Dental Rehabilitation Of Patients Research Articles

Dental Rehabilitation of the Unilateral Cleft Dental Gap: A Single Institution Experience With Long-Term Follow-Up.

The purpose of this study was to identify factors associated with the management of the cleft dental gap after alveolar bone grafting. This was a retrospective cohort study of patients with unilateral cleft lip and alveolus or palate who had successful alveolar bone grafting. Our primary study outcome was alveolar cleft management (orthodontic closure or space maintenance). Our secondary study outcome was the rate of fixed dental rehabilitation. Univariate comparisons were made with SAS 9.4. The final study sample consisted of 54 patients. Most patients were treated with orthodontic closure (55.6%). Patients missing multiple teeth ( P < 0.01) were less likely to receive orthodontic closure. Orthodontic closure was not associated with differences in intermaxillary midline coincidence ( P = 0.22) or the need for LeFort advancement ( P = 0.15). Only 41.7% of patients who were managed with space maintenance obtained a fixed prosthesis. Hispanic ethnicity ( P < 0.01) and Medicaid insurance ( P < 0.01) were associated with lower rates of fixed dental rehabilitation. Orthodontic closure was the most common approach, and it did not result in significant maxillary midline distortion. Less than half of patients treated with space maintenance obtained fixed restorations. Socioeconomic barriers are likely preventing access to definitive dental rehabilitation in patients with unilateral cleft lip and alveolus or palate.

33. Long-term Clinical Outcomes Following Free Fibula Flap Reconstruction of Maxillomandibular Defects with Immediate Dental Implant Placement

PURPOSE: Immediate dental implant placement (IDIP) at the time of ablative/reconstructive surgery for maxillomandibular cancer is a novel technique that has yet to be evaluated for its long-term clinical outcomes. This study describes long-term clinical outcomes with IDIP in free fibula flaps (FFF) for oncologic head and neck reconstruction. METHODS: A retrospective review for patients who underwent oncologic FFF reconstruction of mandibular or maxillary defects with and without IDIP was performed. Average length of follow-up and complication rates over two time periods (1-2 years and 2+ years) were analyzed. Patients who were lost to follow-up, died, or have not reached the 1 year postoperative timepoint were excluded. The number of patients who achieved dental rehabilitation in the IDIP cohort was also examined. RESULTS: 99 patients received FFF reconstruction with IDIP, and 120 historical patients received FFF reconstruction alone. The average length of follow-up was significantly longer in the historical group (1498.9±1700.6 days vs. 565.4±397.9 days, p=0.0005). 63/99 IDIP patients achieved dental rehabilitation. There was no significant difference in the complication rates between the IDIP and historical cohorts in either 1-2 year or 2+ year time period. CONCLUSION: IDIP is an effective method for rapidly achieving dental rehabilitation in patients undergoing maxillomandibular reconstruction with FFF. Long-term complications in IDIP patients were not significantly different from the historical cohort. Further studies investigating patient satisfaction and quality of life scores with IDIP are warranted to elucidate the full benefits of this treatment.

D52. Long-term Clinical Outcomes following Free Fibula Flap Head and Neck Reconstruction with Immediate Dental Implant Placement

PURPOSE: Immediate dental implant placement (IDIP) at the time of ablative/reconstructive surgery for maxillomandibular cancer is a novel technique that has yet to be evaluated for its long-term clinical outcomes. This study describes long-term clinical outcomes with IDIP in free fibula flaps (FFF) for oncologic head and neck reconstruction. METHODS: A retrospective review for patients who underwent oncologic FFF reconstruction of mandibular or maxillary defects with and without IDIP was performed. Average length of follow-up and complication rates over two time periods (1-2 years and 2+ years) were analyzed. The number of patients who achieved dental rehabilitation in the IDIP cohort was also examined. RESULTS: 99 patients received FFF reconstruction with IDIP, and 120 historical patients received FFF reconstruction alone. The average length of follow-up was significantly longer in the historical group (1498.9±1700.6 days vs. 565.4±397.9 days, p=0.0005). 63/99 IDIP patients achieved dental rehabilitation. There was no significant difference in the complication rates between the IDIP and historical cohorts in either 1-2 year or 2+ year time period. CONCLUSION: IDIP is an effective method for rapidly achieving dental rehabilitation in patients undergoing maxillomandibular reconstruction with FFF. Long-term complications in IDIP patients were not significantly different from the historical cohort. Further studies investigating patient satisfaction and quality of life scores with IDIP are warranted to elucidate the full benefits of this treatment.

