Prosthetic Procedures Research Articles

Salvaging the lost smile in amelogenesis imperfecta

Amelogenesis imperfecta has been described as a group of hereditary enamel defects not associated with systemic diseases. Restoration of these defects is important not only because of esthetic and functional concern, but also because there may be a positive psychological impact on the patient. Among various treatments described for rehabilitation of amelogenesis imperfecta, this case report described the rehabilitation of patient utilizing twin stage procedure with aim of improving patient's function, appearance, restoring the proper contacts, and simplifying the prosthetic clinical and lab work procedures. Twin stage procedure is based on the fact that prevents horizontal forces acting during various mandibular excursion in full mouth rehabilitation case, to control horizontal forces which in turn depends upon the condylar path, incisal path, and cusp angle. Among them, role of cusp angle is more supported whereas condylar path and incisal path role is considered unreliable.

Comparative analysis of immediate functional loading and conventional loading about implant survival rate in the completely edentulous: Retrospective study

Introduction: This study researched the clinical application of immediate functional loading technique about implant survival rate in the completely edentulous and suggested our protocol about surgical & prosthetic procedure. Materials and methods: 32 consecutive patients participated in this study. A total of 242 implants were inserted. In test group, 144 implants were inserted in 19 patients with immediate functional loading with occlusal contact. In control group, 98 implants were inserted in 13 patients and conventional loading was done after 4~6 months. Result: In the immediately loaded implants group, overall cumulative survival rate was 98.6%.

Cigarette smoking and dental implant tooth replacement therapy: A questionnaire survey among patients receiving implant prosthetic treatment

Abstract Chronic nicotinism has negative effects, both local and systemic. Its local effects are related to both the immediate thermal influence, as well as the toxic action of the substances contained in the smoke. In addition, the microflora colonizing dental plague is changed. The damage and the inflammatory processes that are incurred, affect the bone tissue of the alveolar processes, the mucosa, gums, and the tooth enamel. In this study, the tobacco smoking-related profile of patients being treated by way of implants was determined. Moreover, the relationship between cigarette smoking and pain sensation was assessed in patients undergoing surgical and prosthetic procedures in the oral cavity. The questionnaire survey covered 464 patients receiving prosthetic treatment at the “Dental” Non-Public Health Care Centre in Tomaszow Mazowiecki. The patients answered questions concerning their sex, age, the period of smoking, number of cigarettes smoked per day and the sensation of pain during bone reconstruction, implant placement and prosthetic procedures. The most numerous group of patients treated with implants were women: either non-smoking or smoking for less than 20 years at a level of less than 20 cigarettes a day, and men aged 40-60 years who have been smoking for over 20 years, at more than 20 cigarettes a day. The results of the survey reveal that non-smoking patients felt pain during bone reconstruction, implant placement and prosthetic procedures more frequently.

Survival rate of osseointegrated implants in atrophic maxillae grafted with calvarial bone: a retrospective study

The aim of this study was to evaluate the clinical survival rate of osseointegrated implants placed in the atrophic maxilla that has been reconstructed by means of autogenous bone grafts harvested from a cranial calvarial site. Further, we sought to analyse the level of peri-implant bone after prosthetic rehabilitation and to determine subjective patient satisfaction with the treatment performed. This study conformed to the STROBE guidelines regarding retrospective studies. Twenty-five patients who had received osseointegrated implants with late loading in the reconstructed atrophic maxilla were included in the study. The survival rate and level of peri-implant bone loss were evaluated. A questionnaire related to the surgical and prosthetic procedures was completed. The observed implant survival rate was 92.35%. The mean bone loss recorded was 1.76mm in the maxilla and 1.54mm in the mandible. The results of the questionnaire indicated a high level of patient satisfaction, little surgical discomfort, and that the patients would recommend the procedure and would undergo the treatment again. From the results obtained, it is concluded that the cranial calvarial site is an excellent donor area; calvarial grafts provided stability and maintenance of bone volume over the course of up to 11 years.

