This document summarizes a clinical case study of immediate implant placement and loading in the esthetic zone. A patient with a fractured maxillary canine was treated with immediate post-extraction implant placement and provisionalization to reduce treatment time and cost. The implant achieved osseointegration and the final restoration demonstrated favorable aesthetic and functional outcomes at 36 months follow up. Key factors for success of immediate loading discussed include primary implant stability, surgical technique, implant dimensions and surface characteristics.
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
differences between natural tooth periodontium and implant bone connection, biomechanics of implants, implant protected occlusion , occlusal principles for single tooth implant prosthetics and implant supported prosthesis on edentulous arch, shortened arch concept, therapeutic occlusion
Implant Loading Protocols Journal Club-Comparative evaluation of the influenc...Partha Sarathi Adhya
This journal club deals with different loading protocols and comparative analysis among them. this basically deals with immediate and delayed loading protocols.
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
differences between natural tooth periodontium and implant bone connection, biomechanics of implants, implant protected occlusion , occlusal principles for single tooth implant prosthetics and implant supported prosthesis on edentulous arch, shortened arch concept, therapeutic occlusion
Implant Loading Protocols Journal Club-Comparative evaluation of the influenc...Partha Sarathi Adhya
This journal club deals with different loading protocols and comparative analysis among them. this basically deals with immediate and delayed loading protocols.
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
Bone replacement grafts are widely used to promote
bone formation and periodontal regeneration.
Xenografts are grafts shared between different species.
Currently, there are two available sources of xenografts
used as bone replacement grafts in periodontics: bovine
bone and natural coral.
This seminar deals with implant-related complications that lead to implant failure.this also discus diagnostic criteria and preventive methods for an implant failure.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
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.
Bone replacement grafts are widely used to promote
bone formation and periodontal regeneration.
Xenografts are grafts shared between different species.
Currently, there are two available sources of xenografts
used as bone replacement grafts in periodontics: bovine
bone and natural coral.
This seminar deals with implant-related complications that lead to implant failure.this also discus diagnostic criteria and preventive methods for an implant failure.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
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.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Esthetic considerations in implant placement Esthetic considerations in implant placementEsthetic considerations in implant placementEsthetic considerations in implant placementEsthetic considerations in implant placementEsthetic considerations in implant placementEsthetic considerations in implant placementEsthetic considerations in implant placementEsthetic considerations in implant placement
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.
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Overdentures can be either tooth or implant supported. Completely edentulous patients whose economic condition Thwarts them to invest in the expensive implant (number based) treatments should be motivated to have at least a two implant-supported overdenture since the prosthesis offers most of the advantages of conventional tooth-supported overdenture. We report a case of an elderly female patient who was reluctant toward surgery, but with moderate education was treated successfully with a two staged, two implant-supported overdenture using a ball abutment with o ring attachment.
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
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.
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case P...Shilpa Shiv
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case Presentations of a Novel Approach to Immediate Implant Placement at Multirooted Molar Sites, IJPRD 2013.
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,
Minimally Invasive Extraction and Immediate Implant Placement with Single-Sta...Abu-Hussein Muhamad
This case report describes extraction of a fractured left maxillary lateral incisor tooth, followed by immediate placement of a dental implant in the prepared socket and temporization by a bonded restoration. Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted. An impression was made 4 months after implant insertion, and a definitive restoration was placed. Results: The atraumatic operating technique and the immediate insertion of the Implant resulted in the preservation of the hard and soft tissues at the extraction site. The patient exhibited no clinical or radiologic complications through 12 months of clinical monitoring after loading. Conclusion: The dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues.
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.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...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.
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
canine to the lateral incisor site and single tooth implants represent the available treatment modalities to replace congenitally missing teeth. This case report
demonstrates the team approach in prosthetic and surgical considerations and techniques for managing the lack of lateral incisors. The aims of this case
report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations.
