This document provides an overview of a case study on immediate dental implantation conducted by Prof. Pavel V. Kuts at the Dental Prosthetics Department of Bogomolets National Medical University in Kiev, Ukraine. The study involved 35 patients who underwent immediate implantation to replace extracted teeth. Bone substitutes were used to augment the alveolar ridge if needed. Temporary and permanent prosthetics were created. Indications for immediate implantation included dental trauma, chronic periodontitis, ineffective treatment of periodontitis, tooth dystopia requiring extraction, and deciduous teeth without permanent successors. The procedure aimed to minimize trauma and preserve bone during extraction and implantation.
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
This document describes a case study involving periodontally accelerated osteogenic orthodontics (PAOO) to accelerate orthodontic tooth movement. PAOO involves selective alveolar decortications and bone grafting to induce regional acceleratory phenomenon and reduce orthodontic treatment time. The case report describes performing corticotomy and bone grafting to close a 6.5mm space between teeth in a 27-year-old female patient, achieving the space closure in 4 months, which is significantly faster than conventional orthodontic treatment. PAOO provides benefits like reduced treatment time, increased bone volume, and improved post-treatment stability compared to traditional orthodontics.
Immediate Placement and Provisionalization of Maxillary Posterior Single Impl...Abu-Hussein Muhamad
Functional immediate load is the most recent concept. This describes a load, within physiological limits, applied to implants before the osseo-integration process is completed. One of the treatment options offered to patients requiring replacement of one or more teeth is the use of prostheses supported by implants. Patients nowadays demand greater aesthetic and functional restorations; therefore, the clinician tries to reduce implant load time. All this leads to the implementation of several modifications to the conventional surgical and prosthetic protocol leading to a reduction in the load time of the implant. This is a case report of the immediate loading of posterior implant.
This document discusses guidelines for ideal implant positioning and treatment modalities for replacing missing teeth in the esthetic zone. It emphasizes the importance of thorough diagnosis, treatment planning, and implant positioning for achieving esthetic success. Key points discussed include assessing the gingival biotype and available bone volume, maintaining proper mesiodistal and buccolingual positioning, and ensuring sufficient apical placement and soft tissue thickness for an ideal emergence profile. Attention to these factors can help minimize risks of recession, bone loss, and compromised soft tissue contours.
This case series examines a new surgical technique for regenerating interimplant papillae using subepithelial connective tissue grafts. 10 patients with missing papillae between implant restorations received the new procedure involving buccal and palatal incisions made away from the papilla to preserve blood supply, and tunneling performed with a specialized instrument. The papillae scores improved on average from 0.8 to 2.4 after 16 months, demonstrating regeneration of the papillae over 11-30 months. However, long-term studies are still needed to validate the technique and outcomes.
Regenerative Nanotechnology in Oral and Maxillofacial SurgeryShreya Das
1. The document discusses the use of nanotechnology in oral and maxillofacial surgery. It describes how nanoparticles like quantum dots, nanocomposites, and nanoscaffolds are being used for tissue engineering, imaging, and drug delivery applications.
2. Specifically, it provides examples of how nanoscaffolds made of materials like PLLA are being used to regenerate bone. It also discusses how quantum dots can be used for imaging and labeling cells due to their tunable fluorescent properties.
3. Studies presented showed that nanohydroxyapatite scaffolds promoted bone regeneration in animal models. A bionic ear was also 3D printed using living cells, hydrogels, and silver nanoparticles
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
This document describes a case study involving periodontally accelerated osteogenic orthodontics (PAOO) to accelerate orthodontic tooth movement. PAOO involves selective alveolar decortications and bone grafting to induce regional acceleratory phenomenon and reduce orthodontic treatment time. The case report describes performing corticotomy and bone grafting to close a 6.5mm space between teeth in a 27-year-old female patient, achieving the space closure in 4 months, which is significantly faster than conventional orthodontic treatment. PAOO provides benefits like reduced treatment time, increased bone volume, and improved post-treatment stability compared to traditional orthodontics.
Immediate Placement and Provisionalization of Maxillary Posterior Single Impl...Abu-Hussein Muhamad
Functional immediate load is the most recent concept. This describes a load, within physiological limits, applied to implants before the osseo-integration process is completed. One of the treatment options offered to patients requiring replacement of one or more teeth is the use of prostheses supported by implants. Patients nowadays demand greater aesthetic and functional restorations; therefore, the clinician tries to reduce implant load time. All this leads to the implementation of several modifications to the conventional surgical and prosthetic protocol leading to a reduction in the load time of the implant. This is a case report of the immediate loading of posterior implant.
This document discusses guidelines for ideal implant positioning and treatment modalities for replacing missing teeth in the esthetic zone. It emphasizes the importance of thorough diagnosis, treatment planning, and implant positioning for achieving esthetic success. Key points discussed include assessing the gingival biotype and available bone volume, maintaining proper mesiodistal and buccolingual positioning, and ensuring sufficient apical placement and soft tissue thickness for an ideal emergence profile. Attention to these factors can help minimize risks of recession, bone loss, and compromised soft tissue contours.
This case series examines a new surgical technique for regenerating interimplant papillae using subepithelial connective tissue grafts. 10 patients with missing papillae between implant restorations received the new procedure involving buccal and palatal incisions made away from the papilla to preserve blood supply, and tunneling performed with a specialized instrument. The papillae scores improved on average from 0.8 to 2.4 after 16 months, demonstrating regeneration of the papillae over 11-30 months. However, long-term studies are still needed to validate the technique and outcomes.
Regenerative Nanotechnology in Oral and Maxillofacial SurgeryShreya Das
1. The document discusses the use of nanotechnology in oral and maxillofacial surgery. It describes how nanoparticles like quantum dots, nanocomposites, and nanoscaffolds are being used for tissue engineering, imaging, and drug delivery applications.
2. Specifically, it provides examples of how nanoscaffolds made of materials like PLLA are being used to regenerate bone. It also discusses how quantum dots can be used for imaging and labeling cells due to their tunable fluorescent properties.
3. Studies presented showed that nanohydroxyapatite scaffolds promoted bone regeneration in animal models. A bionic ear was also 3D printed using living cells, hydrogels, and silver nanoparticles
This study examined 86 children aged 15 or younger who received osseointegrated implants for bone-anchored hearing aids (BAHA) or bone-anchored epistheses (BAE) over a 17-year period. Of 129 implants installed, 6.2% failed, and skin reactions occurred in 7.6% of patients. Revision surgery was required in 30% of patients due to bone growth. While implant failures and skin reactions were comparable to adults, revision surgery was more common in children due to bone growth. Nevertheless, osseointegrated implants can provide good functional and aesthetic outcomes for children with hearing or ear abnormalities.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
IMMEDIATE IMPLANT PLACEMENT WITH ONE YEAR FOLLOW-UP: A CASE REPORTAbu-Hussein Muhamad
This case report describes the immediate placement of a dental implant into the extraction socket of a fractured maxillary central incisor tooth. The tooth was extracted atraumatically without flap reflection to preserve hard and soft tissues. A dental implant was immediately placed into the prepared socket. Four months later, an impression was taken and a definitive restoration was placed. The patient exhibited no clinical or radiographic complications over 12 months of follow-up after loading. Immediate implant placement and provisional restoration provided esthetics, function, and tissue preservation for the patient.
Most of problems in root canal are fixed, re-establishment of strength in weakened crown or root is impossible.
