Immediate loaded fixed complete dentures supported by implants in patients with a history of periodontitis: A retrospective cohort study of 2 to 7 years.

STATEMENT OF PROBLEM: The outcome of implant-supported fixed complete dentures in edentulous patients with a history of periodontitis is unclear. PURPOSE: The purpose of this retrospective clinical study was to assess the clinical outcomes of immediate loaded fixed complete dentures in individuals with a history of periodontitis and to analyze risk factors related to implant failure. MATERIAL AND METHODS: A total of 642 implants (146 prostheses) in 119 patients were included. The follow-up period ranged from 2 to 7 years. Implant survival rates, marginal bone loss, mechanical complications, biologic complications, and patient satisfaction were evaluated. The Pearson chi-square test, independent samples t test, and multivariate generalized estimating equation were performed for statistical analysis (α=.05). RESULTS: Eleven implants in 9 patients failed, leading to overall survival rates of 98.3% at the implant level and 92.4% at the patient level. The mean ±standard deviation marginal bone loss was 0.62 ±0.86 mm, and marginal bone loss did not differ significantly between axial and tilted implants (P>.05). Mechanical complications were detected in 55 (37.7%) definitive prostheses; biologic complications were detected in 318 (49.5%) implants. Smokers had a significantly lower survival rate than nonsmokers (odds ratio: 6.880, P=.013). Bruxers had a significantly higher incidence of mechanical complications than nonbruxers (P<.001). CONCLUSIONS: The immediate loaded fixed complete denture supported by implants is a suitable treatment option for edentulous patients with a history of periodontitis, with high survival implant rates. Smoking is a risk factor for implant failure. Bruxism may increase the incidence of mechanical complications with implant-supported fixed complete dentures, and the overall biologic complication incidence is comparatively high.

Preparation of ICD and overdenture in patients with Cushing's Syndrome: five-year follow-up / Preparo de PTI e overdenture em pacientes com Síndrome de Cushing: cinco anos de acompanhamento

The aim of this study is to report a clinical case of a patient with Cushing's syndrome, low self-esteem and need for oral rehabilitation. A 50-year-old female patient with hypercortisolism sought care at School of Dentistry of the Federal University of Minas Gerais. During anamnesis, the patient reported painful symptoms and mobility of the upper and lower teeth. On clinical examination, absence of many teeth were observed, periodontal disease and caries lesions. After discussion of the case, the planning involved the extraction of all teeth, and the preparation of Maxillary Immediate Complete Dentures (ICD's) and Immediate Mandibular Implant-retained Overdenture (IMIO). The treatment proposed allowed the restored aesthetics, phonetics and chewing(AU)

O objetivo desse estudo é relatar um caso clínico de uma paciente com síndrome de Cushing, baixa autoestima e necessidade de reabilitação oral. Paciente do sexo feminino, 50 anos de idade e com hipercortisolismo, procurou atendimento na Faculdade de Odontologia da Universidade Federal de Minas Gerais. Durante a anamnese, a paciente relatou sintomas dolorosos e mobilidade dos dentes superiores e inferiores. No exame clínico, foi observada a ausência de muitos dentes, doença periodontal e lesões cariosas. Após a discussão do caso, o planejamento envolveu a extração de todos os dentes, e o preparo de Prótese Total Imediata maxilar (PTI), e Overdenture Implantorretida Imediata mandibular. O tratamento proposto permitiu que restaurasse a estética, fonética e mastigação(AU)

Qualitative evaluation of immediate rehabilitation: a case report with 5 years of follow-up / Avaliação qualitativa de reabilitação imediata: relato de caso com 5 anos de acompanhamento

