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Journal articles on the topic 'Implant-prosthesis complex'
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Queiroz, Salomão Israel Monteiro Lourenço, Anderson Nicolly Fernandes-Costa, Bruno Cesar de Vasconcelos Gurgel, Carla Martins de Carvalho, Rodrigo Fromer, and Saulo Hilton Botelho Batista. "Complex rehabilitation of atrophic mandible with implant-supported prosthesis." Revista clínica de periodoncia, implantología y rehabilitación oral 11, no. 1 (April 2018): 47–48. http://dx.doi.org/10.4067/s0719-01072018000100047.
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Marian Anand Bennis and Deepak Nallaswamy V. "Full mouth rehabilitation with maxillary equator® attachment over denture and mandibular hybrid denture - A case report." International Journal of Research in Pharmaceutical Sciences 12, no. 1 (January 13, 2021): 388–91. http://dx.doi.org/10.26452/ijrps.v12i1.4165.
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Implant-supported prosthodontic rehabilitation of total edentulism remains the most complex restorative challenges. The main reason being the number of variables that affect both the aesthetic and functional aspects of the prosthesis. A hybrid denture or the ‘Toronto prosthesis’ is one that is fabricated over a metal framework and retained by screws threaded into implants. This article presents the fabrication of implant-retained maxillary Equator® attachment overdenture opposing mandibular implant-retained hybrid prosthesis. A total of four implants (Equinox® Myriad plus) were placed the maxillary arch and six implants (Equinox® Myriad plus) in the mandibular arch. The patient's occlusal vertical dimension, centric relation, aesthetics and phonetics were determined and maintained throughout the restorative process. This case report describes the management of a completely edentulous patient with a mandibular implant-supported fixed prosthesis and maxillary implant-retained overdenture with Equator® attachment.
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Savabi, Omid, Ebrahim Ataei, and Niloufar Khodaeian. "Fabricating a Soft Liner-Retained Implant-Supported Palatal Lift Prosthesis for an Edentulous Patient: A Case Report." Case Reports in Dentistry 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/203547.
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This case report describes fabrication of a palatal lift prosthesis for a quadriplegic edentulous 30-year-old male with past head traumatic injury. We constructed an implant supported bar and used a soft-lining material for the maxillary palatal lift prosthesis to minimize the possibility of implant overloading and also provide a less complex and less expensive procedure for this patient.
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Wang, Wei Ping, Singare Sekou, Ya Xiong Liu, Di Chen Li, Bing Heng Lu, and Jue Wang. "Study on Integrated Method of Medical Implant Manufacture Based on Rapid Prototyping Technology." Key Engineering Materials 375-376 (March 2008): 353–57. http://dx.doi.org/10.4028/www.scientific.net/kem.375-376.353.
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The traditional method to manufacture the medical implant or prosthesis is based on sculpting and on the tissue site,or takes impressions of the entire face about human. The accuracy and efficiency of medical implant or prosthesis produced by conventional method is heavily relied on the skill and experience of both designer and manufacturer. In this paper, an integrated method of medical implant manufacture is approached. This integrated strategy was to establish a system that allows fabrication of facial prosthesis from digital information, and integrates the rapid prototyping with modeling technology of complex three-dimensional geometry from high-resolution non-invasive imaging, reverse engineering and computer aided design. The research results have shown that the integrated method can produce more exact-fit medical implant, that is, the physical model of the implant is more exactly fitted on the skull model. The advantages of this method are that the surgeon can plan and rehearse the surgery in advance, and a less invasive surgical procedure, and less time-consuming reconstructive, and an adequate esthetic can result.
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Felice, Pietro, Angelica Bertacci, Lorenzo Bonifazi, Maryia Karaban, Luigi Canullo, Roberto Pistilli, Pasquale Sammartino, Roberta Gasparro, and Carlo Barausse. "A Proposed Protocol for Ordinary and Extraordinary Hygienic Maintenance in Different Implant Prosthetic Scenarios." Applied Sciences 11, no. 7 (March 25, 2021): 2957. http://dx.doi.org/10.3390/app11072957.
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Prevention of peri-implantitis involves the early diagnosis of peri-implant mucositis. This article presents a protocol of hygienic maintenance in different implant prosthetic scenarios: single crown, fixed partial prosthesis, fixed full-arch, and overdentures. Others clinical conditions have to be taken into consideration: patient compliance; history of periodontitis; implants placed in augmented bone; short, zygomatic, pterygoid, and tilted implants; and complex prosthesis with false gingiva. Two levels of implant maintenance are described: ordinary, performed by dental hygienist, and extraordinary, carried out by both dentist and hygienist. Extraordinary maintenance also involves the removal and decontamination of the prosthetic structure. To obtain an effective prevention of peri-implantitis, one must plan ordinary and extraordinary hygiene in relation to the type of rehabilitation and clinical parameters.
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WANG, D., A. QU, H. ZHOU, and M. WANG. "BIOMECHANICAL ANALYSIS OF THE APPLICATION OF ZYGOMA IMPLANTS FOR PROSTHESIS IN UNILATERAL MAXILLARY DEFECT." Journal of Mechanics in Medicine and Biology 16, no. 08 (November 25, 2016): 1640030. http://dx.doi.org/10.1142/s0219519416400303.
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The objective of this research is to evaluate the biomechanical effect of zygomatic implant-supported obturator prostheses in unilateral maxillary defect. Based on CT data, four 3D numerical models were built. One model was a normal craniofacial complex (model 1) and other three models were structures with unilateral maxilla defect reconstructed using clasp-retained obturator prosthesis (model 2), one zygomatic implant-supported and clasp-retained prosthesis (model 3), two zygomatic implant-supported and clasp-retained prosthesis (model 4). Bilateral vertical loads of 300[Formula: see text]N were imposed and the stress and displacement distribution were calculated, analyzed and compared. The bilateral occlusal forces dispersed along the three-mechanical-pillar of the maxillofacial region and the displacement distributed symmetrically in model 1. Because of mechanical pillars break on the affected side, all occlusal forces were transferred by clasps and abutment teeth in model 2, which induced the increase in stress and displacement level. The zygomatic implant restored mechanical pillars and greatly reduced the stress and displacements levels in models 3 and 4. The stress and displacement distributions on clasps, bones, teeth and periodontal ligaments were more reasonable with the support of zygomatic implants. Therefore, the zygomatic implant-supported and clasp-retained prostheses were found to be more effective for unilateral maxillary defect reestablishment.