Technical complications and failures of zirconia-based prostheses supported by implants followed up to 7 years: a case series.

To evaluate technical complications and failures of zirconia-based fixed prostheses supported by implants. Consecutive patients received zirconia-based single crowns (SCs) and fixed dental prostheses (FDPs) on implants in a private clinical setting between 2005 and 2010. One dentist performed all surgical and prosthetic procedures, and one master technician performed and coordinated all laboratory procedures. One-piece computer-aided design/ computer-assisted manufacture technology was used to fabricate abutments and frameworks, which were directly connected at the implant level, where possible. All patients were involved in a recall maintenance program and were finally reviewed in 2012. Data on framework fractures, chipping of veneering ceramics, and other technical complications were recorded. The primary endpoint was failure of the prostheses, ie, the need for a complete remake. A life table analysis was calculated. A total of 289 implants supported 193 zirconia-based prostheses (120 SCs and 73 FDPs) in 127 patients (51 men, 76 women; average age: 62.5 ± 13.4 years) who were reviewed in 2012. Twenty-five (13%) prostheses were cemented on 44 zirconia abutments and 168 (87%) prostheses were screw-retained directly at the implant level. Fracture of 3 frameworks (1 SC, 2 FDPs) was recorded, and significant chipping resulted in the remake of 3 prostheses (1 SC, 2 FDPs). The 7-year cumulative survival rate was 96.4% ± 1.99%. Minor complications comprised 5 loose screws (these were retightened), small chips associated with 3 prostheses (these were polished), and dislodgement of 3 prostheses (these were recemented). Overall, 176 prostheses remained free of technical problems. Zirconia-based prostheses screwed directly to implants are clinically successful in the short and medium term.

Prosthetic Survival and Complication Rate of Single Implant Treatment in the Periodontally Healthy Patient after 16 to 22 Years of Follow-Up.

Single implants were introduced in the 1980s, but long-term follow-up is scarce. The study aims to retrospectively investigate the prosthetic survival and complication rates of single implants in periodontally healthy patients after 16-22 years, and to evaluate the influence of different prosthetic procedures. Patients with a single implant were recalled for clinical examination. Prosthetic procedures included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Prosthetic survival, success, and occurrence of biological, technical, and aesthetic complications were obtained. Procedures were compared by log-rank tests. Fifty patients attended the examination. All implants were functional; however, 15% of abutments and 27% of crowns had been renewed. Replacements (1/4) were related to technical issues whereas the main cause was aesthetics. The abutment cumulative survival rate (CSR) differed significantly between ST-PFM (74%), ST-ACR (0%), and CO reconstructions (97%). The crown CSR was significantly lower for ST-ACR crowns (0%) compared with ST-PFM (68%) and CO (81%). Thirty-nine percent of implants remained complication free throughout the mean 18.5 years. Complications (1/3) required component replacement, and 53% occurred within 5 years after surgery. Prosthetic survival rates of single implants are encouraging after 16 to 22 years. However, 66% of the patients encountered at least one complication during follow-up.

Tissue stability of implants placed in fresh extraction sockets: a 5-year prospective single-cohort study.