A New Strategy for Patient-Specific Implant-Borne Dental Rehabilitation in Patients With Extended Maxillary Defects.

Purpose of the StudyPatients undergoing ablative tumor surgery of the midface are faced with functional and esthetic issues. Various reconstructive strategies, such as implant-borne obturator prostheses or microvascular tissue transfer, are currently available for dental rehabilitation. The present study shows the first follow-up of patients treated with patient-specific implants (IPS Implants® Preprosthetic) for the rehabilitation of extended maxillary defects following ablative surgery.Patients and MethodsAll patients treated with patient specific implants due to postablative maxillary defects were included. 20 implants were placed in the 19 patients (bilateral implants were placed in one of the cases). In 65.75% of the cases, resection was performed due to squamous cell carcinoma. In addition to the primary stability, the clinical implant stability, soft tissue management, successful prosthodontic restoration, and complications were evaluated at a mean follow-up period of 26 months.ResultsAll patient-specific implants showed primary stability and were clinically stable throughout the observation period. Definitive prosthodontic restorations were performed in all patients. No implant loosening was observed. Major complications occurred only in previously irradiated patients with insufficient soft tissue conditions (p = 0.058). Minor complications such as exposure of the underlying framework or mucositis were observed, but they never led to failure of restorations or implant loss.ConclusionsTreatment of postablative maxillary defects with patient-specific implants offers a safe alternative with predictable results for full and rapid dental rehabilitation, avoiding time-consuming augmentation procedures and additional donor-site morbidity.

ОЦЕНКА УРОВНЯ КАЧЕСТВА ЖИЗНИ ПАЦИЕНТОВ ПОСЛЕ СТОМАТОЛОГИЧЕСКИХ ВМЕШАТЕЛЬСТВ

Subject. Today, the condition of patients with dental diseases is directly related to the quality of life. The massive need for dental rehabilitation of patients, restoration of chewing function, aesthetic function and normalization of speech requires a full and high-quality treatment result. According to the definition of the World Health Organization, the quality of life is “an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns” [25, 39]. There are two sides of the "quality of life" — internal, which depends on the very personality of a person, and external, due to the degree of development of society and the state. Therefore, the study of the quality of life is not only a reliable and effective way of assessing the general well-being of a person, but also a highly informative, sensitive and economically justified method of assessing the health of both the population as a whole and individual social groups generally accepted in international practice. The techniques described in this review allow one to quantify the multicomponent characteristics of a person's vital activity — his physical, psychological and social functioning. Aim. Analysis of the degree of elaboration of the topic “studying the quality of life”. &#x0D; Materials and methods. The study was conducted based on the search and study of original articles on aspects of the quality of life of patients after dental interventions. In the course of studying the literature in the eLibrary, Pubmed, Google Schoolar databases, 39 sources were included in the study. &#x0D; Conclusions. As a result of the work carried out, it can be concluded that the dynamic assessment of the quality of life of patients in the process of dental treatment is a rather promising direction. Subjective assessment of the quality of life by the patient himself is one of the most important criteria for quality treatment.

Использование коллагеновых пластин при ортопедической стоматологической реабилитации больных медикаментозно компенсированным сахарным диабетом

Использование коллагеновых пластин при ортопедической стоматологической реабилитации больных медикаментозно компенсированным сахарным диабетом

Bruxism: Best Evidence Consensus Statement.