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Romeed, Shihab A., Robert Nigel Hays, Raheel Malik, and Stephen M. Dunne. "Extrasinus Zygomatic Implant Placement in the Rehabilitation of the Atrophic Maxilla: Three-Dimensional Finite Element Stress Analysis." Journal of Oral Implantology 41, no. 2 (April 1, 2015): e1-e6. http://dx.doi.org/10.1563/aaid-joi-d-12-00276.
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Placement of zygomatic implants lateral to the maxillary sinus, according to the extrasinus protocol, is one of the treatment options in the rehabilitation of severely atrophic maxilla or following maxillectomy surgery in patients with head and neck cancer. The aim of this study was to investigate the mechanical behavior of a full-arch fixed prosthesis supported by 4 zygomatic implants in the atrophic maxilla under occlusal loading. Results indicated that maximum von Mises stresses were significantly higher under lateral loading compared with vertical loading within the prosthesis and its supporting implants. Peak stresses were concentrated at the prosthesis-abutments interface under vertical loading and the internal line angles of the prosthesis under lateral loading. The zygomatic supporting bone suffered significantly lower stresses. However, the alveolar bone suffered a comparatively higher level of stresses, particularly under lateral loading. Prosthesis displacement under vertical loading was higher than under lateral loading. The zygomatic bone suffered lower stresses than the alveolar bone and prosthesis-implant complex under both vertical and lateral loading. Lateral loading caused a higher level of stresses than vertical loading.
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Prakash, Poonam, and Ambika Narayanan. "Biomechanics in dental implants." IP Annals of Prosthodontics and Restorative Dentistry 7, no. 3 (September 15, 2021): 131–36. http://dx.doi.org/10.18231/j.aprd.2021.028.
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Achieving primary stability in dental implants is crucial factor for accomplishing successful osteointegration with bone. Micro-motions higher than the threshold of 50 to 100 μm can lead to formation of fibrous tissue at the bone-to-implant interface. Therefore, osteointegration may be vitiated due to insufficient primary stability. Osseointegration is defined as a direct and functional connection between the implant biomaterial and the surrounding bone tissue. Osseointegration development requires an initial rigid implant fixation into the bone at the time of surgery and a secondary stage of new bone apposition directly onto the implant surface. Dental implants function to transfer the load to the surrounding biological tissues. Due to the absence of a periodontal ligament, its firm anchorage to bone, various forces acting on it and the presence of prosthetic components, they share a complex biomechanical relationship. The longevity of these osseointegrated implants depend on optimizing these complex interactions. Hence, the knowledge of forces acting on implant, design considerations of implant and bone mechanics is essential to fabricate an optimized implant supported prosthesis.
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Venezia, Pietro, Ferruccio Torsello, Vincenzo Santomauro, Vittorio Dibello, and Raffaele Cavalcanti. "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." International Journal of Environmental Research and Public Health 16, no. 24 (December 17, 2019): 5160. http://dx.doi.org/10.3390/ijerph16245160.
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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.
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Mestar, Abdelkader, Samir Zahaf, Nourddine Zina, and Ahmed Boutaous. "Development and Validation of a Numerical Model for the Mechanical Behavior of Knee Prosthesis Analyzed by the Finite Elements Method." Journal of Biomimetics, Biomaterials and Biomedical Engineering 37 (June 2018): 12–42. http://dx.doi.org/10.4028/www.scientific.net/jbbbe.37.12.
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The human knee is a complex joint (the largest joint of the human body). During the different daily activities, this joint is exposed to significant loads and movements, may in some cases exceed the limit of the mechanical capacities of its components, which shows that the pathologies are quite numerous at the level of the human knee and the treatment sometimes requires surgery to either repair or implant (implant total knee prosthesis). As we know very well, the success of a total knee implant is highly dependent on the initial stability of the femoral or tibial implant and the integration of femur and tibia bone tissue with these implants in the long term. Due to the optimal distribution of mechanical stresses in the surrounding bone. It is for this reason that the search for reasonable solutions to compensate the damaged knee prosthesis and reduce the stresses in the cortical bone and spongy has become a very important research axis. In this regard, we have proposed three models of prosthesis knee joint from available literature and study the distribution of Von-Mises stresses and strains in the differents composents of knee prosthesis, know the total displacement between the model intact and model artificial of knee, 3D modeling software Solidworks 2016 is used for 3D modeling of knee prosthesis and finite element analysis software ANSYS 16.2 is used for numerical estimation of von-Mises stresses and strains. We find in this study that the maximum stresses and strains of Von Mises at the level of the tibia and tibial bone decrease, that is to say that the cement and the elastomer play a very important role in the absorption of the stresses and their minimization. On the other hand, the four knee prostheses (Model I (Ti6Al4V), Model II (CoCrMo), Model III (316L SS), Model IV (ZrO2)) implanted by elastomer contribute significantly to the reduction of stresses in the patella bone compared to the Intact Model. In general, both models of the knee prosthesis and reinforced by a stress reduction system (cement, elastomer) gave a lower stress level in the tibia and tibial bone of a normal person compared to a healthy model. The results obtained provide a theoretical basis for choosing an appropriate surgical model.
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Scripcaru, Andrei, Grigore Berea, Elena Carmen Cotrutz, Cristinel Ionel Stan, and Bogdan Puha. "Hemiarthroplasty in Complex Proximal Humeral Fractures Is uncemented methaphyseal corundum blasted titanium humeral stem an efficent alternative?" Materiale Plastice 55, no. 4 (December 30, 2018): 676–79. http://dx.doi.org/10.37358/mp.18.4.5099.
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The aim of this experimental study is to reveal the design and characteristics of unipolar shoulder prosthesis type Arrow (Groupe FH�, France) as well as to evaluate the outcome of the proximal humerus fracture treated with this implant. 8 patients with a mean age of 62.5 years were operated with immediate passive rehabilitation and active exercises initiated around day 45. All patients had good results with minimal pain, a mean Constant - Murley score of 74 and an acceptable shoulder amplitude. The clinical success was assured by the anatomic union of the tuberosities around the implant. The Arrow metaphyseal corundum blasted humeral titanium stem assures a perfect osseointegration with optimal stability and is an efficient alternative for shoulder hemiarthroplasty.
