International Journal of Oral Implantology & Clinical Research

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2017 | December | Volume 8 | Issue 2-3

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Ashi Chug, Lanka Mahesh, Sagrika Shukla, Pulkit Chandra

Deciphering All-on-4® and Its Perspectives

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:5] [Pages No:35 - 39]

Keywords: All-on-4®, Immediate loading, Implant, Micromotion, Rehabilitation

   DOI: 10.5005/jp-journals-10012-1165  |  Open Access |  How to cite  | 


All-on-4® treatment concept has been widely accepted by implantologist and has become a common procedure in many dental practices. But is it a favorable technique and how long will the implants last when the entire frame work of 12 teeth is embedded in maxillary soft bone and immediately loaded? It is difficult and baseless to argue and conclude the benefits of All-on-4® as the literature lacks required data; nonetheless, this article has tried to provide readers an unbiased opinion, as the final choice of the treatment lies in the clinician's discretion keeping patient needs in consideration.



AB Tarun Kumar, Dhanya K Budihal, Charu Gupta, Harshul Sharma

A Safe Approach to Full Mouth Rehabilitation

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:5] [Pages No:40 - 44]

Keywords: All-on-4, Immediate loading, Intraoral welding, Multiunit abutments, Tilted implants

   DOI: 10.5005/jp-journals-10012-1166  |  Open Access |  How to cite  | 


The oral rehabilitation for a patient with severe loss of alveolar bone presents a challenge to clinicians. Replacing missing teeth in such a situation with fixed prostheses supported by dental implants often requires either bone grafting or basal implants. Sometimes, multiple surgeries and a longer healing time are required to overcome the unpredictable outcome of bone grafting. In a biomechanically compromised environment, strain to the crestal bone can be reduced by increasing the anteroposterior spread of implants, placement of longer implants, and maximizing the number of implants. Here, we present a clinical case of a patient who had undergone full mouth reconstruction with mandibular implant-supported fixed prostheses and maxillary metalfree crowns for discoloration. This case report demonstrates an immediate implant placement with All-on-4® concept, which may be an alternative to conventional bone grafting followed by implant placement. Also, principles of splinting and load sharing were followed by performing intraoral welding using titanium wires. We hypothesize that primary stability during implant placement is a prime factor contributing to our success.



Rashmi Paramashivaiah, Pabbati K Vardhan, Munivenkatappa L Venkatesh

Guided Bone Regeneration using a Combination of Novel Biomaterial and Type I Collagen for Isolated Ridge Defect to facilitate Delayed Implant Therapy: A Solitary Case Report

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:5] [Pages No:45 - 49]

Keywords: Biomaterial, Collagen, Guided bone regeneration, Implant, Osseointegration, Ridge augmentation

   DOI: 10.5005/jp-journals-10012-1167  |  Open Access |  How to cite  | 


Introduction: Ridge augmentation has attained a key role in implant placement to recreate the natural contour of the hard and soft tissues that may have been lost as a consequence of extraction. Ridge augmentation procedures require bone to be regenerated outside the existing bony walls or housing and are therefore often considered to be one of the most challenging surgical procedures. Materials and methods: In the current case, a Seibert's class III defect was treated, followed by implant placement after 6 months. The bony deficit was managed with guided bone regeneration (GBR) techniques utilizing bone grafting material and membrane. Second surgery and the subsequent morbidity involved in the removal of nonresorbable membranes were tackled with the use of resorbable collagen membranes. Different bone graft materials are used routinely in combination with these membranes to facilitate space maintenance and to prevent membrane collapse. Particulate xenograft was used, as it restores the natural tissue architecture for placement of implant at a later stage. At the time of implant placement, the ridge was found to have the required dimensions. Conclusion: Ridge augmentation using a combination of membrane and xenograft for Seibert's class III ridge defect is a predictable treatment option. It improves the restorative aspect of implant placement in compromised areas.



Atul Bhatnagar, Aprajita Verma, Aratee Gupta, Shankar Singh

Management of Inadequate Bone for Implant Placement in Esthetic Zone: A Case Series

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:5] [Pages No:50 - 54]

Keywords: Block graft, Deficient bone, Distraction osteogenesis, Esthetic zone, Guided bone regeneration, Ridge splitting

   DOI: 10.5005/jp-journals-10012-1168  |  Open Access |  How to cite  | 


Introduction: In the past, it was thought that presence of sufficient bone was mandatory for dental implants for primary stability. However, in the modern era, several techniques and a variety of materials are available for management of such cases. Aim: Bone resorption followed by loss of teeth can lead to alveolar ridge defects, which can further impose problems in placement of dental implants. These defects can be in width or height of available bone. Vertical defects in alveolar ridge are quite difficult to manage for dental surgeons. This report describes several techniques for management of deficient bone in esthetic zone for implant placement. Case report: In this case series, authors have discussed several techniques like ridge splitting and expansion, guided bone regeneration (GBR), block graft, and alveolar distraction osteogenesis (DO) for the management of alveolar defects. Through this case series, authors have tried to describe indications and contraindications of each procedure. Conclusion: The choice of techniques depends upon the situation and clinician's choice. There are no specific guidelines for techniques to be used. Clinical significance: This case series describes several techniques, which can be employed routinely in cases of deficient bone and will facilitate placement of implants.



