Peri-implant bone loss: management of a patient.

This clinical report presents the prosthodontic management of early peri-implant bone loss in a partially edentulous patient. Two narrow Brånemark implants (3.3 mm in diameter) were placed to retain a mandibular implant prosthesis in the area of the mandibular left second premolar and first molar. Two weeks after the prosthesis was put into function, the distal implant exhibited soft tissue reactions. Radiographically, bone corresponding to 4 threads and 7 threads was lost at the mesial and distal sites, respectively. After occlusal load reduction was made to the existing prosthesis, bone was observed to have regenerated sufficiently to restore the defect radiographically, though not to the original level. The bone remained at a similar level at 36 months after treatment.

A new prosthodontic technique for fabricating cement-retained implant-supported prostheses.

This article describes a new technique for fabricating cement-retained implant-supported prostheses. The technique involves cementation of the prostheses over customized gold cylinders. Access channels are incorporated in the prostheses to allow future access of the gold screws. This technique can be used in various clinical situations to achieve total passive fit of the framework without compromising retrievability. The technique overcomes the problems encountered with other previously advocated methods for constructing such prostheses. In addition, maintenance of the resulting prostheses is uncomplicated.

An improved preparation for indirect porcelain veneers.

With a conventional preparation marginal microleakage is often observed at the cervical margin of porcelain laminate veneers. The leakage seems to be associated with the presence of cracks in the adjacent enamel layer. Removing the defective enamel by bevelling the cervical margin prior to cementation appears to be effective in controlling the microleakage. A modified veneer preparation which incorporates this additional short bevel is described in this paper.

A 5-year prospective study on small diameter screw-shaped oral implants.

Alveloar ridges of limited dimensions could preclude the placement of dental implants of the regular dimension. Smaller diameter implants - narrow platform (NP) implants were commercially available to address this issue. The aim of the study was to determine the 5-year clinical performance of 3.3 mm diameter NP implants. Twenty-three machined screw-shaped NP implants were placed in nine patients (six males; three females) between 18 and 70 years of age. Clinical and radiographic examinations were performed annually for 5 years. Recognized implant success criteria was used. The criteria were based on the mean marginal alveolar bone loss, the placement of prosthesis of satisfactory appearance, and the absence of implant mobility, peri-implant radiolucency, pain, discomfort or infection. One implant failed at abutment connection. The remaining 22 implants were restored and functioned successfully according to the criteria. The mean marginal alveolar bone loss during the first year was 0.41 +/- 0.17 mm. The mean marginal alveolar bone loss between the second and fifth year was 0.03 +/- 0.06 mm. The success rate of NP implants according to a well-established set of criteria was 96%.

Retrievable cement-retained implant-tooth-supported prosthesis: a new technique.

Clinicians often encounter difficulties with connecting natural teeth and osseointegrated implants. A new clinical technique with laboratory procedures are presented. The technique involves cementation of a two-part prosthesis over natural teeth and customized implant gold cylinders. This method achieved a passive-fit fixed bridge with retrievability maintained.