Comparison of implant and provisional placement protocols in sinus-augmented bone: a preliminary report.

PURPOSE: To evaluate preliminary data on clinical outcomes associated with timing of placement of single implant-supported provisional crowns and implants in augmented bone. MATERIALS AND METHODS: Twenty patients underwent sinus elevation bone grafting followed by a 6-month healing period before implant placement and immediate placement of a provisional crown (group [G] 1); 20 patients received sinus elevation bone grafting at the time of implant placement and immediate placement of a provisional crown (G2); 20 patients required no bone augmentation before implant placement and immediate placement of a provisional crown (G3); and 20 patients received sinus elevation bone grafting followed by a 6-month healing period before implant placement followed by a 6-month healing period before restoration (G4). The height of the crestal bone was measured and recorded to determine mean bone changes, and success rates were determined. RESULTS: Mean bone level comparisons were made between G2 and G3, G2 and G4, and G3 and G4. No statistically significant differences were found between the groups (P < .05). G1 was discontinued based on the initial results: two implants did not meet the 35-Ncm insertion test, and one implant failed within 1 month after implant placement. The 1-year implant survival rates were 86% (n = 12/14), 95% (n = 19/20), and 100% (n = 16/16) for G2, G3, and G4, respectively. Differences in survival rates between the groups were not statistically significant (P < .05). CONCLUSION: Implant survival is affected by the timing of sinus augmentation and implant placement in relation to the timing of crown placement. Implants that were restored immediately regardless of the timing of bone augmentation showed greater failure rates than implants in augmented bone with delayed restoration protocols or those that were restored immediately in sites without bone augmentation. Neither the timing of loading nor timing of implant placement in relation to bone augmentation surgery affected mean bone loss.

Immediate restoration of single tapered implants with nonoccluding provisional crowns: a 5-year clinical prospective study.

BACKGROUND: Dental literature has limited number of publications regarding long-term outcome data of immediate restoration of single missing teeth with an implant-supported provisional crown. PURPOSE: This 5-year study evaluated hard and soft tissue responses to the immediate placement of single implant-supported provisional crowns. MATERIALS AND METHODS: Twenty patients received one dental implant restored immediately with a provisional acrylic resin screw-retained crown. Crestal bone loss was evaluated from standardized periapical radiographs collected at 3-month intervals for the first 21 months followed by a 5-year evaluation. Historical controls acquired from available dental literature were used for comparison. RESULTS: One implant failed within 2 months of surgical placement, presenting with pain and mobility. The remaining implants demonstrated no infection, pain, or radiolucencies. Nineteen implants were clinically immobile, osseointegrated, and asymptomatic at 21 months. At 5 years, one patient died, three patients were noncompliant, and 15 implants were evaluated as functional. Mean bone loss (MBL) at 1 year and 21 months was approximately 0.5 ± 0.5 mm and 0.70 ± 0.26 mm at 5 years. There was no statistically significant difference between MBLs at p < 0.05. CONCLUSIONS: Immediate provisionalization of single dental implants compares favorably with conventional loading protocols. Long-term data suggest that immediate provisionalization of single dental implants is a viable treatment option.

Pemphigus vulgaris and paraneoplastic pemphigus.

The history, epidemiology, pathophysiology, clinical presentation, diagnostic work-up, histopathology, and treatment of PV and PNP have been presented. These life-threatening, autoimmune, mucocutaneous bullous conditions may be encountered first by oral health providers and, therefore, deserve keen understanding and attention by the oral and maxillofacial surgeon. Great diagnostic and management strides have been made, but morbidity and life quality issues remain a reality for these chronically ill patients.

Preservation of soft tissue contours with immediate screw-retained provisional implant crown.

When a patient with a missing or failing maxillary anterior tooth desires immediate tooth replacement, fabrication of a provisional restoration can be challenging. Due to individual anatomical variations in tooth shape, size, and supporting soft and hard tissue structures, there are no premanufactured components with an anatomical emergence profile that universally suits all individual situations. This article describes the fabrication of a screw-retained immediate provisional restoration that fulfills anatomic, biologic, and esthetic requirements.

A review of the effects of expansion of the nasal base on nasal airflow and resistance.

PURPOSE: The purpose of this article is to inform the reader of the current literature regarding nasal airflow resistance. The anatomy and physiology of nasal airflow resistance will be examined and the known effects of widening of the nasal airway upon airflow will be described. MATERIALS AND METHODS: This article is a review of the current literature regarding nasal airflow and resistance and the effects of widening of the nasal base. No patient data were collected. RESULTS: The literature shows that nasal airflow resistance can be changed by surgical manipulation and by rapid palatal expansion, but that the effects on airflow resistance and future growth and development are unpredictable. CONCLUSION: Patients with a maxilla that is constricted in the transverse dimension and nasal airflow problems may benefit from expansion of the nasal base. The resultant effects upon nasal airflow resistance and subsequent growth and development are unpredictable and therefore airflow issues alone may not be a primary reason to increase the transverse dimension of the nasal base.