Próteses totais imediatas e overdentures mandibulares em carga imediata, são boas alternativas para restaurar a função e a estética. Além disso, proporcionam um fator psicológico positivo, eliminando as consequências emocionais e sociais da perda dos dentes. O objetivo deste estudo foi relatar um caso clínico, com cinco anos de acompanhamento, utilizando parâmetros clínicos e ferramentas qualitativas, para analisar o impacto na qualidade de vida do paciente e no sucesso do tratamento. Este caso clínico foi desenvolvido em um projeto assistencial da Faculdade de Odontologia da Universidade Federal de Minas Gerais, Brasil, que promove a reabilitação oral de pacientes de baixa renda com dentes severamente comprometidos. Paciente do sexo masculino, 57 anos, apresentou-se para tratamento com condição severa de saúde dental e periodontal. O plano de tratamento proposto foi a extração dos dentes remanescentes e confecção de prótese total imediata maxilar e overdenture mandibular, em carga imediata, sobre implantes. O paciente foi acompanhado periodicamente, a cada seis meses, para substituição do o´rings, conforme recomendação do fabricante. Após 5 anos, as próteses foram reembasadas com resina acrílica termopolimerizável e os componentes protéticos da overdenture foram substituídos. Em um acompanhamento qualitativo, a equipe utilizou uma entrevista narrativa, com foco nos impactos do tratamento na qualidade de vida desse paciente. Ele confirmou, em um relato em primeira pessoa, sua satisfação com o tratamento realizado e a melhora nas relações sociais, afetivas e no trabalho, mostrando como a reconquista do sorriso pode transformar a experiência pessoal do indivíduo(AU)

Immediate complete dentures and mandibular immediately loaded overdentures are good alternatives to restore function and aesthetics. Moreover, they provide positive psychological factor, eliminating the emotional and social consequences of tooth loss. The aim of this study was to report a clinical case, with five years of follow-up using clinical parameters and qualitative tools, to analyze the impact on quality of life and the success of treatment. This clinical case was developed in an assistance project of the Dental School of Federal University of Minas Gerais in Brazil, which promotes oral rehabilitation of low-income patients with severely damaged dentitions. A 57-yearold male patient presented for treatment with a severe dental and periodontal health condition. The proposed treatment plan was extraction of the remaining teeth and making maxillary immediate complete denture and mandibular immediately loaded implant-supported overdenture. The patient was monitored periodically, every six months, to replace the polymer ring ball attachment, according to the manufacturer's recommendation. After 5 years, the prostheses were relining with heat-polymerized acrylic resin and overdenture prosthetic components were replaced. In a qualitative follow-up, the team used a narrative interview, focusing on the impacts of treatment in the quality of life of this patient. He confirms, in a firstperson account, his satisfaction with the treatment performed and improvements in social and affective relations and in the work, showing how the reconquest of the smile can transform the personal experience of the individual(AU)

Manejo interdisciplinario para una óptima rehabilitación oral / Interdisciplinary management for optimal oral rehabilitation

Las estrategias para el éxito en la rehabilitación bucal requieren de la interrelación de varias disciplinas que en conjunto logren resultados predecibles y duraderos. La visión individualizada de cada área de especialidad puede conllevar a no ofrecer la mejor alternativa de tratamiento, es por ello que la valoración, el diagnóstico y la planificación del caso clínico debe ser realizada por un equipo interdisciplinario para evitar esta situación y crear una sinergia en donde el «todo sea mayor que la suma de sus partes¼. El objetivo de este trabajo es presentar un caso clínico en el cual intervinieron varias áreas de especialidad: periodoncia, prostodoncia, cirugía oral y patología bucal, logrando devolver la función y la estética a través del manejo interdisciplinario (AU)

The strategies for success in oral rehabilitation require the interrelation of several disciplines, which together, achieve predictable and lasting results. The individualized view of each specialty area may lead to not offering the best treatment alternative, which is why the assessment, diagnosis, and planning of the clinical case must be carried out by an interdisciplinary team to avoid this situation and create a synergy in where the «whole is greater than the sum of its parts¼. The objective of this work is to present a clinical case where several areas of specialty intervened: periodontics, prosthodontics, oral surgery, and oral pathology, thus achieving the return of function and aesthetics through interdisciplinary management (AU)

Digital Immediate Complete Denture for a Patient with Rhabdomyosarcoma: A Clinical Report.

Fabricating an immediate complete denture can be very challenging in some clinical situations. This clinical report describes a digital workflow to fabricate a printed maxillary immediate complete denture for a patient with a severely compromised maxilla. Digital data obtained by using an intraoral scanner was utilized to reconstruct the three-dimensional (3D) image of the jaws at the desirable vertical dimension of occlusion. After performing the virtual teeth extraction and alveoloplasty, the denture base and teeth were designed. The resulting data were exported to a 3D printer for denture fabrication and the 3D printed (additively manufactured) denture was successfully inserted immediately after the surgery. After initial healing and confirmation of good retention and function, a new printed denture was fabricated by digitally duplicating the relined denture maintaining the same teeth positions but adjusting the base to a new intraoral scan of the healed ridge.