Several materials have been used for ridge preservation after tooth extraction. This 5-year prospective single-cohort study is aimed at evaluating the success rate, marginal bone level (MBL), soft tissue stability, and subjective patient evaluation of implants placed in fresh extraction sockets with the use of a flapless technique and a xenograft to treat the peri-implant bone defect. Patients requiring a single implant in fresh extraction sockets were selected. After flapless extraction and implant insertion, the peri-implant bone defect was grafted with porcine bone. Collagen membrane was used to stabilize the graft. Four months later, a second surgery and prosthetic procedures were performed. Clinical parameters (width of keratinized gingiva [WKG], facial soft tissue level [FST], papilla index, plaque index, and bleeding on probing) were measured, and periapical radiographs were taken at the time of implant placement (baseline) and then at 1, 3, and 5 years thereafter. Image analysis software was applied to measure changes in the marginal bone level (ΔMBL). Additionally, patient satisfaction regarding the implant treatment was evaluated. All analyses were collected and measured by an independent, trained observer. Together with descriptive statistics, for each of the outcome variables, pairwise comparisons were performed using the Wilcoxon signed-rank test for matched samples. The level of statistical significance was set at 0.01 for all analyses. Forty-seven consecutive patients were treated, with an implant survival rate at 5 years of 95.7%. ΔMBL showed statistically significant differences: mean values were -0.68 ± 0.39, -0.94 ± 0.44, and -1.08 ± 0.43 mm at the 1, 3, and 5-year follow-up, respectively. Changes in WKG (ΔWKG) and FST (ΔFST) decreased from the 1-year point of the survey (0.80 ± 0.79 and 0.71 ± 0.73 mm for ΔWKG and ΔFST, respectively) to the last follow-up check at 5 years (0.67 ± 0.74 and 0.56 ± 0.69 mm for ΔWKG and ΔFST, respectively), with no significant differences. The papilla indexes showed significant differences among the baseline and all the other time points. Concerning patient satisfaction, at the last survey time point, 74% ± 11.8% of patients were satisfied regarding the overall implant treatment, 73.0% ± 11.1% gave a favorable opinion regarding the appearance of the peri-implant soft tissues, and 80.5% ± 11.3% judged positively the finished appearance of the implant crown. No significant differences were obtained among the three follow-up times. The data of the present study suggest that the placement of a dental implant by means of a flapless technique in a fresh extraction socket filled with slowly resorbable graft biomaterial and with a delayed prosthetic restoration shows positive final esthetic outcomes. At the 5-year point of the survey, the changes in the bone level were minimal. Moreover, both midfacial tissue and the papillae maintained the early increase recorded before the first year of the follow-up.

Posters

Background: Successful implant restorations in the esthetic zone often require demanding surgical and prosthetic therapeutic procedures in order to achieve long term stable results. Anatomical factors such as the thin buccal bone plate, the thin soft tissues and the high scalloping further complicate the decision-making and the treatment workflow. Despite the clinical and scientific evidence the clinical handling and the treatment sequence and workflow is of outmost importance determining the final outcome of the implant restoration. Aim/Hypothesis: The purpose of this report is to describe a methodology and treatment workflow in esthetic implant cases. This treatment sequence is utilizing socket preservation and bone grafting, soft tissue augmentation and temporary restorations to achieve optimum esthetic results. Material and methods: A 30 year old female patient presented with a sugingivally broken central incisor. The root was extracted and ridge preservation, using FDBA and a resorbable membrane was performed. An etched bonded Rochette-type bridge was used to temporarily restore the missing tooth. At 4 months the bone volume of the augmented site was adequate and an implant was placed. A two stage approach was selected and the implant was covered for the osseontegration period. At 4 months the implant was uncovered and a simultaneous soft tissue augmentation using a connective tissue graft was performed. The palate was used as a donor site. A provisional screw retained implant crown was inserted. The provisional crown was utilized to enhance tissue maturation and scalloping by consecutive modifications that created the desired emergence profile in a period of 4 months. The emergence profile was captured via a customized impression procedure. A custom all-ceramic abutment capturing the developed emergence profile was constructed. An all-ceramic crown was used to create the final esthetic result. Results: The soft and/or hard tissue enhancement in the majority if not all of the cases in the esthetic zone is absolutely necessary in order to achieve a highly esthetic and natural appearance of the implant restoration. The dentist can progressively develop the site to accommodate the implant in a perfect position. The interim restoration can be utilized to create the ultimate emergence profile and to allow the patient to evaluate its shape, size and color during the tissue maturation period. A customized impression procedure is utilized to transfer all these information to the laboratory for the construction of the final restoration. Conclusion and clinical implications: This staged approach is a step-by-step procedure that allows the clinician to carefully design and execute all the necessary steps to achieve an optimal result. The transition from the existing dentition to the final one is smooth and allows the patient to evaluate the result as the treatment progresses. The patient has the opportunity to have a significant input in the final esthetic outcome. The drawback of this procedure is the extended period of treatment, although the patient has constantly a fixed and esthetic restoration to accommodate his/her needs.