Laxman R Polsani, Kanapuram VR Reddy, Deepa Pillai, Gargi Jadaun

Rehabilitation of an Adolescent Female by Immediate Loading in the Anterior Esthetic Zone: A Case Report

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:6] [Pages No:55 - 60]

Keywords: Adolescent female, Immediate loading, Implants in road traffic accident

   DOI: 10.5005/jp-journals-10012-1169  |  Open Access |  How to cite  | 


Road traffic accidents are common among young adolescents, which leads to dentoalveolar injuries which are the most commonly encountered injuries. Several rehabilitation techniques are available in the literature which includes preparation of a fracture site with composite, splinting with fiber reinforced composites, removable partial dentures, resin bonded bridges, and the most recent-implants. In recent times, immediate implant placement and loading are found to be the permanent rehabilitation solution for an avulsed tooth as compared to reimplantation. Hence, we present a case report of a 16-year-old female patient who met with a road traffic accident resulting in missing right and left central incisors and fractured left lateral incisor, who was managed by rehabilitation with implants with immediate loading as a permanent solution.



Rathika Rai, Eswaran B, Rahul Singh

Overhauling Implant Thread Exposure: A Case Report

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:4] [Pages No:61 - 64]

Keywords: Implant, Implant thread, Thread exposure, Vestibuloplasty

   DOI: 10.5005/jp-journals-10012-1170  |  Open Access |  How to cite  | 


Dental implants are considered to be one of the most successful forms of prosthetic rehabilitation for both partial and completely edentulous patients. The pros and cons of prosthetic dental implants are attributed to the necessity of technique sensitivity. One of the most common challenges faced during prosthetic dental implant placement is soft tissue management, particularly in the lower posterior partial/ completely edentulous regions. Several factors such as excessive loading of the implant, localized periodontal infection or presence of frenal or muscular pull may lead to exposure of the dental implant threads. With the prevailing dental implant, treatment challenges may occur one of them is implant thread exposure which might require unconventional treatment option because the exposed thread in osseointegrated implant are difficult to clean may not be amenable to regenerative therapy. Following case report elaborates exposure of the threads of dental implants as a result of excessive muscle traction after stage one of implant placement and a successful minor corrective surgical technique was used to correct the aforementioned etiology.



Lanka Mahesh, Gregori M Kurtzman,, Rocco E Mele

Improving Clinical Results in Veterinary Osseous Grafting

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:7] [Pages No:65 - 71]

Keywords: Bond apatite, Calcium sulphate, Immediate implant, Osseous graft, Ridge augmentation, Socket preservation

   DOI: 10.5005/jp-journals-10012-1171  |  Open Access |  How to cite  | 


Veterinary dentistry and oral surgery is beginning to incorporate osseous graft material and techniques into their everyday dental clinical practices. Autogenous, allogenic xenografts and synthetics are all part of a new armamentarium to improve clinical results and achieve osseous reconstruction either to preserve anatomical ridge contours or to support implants placed to replace teeth extracted or previously missing. Clinicians and researchers have been exploring the use of calcium sulfate (CS) for over 100 years in orthopedic, spinal arthrodesis, and maxillofacial surgery. CS is an inexpensive, easy-to-use material that offers many advantages as a predictable and significant bone regeneration substrate.



Lanka Mahesh, Gregori M Kurtzman,, Rocco E Mele, Itzhak Binderman

Veterinary Osseous Site Reconstruction Utilizing Autologous Dentin from Extracted Teeth

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:9] [Pages No:72 - 80]

Keywords: Autologous grafting, Autologous particulate dentin graft, Dentin graft, Smart dentin grinder, Socket preservation, Tooth-derived bone graft

   DOI: 10.5005/jp-journals-10012-1172  |  Open Access |  How to cite  | 


Following tooth extraction, we often observe significant changes of ridge contour that is the result of alveolar bone loss. Most of the bone loss occurs during the first 3 to 4 months following extraction. To prevent this, it is strongly recommended to graft the extraction site with a biocompatible and bioactive osseous graft material at the time of extraction. There are many options available for socket grafting each with its own deficiencies. Most of the synthetic and allograft type bone substitutes preserve the alveolar ridge during the repair phase of the wound healing, but subsequently resorb during the following remodeling phase and therefore only achieve partial ridge restoration. Xenografts, on the contrary, do not osseointegrate sufficiently and form “islands” of foreign body within the bone structure. Recently, a novel procedure was developed where the extracted tooth is immediately processed into an autologous graft that preserves the alveolar ridge for many years and is biocompatible to the host site in a highly predictable manner. The procedure also helps to keep treatment costs lower than prepackaged graft materials. This autologous dentin particulate, made from the extracted tooth of the patient, undergoes ankylosis with the newly formed bone around it. The result is a biological connection or fusion of the graft and the host bone, an interface that is more biological than other alternatives, hence providing optimal and predictable results in the short and long term.



Anshul Chugh, Sunita Rani

Mandibular Tooth-supported Overdenture using Customized Ball Attachments: A Clinical Research

[Year:2017] [Month:December] [Volume:8] [Number:2-3] [Pages:4] [Pages No:81 - 84]

Keywords: Custom-made attachments, Metal copings, Overdenture, Precision attachments, Retained teeth

   DOI: 10.5005/jp-journals-10012-1173  |  Open Access |  How to cite  | 


Tooth-supported overdentures are selectively supported from retained teeth and residual ridge. It helps to maintain the proprioception and preservation of remaining alveolar bone. Use of precision attachments provides with increased retention and gives an excellent sense of satisfaction to the patient. This clinical report describes the use of custom-made ball attachments to retain the tooth-supported mandibular overdenture.


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