The Peri-Implant Zone: A Review of Literature
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:6] [Pages No:61 - 66]
DOI: 10.5005/jp-journals-10012-1037 | Open Access | How to cite |
Aim: The peri-implant zone comprises of a stable crestal bone and overlying peri-implant mucosa. Soft tissue esthetics are not attributed to a single parameter. The aim of this article is to highlight the underlying biology of the soft and the hard tissue complex, the associated vital parameters, implant component characteristics which act as the foundation of a successfully osseointegrated implant. Materials and methods: An electronic Medline was conducted with the search words used as: peri-implant, interdental papilla, peri-implant esthetics. Hand search across the journals referring to implantology, periodontology and prosthodontics was also done. Conclusion: This article presents a comprehensive review of the various factors responsible in determining a successful soft tissue esthetic outcome in implantology.
Medial Mandibular Flexure: A Review of Concepts and Consequences
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:5] [Pages No:67 - 71]
DOI: 10.5005/jp-journals-10012-1038 | Open Access | How to cite |
Mandible is a long bone which is bent in the form of a ‘U’ or bow, supported and articulated with the cranium by means of muscles and ligaments. These muscles, tendons and ligaments attached to the mandible exert force, which causes change in the shape of the mandible at different levels of movement of the jaws. A medial flexure of mandible occurs during wide opening of mouth with the amount of flexure depending on the degree of jaw movement. This mandibular flexure, though minimal, has a profound influence on cross-arch restorations and patients with subperiosteal implants. This article describes the various facts and consequences of mandibular flexure.
Clinicoradiographic Evaluation and Feasibility of Dental Implant in Infected Dentoalveolar Socket
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:5] [Pages No:73 - 77]
DOI: 10.5005/jp-journals-10012-1039 | Open Access | How to cite |
Purpose: To describe a protocol for immediate placement of endosseous implant into debrided infected dentoalveolar socket. Patients and methods: A total of 21 implants were placed in 10 patients. The immediate placement protocol emphasized the meticulous debridement of the infected tissue in combination with periapical ostectomy of socket. Guided bone regeneration was accomplished to support bony healing of alveolar defects surrounding implantation site. Pre- and postsurgical antibiotic therapy was administered. Results: All implants, but one, were osseointegrated after 6 months follow-up and were functional 6 months postoperatively. One implant was mobile on exposure after 6 months and was removed. Conclusion: Successful immediate implantation in debrided infected alveolus depends on complete removal of all contaminated tissue and the controlled regeneration of alveolar defect.
Histologic and Clinical Evaluation of a Bioactive Calcium Phosphosilicate Bone Graft Material in Postextraction Alveolar Sockets
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:6] [Pages No:79 - 84]
DOI: 10.5005/jp-journals-10012-1040 | Open Access | How to cite |
Background: Long-term success of dental implants has been demonstrated when placed simultaneously with or after a socket grafting procedure. Although optimal bone formation can be from 6 to 9 months or longer with grafting materials other than autogenous bone, there is the avoidance of potentially hazardous harvesting autogenous bone. Methods: This study evaluated bone formation following grafting of 22 postextraction alveolar sockets with a bioactive calcium phosphosilicate putty (CPS putty) graft material. Results: At 5 to 6 months postgrafting, there was bone regeneration showing both normal clinical attributes and radiographic trabecular appearance. Histomorphometric analysis revealed average vital bone content of 48.2 ± 6.8% to residual graft content of 2.4 ± 1.4% for the 22 sockets in the study, at an average healing period of 5.4 ± 1.5 months. Conclusions: The high percentage of vital bone content after a relatively short healing phase, suggests that CPS putty can be a reliable choice for osseous regeneration in cases of crest preservation and implant related surgeries.
Immediate Loading with Intraoral Welding for Improved Implant Stability during Healing
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:7] [Pages No:85 - 91]
DOI: 10.5005/jp-journals-10012-1041 | Open Access | How to cite |
Purpose: A clinical case is presented demonstrating the utilization of intraoral welding (syncrystallizer) to stabilize immediate one-piece implants during osteointegration for a fixed full-arch upper and lower rehabilitation with flapless surgical approach. Materials and methods: The surgical and prosthetic technique including postextraction placement of one-piece implants, modification of the implants intraorally for prosthetic angulation, and the method of initial bracing the implants, is described. The procedure has been subdivided by arch, with each arch being treated in a similar manner during a single surgical appointment for the full mouth implant treatment. Outcome: No complications are reported, and no implant has been lost one and a half years following surgical placement and restoration. The patient maintains appropriate oral hygiene and is pleased with the functional and esthetic results. The radiographs demonstrate maintenance of the osseous crestal levels with no peri-implant bone loss. Conclusions: The technique has demonstrated an effective aid for immediate implant stabilization allowing immediate loading without hampering the osteointegration process.
