Sobredentaduras mandibulares sobre dos implantes en pacientes edéntulos totales. Un estudio a tres años / Mandibular overdentures over two implants in totally edentulous patients. A 3-year study

INTRODUCCIÓN: En la actualidad, la implantología oral constituye una modalidad terapéutica en el tratamiento prostodóncico de los pacientes mayores edéntulos totales. El estudio muestra la evaluación del tratamiento con sobredentaduras mandibulares mediante la carga precoz de implantes dentales. MÉTODOS: Treinta pacientes edéntulos totales fueron tratados con 60 implantes con superficie arenada y grabada Galimplant(R) en la mandíbula para su rehabilitación prostodóncica con sobredentaduras. Dos implantes fueron insertados en cada paciente. Los implantes fueron cargados funcionalmente tras un periodo de tiempo de 6 semanas con retenedores de fricción. Los hallazgos clínicos (implantológicos y prostodóncicos) se han seguido durante al menos 24 meses. RESULTADOS: Los resultados indican una supervivencia y éxito de los implantes del 98,3%. Durante el periodo de cicatrización libre de carga funcional, se perdió un implante por movilidad. La pérdida de hueso marginal media fue de 0,4 mm (0-1,1 mm). El 100% de los pacientes fueron tratados mediante una sobredentadura implantorretenida con anclajes de fricción. En cuatro pacientes se realizaron cambios en los componentes plásticos de los ataches. El seguimiento clínico medio fue de 40,8 meses (24-60 meses). CONCLUSIONES: Los resultados del presente estudio indican que la rehabilitación prostodóncica mediante la carga precoz con sobredentaduras con implantes de los pacientes edéntulos mandibulares representa una terapéutica implantológica con éxito

INTRODUCTION: Today, oral implantology constitute a therapeutic modality in the prosthodontic treatment of totally edentulous patients. This study reports the evaluation of treatment with overdentures in the mandible by early loading of dental implants. METHODS: 30 edentulous patients were treated with 60 Galimplant(R) sand-blasted and acid-etched surface implants for prosthodontic rehabilitation with overdentures in the mandible. Two implants were inserted in each patient. Implants were loaded after a healing free-loading period between 6 weeks with locator attaches. Clinical findings (implant and prosthodontics) were followed during at least 24 months. RESULTS: Clinical results indicate a survival and success rate of implants of 98,3%. One implant was lost during the healing period. Media marginal bone loss was 0.4 mm (0-1.1 mm). 100% of patients were treated with overdentures retained with 2 implants with locator attaches. Changes in plastic components of attaches were reported in 4 patients. The media follow-up was of 40.8 months (24-60 months). CONCLUSIONS: Clinical results of this study indicate that prosthodontic rehabilitation in the mandible of edentulous patients with early loading of overdentures supported by implants is a successful implant treatment

[Aspects of complex oral rehabilitation with oral osseointegrated implants]. / Actualitati în reabilitarea orala complexa cu ajutorul implantelor orale osteointegrate.

Dentists and patients become increasingly aware of the complex and predictible results offered by implant-supported dentures. These alternatives fulfill the demands of modern dentistry to rehabilitate the oral health condition according to the highest standards. A deficient residual crest represents a great challenge for the healing and osseointegration of the implants. Dental implants have an essential effect on stopping bone atrophy in the edentulous crest and preserving its condition. Function and esthetics and the patients comfort can be rehabilitated within normal limits. The prosthetic reconstruction based on osseointegration implants has better long-term prognosis if the therapeutic option is judiciously selected. The risk of relative movements at the bone-implant interface decreases according to the difference in value between the elasticity module of the implant and the bone. Prosthetic reconstruction based on implants has a better long-term prognosis if the therapeutic option is judiciously selected from all possibilities according to the osteointegration of an adequate number of implants.

[Preprosthetic surgery (without implantology)]. / Präprothetische Chirurgie (ohne Implantologie).

This paper describes preprosthetic surgery from its historical beginnings to its present state-of-the-art status. Future perspectives of preprosthetic surgery are also outlined, excluding implants. In an enquiry of 250 German-speaking maxillofacial departments, 160 responded. Results showed that a surprising 30-50% of the institutions are still following guidelines for procedures which have been proven by scientific follow-up studies to be almost 100% unsuccessful.

Overview and historical perspective of oral reconstructive surgery.

Pioneers in the field of dental reconstruction had little to offer their edentulous patients other than prostheses that were generally fitted without preparation or augmentation of the alveolar ridge. By the mid-1940s, the development of surgical procedures and the introduction of new materials offered significant advances. Increased denture retention was achieved by some implant methods and through use of the mandibular staple bone plate. Improvements in hydroxylapatite provided a material that could be used for alveolar ridge augmentation. It proved effective in limiting resorption and increasing attachment to soft and hard tissue. The recent development of purified fibrillar collagen in combination with hydroxylapatite enhances our ability to provide effective, long-lasting dental prostheses.

¿Cuándo y porqué de la cirugía bucomaxilofacial con fines protésicos? / When and why of the bucomaxilofacial sugery whit prosthetie fenality?

El autor del trabajo hizo una revisión de la literatura sobre las dos especialidades, las cuales considera se han entrelazado, haciendo necesario la evaluación del paciente con criterios más amplios, que permitan diagnósticar y aplicar un tratamiento integral y coordinado. También se pretendió aportar lineamientos básicos, haciendo examenes a los pacientes con necesidades quirúrgicas-pprotesicas, así como la realización de examenes complementario