Suitable scanning procedures for various prosthodontic treatments and the utilization of intraoral scanner

With the development of digital dentistry, various intra-oral scanners which acquire intraoral image without conventional impression taking and stone pouring steps have been introduced. Fixed dental prostheses such as inlay, onlay, crown, and bridge fabricated by CAD/CAM technique combined with digital impressions is getting popular due to the recent rapid progress of digital impression taking system. In comparison with traditional prosthetic procedure, the advantages of intraoral image acquiring and CAD/CAM technique are as follows; the omission of conventional impression materials, reduced workflow step, and increased efficiency by online communication with clinic and laboratory. This review article covers some opinions about the suitable scanning procedures for the various prosthodontic treatments and the utilization of digital intraoral scanner and CAD/CAM system.

Prosthetic procedure for simultaneous immediate loading of opposing edentulous arches

For patients with complete edentulism, a significant problem is the transfer of diagnostic data to the definitive casts when an immediate loading technique is used. This article presents a prosthetic procedure to allow simultaneous treatment of opposing edentulous arches with immediate implant loading. This technique uses 2 occlusal acrylic resin devices to transfer the diagnostic cast information to the definitive casts. Esthetic and functional fixed dental prostheses are fabricated from diagnostic information acquired in the presurgical phase without any impression or recording of the maxillomandibular relationship during or after surgery. This methodology is applicable when the simultaneous immediate loading of implants in 2 edentulous arches is indicated.

Marginal bone and soft tissue behavior following platform switching abutment connection/disconnection– a dog model study

The effect on the marginal peri-implant tissues following repeated platform switching abutment removal and subsequent reconnection was studied. Six adult female Beagle dogs were selected, and Pm3 and Pm4 teeth, both left and right sides, were extracted and the sites healed for 3 months. At this time, 24 bone level (BL) (Straumann, Basel, Switzerland) Ø 3.3/8 mm implants were placed, 2 in each side on Pm3 and Pm4 regions. In one side (control group), 12 bone level conical Ø 3.6 mm healing abutments and, on the other side (test group), 12 Narrow CrossFit (NC) multibase abutments (Straumann) , Basel, Switzerland) were connected at time of implant surgery. On test group, all prosthetic procedures were carried out direct to multibase abutment without disconnecting it, where in the control group, the multibase abutment was connected/disconnected five times (at 6/8/10/12/14 weeks) during prosthetic procedures. Twelve fixed metal bridges were delivered 14 weeks after implant placement. A cleaning/control appointment was scheduled 6 months after implant placement. The animals were sacrificed at 9 months of the study. Clinical parameters and peri-apical x-rays were registered in every visit. Histomorphometric analysis was carried out for the 24 implants. The distance from multibase abutment shoulder to the first bone implant contact (S-BIC) was defined as the primary histomorphometric parameter. Wilcoxon comparison paired test (n = 6) found no statistically significant differences (buccal P = 0.917; Lingual P = 0.463) between test and control groups both lingually and buccally for S-BIC distance. Only Pm3 buccal aBE-BC (distance from the apical end of the barrier epithelium to the first bone implant contact) (P = 0.046) parameter presented statistically significant differences between test and control groups. Control group presented 0.57 mm more recession than test group, being this difference statistically significant between the two groups (P < 0.001). It can be conclude, within the limits of this animal study, that the connection/disconnection of platform switching abutments during prosthetic phase of implant treatment does not induce bone marginal absorption. Furthermore, it may present a negative influence in the buccal connective tissue attachment that becomes shorter anyway preventing marginal hard tissue resorption, especially in thin biotypes.