After coronal leakage the most common reason for long term failure of endodontically treated teeth is vertical root fracture, if this fracture extents even a millimeter depth into soft tissue attachment then it must be extracted
Term heroic means self reference (treating a tooth with poor prognosis)
List of heroic Endodontics –repair of perforation before MTA, Hemi section/root amputation of teeth with vertical root fracture, forced eruption of a tooth with sub crestal caries, cervical resorption or oblique fracture and internal bonding of root fracture
The primary reason in considering a tooth unworthy is when structural integrity is gone
Immediate placement and provisionalization of maxillary anterior single impla...Nguyễn Thị Minh Hiền
The document describes a clinical case involving immediate placement of an implant to replace a maxillary anterior tooth with an osseous defect. The procedure involved placing the implant 3 mm apically and performing guided bone regeneration with grafts and a membrane. A bilaminar connective tissue graft and coronally positioned flap were used to achieve stable peri-implant tissue. A customized temporary abutment and provisional restoration were fabricated. The outcome was more stable peri-implant tissue in the area of the facial osseous defect.
This document summarizes two clinical cases where minimally invasive antral membrane balloon elevation was used to perform sinus lift procedures for single tooth implant placement in the posterior maxilla with reduced bone height. In both cases, the procedure allowed for sufficient bone augmentation to subsequently place dental implants. The procedure was found to be a relatively simple and safe method for rehabilitation of missing teeth in the challenging posterior maxilla, avoiding the need for more invasive sinus lift surgeries.
This document discusses several controversies in the management of maxillofacial trauma, including:
1) The management of fractures through the angle of the mandible, regarding factors like the location and extension of the fracture line and whether teeth in the line require extraction.
2) The management of condylar process fractures, debating whether closed or open reduction is preferred based on factors like displacement, facial contour, and risk of malocclusion.
3) The techniques for managing comminuted mandible fractures, including traditional conservative approaches versus open reduction and internal fixation using reconstruction plates.
It provides an overview of key points of debate and considerations in the treatment of various types of maxillofacial fractures
Analysis of the gradient of sinus augmentation- histomorphometric studyssuser19a491
This study examined the gradient of new bone formation and residual graft particles at different distances from the sinus floor following maxillary sinus floor augmentation using either freeze-dried bone allografts (FDBA) or biphasic calcium phosphate (BCP) bone substitute. Biopsies were taken from 26 sites in 13 patients at implant placement 9 months after sinus augmentation. Histomorphometric analysis found that the density of new bone decreased with increasing distance from the sinus floor for both graft materials. The percentage of new bone ranged from 31-27.7% near the floor to 23.5-27.7% further away. Residual graft particle area also decreased with distance from the floor. The results support that osteogenesis initi
This study evaluated the healing of mandibular ramus bone block grafts used for alveolar ridge augmentation before implant placement through clinical, histological, and histomorphometric analysis. Bone blocks were harvested from the mandibular ramus in 15 patients and grafted to maxillary defects. After 3-9 months of healing, implants were placed and bone samples were taken. Histological analysis found signs of active remodeling but also substantial amounts of non-vital bone and generally weak neo-vascularization, suggesting that most osteocytes in the grafted bone do not survive and neo-vascularization of non-vital grafted bone is difficult. The outcomes suggest grafted bone undergoes slow remodeling into new vital bone.
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...Dr Mujtaba Ashraf
This document presents a study on a new technique called dentoalveolar distraction (DAD) to rapidly retract canines during orthodontic treatment. The study involved 10 patients where the maxillary first premolars were extracted and a distractor device was used to move the canines into the extraction sites at a rate of 0.8 mm per day. Full canine retraction was achieved in an average of 10 days with minimal anchorage loss. The canines tipped and translated distally on average 13 degrees. No complications were observed. The DAD technique reduces orthodontic treatment time by nearly 50% with no adverse effects on surrounding structures.
This paper describes a novel transoral surgical approach for resecting tumors involving the posterolateral maxilla and infratemporal region. The approach involves a curvilinear incision in the maxillary buccal sulcus, followed by a temporalis myotomy and coronoidectomy. This provides direct visualization of the posterolateral maxilla and infratemporal region, allowing resection of maxillary tumors extending into the posterior sinus wall and pterygoid plates via a transoral route. Previous approaches required transcutaneous incisions that resulted in significant morbidity. The novel transoral approach enables controlled tumor resection while avoiding complications of other techniques.
This document reviews the clinical application of orthodontic miniscrews. It begins by discussing the history and limitations of using dental implants and bone screws for orthodontic anchorage. It then describes the development of smaller miniscrews that address many of the disadvantages of larger implants. The document reviews various miniscrew systems and characteristics like diameter, length, and head design. It provides examples of common clinical applications where miniscrews can provide anchorage, such as space closure, intrusion of overerupted teeth, and correction of canting occlusal planes. The discussion concludes by describing techniques for placing miniscrews and factors to consider for optimal force application.
This article reviews endodontic surgery. It discusses indications for endodontic surgery including when conventional root canal treatment fails or cannot be performed. The article categorizes different types of endodontic surgery including periapical surgery, hemisection/root amputation, intentional replantation, and corrective surgery. Success rates for endodontic surgery can range from 44-95% depending on the procedure and clinical situation.
“Horizontal Ridge Augmentation- Worth or Vain?”- Guest lecture as a part of “Perio Interactions- Edition IX” conducted by Saveetha Dental College and Hospitals, Chennai on 20/12/2017.
A study of 2 bone plating methods for fractures of mandibular symphysis and bodyDr. SHEETAL KAPSE
This study compared outcomes of using two miniplates versus one larger plate for internal fixation of mandibular symphysis and body fractures. Two hundred sixty-five patients were treated with either two miniplates or one larger plate. The use of two miniplates resulted in higher rates of wound dehiscence, plate exposure, and need for plate removal compared to the use of a single larger plate. However, both techniques provided sufficient stability for fracture healing.
Treatment of severe sinus infection after sinus lift procedure a case reportdroliv
This case report describes a patient who developed a severe sinus infection after undergoing a sinus lift and grafting procedure. Two weeks postoperatively, the patient reported pain, drainage from the nasal cavity, and yellow mucus discharge from the right nostril. A CT scan revealed thickening of the Schneiderian membrane and scattered graft material, as well as ostium stenosis (narrowing of the sinus opening). Management included endoscopic nasal examination and ostium enlargement by an otolaryngologist, along with antibiotic treatment and full removal of the graft and diseased tissue. The report concludes that the patency of the sinus ostium should be carefully evaluated before sinus lift procedures using CT scans, and otolaryngology consultations
This case report describes the immediate placement of a dental implant into a fresh extraction socket. A 53-year-old patient had a fractured maxillary lateral incisor extracted. The socket was prepared and a dental implant was immediately placed. Four months later, an impression was taken and a definitive crown placed. The patient exhibited no clinical or radiographic complications over two years of follow-up. Immediate implant placement and provisionalization preserved the hard and soft tissues and provided the patient with immediate aesthetics, function, and comfort.
This document summarizes recent advances in the management of oral and maxillofacial injuries. Key points include:
1) Minimally invasive endoscopic techniques are being used more for fractures of the mandibular condyle, zygomatic complex, orbit, and frontal sinus to limit incisions and improve visualization.
2) Computer-assisted surgery is being used to assist with preoperative planning, intraoperative guidance, and postoperative evaluation for oral and maxillofacial procedures.
