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Radiographic stent for a quick and precise bone height analysis
Radiographic stent for a quick and precise bone height analysis Vincent Bennani, DDS,a and Daniel Serre, DDSb University of Nice Sophia-Antipolis, Nice, France
The use of osseointegrated implants for single-tooth replacement has become a viable treatment option.1 Complications with single-tooth implant restorations have been reported and include the damaging of the neighboring structures and poor esthetic results.2 Attention should be paid to the position, size and shape of the interdental papilla, and its relationship to the underlying bone.3 This article describes a method for making a radiographic guide that will be used with a periapical radiograph film to accurately measure bone height. The success of this procedure depends on the use of a radiopaque-calibrated rod embedded in a silicone index and placed in the mouth for the periapical radiograph. This calibrated rod acts as a ruler on the film, permits evaluation of bone height in the area, and allows measurement of soft tissue thickness.
Fig. 2. Occlusal view radiographic guide on cast, with noted rod position.
PROCEDURE 1. Select the appropriate diameter and length for the metallic rod according to the edentulous space (10 mm in length and 3 mm in diameter) (Fig. 1). 2. On the study cast, fabricate a silicone index of the area (President heavy body, Coltene/Whaledent, Inc, New York, N.Y.). The index should cover at least 1 adjacent tooth on each side.
aAssistant
Professor, Graduate and Postgraduate Prosthodontics, School of Dental Medicine; and Private Practice. bProfessor and Director, Graduate and Postgraduate Prosthodontics, School of Dental Medicine. J Prosthet Dent 2000;83:480-1.
Fig. 1. Study cast shows edentulous area. 480 THE JOURNAL OF PROSTHETIC DENTISTRY
Fig. 3. Periapical film radiographic guide in place. Length of post is known for simple calculation of bone height and soft tissue thickness. VOLUME 83 NUMBER 4
BENNANI AND SERRE
THE JOURNAL OF PROSTHETIC DENTISTRY
3. Before the silicone sets, place the rod in the impression material. (The pin has to be parallel to the adjacent teeth and should be in contact with the ridge [Fig. 2].) 4. When the silicone is set, remove the index from the cast and trim with a scalpel to provide an intimate fit in the mouth. (The rod should be in contact with the ridge.) 5. Take the periapical radiograph using the proper angulation. 6. Process the film and analyze it (Fig. 3).
SUMMARY A simple method of obtaining quick and accurate measurements of bone height and soft tissue thickness is presented. It should be considered as an aid in treatment planning for single implant restorations. This method should be associated with all other factors of the decision-making process.
Noteworthy Abstracts of the Current Literature
REFERENCES 1. Jemt T, Laney WR, Harris D, Henry PJ, Krogh PH, Polizzi G, et al. Osseointegrated implants for single tooth replacement. A one year report from a multicenter prospective study. Int J Oral Maxillofac Implants 1991;6:2936. 2. Engelman MJ. Clinical decision making and treatment planning in osseointegration. 1st ed. Chicago: Quintessence Publishing Co; 1996. p.81-94. 3. Spiekermann H, Donath K, Hassell T, Jovanic S, Richter J. Implantology. 1st ed. New York: Thieme Medical Publishers; 1995. p. 267-73. Reprint requests to: DR VINCENT BENNANI 11, AVENUE FELIX FAURE 06500 MENTON FRANCE FAX: (33) 4-93-57-04-21 Copyright © 2000 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/2000/$12.00 + 0. 10/1/105809 doi:10.1067/mpr.2000.105809
An evaluation of sealant restorations after 2 years Gray GB. Br Dent J 1999;186:569-75.
Purpose. This article reported the results of a 2-year hospital-based clinical study that tested the ultimate performance of sealant restorations placed under ideal conditions for the management of fissure caries. Materials and methods. Suspect fissure caries were investigated in a population of 164 young adults seeking routine dental care at the Glasgow Dental Hospital and Dental School. Only 1 test tooth was included in each patient in this study. The mean age of the patients treated was 23.9 years and the second permanent molar teeth were the most commonly affected teeth requiring treatment in this group. Either type 1 (fissure sealant alone), type 2 (composite plus sealant), type 3 (glass ionomer cement plus sealant), or type 4 (laminate restoration) procedures were used to treat each test tooth. Patients were recalled after 6, 12, and 24 months at which time the sealant retention and performance of the restorative materials were noted. Results were subject to statistical analysis. Results. Of all patients who participated, 91.5% were evaluated in all 3 recall visits. All restorations were present at the 2-year recall. Presence of small composite restorations did not adversely affect fissure sealant retention. However, at the 2-year recall, significantly more sealant was lost from the surface of the light-cured glass ionomer cement and larger composite restorations. Conclusion. The authors conclude that these 4 types of sealant restorations provided an effective method of management of fissure dental caries in young adult patients. 34 References. —RP Renner
APRIL 2000
481
The use of osseointegrated implants for single-tooth replacement has become a viable treatment option.1 Complications with single-tooth implant restorations have been reported and include the damaging of the neighboring structures and poor esthetic results.2 Attention should be paid to the position, size and shape of the interdental papilla, and its relationship to the underlying bone.3 This article describes a method for making a radiographic guide that will be used with a periapical radiograph film to accurately measure bone height. The success of this procedure depends on the use of a radiopaque-calibrated rod embedded in a silicone index and placed in the mouth for the periapical radiograph. This calibrated rod acts as a ruler on the film, permits evaluation of bone height in the area, and allows measurement of soft tissue thickness.