The purpose of this Best Evidence Consensus Statement is to report on the prevalence, potential causes or association, treatment and cure of bruxism. A literature search limited to Clinical Trials, Randomized Controlled Trials, Systematic Reviews and Meta Analyses, with the key words bruxism, and prevalence identified 22 references, bruxism and causation 21, bruxism, and treatment 117, and bruxism and cure none. Prevalence received 5 references which were relevant to the question researched. Causation received 11 relevant references, treatment 34 relevant references and cure none. Eighteen additional references were culled from the reference lists in the aforementioned articles. Due to variations in demographics and the dependence on anamnestic data, the true prevalence of bruxism in any specific population is unknown. There is moderate evidence that psychosocial factors such as stress, mood, distress, nervousness, and feeling blue are associated with sleep bruxism (SB) as well as caffeine, alcohol, and smoking. There is no consensus on what symptoms of SB or awake bruxism (AB) should be treated. There is some evidence that occlusal devices and bio feedback therapies can be utilized in SB treatment. There is conflicting evidence in the use of Botulinum toxin A and no compelling evidence for the use of drug therapy to treat SB. There is not an established cure for bruxism. The clinician is best served in using caution in the dental rehabilitation of patients with severe occlusal wear.

Oral rehabilitation of a patient with hidrotic ectodermal dysplasia (Clouston syndrome)

BACKGROUND: Ectodermal dysplasia is a rare genetic condition affecting the development and homeostasis of two or more ectodermal structures, including hairs, teeth, nails, and some glandular organs. The prevalence is 1.621.9 per 100000. The teeth are affected in 79% of cases. Patients with ectodermal dysplasia have a low level of quality of life affected by unemployment, utilization of removable dentures, and a constant dry mouth condition. The main rehabilitation method of the masticatory-phonic elements for the patient with ectodermal dysplasia is conventional removable prosthodontics. The main treatment objective for these patients is to restore the missing elements of the masticatory-phonic apparatus for normalizing mastication, speech, deglutition, and creating optimal aesthetics. This approach can lead to restoring social activity by the increase of a patients quality of life. A clinical case report of patient M., 20 years old, is presented in this article. Treatment was completed one year ago.&#x0D; CLINICAL CASE: The rehabilitation strategy included producing screw-retained full ceramic opposing prostheses supported by six implants in the upper and lower jaws.&#x0D; DISCUSSION: The choice restoration method of the masticatory-phonic elements for patients with ectodermal dysplasia is prosthodontic treatment with the fabrication of ordinary removable dentures. Early attempts of implant treatment of patients with such conditions led to a low percentage of implant survival. In most works dedicated to treating patients with ectodermal dysplasia, the fabrication of implants supported by a metal resin hybrid prosthesis with acrylic teeth sets is the final rehabilitation. We decided to produce an implant supported by a zirconia ceramic prosthesis with partial layering for patient M. It was feasible because, first of all, his growth was finished, and also this decision gives us the possibility to fabricate a high quality implant supported by a prosthesis enabling optimum function with an unlimited service period. After finishing treatment, 100% of implants and prostheses last one year.&#x0D; CONCLUSION: It is necessary to engage all available clinic diagnostic, planning, therapeutic, and preventive resources to achieve a high aesthetic and functional result of the dental rehabilitation of patients with ectodermal dysplasia. Implementing implant supported prosthetic rehabilitation of such patients after reaching 17 years of age has to be the treatment of choice that could help achieve stable and reliable results. It might also foster social adaptation that would enable high quality of life.

