Short-term clinical data suggest that NDIs may serve in the posterior jaw as an alternative to standard-diameter implants. However, certain clinical conditions must be observed to assure long-term success.
Statement of Problem. Low scientific evidence is identified in the literature for combining implant placement in fresh extraction sockets with immediate function. Moreover, the few studies available on immediate implants in postextraction sites supporting immediate full-arch rehabilitation clearly lack comprehensive protocols. Purpose. The purpose of this study is to report outcomes of a comprehensive protocol using CAD-CAM technology for surgical planning and fabrication of a surgical template and to demonstrate that immediate function can be easily performed with immediate implants in postextraction sites supporting full-arch rehabilitation. Material and Methods. 14 subjects were consecutively rehabilitated (13 maxillae and 1 mandible) with 99 implants supporting full-arch fixed prostheses followed between 6 and 24 months (mean of 16 months). Outcome measures were prosthesis and implant success, biologic and prosthetic complications, pain, oedema evaluation, and radiographic marginal bone levels at surgery and then at 6, 12, 18, and 24 months. Data were analyzed with descriptive statistics. Results. The overall cumulative implant survival rate at mean follow-up time of 16 months was 97.97%. The average marginal bone loss was 0,9 mm. Conclusions. Within the limitations of this study, the results validate this treatment modality for full-arch rehabilitations with predictable outcomes and high survival rate after 2 years.
Implant rehabilitations in the posterior jaw are influenced by many factors such as the condition of the remaining teeth, the force factors related to the patient, the quality of the bone, the maintenance of the hygiene, the limited bone height, the type and extent of edentulism, and the nature of the opposing arch. The gold standard is to place a regular diameter implant (>3.7 mm) or a wide one to replace every missing molar. Unfortunately, due to horizontal bone resorption, this option is not possible without lateral bone augmentation. In this situation, narrow diameter implant (NDI < 3.5 mm) could be the alternative to lateral bone augmentation procedures. This paper presents a clinical study where NDIs were used for the replacement of missing molars. They were followed up to 11 years. Special considerations were observed and many parameters were evaluated. NDI could be used to replace missing molar in case of moderate horizontal bone resorption if strict guidelines are respected. Yet, future controlled prospective clinical trials are required to admit their use as scientific evidence.
Trapped foreign bodies and tissue reactions to foreign materials are commonly encountered in the oral cavity. Traumatically introduced dental materials, instruments, or needles are the most common materials referred to in the dental literature. This paper describes an iatrogenic foreign body encapsulation in the oral mucosa, clinically appearing as 5 × 10 mm tumor-like swelling with an intact overlying epithelium and diagnosed as a polymeric impression material. Detailed case history and, clinical and radiographic examinations including CBCT and spectrometric analysis of the retrieved sample were necessary to determine accurately the nature, size, and location of the foreign body. It is suggested that the origin of the material relates to an impression made 2 years ago, leaving a mass trapped in a traumatized mucosal tissue.
For optimizing functional and esthetic implant therapy results, sufficient bone amount is required at the reception site. A reduced buccolingual ridge dimension may not allow the placement of a standard-diameter implant without the risk of implant thread exposure. In such situations, lateral bone augmentation procedures can be performed that would allow a restorative-driven placement of standard-diameter implants. Conversely, the use of narrow-diameter implants (diameter ≤ 3.5mm) could be another predictable solution to avoid any invasive surgical management. The aim of this review is to analyze the survival rate of narrow-diameter implants as well as the effectiveness of different techniques for lateral bone augmentation in improving implant clinical outcomes.
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