This paper reports a case of a 28-year-old male patient with mandibular fibular graft. The patient underwent dental implant surgery. The left portion of the patient's mandible was resected because of ameloblastoma and restored by vascularized fibular grafting. Four implants were implanted in the fibular graft area after 2 years, and the area was restored with a pure titanium casting rod, Locator abutment, and overdenture. This case provides a feasible solution for the restoration of a fibular graft with a dental implant. The characteristics of the restoration method are described. We hope to improve the quality of life of patients with fibular grafts.
Adult ; Bone Transplantation ; Dental Implants ; Dental Prosthesis, Implant-Supported ; Denture, Overlay ; Fibula ; Humans ; Male ; Mandible ; Mandibular Neoplasms ; Quality of Life

Mandibular defects lead to severe deformation and functional deficiency. Vascularized osteocutaneous tissue has been widely used to reconstruct the mandible. However, it is technically challenging to shape this type of grafts in such a manner that they resemble the configuration of the mandible. A 48-year-old female patient who underwent anterolateral thigh (ALT) flap coverage after a tongue cancer excision was diagnosed with a tumor recurrence during the follow-up. A wide excision mandibulectomy and mandibular reconstruction with an ALT flap and a titanium implant were performed. The prefabricated titanium implant was fixed to the condyle. Then, an ALT flap was harvested from the ipsilateral thigh and anastomosed. After confirming that the circulation of the flap was intact, the implant was fixed to the parasymphysis. On the radiograph taken after the surgery, the prosthesis was well positioned and overall facial shape was acceptable. There was no postoperative complication during the follow-up period, 1 year and 2 months. The prefabricated implant allows the restoration of facial symmetry without harvesting autologous bone and it is a safe and effective surgical option for mandibular reconstruction.
Female ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Prosthesis Implantation ; Mandibular Reconstruction* ; Middle Aged ; Postoperative Complications ; Prostheses and Implants ; Recurrence ; Thigh ; Titanium* ; Tongue Neoplasms ; Transplants

Defects due to mandibulectomy often cause hard and soft tissue loss and result in esthetic problems and functional disorders such as mastication, swallowing, and pronunciation. After the mandibular reconstruction, several complications including loss of alveolar bone can cause limitations in maintenance or supporting of removable prosthesis. For these patients, implant-supported fixed restorations have been an appropriate prosthetic restorative method. In this case report, we report the patient who underwent mandibulectomy and mandibular reconstruction owing to oral cancer, and then restored the current dentition functionally and aesthetically by applying zirconia frameworks and monolithic zirconia crowns by computer-aided design and computer-aided manufacturing.
Carcinoma, Squamous Cell ; Computer-Aided Design ; Crowns ; Deglutition ; Dental Prosthesis, Implant-Supported ; Dentition ; Humans ; Mandibular Reconstruction ; Mastication ; Methods ; Mouth Neoplasms ; Mouth Rehabilitation* ; Mouth* ; Prostheses and Implants

This case study was to report the possible increase in the denture retention and psychological relief using the implant-supported fixed prostheses in a completely edentulous patient. The implants were placed in the anterior portion of the mandible in a patient who had completely edentulous state following the extraction of residual abutment teeth, and consequently a distal extension removable partial denture was fabricated. The patient's adaptation and satisfaction to the new prosthesis was monitored and confirmed in terms of masticatory function and esthetics, by restoring the oral condition similar to initial status before the residual teeth extraction. After 6 months, radiographic examination confirmed that both the abutment teeth and the implants were stable and well maintained. Considering the relatively short clinical follow-up period, however, continuous long-term monitoring was required.
Dental Prosthesis, Implant-Supported ; Denture Retention ; Denture, Partial, Removable ; Esthetics ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Prosthesis ; Prostheses and Implants ; Tooth

OBJECTIVETo clarify the related factors of marginal bone loss (MBL) around tissue level implants in the posterior part of the mandible.