Reproduction of Esthetic Individuality in Upper Immediate Complete Denture / Reproducción de la Individualidad Estética en Prótesis Completa Inmediata Superior

ABSTRACT: Prosthodontics, in general, aims to rehabilitate the masticatory function of the patient, as well as the stomatognathic system, maintaining his or her individual facial characteristics. The immediate removable complete denture is placed immediately after extraction of the natural teeth and allows adaptation of the patient from the dentate state to the denture, until the definitive denture is placed. When an immediate complete denture is fabricated, esthetics plays a fundamental role and thus the assembly of artificial teeth can be performed maintaining the same position, alignment and arrangement of the remaining anterior teeth, providing a natural and esthetic appearance to the denture, thus the transition from the dentate to the edentulous state is less noticeable. This paper reports the case of a patient who needed oral rehabilitation with an immediate upper complete denture and presented favorable smile esthetics of the anterior teeth, which allowed the preservation of alignment, position and arrangement of natural teeth during the assembly of artificial teeth, maintaining and preserving the esthetic individuality and facial harmonization, meeting the patient's desire and expectations.

RESUMEN: La prostodoncia, en general, tiene como objetivo rehabilitar la función masticatoria del paciente, así como el sistema estomatognático, manteniendo sus características faciales individuales. La dentadura postiza completa removible se coloca inmediatamente después de la extracción de los dientes naturales y permite la adaptación del paciente del estado dentado a la dentadura, hasta que se coloque la dentadura definitiva. Cuando se fabrica una dentadura postiza completa inmediata, la estética juega un papel fundamental y, por lo tanto, el ensamblaje de dientes artificiales se puede realizar manteniendo la misma posición, alineación y disposición de los dientes anteriores restantes, proporcionando un aspecto natural y estético a la dentadura, por lo tanto, la transición desde el estado dentado hasta el estado desdentado es menos notable. Este artículo informa el caso de una paciente que necesitó rehabilitación oral con una dentadura postiza completa superior inmediata y presentó una estética de sonrisa favorable de los dientes anteriores, lo que permitió preservar la alineación, la posición y la disposición de los dientes naturales durante el ensamblaje de los dientes artificiales, manteniendo y preservando la individualidad estética y la armonización facial, satisfaciendo los deseos y expectativas del paciente.

Digital prosthodontic management of a young patient with Papillon-Lefèvre syndrome: A clinical report.

Papillon-Lefèvre syndrome (PLS) is a rare disorder that leads to symptoms including the early progressive loss of deciduous and permanent teeth. Prosthodontic management of children and adolescents affected by PLS sometimes requires an immediate complete denture. Tooth mobility presents a challenge to the dentist, especially during impression-making. This clinical report describes the management of a 14-year-old boy with PLS by using an intraoral scanner to prevent conventional impressions and a fully digital workflow for the design and fabrication of immediate complete dentures.

Planejamento cirúrgico-protético na confecção de prótese total imediata: relato de caso clínico / Surgical-prosthetic planning in the immediate denture prosthesis placement: a clinical report

A prótese total imediata é um aparelho provisório construído previamente as extrações dos dentes remanescentes, com a finalidade de auxiliar na cicatrização e favorecer o conforto no pós-operatório, devolvendo função, estética e fonética imediatamente após as exodontias. Desta forma, esse relato de caso clínico tem por objetivo apresentar o planejamento cirúrgico-protético da reabilitação oral por meio de uma prótese total imediata maxilar, bem como os resultados obtidos com essa modalidade de tratamento. Paciente gênero masculino, 77 anos de idade, foi submetido a múltiplas extrações dentárias, seguindo da instalação de uma prótese total imediata superior e uma prótese total convencional provisória inferior. Ambas as próteses foram confeccionadas antes da remoção cirúrgica dos elementos dentários remanescentes e inseridas imediatamente após a cirurgia. Assim, através dessa modalidade de tratamento reabilitador, proporcionamos ao paciente autoestima, conforto, estética e função, imediatamente após as extrações dentárias, diminuindo o tempo entre a exodontia completa e a confecção de uma prótese total convencional(AU)