Impacted Maxillary Central Incisors: Surgical Exposure and Orthodontic Treat...Abu-Hussein Muhamad
The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent
central incisor has multiple etiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally,
the earlier treatment is provided, the higher the likelihood of success and the less the complexity. Our results suggest that close monitoring and interdisciplinary
cooperation during the treatment phases led to a successful esthetic result, with good periodontal health and functional occlusion.
Excess of space in the dental arch is diagnosed as a
generalised spacing or a local divergence, often
observed in the maxillary anterior region, as a median
diastema, traumatic loss of central incisors, or
congenital absence of lateral incisors. Furthermore,
spacing is observed in aging individuals, due to
pathological migration of teeth caused by
periodontitis. Finally, adult individuals with partial
edentulous jaws demand pre-prosthetic orthodontic
treatment from functional aspects. Thus, indication for
orthodontic treatment in subjects with spacing of teeth
exists for aesthetic reasons, but also for facilitating
prosthetic restorations with optimal occlusalstability.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting
cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically
induced failures, since low primary implant stability, low bone density, short implants and overload have been
identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a
successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations
Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
The multifactorial factors influenc cleft Lip-literature review Abu-Hussein Muhamad
Congenital cleft-Lip and cleft palate have been the subject of many genetic
studies, but until recently there has been no consensus as to their modes of
inheritance. In fact, claims have been made for just about every genetic
mechanism one can think of. Recently, however, evidence has been
accumulating that favors a multifactorial basis for these malformations. The
purpose of the present paper is to present the etiology of cleft lip and cleft palate
both the genetic and the environmental factors. It is suggested that the genetic
basis for diverse kinds of common or uncommon congenital malformations may
very well be homogeneous, whilst, at the same, the environmental basis is
heterogeneous.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically induced failures, since low primary implant stability, low bone density, short implants and overload have been identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
Immediate Restoration of Single Implants Replacing Lateral Incisor Compromis...Abu-Hussein Muhamad
Today, the diagnosis of internal root resorption is significantly improved by the three-dimensional imaging. Furthermore, the CBCT’s superior diagnosis accuracy resulted in an improved management of the resorptive defects and a better outcome of Implant therapy of teeth with internal resorption.Implant has become a wide option to maintain periodontal architecture. Diagnosis and treatment planning is the key factors in achieving the successful outcomes after placing and restoring implants placed immediately after tooth extraction. The purpose of this clinical update is to report on the success and survival of Immediate restoration of single implants replacing right lateral incisor compromised by internal resorption.
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber
with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and
requires special handling because of the proximity and apical displacement of the roots. The present article describes the
diagnosis and management of hypertaurodontism by endodontic treatment in a left mandibular second molar.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Immediate Implant Placement and Loading in Esthetic Zone
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 1 Ver. I (Jan. 2016), PP 00-00
www.iosrjournals.org
DOI: 10.9790/0853-151XXXXX www.iosrjournals.org 1 | Page
Immediate Implant Placement and Loading in Esthetic Zone
Abu-Hussein Muhamad1
, Chlorokostas Georges 2
, Abusalih Ahmet3
, Ismail
Hakki Bayraktar4
, Abdulgani Azzaldeen5
1, 2,3,4,5
Al-Quds University, Faculty of Dentistry,Jerusalem,Palestine
Abstract: Immediate implant placement has been the acceptable procedure for the past two decades. Perhaps
the most important aspect of any implant surgery in accordance with the successful procedure is implant
surgery and bone to implant contact.The aim of this article is to describe a clinical case in which a fractured
maxillary canine was replaced by an immediately loaded postextraction implant using a simplified technique,
which 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.
