Two bilateral zygomatic implants placed and immediately loaded: A retrospective chart review with up-to-54-month follow-up

Purpose: To report on the outcome of placement of two bilateral zygomatic implants with an immediately loaded prosthesis. Materials and Methods: A retrospective chart review was conducted of all patients treated with zygomatic implants between August 1, 2011 and June 6, 2016. All patients had at least two zygomatic implants placed bilaterally and immediately loaded with a provisional prosthesis the same day of implant placement. The implants were Nobel Biocare TiUnite or machined surface with lengths of 30 to 52.5 mm. All patients were treated by a team consisting of one surgeon, a restorative dentist or prosthodontist, an anesthesiologist, and a laboratory technician. Implant success was defined as successful integration of the implant; prosthetic success was defined as retention of the prosthesis under normal function. Results: One hundred five zygomatic implants were placed and immediately loaded in 28 patients over a period of 1 to 60 months. Ages ranged from 46 to 81 years, with 26 female and 2 male patients. All the implants were placed by one surgeon. The immediate load on the day of implant placement was completed by either one of 2 prosthodontists or 11 restorative dentists. Implant success was 96% (101/105). All four failed implants were in one patient and were TiUnite surface coated. Conclusion: This study demonstrated that two zygomatic implants bilaterally placed and immediately loaded with a full-arch splinted prosthesis will provide a predictable outcome. © 2017 by Quintessence Publishing Co Inc

Analysis of buccolingual dimensional changes of the extraction socket using the ice cream cone flapless grafting technique

The socket or ridge preservation approach known as the ice cream cone technique was used in type 2 sockets in this retrospective analysis of 11 extraction sites. A type 2 extraction socket is defined as having the presence of facial soft tissue with a partial or complete dehiscence of the buccal bone plate. All teeth were extracted atraumatically without flap elevation. A resorbable collagen membrane was contoured into an ice cream cone- shape, placed into the socket defect, and grafted with human freeze-dried bone allograft. Buccolingual dimensional changes were measured manually with a digital caliper sensitive to 0.01 mm on pre- and posttreatment casts using an acrylic template and a three-dimensional (3D) digital scanner, as well as radiographically with pre- and post-cone beam computed tomography (CBCT) scans. All implants were placed 6 months after socket preservation and achieved primary stability with a minimum torque value of 35 Ncm with a mean buccal-lingual dimensional loss of 1.32 mm. The dimensional change of the ridge from pre- to postextraction reflective of the healed grafted site ranged from a loss of 0.46 to 2.25 mm with a mean of 1.28 mm (CBCT), 0.31 to 2.71 mm with a mean of 1.36 mm (digital calipers), and 0.21 to 2.80 mm with a mean of 1.32 mm (3D digital scanner). All 11 implants were immobile and clinically osseointegrated. The so-called ice cream cone technique allows for the reconstruction of a buccal plate dehiscence to enable the placement of an implant; however, the ridge dimension was diminished by 1.32 mm compared with the width of the extraction socket prior to tooth removal

Combination lower lip prosthesis retained by an intraoral component

Patients who have had a partial or full surgical resection of the maxillary or mandibular lip experience difficulties with articulation of speech, swallowing, and salivary control. This is further complicated by significant alterations in facial esthetics and lowered self-esteem. This clinical treatment will describe the fabrication of a two-piece tooth-retained maxillofacial prosthesis. An intraoral retentive portion and an extraoral section restoring lip anatomy were attached by retentive elements. This prosthesis restored the patient\u27s esthetics, oral function, and self-esteem. © 2013 by the American College of Prosthodontists

The Effect of Tissue Entrapment on Screw Loosening at the Implant/Abutment Interface of External- and Internal-Connection Implants: An In Vitro Study

PURPOSE: To compare the removal of torque values of machined implant abutment connections (internal and external) with and without soft tissue entrapment using an in vitro model. MATERIALS AND METHODS: Thirty external- and 30 internal-connection implants were embedded in urethane dimethacrylate. Porcine tissue was prepared and measured to thicknesses of 0.5 and 1.0 mm. Six groups (n = 10) were studied: External- and internal-connection implants with no tissue (control), 0.5, and 1.0 mm of tissue were entrapped at the implant/abutment interface. Abutments were inserted to 20 Ncm for all six groups. Insertion torque values were recorded using a digital torque gauge. All groups were then immersed in 1 M NaOH for 48 hours to dissolve tissue. Subsequent reverse torque measurements were recorded. Mean and standard deviation were determined for each group, and one-way ANOVA and Bonferroni test were used for statistical analysis. RESULTS: All 60 specimens achieved a 20-Ncm insertion torque, despite tissue entrapment. Reverse torque measurements for external connection displayed a statistically significant difference (p \u3c 0.05) between all groups with mean reverse torque values for the control (13.71 +/- 1.4 Ncm), 0.5 mm (7.83 +/- 2.4 Ncm), and 1.0 mm tissue entrapment (2.29 +/- 1.4 Ncm) groups. Some statistically significant differences (p \u3c 0.05) were found between internal-connection groups. In all specimens, tissue did not completely dissolve after 48 hours. CONCLUSIONS: External-connection implants were significantly affected by tissue entrapment; the thicker the tissue, the lower the reverse torque values noted. Internal-connection implants were less affected by tissue entrapment