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Paes-Junior, Tarcisio José de Arruda, Paolo Freitas, Renato Sussumu Nishioka, Gabriela Nogueira de Melo Nishioka, and Leonardo Jiro Nomura Nakano. "Open tray impression technique using a silica-nylon mesh for splitting implants: a case report." ARCHIVES OF HEALTH INVESTIGATION 10, no. 7 (July 16, 2021): 1141–46. http://dx.doi.org/10.21270/archi.v10i7.5301.
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This article describes an alternative open tray technique for implant impressions using a novel reinforced silica-nylon mesh covered with acrylic resin as a splitting system in assembling the abutment complex. The purpose of the procedure is to simplify the technique and improve the resin contraction during clinical procedure, and also optimizes and reduces the chairside time for the patient. The clinical report was supported by an in vitro study where an analysis tool, Strain Gauge Analysis, was used to prove the clinical effectiveness of the technique. The peri-implant strain was determined on polyurethane casts with the torqued prosthesis, and statistically there was no difference in strain under torque of transfers or in the final prosthesis. The nylon mesh attached to acrylic resin represents a promising option for open tray impression technique, creating a resistant union to transfer in an excellent procedure time.
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Hennessy, David, Megan Anderson, and Santiago Lozano-Calderón. "Complex Pelvic Reconstruction using Patient-Specific Instrumentation and a 3D-Printed Custom Implant following Tumor Resection." Journal of Hip Surgery 02, no. 02 (February 13, 2018): 061–67. http://dx.doi.org/10.1055/s-0037-1618581.
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AbstractResection of a periacetabular sarcoma is a difficult surgical problem due to the complex bony and soft tissue anatomy. The challenge of pelvic tumor resection lies in achieving clear margins while also reconstructing the defect with a durable construct. Limb salvage surgery involving these types of tumors, as well as other tumors of the pelvis, has made great progress recently due to remarkable technological innovation in the field of computer-assisted surgery and custom implant design. In this study, the authors review the case of a 9-year-old child with an osteosarcoma arising from the proximal femur with local spread into the hip joint and a skip metastasis in the ipsilateral acetabulum. They undertook limb-sparing extra-articular resection of the sarcoma with a reconstruction consisting of a 3D-custom printed pelvic implant and a proximal femur extendible prosthesis. The resection of the pelvis was performed with patient-specific cutting guides, rather than computer-assisted navigation. The resection resulted in a clear margin and the patient has had no evidence of local recurrence. These patient-specific guides closely matched the planned resection in terms of orientation in the pelvis, which allowed for straightforward implantation of the custom prosthesis at the time of surgery. The result has been a durable reconstruction that has produced an excellent functional outcome for this patient.
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Ghiban, Brandusa. "Failure Modes of the Biometallic Materials - Case Study." Key Engineering Materials 752 (August 2017): 111–16. http://dx.doi.org/10.4028/www.scientific.net/kem.752.111.
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Hip fractures/arthrosis were, still are and will be a challenge for the orthopedic surgeon. In this paper we conducted a case study on a rod used for hip replacement due to coxartrosis. The implant was used for hip replacement for NC patient aged 82 years. After twelve months the patient returns for the ablation of osteosynthesis material. Clinical and strengthen the fracture hip is found radiologic hypertrophic and degradation plaque. It was used a rod implant, on which were made following investigations in order to establish the causes that led to the fracture, namely: determining the chemical composition through spectral analysis, analysis macrostructural in stereo, microstructural analysis optical microscope metallographic respectively analysis fractogr aphic electron microscope streak. Complex analysis of the fracture surfaces of the hip prosthesis has led to the ultimate conclusion that the material has been made the hip prosthesis is inadequate chemical purity satisfactory embedding, which has led to breakage within an area of non-homogeneous structure.
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Turcu, Razvan, Marius Moga, and Adrian Barbilian. "Aspects of Cementation in Shoulder Hemiarthroplasty after Complex Fracture of the Proximal Humerus." Revista de Chimie 69, no. 9 (October 15, 2018): 2435–37. http://dx.doi.org/10.37358/rc.18.9.6548.
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The first uses of the polymers at the articular level were: joint components, cement fixation of prosthetic components at the bone, and sutures of tendons and ligaments. Since 1970, when polymethyl methacrylate (PMMA) was introduced, bone cement is the choice of choice to fix the prosthetic implant to bone. The cementation of the implant components is a commonly used procedure for hip, knee and shoulder arthroplasty: the femoral stem and the acetabular cup (in the case of total hip arthroplasty), the femoral and tibial components (in the case of total knee arthroplasty), the humeral stem (in hemiarthroplasty, total arthroplasty: anatomical or arthroplasty with inverse shoulder prosthesis) The objectives of this study are to establish the optimal indication of the cementing process, to evaluate and compare the results of cemented hemiarthroplasty, the real benefit from the immediate postoperative functional recovery program, for elderly patients with a diminished bone stock with complex fractures of proximal humerus. The success of the surgical treatment for complex fractures of proximal humerus depends to a large extent on establishing a correct diagnosis, an optimal surgical indication, a thorough preoperative planning, an optimal implant, a periarticular soft tissue reconstruction, and an effective postoperative recovery program.
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Salah A. Youssef, Rami Mohammed Galal, Ghada E. Hamza, Ghith Fayez Saeed Aldhahri, Ahmad Ramzi Abdu Alzaylaei, Mohammed Saleh Mohammed Alamoudi, Abdullah Abdulrahman Ahmad Benjabi, et al. "Finite Element Analysis on All on Four Implant Screw Retained Mandibular Fixed Prosthesis. (Material Selection Role)." International Journal of Innovative Research in Medical Science 5, no. 12 (December 28, 2020): 650–55. http://dx.doi.org/10.23958/ijirms/vol05-i12/1027.
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Aim: to indicate the importance of adequate selection of all on four-fixed implant supported hybrid mandibular prosthesis material to reduce bone stresses. Materials and methods: one three-dimensional simplified geometric model, for bone and fixed prosthesis, was created by using engineering CAD/CAM software. On the other hand, implant system manufacturer data gave sufficient geometrical data to model it exactly. The modelled part was transferred to ANSYS for assembly, meshing, and analysis. Three overlying materials were tested; Acrylic, Polycarbonate, and Zirconia above the cobalt chromium bar. The lowest area of the cortical bone was set to be fixed in place as boundary condition. While unilaterally load of 250N was applied vertically on central fossa of first and second molars as two loading cases. Results: changing overlying material resulted in, cortical bone and implant complex receiving Von Mises stress in sequence with material rigidity. The more rigid the overlying material the less bone stresses with first molar loading, while, opposite trend (sequence) appeared with second molar loading. On the other hand, bar, coping, screws, mucosa, and spongy bone deformations and stresses decreased with increasing overlying material rigidity. Where, all the model components showed stresses and deformations within the physiological limits. Conclusions: More rigid overlying material is recommended to reduce stresses on bar, coping, screws, mucosa, and spongy bone. Overlying material selection for cortical bone and implant complex is extremely tricky. That it showed same behaviour as other soft tissues with applying load close to the bar (short cantilever arm), then inverted behaviour with shifting the applied load away from first to second molar (increasing cantilever arm).