3) Advances have been made in the treatment of many specific facial fractures including mandibular, midfacial, orbital, nasal, frontal, and temporomandibular joint fractures through the use of new techniques,
This study compared a supratemporalis approach to the traditional preauricular approach for treating intracapsular condylar fractures. 84 patients were treated with one of the two approaches. The supratemporalis approach provided excellent exposure while preventing facial nerve injury, which has a risk of 1-32% with the preauricular approach. No additional complications occurred with the supratemporalis approach. The authors conclude it is an effective routine approach for intracapsular condylar fractures due to its safety advantages over the traditional method.
Article teixeira effects of micro-osteoperforationCentric Learning
1. The study examined the effect of micro-osteoperforations (MOPs) on the rate of tooth movement in 20 patients undergoing orthodontic treatment.
2. The experimental group received MOPs on one side of the maxilla prior to canine retraction, while the control group did not receive MOPs.
3. MOPs significantly increased the rate of tooth movement by 2.3-fold and increased inflammatory marker levels. Patients did not report significant pain from the procedure.
Emmy Jerotich is a 23-year-old Kenyan citizen currently pursuing a Bachelor of Business Management in Banking and Finance at the University of Kabianga. She has completed Computerized Accounting courses at Destiny College of Accountancy and holds a CPA Part 3 certification. Emmy seeks to utilize her academic qualifications, computer skills, and experience in finance and accounting roles to contribute positively to society.
This document lists 150 students who are leading candidates for the All-American Scholarship Program. It provides information such as their name, location, and the college they attend. The students are ranked based on their total points in the scholarship program.
This study examined 86 children aged 15 or younger who received osseointegrated implants for bone-anchored hearing aids (BAHA) or bone-anchored epistheses (BAE) over a 17-year period. Of 129 implants installed, 6.2% failed, and skin reactions occurred in 7.6% of patients. Revision surgery was required in 30% of patients due to bone growth. While implant failures and skin reactions were comparable to adults, revision surgery was more common in children due to bone growth. Nevertheless, osseointegrated implants can provide good functional and aesthetic outcomes for children with hearing or ear abnormalities.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
IMMEDIATE IMPLANT PLACEMENT WITH ONE YEAR FOLLOW-UP: A CASE REPORTAbu-Hussein Muhamad
This case report describes the immediate placement of a dental implant into the extraction socket of a fractured maxillary central incisor tooth. The tooth was extracted atraumatically without flap reflection to preserve hard and soft tissues. A dental implant was immediately placed into the prepared socket. Four months later, an impression was taken and a definitive restoration was placed. The patient exhibited no clinical or radiographic complications over 12 months of follow-up after loading. Immediate implant placement and provisional restoration provided esthetics, function, and tissue preservation for the patient.
Most of problems in root canal are fixed, re-establishment of strength in weakened crown or root is impossible.
After coronal leakage the most common reason for long term failure of endodontically treated teeth is vertical root fracture, if this fracture extents even a millimeter depth into soft tissue attachment then it must be extracted
Term heroic means self reference (treating a tooth with poor prognosis)
List of heroic Endodontics –repair of perforation before MTA, Hemi section/root amputation of teeth with vertical root fracture, forced eruption of a tooth with sub crestal caries, cervical resorption or oblique fracture and internal bonding of root fracture
The primary reason in considering a tooth unworthy is when structural integrity is gone
Immediate placement and provisionalization of maxillary anterior single impla...Nguyễn Thị Minh Hiền
The document describes a clinical case involving immediate placement of an implant to replace a maxillary anterior tooth with an osseous defect. The procedure involved placing the implant 3 mm apically and performing guided bone regeneration with grafts and a membrane. A bilaminar connective tissue graft and coronally positioned flap were used to achieve stable peri-implant tissue. A customized temporary abutment and provisional restoration were fabricated. The outcome was more stable peri-implant tissue in the area of the facial osseous defect.
This document summarizes two clinical cases where minimally invasive antral membrane balloon elevation was used to perform sinus lift procedures for single tooth implant placement in the posterior maxilla with reduced bone height. In both cases, the procedure allowed for sufficient bone augmentation to subsequently place dental implants. The procedure was found to be a relatively simple and safe method for rehabilitation of missing teeth in the challenging posterior maxilla, avoiding the need for more invasive sinus lift surgeries.
This document discusses several controversies in the management of maxillofacial trauma, including:
1) The management of fractures through the angle of the mandible, regarding factors like the location and extension of the fracture line and whether teeth in the line require extraction.
2) The management of condylar process fractures, debating whether closed or open reduction is preferred based on factors like displacement, facial contour, and risk of malocclusion.
3) The techniques for managing comminuted mandible fractures, including traditional conservative approaches versus open reduction and internal fixation using reconstruction plates.
It provides an overview of key points of debate and considerations in the treatment of various types of maxillofacial fractures
Analysis of the gradient of sinus augmentation- histomorphometric studyssuser19a491
This study examined the gradient of new bone formation and residual graft particles at different distances from the sinus floor following maxillary sinus floor augmentation using either freeze-dried bone allografts (FDBA) or biphasic calcium phosphate (BCP) bone substitute. Biopsies were taken from 26 sites in 13 patients at implant placement 9 months after sinus augmentation. Histomorphometric analysis found that the density of new bone decreased with increasing distance from the sinus floor for both graft materials. The percentage of new bone ranged from 31-27.7% near the floor to 23.5-27.7% further away. Residual graft particle area also decreased with distance from the floor. The results support that osteogenesis initi
This study evaluated the healing of mandibular ramus bone block grafts used for alveolar ridge augmentation before implant placement through clinical, histological, and histomorphometric analysis. Bone blocks were harvested from the mandibular ramus in 15 patients and grafted to maxillary defects. After 3-9 months of healing, implants were placed and bone samples were taken. Histological analysis found signs of active remodeling but also substantial amounts of non-vital bone and generally weak neo-vascularization, suggesting that most osteocytes in the grafted bone do not survive and neo-vascularization of non-vital grafted bone is difficult. The outcomes suggest grafted bone undergoes slow remodeling into new vital bone.
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...Dr Mujtaba Ashraf
This document presents a study on a new technique called dentoalveolar distraction (DAD) to rapidly retract canines during orthodontic treatment. The study involved 10 patients where the maxillary first premolars were extracted and a distractor device was used to move the canines into the extraction sites at a rate of 0.8 mm per day. Full canine retraction was achieved in an average of 10 days with minimal anchorage loss. The canines tipped and translated distally on average 13 degrees. No complications were observed. The DAD technique reduces orthodontic treatment time by nearly 50% with no adverse effects on surrounding structures.
This paper describes a novel transoral surgical approach for resecting tumors involving the posterolateral maxilla and infratemporal region. The approach involves a curvilinear incision in the maxillary buccal sulcus, followed by a temporalis myotomy and coronoidectomy. This provides direct visualization of the posterolateral maxilla and infratemporal region, allowing resection of maxillary tumors extending into the posterior sinus wall and pterygoid plates via a transoral route. Previous approaches required transcutaneous incisions that resulted in significant morbidity. The novel transoral approach enables controlled tumor resection while avoiding complications of other techniques.
