived surgical templates. However, because of relatively unsatisfactory match between the templates and receptor sites, conventional surgical templates may not be accurate enough for the severely resorbed edentulous cases during the procedure of transferring the preoperative plan to the actual surgery. The purpose of this study is to introduce a novel bone,tooth-combined-supported surgical guide, which is designed by utilizing a special modular software and fabricated via stereolithography technique using both laser scanning and CT imaging, thus improving the fit accuracy and reliability. Materials and Methods: A modular preoperative planning software was developed for computer-aided oral implantology. With the introduction of dynamic link libraries and some well-known free, open-source software libraries such as Visualization Toolkit (Kitware, Inc., New York, USA) and Insight Toolkit (Kitware, Inc.) a plug-in evolutive software architecture was established, allowing for expandability, accessibility, and maintainability in our system. To provide a link between the preoperative plan and the actual surgery, a novel bone,tooth-combined-supported surgical template was fabricated, utilizing laser scanning, image registration, and rapid prototyping. Clinical studies were conducted on four partially edentulous cases to make a comparison with the conventional bone-supported templates. Results: The fixation was more stable than tooth-supported templates because laser scanning technology obtained detailed dentition information, which brought about the unique topography between the match surface of the templates and the adjacent teeth. The average distance deviations at the coronal and apical point of the implant were 0.66 mm (range: 0.3,1.2) and 0.86 mm (range: 0.4,1.2), and the average angle deviation was 1.84° (range: 0.6,2.8°). Conclusions: This pilot study proves that the novel combined-supported templates are superior to the conventional ones. However, more clinical cases will be conducted to demonstrate their feasibility and reliability. [source]

A New Technique for Reconstruction of the Atrophied Narrow Alveolar Crest in the Maxilla Using Morselized Impacted Bone Allograft and Later Placement of Dental Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2008
Per Holmquist DDS
ABSTRACT Background: In cases when the alveolar crest is too narrow to host an implant, lateral augmentation is required. The use of autogenous bone blocks harvested from the iliac crest is often demanded. One disadvantage is the associated patient morbidity. Purpose: The purpose of this study was to clinically and histologically evaluate the use of morselized impacted bone allograft, a novel technique for reconstruction of the narrow alveolar crest. Materials and Methods: Two patients with completely edentulous maxillae and one partially edentulous, with a mean age of 77 years (range 76,79 years) were included in the study. The alveolar crest width was <3 mm without possibility to place any implant. Bone grafts were taken from a bone bank in Gävle Hospital. Bone from the neck of femur heads was milled to produce bone chips. The milled bone was partially defatted by rinsing in 37°C saline solution. After compression of the graft pieces with a size of 15 mm (height), 30 mm (length), and 6 mm (width), they were then fit to adapt to the buccal surface of the atrophied alveolar crest. One piece was placed to the right and one to the left side of the midline. On both sides fibrin glue was used (Tisseel®, Baxter AG, Vienna, Austria) to stabilize the graft. After 6 months of graft healing, dental implants were placed, simultaneously biopsies were harvested and in one patient two oxidized microimplants were placed. At the time of abutment connection, microimplants were retrieved with surrounding bone for histology. Fixed screw-retained bridges were fabricated in mean of 7 months after implant surgery. Radiographs were taken before and after implant surgery and after 1 year of loading. Results: Sixteen implants with an oxidized surface were placed (TiUnite®, Nobel Biocare AB, Göteborg, Sweden). After 1 year of functional loading, all implants were clinically stable. The marginal bone loss was 1.4 mm (SD 0.3) after 1 year of loading. The histological examination showed resorption and subsequent bone formation on the allograft particles. There were no signs of inflammatory cell infiltration in conjunction with the allograft. The two microimplants showed bone formation directly on the implant surface. Conclusions: This study shows that morselized impacted bone allograft can be used to increase the width of the atrophied narrow alveolar crest as a good alternative to autogenous bone grafts in elderly patients. The histological examination of biopsies revealed a normal incorporation process and no signs of an immunological reaction. Further studies with larger samples are of important to be able to conclude if equal results can be obtained using morselized impacted bone allograft as for autogenous bone graft. [source]

Report of a Case Receiving Full-Arch Rehabilitation in Both Jaws Using Immediate Implant Loading Protocols: A 1-Year Resonance Frequency Analysis Follow-Up