Immediate denture prosthesis is a temporary rehabilitating that is fabricated before all the remaining teeth have been removed, with the purpose of assisting in healing and favoring patient comfort in the postoperative period, returning function, aesthetic and phonetics immediately after the exodontia. Thus, this clinical case report aims to present the surgical-prosthetic planning of the oral rehabilitation through an immediate total maxillary prosthesis, as well as the results obtained with this treatment modality. A 77 years old male patient underwent multiple upper dental extractions, followed by the installation of an immediate superior total prosthesis and lower provisional total conventional prosthesis. Both dentures were made before surgical removal of the remaining dental elements and inserted immediately following the surgery. Like this, through this modality of rehabilitation treatment, we provide the patient with self-esteem, comfort, esthetics and function, immediately after the teeth extractions, reducing the time between the complete extraction and the construction of the conventional denture prosthesis(AU)

A Technique to Correct Anterior-Posterior Tooth Discrepancy for a Maxillary Immediate Complete Denture.

This article describes a chairside technique to correct inappropriate occlusal vertical dimension as well as the inaccurate anterior-posterior tooth set-up of a maxillary immediate complete denture. When fabricating an immediate denture, the inability of a wax-denture trial and the potential for unpredictable complications during surgery, compromised esthetics and function of an immediate complete denture may pose a clinical problem, which needs instant correction. The technique described can provide an alternative method to correct and deliver a definitive immediate complete denture on the day of surgery.

Immediate Postextraction Screw-Retained Partial and Full-Arch Rehabilitation: A 3-Year Follow-up Retrospective Clinical Study.

The aim of this study was to document the performance of a novel technique (OnlyOne), involving immediate restoration of postextraction implants supporting a partial or full-arch restoration. A retrospective analysis of patients with at least 3 years of follow-up was performed. Implants were tilted mesiodistally and vestibulopalatally according to the available bone. Prosthetically guided definitive abutments were connected at surgery and never disconnected. Anorganic bovine bone grafting was done to preserve the buccal bone and the ridge contour. Patients received a screw-retained provisional prosthesis within 24 hours of surgery and a final screw-retained prosthesis within 1 year. Prostheses emerged from natural soft tissue. Clinical and radiographic evaluation was routinely performed. A total of 70 patients received 153 implants in fresh extraction sockets. The mean follow-up was 38.0 ± 3.0 months (range 36 to 51 months). One implant failed at the 3-year follow-up. Implant survival was 99.3%. Marginal bone level change averaged -0.68 ± 1.2 mm at the last radiographic control. Immediate placement and restoration of implants designed for high primary stability with a definitive abutment placed at surgery and final screw-retained prosthesis with no artificial gingiva is a viable procedure with excellent medium-term outcomes.

Importancia estética de la prótesis inmediata / Cosmetic importance of the immediate prosthesis

Se presentan los casos clínicos de 3 adultos con dientes extraídos, atendidos en la consulta de prótesis dental del Policlínico Docente 30 de Noviembre" de Santiago de Cuba, a quienes se les colocó prótesis inmediata como única solución ante el deterioro bucal que presentaban. Con el proceder realizado se logró la recuperación estética de los pacientes, así como la reinserción en las actividades sociales y laborales, evitando así las afectaciones psíquicas que suelen aparecer

The case reports of 3 adults with extracted teeth are presented. They were assisted in the dental prosthesis service of 30 de Noviembre Teaching Polyclinic in Santiago de Cuba to whom immediate prothesis were placed as the only solution due to the oral deterioration that presented. With this procedure the cosmetics of the patients was recovered and their reintegration to the social and labor activities was achieved, with which the psychic disorders that usually appear were avoided

Confecção de prótese imediata do tipo protocolo, utilizando transferentes multifuncionais PEEK / Preparation of immediate prosthesis of protocol type, using PEEK multifunctional transfer devices

A possibilidade de reabilitação oral com implantes dentários tem mostrado avanços surpreendentes. A evolução das técnicas cirúrgicas e os materiais disponíveis para reabilitação viabilizam a confecção de protocolos de único estágio. O relato clínico demonstra a substituição da prótese parcial superior por prótese fixa tipo protocolo imediato, utilizando-se do componente transferente do tipo PEEK, proporcionando maior conforto, estética e eficiência mastigatória.