Influence of Dental Implant Diameter on Implant Success

Background: Missing teeth may result in a functional and cosmetic deficit and have traditionally been replaced with dentures or bridges. Dental implants offer an alternative; they are inserted into the jawbones and used to support dental prostheses. Objective: To relate diameter of dental implants with im- plant success. Patients and Methods: Implants with a root form, conical morphology and internal hex design, with SLA (sand blast large grid acid etch) surface treatment was used in this study. Two surgical procedures technique for submerged, bone level implants were used and 3 years follow up after prosthetic procedure was done. The diameter was classified as narrow, regular, or wide. The statistics were computed with Epi Info Version 6. Results: In this study, 603 dental implants (312 maxillary and 291 mandibular) were placed in 285 patients (mean age, 45.23 years) involving 152 males and 133 females with 1.2: 1 male to female ratio. The 3 years survival rate for all 603 implants was 96.02%. The largest success rate was observed in wide diameter implants (99%), followed by regular diameter (97.6%) and then narrow diameter (94.11%). According to Epi Info Version 6 analysis the chi2= 7.6 and P- value= 0.03 associated with 3 years follow up. Conclusion: According to this study there is relationship of implant diameter with success rate. Key words: Dental implant, implant diameter, implant success.

Immediate loading with fixed full-arch prostheses in the maxilla: review of the literature.

Objectives: To critically review the evidence-based literature on immediate loading of implants with fixed full-arch prostheses in the maxilla to determine 1) currently recommended performance criteria and 2) the outcomes that can be expected with this procedure. Study Desing: Studies from 2001 to 2011 on immediate loading with fixed full-arch maxillary prostheses were reviewed. Clinical series with at least 5 patients and 12 months of follow-up were included. Case reports, studies with missing data and repeatedly published studies were excluded. In each study the following was assessed: type of study, implant type, number of patients, number of implants, number of implants per patient, use of post-extraction implants, minimum implant length and diameter, type of prosthesis, time until loading, implant survival rate, prosthesis survival rate, marginal bone loss, complications andmean follow-up time. Criteria for patient selection, implant primary stability and bone regeneration were also studied. Results: Thirteen studies were included, reporting a total of 2484 immediately loaded implants in 365 patients. Currently accepted performance criteria regarding patient and implant selection, and surgical and prosthetic procedures were deduced from the reviewed articles. Implant survival rates went from 87.5% to 100%, prosthesis survival rates from 93.8% to 100% and radiographic marginal bone loss from 0.8 mm to 1.6 mm.No intraoperative complications and only minor prosthetic complications were reported. Conclusions: The literature on immediate loading with fixed full-arch prostheses in the maxilla shows that a successful outcome can be expected if adequate criteria are used to evaluate the patient, choose the implant and perform the surgical and prosthetic treatment. Lack of homogeneity within studies limits the relevance of the conclusions that can be drawn, and more controlled randomized studies are necessary to enable comparison between the immediate and the conventional loading procedures. Key words:Immediate loading, full-arch, dental implants, loading protocols.

Geriatric slim implants for complete denture wearers: clinical aspects and perspectives

BackgroundAdvances made in prevention have helped postpone complete edentulism in older patients. However, in the elderly, the physiological state reduces patients’ ability to adapt to oral rehabilitation and degrades the patient’s oral condition. Consequently, elderly edentulous subjects avoid many types of foods, which can lead to substantial nutritional consequences. Complete dentures retained by implants are, currently, the treatment of reference in prosthodontic mandibular rehabilitation. Indeed, the mandibular symphysis generally tolerates implantation, even when the mandible is strongly resorbed. However, in the elderly, implant rehabilitation is compromised by the complexity of the surgical protocol and possible postoperative complications. In this context, the use of geriatric “slim implants” (GSI) offers an interesting alternative.MethodsIn the present study, the surgical and prosthetic procedures for the use of GSI in a French dental hospital are presented. The objective was the stabilization of a complete mandibular denture in an elderly person, with the immediate implantation of four GSI.ResultsThe operating procedure was found to be less invasive, less expensive, simpler, and more efficient than the conventional procedure.ConclusionThe result strongly suggests that this protocol could be used systematically to treat complete edentulism in very elderly patients. Long-term monitoring and the evaluation of the reliability of this type of rehabilitation should be undertaken.

