The International journal of oral implantology : implantologist最新文献

{"title":"Immediate Prosthetic Loading of Implants Placed in Reconstructed Jaws After Hyperbaric Oxygen Therapy.","authors":"M. T. F. Oliveira, D. Zanetta-Barbosa, L. Lima, L. Raposo, L. C. Gonçalves, P. Simamoto-Júnior","doi":"10.1563/aaid-joi-D-16-00117","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-16-00117","url":null,"abstract":"T reatment of facial tumors by mandibulectomy can cause severe esthetic, functional, and psychosocial issues. Reconstruction of facial bone defects is challenging, generally involving multidisciplinary approaches to rehabilitate affected patients. Large reconstructions using free bone grafts are possible; however, some patients require special attention when it comes time to decide which type of reconstruction procedure will be performed, such as cancer patients and patients under bisphosphonate treatment. Additionally, these grafts may present increased difficulty to be incorporated compared with vascularized bone grafts. Thus, the use of hyperbaric oxygen therapy (HOT) has been stimulated due to the potential neo-osteogenesis and angiogenesis offered by this technique in accelerating healing of bone grafts. Oral rehabilitation following bone reconstruction is commonly indicated and conducted using different techniques. Implant-supported restorations are the primary restorative option, because dental implants can be successfully installed over grafted areas after the bone maturing period. However, the ideal loading moment of such implants is still a controversial topic. However, some studies suggest that adequate osseointegration is possible after immediate loading of implants in reconstructed areas. This report describes 3 cases of mandibulectomy followed by reconstruction using free iliac bone grafting associated to HOT and rehabilitation with immediate prosthetic loading of implants.","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"53 1","pages":"145-150"},"PeriodicalIF":0.0,"publicationDate":"2017-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86725036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covering the Implant Prosthesis Screw Access Hole: A Biological Approach to Material Selection and Technique.","authors":"Todd R. Schoenbaum, C. Wadhwani, R. Stevenson","doi":"10.1563/aaid-joi-D-16-00119","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-16-00119","url":null,"abstract":"W ith implant treatment in the esthetic zone, it is a constant endeavor to maintain and increase the volume of peri-implant tissues. Many recent developments in implant and abutment design have this as the primary goal. Thus we have seen the evolution and creation of ‘‘platform switch’’ abutments, narrowed abutment diameters, and conical implant connections—all in an effort to maximize the volume of the peri-implant bone and soft tissues. The conical connection in particular was developed with the aim of maximizing the integrity of the abutment– implant connection and thus reducing movement, decreasing peri-implant bone stress, and minimizing leakage of the contents inside the abutment into the delicate zone where bone, connective tissue, implant, and abutment all merge (Figure 1). This concept is sound and it does appear to reduce leakage into the peri-implant tissues, but it does not eliminate leakage. This is a problem that worsens over time with repeated loading. The ‘‘platform switch’’ design has mostly (but not entirely), proven to better maintain bone levels than abutments that flare directly from the head of the implant. Multiple finite element analyses have shown that the conical connection may serve to significantly reduce the stresses on the peri-implant crestal bone. It appears that the mechanical integrity of the conical connection provides a biologic benefit even outside the implant itself. The reason for the success seen with platform switch implants appears to be twofold: First, the nonintegrating abutment components are more narrow and thus further away from the bone allowing more space for the necessary biologic width. When nonintegrating components encroach upon this space, the bone remodels laterally and apically to create the necessary biologic space. Secondly, the platform switch design moves the implant–abutment junction (IAJ) away from the bone, and thus moves the inflammatory cell infiltrate coming from inside the implant / abutment and exiting at the IAJ further away from the crestal bone. Much histological study has been made into the biologic environment adjacent to the IAJ, and it has been well established that bone is maintained at a more coronal position when leakage is minimized by use of conical connections, and when the leakage that does occur is moved further away from the bone by use of platform switch abutments. Recent short-term data suggest that the conical connection and minimizing leakage at the IAJ is the more important factor in limiting bone loss. Based on these concepts, it is evident that the contents inside the implant/ abutment directly, and negatively, affect the peri-implant bone position. Leakage from the IAJ cannot be eliminated, but efforts should be made by the clinician to minimize it. It is clear that the contents of the implant/abutment negatively affect the