The possibility of oral rehabilitation with dental implants has been showing surprising advances. The evolution of surgical techniques and the materials available for rehabilitation enable the elaboration of single-stage protocols. The clinical report presents the upper partial prosthesis replacement with immediate protocol fixed prosthesis type, using the PEEKtype transfer component, providing greater comfort, aesthetics and masticatory efficiency.

Reabilitação oral após o uso de prótese total imediata: relato de caso clínico / Oral rehabilitation after the use of immediate denture prosthesis: a case report

A reabilitação oral (RO) de pacientes edêntulos através de Prótese Total Convencional (PTC) após o uso da Prótese Total Imediata (PTI) resulta em uma melhora fisiológica, funcional e psicológica. Assim, este relato de caso clínico tem por objetivo descrever o passo a passo do planejamento reabilitador de um paciente do gênero masculino, 77 anos, o qual foi reabilitado através de PTC superior e inferior após 6 meses do uso da PTI superior e PTC provisória inferior no período de remodelação e reabsorção óssea. Este modelo de planejamento reabilitador permitiu uma adaptação funcional e psicológica do paciente previamente ao reestabelecimento definitivo com PTC, reestabelecendo a função, fonética e a estética(AU)

The Oral Rehabilitation (OR) of edentulous patients through Conventional Denture Prosthesis (CDP) after the use of Immediate denture Prosthesis (IDP) results in a physiological, functional and psychological improvement. Thus, this clinical case report aims to describe the step-by-step of rehabilitation planning of a 77-year-old male patient who was rehabilitated through maxillary and mandibular CDP after 6 months of use of the provisional CDP in the remodeling and bone resorption period. This model of rehabilitation planning allowed a functional and psychological adaptation of the patient prior to definitive reestablishment with CDP, reestablishing function, phonetics and aesthetics(AU)

Overdentures mandibulares sobre implantes imediatos não esplintados, em carga imediata: acompanhamento de 36 meses / Mandibular overdentures on implants immediately implanted, immediate load: 36 month follow-up

Objetivo: Relatar a taxa de sobrevivência de implantes imediatos suportando overdentures mandibulares, em carga imediata, e o índice de sucesso dos tratamentos acompanhados por 36 meses. Métodos: Os implantes foram instalados em um projeto de extensão universitária que se propõe a reabilitar pacientes de baixa renda, com dentição seriamente comprometida. Quarenta e dois pacientes foram selecionados para o estudo. Em três casos, não se alcançou travamento primário compatível com o procedimento de carga imediata sobre implantes. Nesses pacientes, as próteses foram capturadas de forma convencional, após o período de osseointegração. Trinta e nove pacientes receberam o tratamento proposto. Três deles sofreram perda precoce de um dos implantes, todos ainda no primeiro mês após os procedimentos. Os implantes perdidos foram, posteriormente, substituídos e recapturados após três meses. Trinta e seis pacientes completaram o período de osseointegração sem apresentar perdas. Os pacientes passaram, então, a ser avaliados semestralmente, sendo que 25 completaram o estudo. Onze pacientes não compareceram às consultas de reavaliação por motivos variados. Resultados: A taxa de sobrevivência, até o final do período de osseointegração foi de 96,15%, isso é, 3 implantes perdidos em 78 imediatamente carregados. O índice de sucesso dos tratamentos acompanhados por 36 meses foi de 100%, uma vez que não foi observada nenhuma perda adicional de implantes. Conclusão: A reabilitação oral de pacientes que perderam todos os seus dentes mandibulares, por meio de overdentures sobre implantes imediatos não esplintados, em carga imediata, utilizando-se o sistema bola, mostrou-se muito satisfatório, com alta taxa de sobrevivência dos implantes, e alto índice de sucesso dos tratamentos acompanhados por 36 meses. O projeto de extensão tem observado resultados clínicos, tanto estéticos quanto funcionais, altamente satisfatórios, proporcionando uma melhora acentuada na autoestima e na qualidade de vida da população assistida.

