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  • 1
    ISSN: 1365-2842
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: summary  The objective of the present study was to analyse the effects of implant supported overdentures on masticatory function in patients with an extremely resorbed mandible, and to compare the masticatory function in these patients using three differing types of implant treatment protocols. The mandibular overdentures were retained by a transmandibular implant, by four endosseous implants following augmentation of the mandible, and by four short endosseous implants, respectively. Sixty patients (50 women, 10 men, mean age 59·4 years) were randomly allocated to one of the three treatment groups. Masticatory function was assessed before and after treatment using a questionnaire, a masticatory performance test, and a structured interview. The patient-based masticatory function improved significantly. Concerning these parameters there were no significant differences between the three groups before and after treatment. A significant difference existed between the three groups for the laboratory-assessed masticatory function before treatment, but after treatment this difference was no longer significant. From this study it can be concluded that patients with an extremely resorbed mandible and functional complaints of their lower denture report significant improvement in masticatory function after implant-overdenture treatment. Differences in masticatory function between the three studied modalities were not significant after treatment.
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  • 2
    ISSN: 1365-2842
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: summary In a controlled clinical trial, treatment effects of mandibular overdentures on two different implant-systems in edentulous patients were compared one year after insertion of the new dentures. The implant-systems used were the Brånemark system (Brå) and the IMZ-system. Treatment was randomly assigned to 60 patients according to a balanced allocation method. Evaluation included peri-implant and radiographical parameters. According to the Delphi method a clinical implant performance scale (CIP) was constructed based on all conceivable complications of the different implant systems. During the osseointegration period, five Brå- and one IMZ-implants were lost. The results of one of the peri-implant parameters and the radiographical score showed significant differences considering the (pseudo) pocket probing depth (Brå better than IMZ, P〈 0.001) and the radiographic-score (IMZ better than Brå, P 〈 0003). The results for the CIP-scale were less favourable for the Brå-group than for the IMZ-group; however, these differences were not significant.
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  • 3
    ISSN: 1365-2842
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of this multicentre randomized clinical trial was to analyse surgical and prosthetic aftercare and clinical implant performance of edentulous patients with implant-retained mandibular overdentures and of patients with conventional dentures, either or not after pre-prosthetic vestibuloplasty and deepening of the floor of the mouth. The evaluation period was 5 years. The implant systems evaluated were the IMZ implant system, the Brånemark implant system and the Transmandibular Implant system. The centre in Groningen had five groups (n=149) and the centre in Nijmegen had three groups (n=86). The evaluation comprised of surgical and prosthetic aftercare, together with clinical implant performance (CIP). The highest implant loss (29%) is found in the Transmandibular Implant group. All groups had prosthetic revisions and complications according to the CIP-scale. The majority of the patients in the endosseous implant groups were subject to minor complications. The CIP-score of the Transmandibular Implant group is significantly higher than the scores of the other groups, because of the high number of lost posts. In 26˙1% of the patients in this group score 4 is given, which means failure of the implant system. From this study it can be concluded that the endosseous implant systems used in this study have less surgical aftercare and a better clinical implant performance than the Transmandibular Implant system and are therefore the systems of choice for the edentulous mandible.
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  • 4
    ISSN: 1434-3940
    Keywords: Keywords Endosseous implant ; Maxilla ; Bone grafting ; Sinus augmentation ; Oral rehabilitation ; Schlüsselwörter Enossales Implantat ; Oberkiefer ; Knochentransplantat ; Kieferhöhlenbodenaugmentation ; Orale Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Verankerung enossaler Implantate in den atrophierten Oberkiefer ist oft durch das Fehlen von unterstützendem Knochen begrenzt. Eine neue zuverlässige Behandlungsmethode scheint die Augmentation des Kieferhöhlenbodens mit autologen Knochentransplantaten zu sein. An 75 Patienten wurden nach Augmentation des Oberkieferhöhlenbodens die Morbidität und die Komplikationsrate untersucht. Zur Augmentation wurden Transplantate aus Beckenkamm (n = 65, 128 Sinus, 276 Implantate), mandibularer Symphyse (n = 8, 10 Sinus, 21 Implantate) oder maxillarer Tuberositas (n = 2, 2 Sinus, 2 Implantate) verwendet. Die Breite des Alveolarkamms mußte bei 52 Patienten rekonstruiert werden, während bei den anderen 23 Patienten die Augmentation und die Implantation simultan durchgeführt wurden. Die Sinusmembran wurde in 45 Fällen perforiert, was aber nicht zu einer Prädisposition für die Entstehung einer Sinusitis führte. Der Verlust von Knochenpartikeln und -sequestern wurde bei 1 (diabetischen) Patienten beobachtet, bei dem auch eine mukosale Dehiszenz auftrat. Eine 2. Augmentation war erfolgreich. Symptome einer transienten Sinusitis wurden bei 2 von 7 Patienten mit einer Sinusitisprädisposition beobachtet. Diese Symptome wurden erfolgreich mit Dekongestionsmitteln und Antibiotika behandelt. 1 Patient entwickelte eine purulente Sinusitis, die nach nasaler Antrostomie verschwand. In allen Fällen war das Knochenvolumen für die zu inserierenden Implantate ausreichend. 20 von 299 inserierten Brånemark-Implantaten (6,7%) wurden während der Nachbeobachtungszeit (durchschnittlich 32 Monate) verloren, es wurde keine Sinuspathologie beobachtet. Die Patienten erhielten Implantat-gestützte Gebisse (58 Patienten) oder feste Brücken (17 Patienten) und zeigten hinsichtlich der Knochentransplantate und der Implantate keine Beschwerden. Wir schließen hieraus, daß die Morbidität und die Komplikationsrate von autologen Knochentransplantaten des Kieferhöhlenbodens niedrig sind.
