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.

Innovative subtractive production of a digital removable complete denture from start to finish: a JPD Digital video presentation.

This JPD Digital video presentation presents the clinical treatment from start to finish in which a dual-shaded bi-coloured monolithic disk was used for the fabrication of an immediate digital complete denture followed by the delivery of a definitive digital complete denture. The treatment plan included extraction of the remaining maxillary and mandibular teeth followed by an esthetic evaluation with digital smile design. The digital definitive complete dentures were milled from a monolithic dual-shaded disk.

Improving digital scans by using a peripheral custom tray: A dental technique.

A digital dental technique is described for registering functional borders of immediate complete dentures, by using an intraoral scanner, a dental computer-aided design software program, and a peripheral custom tray. This article also illustrates how to virtually match the recorded information in order to transform the initial intraoral scan into definitive digital scans.

A Technique to Fabricate an Interim Implant-Supported Fixed Complete Denture for Immediate Loading.

Converting an acrylic resin removable complete prosthesis into a fixed implant-supported prosthesis to immediately load the implants can be a challenging procedure. Using acrylic resin to secure titanium interim copings intraorally may be a difficult task, and any process to facilitate this procedure may be advantageous for the clinician and the patient. This report describes a technique for facilitating the fabrication of an interim immediately loaded implant-supported fixed complete prosthesis. This technique and the materials used enabled the efficient fabrication and delivery of the prosthesis with an appropriate soft-tissue surface and acrylic resin thickness without irritating newly sutured soft tissues.

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.

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.

A digital technique for fabricating an interim implant-supported fixed prosthesis immediately after implant placement in patients with complete edentulism.

The conversion of a denture into an interim implant-supported, screw-retained restoration has become the standard method for immediate interim restoration in patients with complete edentulism. The most critical steps of the denture conversion process are the creation of appropriate denture access holes to prevent displacement of the denture by the interim cylinders and removal of the denture flanges to facilitate both good esthetics and accessibility for oral hygiene after the denture is connected to the interim cylinders. This article presents a digital technique for designing and fabricating an interim implant-supported, fixed prosthesis for edentulous patients. The interim prosthesis has cylinder access holes that are digitally prefabricated and a denture flange part that is designed to be easily sectioned. This technique facilitates more straightforward and efficient immediate restoration for edentulous patients after implant placement.

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.

Fabrication of an implant-supported fixed complete denture using multiple digital technologies for a patient with a perioral burn: A clinical report.

This clinical report describes the prosthetic and surgical management of a patient with a restricted oral orifice due to a perioral burn. Complete oral rehabilitation was achieved with maxillary and mandibular implant-supported fixed prostheses using a combination of digital and conventional impressions, design, and processing techniques.

In-office fabrication of a definitive cast and duplication of an interim implant-supported fixed acrylic resin complete denture.

The information contained in an interim implant-supported fixed acrylic resin complete denture is a starting point for fabricating the definitive restoration. Duplicating this information in an expedient, precise, and sanitary fashion is desirable so that the interim restoration can be returned to the waiting patient. A technique is described to fabricate an accurate definitive polyvinyl siloxane cast with laboratory analogs bonded to a prepolymerized, dimensionally stable, composite resin baseplate. A screw-retained polyvinyl siloxane duplication of the interim denture is related to this cast. This combination allows for most of the relevant information of the interim denture to be communicated to the dental laboratory.

Complications after use of elastomeric pressure-indicating media at 24-hour follow-up visit for immediate maxillary complete removable dental prosthesis: A clinical report.

Various pressure-indicating media are available to assess the adaptation of the intaglio surface of a removable dental prosthesis at the insertion and follow-up appointments. This clinical report describes the use of an elastomer that entered the maxillary sinus through an undetected oroantral communication at the 24-hour follow-up for an immediate maxillary complete removable dental prosthesis. A Caldwell-Luc sinusotomy procedure was required to remove the material, and the patient required over 1 year of healing time before his reported symptoms resolved.