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Vichnin, H. H., and S. C. Batterman. "Stress Analysis and Failure Prediction in the Proximal Femur Before and After Total Hip Replacement." Journal of Biomechanical Engineering 108, no. 1 (February 1, 1986): 33–41. http://dx.doi.org/10.1115/1.3138577.
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An investigation was performed to determine the effects of the presence of two lengths of proximal Mu¨ller prosthesis on predicted failure loads, as compared to those for an intact femur. Three-dimensional stresses in a bone/cement/prosthesis system were determined using finite element methods, with both isotropic and transversely isotropic material properties used for the diaphyseal cortex. Significant increases in prosthesis stem stresses were found when the transversely isotropic material properties were employed in the diaphyseal cortex. This leads to the conclusion that accurate anisotropic material properties for bone are essential for precise stress determination and optimum design in prosthetic implants. Failure loads were also predicted for vertical compression and axial torque, similar to available experimental conditions, and were within the range of the experimental failure data found in the literature. The technique developed herein can be used to systematically assess existing as well as future implant designs, taking into account the complex three-dimensional interaction effects of the overall bone/cement/prosthesis system.
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Sender, Benjamin, Thibault Lacroix, Philippe Jaby, and Anne-Gaelle Chaux-Bodard. "Are zygomatic implants a simple and reliable technique for the stabilization of obturator prostheses? Case report and review of the literature." Journal of Oral Medicine and Oral Surgery 26, no. 2 (2020): 12. http://dx.doi.org/10.1051/mbcb/2020002.
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Zygomatic implants have been used for several years for the treatment of extremely resorbed maxilla. Indications were extended for oral rehabilitations after maxillectomy in oncologic patients. A 24-year old patient with a triple A syndrome who underwent a left maxillectomy due to a spinocellular tumour was addressed for prosthetic rehabilitation. As his obturator prosthesis failed, surgical closure of the defect combined with 2 zygomatic implants to support the prosthesis was proposed. Despite a small persistent oro-antral fistula, the new obturator prosthesis restored the patient's functions and esthetics and improved his quality of life. The literature reports less than 40 cases of maxillectomy patients rehabilitated with zygomatic implants (with or without flap closure of the defect). Regardless of implant placement, there is no significant difference between reconstructive surgery and obturator prosthesis. Thus, zygomatic implants seem to be a reliable method for the stabilization of obturator prosthesis, without complex surgical procedure. Nonetheless, reservations should be expressed given the lack of data in terms of long-term follow up.
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Pecoraro, S., A. Fienga, and B. Giammusso. "VID-05.02: Three piece penile prosthesis implant (Titan® with Resist®) in complex cases." Urology 70, no. 3 (September 2007): 182. http://dx.doi.org/10.1016/j.urology.2007.06.584.
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Guttal, Satyabodh S., Anand K. Tavargeri, Ramesh K. Nadiger, and Srinath L. Thakur. "Use of an Implant O-Ring Attachment for the Tooth Supported Mandibular Overdenture: A Clinical Report." European Journal of Dentistry 05, no. 03 (July 2011): 331–36. http://dx.doi.org/10.1055/s-0039-1698900.
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ABSTRACTRetention of a mandibular denture can be achieved by an implant-retained or natural toothretained bar and stud attachment in the anterior segment of the mandible. The same design principles holds true for both implant-retained and tooth-retained methods of anchoring the bar and stud attachment. A simple and cost effective treatment for more complex implant overdenture is the concept of conventional tooth-retained overdentures. When few firm teeth still remain in a compromised dentition, preservation of these teeth for overdentures can improve retention and stability. The authors present a clinical report of a patient treated with a mandibular tooth-borne overdenture with bar and O-ring attachment. A splinted bar supported the prosthesis and an O-ring retained the denture. (Eur J Dent 2011;5:331-336)
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Bousquet, Philippe, Delphine Carayon, and Jean-Cedric Durand. "Using the “One Shot” Concept for Immediate Loading Implant Protocol in Edentulous Patient Rehabilitation with a Fixed Prosthesis: A 6-Year Follow-Up." Case Reports in Dentistry 2021 (February 24, 2021): 1–7. http://dx.doi.org/10.1155/2021/8872277.
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Immediate-loaded implants with a fixed prosthesis are a viable option for the restoration of edentulous ridges. Several procedures now allow for the fabrication of immediate-loading provisional and definitive prostheses. However, this complex treatment is not accessible to all patients with budget restrictions. By using a unique master model with a single titanium framework prosthesis can simplify and shorten the treatment, as well as reduce costs. After surgical placement of implant fixtures, an interim prosthesis was fabricated using a laser-welded definitive titanium framework. The prosthesis was fitted intraorally following the immediate loading protocols. The master cast model used to fabricate interim prosthesis was conserved and subsequently used in modifying the final prosthesis. After the healing process and complete soft tissue stability, an impression was made to register the clearance between the gingiva and resin. The light silicone material was directly injected under the prosthesis screwed in the mouth. In the master cast model, the stone was eliminated between the implants and a new plaster was poured to modify the crest profile with the posthealing new shape. With this modified model, it is possible to rehabilitate the denture to the new gingival anatomy in 3 to 4 hours and, if necessary, the tooth rearrangement. This “one shot” concept combines the single definitive titanium welded framework and limited laboratory work with a unique master model thereby decreasing the cost and the time of treatment.
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Coachman, Francis, Gustavo Petrili, Guilherme José Pimentel Lopes de Oliveira, Bruna Ghiraldini, and Fábio José Barbosa Bezerra. "The DSD clicGuide system: a new concept for full-arch implant placement and immediate loading rehabilitation using the digital workflow: a clinical report of three cases." Revista Odontológica do Brasil Central 30, no. 89 (February 6, 2021): 20–32. http://dx.doi.org/10.36065/robrac.v30i89.1432.
