The Journal of dental symposia最新文献

Early techniques in implant dentistry utilized immediate impression-taking and loading of endosseous implants. Because these techniques became associated with an unacceptably high incidence of complications and failures in early implant dentistry, many dental professionals came to look upon the procedures with disfavor. This disregard overlooked the fact that in many cases the utilization of immediate impression-taking and loading was successful. This presentation suggests to the clinicians to reconsider the issue of immediate loading from two contemporary perspectives. First, the author's research indicates that the benefits of single-stage implant treatment can be realized with a two-stage implant. Second, even when single-stage treatment is not elected, the advantages of faster, more convenient (and therefore more acceptable) treatment for the patient can be realized by taking an impression at the time of implant placement with the use of a new insertion tool/impression pin currently in clinical trials and described in this paper.

Placement of implants in the dental alveolus crest of the mandible and maxilla is limited by the height of bone between the alveolar crest and the maxillary sinus, floor of the nose, and the inferior alveolar canal. This paper discusses three surgical grafting procedures--the sinus lift and graft, the split cortical (or sandwich) graft, and the onlay graft--these add additional bone to the anterior and posterior maxilla, and also the procedure to reposition and protect the neurovascular bundle so that endosseous implants may be placed.

Root form implants may be either cylindrical or threaded, metal or calcium-phosphate-ceramic (CPC) coated. Biological and mechanical principles dictate a preference for threaded implants, and a retrospective study comparing surface characteristics reveals a marked preference for HA-coated threaded implants, at least in the short-term period of observation.

The use of implants with fixed partial dentures requires that the restorative dentist address a new set of concerns when planning treatment. This paper presents some important issues and evaluates the advantages and disadvantages of each choice, including the decision whether to treat the patient as a totally implant-supported or as a combination case. The special problems of posterior restorations include occlusion, rigid versus nonrigid coupling mechanisms, root intrusion, and screw versus cement retention.

The rationale and protocol to gradually load the implant after the initial bone interface have been established and discussed. Bone density is the most critical factor in determining the amount of healing time between first and second-stage surgeries and also between the five appointments for prostheses which are cement-retained.

Controversy has recently arisen regarding hydroxylapatite (HA) coatings and HA-coated implants. The frequent absence of information about relevant scientific parameters in critical articles and presentations makes it difficult for clinicians to accurately assess the validity of these reports and/or the quality of the products being reported. In order to make informed decisions regarding HA-coated products, clinicians need to familiarize themselves with the critical variables of HA crystallinity, purity, density, bond strength, and dissolution rate. Clinical and histological studies indicate that when high standards are observed for these five parameters, HA coatings and HA-coated products provide a reliable component of the clinical armamentarium.

This article discusses the "implant team" concept as it is actually carried out in an implantology practice. The restorative dentist is designated to function as the head of the team, directing each stage of the treatment. He is the first one the patient consults, he refers the patient to the surgeon, and he consults other specialists, if necessary. Excellent communication between the members of the team is stressed throughout.

Hydroxylapatite (HA) coatings have shown promise due to the enhanced integration of osseous tissues to coated implant surfaces, particularly in sites where bone quality or quantity is compromised. This promise has resulted in a dramatic increase in clinical utilization of HA-coated implants. In spite of encouraging clinical findings, the long-term stability of the hydroxylapatite/bone interface has been challenged. Microbiologically the HA-coated implant surface may be more susceptible to the formation of bacterial plaque. Additionally, critical variations exist between implant coatings that may affect long-term survival. Despite such concerns, after eight years of clinical utilization, the hydroxylapatite-coated implant surface has not been shown to be predisposed to increased long-term failure.