Survival Rate of Ultrawide Diameter Implants Placed into Molar Postextraction Sockets and in Function for Up to 144 Months.

PURPOSE: Innovations in macroimplant design, specifically ultrawide implants 7.0 mm or greater in diameter, have allowed immediate molar replacement. This is a retrospective study assessing the survival rates of ultrawide diameter implants (7.0, 8.0, 9.0 mm) immediately placed into molar extraction sockets. Implants were followed up to 144 months postplacement. MATERIALS AND METHODS: A retrospective study was conducted of all patients treated in a private surgical practice between January 1, 2008 and December 31, 2020, who received ultrawide dental implants (7.0, 8,0, 9.0 mm.) placed immediately into molar extraction sockets. Wide diameter healing abutments were placed on all implants at the time of surgery. Abutments and crown restorations were fabricated after at least 4 months of unloaded healing. Patient age, sex, implant location and implant diameters were examined for survival. Insertion torque values at the time of placement and time in function were also evaluated. Biometric statistics were computed with p-values (<0.05. Descriptive and bivariate statistics were computed; p-values were set at 0.05. RESULTS: Five hundred forty-four patients (225 males; 319 females) average age 62.5 years (range 27 to 95) had 563 implants placed. Five hundred thirty-five of five hundred sixty-three (535/563) implants survived; 28 failed [clinical survival rate (CSR) 95.03%]. Number and time in function were: 0 to 12 years 100%; 0 to 9 years 85%; 0 to 6 years 69%; 0 to 3 years 35% or 10 to 12 years 16%; 7 to 9 years 16%; 4 to 6 years 34%; 0 to 3 years 35%. No significant differences were found between sex and implant failures (p = 0.22). Maxillary (266/285; 93.3%) and mandibular (269/278; 96.8%) implant CSRs were not significantly different. Three implant diameters were used: 7.0 mm (206/563) [36.6%]; 8.0 mm (267/563) [47.4%]; 9.0 mm (90/563) [15.9%]. Clinical survival rates were: 7.0 mm (201/206) [97.6%]; 8.0 mm (252/267) [94.4%]; 9.0 mm (82/90) [91.1%]. Mean age for patients with failed implants did not show any significant differences (p = 0.1398). Fifteen of the 28 failed implants failed within 120 days of surgical placement (prior to definitive restoration; [53.6%]; 4 implants failed between 4 and 12 months [14.3%]; 9 implants failed at least 1-year postloading [32.1%]. CONCLUSIONS: The results of this long-term retrospective study regarding ultrawide diameter implants suggested that these implants were viable treatment options for immediate molar replacement following tooth extraction in either jaw with an unloaded healing protocol. High clinical survival rates were reported over a 144-month (12-year) timeframe.

Oral and maxillofacial injuries experienced in support of Operation Iraqi Freedom I and II.

Penetrating, perforating, and avulsive fragmentation injuries present a unique surgical challenge for oral and maxillofacial surgeons in the Iraqi theater of operation. Maxillofacial injuries encountered in Operation Iraqi Freedom I and Operation Iraqi Freedom II have presented injury patterns not encountered previously in other large-scale armed conflicts. Current literature in the field of oral and maxillofacial surgery does not cover adequately the concerns that are inherent to care and treatment planning at an echelon III facility. This article addresses clinical and surgical practice guidelines that were developed by oral surgeons in theater and from feedback they received from higher echelons of care.

Maxillofacial trauma treatment protocol.

The management of complex maxillofacial injuries sustained in modern warfare or terrorist attack has presented military surgeons with a new form of injury pattern previously not discussed in the medical literature. The unique wounding characteristics of the IED, the portability of the weapon platform, and the relative low cost of development make it an ideal weapon for potential terrorist attacks. If potential future terrorist attacks in the United States follow the same pattern as the incidents currently unfolding in the Middle East, civilian practitioners will be required to manage these wounds early for primary surgical intervention and late for secondary and tertiary reconstructive efforts.