Placement Of Endosteal Implants Research Articles

INDIRECT SINUS LIFT

The indirect sinus lift is a procedure to lift the augment/regenerate alveolar bone in atrophied residual maxillary posterior alveolar crest . The posterior maxilla is always considered as difficult site for the placement of implant than the mandible due to the presence of various anatomical land mark such as maxillary sinus. The anatomical structure of maxillary sinus often makes every dental implant surgeons a challenge task in placement of endosteal implants in the chronic atrophic maxilla and difficulty in osseointegration and further functional and aesthetic implant supported prosthesis. Various techniques in sinus lifting procedure enables the additional anchorage and stability in implants placed support in maxillary segments in with atrophic ridges and pneumatic sinuses. Lack of sufficient bone height along maxillary sinus poses significant difficulty for placement of implants in edentulous maxillary jaw. Minimally invasive sinus augmentation is an effective solution for this problem. In 1960 Boyne introduced sinus lift through lateral access which was initially used as a pre-prosthetic procedure for removable complete dentures purpose. In 1980 Boyne and James used the bone created by sinus lift procedures to place implants. In pursuit of less invasive techniques , in 1994 Summer’s explained a technique which offers access to sinus floor through residual alveolar crest. Using the elasticity of bone, floor dilatation of sinus was performed to increase the length of implants .

Prosthodontic Rehabilitation in Patient With Ectodermal Dysplasia Combining Preprosthetic Techniques

Oral manifestations in ectodermal dysplasia include oligodontia, alveolar ridges hypoplasia, and others. Due to the special conditions in terms of unhealthy teeth and lack of bone, implant-supported rehabilitation seems to offer the most satisfactory outcome. A 27-year-old male diagnosed with ectodermal dysplasia was referred to our department for oral rehabilitation. Oral manifestations included oligodontia, maxillary and mandibular atrophy, mandibular alveolar ridge with knife-edge morphology, and conical teeth. Treatment planning consisted of a Le Fort I osteotomy with interpositional grafts, bilateral sinus lift, and placement of maxillary and mandibular inlay and onlay corticocancellous grafts, using autologous iliac crest bone. In the second surgery, all remaining teeth were removed and 11 endosteal implants were placed. Six months after implant placement, a bimaxillary fixed implant-supported prosthesis was delivered, maintaining a satisfactory esthetic and functional result after a 2-year follow-up. The use of combined preprosthetic techniques allows the placement of endosteal implants and a fixed implant-supported prosthesis in patients with oligodontia and ectodermal dysplasia, providing an esthetic and functional oral rehabilitation.

Microbial Contamination and the Sterilization/Disinfection of Surgical Guides Used in the Placement of Endosteal Implants

The purpose of this study was twofold: (1) to estimate the level of microbial contamination found on commercial guides (CG) and in-house laboratory guides (LG) prior to use, and (2) to evaluate the antimicrobial potential of disinfectants commonly used in dentistry to decontaminate heat-sensitive surgical guides. Ethylene oxide gas was used as the positive control; sterile water served as a negative control.Evaluation of CGs and LGs for bacterial contamination occurred soon after their arrival in the laboratory. Some guides went directly into tubes of trypticase soy broth solution, vortexed and equally divided into two tubes. One tube went into an 80°C bath for 19 minutes, while the other stayed at room temperature. After plating, half of the samples underwent anaerobic incubation. All incubation was for 48 hours at 37°C. Other guides underwent water rinsing or disinfection by various methods for 5 or 15 minutes or ethylene oxide gas sterilization prior to sampling.Untreated CG specimens showed modest levels of bacterial contamination, with most colonies coming from liquid specimens not exposed to 80°C. LG specimens had more bacteria from both heat-treated and non-heat-treated aliquots. Chlorhexidine gluconate, diluted bleach, and water rinsing were not able to completely eliminate microorganisms on the specimens, but no viable microorganisms were present on specimens treated with gas sterilization or 70% ethanol for 15 minutes.CGs and LGs, on average, had different levels of bacterial contamination prior to disinfection. Water, chlorhexidine gluconate, and diluted bleach were not totally successful in decontaminating the surgical guides, but no growth was found after 15 minutes of immersion in 70% ethanol. Preferably, surgical guides should be submerged in 70% alcohol for a minimum of 15 minutes or undergo sterilization using ethylene oxide gas.

Horseshoe Le Fort I osteotomy in combination with endosteal implants — a median-term follow-up study

Fourteen patients with Class VI resorption of the maxilla were treated with horseshoe Le Fort I osteotomy. In 11 cases, the procedure was followed by the placement of endosteal implants. In six patients, simultaneous placement of implants was carried out, while in five patients this was done in a second procedure. Ten patients wore their implant-supported dentures. In one patient, 5/8 implants were lost due to nonintegration. Three patients lost one implant each. The total number of implants placed was 76, and the survival rate of the implants was 88.1%. In the one-step procedure ( n=42), the survival rate was 84.8%; in the two-step procedure ( n=34), 92.3%. In comparison of the one-step to the two-step procedure, there was no statistically significant difference ( P>0.11) between the amount of marginal peri-implant bone loss and the condition of the peri-implant soft tissues as measured 2 years after implantation.

Simultaneous split-thickness skin grafting and placement of endosteal implants in the edentulous mandible: A preliminary report

Reconstruction of the edentulous atrophic mandible continues to be a treatment problem for the oral and maxillofacial surgeon. Clearly, endosteal osseointegrated implants are indicated for rehabilitation, but a total implant-supported prosthesis may not always be possible. The implant-supported overdenture is an excellent alternative, but modifications of the unfavorable residual ridge may be necessary. Attached crestal soft tissue, resistant to mechanical trauma, and improvement of the residual ridge anatomy are provided by adding a split-thickness skin graft vestibuloplasty (VSG) and lowering of the floor of the mouth (LFM). Simultaneous VSG and LFM with placement of endosteal implants provides the optimal condition for maximal rehabilitation of the atrophic mandible with specific indications. Results of four skin grafts and eight implants simultaneously placed are reported.