Aim:This study aimed to report the survival rate of immediate implants supporting mandibular overdentures, which have been immediately loaded, and the success rate of the treatments followed up for 36 months. Methods: The implants were installed in a university extension project that seeks to rehabilitate low-income patients with seriously compromised dentitions. Forty-two patients were selected for the study. In three cases, the primary stability proved to be incompatible with the immediate loading procedure on implants. Thus, in these cases prostheses were captured conventionally after the period of osseointegration. Thirtynine patients received the proposed treatment. Three of them suffered an early loss of one of the implants, all in the first month after the procedures. The lost implants were replaced and recaptured after three months. Thirty-six patients completed the period of osseointegration without implant loss. The patients were evaluated every six months, and twenty-five patients completed the study. Eleven patients did not take part in the follow-up sessions for various reasons. Results: The survival rate until the end of the period of osseointegration was 96.15%, in other words, within the 78 immediately loaded implants, three were lost. The success rate of treatments followed up for 36 months was 100%, without additional loss of implants. Conclusion: The oral rehabilitation of patients using overdentures on immediate implants with immediate loading, using the ball system, proved to be very satisfactory, with a high survival rate of the implants, and high success rates of treatments followed up for 36 months.

Prótesis inmediata con analgesia acupuntural en una adulta mayor / Immediate prosthesis with acupunctural analgesia in an elderly

Se describe el caso clínico de una paciente de 62 años de edad, quien temía a los anestésicos dentales convencionales, pero tenía gran preocupación por rehabilitar su estética con prótesis inmediata. Se decidió aplicar anestesia acupuntural y realizar las extracciones dentales para que recibiera el tratamiento deseado. No se manifestaron reacciones adversas y la paciente quedó satisfecha por los resultados obtenidos, así como por las ventajas que ofrece esta terapia natural.

The case report of a 62 years patient is described who was afraid of the conventional dental anesthetics, but she had great concern to rehabilitate her aesthetics with immediate prosthesis. It was decided to apply acupunctural anesthetic and to carry out the dental extractions so that she received the desired treatment. There were not adverse effects and the patient was satisfied with the results obtained, as well as with the advantages of this natural therapy.

Prótese total imediata ­ do planejamento à instalação / Complete immediate denture ­ planning and performing

A confecção de uma Prótese Total Imediata é um procedimento complexo para os profissionais e estressante para o paciente. O presente artigo descreve a sequência clínica do planejamento à realização deste procedimento, com segurança e previsibilidade.

The fabrication of an Immediate Complete Denture is a complex procedure for the practitioners involved and a stressing situation for the patient. This article describes the clinical sequence for planning and performing this procedure with safety and predictability.

Straight Versus Angulated Abutments on Tilted Implants in Immediate Fixed Rehabilitation of the Edentulous Mandible: A 3-Year Retrospective Comparative Study.

PURPOSE: The aim of this study was to evaluate and compare the use of straight versus angulated abutments on tilted implants in the All-on-Four immediate function protocol. MATERIALS AND METHODS: A total of 85 patients (36 men and 49 women; mean age 56.5 years) with edentulous mandibles were treated according to the All-on-Four concept using computer-guided implant placement. All patients received immediate interim prostheses screwed onto distal tilted implants by means of angulated (control group, n = 42) or straight abutments (test group, n = 43) and were followed for at least 3 years. Outcome considerations comprised implant and prosthetic survival and success rates, marginal bone level changes, patient satisfaction, and required clinical time. Student t test at a significance level of P < .05 was used to correlate the influence of the prosthetic protocol on marginal bone levels around the implants. RESULTS: Overall implant survival rate was 98.21% for the control group and 98.83% for the test group. None of the 85 fixed prostheses were lost during the observation period (prosthetic survival rate of 100%). Statistically significant differences (P = .0068) in marginal bone loss were found between control and test groups. All patients were functionally and esthetically satisfied with their restorations. Required clinical time averaged 50 minutes for the control group and 30 minutes for the test group. CONCLUSION: The described simplified and shortened surgical-prosthodontic protocol that avoids use of angulated abutments may be considered a reliable alternative to the traditional All-on-Four protocol.

Photogrammetry Impression Technique: A Case History Report.

