AIMThis paper deals with the treatment of an atrophied toothless mandible with a fixing bridge carried by two nonstandard implant systems.

METHODOLOGYFour bicortical screws were implanted into the frontal part of the mandible and one implant on each side was placed into the distal area of the mandible as a support for a fixing bridge.

RESULTSDuring the years 2002 - 2007 the authors placed a total of 256 bicortical screw and 84 blade implants. During this period only four bicortical screws and one blade implant failed. The primary and secondary surgical success rate was therefore above 98%, while the prosthetic success rate was 100%. (Bridges which had to be re-fabricated due to implant failure were not taken into account.)

CONCLUSIONThis approach is recommended as a highly successful and affordable option for a wide range of patients.

Blade Implantation ; Dental Implantation, Endosseous ; instrumentation ; methods ; Dental Implants ; Dental Prosthesis, Implant-Supported ; Female ; Humans ; Jaw, Edentulous ; rehabilitation ; Male ; Mandible ; surgery ; Middle Aged

Dental Implantation, Endosseous ; Esthetics ; Humans

OBJECTIVE: To compare the volume of autogenous bone particles harvested utilizing different techniques and various implant systems during implant surgery, and to determine the advantageous method to collect autogenous bone particles. METHODS: Homogeneous epoxy resin simulated jaw bone model was enrolled. Bicon, Bego implant systems and Straumann tissue level implant systems were utilized. The two techniques were investigated. One method was low-speed drilling (50 r/min) without water irrigating, and the other one was drilling with cold water irrigating to the ideal depth, then closing the water and drilling out with low speed (50 r/min). The bone particles in the drill groove and implant beds were collected. The volumes of the bone harvested were compared between the different techniques and also among the three implant systems, then they were compared with the volume of the bone harvested by the special bone drill. The sample size of each sub-group was 10. The bone particles were weighed by electronic balance after drying. RESULTS: The harvested bone volume between the latch reamers and hand reamers of Bicon system with the first method was not significantly different. When the same size implant bed was prepared, the volume of the bone particles produced during the implant surgery with low-speed drill without water was significantly higher than that with the other method no matter Bicon [3.5 mm×10 mm hole for example (28.42±6.04) mg vs. (6.30±2.51) mg, P<0.001] or Bego system [2.8 mm×10 mm hole for example (28.95±5.39) mg vs. (4.61±3.39) mg, P<0.001] was used, and the ratio of bone volume between the first method and the second one was approximately 3.3 to 7.0 times. When using the second method to prepare the similar size implant bed, the bone volume was not significant different among Bicon, Bego and Straumann implant systems [Bicon (9.90±3.42) mg, Bego (8.70±4.09) mg, and Straumann (10.56±5.66) mg, P=0.69]. When preparing a 5 mm-diameter-10 mm-length hole with Bicon implant system and a 4.7 mm-diameter-10 mm-length with Bego implant system, the bone quantity harvested from each group was less than that harvested by special bone drill from Neo Biotech [Bicon (82.54±12.26) mg, Bego (85.07±12.64) mg vs. Neo Biotech (96.78±13.19) mg, P<0.05]. CONCLUSION More autogenous bone can be harvested from implant beds by preparing with low-speed rolling without water than the method with water irrigation. When utilizing the same preparing method, the implant system has no impact on the volume of the bone harvested.
Bone and Bones ; Dental Implantation, Endosseous

Management of mid-root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This article presents two varied treatment options for mid-root fractures. A 15-year-old female reported an impact injury to the maxillary anterior teeth 2 days after its occurrence. Clinically, the maxillary left central incisor was palatally-extruded with a negative vitality response and radiographic evidence of an oblique fracture at the middle third of the root. An endodontic implant was employed which utilized an open technique and has been on follow-up for ten months. A 32-year-old male reported an injury, which resulted in a mobile maxillary right central incisor, three months after its occurrence. Through clinical and radiographic means, a discolored, extruded, and non-vital maxillary right central incisor with an oblique root fracture at the alveolar-crest level was observed. Exploratory surgery was performed; an apical barrier was created with a mineral trioxide aggregate and obturated with gutta percha. The fragments were stabilized with a fiber post and patient has been on follow-up for five months. Short-term follow-up for both of the cases showed promising results both clinically and radiographically.
Adolescent ; Adult ; Bone Screws ; Dental Implantation, Endosseous, Endodontic ; Female ; Humans ; Incisor ; injuries ; Male ; Maxilla ; Post and Core Technique ; Root Canal Therapy ; methods ; Tooth Fractures ; therapy

OBJECTIVETo investigate the existence of functional neuroreceptors in peri-implant bone tissue and to test the peri-implant neural feedback pathway reconstruction and its influential factors.

METHODSThree beagle dogs were involved in this study. After the extraction of 3 premolars and 1 molar of the bilateral mandible, 27 implants were placed immediately or delayed. The implants were loaded for 3 - 6 months, then sensory nerve action potential (SNAP) tests were performed. The stimulating electrode was connected to the implant or natural tooth. The recording electrode was fixed near the inferior alveolar nerve (IAN) to record the latency period and amplitude of SNAP. The specimens with peri-implant bone tissues were taken and examined by immunohistochemistry.

