The World's Longest Functioning Implant: A Verified Case Report.

Satisfactory function, esthetics, and phonetics together with long-term stability and minimal complications are all considered as metrics that define a successful outcome. The current case report is documentation of a mandibular subperiosteal implant with a successful follow-up of 56 years. Numerous issues can be credited for the long-term successful outcome including selection of the patient, heedfulness of basic anatomic and physiologic principles, design of the implant and superstructure, surgical execution, application of sound restorative principles, conscientious hygiene, and clockwork recare. The case demonstrates intense cooperation and coordination among the surgeon, restorative dentist, and laboratory technical staff, together with long-lasting patient compliance. Execution of the treatment with a mandibular subperiosteal implant helped this patient overcome the status of a dental cripple. The highlight of the case is that it is the longest success ever documented in the history of any type of implant treatment.

The Mandibular Canal: A Study to Determine If Cortical Bone Exists as a Protective Roof for the Inferior Alveolar Nerve.

Placement of dental implants has many inherent risks, of which all clinicians must be aware. One of the most important concepts in dental implantology is avoidance of the vital structures present in the human jaws, which can have both immediate as well as long-standing implications. The inferior alveolar nerve (IAN) is one of these vital structures located in the posterior body of the mandible. Invasion of this sensory nerve with a dental implant can result in transient or permanent paresthesia, anesthesia, or dysesthesia. Radiographic imaging is done routinely order to assess the bone volume prior to implant surgery and plan for a safety zone above the IAN. The IAN is contained within the mandibular canal, and this structure is usually visualized during cone-beam computerized tomography (CBCT) scans. The mandibular canal, as it is viewed on CBCT, appears to have a cortical layer of bone protecting the IAN, and clinicians often discuss a bony layer of protection that can be felt by the clinician during osteotomy preparation. The purpose of this research project was to ascertain whether the mandibular canal has continuous or partial remnants of cortical bone lining the roof of the canal or whether the IAN simply travels through spongy, cancellous bone with no cortical bony protection.

Frictional wear of stud implant overdenture abutments after 2 years of in vitro simulated function.

Progressive wear of the components of an implant-supported overdenture can lead to loss of denture retention, which affects masticatory function and the patient's quality of life. The primary objective of this in vitro study was to investigate frictional wear in a type of commonly used abutment and thereby estimate the general clinical lifespan of a typical stud abutment and establish a protocol for replacement. Therefore, simulated overdenture insertions and removals equivalent to 2 years of overdenture use were performed to evaluate surface changes in the metal stud abutment component. A digital caliper, scanning electron micrographs taken at ×500 magnification, and profilometer data were used to determine the wear rate and surface roughness. A universal testing machine was used to measure retention load force with 4 clear male nylon inserts (5.0-lb retention) during 2160 insertion and removal cycles. The results showed that with a 6-month replacement program for clear male nylon inserts, the frictional wear on the titanium nitride coating of abutments placed at a 0° position resulted in a decrease of up to 50% in removal forces of the inserts after a simulated 2 years of wear. The combination of wear of the titanium nitride coating and the decrease in retention load values suggests that stud abutments should be replaced after 2 years of use for optimal retention.

Implant Rehabilitation After a Partial Resection of the Mandible Resulting from Submandibular Gland Malignancy-A Case Report.

Adenoid cystic carcinoma of the submandibular gland is a relatively rare malignancy of the oral and maxillofacial region. It is an insidious disease characterized by regional spread, perineural invasion, and potential distant metastases. Because of the aggressive nature of this lesion, it is often impossible to completely excise the tumor, necessitating combination therapy of surgery and radiation. The consequences of surgical ablation coupled with radiation treatment can result in complex considerations in the dental care of these patients. This case report outlines a patient who has recovered from multiple surgeries and radiation therapy, requiring mandibular dental implant reconstruction for a return to normal comfort and function.

Management of Biotechnical Complications Associated with a Full-Arch Implant Restoration Using Digital and Conventional Workflows: A Clinical Report.

Full-arch implant-supported restorations using a metal-acrylic resin design have had a high success rate but are also associated with frequent technical complications including framework misfit due to casting errors, debonding of denture teeth, and fracture of the acrylic from the metal framework. This clinical report describes a case of maxillary and mandibular full-arch implant-supported rehabilitation associated with technical and biological complications and use of digital technology for fabricating monolithic restorations. The use of a bio-functional try-in and its subsequent use as a conversion prosthesis for fabricating a master cast is described. The use of the patient's existing metal bar to fabricate a retread type prosthesis is also described along with using digital technology for fabricating a new metal bar and a monolithic type of restoration. The integration of digital and conventional workflows to obtain an increased level of accuracy and simplicity is also discussed.

