Evaluation of Active Tactile Perception of Single Tooth Implant Prosthesis
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:6] [Pages No:1 - 6]
DOI: 10.5005/JP-Journals-10012-1085 | Open Access | How to cite |
Purpose: The phenomenon of developing a certain tactile sensibility through osseointegrated dental implants is called osseoperception. Active tactile sensibility can be tested by having the subject bite on test bodies. The aim of the study was to assess the active tactile sensibility of osseointegrated single tooth dental implants according to psychophysical method of constant stimuli. Materials and methods: Twenty subjects (10 male and 10 female) with single tooth implants located in the posterior region with natural, healthy antagonistic teeth were included in the study. Ten implants were located in the maxilla and 10 in the mandible. The subjects were also divided into two age groups 30 to 40 years and 40 to 50 years, and the active tactile perception was studied according to the psychophysical method of constant stimuli. Results: The active tactile perception of osseointegrated single tooth dental implants with natural healthy antagonist revealed a threshold ranging between 24 ± 8 μ. The active tactile perception of healthy natural tooth with natural healthy antagonist revealed a threshold ranging between 12 ± 4 ì. No statistically significant results were found between different age groups (30-40 years age group and 40-50 years age group). The threshold for tactile perception was found to be similar in both male and female subjects. No statistical significance was found in the threshold between different implant locations (maxilla and mandible). Conclusion: Active tactile sensibility of implants with natural antagonistic teeth is similar to that of teeth. Implant-supported prosthesis restores jaw function more appropriately, with improved psychophysiological discriminatory ability.
Immediate Placement Implant in Fresh Extraction Socket: A Clinical Study of Seven Cases
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:9] [Pages No:7 - 15]
DOI: 10.5005/JP-Journals-10012-1086 | Open Access | How to cite |
Aims and objectives: To reduce the prolonged waiting period post tooth extraction for rehabilitation with implants. This study was carried out to determine the outcome of implants placed into fresh extraction sockets with the simultaneous use of particulate bone graft. Patient response to rehabilitation with immediate placement single tooth implants was monitored clinically and radiographically. Materials and methods: Among seven patients, with the average age of 28 years were treated for single tooth replacement in fresh extraction sockets in the esthetic zone by means of 2 stage immediate placement of implant. Bioactive glass particulate bone graft was used as bone graft material. Reason for teeth loss was caries, trauma and internal resorption. All patients were followed clinically and radiographically for 1 year after loading of implant. Results: Follow-up was done after stage I surgery (placement of implant) for pain, soft tissue dehiscence, inflammation, altered sensation at site of implant placement monthly for 4 to 6 months. After giving final prosthesis, patients were evaluated for bleeding index (Muhlemann and Son), plaque index (Turesky- Gilmore- Glickman) gingival index (Loe and Silness), marginal bone loss (parallel cone technique using IOPA) with follow-up at 6th and 12th months. All the implants were osseointegrated at the time of abutment placement. Radiographic examination showed only slight marginal bone around the implants. Conclusion: Hence, implants can be placed successfully in fresh extraction socket using bioactive glass (perioglass) particulate bone graft material to fill gap between implant and bone through a submerged (2 stage) surgical technique.
Influence of Occlusal Forces on Stress Distribution on Preloaded Dental Implant Abutment Screws: A Finite Element Analysis Study
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:8] [Pages No:16 - 23]
DOI: 10.5005/JP-Journals-10012-1087 | Open Access | How to cite |
Purpose: The aim of the study is to determine stress distribution on preloaded implant-abutment screws in three different implant systems under simulated occlusal loads. Materials and methods: Three abutments to implant internal hex joint systems were simulated by using the 3-dimensional finite element analysis; (1) Nobel Biocare replace tapered (2) Uniti (3) Lifecare self-threaded tapered cement retained abutments. Thermal load and contact analysis were used to simulate preload resulting from the torque in implant screw joint assemblies. The simulated preload implants were then loaded with three static occlusal loads (10N horizontal; 35N vertical; 70N oblique) onto the crown into the implant complex. Materials and methods: Three abutments to implant internal hex joint systems were simulated by using the 3-dimensional finite element analysis; (1) Nobel Biocare replace tapered (2) Uniti (3) Lifecare self-threaded tapered cement retained abutments. Thermal load and contact analysis were used to simulate preload resulting from the torque in implant screw joint assemblies. The simulated preload implants were then loaded with three static occlusal loads (10N horizontal; 35N vertical; 70N oblique) onto the crown into the implant complex. Results: Under preload and static occlusal forces, maximum Von-Mises stresses were concentrated at the lower portion of abutment for all systems. Maximum stresses were concentrated at lower threaded portion of abutment screw in Nobel Biocare, Uniti but in Lifecare system, stresses were concentrated at the middle threaded portion. Maximum stresses were concentrated at middle threaded portion of implant in Nobel Biocare, Uniti but at the upper threaded portion in Lifecare. Stresses increased under static occlusal forces in abutment screw in Nobel Biocare and Uniti but were more under oblique forces. In Lifecare stresses decreased under horizontal forces and increased in vertical and oblique forces. Conclusion: Although, an increase or decrease was demonstrated for the maximum calculated stress values in preloaded screws. After occlusal loads, these maximum stress values were well below the yield stress of abutment screw systems tested.