КЛИНИЧЕСКИЙ СЛУЧАЙ ОРТОПЕДИЧЕСКОЙ СТОМАТОЛОГИЧЕСКОЙ РЕАБИЛИТАЦИИ ПАЦИЕНТА С СИНДРОМОМ КЛОУСТОНА И ВРОЖДЕННОЙ АДЕНТИЕЙ

Subject. Clouston syndrome is within the list of rare (orphan) congenital diseases. The issue of peculiarities in dental rehabilitation of patients with Clouston syndrome and congenital edentulism remains discussable. There are no approved clinical guidelines regarding this problem for dental practitioners.&#x0D; Aim ― improvement of diagnostic and treatment procedures efficacy for children with Clouston syndrome and congenital edentulism in the orthopedic dentistry and orthodontics clinic.&#x0D; Methodology. In order to demonstrate capabilities of efficacious orthopedic dental rehabilitation, a clinical case of a 14-years old patient with Clouston syndrome and congenital edentulism in an ambiguous oral cavity condition is presented, demonstrating the most justified and predictable approach to clinical management of patients.&#x0D; Results. The paper describes results of analysis of domestic and foreign literature devoted to the issue of determining distinctive diagnostic features of patients with Clouston syndrome used in the diagnostic process in the presented clinical case. Technological peculiarities and advantages of the chosen minimally invasive treatment approach – application of removable dentures – are described. The article demonstrates photographs depicting orthopaedic dental treatment results providing evidence of aesthetic, functional and social rehabilitation of the patient.&#x0D; Findings. The presented literature review of main distinctive clinical features of Clouston syndrome is an efficacious diagnostic algorithm in clinical orthopedic dentistry and orthodontics that forms a clear route for allied specialists in terms of diagnosis of this pathology in patients. The presented clinical case of minimally invasive orrthopedica dental treatment methods for rehabilitation of patients with Clouston syndrome and congenital edentulism is an option that provides for predictable satisfactory aesthetic and functional results of treatment, social adaptation of patients and a wide spectrum of further clinical decisions in short- and long-term follow-up management of patients.

Causal relationship between periodontitis and obstructive sleep apnea syndrome. Literature review

Purpose. To highlight the problem of periodontal lesions in patients with obstructive sleep apnea syndrome (OSA) from the clinical-laboratory position and evaluate their relationship. In the pathogenesis of chronic generalized periodontitis, systemic diseases of the body play an important role, including obstructive sleep apnea syndrome. The main dental symptom of OSA is dry mouth due to oral breathing, which is a significant risk factor for periodontal disease. The review presents the results of a number of clinical studies dedicated to assessing the relationship of periodontal disease and obstructive sleep apnea. This review summarizes knowledge about the effect of obstructive sleep apnea on the rate of progression and the severity of periodontal disease. Literature data indicate the need for further study of the characteristics of periodontal disease and the development of individual plans for dental rehabilitation of patients with OSA.

ОЦЕНКА ЭФФЕКТИВНОСТИ РЕАБИЛИТАЦИИ ПАЦИЕНТОВ, НУЖДАЮЩИХСЯ В ПОЛНОЙ РЕСТАВРАЦИИ ЗУБНЫХ РЯДОВ С РАССТРОЙСТВОМ ФУНКЦИОНАЛЬНОСТИ МЫШЦ И ВИСОЧНО-НИЖНЕЧЕЛЮСТНОГО СУСТАВА С ПОМОЩЬЮ МЕТОДОВ КОНДИЛОГРАФИИ И ЭЛЕКТРОМИОГРАФИИ