METHODSA total of 116 tissue level implants were implanted in the mandibular posterior region of 76 patients. Patients' information, including general characteristics, implant characteristics, implant site characteristics, and prosthesis characteristics, was recorded. Their cone beam computed tomography data were measured immediately after implant placement, 3 months later, and 3 and 12 months after prosthesis loading. The measurement of MBL was conducted by One Volume Viewer software. SPSS 20.0 was used for statistic analysis.

RESULTSSmoking, cortical bone thickness (CBT), collum angle (CA), and implant local sanitation showed significant differences with body mass loss (P<0.05). No significant differences were found among sex, age, length of implant, diameter of implants, implant systems, bone height, prosthesis type, and MBL (P>0.05).

CONCLUSIONThe risk factors that caused MBL were smoking, thicker CBT, larger CA, and poor implant local sanitation. Among them, poor implant local sanitation had the highest correlation with MBL.

Alveolar Bone Loss ; epidemiology ; etiology ; Cone-Beam Computed Tomography ; Dental Implants ; adverse effects ; Dental Prosthesis Design ; Dental Prosthesis, Implant-Supported ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Prosthesis ; statistics & numerical data ; Oral Hygiene ; Postoperative Complications ; Smoking ; adverse effects ; Treatment Outcome

PURPOSE: The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS: This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS: Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION: The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required.
Congenital Abnormalities ; Female ; Head and Neck Neoplasms ; Humans ; Insurance ; Korea* ; Male ; Mandibular Prosthesis ; Maxillofacial Prosthesis ; Palatal Obturators ; Palate, Hard ; Prosthodontics ; Rehabilitation ; Retrospective Studies ; Specialization ; Velopharyngeal Insufficiency

PURPOSE: The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS: A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS: Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION: For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.
Dental Implants ; Denture Rebasing ; Denture, Overlay* ; Dentures ; Female ; Gingiva ; Hemorrhage ; Humans ; Mandibular Prosthesis ; Occlusal Adjustment ; Oral Health ; Patient Satisfaction ; Periodontal Index ; Survival Rate ; Visual Analog Scale ; Surveys and Questionnaires

This paper is to report our study in which the differences between prosthetic restoration and surgical reconstruction using traditional clasp retention technology were analyzed based on three-dimensional finite element methods in our laboratory. Firstly, the maxillary unilateral defect model was developed using medical image processing software MIMICS. Secondly, the prosthesis was generated by mirroring technology. The clasp was designed according to the methods raised by Aramany. Then, the stress distribution of maxilla was calculated by simulating occlusion. According to the results, after osseointegration of surgical reconstruction, stresses of unaffected abutments were reduced significantly, and less stress of junction occurred near zygoma of affected side, which were all less than stresses of prosthesis restoration. Thus, removing the clasp of surgical reconstruction increased the stresses of unaffected abutments. The stress trends of maxillary components were different between prosthetic restoration and surgical reconstruction. Surgical reconstruction is better than prosthesis restoration in protection of the abutments. Clasp can alleviate the occlusal burden of maxilla. Varieties of retentive technologies can be considered in prosthesis restoration. The surgical reconstruction is more conducive to rehabilitate unilateral maxilla biomechanically in clinic.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Image Processing, Computer-Assisted ; Mandibular Reconstruction ; methods ; Maxilla ; surgery ; Maxillofacial Prosthesis ; Osseointegration ; Zygoma

PURPOSE: The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction. MATERIALS AND METHODS: A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants. RESULTS: Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants. CONCLUSION: The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants.
Dental Implants ; Denture Repair ; Denture, Overlay ; Dentures ; Humans ; Mandibular Prosthesis ; Patient Satisfaction ; Survival Rate

PURPOSE: The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction. MATERIALS AND METHODS: A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems. RESULTS: Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems. CONCLUSION: The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system.
Dental Implants ; Denture, Overlay ; Dentures ; Hand ; Humans ; Magnets ; Mandibular Prosthesis ; Patient Satisfaction ; Survival Rate ; Treatment Outcome