Key words: Immediate implant placement, Immediate loading, Immediate provisionalisation, Esthetics
I. Introduction
Immediate implant loading can be briefly defined as the loading of a dental implant immediately or few
hours after being placed. Misch and coworkers defined as immediate occlusal loading within two weeks of
implant insertion. Wang et al defined Immediate implant loading as an implant-based surgical technique in
which the “implant supported restoration is placed into occlusal loading within at least 48 hours after implant
placement.” On basis of the consensus obtained from International Congress of Oral Implantologists meeting at
Naples (Italy) in May 2006. The terms „non-functional immediate loading‟ and „immediate restoration‟ are used
when a prostheses is fixed to the implants within 72 hrs without achieving full occlusal contact with the
opposing dentition.[1]
Several investigators have suggested the loading of implants at different intervals of time. Mish et al
(2004) has classified the implant loading as - immediate occlusal loading, early occlusal loading, non- functional
immediate restoration, non- functional early restoration and delayed occlusal loading. Immediate D direct
loading: the provisional D definitive prosthetic construction is attached to the implant within 24 hours of the
implant being placed. Whereas Early loading D Early functional loading: the provisional D definitive prosthetic
construction is attached to the implant within days D weeks of the implant being placed.[2]
Planning an implant treatment for a hopeless tooth starts prior to the extraction. The timing and
technique of extraction and the timing of implant placement all play an important role in treatment outcome.3
With immediate implant placement becoming increasingly predictable as the parameters for successful
treatment outcome with considerably reduced treatment time and increased patient compliance.[3]
Implant immediate loading includes all of the advantages of a one stage surgical approach. Also, during
the osseointegration process, the patient does not have to use a removable denture, which increases function,
speech, stability, comfort and improves certain psychological factors [1,4]. Splinted implants can decrease the
risk of overload to each implant because of the greater surface area and improved biomechanical distribution.[4]
Table.1; Immediate implant placement
The concept of an immediate restoration includes a nonsubmerged first stage surgery and also implies
that the occlusal surfaces and implants are loaded with a provisional of definitive restoration [ 5,6]. A delayed or
staged loading refers to an implant prosthesis with occlusal load after more than 3 months (mandible) or 6
2. Immediate Implant Placement And Loading In Esthetic Zone
DOI: 10.9790/0853-151XXXXX www.iosrjournals.org 2 | Page
months (maxilla) post-implant insertion. Using a delayed approach allows you to use a 2 stage surgical
procedure that covers implants with tissue or one stage approach that exposes a portion of the implant at the
initial surgery.[7]
Table.2; Option I
Recently, single-stage, immediate loading of implants are done using flapless surgery. Single-stage
protocol involves either one-piece implant, consisting of implant and abutment manufactured as one-piece or
placement of two-piece implant system in one surgical procedure. Planning for immediate loading of dental
implants is facilitated by advanced imaging techniques. These techniques allow for selection of implant sites
that have the highest Hounsfield values, which correlate with denser bone[8,9] . In the flapless surgical
procedure, a round tissue punch is used to remove the soft tissue on the crestal bone at the implant site, or the
osteotomy is directly initiated through the soft tissue. Primarily two different options are available for
immediate occlusal loading: First option loads the implants the same day as the surgery; Second option is to
place the implant and make an impression at surgery and 7 to 12 days later, deliver
the transitional prosthesis.[9]
Option I: On the day of surgery, the implant is inserted into the pre established positions. After implant
insertion the final abutment is placed and tightened. Final abutments are prepared intraorally for parallelism and
proper height requirements. The transitional prosthesis relined with light cured composite to eliminate toxic
contact of monomer with the bone. The transitional prosthesis is evaluated for harmonious occlusal contact in
centric occlusion.
Option II: Implant positioning during surgery are same as in option I. However, in option II an impression with
additional silicone impression of implant body position is recorded. After the impression, the abutments are
removed from the implant body and replaced with permucosal extension. The laboratory inserts the implant
body analogs connected to the abutment into the impression, pours the impression with die stone and mounts the
cast to the opposing arch. The laboratory selects and prepares the abutment for restoration and fabricates a
transitional prosthesis. After 7-14 days of surgery, per mucosal extensions are replaced with the selected and
prepared abutments the transitional prosthesis is also cemented.