The subject ― is the total restoration of the dentition. The goal ― the study was aimed at evaluating clinical effectiveness of orthopedic dental treatment for patients requiring full-mouth rehabilitation on the basis of the functional state of the muscles in the maxillofacial area. Methodology. Within the research, a thorough examination and treatment of 647 patients with adentia requiring full-mouth rehabilitation were performed. Patients were distributed to three groups. The treatment of the first group (218 people) included standard orthopedic dentistry techniques. During the provision of medical care to the second group (195 people), several elements of an interdisciplinary approach to orthopedic dental rehabilitation were applied. In the third group (234 patients), only the multidisciplinary approach to orthopedic dental rehabilitation was proposed. The patient monitoring process was carried out for seven years. Results. It was discovered that the application of the integrated multidisciplinary approach contributes to the reduction of pain during palpation of the postural muscles and muscles of the maxillofacial area already in a year after the start of treatment. It was also remarked that the improvement of the temporomandibular joint (TMJ) condition during the implementation of the interdisciplinary approach manifested in significant improvement of several indicators. In particular, among patients lessening of pain in the joint area, better results of radiological diagnostics, condylography, electromyography, and retrusive stability were noted. Conclusions. As part of a set of measures to orthopedic dental rehabilitation of patients with adentia, it is necessary to assess the condition of the muscles in the maxillofacial area and the severity of TMJ dysfunction. The most important stage in the implementation of the proposed approach is a complete and consistent screening of patients requiring a full-mouth rehabilitation, with the addition of a clinical examination through radiation diagnostics, condylography, and electromyography.

Assessment of vertical ridge augmentation and marginal bone loss using autogenous onlay vs inlay grafting techniques with simultaneous implant placement in the anterior maxillary esthetic zone: A randomized clinical trial.

Bony reconstruction and dental rehabilitation of patients with posttraumatic anterior maxillary alveolar defects is a very complicated procedure. The aim of this study is the assessment of vertical ridge augmentation using autogenous onlay vs inlay bone grafting techniques in the anterior maxilla. Sixteen patients (40 implants) with vertically deficient anterior maxillary alveolar ridges were equally allocated into two groups; Autogenous block bone graft was harvested from the chin with simultaneous implant placement was done either onlay (control) or inlay (study). Radiographic assessment was performed preoperatively, 1 week and 6 months postoperatively. Assessment included measurements of linear changes in the vertical height on cross sectional cuts of cone beam computed tomography (CBCT) using special software. Finally, the amount of vertical gain and marginal bone loss in each group was compared to that of the other. Wound healing was uneventful for all cases except three cases of the onlay group showed wound breakdown and graft loss. The mean vertical bone gain in the control group was -0.02 mm while in the study was 3.34 mm. While the mean of the crestal bone loss of the control group was 4.77 mm and that of the study group was 1.65 mm. The final vertical bone gain was statistically significant in the study group, so the inlay bone grafting technique with immediate implant placement could be used successfully for vertical alveolar ridge augmentation in the esthetic zone.

Assessment of three dimensional bone augmentation of severely atrophied maxillary alveolar ridges using prebent titanium mesh vs customized poly-ether-ether-ketone (PEEK) mesh: A randomized clinical trial.

Alveolar bone grafting techniques and dental rehabilitation of patients with maxillary alveolar defects is a very challenging and costly procedure. Various methods have been described to reconstruct these defects in order to facilitate the placement of dental implants. The aim of this study was to assess three dimensional (3D) maxillary ridge augmentation using two innovative, accurate, and time saving protocols. Sixteen patients (32 implants) with vertically and horizontally deficient maxillary alveolar ridges, were equally allocated into 2 groups; a mix of particulate autogenous and xenogenic bone grafts loaded in a prebent titanium mesh (Control group) vs patient specific poly-ether-ether ketone meshes (Study group). Radiographic assessment was performed preoperatively, 1 week and 6 months postoperatively. Assessment included measurements of linear changes in the vertical and horizontal dimensions on cross sectional cuts of cone beam computed tomography using special software. Finally; the percentage of 3D bone gain in each group was compared to that of the other. Wound healing was uneventful for all cases except one patient in each group were the meshes were exposed 2 weeks' postsurgery. There was no statistical significance between both groups (P value = 0.2). Within the limitations of the sample size of this study, both techniques could be used as a successful method of ridge augmentation with no statistical significance between them.