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One of the limitations of using guided surgery for full arch rehabilitation is related to the cases where it is necessary to perform osteotomy prior to the placement of the implant. The Digital Smile Design ClicGuide (DSD ClicGuide) is a digital rehabilitation planning system recommended in the rehabilitation of fully edentulous jaws, which orients implant placement procedures and immediate provisional loading based on an ideal three-dimensional design. This system consists of a sequence of surgical guides used during the clinical procedures that may include teeth extractions, osteotomies, implant placements, and immediate prothesis installation, increasing the level of predictability of rehabilitation procedures in these complex clinical cases. The aim of this case series report is to describe the oral rehabilitation of three patients treated according to the DSD ClicGuide technique, who received a total of twenty dental implants. All the patients treated required total oral rehabilitation in at least one of the arches and required osteotomies in order to regularize the alveolar ridge before the placement of the implant. Once the rehabilitation parameters were defined and the treatment plan was approved, the following guides were printed and used in sequence: a base guide that was used as a reference for the osteotomy procedure; a guide for installing the implants; and a guide with the printed temporary prosthesis for immediate loading. It can be conclude that the DSD ClicGuide system enabled the osteotomy, implants placement, and installation of an immediate loading prosthesis in totally edentulous patients, with a high level of predictability.
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Lanza, Alessandro, Fabrizio Di Francesco, Gennaro De Marco, Fabio Scognamiglio, Valeria Aruta, and Angelo Itro. "Multidisciplinary Approach in the Management of a Complex Case: Implant-Prosthetic Rehabilitation of a Periodontal Smoking Patient with Partial Edentulism, Malocclusion, and Aesthetic Diseases." Case Reports in Dentistry 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/6348570.
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Complex periprosthetic cases are considered as challenges by clinicians. Clinical and radiographic parameters should be considered separately to make the right choice between an endodontically or periodontally compromised treated tooth and implant. Therefore, in order to decide whether the tooth is safe or not, data that have to be collected are specific parameters of both the patient and the clinician. In addition, the presence of periodontal, prosthetic, and orthodontic diseases requires patients to be set in multidisciplinary approach. The aim of this case report is to describe how the multidisciplinary approach could be the best way to manage difficult cases of implant-prosthetic rehabilitation. How to rehabilitate with fixed prosthesis on natural teeth and dental implants a smoker patient who presents with active periodontitis, multiple edentulous areas, dental malocclusion, and severe aesthetic problems was also described.
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Chen, Alvin Chao-Yu, You-Hung Cheng, Chih-Hao Chiu, Chun-Ying Cheng, and Yi-Sheng Chan. "Long-Term Outcomes of Radial Head Arthroplasty in Complex Elbow Fracture Dislocation." Journal of Clinical Medicine 10, no. 16 (August 7, 2021): 3488. http://dx.doi.org/10.3390/jcm10163488.
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The purpose of the current study was to investigate the long-term outcomes of radial head arthroplasty in complex elbow injuries through radiographic analysis and functional correlation. We evaluated 24 radial head arthroplasties in 24 consecutive patients with complex elbow fracture dislocation. All patients were treated with a single type of modular monopolar prosthesis containing smooth stem in press-fit implantation. Clinical survey using the Mayo Elbow Performance Score (MEPS), self-reported scales of shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the visual analog scale (VAS) at more than 10-year follow-up were reported and compared to 2-year outcomes. Periprosthetic osteolysis was measured in the 10 zones of prosthesis-cortical interface with a modified radiolucency score, which was calibrated by each prosthesis size. Pearson correlation analysis was performed to detect the association between periprosthetic radiolucency and clinical assessment. At the final follow-up, MEPS, QuickDASH score and VAS score averaged 82.5 ± 15, 14.1 ± 14.3 and 1.6 ± 1.2 respectively. A decline in functional status was noted, with decreased mean MEPS and increased mean QuickDASH and VAS scores as compared to the 2-year results while the difference was insignificant. Periprosthetic osteolysis was more prevalent around stem tip of zone 3 and zone 8. The final and 2-year radiolucency scores averaged 7.4 ± 4.2 and 2.6 ± 2.3 respectively with significant difference. Pearson correlation analysis indicated that the difference between radiolucency scores and clinical outcomes in MEPS/QuickDASH/VAS was −0.836, 0.517 and 0.464. Progression of periprosthetic osteolysis after postoperative 10 years is more prevalent around the stem tip with moderate to high correlation to clinical outcomes. Sustained follow-up is warranted to justify subsequent surgery for revision or implant removal.
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Volp Junior, Luiz Carlos, Iago Ridão Scandinari, Helder Fernando Borges Junior, Fernanda Ferruzzi Lima, and Sérgio Sábio. "Dynamic UCLA for aesthetic rehabilitation on implant in a patient with special needs: A 4-year follow-up case report." Research, Society and Development 9, no. 9 (August 30, 2020): e557997715. http://dx.doi.org/10.33448/rsd-v9i9.7715.
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This study aims to present the dynamic UCLA as a prosthetic option to restore a tilted implant, replacing a missing maxillary left lateral incisor with a functional and aesthetic screw-retained crown. Dental implants show high success rates; however, complications related to three-dimensional positioning of the implant are common. The correction of the implant position usually requires machined angled abutments or complex surgical procedures, which results in long and difficult treatment, and increases the treatment final cost. A 45-years-old male patient sought for specialized dental care to restore the front missing tooth esthetic area. The patient has limited mouth opening, mental and physical disabilities, so the construction of a metal-ceramic prosthesis with the aid of dynamic UCLA was proposed as a straightforward and low-cost procedure under the sign of free and informed consent. The prosthetic treatment provided aesthetic results and patient satisfaction without complications after a four-year follow-up.
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Muraru, L., S. V. N. Jaecques, C. Van Lierde, E. De Smet, I. Naert, and J. Vander Sloten. "Personalised FE modelling of the mandible and the prosthesis-implant complex to estimate a bone strain warning threshold for an oral rehabilitation “smart” prosthesis." Journal of Biomechanics 39 (January 2006): S200. http://dx.doi.org/10.1016/s0021-9290(06)83726-7.