This document reviews the clinical application of orthodontic miniscrews. It begins by discussing the history and limitations of using dental implants and bone screws for orthodontic anchorage. It then describes the development of smaller miniscrews that address many of the disadvantages of larger implants. The document reviews various miniscrew systems and characteristics like diameter, length, and head design. It provides examples of common clinical applications where miniscrews can provide anchorage, such as space closure, intrusion of overerupted teeth, and correction of canting occlusal planes. The discussion concludes by describing techniques for placing miniscrews and factors to consider for optimal force application.
This article reviews endodontic surgery. It discusses indications for endodontic surgery including when conventional root canal treatment fails or cannot be performed. The article categorizes different types of endodontic surgery including periapical surgery, hemisection/root amputation, intentional replantation, and corrective surgery. Success rates for endodontic surgery can range from 44-95% depending on the procedure and clinical situation.
“Horizontal Ridge Augmentation- Worth or Vain?”- Guest lecture as a part of “Perio Interactions- Edition IX” conducted by Saveetha Dental College and Hospitals, Chennai on 20/12/2017.
A study of 2 bone plating methods for fractures of mandibular symphysis and bodyDr. SHEETAL KAPSE
This study compared outcomes of using two miniplates versus one larger plate for internal fixation of mandibular symphysis and body fractures. Two hundred sixty-five patients were treated with either two miniplates or one larger plate. The use of two miniplates resulted in higher rates of wound dehiscence, plate exposure, and need for plate removal compared to the use of a single larger plate. However, both techniques provided sufficient stability for fracture healing.
Treatment of severe sinus infection after sinus lift procedure a case reportdroliv
This case report describes a patient who developed a severe sinus infection after undergoing a sinus lift and grafting procedure. Two weeks postoperatively, the patient reported pain, drainage from the nasal cavity, and yellow mucus discharge from the right nostril. A CT scan revealed thickening of the Schneiderian membrane and scattered graft material, as well as ostium stenosis (narrowing of the sinus opening). Management included endoscopic nasal examination and ostium enlargement by an otolaryngologist, along with antibiotic treatment and full removal of the graft and diseased tissue. The report concludes that the patency of the sinus ostium should be carefully evaluated before sinus lift procedures using CT scans, and otolaryngology consultations
This case report describes the immediate placement of a dental implant into a fresh extraction socket. A 53-year-old patient had a fractured maxillary lateral incisor extracted. The socket was prepared and a dental implant was immediately placed. Four months later, an impression was taken and a definitive crown placed. The patient exhibited no clinical or radiographic complications over two years of follow-up. Immediate implant placement and provisionalization preserved the hard and soft tissues and provided the patient with immediate aesthetics, function, and comfort.
This document summarizes recent advances in the management of oral and maxillofacial injuries. Key points include:
1) Minimally invasive endoscopic techniques are being used more for fractures of the mandibular condyle, zygomatic complex, orbit, and frontal sinus to limit incisions and improve visualization.
2) Computer-assisted surgery is being used to assist with preoperative planning, intraoperative guidance, and postoperative evaluation for oral and maxillofacial procedures.
3) Advances have been made in the treatment of many specific facial fractures including mandibular, midfacial, orbital, nasal, frontal, and temporomandibular joint fractures through the use of new techniques,
This study compared a supratemporalis approach to the traditional preauricular approach for treating intracapsular condylar fractures. 84 patients were treated with one of the two approaches. The supratemporalis approach provided excellent exposure while preventing facial nerve injury, which has a risk of 1-32% with the preauricular approach. No additional complications occurred with the supratemporalis approach. The authors conclude it is an effective routine approach for intracapsular condylar fractures due to its safety advantages over the traditional method.
Article teixeira effects of micro-osteoperforationCentric Learning
1. The study examined the effect of micro-osteoperforations (MOPs) on the rate of tooth movement in 20 patients undergoing orthodontic treatment.
2. The experimental group received MOPs on one side of the maxilla prior to canine retraction, while the control group did not receive MOPs.
3. MOPs significantly increased the rate of tooth movement by 2.3-fold and increased inflammatory marker levels. Patients did not report significant pain from the procedure.
Emmy Jerotich is a 23-year-old Kenyan citizen currently pursuing a Bachelor of Business Management in Banking and Finance at the University of Kabianga. She has completed Computerized Accounting courses at Destiny College of Accountancy and holds a CPA Part 3 certification. Emmy seeks to utilize her academic qualifications, computer skills, and experience in finance and accounting roles to contribute positively to society.
This document lists 150 students who are leading candidates for the All-American Scholarship Program. It provides information such as their name, location, and the college they attend. The students are ranked based on their total points in the scholarship program.
El documento propone actividades creativas pero no realiza devoluciones individuales de las mismas, lo cual sería útil para los alumnos. Se recomienda que el autor realice devoluciones individuales de las actividades planteadas.
En 3 oraciones o menos:
El documento presenta una bitácora de una alumna sobre las clases de la cátedra de TIC. Describe las actividades realizadas como aprender sobre comunidades virtuales, blogs educativos, y la creación de su propio blog. La alumna expresa que le llamó la atención participar en blogs y apreció que el profesor enseñara de manera didáctica combinando presentaciones, videos e imágenes.
El documento propone actividades creativas pero no realiza devoluciones individuales de las mismas, lo cual sería útil para los alumnos. Se recomienda que el autor realice devoluciones individuales de las actividades planteadas.
Theodelphia Stevens is a female consultant at Standard Bank working in Merchant and Payment Solutions. She has over 10 years of experience in roles related to data capturing, reconciliations, and customer service at Standard Bank. Her duties have included verifying documents, managing accounts, resolving queries, and reconciling various suspense accounts. She is proficient in Microsoft applications and bank systems such as RMS, SAP R3, and BDS.
Dokumen tersebut membahas tentang alat pernapasan pada manusia dan hewan. Pada manusia, alat pernapasannya terdiri atas hidung, tenggorokan, dan paru-paru. Sedangkan pada hewan, alat pernapasannya berbeda-beda sesuai jenisnya, seperti insang pada ikan, permukaan kulit pada cacing tanah, dan paru-paru beserta pundi-pundi hawa pada burung. Dokumen ini juga menjelask
This short document contains 5 photos credited to different photographers and promotes creating presentations on SlideShare using Haiku Deck. It encourages the viewer to get started making their own Haiku Deck presentation by providing the photos as examples and including a call to action to get started on SlideShare.
This Presentation made by Forth Group to fulfill assignment of Construction Method Subject in Department of Civil Engineering, Sebelas Maret University (UNS) Surakarta
This document summarizes a study on using bone grafts and immediate implant placement in areas of high aesthetic value. It describes using block bone grafts taken from the mandible to augment alveolar ridge deficiencies in the maxilla before placing implants. The goals were to assess success rates of implants placed in grafted bone and determine if this technique is suitable for aesthetic areas. The methodology involved using SPI implants and placing immediate provisional restorations on the implants after grafting and implantation to condition the soft tissues during healing. Success was based on radiographic and clinical assessments during outpatient follow-ups.
