Immediate implantation of pure titanium implants into extraction sockets of Macaca fascicularis. Part II: Histologic observations.

The purpose of this study was to evaluate immediate implants with implants placed in ossified extraction (control) sites. Histologic observation of immediate and control implants showed similar levels of bone integration at the light microscopic level using ground-section and decalcified thin-section histologic methods. Both histologic methods provided similar information in relation to determination of hard and soft tissue components measured at the interface. The percentage of bone integration was similar in different anatomic regions of the oral cavity. Bone patterns peripheral to the interface region differed, suggesting that special consideration be given to implants placed in the posterior regions of the maxilla and mandible.

Immediate implantation of pure titanium implants into extraction sockets of Macaca fascicularis. Part I: Clinical and radiographic assessment.

Immediate implants have the advantages of few surgical exposures, short treatment time, and maintenance of alveolar bone height and width. The purpose of this study was to compare immediate implants with conventional implants (implants placed into ossified extraction sites) in adult monkeys. Forty-eight implants were placed and allowed to heal for a 6-month period. Following a 7-month loading period, the monkeys were sacrificed, and implant sections were evaluated histologically. Clinical and radiographic measurements showed few significant differences between immediate and control implants.

The growth of postdoctoral general dentistry programs.

From 1972 to 1990, the number of Postdoctoral General Dentistry (PGD) programs increased by 57% and enrollment increased by 57% and enrollment increased by 131% for a total of 118 PGD programs and 1,367 positions. Although there has been some increase in military and Veterans Affairs (VA) programs, the major increase was in civilian programs. From 1972-78, the major impetus for growth was hospital sponsorship of General Practice Residency (GPR) programs. With federal funding of PGD programs, civilian GPR programs continued to be the main source of growth until the accreditation of Advanced Education in General Dentistry (AEGD) programs in 1981. Subsequently, almost all increases were in AEGD programs. Over the 12-year period of federal funding (1978-90), there was an increase of 406 civilian PGD positions to make a total of 925 positions. The increase in enrollment directly attributable to federal funding was 242. The "unmet demand" for PGD programs was estimated to be approximately 300 positions for 1990, from data derived from the Survey of Dental Seniors and the Matching Program. Assuming that the number of PGD positions continues to increase by 35 positions a year, as it has in the past 12 years, the unmet demand would be met in slightly less than 10 years. If, however, a postdoctoral year was mandated for licensure, the increase in the number of positions would be far short of projected need.

Prepubertal trauma and mandibular asymmetry in orthognathic surgery and orthodontic patients.

The association between radiographic evidence of mandibular asymmetry and history of prepubertal trauma was analyzed in orthognathic surgery patients and orthodontic patients. There were statistically significant associations between radiographic evidence of mandibular asymmetry and a history of prepubertal trauma in both patient groups. The results suggest that prepubertal trauma could be one etiologic factor for the development of mandibular asymmetry.

Practice characteristics of graduates of postdoctoral general dentistry programs.

A mail questionnaire was sent to 900 dentists who completed a Postdoctoral General Dentistry (PGD) program in 1985 and 900 dentists who graduated from dental school in 1985 but did not participate in a PGD program. The response rate was 57 percent. Three-quarters of the PGD graduates trained in civilian programs with the remainder being equally divided between military and Veterans Administration (VA) programs. Graduates of military programs continued to be employed by the military five years after graduation in contrast to the VA where less than 2 percent of graduates were employed after five years. The percent of dentists who are specialists or are enrolled in specialty programs five years after graduation was approximately 13 percent and the rates were similar for PGD and non-PGD dentists. The patterns of care in private practice tended to be similar for both groups; however, in institutions GPR graduates provided more treatment for special care patients and patients who were economically disadvantaged. GPR graduates also were more involved in teaching and in hospital activities.

An American Board of Orthodontics case report. Correction of a Class III mandibular prognathism and asymmetry through orthodontics and orthognathic surgery.

The Class III malocclusion with mandibular prognathism can involve many factors, among which are excessive mandibular growth, underdevelopment of the maxilla, environmental factors, and trauma to the jaws. The correction of this malocclusion can involve an orthodontic or a combined orthodontic-orthognathic approach. Skeletal asymmetries can complicate this situation, making treatment either more difficult, more complicated, or both. This case presentation involves treatment with a combined orthodontic-orthognathic approach. [This case was presented to the American Board of Orthodontics in partial fulfillment of the requirements for the certification process conducted by the Board.]

Immediate implantation of a pure titanium implant into an extraction socket: report of a pilot procedure.

The conventional osseointegration protocol calls for waiting up to 12 months for ossification of an extraction socket to heal before placing an endosseous implant. In this study the possibility of placing a pure titanium implant directly into an extraction socket immediately after extraction was investigated. A pure titanium Nobelpharma 10-mm implant was placed into a central incisor extraction socket of a stump-tailed monkey and allowed to heal for a period of 6 months, followed by functional loading of the implant. The implant was osseointegrated on a clinical and histological level. This pilot study suggests that pure titanium implants have the potential to integrate when placed immediately after extraction of the teeth and warrants further investigation.

Resolving esthetic and phonetic problems associated with maxillary implant-supported prostheses. A clinical report.

A technique has been presented for placement of an implant prosthesis without a visually detectable space between the prosthesis and soft tissue or visibility of the metal abutments. The prosthesis permits better phonetics and greatly improved esthetics including better lip support. Proper presurgical planning and careful assessment of the potential level of home care are especially important when this technique is used.

An American Board of Orthodontics case report. A combined face mask-orthognathic surgical approach in the treatment of skeletal open bite and maxillary deficiency.

This case report is presented following the specifications of the American Board of Orthodontics. The patient had a true skeletal open bite with maxillary and mandibular asymmetry. She was treated with an orthognathic surgical approach and face mask therapy to stabilize the postsurgical result.

Evaluation of common predictors for selection of postdoctoral dental students.

Certain predictors are traditionally presumed to be reliable measures for selection of candidates for general dentistry training programs. The purpose of this study was to assess the relative value of academic standing, letters of recommendation, and personal interview impressions by comparing them with performance during training. Predictor data were collected from the application files of all postdoctoral trainees in the advanced general dentistry training program at the Eastern Dental Center of the past ten years (N = 154). However, only 102 postdoctoral students had information available for all three predictor criteria. Performance was rated subjectively on completion of training by two faculty members on a six-point rating scale. The highest correlations between predictors and performance were to academic achievement (r = 0.347). Weaker, though statistically significant, correlations were found for the personal interview (r = 0.206) and letters of recommendation (r = 0.192). Although these predictor criteria will continue to be used in the selection of candidates, administrators and selection committees must be aware of the limitations of such criteria in predicting performance.

Ambulatory hospital dentistry.

The scope of outpatient hospital dentistry is broad and embraces a full range of patient care as well as education and investigative activities. The ambulatory dental service provides an ideal setting for the care of medically compromised patients and treatment requiring a multidisciplinary approach. The hospital dental staff and administration are especially well qualified to bring dignified, high quality, total health care to patients and educational programs to the profession. These factors are paramount in formulating a strategy for meeting the future health care needs of our population.