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Wegmann, Kilian, Nadine Ott, Tim F. Leschinger, Andreas Harbrecht, Lars P. Müller, and Michael Hackl. "Prosthetic replacement of the radial head." Obere Extremität 15, no. 4 (September 9, 2020): 310–15. http://dx.doi.org/10.1007/s11678-020-00595-9.
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Abstract Background Radial head replacement is an established option in patients with comminuted radial head fractures and complex elbow trauma. While studies demonstrated that asymptomatic radiolucencies around the stem are common, the incidence and clinical significance of bone loss at the proximal part of the radius, just distal to the neck of the prosthesis (collar resorption), is unknown. Objectives The aim of this retrospective study was to analyse the incidence of collar resorption after radial head replacement and investigate whether this correlates with specific patient characteristics such as gender, age, indication for index surgery and the size of implant used. Materials and methods The study group consisted of 30 patients (average age 60.1 years) having undergone prosthetic replacement with a monopolar press-fit implant of the radial head at an average follow-up of 23 months. Indications for surgery included trauma sequelae or revision in 16 patients and acute, unreconstructable fractures of the radial head in 14 cases. Symptoms of loosening and revision surgery were recorded. Radiographs were analysed for signs of lucency between the bone and the implant as well as for signs of resorption of bone mass around the neck (section 1). These values were correlated with age, gender, indication for index surgery and size of implant. Results In all, 28/30 (93.3%) prostheses showed proximal osteolysis around the neck of the shaft. Of the 30, one prosthesis presented signs of shaft loosening. The average amount of osteolysis was 8.78% (range 0–26.1%; ±6.0%) of the overall length of the prosthetic shaft (OL). There was no significant difference (p = 0.49) between the amount of resorption in section 1 between the primary fracture cases (8.75 ± 4.5%; range 1.2–15.8%) and the group of secondary implantations due to degeneration or fracture sequelae (8.8 ± 7.2%; range 0–26.1%). Furthermore, the analysis did not reveal any statistically relevant correlations between the amount of neck resorption and the other cohort characteristics (age, gender, size of the components). Conclusions In the study cohort, a high amount of osteolysis/bone resorption was assessed around the neck of the press-fit radial head prosthesis used. However, no significant correlation between collar resorption, patient demographics and indication for index surgery was found at short-term follow-up.
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Picos, Alina Monica, Andrei Picos, Petra Nicoara, and Monica M. Craitoiu. "Dental erosion in a partially edentulous patient with gastroesophageal reflux disease: a case report." Medicine and Pharmacy Reports 87, no. 4 (December 19, 2014): 284–87. http://dx.doi.org/10.15386/cjmed-388.
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Diseases such as gastroesophageal reflux disease (GERD), bulimia, anorexia, and extrinsic alimentary factors may cause dental erosion (DE). The minimally invasive therapeutic attitude preserves the remaining healthy tooth structure. In the earlier stages, the direct restoration of dental lesions is possible, using composite materials. In advanced stages of DE, prosthetic treatments are recommended for stable esthetic and functional results. We present a case of DE in a partially edentulous patient who benefited from a complex therapy. The prosthetic project of the case involves ceramic veneers associated with dental and implant supported fixed prosthesis for the restoration of esthetics, mastication, phonetics and their maintenance
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Kim, Seong-Min, Keunbada Son, Duk-Yeon Kim, and Kyu-Bok Lee. "Digital Evaluation of the Accuracy of Computer-Guided Dental Implant Placement: An In Vitro Study." Applied Sciences 9, no. 16 (August 16, 2019): 3373. http://dx.doi.org/10.3390/app9163373.
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Compared to traditional implant surgical guides, computer-assisted implant surgical guides can be considered for positioning implants in the final prosthesis. These computer-assisted implant surgical guides can be easily fabricated with personal 3D printers after being designed with implant planning CAD software. Although the accuracy of computer-assisted implant surgical guides fabricated using personal 3D printers is an important factor in their clinical use, there is still a lack of research examining their accuracy. Therefore, this study evaluated the accuracy of computer-assisted implant surgical guides, which were designed using two implant planning CAD software programs (Deltanine and R2gate software) and fabricated with personal 3D printers using a non-radiographic method. Amongst the patients who visited Kyungpook National University Dental Hospital, one patient scheduled to undergo surgery of the left mandibular second premolar was randomly selected. Twenty partially edentulous resin study models were produced using a 3D printer. Using the Deltanine and R2gate implant planning CAD software, 10 implant surgical guides per software were designed and produced using a personal 3D printer. The implants (SIII SA (Ø 4.0, L = 10 mm), Osstem, Busan, Korea) were placed by one skilled investigator using the computer-assisted implant surgical guides. To confirm the position of the actual implant fixture, the study models with the implant fixtures were scanned with a connected scan body to extract the STL files, and then overlapped with the scanned file by connecting the scan body-implant fixture complex. As a result, the mean apical deviation of the Deltanine and R2gate software was 0.603 ± 0.19 mm and 0.609 ± 0.18 mm, while the mean angular deviation was 1.97 ± 0.84° and 1.92 ± 0.52°, respectively. There was no significant difference between the two software programs (p > 0.05). Thus, the accuracy of the personal 3D printing implant surgical guides is in the average range allowed by the dental clinician.
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Hossain, Fahad, Sujith Konan, Babar Kayani, Christina Kontoghiorghe, Toby Barrack, and Fares Sami Haddad. "Early Clinical and Radiological Outcomes of the Metaphyseally Fixed Totally Stabilized Knee Prosthesis in Primary Total Knee Arthroplasty." Journal of Knee Surgery 33, no. 07 (April 8, 2019): 678–84. http://dx.doi.org/10.1055/s-0039-1683976.
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AbstractThe use of valgus–varus constrained (VVC) implant designs in primary total knee arthroplasty (TKA) is considered in situations of severe deformities, bone loss, and inadequate soft tissue balance. It is not known whether the use of such prosthesis designs may predispose to reduced function owing to its constraining design. The components are usually implanted with diaphyseal stem extensions to dissipate the increased forces. The totally stabilized (TS) implant is a contemporary VVC design with metaphyseal fixation only. It has a conforming articulation with increased rotational freedom compared with conventional VVC designs. The aim of this study was to assess whether the use of the contemporary TS implant with its metaphyseally fixed components would be associated with inferior outcomes compared with conventional standard primary posterior stabilized (PS) implants. We reviewed 38 consecutive complex primary TKAs performed using the metaphyseally fixed TS implant and 76 matched patients receiving primary PS TKA, at a minimum follow-up of 24 months. The mean follow-up was 61.1 months (24–102). Only patients with osteoarthritis were included. Clinical outcome was assessed using range of motion (ROM) and Oxford knee score (OKS). Radiographic assessment was performed using the femorotibial angle (FTA) at 6 weeks followed by assessment of bone–implant interface lucencies at final follow-up. There were no major early postoperative complications. The mean postoperative ROM in the TS and PS groups were 114.1 and 112.0, respectively. There was no difference in the mean ROM and OKS between the two groups. The mean FTA for patients in both groups was within 3° of the expected. There was no evidence of progressive lucencies or implant migration at final follow-up. The metaphyseally fixed TS knee design achieves comparable short-term functional outcomes when compared with conventional PS designs in primary knee arthroplasty. Long-term follow-up studies are required to assess survivorship.