    Notes: Summary Placement of endosseous implants in the atrophic maxilla is often limited because of a lack of supporting bone. A technique to augment the floor of the maxillary sinus with autogenous bone graft seems to be a new reliable treatment modality. The morbidity and complication rate of augmentation of the maxillary sinus floor was studied in 75 patients. The sinus floor was augmented with iliac crest (n = 65, 128 sinuses, 276 implants), mandibular symphysis (n = 8, ten sinuses, 21 implants), or maxillary tuberosity grafts (n = 2, two sinuses, two implants). The width of the alveolar crest had to be reconstructed in 52 patients, while in the other 23 patients augmentation and implantation were performed simultaneously. Perforation of the sinus membrane occurred in 45 patients, but this did not predispose them to the development of sinusitis. Loss of bone particles and sequesters were observed in one (diabetic) patient only, in whom a mucosal dehiscence occurred. A second augmentation procedure was successful. Symptoms of transient sinusitis were observed in two of the seven patients with a predisposition for sinusitis. These symptoms were successfully treated with decongestants and antibiotics. One patient developed a purulent sinusitis which resolved after a nasal antrostomy. The bone volume was sufficient for insertion implants in all patients. Twenty of 299 patients (6.7%) in whom Brånemark implants had been inserted were lost to follow-up (mean, 32 months); no sinus pathology was observed. The patients received implant-supported overdentures (58 patients) or fixed bridges (17 patients) and experienced no complaints with regard to the grafts or implants. We conclude that the morbidity and complication rate of bone grafting of the floor of the maxillary sinus floor with autogenous bone is low.
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1600-0714
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Eruption disturbances of permanent molars may become clinically and radio-graphically manifest as impaction, primary retention or secondary retention. This may result in clinical problems such as malocclusion and loss of neighboring teeth due to caries and periodontal disease. Which of these disorders will develop, depends primarily on the eruptive stage. Factors that may interfere with the eruptive stages (i.e. follicular growth, pre-emergent eruptive spurt, postemergent eruptive spurt, juvenile occlusal equilibrium, circumpubertal occlusal eruptive spurt, adult occlusal equilibrium) and the clinical consequences of that interference are reviewed. Treatment recommendations are given.
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  • 6
    ISSN: 1600-0714
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The etiology of secondary retention is not well understood, but ankylosis is often considered to be an important factor in primary molars. Data concerning the mechanism of secondary retention in the permanent dentition are insufficient, although a possible role of ankylosis has been suggested. In order to analyze the frequency of occurrence and localization of ankylosis in secondarily retained permanent teeth, 26 secondarily retained molars and for comparison six normal molars were studied histologically. These data were compared with the clinical and radiographic findings. Areas of ankylosis were observed along the roots of all secondarily retained molars. In 81% of the cases these areas were located at the bifurcation and interradicular root surface. No signs of ankylosis were found in normal molars. When these results were compared with the clinical and radiographic data, it was obvious that the latter gave many false negative results, because the areas of ankylosis were often too small to be detected clinically or radiographically.
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  • 7
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Between 1987 and 1990, 57 edentulous patients were treated with overdentures supported by 2 endosseous IMZ implants connected by a bar in the lower jaw. The condition of the peri-implant tissue was evaluated for a loading period ranging from 12 to 57 months (mean 30 months and median 24 months). The evaluation parameters included Plaque Index, Bleeding Index, Gingiva Index, pocket depth, dysesthesia of chin or lip, peri-implant bone loss and loss of implants. During the healing phase prior to the construction of an overdenture, 3 implants were lost. After a healing period of 6 months, these implants were successfully replaced. During the follow-up period, a Plaque Index ≤1 was observed in 45 patients and an abundance of plaque and calculus was observed in 1 patient. Heavy or profuse bleeding and severe gingival inflammation was observed in 3 patients. The mean pocket depth was 3.6±1.7 mm. None of the patients experienced lip or chin dysesthesia. Marginal bone loss was observed around 30 (26%) implants. From this study it is concluded that, once proper osseointegration is obtained, 2 IMZ implants connected with a bar in the lower jaw supply a proper base for the support of an overdenture; the condition of the peri-implant tissues is steady and independent of the follow-up time.
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