Table.2; Option II
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The aim of this article is to describe a clinical case in which a fractured maxillary canine was replaced
by an immediately loaded postextraction implant using a simplified technique, which 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.
Case Report
A 54-year-old male patient with a number of contraindications to treatment, such as smoking and
chronic periodontitis, was referred to our pivate dental clinic with a non-restorable left maxillary canine to be
removed due to a crown fracture. The patient expressed his desire to have a rehabilitation that could offer a
satisfactory aesthetic outcome at a lower cost. Treatment options were reviewed, and informed consent was
obtained. Based on the patient‟s express desire to reduce the treatment time, we decided to perform a
postextraction implant placement with immediate provisionalization since his clinical and radiographic
examinations revealed ideal hard and soft tissue contours for this procedure. A preliminary impression of the
maxillary arch was made with alginate , a diagnostic waxing was prepared on the maxillary cast, and a
provisional crown was fabricated for immediate provisionalisation of the implant. [Fig. 1]
Before starting the surgical procedure, in order to permit the growth of soft tissue above the root, soft tissue was
abraded and the residual crown was smoothed and cut down with a rosette bur. This provided more voluminous
gingival tissue, making it possible to create a correct appearance profile on the part of the gingival architecture.
Fig. 1; Preoperative oral
On the day of surgery the patient received 2 g of amoxicillin 1 hour before surgery, chlorhexidine and 1
g of amoxicillin 6 hours after surgery to reduce the risk of infection. Local anaesthetic was injected into the oral
mucosa and palatally . An atraumatic extraction was performed without flap elevation to preserve the integrity
of the interproximal papillae and remaining buccal and lingual bone plates. The tooth was carefully extracted
using a luxator and forceps, the extraction being accomplished with light twisting movements to avoid breaking
the bony margins of the alveolus. The extraction socket was debrided using a manual instrument and was
irrigated with sterile saline. The alveolus showed the absence of fenestrations or dehiscences of the bone walls
and a ≤ 2 mm residual gap between the implant surface and surrounding bone walls. The implant site was
prepared at the bottom of the socket according to standard procedures.A conical implant with an MP-1
hydroxyapatite surface was placed completely within the confines of the socket using the sterile surgical
technique prescribed by the manufacturer . Evaluating the three dimensions, the implant was guided by the
provisional restoration using a surgical template to achieve the optimal prosthetic position. The implant shoulder
was positioned 1.5-2 mm from the adjacent teeth, 3 mm apical to the anticipated gingival margin, and 1 mm
apical to the height of the most coronal wall of the alveolus. After placement of the implant a marginal defect
area surrounding the implant was identified, measured as a distance of 1.5 mm mid-buccally and 1.2 mm mid-
palatally.In order to obtain bone regeneration and bone integration in the circumferential defect area, autologous
bone obtained during implant site preparation was lightly packed into the alveolus and then compressed and
condensed by the implant placement; the residual gap was filled with a gelatin sponge . The implant was
inserted with a torque of 35 Ncm to obtain optimal primary stability. After insertion the implant was first
unscrewed and later screwed to control the torque between 35 and 50 Ncm and to permit appropriate passivity
of the implant ithe prepared site . [Fig. 2,3 ]
A mount was prepared and refined to create an abutment, which was positioned on the implant. A
provisional composite resin crown was then positioned on the abutment previously created with assessment of
adjacent tooth reference points (occlusal stops) and was fixed in the correct position, filling the gap between the
provisional crown and the abutment with flowable composite resin . In this way the provisional crown and the
abutment were united to form a single structure. This was subsequently removed from the implant to eliminate
the occlusal stops and refine and contour the surface profile so as to achieve proper adaptation of the gingival
soft tissue. The occlusion was adjusted to clear all contacts in maximum intercuspation and in lateral and
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protrusive excursions: any occlusal contacts during centric and eccentric movements on the provisional
restoration were eliminated. The screw-retained structure was connected to the implant to allow maturation and
integration of the peri-implant soft tissues and to facilitate osseointegration. [Fig. 4]
Fig. 2; Implant with healing abutment and suture around implant
The patient was instructed to consume a soft diet and to avoid placing food in the surgical area during
the first 6 weeks and was instructed to rinse twice daily with 0.2% chlorhexidinedigluconate and avoid
brushing the surgical site for the first 2 weeks. He was also given amoxicillin 1 g every 8 hours for one week
and non-steroidal-anti-inflammatory drugs for 5 days.
