Clinical outcomes and cost effectiveness of computerâ guided versus conventional implantâ retained hybrid prostheses: A longâ term retrospective analysis of treatment protocols

BackgroundComputerâ guided systems were developed to facilitate implant placement at optimal positions in relation to the future prosthesis. However, the time, cost and, technique sensitivity involved with computerâ guided surgery impedes its routine practice. The aim of this study is to evaluate survival rates and complications associated with computerâ guided versus conventional implant placement in implantâ retained hybrid prostheses. Furthermore, longâ term economic efficiency of this approach was assessed.MethodsPatients were stratified according to implant placement protocol into a test group, using computerâ guided placement, and a control group, using traditional placement. Calibrated radiographs were used to measure bone loss around implants. Furthermore, the costs of the initial treatment and prosthetic complications, if any, were standardized and analyzed.ResultsFortyâ five patients (149 implants in the test group and 111 implants in the control group) with a minimum followâ up of 5 years, and a mean followâ up of 9.6 years, were included in the study. While no significant difference was found between both groups in terms of biologic and technical complications, lower incidence of implant loss was observed in the test group (P  0.05).ConclusionsComputerâ guided implant placement for an implantâ supported hybrid prosthesis is a valid, reliable alternative to the traditional approach for implant placement and immediate loading. Computerâ guided implant placement showed higher implant survival rates and comparable longâ term cost to nonâ guided implant placement.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145504/1/jper10157.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145504/2/jper10157_am.pd

An innovative prostheses design for rehabilitation of severely mutilated dentition: a case report

Partial edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism. The main clinical findings were unopposed remaining teeth, overeruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with crown lengthening surgery and strategic implant placement. Series of provisional prostheses were applied to facilitate the transition to the final treatment

Intraoperative Complications during Sinus Floor Elevation Using Two Different Ultrasonic Approaches: A Two-Center, Randomized, Controlled Clinical Trial

The aim of this study was to assess the prevalence of intraoperative complications during maxillary sinus elevation with lateral approach using a piezoelectric device with two different surgical techniques. MATERIALS AND METHODS: Antrostomies were randomly performed by outlining a window (group A, 36 patients) or by eroding the cortical wall with a grinding insert until the membrane was visible under a thin layer of bone, before outlining the window (group B, 36 patients). Occurrence of membrane perforation, laceration of vascular branches, and surgical time was recorded. RESULTS: Seventy-two patients underwent sinus floor elevation: four perforations (11.1%) were observed in group A (two occurred during elevation with hand instruments) and zero perforations in group B (p\u2009<\u2009.05). No evidence of vascular lacerations was registered in both groups. A clinically insignificant but statistically shorter surgical time was recorded in group A (9.2\u2009\ub1\u20093.7 minutes) than in group B (13.3\u2009\ub1\u20092.4 minutes; p\u2009<\u2009.05). CONCLUSIONS: Within the limits of the present study, it may be concluded that ultrasonic erosion of the lateral wall of the sinus is a more predictable technique than piezoelectric outlining of a bone window in preventing from accidental perforations of Schneiderian membrane during sinus augmentation procedure