RESULTSSNAP of IAN could be recorded following stimulations to natural teeth and implants. The differences in SNAP amplitudes between natural teeth [(44.04 +/- 6.23) microV] and all implant groups were statistically significant (P < 0.01). Free nerve endings and nerve tract were found in the peri-implant bone tissue, but much less than those in periodontal membrane. Some nerve fibers were directly connected with implant surface.

CONCLUSIONSFunctional neuroreceptors, though much less than that of natural tooth, exist in peri-implant bone tissue. Surgical methods and loading time do not have obvious influences on peri-implant neural feedback pathway reconstruction.

Action Potentials ; physiology ; Animals ; Bicuspid ; surgery ; Dental Implantation, Endosseous ; Dental Implants ; Dogs ; Immediate Dental Implant Loading ; Mandible ; Molar ; surgery ; Osseointegration ; Sensory Receptor Cells ; physiology ; Tooth Extraction

Objective: To study the clinical outcomes and feasibility of immediate implantation after flap surgery and minimally invasive extraction in the maxillary molar area and to provide a reference for it. Methods: Forty-one patients (41 molars in total) with maxillary molars that could not be preserved, treated from June 2018 to June 2020 at the Department of Oral and Maxillofacial Surgery at the Affiliated Hospital of Qingdao University, were selected. There are 24 males and 17 females with the age of (49.7±1.8) years (range 18-66 years). Pre-operative cone-beam CT (CBCT) was taken for measurement and analysis. After flap surgery and minimally invasive tooth extraction, the inflammatory granulation tissues attached to the soft and hard tissues were completely scraped and clipped, followed by the preparation of the implants in the correct three-dimensional position. Torque value and implant stability quotient (ISQ) were recorded after implant placement and with non-submerged healing. CBCT examination was taken 6 months after surgery and ISQ value was checked before crown restoration. CBCT examination was also taken 1 year after the permanent restoration. The survival rate of 6 months after surgery, the success rate of 1 year after permanent restoration, and the size of jump gaps immediately after surgery, 6 months after surgery, 1 year after permanent restoration respectively, were performed. The ISQ values were compared immediately and 6 months after surgery. Results: A total of 41 implants were placed in 41 patients. Six months after surgery, the survival rate was 100% (41/41). Twelve months after permanent restoration, the success rate of the implant restoration was 100% (41/41). The torque value after implant implantation was (42.77±0.79) N·cm. The buccal and palatal jump gaps were (3.15±0.16) mm and (2.86±0.18) mm immediately after surgery, respectively. The mesial and distal jump gaps were (2.94±0.19) mm and (3.77±0.21) mm, respectively. CBCT showed that no jump gap around the implants at 6 months after surgery and 1 year after permanent restoration. The ISQ values at immediately and 6 months after surgery were (74.78±0.59) and (80.20±0.49) respectively, and the difference was statistically significant (t=-9.03, P<0.001). Conclusions: Immediate dental implantation in the correct three-dimensional position could achieve good osseointegration by means of flap surgery, minimally invasive extraction and thorough removal of inflammatory tissue on the surface of soft and hard tissues. The clinical outcomes were satisfactory.
Adolescent ; Adult ; Aged ; Dental Implantation, Endosseous/methods* ; Dental Implants ; Feasibility Studies ; Female ; Humans ; Immediate Dental Implant Loading ; Male ; Middle Aged ; Molar/surgery* ; Young Adult

The purpose of this study was to investigate the cortical bone thickness of the inter-dental area of both jaws for orthodontic miniscrew placement. The cone-beam computerized tomography images of 32 non-orthodontic adults with normal occlusion were taken to measure the cortical bone thickness in both jaws. One-way analysis of variance (ANOVA) was used to analyze the differences in cortical bone thickness. Buccal cortical bone in the mandible was thicker than that in the maxilla. In the maxilla, cortical bone thickness was thicker in the buccal side than in the palatal side. Buccal cortical bone thickness in the mandible was thickest at the site distal to the first molar, and in the maxilla it was thickest at the site mesial to the first molar, while in the palatal side of maxilla it was thickest at the site mesial to the second premolar. The changing pattern of cortical bone thickness varies at different sites. In the buccal side of maxilla, the thinnest cortical bone thickness was found to be at 4 mm level from the alveolar crest, while the thickest was at 10 mm level (except for the site mesial to the first premolar). The buccal cortical bone thickness at the sites mesial or distal to the first molar in the mandible and palatal cortical bone thickness of maxilla tended to increase with increasing distance from the alveolar bone.
Adult ; Bone Screws ; Cone-Beam Computed Tomography ; methods ; Dental Implantation, Endosseous, Endodontic ; instrumentation ; methods ; Female ; Humans ; Male ; Mandible ; diagnostic imaging ; surgery ; Maxilla ; diagnostic imaging ; surgery ; Radiography, Dental ; methods ; Reproducibility of Results ; Sensitivity and Specificity ; Surgery, Computer-Assisted ; methods ; Young Adult

Dental Implantation, Endosseous ; Diphosphates ; therapeutic use ; Humans

Dental Implantation, Endosseous ; Humans ; Maxillary Sinus

Dental Implantation, Endosseous ; Humans ; Tooth Socket ; surgery