Five weeks after surgery the soft tissues showed a favorable healing pattern with no inflammation, no
recession, and preservation of the interdental papillae . A definitive abutment was prepared from the mount and
refined, and a definitive metal-ceramic crown was created for aesthetic finalisation. The definitive abutment was
positioned and screwed to the implant, and the definitive crown was positioned and cemented onto the
abutment.The morphology of the occlusal surfaces was similar to that of natural teeth with occlusal contacts in
maximum intercuspation and cusp inclination, and with functional contacts during lateral and protrusive
excursions. The definitive restoration was placed seven weeks after implant placement. [Fig. 5]
Fig. 3; Provisional prosthesis cemented with flowable composite resin
When monitored at three months and one year, the hard tissues also showed a favourable healing
pattern with no radiolucency around the implant and no resorption of the alveolar ridge. Post-surgical follow-up
visits and professional oral hygiene were carried out at months 1, 3, 6, 12, 18, and 24 after the surgical
procedure. At each follow-up visit a clinical evaluation was performed, and an intraoral radiograph was obtained
using a customised right-angle holder. At month 36, the clinical and radiographic parameters were optimal: the
interproximal papilla and gingival buccal margin levels remained stable, and the interproximal bone level also
showed no change over this period of time. [Fig.6 ]
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Fig. 4; Soft tissue after five weeks and definitive abutment.
II. Discussion
Immediate implant placement, in which the clinician places the implant immediately following
extraction, can be chosen if the periodontium is intact. This approach offers the advantages of decreased
treatment time and morbidity, while exhibiting success rates similar to those of the traditional approach [11,12].
Additionally, it also offers the option of immediate provisionalization and enhanced esthetic outcomes.
Fig. 5; Postoperative oral condition: it is noticeable the definitive left maxillary canine.
An immediate implant placement and provisionalization approach has been increasingly adopted by
clinicians because the technique seems to predictably improve esthetic outcomes. Favorable results were
originally reported over a decade ago [12, 13]. However, subsequent publications reported recession and loss of
labial crest height [14]. Although buccal implant placement was the main cause of recession in many instances,
biotype and factors affecting crestal bone maintenance may also play a role. A more recent animal study
demonstrated that the labial plate is maintained when implants are placed in a lingual position [15].
Fig. 6 ; Final radiograph obtained at 36months after implant placement
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Immediate loading can be attempted in the edentulous mandible and maxilla, single tooth/ multiple teeth
situations in extraction sockets. Immediate loading in the edentulous mandible is the most common indication
for immediate loading. In single tooth implant cases, immediate restoration with or without occlusal contact
have been advocated according to some studies.
Factors Affecting the Success of Immediate Implant Loading
a.Surgical factors
A.a-Primary implant stability: It is evident in the literature that stability seems to be the most important factor
for immediate implant loading. If an implant is placed in the soft spongy bone poor initial stability, it usually
results in the formation of connective tissue encapsulation, similar to the pseudoarthrosis observed in an
unstabilized fracture site. Micro movements of more than 100 mm are sufficient to jeopardize healing with
direct BIC (16). This observation was also reported by Szmukler-Moncler et al. and Jo et al. supported the fact
that the main factor influencing the success of immediate loading is the primary stability of the implants at the
time of the loading ( 17,18).