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.

Case report: a patient who had not removed her lower denture for 54 years.

BACKGROUND: A 71-year-old female presented with a left submandibular space abscess. This was found to be due to large accumulations of calculus on the lingual flanges of her lower denture ulcerating the floor of the mouth. She had not taken the prosthesis out since it was provided as an immediate denture after extractions 54 years previously. At presentation she could not take her denture out as the calculus locked the denture under lingual undercuts. The denture was sectioned in the midline to remove it and the submandibular abscess was drained via a neck incision. FINDINGS: Prior to removal the denture was remarkably stable and she had enjoyed a long period of problem free denture wearing and had had exceptional value from it. There was also surprisingly little mandibular alveolar bone resorption. CONCLUSION: The case demonstrates what may happen if a lower denture is not taken out for over half a century. The calculus on the lingual flanges provided both stability and retention for the denture, and it appeared to have protected the ridge from resorption. While the calculus may have provided some surprising benefits to her lower denture it ultimately led to a serious infection.

Training Plates: A Solution for Patients Unable to Tolerate a Removable Prosthesis.

Dealing with patients who are unable to tolerate dentures can present a challenge to the general dental practitioner (GDP). Careful assessment of patients and their dentures will identify any causes of the intolerance to dentures. Training plates are a useful technique that can be used to allow patients to become accustomed to removable prosthesis but will inevitably lengthen the treatment process. CPD/Clinical Relevance: Training plates offer a possible solution to general dental practitioners who treat patients who are struggling to tolerate dentures.

Complete oral rehabilitation of a patient with hereditary gingival fibromatosis: a clinical report.

Hereditary gingival fibromatosis is a rare disease that has several debilitating oral and psychological manifestations, especially with young children and adolescents. The complexity of the treatment as well as the timing relative to the growth and maturation of the patient present a challenge. Few treatment options have been reported in the literature. This clinical report presents a multidisciplinary approach to treating a young patient with hereditary gingival fibromatosis by using implant-supported prostheses. The treatment steps and its outcome are discussed.

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.

Surgical and prosthetic management of a complex edentulous patient for fabrication of complete dentures.

Fabrication of well-fitting complete dentures becomes a challenge in the presence of epulis fissuratum in the maxilla or severely resorbed alveolar tissue in the mandible. This clinical report describes the surgical and prosthetic treatment of a patient who presented with both problems. The neutral zone technique was used to improve the stability of the mandibular complete denture. Both dentures were fabricated prior to surgical excision of the epulis fissuratum and inserted immediately following the surgery.

The Evolution and Fabrication of Implant-supported Full-arch Hybrid Prostheses. From Conventional Casted Metal to an All-Ceramic Zirconia.

Implant-supported, full-arch hybrid prostheses have developed from cast-metal frameworks with acrylic or porcelain to all-ceramic zirconia frameworks. CAD/CAM manufacturing removed the inaccuracies seen with casting and made use of zirconia possible. The materials and processes for prosthodontic fabrication are explained. Zirconia is highly opaque and versatile. However, porcelain-veneered zirconia frameworks have shown higher enamel wear, among other problems. Lithium disilicate has been shown to be more translucent than zirconia. Improved stained and more translucent zirconia frameworks have been produced as well. These promising new methods have gained popularity, but long-term studies are scarce and, thus, more research is required.

[Transient removable dentures]. / Les prothèses amovibles transitoires.

Removable dentures are always transient current. The epidemiology and causes of tooth gaps demonstrate the need to master the different prosthetic treatment. This made whether to propose treatment plans that take into account psychological, physiological and technical support for this patient. Different situations may arise. A gradual transition may be considered or immediate passage to the total edentulous according to general criteria, local and desiderata of patients. After tooth extraction, the transitional prosthesis can control bone lysis thereby it is part of a complete treatment before prosthesis. It also facilitates a good psychological and physiological integration before the prosthesis use.