Implant placement in alveolar composite defects regenerated with rhBMP-2, anorganic bovine bone, and titanium mesh: a report of eight reconstructed sites.

PURPOSE: To present a retrospective report of eight significant alveolar defects in which the alveolus was regenerated with recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with anorganic bovine bone and contoured using titanium mesh to facilitate implant-supported restorations. MATERIALS AND METHODS: A total of seven patients underwent extractions and debridement of the compromised alveolar sites with simultaneous grafting using a mixture of rhBMP-2 and anorganic bovine bone. The three-dimensional contour of the compromised alveolus was reestablished using titanium mesh with rigid screw fixation. Implants were placed a minimum of 6 months after healing and subsequently were restored. RESULTS: The treated defects were successfully regenerated and did not require any additional surgery prior to implant placement or prosthetic restoration. A total of 14 implants were placed and restored with fixed single or multiple restorations. Thirteen of the 23 treated sites were in the anterior esthetic zone. CONCLUSION: Vertical and horizontal alveolar bone defects can be predictably regenerated by grafting with a combination of rhBMP-2 and anorganic bovine bone contained by titanium mesh to successfully accommodate implant placement.

Combined immediate loading of zygomatic and mandibular implants: a preliminary 2-year report of 19 patients.

PURPOSE: A retrospective study was performed to evaluate the feasibility of simultaneous use of immediately loaded zygomatic and mandibular implants for full maxillomandibular restoration. MATERIALS AND METHODS: A total of 40 zygomatic and 112 conventional implants were placed in 19 edentulous and partially edentulous patients and restored with full-arch acrylic resin prostheses within 3 hours of surgery. Implant insertion torque values were between 35 and 45 Ncm. RESULTS: During the 1-year follow-up period, none of the 19 patients experienced implant or prosthesis failures. The patients did not experience any sinus infections or any other surgical complications from the performed procedures. CONCLUSION: Zygomatic and conventional implants can be simultaneously placed in the maxilla and mandible and successfully loaded with an acrylic resin prosthesis using the All-on-Four concept.

Immediate loading of dental implants in the esthetic region using computer-guided implant treatment software and stereolithographic models for a patient with eating disorders.

This manuscript describes the reconstruction of a maxillary anterior segment using immediate implant placement and immediate implant loading techniques, aided by computer-guided implant treatment software and stereolithographic models and surgical templates, in a patient with a history of eating disorder. Her medical and dental histories did not make her a candidate for the use of conventional 2-stage implant surgery and restorative procedures along with an interim removable prosthesis.

Immediately loaded mandibular fixed implant prostheses using the all-on-four protocol: a report of 183 consecutively treated patients with 1 year of function in definitive prostheses.

PURPOSE: The purpose of this study was to evaluate a specific protocol using four implants to support immediately loaded fixed prostheses to restore edentulous and partially edentulous mandibles and report on the outcome after 1 year of function with the definitive prostheses. MATERIALS AND METHODS: A retrospective study was conducted of all patients who were treated between June 2008 and December 2010 with fixed prostheses that were loaded immediately after placement of implants. The provisional prostheses were later replaced with computer-aided design/computer-assisted manufacture titanium frames supporting acrylic resin and denture teeth in the definitive prosthesis. All patients were followed for a minimum of 12 months and were assessed for implant survival and prosthetic performance, with descriptive statistics utilized to demonstrate results. RESULTS: One hundred eighty-three consecutive patients received immediately loaded axial and tilted implants according to the defined protocol. One implant failed, resulting in a 99.86% implant success rate. There were two catastrophic prosthetic failures (fracture of the titanium framework), for a 98.9% prosthetic success rate. Three patients (1.6%) presented with fracture of a prosthetic mandibular incisor tooth. No prosthetic screw loosening or fractures were seen. Radiographic evaluation revealed no major bone loss around dental implants. CONCLUSIONS: Based on this retrospective study, the following conclusions can be drawn: (1) this technique appears to provide a highly predictable implant performance; (2) it is necessary to critically evaluate framework design, especially around the connectors for cantilever extensions around the most distal implants; and (3) minor complications related to acrylic resin tooth fracture may be anticipated during the early phases of prosthetic treatment.

Mandibular all-on-four therapy using angled implants: a three-year clinical study of 857 implants in 219 jaws.

Immediate function with Brånemark implants is well established for the mandible. This article describes a series of 857 implants placed consecutively in which very few implants failed or lost bone despite the dynamic healing conditions of simultaneous dental extractions and bone leveling. Though these findings are relatively early, 3 years or fewer, it appears that the immediate function All-on-Four procedure can be done with a high degree of confidence for the mandible--putting into question the need for additional implants.

Hourglass mandibular anatomic variant incidence and treatment considerations for all-on-four implant therapy: report of 10 cases.

PURPOSE: The purpose of this study was to determine the incidence and treatment of hour glass variant mandibles for All On Four implant placement. MATERIALS AND METHODS: Cone beam CAT scans were analyzed for 719 patients to determine the incidence of alveolar constriction in the mandible. Ten patients with alveolar constriction were treated over a 2-year period and retrospectively studied after 1 year in function. RESULTS: Of 719 mandibles studied, 28 have "hour glass" variants identified for an incidence of 3.89%. Treatment of these cases were variously done including the use of guided bone regeneration, the use of long implants, bone reduction, and angulation strategies. CONCLUSIONS: The hour glass mandibular finding is a developmental or genetic variant that poses a significant anatomic difficulty for dental implant surgery for All On Four immediate function.

Mandibular all-on-four therapy using angled implants: a three-year clinical study of 857 implants in 219 jaws.

Immediate function with Brånemark implants is well established for the mandible. This article describes a series of 857 implants placed consecutively in which very few implants failed or lost bone despite the dynamic healing conditions of simultaneous dental extractions and bone leveling. Though these findings are relatively early, 3 years or fewer, it appears that the immediate function All-on-Four procedure can be done with a high degree of confidence for the mandible-putting into question the need for additional implants.