Precision of Simultaneous Guided Dental Implantation in Microvascular Fibular Flap Reconstructions With and Without Additional Guiding Splints

Dental rehabilitation in patients receiving free flap reconstructive surgery on the mandible or maxilla is an important part of bringing patients back to normality in both a physical and psychological way. It is therefore important to be able to do this in the fastest way possible. Virtual preplanned reconstructions of jaws with implants placed simultaneously are a good way to expedite this process and have the advantage of allowing true backward planning to achieve bone placement where it prosthetically needs to be. Thus, the precise transfer of the virtually preplanned implant position to the intraoperative situation is crucial for prosthetic rehabilitation. We compared a control group of patients (4 patients with 15 implants) with preplanned fibular reconstructions of the mandible with implants incorporated in the planning and a trial group of patients (4 patients with 13 implants) with an additional intraoperative splint for the verification of the implants' angulation. The preoperative planning and postoperative computed tomography scans were compared. The average positioning error at bone level was 0.9mm in the trial group and 1.3mm in the control group. The average angulation error in the buccolingual plane was 2.9° in the trial group and 5.5° in the control group; axially, the difference was 6.3° in the trial group and 4.1° in the control group. The use of digitally backward-planned fibula cutting guides with direct dental implant positioning is feasible, and the precision found is comparable with that of standard splint-guided implant placement in the general population. Although the axial angulation error has more to do with anatomic variance and positioning of the bony cutting guide, the trial population clearly profited from the additional splint in the important buccolingual angulation. Overall, we showed a high level of precision over all implants in both groups.

Factors Affecting Dental Rehabilitation Following Jaw Reconstruction With Free-Fibular Graft In Patients With Head and Neck Cancer.

Existing anatomic factors play a significant role in affecting the possibility of dental rehabilitation in head and neck cancer patients undergoing free-fibular graft reconstruction. An observational, cross-sectional study was initiated to evaluate factors affecting dental rehabilitation following free-fibular graft jaw reconstruction in head and neck cancer patients.Patients who had undergone jaw reconstruction with free-fibular graft, requiring dental rehabilitation were recruited. Irradiated, reconstructed patients who had completed at least 1 year since the last dose of radiotherapy and nonradiated patients who had completed 6 months since reconstruction were recruited. Patients who had undergone soft-tissue reconstruction or free-fibular graft in non-condyle sparing resections were excluded. Patient's demographic data, disease and treatment-related data were obtained. An intra-oral examination was carried out to evaluate anatomic variables affecting dental rehabilitation. Descriptive statistical analyses were carried out to study demographic data. Logistic regression analysis was carried out using Pearson χ test and Fisher exact test. Estimates of regression coefficient and their standard errors with 95% confidence interval were calculated.Total of 138 patients were enrolled and considered for prosthetic rehabilitation. A review of the frequency-based data revealed that 30% (n = 41) patients were considered suitable for prosthetic rehabilitation. On multivariate logistic regression analysis, morbidity of radiotherapy (P = 0.01), interference to placement of implants by reconstruction plates and screws (P = 0.023), unfavorable diagnostic maxilla-mandibular relationship (P = 0.011), and obliterated vestibule (P = 0.001) were statistically established (P < 0.05) as the most significant reasons for not carrying out dental rehabilitation in patients who had undergone free-fibular graft reconstruction.

JUSTIFICATION OF RESEARCH ON SYSTEM OPTIMIZATION OF SURGICAL DENTAL CARE TO PATIENTS WITH HIV INFECTION. ANALYTICAL REVIEW OF LITERATURE

The article presents an analysis of the Russian and foreign specialized literature on the problem of dental rehabilitation of patients with HIV infection. It has been revealed that the structure and prevalence of dental surgical pathology in HIV infection has not been studied to date, the indices of the need for treatment of diseases of the dental profile have not been determined. Unsatisfactory access to qualified dental care has been identified, including due to discrimination and stigmatization by health professionals regarding both the disease itself and patients with HIV infection. The urgency of improving the system of rendering surgical dental care to HIV-infected with the aim of ensuring the maximum achievable level of health is substantiated. The data of the presented analytical review represent an important theoretical basis for the development of new tactical approaches to the implementation of the strategic direction of dental implant treatment of people living with HIV to expand access to this medical service.