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Rajendran, Sridharan, and FNU Baburajan. "Combination Syndrome." International Journal of Prosthodontics and Restorative Dentistry 2, no. 4 (2012): 156–60. http://dx.doi.org/10.5005/jp-journals-10019-1066.
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ABSTRACT Combination syndrome (CS) is a dental condition that is commonly seen in patients with a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth. This syndrome consists of severe anterior maxillary resorption combined with hypertrophic and atrophic changes in different quadrants of maxilla and mandible. This makes it a challenging condition in dentistry that requires significant experience along with advanced restorative and surgical skills. The causes of maxillary bone resorption and ways to correct it are discussed in this article. Conventional treatment with full upper and partial lower dentures for the CS patients is not always adequate or satisfying for patients and it often requires multiple remakes due to continuing bone resorption. Dental implant rehabilitation challenges conventional treatment with bone-anchoring techniques to provide improved retention and stability for implant-retained and supported prostheses. This article presents a successful implant treatment of the partially edentulous maxilla in CS patient. The necessity of a multidisciplinary approach for early prevention and treatment of this complex condition is emphasized. This article illustrates a review of the changes and difficulties faced when treated with conventional approach which can be overcome with the aid of implant-supported prosthesis. How to cite this article Rajendran S, Baburajan. Combination Syndrome. Int J Prosthodont Restor Dent 2012;2(4):156-160.
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Scaringi, Riccardo, Michele Nannelli, Alessio Franchina, Giuseppe Lizio, Luigi V. Stefanelli, Michele Pagliarulo, Francesca De Angelis, and Gerardo Pellegrino. "Full Zirconia Implant-Born Prosthetic Rehabilitation with CAD/CAM Technology after Accurate Digital Planning. A Case Report." International Journal of Environmental Research and Public Health 18, no. 15 (July 28, 2021): 7998. http://dx.doi.org/10.3390/ijerph18157998.
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CAD/CAM technology can enhance the dentistry application of ceramic materials that meet the more relevant biocompatibility and aesthetics demands. In implant-borne prosthesis rehabilitation, yttria-stabilized zirconia appeared to be a valid alternative to metal-alloys and titanium, with comparable mechanical properties and even better interaction with bone and soft tissues. The improvement of monolithic CAD/CAM manufacturing allows for a reliable, predictable, and rapid workflow that can correspond to a holistic treatment philosophy associated with zirconia fixtures. This reported clinical case highlights the advantages of this approach in resolving particularly functionally and aesthetically complex situations. A 40-year-old patient with permanent canine impaction and the persistence of a deciduous tooth compromised by caries was successfully rehabilitated with the surgical removal of the enclosed tooth, the seating of a mono-phase zirconia implant after the deciduous extraction and its loading with a zirconia single crown, without any clinical or radiographical alteration up to seven years follow-up.
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Talpos, Serban, Tareq Hajaj, Costin Timofte, Mircea Rivis, Felicia Streian, Malina Popa, cosmin Sinescu, et al. "Implant Surgery Using Bio-compatible Guides." Materiale Plastice 55, no. 1 (March 30, 2018): 38–41. http://dx.doi.org/10.37358/mp.18.1.4959.
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Implants and biomaterials used in hard and soft oral tissue augmentation are very complex, but predictable to use nowadays, as the technological advances haven�t skipped this field of medicine. Cases that were impossible to treat with implant retained fixed prosthesis some years ago, have become the daily practice of oral surgeons and dentists around the world. The new user-friendly products, together with simplified protocols, increased the practitioners� predictability and success rate, thus the biomaterial industry took a huge leap forward. As the biomaterial industry keeps developing continuously, making better and safer products, the surgical and prosthetic protocols evolve and change as well. On this matter, the implant placement has become safer, using digital surgical guides. Guided implant placement doesn�t just allow the practitioner place the implant in the patient�s bone, but, moreover, it helps him place it in the correct, 3D, prosthetic position. And, thus, guiding the future bone augmentation and regeneration as well, accordingly. So, the implant placement has shifted from bone-orientated to prosthetic-orientated, offering at the same time a better primary stability for the implants, due to the prior planning. The present clinical study aims to analyze the outcome of the digital guided protocol. Unlike the free-handed surgery, the digital guided surgery allows dentists and oral surgeons to place implants according to the future prosthetic position of the crowns, even in conditions of alveolar ridges with bone resorption. Moreover, it makes possible the �one day implant� concept, the dental technician being able to create the provisional crown/s in advance, knowing precisely the future position of the implant placement. So, at the time of the surgery, the provisional crown is also put in place, guiding the soft and hard tissue healing and also giving the patient a greater satisfaction.
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Tilton, Maryam, Gregory S. Lewis, Michael W. Hast, Edward Fox, and Guha Manogharan. "Additively manufactured patient-specific prosthesis for tumor reconstruction: Design, process, and properties." PLOS ONE 16, no. 7 (July 14, 2021): e0253786. http://dx.doi.org/10.1371/journal.pone.0253786.