V1582 HIGH SUBMUSCULAR PLACEMENT OF UROLOGIC PROSTHETIC BALLOONS AND RESERVOIRS VIA TRANS-SCROTAL APPROACH

You have accessJournal of UrologyInfertility, Sexual Dysfunction and Testis1 Apr 2013V1582 HIGH SUBMUSCULAR PLACEMENT OF UROLOGIC PROSTHETIC BALLOONS AND RESERVOIRS VIA TRANS-SCROTAL APPROACH Allen F. Morey, Steven K. Wilson, James R. Flemons, Christopher A. Cefalu, Lee C. Zhao, Steven J. Hudak, and Edward L. Gheiler Allen F. MoreyAllen F. Morey Dallas, TX More articles by this author , Steven K. WilsonSteven K. Wilson Indio, CA More articles by this author , James R. FlemonsJames R. Flemons Dallas, TX More articles by this author , Christopher A. CefaluChristopher A. Cefalu Dallas, TX More articles by this author , Lee C. ZhaoLee C. Zhao Dallas, TX More articles by this author , Steven J. HudakSteven J. Hudak Dallas, TX More articles by this author , and Edward L. GheilerEdward L. Gheiler Hialeah, FL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3132AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Traditional placement of inflatable penile prosthesis (IPP) reservoirs and/or artificial urinary sphincter (AUS) balloons into the space of Retzius may be challenging following major pelvic surgery. The aim of this study is to report our one year experience using a novel technique for high balloon/reservoir placement beneath the rectus abdominus muscle, thus completely obviating deep pelvic dissection during prosthetic urologic surgery. METHODS A retrospective review of all patients who underwent IPP and/or AUS placement between June 2011 and September 2012 was performed. All had AUS balloons and/or IPP reservoirs placed in a submuscular location by bluntly tunneling through the external inguinal ring into a potential space between the transversalis fascia and the rectus abdominus muscle using a long, angled, lung grasping clamp. Patient demographics, perioperative outcomes, and follow up patient reported outcomes were reviewed. RESULTS During the study period, 170 submuscular balloons/reservoirs were inserted in 157 consecutive patients who underwent placement of an IPP (111 patients), AUS (33 patients), or both (13 patients). Among our 71 most recent patients who completed the follow-up questionnaire, 61 (86%) reported they were totally unable to feel their balloon/reservoir, and all but 2 (97%) reported no bother from the submuscular balloon/reservoir placement. Overall satisfaction was high with 70% of patients stating that they were “delighted” with their implant. The prosthetic balloon or reservoir was not palpable or minimally palpable to the surgeon on follow-up in 97% of patients. Of the 170 total submuscular balloons and reservoirs, surgical time and outcomes of the prosthetic procedures appeared similar to those placed using traditional methods; two reservoirs required revision surgery for repositioning. CONCLUSIONS High submuscular placement of genitourinary prosthetic balloons and reservoirs via a trans-scrotal approach is both safe and effective, while avoiding deep retropubic dissection. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e650 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Allen F. Morey Dallas, TX More articles by this author Steven K. Wilson Indio, CA More articles by this author James R. Flemons Dallas, TX More articles by this author Christopher A. Cefalu Dallas, TX More articles by this author Lee C. Zhao Dallas, TX More articles by this author Steven J. Hudak Dallas, TX More articles by this author Edward L. Gheiler Hialeah, FL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