A.b-Surgical technique: Gentle surgical placement is also a key element for implant success regardless of the
applied treatment protocol. Excessive surgical trauma and thermal injury may lead to osteonecrosis and result
in fibrous encapsulation of the implant ( ). Heat generated during drilling without adequate
cooling is associated with bone damage ( 19,20).
b.Implant factors
B.a-Dimensions of the implant: The implant length may also influence the outcome of immediate implant
loading. For every 3mm increase in length of a cylinder-shaped implant, the surface area increases by an
average mof 20–30%. The majority of studies have suggested that implants should be 10mm long to ensure high
success rates. Therefore, the critical length and diameter of immediately loaded implants remains to be
determined. surfaces render a significant increase of BIC. The shear strength of implants with a rough surface
was shown to be about 5 times as high as that of implants with a smooth surface. In addition, greater forces are
required to remove implants with a rougher surface compared to implants with a smoother surface. Rough
implant surfaces render a significant increase of BIC (21). In addition, greater forces are required to remove
implants with a rougher surface compared to implants with a smoother surface (2 2). Future studies should still
be conducted in regions with softer bone to evaluate if implant surfaces play a relevant role in immediate
implant loading success.
b.b-Designs/Configurations: Implant configuration has been considered as an essential requirement for implant
success. The screw implant design develops higher mechanical retention as well as greater ability to transfer
compressive forces. The screw design not only minimizes micro motion of the implant but also improves the
initial stability, the principal requirement for immediate loading success. Use of threaded implants results in
high percentage of the implants in contact with bone cortex. Threaded implants show a greater functional area
effecting a better stress distribution at the implant bone interface. As a general concept, the screw implant design
develops higher mechanical retention as well as greater ability to transfer compressive forces.
b.c-Surface Textures: Rough implant surfaces render a significant increase of BIC. The shear strength of
implants with a rough surface was shown to be about 5 times as high as that of implants with a smooth surface.
In addition, greater forces are required to remove implants with a rougher surface compared to implants with a
smoother surface. Rough implant surfaces render a significant increase of BIC (21). In addition, greater forces
are required to remove implants with a rougher surface compared to implants with a smoother surface (22).
Future studies should still be conducted in regions with softer bone to evaluate if implant surfaces play a
relevant role in immediate implant loading success.
c.Occlusal Factors
The occlusal scheme may be another key factor for a successful outcome with immediately loaded
implants Basic principles of implant occlusion may include bilateral stability in centric (habitual) occlusion,
evenly distributed occlusal contacts and force. There should be no interferences between retruded position and
centric Position and smooth, even, lateral excursive movements.
d.Host Factors
d.a.Wound Healing: Metabolic diseases that directly affect bone metabolism may significantly influence
implant wound healing. In fact, some data have demonstrated that early load increased BIC and allowed a faster
remodeling process when compared to unloaded controls (23). This concept of the mechanical stimulation of
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bone around implants was also evaluated and confirmed by Rubin and McLeod (24). It can be speculated that
immediate loading of dental implants may accelerate bone formation, but primary stability is essential for this
process to occur.
d.B.Quality And Quantity Of Cortical And Trabecular Bone: In most of the studies on immediate loading,
good bone quality has been mentioned as an important prognostic factor for the success of the procedure. The
prime factor that determines the success of immediate loading is the quality of the bone, the suggested best type
being type II. Host bone density plays an important role in determining the predictability of the immediate
implant loading success. An implant placed in compact dense bone is more likely to ensure initial stability and
thus, better will be able to sustain such immediate forces. This clinical case shows that an immediate implant
restoration placed in a postextraction site can constitute a safe and successful treatment procedure. Several
authors have shown that immediately loaded postextraction implants have a survival rate of 94.5-100% after
twelve months of follow-up. Correct clinical, prosthetic and surgical management of endosseous implants
replacing missing teeth in the anterior maxilla enables the dental surgeon to achieve predictable aesthetic
outcomes. The immediate placement in postextraction sites is a surgical option capable of ensuring ideal peri-
implant tissue healing, while at the same time preserving the pre-surgical gingiva and bone [ 24,25]. To achieve
prosthetic success, it is essential to understand the patient‟s expectations and desires, paying particular attention
to his or her psychological and socio-economic status, as well as to his or her oral condition [ 26]. The
prosthesis should integrate itself from the biological, functional and aesthetic points of view [ 27]. Some patients
seek a rehabilitation capable of yielding the best aesthetic outcome possible despite the cost, whereas others
request a rehabilitation capable of affording a satisfactory aesthetic result at a lower cost [ 28]. In cases such as
the one reported here, we propose a simplified technique, which makes it possible to reduce the number of
implant components and materials involved, and consequently to reduce the cost of treatment, while maintaining
acceptable aesthetic and functional outcomes.