Rehabilitation of the edentulous maxilla complicated by combination syndrome with an implant overdenture: a case report.

The treatment of the edentulous jaws with complete dentures is determined individually and often is unpredictable. Implant-assisted overdentures are a significant improvement over conventional complete dentures in terms of patient comfort and function. Combination syndrome refers to a dramatic exaggeration of maxillary alveolar resorption leading to a more complicated rehabilitation. This article reviews how the edentulous maxilla can be rehabilitated with an implant-assisted overdenture. A case report is presented which utilizes a computer-aided design/computer-aided manufactured milled titanium connecting bar to retain a chrome-cobalt based, precision attachment, palateless prosthesis.

The use of root form implants in overdenture treatment for the atrophic mandible: a clinical report.

Four short root form implants were inserted in an atrophic mandible and the case restored with a lower connecting bar and an overdenture, opposing a complete maxillary denture. Root form implants were selected, as opposed to a subperiosteal implant in this case. The patient had a favorable medical history, appeared healthy, did not smoke, drink, or do illicit drugs, and had good bone quality.

Metal bases for implant overdentures.

Reinforcement of implant overdenture bases with chromium alloys offers a number of advantages that offset the initial greater cost. These bases offer increased strength, the ability to detect thermal changes, and the option for use when space is at a minimum. Both acrylic resin and chromium alloy have long (approximately 80 years), successful histories as accepted dental materials. Low-heat (nickel) or high-heat (cobalt) chromium alloys can be used with equal success.

Using CAD-CAM technology for the full-mouth, fixed, retrievable implant restoration: a clinical report.

Computer-assisted design (CAD) and computer-assisted manufacture (CAM) are technologic advancements used in dentistry today. These technologies have been developed to fabricate a complete arch substructure from a solid piece of titanium for a fixed, screw-retained implant-supported prosthesis. This clinical report demonstrates a treatment approach which uses CAD-CAM technology to incorporate a milled, titanium framework with retrievable metal ceramic crowns.

An in vitro analysis of implant screw torque loss with external hex and internal connection implant systems.

PURPOSE: The purpose of this study was to examine, in a controlled environment, effects of connection design upon screw stability. Implant fixtures have 2 types of connections to the abutment: internal connection and external hex. Four implant systems were tested: Bio-Lok (external hex; Bio-Lok International, Inc., Deerfield Beach, FL); Zimmer (internal connection; Zimmer Dental, Carlsbad, CA); Nobel Biocare (external hex; Nobel Biocare USA, Inc., Yorba Linda, CA); and Astra Tech (internal connection; Astra Tech Inc., Waltham, MA). MATERIALS AND METHODS: Ten samples of each system, including base, implant, abutment, and molar crown, were loaded to 200 N for 1 x 10(6) cycles. Screws were tightened to manufacturers' recommendations,and torque audits done at 2.5 x 10(5), 5 x 10(5), 7.5 x 10(5), and 1 x 10(6) cycles. RESULTS: The Bio-Lok samples lost an average of 10% of the original torque values, the Astra Tech group lost almost all of the torque and loosened, while the Zimmer and Nobel Biocare samples lost an average of 50% of the torque but did not loosen (P

Tooth position in full-mouth implant restorations--a case report.

Reconstructing the edentulous mouth with opposing, fixed, implant-supported metal-ceramic restorations demands great attention to detail. This article reviews the basic principles of tooth position in dentate patients and in complete denture prosthodontics and relates them to the edentulous patient undergoing implant restoration. Determining gnathologic points and recognizing anatomic landmarks found in the edentulous jaws aid in correct tooth positioning, resulting in proper comfort, function, speech, esthetics, and a prearranged occlusal scheme, all of which are critical factors behind restorative-driven implant dentistry.

An overview of the O-ring implant overdenture attachment: clinical reports.

The O-ring is used to increase retention of implant complete and partial overdenture prostheses. They possess a number of advantages, including ease of use and maintenance, low cost, and possible elimination of a superstructure bar. O-rings wear over time, gradually lose retention, and must be replaced periodically. It is essential that O-ring abutments be parallel to each other. Two cases are presented showing the use of O-rings with a complete mandibular implant overdenture and a maxillary removable partial denture.