Anatomical Considerations in Implant Selection and Positioning
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:6] [Pages No:24 - 29]
DOI: 10.5005/JP-Journals-10012-1088 | Open Access | How to cite |
This article reviews the various anatomical facts significant for preoperative planning of implant procedures in the mandible and the maxilla. This planning includes the precise evaluation of distinct anatomical factors, such as the position of the mandibular canal, the maxillary sinus, the width of the cortical plates, the existing bone density, appropriate implant selection and planning the most appropriate implant position in the existing clinical condition.
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:6] [Pages No:30 - 35]
DOI: 10.5005/JP-Journals-10012-1089 | Open Access | How to cite |
Diabetes mellitus has become a public health problem because of its increased prevalence all over the world. Diabetes is associated with altered glucose homeostasis. Diabetics have impaired wound healing and impaired bone metabolism. Safely managing the patient with diabetes requires effective communication among multiple health care providers. Although implants are increasingly used in healthy patients, their appropriateness in diabetic patients is less equivocal. Perhaps surprisingly, the evidence of their efficacy in these groups of patients is quite sparse. It is known to impair healing which increases the risk of tissue necrosis and infection. Improvement in glycemia levels in previous studies are well suited to dental implant surgery with acceptable degree of predictability. This article review the implications of diabetes and glycemic control for the prognosis and evolution of dental implants.
Synergy between 3D Models and Tissue Engineering to Optimize Sinus Lift, Implant Placement and Immediate Loading in Partially Edentulous Patients
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:8] [Pages No:36 - 43]
DOI: 10.5005/JP-Journals-10012-1090 | Open Access | How to cite |
Tissue engineering is a clinical approach toward the development of dynamic molecular delivery that can restore and improve regeneration. The 3D models and regenerative principles applied during implant guided dental surgery open new approaches for tissue constructs favoring sinus lift and implant placement. Purpose: The aim of the present clinical study was to determine evidence that synergy between 3D models and bone regeneration utilizing autologous fibroblast growth factor (FGF) and growth factors matrices mixed with demineralized freezedried bone allograft (DFDBA) particles optimize tissue engineering for immediate dental implant placement and loading during sinus lift procedure. Materials and methods: Twelve endo-osseous implants were placed into residual crestal bone (5.0 ± 0.15 mm). A minimal invasive osteotome Summer's technique was performed in combination with autologous FGF matrices mixed with FDBA particles. Soft tissue height and width were measured at baseline, 1, 3 and 6 months. Engineered bone surrounding implants was analyzed through 3D metric models for volume and contact interface from baseline to 6 months. Results: Healing was uneventful. The surgical guide and the osteotome technique significantly contribute to the initial implant stability. Gingival soft tissue improves in color and contour. Soft tissue height and width both increased from baseline to 6 months. At 1 month, soft tissue height (STH) increase was 2.55 ± 0.30 mm (CI 95%—p = 0.001), and soft tissue width (STW) gain was 1.50 ± 0.50 mm (p = 0.001—CI 95%). At 3 months, STH increased to 3.12 ± 0.50 mm and STW gain was 2.40 ± 0.40 mm (p = 0.001—CI 95%). At 6 months, these values remained stable. Implant sites receiving autologous FGF matrices mixed with DFDBA exhibited a BV gain of 0.47 ± 0.10 cm3—bone fill averaging 100% at 6 months (p = 0.001). Conclusion: The osteotome Summer`s technique was a predictable technique to increase bone volume. Autologous FGF matrices mixed with DFDBA favors 3D scaffold enhancing bioguided soft tissue gain and bone engineering at implant interface. Sinus membrane perforations were favorable controlled. Guided dental surgery and three-dimensional metric applications improve surgical placement, mechanical support, clinical performance and patient cost/benefit satisfaction. Further studies with a larger sample are needed to enhance the statistical significance of our clinical findings.
Prosthetically Driven Implants: How much a Reality?
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:3] [Pages No:44 - 46]
DOI: 10.5005/JP-Journals-10012-1091 | Open Access | How to cite |
Implants are fast becoming an integral part of modern dentistry. It is the only treatment modality where additional abutments can be created for improving the esthetics and function. When diagnostic protocol involves both the surgeon and the prosthodontist, the biomechanical, technical and esthetic compromises are circumvented. Careful planning, evaluation of all the diagnostic aids, mock wax up and using a surgical guide helps to accurately locate the implant fixture regarding the depth and angulation which is critical to the esthetic and biomechanical success of the prosthesis. The clinical case depicted here is an illustration of how difficult it becomes to restore the case when the fixtures are placed in incorrect location and/or angulation.
Implant Supported Overdenture: An Ameliorating Alternative for Edentulism
[Year:2013] [Month:January-April] [Volume:4] [Number:1] [Pages:7] [Pages No:47 - 53]
DOI: 10.5005/JP-Journals-10021-1092 | Open Access | How to cite |
Fixed and removable implant-supported restorations successfully address problems associated with complete dentures in edentulous mandibles. Implant-supported overdenture improves retention, stability, function, proprioception and comfort. This case report depicts step-by-step procedure for fabrication of implant-supported overdenture with castable bar and clip attachment. The bar was fabricated from readily available castable bar system and clips were attached to denture by indirect technique. The shortcomings of direct technique are overcome by this procedure. It is relatively simple and easy technique to produce an accurate prosthesis.