미맹출 견치의 특발성 근심 이동

상악 견치는 이소 맹출이나 매복이 빈번히 관찰되는 치아로, 그 가능성을 조기에 발견했을 때에, 자연 개선 가능성을 고려한 합리적이고 체계적인 대처가 가능해진다. 체계적인 대처라 함은, 일단 주기적으로 관찰 하다가 개선되지 않을 경우 견치의 정상적인 맹출 시기에 인접하여 유견치를 발치해서 다시 한번 자연 개선을 기다려보는 것인데, 이 때 추가적으로 공간 유지 장치나 부차적인 개창술을 고려해 볼 수도 있을 것이다. 단, 너무 어린 나이에 유견치를 발치하면, 발치와가 단단한 경조직으로 채워지며 오히려 맹출 경로가 막힐 수 있으므로, 정상 맹출 시기의 약 6개월 전 정도에 발치하는 것이 바람직 하다. 이렇게 해도 자연 개선 되지 않는다면, 가급적 견치의 치근이 완성되기 전에, 외과적으로 버튼을 접착하고 올바른 위치로 교정적 견인하는 방법을 고려해 볼 수 있다. 환자가 늦게 내원했거나, 적극적 치료가 늦어 이미 위치가 심하게 변위 됐거나, 인접한 절치의 치근 흡수가 진행된 경우, 외과적 발치술 혹은 향후 보철적 치료가 추가될 것이다. 본 증례는 매복된 상악 견치의 특발성 악화 현상을 관찰하고 보고하는 바이다. Maxillary canines are the most commonly impacted or ectopically erupted teeth. If we find the abnormality of maxillary canines early, we can manage it reasonably and systematically. If we cannot see the spontaneous normalization at the periodic recall, primary canine extraction will be the next treatment choice. However, if the primary canine is extracted too early, the extraction socket will be filled with hard bone and then the eruption pathway can be locked. So it is more beneficial to extract the primary canine at the period about 6 months before the normal canine eruption time. The next treatment plan can be surgical and orthodontic approaches before the root apical closure of the impacted canine. Sometimes, surgical extraction and further prosthetic procedure can be needed for a severely malposed impacted canine or badly resorpted incisor. This is the case of the idiopathic mesial movement of impacted maxillary canines.

일부지역 남자고등학생들의 구강건강상태와 체질량 상태와의 관계

Objectives : For investigating relationship between oral condition and body mass of adolescent period and helping to make basic data which make oral care systematically while performing health care for adolescent. Methods : This research was carried out by performing oral and physical test of 273 high school students in some reasons from July 2nd to 16th in 2012. Results : There were significant differences, since the more subjects had irregular occlusion, the more they had loosing tooth(p<0.05). There was a significant difference, since when subjects had more numbers of regular occlusion, they had higher BMI and heavier weight.(p<0.001). There are significant different, since when the subjects had worse peridontal condition, they had more numbers of DT(p<0.001). There was a significant difference in occlusion and body mass group, since when subjects had regular occlusion, 46.4% of subjects were standard body weight, 41.0% of subjects were overweight and when subjects needed orthodontics, 52.7% of subjects were standard body weight, 33.8% of subjects were low-weight, and 13.5% of subjects were overweight(p<0.001). In the correlation between oral condition and BMI, DT index showed negative interrelation with FT index(r=-0.179) and positive interrelation with periodontal condition(r=0.221), MT index showed positive interrelation with occlusion(r=0.137) and FT index showed positive interrelation with height(r=0.136). BMI showed highly positive interrelation with weight(r=0.940), and when occlusion was worse, it shows negative interrelation with BMI(r=-0.293). Height showed highly positive interrelation with weight(r=0.447), and when the more subjects had malocclusion, it showed low negative interrelation with weight (r=-0.257). Conclusions : It was considered that an adolescent period forms health habits, so it was important to increase health action through education for growing healthy adult and not only guiding improvement of dietary life for keeping normal weight, but also conducting oral health education for treating regular occlusion of oral condition and prosthetic procedures for loosing tooth right time.