Alat pencernaan utama manusia terdiri dari mulut, kerongkongan, lambung, usus halus, usus besar, dan anus. Mulut berperan mencerna makanan secara mekanis menggunakan gigi dan lidah, serta secara kimiawi menggunakan enzim ludah. Lambung melanjutkan pencernaan secara kimiawi menggunakan enzim dan asam lambung. Usus halus dan usus besar menyerap nutrisi makanan dan membuang sisa melal
Tons of content is uploaded on social every minute. To gain quick access to content that interests you, it is important to understand the search feature across these popular social media platforms. This presentation aims at giving some insights into the search feature on social media.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...Abu-Hussein Muhamad
Abstract: Severe atrophy of the inferior alveolar process and underlying basal bone often results in problems with a lower denture. These problems include insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. In this case report, patient with resorbed edentulous mandible was successfully rehabilitated using two dental implants placed in the interforaminal region with ball abutments opposing conventional maxillary complete denture. Key Words: dental implants; dental prosthesis, implant-supported; resorption,
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...iosrjce
This document summarizes a case report of a patient with a severely resorbed edentulous mandible who was successfully rehabilitated with two dental implants placed in the interforaminal region with ball attachments supporting an overdenture. After 10 years of follow-up, the patient was highly satisfied with the retention, comfort and function provided by the implant-retained overdenture. The case report also reviews literature on the use of implant-supported overdentures for treating resorbed edentulous ridges, finding they provide better function and retention compared to conventional dentures and reduce further bone loss.
This document describes a study on the socket shield technique for tooth replacement with dental implants. The socket shield technique involves retaining part of the facial root when extracting a tooth and immediately placing a dental implant. The study examined 15 patients treated with this technique between 2011-2018. Volumetric analysis using CT scans found that the socket shield technique helped maintain hard and soft tissue volumes compared to traditional immediate implant placement. The technique is described as an effective way to preserve alveolar bone and provide esthetic outcomes for dental implant treatment.
Immediate implant placement following tooth extraction a case reportAbu-Hussein Muhamad
Immediate dental implants are an attractive option to patients and dentists. This paper report the management of a
fractured right permanent maxillary central incisor with extraction of the root followed by immediate implant placement
with two years follow-up.
Immediate Implants Placed Into Infected Sockets: Clinical Update with 3-Year ...Abu-Hussein Muhamad
Dental implants can be placed immediately into healthy extraction sites with high success and survival rates. It has been suggested, however, that immediate placement of implants into infected extraction sites is contraindicated due to the pathology interfering with osseointegration resulting in decreased implant survival and success With many potential implant sites presenting with a preexisting periapical or periodontal infection, treatment protocols have been advocated for immediate placement of implants in these infected sites. Advancements in surgical techniques and implant surface technology have made immediate placement of implants a more predictable and accepted treatment option; however, there is still debate about whether infected extraction sites should be used for immediate implant treatment approaches. The purpose of this clinical update is to report on the success and survival of implants placed immediately into infected extraction sites.
Modified osteotome sinus floor elevation by using combination PRF membrane, b...Dr. Anuj S Parihar
The osteotome technique is more predictable with simultaneous implant placement when there is less than 5 to 7 mm of pre-existing alveolar bone height beneath sinus. Proper combination of PRF membrane, MFDBA and autogenous bone has been recommended for this situation. The purpose of this article is to describe the proper method and materials which can grow more than 10 mm bone with osteotome technique and grafting materials where the edentulous posterior maxilla radiographically showed less bone between the alveolar crest and sinus floor.
Tooth avulsion, or the complete displacement of a tooth from its socket, is a serious dental injury that can lead to complications if not treated properly. The patient, a 13-year-old girl, had her two front teeth avulsed after a bicycle accident. Her teeth were replanted but later became mobile and were extracted. Dental implants were placed but required soft tissue grafting due to insufficient bone and tissue. Pink porcelain crowns were ultimately used to improve esthetics. Dental hygienists play an important role in educating patients on proper oral hygiene to promote the long-term success of replanted or implanted teeth.
This study analyzed the position and angulation of 300 maxillary central incisors using cone beam imaging to provide data to help clinicians achieve good esthetic results for immediate dental implants. The thickness of buccal and palatal bone and apical bone height were measured. Incisors were classified according to their position (buccal, midline, palatal) and angulation (toward buccal, anterior to A point, parallel to alveolus). Most incisors were positioned buccally. Recommendations for implant placement based on tooth classification aim to maintain adequate buccal bone thickness and prevent complications.
Periodontally Accelerated Osteogenic Orthodontics with Piezoelectric Surgery...Abu-Hussein Muhamad
Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.
Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement
Extraction and Immediate Implant Placement, and Provisionalization with two Y...Abu-Hussein Muhamad
Extraction and Immediate Implant Placement, and Provisionalization with two Years Follow-up: A Case Report. PDF
Abu-Hussein Muhamad, Bajali Musa, Abdulgani Azzaldeen
Zygoma implants provide an alternative treatment for severely resorbed maxillae, avoiding the need for bone grafts. Three clinical cases are described where zygoma implants were used to support fixed prostheses for edentulous maxillae or maxillary defects. For patients with advanced resorption or anatomical constraints, zygoma implants can be placed high in the cheekbone to provide support without additional grafting, though complications like fracture can occasionally occur.
Periodontally Accelerated Osteogenic Orthodontics: A Surgical Technique and C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study aims to prospectively evaluate and compare the socket shield technique versus the conventional technique for immediate dental implants. The socket shield technique involves retaining the buccal root portion after extraction to preserve the buccal bone and soft tissues, while the conventional technique is immediate implant placement after full root extraction. Thirty patients needing a single anterior tooth extraction will be randomly allocated to receive implants with either the socket shield technique or conventional technique. Outcomes of implant survival, marginal bone loss, and esthetics will be clinically and radiographically evaluated.
This study evaluated 14 cases of autogenous maxillary canine transplantation in young patients. Impacted or partially erupted maxillary canines were extracted and immediately transplanted to prepared recipient sites. Two years later, 12 cases showed normal mobility and lamina dura formation on radiographs, indicating successful transplantation. Two cases showed inflammatory resorption, increased mobility, and widening of the periodontal space, indicating unsuccessful transplantation. Autotransplantation of impacted or partially erupted maxillary canines can be a viable alternative to other treatments like orthodontics or dental implants when patient selection criteria are met and proper surgical technique is followed.
1) A 10-year prospective study evaluated 121 oxidized titanium implants in 46 patients. 2) After 10 years, the survival rate was 99.2% with only 1 implant failing. 3) Marginal bone loss averaged 0.7 mm over 10 years, with 11.3% of implants showing over 2 mm of bone loss and 4.7% over 3 mm of bone loss. 4) Implants with over 3 mm bone loss showed bleeding and pus on probing, indicating peri-implantitis.
A technique for immediate occlusal implant loading of a completely edentulo...jackabcdental
This document describes a technique for immediate loading of implants in the completely edentulous mandible using a custom-fabricated interim implant-supported prosthesis. Four implants were placed between the mental foramina and immediately loaded with an interim acrylic resin prosthesis. Transparent surgical guides and templates were used to identify implant positions, which allowed for minimal denture modification and improved structural integrity and esthetics of the interim prosthesis. At 3 months, a definitive implant-supported prosthesis was fabricated. This technique aims to reduce treatment time and postoperative discomfort through immediate loading of implants in the mandible.
Clinical Replacement Therapy and the Immediate Post-extraction Dental ImplantAbu-Hussein Muhamad
Immediate dental implants have greatly reduced the treatment time and the number of surgical intervene tions. Recently it has been noted that this treatment modality can be used in aesthetically demanding cases especially the anterior maxilla. The aim of this article is to describe a clinical case in which a fractured maxillary canine was replaced by an osseointegrated implant using a simplified technique in a patient who was a smoker and presented poor oral hygiene. The technique adopted permits a reduction of the number of implant components and consequently a lower cost of treatment, while at the same time maintaining acceptable aesthetic and functional outcomes.