The technique described in this report is characterised by the immediate loading of a conical implant in
a postextraction site, with no flap elevation, filling the socket not with heterologous bone but with a fibrin
sponge, the use of a mount as transfer and abutment, and finalisation with a metal-ceramic crown.[11,12,13,14]
The advantages of placing implants in fresh extraction sockets and putting them in immediate/early function are
many. A predictable protocol affords the possibility of performing a single surgical procedure, giving the patient
a temporary prosthesis immediately, and minimising the shrinkage of hard tissue and soft tissue recession [
11,12]. There is a risk of mucosal recession and adverse soft tissue aesthetics with immediate implant
placement. However, this risk may be reduced by avoiding a buccal position of the implant in the extraction
socket [13,14,15 ].
Immediate provisionalisation of dental implants enables the patient to avoid the physical discomfort of
wearing a removable interim prosthesis or the psychological trauma of a compromised smile [ 29]. The
provisionalisation makes it possible to condition implant soft tissues in order to preserve the interproximal
papillae and restore a curved/rounded appearance of the gingival margin; it also permits immediate healing of
the soft tissue with the formation of an adequate mucosal seal [11,12]. For a predictable aesthetic result, an
important aspect seems to be the height and thickness of the buccal bone wall, which remains after immediate
placement of the fixture [ 11]. The immediate replacement of the missing root with a postextraction implant
avoids the loss of bone in height and width [ 12].
A number of studies indicate that there is no evidence of different responses and behavior of the peri-
implant marginal bone and soft tissue when titanium or gold-alloy abutments are used in conjunction with
cemented single-tooth implant restorations [.29,30].
The choice of a metal-ceramic crown was based on the patient‟s limited economic resources as well as
on his limited aesthetic requirements as a result of his poor general oral condition . It was, however, possible to
obtain a prosthesis integrated aesthetically and biologically with the remaining denture. The prosthesis presents
a natural appearance without dark or opaque gingival margins due to metal prosthetic margins covered by
gingival tissue[29].
The case presented consisted of a maxillary canine extraction and immediate non-functional implant
loading.This approach preserved both soft and hard tissues, and created a harmonious relationship among the
implant, the restoration and the surrounding tissues. What should be emphasized is the necessity of the
appropriate case evaluation and selection as well as the careful treatment planning.These parameters along with
patient‟s compliance are of utmost importance for a successful outcome.Implant overloading attributes to
clinical complications such as screw loosening, screw fractures, fractures of veneering materials, prosthesis
fractures, continuing marginal bone loss below the first thread along the implant, implant fractures, and implant
loss. These complications can be prevented by application of sound biomechanical principles such as passive fit
of the prosthesis, narrowing the buccolingual/ mesio-distal width of implant prosthesis, reducing cantilever
length, maintaining implant load within the physiological limits of individualized occlusion. For accomplishing
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these objectives, improved force direction, increased support area and reduced force magnification are
indispensable.[29]
III. Conclusion
Immediate implants are increasingly predictable and are described in this case report with all
parameters being favorable to success and can provide esthetically superior results. Immediate loading protocol
can be successful in judiciously selected cases where in high implant stability has been achieved in good bone
volume quality.
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