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Nigerian Journal of Clinical Practice Aug 2019The objective of this review is to evaluate maxillary and mandibular all-on-four implant designs, their indications and contraindications, advantages and disadvantages. (Review)
Review
OBJECTIVE
The objective of this review is to evaluate maxillary and mandibular all-on-four implant designs, their indications and contraindications, advantages and disadvantages.
METHODS
By using Pubmed, Cochrane Library, and Google Scholar, data from January 2003 to February 2018 were scanned electronically and manually as the title, abstract, and full text. The keywords specified were determined to be the all-on-four concept, full-arch implant prostheses, 4-implant full-arch, and tilted implants. The inclusion criteria consisted of the all-on-four implant design, its use in completely edentulous maxillary and mandibular cases, advantages and disadvantages of the technique, and changes observed in the maxilla and mandible in completely edentulous cases. Clinical trials and laboratory studies on the subject using the full text and English language were evaluated.
RESULTS
A total of 176 articles were found as a result of Google Scholar, Pubmed, and Cochrane Library. Thirty-seven articles were selected according to inclusion criteria; of these, 20 were related to the clinical trials. In addition, a total of 13 articles were found as a result of an additional hand search by screening the reference list of all included publications; of these, 11 was related to the clinical trials.
CONCLUSIONS
It is necessary to carry out longer-term clinical and laboratory studies to determine long-term success criteria in all-on-four implant designs and to use new ceramic systems.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Humans; Jaw, Edentulous; Mandible; Maxilla
PubMed: 31417044
DOI: 10.4103/njcp.njcp_273_18 -
Journal of Plastic, Reconstructive &... Jul 2023Fibula Jaw-in-a-Day (JIAD) is considered the most advanced approach for segmental mandibular defect reconstruction and dental rehabilitation. However, it has limitations...
BACKGROUND
Fibula Jaw-in-a-Day (JIAD) is considered the most advanced approach for segmental mandibular defect reconstruction and dental rehabilitation. However, it has limitations and challenges for further pursuit. We propose Fibula Jaw-during-Admission (JDA) as a solution.
MATERIALS AND METHODS
From 2019 to 2021, six patients received fibula "Jaw-during-Admission." Segmental mandibulectomy, fibula transfer, and immediate dental implantation were performed simultaneously during a single surgery. Intraoral scans were used to fabricate temporary light occlusion contact dental prostheses while on the ward prior to discharge during the first and second week post operation. The prostheses were installed before discharge and changed to permanent ones with normal occlusal contact in the clinic at about six months after X-ray confirmation of bone healing.
RESULTS
All six surgeries succeeded. Four patients received palatal muco-periosteal graft after debridement of peri-implant overgrown granulation tissue. Follow-up ranged from 12 to 34 months (average 21.2 months) and revealed good function and appearance in all patients.
CONCLUSION
Fibula JDA is superior to the Fibula JIAD approach for simultaneous mandibular reconstruction with fibula and dental rehabilitation. There is no need for postoperative intermaxillary fixation. The surgery can be performed more reliably with less stress. It provides an additional opportunity for dental rehabilitation if initial dental prosthesis installation during JIAD fails. Postreconstruction intraoral scans provide greater precision and more flexibility in milling dental prosthesis which are mapped to the reconstructed mandible during the postoperative period.
Topics: Humans; Fibula; Mandible; Plastic Surgery Procedures; Mandibular Osteotomy; Mandibular Reconstruction; Bone Transplantation; Dental Implantation, Endosseous; Free Tissue Flaps
PubMed: 37207438
DOI: 10.1016/j.bjps.2023.01.010 -
The Journal of Oral Implantology Oct 2021Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated... (Review)
Review
Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated with mini implants. Mini implants have less percutaneous exposure and displacement that may reduce complications. Nonetheless, mini implants transmit about twice the load to the supporting bone, and thus, control of occlusal loading is important. In fixed prosthetics, rounded flat cusps, splinting, implant protective occlusal schemes, and placement only in dense bone sites are features of successful mini implant treatment. With removable prosthetics, multiple mini implants may be needed for appropriate retention and load resistance. Maxillary lateral incisor and mandibular incisor sites may be best suited for mini implant treatment. However, past research on dental implants has been directed at standard sized implants. While mini implants are indeed dental implants, they behave somewhat differently under functional load, and the clinician should be circumspect and very judicious in their use. This article is a mini review and not a systematic review. The topics covered are not pervasive because each would require a monograph or textbook for a complete discussion.
Topics: Crowns; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Mandible
PubMed: 32663848
DOI: 10.1563/aaid-joi-D-19-00317 -
International Journal of Environmental... Dec 2019To describe a technique intended to transfer of the intermaxillary and occlusal relationships in a fully digital environment from a complete denture to an...