This document summarizes a study on using bone grafts and immediate implant placement in areas of high aesthetic value. It describes using block bone grafts taken from the mandible to augment alveolar ridge deficiencies in the maxilla before placing implants. The goals were to assess success rates of implants placed in grafted bone and determine if this technique is suitable for aesthetic areas. The protocol involved using SPI implants and placing immediate provisional restorations on the implants after graft integration to condition the soft tissues during healing. The study aims to evaluate if this technique can provide rigid fixation and osseointegration of implants in grafted bone for functional loading.
This document discusses the use of short implants for treating atrophic maxillae. It defines short implants as those less than 7mm in length and notes they offer advantages over traditional longer implants including requiring only a single surgery, shorter recovery time, and lower costs. The document presents two case studies where short implants were successfully used to treat bone resorption in the maxilla, with outcomes comparable to traditional longer implants. It concludes that short implants can yield results similar to conventional implants when the bone bed is properly prepared and splinted implants with canine guidance are used.
Dr. Magda Mensi presents a case study of a 40-year old patient with aggressive periodontitis who received an Alpha-Bio Tec SPI dental implant and aesthetic restoration. The patient's bone height was 4mm below the maxillary sinus floor. Dr. Mensi performed a crestal sinus elevation procedure using autologous CGF and inserted an 8mm implant. A temporary crown was placed and after 15 days, a final ceramic crown was cemented using an aesthetic abutment. A 6-month follow-up x-ray showed good integration of the implant and prosthetic restoration with no crestal bone loss.
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1. Prof. Pavel V. Kuts
Dental Prosthetics Department
O.O. Bogomolets National Medical University, Kiev, Ukraine
(Department Chair – V.P.Nespryad'ko, Professor)
Immediate Dental Implantation
Case Study 27
2. 2
Prof. Pavel V. Kuts
Dental Prosthetics Department
O. O. Bogomolets National Medical University, Kiev, Ukraine
(Department Chair - V.P. Nespryad'ko, Professor)
Overview
Despite the great scientific and practical experience accumulated worldwide
and in Ukraine with regards to the issues pertaining to dental implantology, the
number of studies in the field of immediate implantation remains insufficient, as
there is no universal approach to carrying out surgical operations, time frames
loading time frames, selection of bone substitutes and implants, as well as
variations in temporary and permanent prosthetics.
Relevance
In the last 40-50 years in Ukraine and similarly around the globe, research has
been underway to study the essential scientific and clinical issues in dental
implantation [5, 9, 12]. Advances deployed in fundamental and interdisciplinary
applied sciences, versatile experimental inventions and clinical successes,
have made dental implantation a mandatory technique in daily dental practice.
Today, discussions continue on enhancing the list of dental implant indications,
expanding the use of implants to restore dental arch defects as well as adjusting
surgical and prosthetic protocols and procedures.
One of the developments is replacing the tooth with a dental implant, where by
an implant is inserted into the socket at the time of tooth extraction, referred
to as immediate implantation [1, 7, 8]. The idea of restoring the extraction site
with an artificial tooth inserted into the socket similar to the natural one was
implemented years ago and remains the basis of intraosseous implantation.
The majority of experimental and clinical studies from the middle of the 19th
century until the 1950s were in fact, on immediate implantation (Znamenskiy
N. N., 1891; Vares E. Ya., 1955; Greenfield E.J, 1913; Strock A.E, 1938) [6, 10].
The winner, however, was the concept of surgical implantations into a fully
intact bone tissue of the mandible and maxilla. A full regeneration of bone tissue
within the limits of the extraction socket is possible no earlier than six months
upon the extraction. Most patients receive implants in the site of teeth extracted
1-10 years prior to the procedure [2, 4]. During this time, however, alveolar bone
atrophy inevitable occurs coupled with distortions and deformations in the
3. 3
other elements of the dentoalveolar system, including adjacent and antagonistic teeth, as well as
contralateral teeth, due to overload, periodontal tissues, TMJ, and neuromuscular apparatus, which, in
turn, creates an unfavorable context for dental implantation or even renders it impossible [3, 11].
At this point, the defect could only be managed with conventional prosthetics techniques such as bridges
or removable dentures.
The relevance of immediate dental implantation is evident. This approach is more than just a treatment
modality, as in addition to therapy, it plays a prophylactic role. Implant insertion is performed together
with tooth extraction, merging two surgical procedures into one, which alleviates the psychological stress
for the patient and injury and trauma to the tissues. Further, the time span between tooth loss and its
replacement with a dental restoration becomes shorter, i.e., restoring esthetics and function ensues more
rapidly [1].
Studiesonimmediateimplantationhowever,remaininsufficient,asmostofthemfocusprimarilyonsingle-
rooted teeth, incisors, canines and premolars. This is the result of inevitable challenges related to implant
insertion into post-extraction socket. Firstly, it is difficult to establish congruency of the implant and the
socket, particularly in the presence of alveolar bone defects. Secondly, it is hard to ensure a complete
contactoftheimplantsurfacewiththesiteintheboneandachieveprimarystability.Thirdly, itisimperative
to consider the pathological modification of the bone tissue resulting from chronic inflammation and/or
infection or dental trauma [4, 6, 9].
Thirty five patients, 19 female and 16 male, in overall normal psychosomatic health, participated in the
study. Informed consent was obtained from each patient for the clinical study and further use of its results
in academic work. All patients underwent conventional preoperative clinical and laboratory examination.
Complaints and history were recorded including symptom on set time and causes of the tooth lesion.
General diseases and surgical interventions previously undergone by the patient were recorded, as well as
allergies, bad habits and other circumstances, including diagnosis and correction of emotional responses,
such as asthenic response, anxiety, hypochondriac and hysteric reactions.
Dental status investigation began with the observation of the face appearance and examination of the
oral mucosa, noting its color, wetness, presence of bleeding, epithelial desquamation, ulcers, atrophy and/
or hyperplasia. Periodontal probing was conducted noting any exudation from the pockets, if present.
Presence of plaque and calculus was noted. A special probe was used to determine mucosa thickness
and type, as well as its attachment. Dental exam included diagnosing caries and its complications, non-
carious hard tissue lesions, tooth stability and mutual positioning, as well as occlusion type. Tongue
characterizations, salivary gland function, mouth opening and amount of soft tissue subcutaneous fat
were recorded. Complete oral hygiene and conservative treatments were performed, where the patient
was instructed in oral hygiene.
At treatment planning stage, impressions were taken to cast diagnostic models and conduct their
anthropometric analysis in the articulator, upon which the wax-up of prospective superstructure was
performed (Fig. 1a, 1b). Imaging techniques included panoramic X-ray, computer tomography, and spot
X-ray (Fig. 2a-2d). This enabled evaluation of the mandibular and maxillary topography and anatomy,
determining relative positioning of the mandibular canal and maxillary sinus floor, assess the bone tissue
structure, as well as the status of periapical and marginal bone around intact teeth and teeth requiring
extraction.
Materials and methods
4. 4
Immediate Dental Implantation
Immediate implantation includes the stage of alveolar ridge augmentation with autologous bone or
its synthetic or xenograft substitutes. In this study, bone substitutes produced by Alpha-Bio's GRAFT
(Israel) were used.