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006
Michael Portmann DDS
ABSTRACT Background:, Immediate occlusal implant loading has been documented as a viable treatment option for various indications. However, documentations related to full-arch rehabilitation are usually limited to treatment of one jaw at a time, thereby leaving the opposing dentition unchanged. Furthermore, clinical documentation using traditional, well-accepted measuring techniques may not be adequate when it comes to short-term evaluation of the success or failure of implants subjected to immediate occlusal loading. Purpose:, The purpose of this case report is to (1) present an implant stability follow-up of a patient receiving an immediate, implant-supported full-arch rehabilitation in both jaws and (2) evaluate the patient's acceptance of this rehabilitation. Materials and Methods:, A 68-year-old patient scheduled for implant treatment was selected for an immediate implant loading protocol in both jaws. During two surgical events 3 weeks apart, eight maxillary and four mandibular Brånemark System® Mk IV TiUniteTM fixtures (Nobel Biocare AB, Göteborg, Sweden) were inserted and subsequently used to immediately support a cross-arch fixed prosthesis in the maxilla and a bar-retained overdenture in the mandible. Implant stability was recorded from the day of surgery periodically during a 1-year follow-up using resonance frequency analysis (RFA). Results:, At the 1-year follow-up, based on clinical, RFA, and radiographic evaluations, all implants and the reconstructions were classified as successful. All maxillary implants showed a decrease in the implant stability quotient (ISQ) value from the measurement at the time of surgery to the first follow-up, whereas two of four mandibular implants revealed an initial drop in stability. Irrespective of a specific ISQ level measured at implant surgery (ISQ range 53,74) and despite an initial decrease in stability, measurements recorded at the 12-month follow-up indicated similar stability levels for all maxillary implants (ISQ range 64,68) or the group of mandibular implants (ISQ range 72,75) but with a higher ISQ level for mandibular implants. Furthermore, the patient's acceptance of the immediate full-arch rehabilitation in both jaws was high. Conclusions:, The present case report demonstrates that a slightly staged approach for full-arch rehabilitation in both jaws using immediate implant loading protocols is a realistic treatment option. Furthermore, RFA follow-up indicates that immediately occlusally loaded implants placed in reduced bone quality and quantity are more prone to loose stability in the early healing period compared with implants placed in dense bone quality. [source]

Clinical Assessment and Surgical Implications of Anatomic Challenges in the Anterior Mandible

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2003
Nuri Mraiwa BDS
ABSTRACT Background: The anterior mandible is generally considered a rather safe surgical area, involving few risks of damage to vital anatomic structures. Nevertheless, both neurosensory disturbances and hemorrhages have been reported after implant surgery in that particular area. Purpose: With the increasing demand for oral implant placement, the anatomy of the anterior mandible should receive more attention. This review will focus on the anatomic peculiarities of the anterior mandible and the related clinical implications. Methods: The scientific evidence on the anatomic, histologic, physiologic, and clinical aspects of the neurovascularization of the anterior mandible will be reviewed. Results: Surgical complications may be attributed to the existence of a mandibular incisive canal with a true neurovascular supply. Potential risks may also be related to the presence of the lingual foramen and anatomic variations, such as an anterior looping of the mental nerve. Conclusions: Preoperative radiographic planning for oral implant placement in the anterior mandible should therefore not only consider all esthetic and functional demands but should also pay particular attention to the anatomic peculiarities of this region to avoid any neurovascular complications. [source]

Early Functional Loading of Unsplinted Roughened Surface Implants with Mandibular Overdentures 2 Weeks after Surgery

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2003
Alan G.T. Payne BDS, FCD (SA), MDent
ABSTRACT Background: Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach. Purpose: To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures. Materials and Methods: Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland; or Southern Implant System, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants used a soft diet. Two weeks after implant surgery and following some mucosal healing, the mandibular dentures had the tissue conditioner removed and the appropriate matrices included for an unsplinted prosthodontic design. Results: No implant from either group was lost. Resonance frequency analysis (RFA) indicated higher primary stability at surgery for the Southern group than for the ITI group, with a statistically significant difference between the groups throughout the study period. The drop in RF values between surgery and 6 weeks was significant and was greater for the Southern group. RFA also indicated stabilized osseointegration between 6 to 12 and 12 to 52 weeks, with no participant showing any decrease in those values over time. Participants with type 3 bone showed a significant improvement in RF values between 12 and 52 weeks, eventually matching those of participants with type 2 bone. There were no significant differences in marginal bone loss, periimplant parameters, or prosthodontic maintenance between the groups over the study period. Conclusions: Using only strict patient selection criteria, 1-year follow-up data indicate that early functional loading of ITI and Southern implants with mandibular two-implant overdentures is possible as early as 2 weeks after implant surgery. [source]