Fig. 2. Occlusal view radiographic guide on cast, with noted rod position.
PROCEDURE 1. Select the appropriate diameter and length for the metallic rod according to the edentulous space (10 mm in length and 3 mm in diameter) (Fig. 1). 2. On the study cast, fabricate a silicone index of the area (President heavy body, Coltene/Whaledent, Inc, New York, N.Y.). The index should cover at least 1 adjacent tooth on each side.
aAssistant
Professor, Graduate and Postgraduate Prosthodontics, School of Dental Medicine; and Private Practice. bProfessor and Director, Graduate and Postgraduate Prosthodontics, School of Dental Medicine. J Prosthet Dent 2000;83:480-1.
Fig. 1. Study cast shows edentulous area. 480 THE JOURNAL OF PROSTHETIC DENTISTRY
Fig. 3. Periapical film radiographic guide in place. Length of post is known for simple calculation of bone height and soft tissue thickness. VOLUME 83 NUMBER 4
BENNANI AND SERRE
THE JOURNAL OF PROSTHETIC DENTISTRY
3. Before the silicone sets, place the rod in the impression material. (The pin has to be parallel to the adjacent teeth and should be in contact with the ridge [Fig. 2].) 4. When the silicone is set, remove the index from the cast and trim with a scalpel to provide an intimate fit in the mouth. (The rod should be in contact with the ridge.) 5. Take the periapical radiograph using the proper angulation. 6. Process the film and analyze it (Fig. 3).
SUMMARY A simple method of obtaining quick and accurate measurements of bone height and soft tissue thickness is presented. It should be considered as an aid in treatment planning for single implant restorations. This method should be associated with all other factors of the decision-making process.
Noteworthy Abstracts of the Current Literature
REFERENCES 1. Jemt T, Laney WR, Harris D, Henry PJ, Krogh PH, Polizzi G, et al. Osseointegrated implants for single tooth replacement. A one year report from a multicenter prospective study. Int J Oral Maxillofac Implants 1991;6:2936. 2. Engelman MJ. Clinical decision making and treatment planning in osseointegration. 1st ed. Chicago: Quintessence Publishing Co; 1996. p.81-94. 3. Spiekermann H, Donath K, Hassell T, Jovanic S, Richter J. Implantology. 1st ed. New York: Thieme Medical Publishers; 1995. p. 267-73. Reprint requests to: DR VINCENT BENNANI 11, AVENUE FELIX FAURE 06500 MENTON FRANCE FAX: (33) 4-93-57-04-21 Copyright © 2000 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/2000/$12.00 + 0. 10/1/105809 doi:10.1067/mpr.2000.105809
An evaluation of sealant restorations after 2 years Gray GB. Br Dent J 1999;186:569-75.
Purpose. This article reported the results of a 2-year hospital-based clinical study that tested the ultimate performance of sealant restorations placed under ideal conditions for the management of fissure caries. Materials and methods. Suspect fissure caries were investigated in a population of 164 young adults seeking routine dental care at the Glasgow Dental Hospital and Dental School. Only 1 test tooth was included in each patient in this study. The mean age of the patients treated was 23.9 years and the second permanent molar teeth were the most commonly affected teeth requiring treatment in this group. Either type 1 (fissure sealant alone), type 2 (composite plus sealant), type 3 (glass ionomer cement plus sealant), or type 4 (laminate restoration) procedures were used to treat each test tooth. Patients were recalled after 6, 12, and 24 months at which time the sealant retention and performance of the restorative materials were noted. Results were subject to statistical analysis. Results. Of all patients who participated, 91.5% were evaluated in all 3 recall visits. All restorations were present at the 2-year recall. Presence of small composite restorations did not adversely affect fissure sealant retention. However, at the 2-year recall, significantly more sealant was lost from the surface of the light-cured glass ionomer cement and larger composite restorations. Conclusion. The authors conclude that these 4 types of sealant restorations provided an effective method of management of fissure dental caries in young adult patients. 34 References. —RP Renner
APRIL 2000
481