peri-implant bone, and that they will leak from the IAJ. Thus, what is put into the abutment to cover the screw can have a significant","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"11 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2017-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80049265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-Implant Mucositis and Peri-Implantitis: A Current Understanding of Their Diagnosis, Clinical Implications, and a Report of Treatment Using a Combined Therapy Approach.","authors":"P. Poli, M. Cicciu', M. Beretta, C. Maiorana","doi":"10.1563/aaid-joi-D-16-00082","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-16-00082","url":null,"abstract":"Abstract The clinical condition involving dental implants, characterized by soft tissue inflammation, bleeding, suppuration and rapid bone loss is widely known as peri implantitis. The main objective in the treatment of peri-implantis is to arrest the progression of the disease and at the same time to keep the dental implant in the mouth solving the inflammations signs of bleeding and pain. The aim of this paper is to highlight the effectiveness of the use of titanium brush and antimicrobial photodynamic therapy (aPDT) to decontaminate the implant surface, in association with regenerative procedures by means of autologous bone and demineralized bovine bone mineral (DBBM) in the treatment of peri-implantitis defects.","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"139 1","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"2017-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80118348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-Implantitis Associated With a Pre-Existing Pathology.","authors":"Se‐Lim Oh","doi":"10.1563/aaid-joi-D-16-00211","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-16-00211","url":null,"abstract":"This case report presents a treatment of peri-implantitis associated with a pre-existing pathology. Peri-implantitis around implant #19 was detected from pus discharge upon probing. Guided bone regeneration was performed to treat the peri-implantitis with the administration of antibiotics. The histopathologic evaluation of soft tissue taken from the circumferential defect around the implant exhibited a cyst. The postsurgical CBCT and the follow-up radiograph confirmed the maturing bone graft and a reduced size of the defect around the implant.","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"28 1","pages":"232-236"},"PeriodicalIF":0.0,"publicationDate":"2017-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75026081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixed Implant-Supported Full-Arch Prosthesis in Epidermolysis Bullosa With Severe Symptoms.","authors":"Marcelo Guzmán Letelier, Claudia Crisosto Jara, S. Peñarrocha-Oltra, Sonia Gomar-Vercher, M. Diago","doi":"10.1563/aaid-joi-D-14-00104","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-14-00104","url":null,"abstract":"E pidermolysis bullosa (EB) is a group of rare hereditary mucocutaneous disorders that is characterized by the presence of a mechanical defect between the skin and the mucosa membranes with recurring appearances of blisters and vesicles. This disorder is classified in 4 principal groups—Simplex, Junctional, Dystrophic, and Kindler syndrome—and 32 subtypes. Recessive dystrophic with generalized impact presents most frequently in the oral mucosa. Systemic features of this disease include blisters on the entire body—particularly in areas of friction, such as the hands, the feet, the elbows and the knees. The blisters subsequently burst, leaving painful ulcers that heal via contraction of the soft tissue. In its most severe presentations, junctional and dystrophic EB, this contraction of the soft tissue often results in digital syndactyly, with the formation of stumps and stenosis of the superior third of the esophagus; this, in turn, causes dysphagia. Oral symptoms include the formation of recurring blisters and scars, limited oral aperture, ankyloglossia, obliteration of the buccal grooves, microstomia, severe periodontal disease and resorption of the alveolar bone, maxilla atrophy with mandibular prognathism, increased mandibular angle, and a predisposition to oral carcinoma. Routine dental care and regular brushing of the teeth can also cause blisters and lesions in the oral mucosa. In some cases, rampant caries associated with hypoplastic enamel and poor oral hygiene are observed. The treatment of EB patients with conventional removable dentures has resulted in development of blisters in the oral mucosa as a result of mechanical friction of the prosthesis over the tissues. As a result, restoration using dental implants and a fixed prosthetic is likely to be better tolerated by the patient, as it limits the possibility of lacerations and blisters in the soft tissue. The objective of this clinical case is to describe the restoration of the complete arch in an atrophic maxilla using endosseous implants and an implant-supported fixed prosthetic in a patient diagnosed with RDEB who is exhibiting severe general and oral symptoms. We will also evaluate improvements in the patient’s quality of life using a subjective scale of satisfaction.","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"12 