Clinical outcome of 103 consecutive zygomatic implants: a 6-48 months follow-up study.

The purpose of this study was to evaluate retrospectively, after a period of 6-48 months follow-up of prosthetic loading, the survival rate of 103 zygomatic implants inserted in 55 totally edentulous severely resorbed upper jaws. Fifty-five consecutive patients, 41 females and 14 males, with severe maxillary bone resorption were rehabilitated by means of a fixed prosthesis supported by either 1 or 2 zygomatic implants, and 2-6 maxillary implants. This retrospective study calculated the success and survival rates at both the prosthetic and implant levels. Out of 55 prostheses, 52 were screwed on top of the implants, while 3 were modified due to loss of standard additional implants and transformed in semimovable prosthesis. Although osseointegration in the zygomatic region is difficult to evaluate, no zygomatic implant was considered fibrously encapsulated and they are still in function. This study confirms that zygoma bone can offer a predictable anchorage and support function for a fixed prosthesis in severely resorbed maxillae.

A surgical stent for the Brånemark Novum bone reduction procedure.

BACKGROUND: The Brånemark Novum concept (Nobel Biocare AB, Göteborg, Sweden) was introduced to load implants immediately with a definitive fixed prosthesis in the edentulous mandible. This concept is based on the use of prefabricated templates to allow precise placement of three implants and a prefabricated bar structure for the prosthetic procedure. To obtain three-dimensional stability in these prefabricated templates, surgical bone reduction may be necessary to obtain a stable adaptation between the templates and the recipient bone site. PURPOSE: The aim of this work was to design a surgical stent for predictable reduction of the residual alveolar crest prior to the implant placement procedures. MATERIALS AND METHODS: A predetermined alveolar crest platform based essentially on a lateral cephalometric radiographic evaluation was simulated on a cast in order to design a transparent resin surgical guide. The predictability potential of the procedure was then evaluated in 10 patients. The prosthetic outcomes were compared with those of a similar group of 10 patients treated without the presented stent by evaluating two factors, namely, the anterior dimensions of the prostheses and the required posterior adjustments of the upper bar. RESULTS: Correlation analysis of our series suggested a good predictability potential for this procedure (r = 0.9215). The mean anterior prosthetic dimension was 32% lower and was more predictable (narrow range of 8-12 mm vs broad range of 8-21 mm) when the stent was used. Furthermore, since half as many posterior adjustments of the upper bar were required, the laboratory procedure was facilitated. CONCLUSION: This individualized guide allows appropriate bone reduction for obtaining a predictable surgery and prosthetic stage.

Impact of dental and skeletal movements on the facial profile within the framework of orthodontic and surgical treatments.

The impact of dental and skeletal movements on the soft tissues during orthodontic and surgical treatments is widely known. Most studies are limited to examining the repercussions of a dental or skeletal movement on a given soft tissue point. The uniqueness of the present study, carried out on 95 patients, lies in the examination of the impact of movements of various landmarks--2 dental points (incision superius and incision inferius) and 4 skeletal points (anterior nasal spine, point A, point B, andpogonion)--on 7 soft tissue landmarks (from the tip of the nose to soft tissue pogonion). The study was carried out with the purpose of providing a simple, practical, and accurate tool for clinical use to assist in treatment planning. This article outlines the main aspects of the tool while specifying its limitations and error margins.