The immediate dental implantation surgery was conducted both in the sites of the front and posterior
teeth under local anesthesia with Sol.Septanest 4%. More often, nerve block anesthesia was used with
additional infiltration anesthesia directly at the surgical site. Some patients (with expressed gag reflex,
hypertension or phobia) received intravenous general anesthesia. Amnesia, analgeia and neurovegetative
protection were achieved with the use of the following medicaments: propofol, sibasone, antalgic
substances (pentazocine, nubaine, tramal) (Fig. 3 a-c). The circular ligament was then separated with the
extration performed to preserve interradicular septum, bony walls and the floor of the socket as much as
possible. The emptied alveola was curetted in order to remove all pathological soft tissue growth. A round
drill was used to reduce and perforate the internal cortical plate of the socket to trabecular bone.
The implant site was prepared with Alpha-BioTec's internal irrigation drills at a speed of 400-1000 rpm
under the depth probe and implant pin control, and with continuous cooling with saline NaCl 0.9%.
Implant was inserted, and, in case of soft tissue deficit for would closure, soft tissue augmentation
was conducted with an immediate healing cup placement (Fig. 4a-4d). Post-operatively, patients were
prescribed broad-spectrum antibiotics, hyposensibilization medication and NSAIDs administered orally
or intramuscularly. Antiseptic treatment of the surgical site was performed daily in all patients, with
gentle hygiene recommended.
The second stage of immediate implantation commenced only upon X-ray confirmation of alveolar bone
regeneration and implant osseointegration. With infiltration anesthesia incisions were made in the
mucosa, with oral repositioning; cover screw was removed and healing cup was installed. Two to three
weeks later, impressions were made in conventional tray with alginate putty. Models were cast to create
customized impression trays with transfer openings and residual dentition stoppers (Fig. 5a). Following,
with the help of transfers, anatomical impressions were taken with A-silicone or polyether materials
(Fig. 5b), and fixed temporary and final prosthesis were produced according to the protocol.
Subsequent to examining the clinical picture and X-ray data, the following indications for post-extraction
immediate implantation were determined:
Immediate implantation is performed exclusively upon the completion of bone growth, i.e., not early than
the age of 18 or 20. It is necessary to have a socket with the bone available circumferentially around the
implant inserted in it.
1. Dental trauma (Fig. 6a-6e)
2. Chronic periodontitis with extensive coronal tissue and partial root tissue destruction (Fig. 7)
3. Ineffective conservative treatment of chronic periodontitis
4. Periodontaldisease(IandIIdegree),toothdystopiaandindicationforextractionforprostheticpurposes
5. Deciduous dentition with lysed root without permanent tooth buds (Fig. 8a, b)
5. 5
Osteotomy and Implant Insertion in the Maxilla
Tooth extraction was performed according to the generally accepted rules of dental surgery and with
minimal socket and surrounding bone trauma. Special attention was paid to separating the mucosa off
the neck and root of the tooth. During extraction, a separator was used together with angulated and
straight elevators with thin grips. While working, care was taken to avoid trauma to the bone of the
socket. If the tooth was mobile, it was removed using for ceps, generally universal, with thin grips. It is
not recommended to perform luxating movements, particularly in the buccal direction. Having selected
an implant from among those prepared for the surgery, socket depth was examined and compared
against root measurements and X-ray data in order to establish the potential available bone dimensions
for implant insertion.
Further, the relationship between the prospective element's apical part and the nasal cavity floor,
maxillary sinus, mental foramen and mandibular canal was examined. Drilling was performed with a
pilot implant drill with external irrigation (0.9% isotonic solution of sodium chloride). When the site was
prepared, Alpha-Bio Tec’s SPI implant was inserted. It is imperative to achieve the implant's primary
stabilization in the bone; if found in the socket, cavities were filled with a biomaterial, i.e., either
autologous or artificial bone (Fig. 9a). It is more challenging to create implant site in the canine and
premolar areas. When insufficient bone was available, often on the buccal aspect in the area of central
incisors, the implant site was prepared palatally (Fig. 9b).
If the cortical plate in the area of the maxillary sinus floor was too delicate, the preparation was
performed distal of the top of the cortical bone, while preserving no less than 1-2 mm of bone between
the implant's apex and the adjacent intact tooth. In the case of a double-rooted premolar, it is preferable
to insert the implant into the socket of the buccal root whenever impossible. As long as there is
insufficient distance to the maxillary sinus floor, the palatal root socket was used or a closed (open)
sinus lifting procedure was conducted. The alveola of the second premolar has quite a wide orifice and
a narrow diameter apically. Moreover, it may be oval in the bucco-palatal direction. The implant should
be selected according to the bucco-palatal dimension of the alveola. The distance between the implant
to the buccal root of the first molar and first premolar should be no less than 2 mm.
Osteotomy and Implant Insertion in the Mandible
Implant insertion in the mandible in the incisor and canine area is similar to the procedure in the maxilla
(Fig.10a,b),whereasinthepremolararea,thesurgeryrequiredmeticulousanalysisofthesite'sanatomy,
such as the position of the mental foramen, and shape and position of the mental nerve loop, with the
aid of computer tomography (Fig. 11). This determined the location of the soft tissue incisions and the
shape of the flap raised. With implant insertion in the molar area of the mandible, predictable stability
was possible as long as the roots were not merging and the interradicular septum was wide. To replace
a mandibular molar (first or second), it is desirable to insert two implants in the projection of the medial
and distal roots or with one large diameter implant (5.0-6.0 mm) in the furcation area.
Immediate Implantation: main surgical stages
Bone Wound Care
Curettage was only performed in the case of granulating periodontitis or when locating a granulome or
fibrous thickening at the root apex. Curetting in the socket must becarefully executed. Excess mucosa,
6. 6
as well as tissues modified by the inflammation process and grown into the root cavity, were removed.
When granulation was located on the internal surface of the gingival margin, it was also removed.
The socket was rinsed with chlorehexidine solution, gentamycin or 0.9% saline.
The implant was selected based on the root assessment and root diameter measurement at different
levels. The choice should be based on the following criteria: the implant should be 2-4 mm longer and
1-2 mm winder than the extraction socket (Fig. 12). Ensuring that the soft tissue volume is sufficient for
the wound closure without tension, the final stage of the implantation was completed with the suturing
of the flap. When strong tension was present, a 1 cm long releasing incision was performed near the
transitory fold (mucogingival junction). Mucoperiosteal flap was repositioned and sutured with Catgut
chromic sutures, polyamide thread or thin silk sutures. In the central incisor area 1-2 mattress sutures
were made. Post-operatively, cold (for 2-3 hours) and a pressure dressing (on the surgical site's soft
tissue) were applied. Antibiotic therapy was prescribed on the day of surgery (amoxyclav 375 mg, 1 pill
2-3 times daily; loratadine 0.1 mg, 1 pill once daily), as well as mouth wash with 0.12% chlorehexidine
solution. Patients were asked to take only soft and liquid food during the 7-10 days following the
surgery. Implant position was checked with the X-ray on the day of surgery.
Table 1
Location and indications for extraction and immediate implantation with immediate restoration
4 10 2 16
1 2 1 4
5 4 0 9
0 6 0 6
1 2 0 3
2 6 1 9
1 3 1 5
0 5 0 5
0 8 4 12
1 2 0 3
15 48 9 72
Two months following immediate implantation, 33 patients demonstrated the implants' stability, both
clinically and radiologically, with the absence of inflammatory modifications in the soft tissues. Two
patients had a different outcome: Due to trauma, inflammatory processes developed (on day 10 in
one patient and after 2 months in the second patient) leading to the implants' mobility and extraction.
