The present paper was conducted to a systematic method of surgical guide for dental implant based on computer-aided technology through CT data and dental-cast data. By analyzing the patient's CT data, the implant region was planned using image processing techniques. For the specified implant region, the computer-aided method for the rational allocation of dental implant was addressed in a sense of anatomy. With biomechanical principles as well as aesthetical and functional requirements as preconditions, this method can make full use of bone quantity and quality to produce the optimum implantation axis. The transferring of implant planning to the patient was then realized by registration between CT models and dental-cast models. A case research explained the whole process of the surgical guide. The results validated the correctness and feasibility of this method, which has a great significance to enhance the quality and accuracy of implant surgery.
Computer-Aided Design ; Dental Implantation, Endosseous ; instrumentation ; methods ; Dental Models ; Dental Prosthesis Design ; instrumentation ; methods ; Humans ; Oral Surgical Procedures, Preprosthetic ; methods ; Patient Care Planning ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Dental Implantation ; methods ; Humans ; Maxillary Sinus ; Oral Surgical Procedures, Preprosthetic ; Pressure ; Sinus Floor Augmentation ; methods

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

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 evaluate the result of bone regeneration due to using PRP in combination with beta-TCP in bone defect adjacent to oral implantation.

METHODSTen patients (6 males, 4 females, with an average age of 49.6 years) participated in this study. Seven of them underwent maxillary sinus augmentations, and 3 underwent GBR for peri-implant bone defects. PRP + beta-TCP was used in 4 cases and beta-TCP in other 6 as control. X-ray examinations were carried out prior to operation and in 1 week, at 3 months, 6 months after operation. After 4 - 6 months, 3 biopsy specimens were obtained at the time of the second stage operation in each group.

RESULTSBone grafts healed well without any infection in all cases. Radiographs showed that bone grafts integrated together with the bone. The histological result showed that new bone was formed among particles of beta-TCP in both groups, but in PRP + beta-TCP group denser and better arranged woven bone was observed, and more new bone was formed into the micropores of the particles.

CONCLUSIONSThe result in this study implied that PRP in combination with beta-TCP can improve bone regeneration in bone defect adjacent to oral implantation.

Adolescent ; Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Bone Regeneration ; Bone Substitutes ; therapeutic use ; Bone Transplantation ; methods ; Female ; Guided Tissue Regeneration, Periodontal ; methods ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged ; Oral Surgical Procedures, Preprosthetic ; methods ; Platelet Transfusion ; methods ; Treatment Outcome

Adult ; Humans ; Oral Surgical Procedures, Preprosthetic ; methods ; Orthodontics, Corrective ; Tooth Movement Techniques

OBJECTIVETo evaluate the clinical result of alveolar vertical distraction osteogenesis for implant.

METHODS19 cases with severe vertical alveolar defects (more than 10 mm defect) underwent vertical distraction procedure before implant placement. 15 cases were male and 4 cases were female. The alveolar bone defects were caused by tumor resection in 10 cases, by trauma in 8 cases, and due to congenital defect in 1 case. The vertical defects in all cases were over 10 mm. X-ray examination were taken prior to operation and in 1 week, 2 week, 4 week, the end of active distraction and before removing distractor. Implants were placed in 17 cases after removing distractors. The prosthesis were finished 6 month later.

RESULTS11 cases out of 19 had implant prosthesis. 6 cases had implant in the jaw but waiting for the prosthesis. Altogether 65 dental implants were placed, 2 cases did not receive further implant treatment because of cost problem. The study showed that new bone formed after distraction in all 19 cases. Average gained height of new bone was 13 mm.

COMPLICATIONSUnexpected mandible fracture in 2 cases, infection in 1 case.

CONCLUSIONSAlveolar vertical distraction is a good alterative for severe alveolar defects. The distractor should be further developed and modified.

Alveolar Ridge Augmentation ; Dental Implantation, Endosseous ; Dental Implants ; Humans ; Mandible ; surgery ; Osteogenesis, Distraction

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

Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.
Dental Implantation, Endosseous/methods* ; Dental Implants ; Esthetics, Dental ; Alveolar Ridge Augmentation/methods* ; Osseointegration ; Maxilla/surgery* ; Dental Implants, Single-Tooth

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