PURPOSE: The aim of this report is to present photogrammetry as a reliable step in the fabrication of a full-arch immediate rehabilitation. MATERIALS AND METHODS: A 59-year-old man attended the department seeking dental rehabilitation for the sequelae of severe oral health neglect. The mandibular teeth suffered from advanced periodontal disease and the patient wore a maxillary complete denture. An irreversible hydrocolloid impression of the mandibular arch was made, poured in stone, and digitally scanned to create the first stereolithography (STL) file. All teeth with the exception of two retained as landmarks were extracted, and seven implants were placed under local anesthesia and their positions recorded using photogrammetry. Maxillary and mandibular dental arch alginate impressions were made, poured in laboratory stone, and scanned. A provisional restoration was placed 7 hours after surgery using the STL files to determine the best-fit line. RESULTS: Radiographic and clinical follow-up after 1 year showed a favorable evolution of the implants. No screw loosening or other mechanical or biologic complications were observed. CONCLUSION: The case history using the described system suggests certain advantages over conventional techniques. More research is needed to assess the possible benefits associated with photogrammetry when making implant-supported restorations.

Early loading of splinted implants supporting a two-unit fixed partial denture in the posterior maxilla: 13-month results from a randomized controlled clinical trial of two different implant systems.

OBJECTIVES: The aim of this study was to evaluate early-loaded implants supporting a two-unit fixed dental prosthesis in the posterior maxilla and to compare the clinical and radiological outcomes of two different implant systems in terms of success rates, implant stability quotient (ISQ) values, and peri-implant parameters. MATERIALS AND METHODS: Thirty patients with the unilateral loss of two consecutive maxillary posterior teeth were randomly assigned to two different implant systems: SLActive Bone level implant (Institut Straumann AG, Basel, Switzerland) in the control group and CMI IS-II active implant (Neobiotech Co., Seoul, Korea) in the experimental group. The patients received provisional and definitive two-unit fixed prostheses at 4 weeks and 6 months after implant surgery, respectively. The peak insertion torque was recorded at surgery. The stability of each implant was evaluated during surgery and at 2, 3, and 4 weeks and 6 and 13 months after implant placement by means of ISQ values. In addition, periapical radiographs and peri-implant parameters were taken throughout the trial. RESULTS: Overall, comparable results were obtained between the control and experimental groups in terms of insertion torque, ISQ values, marginal bone loss, and peri-implant soft tissue parameters. All 60 implants had 100% of success rate. The average insertion torque was 36.83 ± 6.09 (control) and 35.33 ± 3.20 (test) Ncm. The ISQ values remained steady until 4 weeks and then increased with statistical significance during 4 weeks to 13 months after surgery. Both groups exhibited no stability dip during the early phase of healing. The average marginal bone loss from the baseline of implant placement for the control and experimental groups was 0.38 and 0.45 mm after 4 weeks and 0.98 and 0.61 mm after 13 months. All of the soft tissue parameters were within normal limits. CONCLUSIONS: The results of this study indicate that the concept of early loading at 4 weeks after placement in the posterior maxilla can be an effective treatment option, even in the areas of low bone density, when implants satisfy the inclusion criteria of minimum insertion torque and ISQ of 30 Ncm and 65, respectively.

Using the "final-on-four" concept to deliver an immediate metal-resin implant-fixed complete dental prosthesis.

In traditional dental implant therapy, the time between implant placement and delivery of the definitive prosthesis can be long and uncomfortable for a patient wearing a conventional removable denture on an atrophied ridge. New clinical protocols, often with tilted implants, are being used to immediately restore mandibular implants with interim restorations, thus shortening the patient's return to function. However, these conversion type interim restorations do not decrease the time to definitive prosthetic rehabilitation. The Ohio State University (OSU) developed an immediate load surgical and prosthetic protocol to compensate for the disadvantages of previous techniques. With this protocol, a custom, definitive, screw-retained metal-resin fixed prosthesis can be delivered 2 to 4 days postoperatively and has been described using 5 implants. This clinical report presents the OSU immediate loading protocol, combined with a tilted implant technique, for the fabrication of a mandibular metal-resin implant fixed complete dental prosthesis (MRIFCDP) in 3 days postoperatively and with only 4 implants. Replacing the mandibular dentition with an immediate load-fixed metal-resin prosthesis by means of the "final-on-four" technique resulted in a custom, definitive, and functional restorative solution immediately after surgery.