Full Digital Workflow for the Treatment of an Edentulous Patient with Guided Surgery, Immediate Loading and 3D-Printed Hybrid Prosthesis: The BARI Technique 2.0. A Case Report.
PURPOSE
To describe a technique intended to transfer of the intermaxillary and occlusal relationships in a fully digital environment from a complete denture to an implant-supported 3D-printed hybrid prosthesis (an acrylic resin complete fixed dental prosthesis supported by implants).
METHODS
In edentulous cases, the physiological mandibular position should be determined before the immediate loading procedures. In some cases, the use of interim removable prostheses for a few weeks could be useful to test the new occlusion in centric relation and to verify the prosthetic project. When the correct intermaxillary relationships are achieved, it is difficult to transfer them from the provisional to the final prostheses, as impressions or scans of edentulous arches do not have reference points for intermaxillary records. This paper presents a complex case and the technique used to transfer information from a complete denture to an implant-supported prosthesis with a digital workflow. A prosthetic stent has been used to scan the edentulous mandibular arch and to record the intermaxillary relation.
RESULTS
The delivery of the hybrid implant-supported prostheses was carried out with no problems and minimal occlusal adjustments. The patient was extremely satisfied with the treatment and the situation remained stable at the 1-year follow up.
CONCLUSIONS
The approach described in the present article predictably maintains prosthetic information and allows the delivery of a final implant-supported restoration with the same occlusal relationship as the one tested with the provisional diagnostic dentures.
Topics: Aged; Dental Prosthesis, Implant-Supported; Female; Follow-Up Studies; Humans; Immediate Dental Implant Loading; Male; Middle Aged; Mouth, Edentulous; Printing, Three-Dimensional; Treatment Outcome; Workflow
PubMed: 31861166
DOI: 10.3390/ijerph16245160 -
Journal of Indian Prosthodontic Society 2021Surgical resection of the lower jaw due to the presence of a benign or malignant tumor is the most frequent cause of mandibular deviation. Location and extent of the...
Surgical resection of the lower jaw due to the presence of a benign or malignant tumor is the most frequent cause of mandibular deviation. Location and extent of the tumor decide the surgical modality of mandibulectomy to be performed. The clinician must wait for an adequate span of time for completion of the healing and acceptance of the osseous graft before considering a definitive prosthesis. During the inceptive healing period, prosthodontic intervention is of utmost priority for preventing the mandibular deviation. A corrective appliance termed "guide flange prosthesis (GFP)" is indicated to limit this clinical manifestation. The basic intention of rehabilitation is to train the mandibular muscles and to re-establish an acceptable occlusal relationship so that the patient can adequately control the opening and closing movements. This case series describes early prosthodontic management of three patients who had undergone hemimandibulectomy, with different techniques of fabrication of a GFP. The three techniques described consist of two conventional methods of fabrication while the third technique is a new innovative approach.
Topics: Humans; Malocclusion; Mandible; Mandibular Osteotomy; Mandibular Prosthesis; Mandibular Prosthesis Implantation
PubMed: 33938873
DOI: 10.4103/jips.jips_12_21 -
Journal of Otolaryngology - Head & Neck... Jul 2023Resection of the mandible and temporomandibular joint (TMJ) without formal reconstruction is a devastating condition that negatively affects all aspects of the patient's...
INTRODUCTION
Resection of the mandible and temporomandibular joint (TMJ) without formal reconstruction is a devastating condition that negatively affects all aspects of the patient's life. We have approached the reconstruction of mandibular defects that include the condyle with simultaneous reconstruction with a vascularized free fibular flap (FFF) using Surgical Design and Simulation (SDS) and alloplastic TMJ prosthesis. The objective of this study is to report the functional and quality of life (QOL) outcomes in a cohort of patients that had undergone our reconstructive protocol.
METHODS
This was a prospective case series of adult patients that underwent mandibular reconstruction with FFF and alloplastic TMJ prosthesis at the our center. Pre-operative and post-operative maximum inter-incisal opening (MIO) measurements were collected, and patients completed a QOL questionnaire (EORTC QLQ-H&N35) during those perioperative visits.
RESULTS
Six patients were included in the study. The median patient age was 53 years. Heat map analysis of the QOL questionnaire revealed that patients reported a positive clinically significant change in the domains of pain, teeth, mouth opening, dry mouth, sticky saliva, and senses (relative change of 2.0, 3.3, 3.3, 2.0, 2.0, and 1.0 respectively). There were no negative clinically significant changes. There was a median perioperative MIO increase of 15.0 mm, and this was statistically significant (p = 0.027).
CONCLUSIONS
This study highlights the complexities involved in mandibular reconstruction with involvement of the TMJ. Based on our findings, patients can obtain an acceptable QOL and good function following simultaneous reconstruction with FFF employing SDS and an alloplastic TMJ prosthesis.