High Submuscular Placement of Urologic Prosthetic Balloons and Reservoirs via Transscrotal Approach

Traditional placement of inflatable penile prosthesis (IPP) reservoirs and/or artificial urinary sphincter (AUS) balloons into the space of Retzius may be challenging following major pelvic surgery. The aim of this study is to report our 1-year experience using a novel technique for high balloon/reservoir placement beneath the rectus abdominus muscle, thus completely obviating deep pelvic dissection during prosthetic urologic surgery. A retrospective review of all patients who underwent IPP and/or AUS placement between June 2011 and June 2012 was performed. All had AUS balloons and/or IPP reservoirs placed in a submuscular location by bluntly tunneling through the external inguinal ring into a potential space between the transversalis fascia and the rectus abdominus muscle using a long, angled, lung grasping clamp. Patient demographics, perioperative outcomes, and initial follow-up patient-reported outcomes were reviewed. During the study period, 120 submuscular balloons/reservoirs were inserted in 107 consecutive patients who underwent placement of an IPP (61 patients), AUS (33 patients), or both (13 patients). Among our 48 most recent patients, 41 (85%) reported they were totally unable to feel their balloon/reservoir, and all but two patients reported no bother from the submuscular balloon/reservoir placement. Of the 120 total submuscular balloons and reservoirs, surgical time and outcomes of the prosthetic procedures appeared similar to those placed using traditional methods; two reservoirs required revision surgery for repositioning. High submuscular placement of genitourinary prosthetic balloons and reservoirs via a transscrotal approach is both safely and effective, while avoiding deep retropubic dissection.

Retrospective Study of the Survival and Associated Risk Factors of Wedge-Shaped Implants

To assess the long-term behavior of wedge-shaped implants and evaluate the influence of the associated risk factors on implant survival rates. A retrospective review of clinical records of patients treated with wedge-shaped implants between 1992 and 2011 was conducted. Data on patient sex, age, smoking habits, and history of periodontitis; details of implant length, diameter, angle, and location; and data on surgical, reconstructive, and prosthetic procedures, and systemic disease were selected for analysis. A total of 1,169 implants placed in 154 patients (mean age 55.17 ± 11.33 years) were evaluated. Women received 637 implants, and men received 532 implants; 60.4% were placed in patients who were undergoing periodontal maintenance care, 17.9% in smokers, 17.7% in hypertensive patients, 5.7% in diabetic patients, and 4.4% in cardiac patients. The mean overall survival for implants was 194.26 ± 9.91 months. Seventy-three implants were lost: 3 before implant loading and 70 after loading. The cumulative survival rates at 5 and 10 years were 96.6% (confidence interval [CI]: 95.5% to 97.7%) and 91.8% (CI: 90.1% to 94.1%), respectively. Univariate analysis indicated tobacco smoking (P = .014) and implant location (P < .001) as significant risk factors for implant failure. The multivariate analysis showed tobacco smoking (P = .016), location (P = .001), and male sex (P = .038) as significant, and the latter factor was associated with previous periodontal disease. Overall survival of the wedge-shaped implant showed good long-term results. Male sex, tobacco smoking, and posterior maxillary location were associated with a greater risk of implant failure.

Maxillary Full-Arch Alveolar Split Osteotomy with Island Osteoperiosteal Flaps and Sinus Grafting Using Bone Morphogenetic Protein-2 and Retrofitting for Immediate Loading with a Provisional: Surgical and Prosthetic Procedures and Case Report

A case report and description of a new technique for bone morphogenetic protein-2 augmentation of the maxilla are provided here. Horizontal maxillary atrophy was treated with a full-arch alveolar split osteotomy combined with sinus floor intrusion. The defect was grafted with bone morphogenetic protein-2 and demineralized freeze-dried bone allograft. Nine months later, a transgingival approach was used to place dental implants and a prefabricated provisional denture. The provisional was attached to several implants and retrofitted into place following gingival sculpting to create a tooth emergence effect. To date, this patient has been followed for 2.5 years with no implant losses or bone level changes. In addition, the gingival profile appeared to be stable.