- Email: [email protected]
Immediate loading of interforaminal implants
Implants Immediate loading of interforaminal implants Background.—Osseointegration is the term used to describe the structural and functional connection made between implants and bones that form a strong union. With functional loading, the bone-to-implant connection appears to increase. However, there is a long-standing prohibition against loading implants for at least 4 months. Patients were given implants that underwent immediate loading with bar-retained overdentures. The cases were evaluated after 8 to 18 years of function.
Discussion.—The immediate loading of these implants with a hybrid prosthesis did not adversely affect the vast majority of the cases. It seems likely that patients who are edentulous in the mandible can receive interforaminal implants fitted with bars and immediately loaded with the expectation of good service for as long as 18 years. The 4-month healing period observed for osseointegration appears to be unneeded.
Methods.—The 44 patients received 176 interforaminal implants between 1981 and 1991. On the day of the operation patients were fitted with a bar that was loaded immediately with a hybrid prosthesis. On reevaluation, 23 patients (89 implants) were assessed for clinical and functional status.
Clinical Significance.—In this long-term retrospective clinical study, light is shed on the question of how long to wait before implants can be safely loaded. The results are encouraging. The traditional 4-month integration period before loading of interforaminal fixtures supporting a fixed-tissue bar supporting a previously constructed removable prosthesis was deemed unnecessary.
Results.—Three implants were lost and 5 did not meet the criteria for success that had been set. Of 356 sites examined, 181 (52%) were free of plaque. At 269 (75.6%) of the sites evaluated for gingival index, none demonstrated inflammation. The mean probing depth was 2.4 mm, with a range of 1 mm to 13 mm. Testing for bleeding on probing yielded 271 (76.1%) positive sites and 85 (23.9%) negative sites. Seventeen of the 23 patients had the same prosthesis that was placed at the initial operation. The probability of success was 83.3%.
Lambrecht JT, Hodel Y: Long-term results of immediately loaded interforaminal implants. Quintessence Int 38:111-119, 2007 Reprints available from JT Lambrecht, Dept of Oral Surgery, Oral Radiology and Oral Medicine, Univ of Basel, Hebelstrasse 3, 4056 Basel, Switzerland; fax: þ41-61-267-26-07; e-mail: J-Thomas. [email protected]
Oral Biology Revascularization of immature necrotic pulp Background.—Immature tooth treatments can differ from those used for mature teeth. For example, pulpal necrosis of an immature tooth after carious involvement or trauma cannot be managed by the typical chemomechanical instrumentation and disinfection of the root canal system because of the anatomy of the immature tooth. The arrested development of dentinal walls because of pulp necrosis leaves a weak tooth and thin dentinal walls liable to fracture. Root reinforcement techniques can be used for immature, thin-walled teeth, but these methods can seriously complicate later root canal retreatment. Even using calcium hydroxide long-term weakens immature teeth, leaving them more susceptible to fracture. Studies on traumatic injuries to immature teeth have demonstrated that
320
Dental Abstracts
revascularization of the root canal system may be accomplished. Uninfected necrotic pulp is used as a scaffold for new tissue ingrowth, with an emphasis on the effective disinfection of the root canal system. A treatment protocol combining ciprofloxacin, metronidazole, and cefaclor was devised to disinfect carious dentin and necrotic infected root canals. The scaffold can be supplied by a blood clot. A case reported disinfection of the root canal system and use of a blood clot to provide scaffolding for new growth. Case Report.—A boy, 9, demonstrated maxillary anterior swelling associated with his permanent maxillary right central incisor (Fig 1). Testing indicated the tooth had a necrotic pulp. An acute apical abscess was incised and drained.
Discussion.—The immediate loading of these implants with a hybrid prosthesis did not adversely affect the vast majority of the cases. It seems likely that patients who are edentulous in the mandible can receive interforaminal implants fitted with bars and immediately loaded with the expectation of good service for as long as 18 years. The 4-month healing period observed for osseointegration appears to be unneeded.
Methods.—The 44 patients received 176 interforaminal implants between 1981 and 1991. On the day of the operation patients were fitted with a bar that was loaded immediately with a hybrid prosthesis. On reevaluation, 23 patients (89 implants) were assessed for clinical and functional status.
Clinical Significance.—In this long-term retrospective clinical study, light is shed on the question of how long to wait before implants can be safely loaded. The results are encouraging. The traditional 4-month integration period before loading of interforaminal fixtures supporting a fixed-tissue bar supporting a previously constructed removable prosthesis was deemed unnecessary.
Results.—Three implants were lost and 5 did not meet the criteria for success that had been set. Of 356 sites examined, 181 (52%) were free of plaque. At 269 (75.6%) of the sites evaluated for gingival index, none demonstrated inflammation. The mean probing depth was 2.4 mm, with a range of 1 mm to 13 mm. Testing for bleeding on probing yielded 271 (76.1%) positive sites and 85 (23.9%) negative sites. Seventeen of the 23 patients had the same prosthesis that was placed at the initial operation. The probability of success was 83.3%.
Lambrecht JT, Hodel Y: Long-term results of immediately loaded interforaminal implants. Quintessence Int 38:111-119, 2007 Reprints available from JT Lambrecht, Dept of Oral Surgery, Oral Radiology and Oral Medicine, Univ of Basel, Hebelstrasse 3, 4056 Basel, Switzerland; fax: þ41-61-267-26-07; e-mail: J-Thomas. [email protected]
Oral Biology Revascularization of immature necrotic pulp Background.—Immature tooth treatments can differ from those used for mature teeth. For example, pulpal necrosis of an immature tooth after carious involvement or trauma cannot be managed by the typical chemomechanical instrumentation and disinfection of the root canal system because of the anatomy of the immature tooth. The arrested development of dentinal walls because of pulp necrosis leaves a weak tooth and thin dentinal walls liable to fracture. Root reinforcement techniques can be used for immature, thin-walled teeth, but these methods can seriously complicate later root canal retreatment. Even using calcium hydroxide long-term weakens immature teeth, leaving them more susceptible to fracture. Studies on traumatic injuries to immature teeth have demonstrated that
320
Dental Abstracts
revascularization of the root canal system may be accomplished. Uninfected necrotic pulp is used as a scaffold for new tissue ingrowth, with an emphasis on the effective disinfection of the root canal system. A treatment protocol combining ciprofloxacin, metronidazole, and cefaclor was devised to disinfect carious dentin and necrotic infected root canals. The scaffold can be supplied by a blood clot. A case reported disinfection of the root canal system and use of a blood clot to provide scaffolding for new growth. Case Report.—A boy, 9, demonstrated maxillary anterior swelling associated with his permanent maxillary right central incisor (Fig 1). Testing indicated the tooth had a necrotic pulp. An acute apical abscess was incised and drained.