1","pages":"498-505"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89871440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertical Alveolar Ridge Augmentation in Implant Dentistry: A Surgical Manual and Horizontal Alveolar Ridge Augmentation in Implant Dentistry: A Surgical Manual. Tolstunov L, ed. Hoboken, NJ: John Wiley & Sons, Inc. Hoboken, New Jersey.","authors":"J. Rutkowski","doi":"10.1563/aaid-joi-D-Review.4206","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-Review.4206","url":null,"abstract":"","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"28 1","pages":"518"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74076379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Judgment and Evidence Based Knowledge: A Prescription for Clinical Confidence.","authors":"J. Rutkowski","doi":"10.1563/aaid-joi-D-Editorial.4206","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-Editorial.4206","url":null,"abstract":"C linical judgment is a central component of the practice of implant dentistry. It is part diagnosis, treatment planning, operative routine, postoperative management, and assessment of treatment both in the shortand long-term. Clinical judgment also generates information that maybe shared with other clinicians through conversations, lectures or clinical case letters. Dental implantology is a profession in which the clinician’s knowledge, skills, and judgment are used in ‘‘the service of protecting and restoring human well-being.’’ Clinical judgment is the heart of dental teams’ know-how and skill. It may well be ‘‘almost as important as the technical ability to carry out the procedure itself.’’ Judgment develops through continual practice, the totality of both good and bad experiences, the continual quest of knowledge (education), and endless critical analysis. Clinical judgment is important to daily practice yet the physician author of the book titled How Doctors Think: Clinical Judgment and the Practice of Medicine asks, ‘‘Why is it that it is so difficult to define clinical judgment, and why do we doctors squirm when we are forced to admit just how reliant we are on it?’’ This is problematic for all of us, because as clinicians we should back up our clinical actions with science. As the practice of medicine and dentistry has changed, so has the validity of clinical judgment. Many of us remember how we marveled at our mentors for the competency and creativity they demonstrated in making operative decisions. Many of our mentors were ‘‘pioneers’’ and were creating the ‘‘rules’’ of implant dentistry as they went through a day’s work of restoring patients’ oral cavities to a state of function. Their competency was often based more on ‘‘gut-decisions’’ than on science, because through no fault of their own, there was little science on which to depend. Nonetheless, as the profession made progress based on scientific findings, clinical judgment was regarded as a fallacious trait and looked upon as being ‘‘charlatan-like’’. Unfortunately, some have gone to an extreme and advise clinicians ‘‘to guard against any use of judgment.’’ Interestingly, the shame of personal judgment was not revealed by scientifically based systematic analyses, but rather on anecdotal examples of inexperience or errors made and caught after the fact. Clinicians can be wrong in their beliefs, expectations, or understanding of the clinical practice of implant dentistry. As clinicians our judgment has to be more than post hoc ergo propter hoc (since event Y followed event X, event Y must have been caused by event X). This may be frequently true but when used as the only guide it will eventually become a ‘‘post hoc fallacy’’. Judgment alone will be in error on many occasions. The issue is that a clinician may not recognize factually wrong clinical judgment that has evolved solely from personal experiences. Therefore, clinical practice must be more than judgment, but rather judgment","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"169 1","pages":"451-452"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80625516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Truth About Flossing.","authors":"J. Rutkowski","doi":"10.1563/AAID-JOI-D-EDITORIAL.4205","DOIUrl":"https://doi.org/10.1563/AAID-JOI-D-EDITORIAL.4205","url":null,"abstract":"R ecently the lay press extrapolated a change in the 2010 US government’s Dietary Guidelines for Americans, that specified, ‘‘. . .A combined approach of reducing the amount of time sugars and starches are in the mouth, drinking fluoridated water, and brushing and flossing teeth, is the most effective way to reduce dental caries.