Mini Dental Implants as a Simple Treatment Alternative for Edentulous Mandibular Cases
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:4] [Pages No:93 - 96]
DOI: 10.5005/jp-journals-10012-1042 | Open Access | How to cite |
Path-breaking treatment plans for edentulous patients have been theorized by researchers. Implant retained overdentures using mini dental implants are a simple treatment alternative to the problem of an unstable mandibular complete denture and a long, traumatic and expensive treatment plan of conventional implant-supported prostheses. This paper reports on two patients, who have been successfully rehabilitated with implant-retained overdentures using mini dental implants (3M Imtec). The methodology of treatment has also been explained.
Polyetheretherketone (PEEK) Dental Implants: A Case for Immediate Loading
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:7] [Pages No:97 - 103]
DOI: 10.5005/jp-journals-10012-1043 | Open Access | How to cite |
In the last three decades, polyetheretherketone (PEEK) has been increasingly employed as a biomaterial for orthopedic and spinal implants. PEEK dental implants have shown equal promise and are currently being used and investigated in many parts of the world. While their osseointegration capacity has been established beyond doubt, it is not clear whether these implants are suitable for specific situations with low functional and high esthetic demands or as completely viable alternatives to titanium in all situations. We present a brief introduction to the PEEK implants, a representative system and kit and the advantages and disadvantages as compared to titanium implants. It is our observation that PEEK implants function well in anterior as well as posterior regions and when loaded immediately (one week after placement). Their use in the esthetic zone can be of significant advantage to the surgeon as well as patient. However, diminished radiopacity and limitation of available sizes may be causes for concern.
Augmentation Procedures for the Maxillary Sinus: A Case Report with 10-year Follow-up
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:5] [Pages No:105 - 109]
DOI: 10.5005/jp-journals-10012-1044 | Open Access | How to cite |
A partially edentulous maxilla is treated with bilateral sinus lifts and implant placement. The maxilla presented with total pneumatization at the right and left molar area and partial pneumatization on the left premolar. Soft and hard tissue anatomy for lower arch was suitable for implant placement, while in the maxilla bone was not adequate for placing the implants. In the maxillary right and left molar areas, a lateral sinus lift procedure was needed before implant placement. While in the left premolar area, an internal sinus lift procedure could be performed immediately before implant placement. Panoramic radiographs were taken on regular basis to document the implant survival and crestal bone levels, which were maintained at 10-year follow-up.
Restoration of Congenitally Missing Lateral Incisors with Single Stage Implants: An Interdisciplinary Approach
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:5] [Pages No:111 - 115]
DOI: 10.5005/jp-journals-10012-1045 | Open Access | How to cite |
The primary goal of the dental surgeon is to restore function as well as esthetics, and these objectives influence both the surgical and restorative phases of treatment. This report presents a conservative management of congenitally missing bilateral maxillary lateral incisors that was treated with a multidisciplinary approach between an orthodontist and a prosthodontist to redistribute spaces and establish buccolingual alveolar width by orthodontic movement of permanent canines distally in the maxillary arch followed by placement of implants to achieve a desirable esthetic result.
Free Gingival Grafting to Increase the Zone of Keratinized Tissue around Implants
[Year:2011] [Month:May-August] [Volume:2] [Number:2] [Pages:4] [Pages No:117 - 120]
DOI: 10.5005/jp-journals-10012-1046 | Open Access | How to cite |
Purpose: The importance of an adequate width of attached gingiva around periodontally affected teeth has been well-documented. However, there is no consensus regarding the relationship between the width of keratinized tissue and the health of peri-implant tissues. Clinicians in general prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. There are various methods of increasing the width of keratinized tissue around implants at various stages of treatment. This article aims at presenting a case report where free gingival grafting was done prior to implant placement to predictably increase the width of keratinized tissue and thus enhance the long-term success of the implants. Methods: Free gingival grafting was done in the edentulous region prior to implant placement to increase the width of keratinized tissue at the future implant sites. Two implants were then placed to replace the missing teeth. Results: Free gingival grafting resulted in an increase in the keratinized tissue at the implant sites and also favorably increased the vestibule depth. Clinically healthy keratinized tissue was achieved and maintained around both implants. The patient was able to adequately maintain oral hygiene, with no discomfort. Conclusion: The free gingival graft can be used to increase the width of keratinized tissue and increase the depth of the vestibule around implants, thus favoring their long-term prognosis.