A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2010
Jerome A. Lindeboom
Abstract Background: Flapless implant surgery is considered to offer advantages over the traditional flap access approach. There may be minimized bleeding, decreased surgical times and minimal patient discomfort. Controlled studies comparing patient outcome variables to support these assumptions, however, are lacking. Aim: The objective of this clinical study was to compare patient outcome variables using flapless and flapped implant surgical techniques. Patients and methods: From January 2008 to October 2008, 16 consecutive patients with edentulous maxillas were included in the study. Patients were randomly allocated to either implant placement with a flapless procedure (eight patients, mean age 54.6±2.9 years) or surgery with a conventional flap procedure (eight patients, mean age 58.7±7.2 years). All implants were placed using a Nobel guide® CT-guided surgical template. Outcome measures were the Dutch version of the Impact of Event Scale-Revised (IES-R), dental anxiety using the s-DAI and oral health-related quality of life (OHIP-14). Results: Ninety-six implants were successfully placed. All implants were placed as two-phase implants and the after-implant placement dentures were adapted. No differences could be shown between conditions on dental anxiety (s-DAI), emotional impact (IES-R), anxiety, procedure duration or technical difficulty, although the flapless group did score consistently higher. The flap procedure group reported less impact on quality of life and included more patients who reported feeling no pain at all during placement. Conclusions: Differences found in the patient outcome variables do suggest that patients in the flapless implant group had to endure more than patients in the flap group. To cite this article: Lindeboom JA, van Wijk AJ. A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement. Clin. Oral Impl. Res. 21, 2010; 366,370. doi: 10.1111/j.1600-0501.2009.01866.x [source]

CAD/CAM fabrication and clinical application of surgical template and bone model in oral implant surgery

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2009
Taiji Sohmura
Abstract Objectives: A novel implant surgery support system with computer simulation for implant insertion and fabrication of a surgical template that helps in drilling bone was developed. A virtual reality haptic device that gives the sense of touch was used for simulation and a surgical template was fabricated by CAD/CAM method. Surgical guides were applied for two clinical cases. Material and methods: Three-dimensional (3D) jaw bone images transferred from DICOM data filmed by CT scanner were fed to the software and manipulated using the haptic device. The site for implant insertion was determined after evaluating the quality of bone and position of the mandibular canal. The surgical template was designed with ease using the free design CAD function of haptic device. The surgical template and bone model were fabricated by a fused deposit modeling machine. Two clinical cases were applied using the present system. Results: Simulation to determine the site of implant insertion and fabrication of the surgical bone templates were successfully done in two clinical cases, one for three implant insertion in lower right jaw and the other is for seven implant insertion in lower edentulous jaw, respectively. During surgery, the templates could be firmly adapted on the bone and drilling was successfully performed in both cases. Conclusion: The present simulation and drilling support using the surgical template may help to perform safe and accurate implant surgery. [source]

Placement of Brånemark implants in the maxillary tuber region: anatomical considerations, surgical technique and long-term results

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2009
Arne Ridell
Abstract Background: Fixture placement in the tuber area is one way to overcome the problem of insufficient bone volume for routine implant surgery in the posterior maxilla due to severe resorption of jawbone and an extensive enlargement of the maxillary sinus. However, little is known about the long-term results. Purpose: The aim of this study was to retrospectively evaluate the survival rate and marginal bone conditions at fixtures placed in the tuber region of the maxilla. Material and methods: Twenty-one patients previously treated with at least one implant in the tuber region of the maxilla were included in this retrospective analysis. A total of 23 standard Brånemark System fixtures with a turned surface had been surgically placed in the tuber regions and 71 additional implants in adjacent areas to support fixed dental bridges. All implants were allowed to heal for 6,8 months before abutment connection and following prosthetic treatment. The patients were radiographed after 1,12 years for evaluation of marginal bone levels. In addition, the relation between the apex of the fixture in the tuberosity area and the posterior border of the maxilla was measured. Results: Twenty of the 21 patients representing 22 tuber and 64 additional implants were radiographically evaluated. No implants in the tuber areas were lost during the follow-up whereas two fixtures in the anterior region had to be removed, one before loading and the other after 4 years of loading not interfering with the prosthesis stability. The mean marginal bone level at tuber implants was situated on average 1.6 mm (SD 1.1, n=22) from the abutment-fixture junction, whilst the other implants showed an average bone level of 1.9 mm (SD 0.8, n=64). The results were similar when comparing partially and totally edentulous patients. Conclusion: The present retrospective study shows good clinical outcome with standard Brånemark fixtures placed in the tuber region of the posterior maxilla using a two-stage procedure. In appropriate cases where bone of adequate volume and density is available, our data indicate that the technique can be used as an alternative to more extensive surgery and especially to the sinus lift procedure. However, prospective comparative studies are needed in order to evaluate the efficacy of the described technique for this purpose. [source]