\" The previous flossing recommendation had been in effect since 1979. The newer 2015 recommendations were brought into compliance with US law, which requires that all recommendations put forth by US government health guidelines must be based upon scientific evidence. This change is the result of an inquiry, through the Freedom of Information Act, from the Associated Press (AP) asking the Health and Human Services, and Agriculture Departments for the scientific evidence supporting the health benefits for using dental floss. The government acknowledged that the effectiveness of flossing in controlling dental caries had never been adequately researched, and therefore, the recommendation would no longer be made. Therefore, because of the law, the recommendation has been changed. However, the change was recklessly simplified to suggest that dental flossing is no longer necessary. The question regarding the benefits of flossing in managing periodontal disease and dental caries was examined by Sambunjak et al. in a 2012 article titled, ‘‘Flossing for the management of periodontal diseases and dental caries in adults’’. The systematic review examined the benefits of toothbrushing with and without dental flossing in patients’ age 16. The authors concluded, ‘‘...results showed that at the 3 time points studied (1, 3 and 6 months), there was a statistically significant benefit in the reduction of gingivitis by using floss plus toothbrushing, compared to toothbrushing alone’’. Additionally, ‘‘Along with demonstrating a statistical significance, there is a clear indication of an important clinical benefit [to flossing]. Patients are often rightly concerned about ‘bleeding gums’ and this review shows that flossing is effective in reducing gingivitis and the tendency for gums to bleed.’’ Therefore, ‘‘. . .patients will have an improved gingival condition and an improved quality of life.’’ The authors were not able to conclude that flossing reduced dental caries because the dental caries question was not asked in any of the studies. It has been well accepted that bacterial growth found in dental plaque can lead to inflammation that may cause alveolar bone loss and therefore subsequent loss of teeth. The effectiveness of dental floss was evaluated in a 1979 Journal of Dental Research publication that found that flossing by a dental hygienist using either unwaxed or waxed dental floss was effective in reducing gingival inflammation. When clinically examining specific groups such as the young, aged, those with a poor diet, medically compromised, and patients with dry mouth it is often discovered that not flossing can be both dentally and fi","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"98 1","pages":"385"},"PeriodicalIF":0.0,"publicationDate":"2016-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86950156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Space Maintenance Using Tenting Screws in Atrophic Extraction Sockets.","authors":"T. S. Reddy, Nidhi R Shah, Analia Roca, Andrew J Sullivan, J. Pascuzzi, H. Drew","doi":"10.1563/aaid-joi-D-15-00048","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-15-00048","url":null,"abstract":"","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"6 1","pages":"353-7"},"PeriodicalIF":0.0,"publicationDate":"2016-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90864502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertical Ridge Augmentation With Mandibular Lingual Torus Block Graft.","authors":"Chin-Wei Jeff Wang, Chung-Hsun Bruce Huang, Stephen H. Grossman, Jacob Pourati","doi":"10.1563/aaid-joi-D-15-00151","DOIUrl":"https://doi.org/10.1563/aaid-joi-D-15-00151","url":null,"abstract":"D ental implant prostheses often provide an ideal restorative option to replace missing teeth. Severe alveolar ridge resorption—resulting from periodontal infections, iatrogenic trauma from extractions, or subsequent bone loss following prolonged edentulism—often preclude proper implant placement and positioning. Under such conditions, ridge augmentation procedures may be required prior to implant therapy. Numerous techniques have been developed for alveolar ridge augmentation. An onlay block graft is one of the procedures designed to correct deficient alveolar ridges. While allografts, xenografts, and synthetic block grafts are viable options, an autogenous block graft may still be considered the gold standard. Autogenous bone grafts harvested from intraoral sources (including mandibular ramus, mandibular symphysis, or maxillary tuberosity) have demonstrated better integration to the recipient site, often with less resorption than bone from extraoral sources. However, the risk of donor site morbidity and postoperative complications have raised concerns about their applications. Tori are benign outgrowths of bone that could function as an alternative source of autogenous bone, concomitantly diminishing complications associated with harvesting. Several case reports have demonstrated successful horizontal ridge and sinus augmentation when utilizing block or particulate form of tori. It is generally accepted that horizontal ridge augmentation and sinus lifting are much more predictable compared to vertical ridge augmentation. Since there is limited literature addressing the feasibility of using tori as an onlay block graft for vertical ridge augmentation, the objective of this case report is to introduce the use of a mandibular lingual torus as an onlay block graft for a vertically deficient alveolar ridge. The successful vertical increase of the deficient mandibular ridge and ultimate implant placement and restoration was demonstrated. CASE PRESENTATION","PeriodicalId":77634,"journal":{"name":"The International journal of oral implantology : implantologist","volume":"23 1","pages":"369-72"},"PeriodicalIF":0.0,"publicationDate":"2016-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91343479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}