Topics: Adult; Humans; Middle Aged; Mandibular Reconstruction; Free Tissue Flaps; Quality of Life; Joint Prosthesis; Temporomandibular Joint; Treatment Outcome
PubMed: 37400904
DOI: 10.1186/s40463-023-00639-4 -
Journal of Stomatology, Oral and... Sep 2023Alloplastic total temporomandibular joint replacement (TMJR) is the treatment of choice for end-stage temporomandibular joint diseases. Extended TMJR (eTMJR) is a... (Review)
Review
Alloplastic total temporomandibular joint replacement (TMJR) is the treatment of choice for end-stage temporomandibular joint diseases. Extended TMJR (eTMJR) is a modification of the standard alloplastic fossa-condyle joint that includes components extending further to the skull base or the mandible. The aim of this study is to review the use of the eTMJR prosthesis for the treatment of large craniomaxillofacial defects. Data mining was performed according to the PRISMA statement using online search in databases such as PubMed (Medline), Google Scholar, Dimensions, Semantic Scholar and Web of Science. A total of 19 case reports, 08 case series and 03 retrospective studies were identified. A total of 49 patients were presented in the case reports and case series, who were implanted with 56 eTMJR prostheses (07 bilateral and 42 unilateral procedures). The mean age of the patients was 36.02±16.54 years, the male to female patient ratio was 1:1.72 and the mean follow-up time was 23.74 ± 19.83 months. The eTMJR prosthesis was most frequently used to treat ameloblastoma and hemifacial microsomia. Analysis of the retrospective studies was performed in three domains: the baseline characteristic of patients, treatment outcomes in terms of functional variables and complications after eTMJR prostheses implantation. This study concluded that the implantion of the eTMJR prosthesis was uncommon, that appropriate class of eTMJR prosthesis was not reported, and that the width of the mandibular component (like the length) of eTMJR prosthesis has substantial variations.
Topics: Adult; Female; Humans; Male; Middle Aged; Young Adult; Arthroplasty, Replacement; Joint Prosthesis; Retrospective Studies; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 36720364
DOI: 10.1016/j.jormas.2023.101404 -
Oral and Maxillofacial Surgery Sep 2020This systematic article reviews the literature on the confounding parameters that affect short implant survival in order to establish specific surgical and prosthetic... (Review)
Review
AIM
This systematic article reviews the literature on the confounding parameters that affect short implant survival in order to establish specific surgical and prosthetic protocols that create an optimal biomechanical scenario and ensure implant longevity.
MATERIALS AND METHODS
The available literature was screened for randomized clinical trials and prospective cohort and retrospective studies, published up to February 20, 2020, on the prognosis of short-length implants placed in posterior jaws. Studies evaluating the 5-year clinical performance of short dental implants (5 mm or 6 mm) in fixed rehabilitations of partially edentulous posterior jaws were included.
RESULTS
Eleven studies were selected after assessment of inclusion and exclusion criteria, of which 8 were RCTs, 2 were prospective studies, and 1 was a retrospective study. After 5 years in function, 22 short (12 in maxilla and 10 in mandible) and 10 standard (2 in maxilla and 8 in mandible) implants were lost, resulting in high survival rates independent of implant length or location. More biological complications were found in standard implants especially those placed in augmented posterior mandibles (135 complications compared to 48 in short mandibular implants). Splinted prostheses were associated with less technical complications (15 out of 53 complications affecting short implants).
CONCLUSION
The findings of this review showed that, when used correctly, short implants achieve predictable and promising long-term outcomes, provided they are placed following a comprehensive surgical and prosthetic protocol, based on the different biomechanical parameters essential to optimize long-term prognosis.
CLINICAL SIGNIFICANCE
The use of short implants in clinical practice has considerably increased in a wide variety of cases, given that they offer several advantages for both patient and practitioner. Recent literature shows that, when specific criteria are respected, new generations of short implants present high, long-term survival rates. This review is designed to provide a thorough understanding of the surgical and prosthetic protocols that create an optimal biomechanical scenario for short implants and improve their prognosis.
Topics: Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Mandible; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 32323043
DOI: 10.1007/s10006-020-00841-y -
Journal of Pharmacy & Bioallied Sciences Jul 2022Rehabilitation of distal extension cases is one of the common challenges in dentistry as fabrication of fixed prosthesis is impossible. For the prosthetic rehabilitation...
Rehabilitation of distal extension cases is one of the common challenges in dentistry as fabrication of fixed prosthesis is impossible. For the prosthetic rehabilitation of distal extension, implant-supported prosthesis, cast partial denture, and precision attachment prosthesis can be used. Precision attachment helps in the distribution of masticatory forces, minimizes trauma to abutments and soft tissues, improves the esthetics, and retains proprioception and thus better comfort to the patient. This case report presents the fabrication of precision attachment to retain maxillary and mandibular partial dentures.
PubMed: 36110812
DOI: 10.4103/jpbs.jpbs_581_21