Survival of dental implants placed in vascularised fibula free flaps after jaw reconstruction

PurposeAblative oncological surgery to treat head-and-neck cancer often triggers a requirement for jaw reconstruction. Modern surgical procedures using free microvascular flaps afford acceptable outcomes in terms of restoration of bony and soft tissue defects. A fibula free flap is often the preferred flap, as the bone length is considerable and a two-surgeon approach is possible. Dental implants play important roles in functional rehabilitation. Our aim was to evaluate the survival of dental implants placed in reconstructed areas after transfer of fibula tissue to the jaw. Materials and methodsWe retrospectively studied 34 patients who underwent ablative tumour surgery and jaw reconstruction using osteocutaneous fibula free flaps and who then received dental implants. We evaluated implant survival and success, survival of the fibula flap, and clinical and radiographic data. ResultsWe included 34 patients, 23 of whom were diagnosed with squamous cell carcinoma. In total, 134 dental implants were inserted in transferred fibula bone. The cumulative implant survival rate was 81%. The survival rate of the 34 fibula flaps transplanted after surgical reconstruction was 97%. ConclusionThe insertion of endosseous implants after jaw reconstruction using vascularised fibula tissue yields successful dental rehabilitation in patients with oral cancers.

FEATURES OF CORRELATION OF ELECTROMYOGRAPHICAND AXIOGRAPHIC STUDIES IN PATIENTSWITH INCREASED ERASURE OF HARD DENTAL TISSUES

Clinical and instrumental diagnostics, including electromyographic (EMG) and axiographic (EA) study of 24 patients to improve the efficiency of planning and predicting the results of their dental treatment was carried out. Correlation links were studied both within EMG and EA studies, and between them. There were no significant correlations between the parameters of EMG and EA of the methods of investigation. Therefore, for full dental rehabilitation ofpatients with tooth wear in the diagnosis and monitoring of the stages and results of treatment, it is necessary to carry out both methods, since they do not exclude each other, but supplement

A customised digitally engineered solution for fixed dental rehabilitation in severe bone deficiency: A new innovative line extension in implant dentistry

ObjectivesNumerous procedures including soft and hard tissue reconstructions are necessary to allow for final implant-borne dental rehabilitation in patients with severe alveolar atrophy or resected jaws. In these cases, customised digitally engineered patient solutions for fixed or removable dental rehabilitation provide an innovative line extension to conventional implant dentistry. Material and methodsA wax-up was performed on plaster models that were scanned by 3D laser. The generated stereolithographic files were then fused with the preoperative 3D imaging data. The individualised “dental” patient solutions were designed digitally and comprised a skeletonised anchorage system and a suprastructure connection system. Insertion of the implants was performed on an outpatient basis. Conventional implant-supported prosthodontic rehabilitation was performed. ResultsThis digital planning algorithm can be applied to manufacture individualised patient solutions. Similar to conventional implant-supported dentures, these implants can be equipped with individual suprastructure connection systems for internal conical connection, ball-retained attachment, and external conical (telescopic) connection. ConclusionsIn patients with severe atrophy or resected jaws, particularly following ablative tumour surgery, customised digitally engineered solutions allow for an innovative, less invasive line extension to conventional implant dentistry. When conventional implant dentistry reaches its limits, they still offer a strategy for implant-borne dental rehabilitation.

Dental rehabilitation of patient with complex odontoma: A case report and review of literature

Odontomas are the most common odontogenic tumors. These tumors are asymptomatic and are generally diagnosed on radiographic examination. The sole management depends on the early diagnosis, histopathological examination, and excision of the pathological tissue. This article presents surgical management of excision complex odontoma in 22-year-old female patient followed with prosthetic rehabilitation with dental implants for replacement of missing teeth. After excision, bone grafts may be necessary depending on the need for further treatment. The present case emphasizes that new bone formation can take place without using any graft materials for the placement of dental implants in a cases of benign pathology.