Further post-operative period for the 33 patients continued without complications.
Results
Immediate Dental Implantation
Endodontic
treatment failure
Tooth
fractureLocation
Maxillary central incisor
Maxillary lateral incisor
Maxillary premolars
Maxillary molars
Maxillary canine
Mandibular central incisor
Mandibular laterla incisor
Mandibular premolars
Mandibular molars
Mandibular canine
Root
resorption Total
Total
7. 7
Implant exposure was performed via an incision above the neck of the implant. The cover screw was then
removed, hygienic treatment was conducted on the internal part of the implant with chlorehexidine
solution or hydrogen peroxide, and healing cup was place to remain fixed for 2-3 weeks. Check-ups
were performed on days 2 and 10 following the exposure. Tissues were treated with disinfecting
solutions, dressings were applied containing metrogyl, sea buckthorn and briar oils, Solcoseryl gel and
conventional periodontal emulsions and ointment, which assisted in anti-inflammatory control and
rapid would healing around healing cups.
All patients were invited for a radiological check-up to examine the implant's position and the condition
of the surrounding bone. The data of spot X-ray filming were analyzed to see the implant position
relative to the bone margin and bone resorption level during the time in function. When the implant was
positioned 2 mm deeper than the socket edge, bone was forming above the cover screw, which created
certain difficulties when installing superstructures (excess bone was reduced with a bur or a drill).
Inserting the implant at the bone margin level created optimal conditions for prosthetic rehabilitation,
with bone resorption during the first year being within normal limits. Filling cavities with biomaterials
resulted in less inflammatory response during the early post-operative period and less bone resorption
at a later stage. Bone resorption during the first year was within 1.0-1.1 mm and increased by 0.1 mm
every year following. The structure of peri-implant bone tissue was denser. The best results were
obtained when combining autologous bone with Alpha-Bio's GRAFT in the 1:1 ratio.
Table 2
Immediate implantation and immediate prosthetic rehabilitation: aggregated probability of success
15 0 100
15 0 100
18 0 100
24 1 96
72 1 98,6
1-12
13-24
25-36
37-60
Total
Follow-up time (mo.) Number of implants Number of failures Success rate (%)
Between 2007 and 2012, 35 patients between the ages of 18 and 65 (mean age = 36.5 yrs.) received
72 Alpha-Bio Tec screw-type implants in the sockets of newly extracted teeth. The patients were
followed up during a five year period. In total, 25 central incisors, 9 lateral incisors, 6 canines, 14
premolars and 18 molars were extracted (see Table 1). Indications for extraction included tooth
fracture (15 cases), endodontic treatment failure (48 cases), and root resorption (9 cases) (see Table
1). Follow-up time varied from 1-60 months. As a result, a 5-year success record of the implantation
has reached 98.6% (see Table 2).
At the time of temporary crowns, four patients developed fistulas at the level of crown-abutment
interface and implant-abutment interface (i.e., between 1-3mm subgingivally). In three patients,
temporary crowns lost cement fixation, with two out of these three patients having repeated crown
adhesion loss. Loosening of the temporary abutment screw was observed twice in two patients. After
permanent crowns were fixed, no further complications were observed.
8. 8
The outcome demonstrates that immediate implantation is an efficient tooth replacement method
when tooth extraction is indicated. Atraumatic surgical intervention, good esthetic results, and the
possibility of using implants of other dimensions in case of initial failure, may all point to that it is
desirable to implement this method in the clinical practice as a factor in dentoalveolar deformation
prevention. The positive results obtained by this study at the success rate of 98.6% make it possible
to recommend immediate implantation with the use of Apha-Bio Tec SPI implants to replace teeth
immediately upon extraction. Clinical selection of patients based on the functional status of health and
immunity, both generally and locally, enables the increased efficiency of the interventions. Clinical,
immunological and radiological follow-up as well as maintaining proper oral hygiene determine the
longevity of the implant functioning as a denture support.
Conclusions
References
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s primeneniem vnutrikostnyh implantatov / Avtoref. dis.kand. med. nauk. – M., 2002. – S. 25.
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Volume 14, #2, 2003.
9. 9
7 8 9
1 Fig. 1a: Wax-up of the future
prosthesis in the articulator.
Fig. 1b: Wax-up of the future
prosthesis in the articulator.
Fig. 2a: Radiological examination
and treatment planning techniques
used in dental implantation.
2 3
4 5 6Fig. 2b: Radiological examination
and treatment planning techniques
used in dental implantation.
Fig. 3b: Oxymeters to monitor
arterial blood pressure, pulse and
oxygen saturation.
Fig. 3a: Electric sensor to monitor
arterial blood pressure, pulse and
oxygen saturation.
Fig. 3c: Oxymeters to monitor
arterial blood pressure, pulse and
oxygen saturation.
Fig. 2c: Radiological examination
and treatment planning techniques
used in dental implantation.
Fig. 2d: Radiological examination
and treatment planning techniques
used in dental implantation.
10. 10
10 11 12
13 14 15
16 17 18
Fig. 4a: Connective tissue grafted
buccally during immediate
implantation in regio 21.
Fig. 4d: Connective tissue grafted
buccally during immediate
implantation in regio 21.
Fig. 5a: Customized tray with
openings for transfers.
Fig. 5b: Implant analogs connected
to transfers in the impression tray.
Fig. 4b: Connective tissue grafted
buccally during immediate
implantation in regio 21.
Fig. 4c: Connective tissue grafted
buccally during immediate
implantation in regio 21.
Fig. 6c: Immediate implantation
following injury to tooth 11,
with maxillary tuberosity graft
transplanted to compensate for
soft tissue deficiency.
Fig. 6b: Immediate implantation
following injury to tooth 11,
with maxillary tuberosity graft
transplanted to compensate for
soft tissue deficiency.
Fig. 6a: Immediate implantation
following injury to tooth 11,
with maxillary tuberosity graft
transplanted to compensate for
soft tissue deficiency.
Immediate Dental Implantation
11. 11
19
25
20
26
26
21
22 23 24
27
25
Fig. 6d: Immediate implantation
following injury to tooth 11,
with maxillary tuberosity graft
transplanted to compensate for
soft tissue deficiency.
Fig. 8a: Congenital agenesis of
permanent teeth is an indication
for dental implantation.
Fig. 8b: Congenital agenesis of
permanent teeth is an indication
for dental implantation.
Fig. 6e: Immediate implantation
following injury to tooth 11,
with maxillary tuberosity graft
transplanted to compensate for
soft tissue deficiency.
Fig. 7: A significant destruction
of the crown of tooth 15 is an
indication for dental implantation.
Fig. 9a: Augmentation during
immediate implantation in regio 21.
Fig. 9b: SPI implant inserted with
a palatal inclination in regio 21.
Fig. 11: CT-scan to examine for the
inferior alveolar nerve position.
Fig. 12: SPI implant, l = 6.0 mm.
Fig. 10a: Immediate implantation in
regio 31, 4: ARRP implants
(Alpha-Bio Tec).
Fig. 10b: Immediate implantation in
regio 31, 4: ARRP implants
(Alpha-Bio Tec).
12. www. alpha-bio.net
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