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Design and processing capabilities of additive manufacturing (AM) to fabricate complex geometries continues to drive the adoption of AM for biomedical applications. In this study, a validated design methodology is presented to evaluate AM as an effective fabrication technique for reconstruction of large bone defects after tumor resection in pediatric oncology patients. Implanting off-the-shelf components in pediatric patients is especially challenging because most standard components are sized and shaped for more common adult cases. While currently reported efforts on AM implants are focused on maxillofacial, hip and knee reconstructions, there have been no reported studies on reconstruction of proximal humerus tumors. A case study of a 9-year-old diagnosed with proximal humerus osteosarcoma was used to develop a patient-specific AM prosthesis for the humerus following tumor resection. Commonly used body-centered cubic (BCC) structures were incorporated at the surgical neck and distal interface in order to increase the effective surface area, promote osseointegration, and reduce the implant weight. A patient-specific prosthesis was fabricated using electron beam melting method from biocompatible Ti-6Al-4V. Both computational and biomechanical tests were performed on the prosthesis to evaluate its biomechanical behavior under varying loading conditions. Morphological analysis of the construct using micro-computed tomography was used to compare the as-designed and as-built prosthesis. It was found that the patient-specific prosthesis could withstand physiologically-relevant loading conditions with minimal permanent deformation (82 μm after 105 cycles) at the medial aspect of the porous surgical neck. These outcomes support potential translation of the patient-specific AM prostheses to reconstruct large bone defects following tumor resection.
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Menini, Maria, Francesca Delucchi, Francesco Bagnasco, Francesco Pera, Nicolò Di Tullio, and Paolo Pesce. "Analysis of the Subgingival Microbiota in Implant-Supported Full-Arch Rehabilitations." Dentistry Journal 8, no. 3 (September 5, 2020): 104. http://dx.doi.org/10.3390/dj8030104.
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Background: The etiology of peri-implantitis is multifactorial, and it is not directly linked to the quantitative amount of plaque. The aim of this study was to evaluate the influence of subgingival microbiota around implants supporting full-arch restorations on clinical indexes of peri-implant health. Method: 47 patients (54 full-arch fixed rehabilitations) were included. Based on the highest value of probing depth (PD), 47 implants (in the test arch), 40 natural teeth and 7 implants (in the antagonist arch) were selected for microbiological sampling (traditional PCR and real-time PCR). Periodontal indexes (plaque index, PlI; probing depth, PD; bleeding on probing, BOP; peri-implant suppuration, PS) and marginal bone loss were also recorded. Results: Despite abundant plaque accumulation, the peri-implant parameters were within normal limits. No statistical difference was found in the microbial population around the test implants and antagonist natural teeth. Treponema denticola was present in a significantly higher amount around implants with increased PlI. Implants with increased BOP showed a significant increase in Treponema denticola and Tannerella forsythia. A significantly higher presence of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia was identified around the implants affected by peri-implantitis and in smokers. Conclusions: Peri-implantitis is characterized by a complex and polymicrobial disease, that might be influenced by the qualitative profile of plaque. Smoking might also favor implant biological complications in full-arch fixed prosthesis.
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Figliuzzi, M. M., A. Giudice, and L. Fortunato. "Advanced Implant-Prosthetic Rehabilitation: How to Obtain a Correct Restoration of Both Functions and Aesthetics in Patients with Complex Combined Dental and Maxillofacial Trauma: A Case Report and Topical Review of the Literature." Case Reports in Dentistry 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/7146126.
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Aim. This study aims to explain the main steps that characterize the implant-prosthetic rehabilitation in complex combined dental and maxillofacial trauma.Material and Methods. A 20-year-old patient reported an extensive facial trauma which also involved the alveolar process of the maxillary bone. The patient reported a maxillofacial fracture and the loss of teeth 1.3, 1.2, 1.1, and 2.1. A “Le Fort” type 2 fracture was also reported, with the malar bone involvement. After reduction and containment of bone fractures, through appropriate mounting plates, appropriate functional and aesthetic rehabilitation of the patient were replaced thanks to a temporary removable prosthesis. After 6 months, the patient performed numerous clinical investigations, aimed at a proper planning of implant-prosthetic rehabilitation of the upper dental arch.Conclusion. With the planning of the case, as well as respecting the surrounding biological structures, the surgery of implants can be carried out with the most appropriate procedure. Lastly, new dental implants with highly bioactive surfaces have been developed, providing an excellent and rapid bone integration.
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Chatain, Grégoire P., and Michael Finn. "Compassionate use of a custom 3D-printed sacral implant for revision of failing sacrectomy: case report." Journal of Neurosurgery: Spine 33, no. 4 (October 2020): 513–18. http://dx.doi.org/10.3171/2020.3.spine191497.
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Reconstruction of the spinopelvic continuity after sacral resection for primary sacral tumors remains challenging. Complex anatomical and biomechanical factors of this transition zone may be addressed with the advancement of 3D-printed implants. Here, the authors report on a 67-year-old patient with a sacral chordoma who initially underwent total en bloc sacrectomy followed by standard spinopelvic reconstruction. Pseudarthrosis and instrumentation failure of the lumbosacral junction construct subsequently developed. A custom 3D-printed sacral prosthesis was created using high-resolution CT images. Emergency Food and Drug Administration approval was obtained, and the custom device was implanted as a salvage reconstruction surgery. Made of porous titanium mesh, the custom artificial sacrum was placed in the defect based on the anticipated osteotomic planes and was fixed with a screw-rod system along with a fibular bone strut graft. At the 18-month follow-up, the patient was disease free and walking short distances with assistance. CT revealed excellent bony incorporation into the graft.The use of a custom 3D-printed prosthesis in spinal reconstruction has been rarely reported, and its application in sacral reconstruction and long-term outcome are novel. While the implant was believed to be critical in endowing the region with enough biomechanical stability to promote healing, the procedure was difficult and several key learning points were discovered along the way.
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Parra, Marcelo, Sergio Olate, Roberto Vogel, and Nicolas Restovic. "Assisted Maxillary Expansion for Oral Rehabilitation with Dental Implants." International Journal of Medical and Surgical Sciences 3, no. 2 (October 26, 2018): 875–79. http://dx.doi.org/10.32457/ijmss.2016.020.
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The aim of this paper is to show a case of a patient with a transversal deficience of maxillae treated to make rehabilitation in the anterior area. The diagnosis of dentofacial deformities was realized using routine studies incorporating image and clinical analysis to observe the bilateral posterior crossbite and abnormal position in tooth 11 and 21; the 11 showed alterations in bone and teeth with no possibilities to make the prosthetic treatment making the dental extraction. Later, was realized the installation of the implant and the rehabilitation with fixed prosthesis. Is discussed the treatment and the options used in the approach. Was concluded that the integration of diagnosis dental, skeletal and facial could make an adequate therapy in complex cases.
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Russo, Raffaele, Giuseppe Rotonda, Michele Ciccarelli, and Fabio Cautiero. "Analysis of complications of reverse total shoulder arthroplasty." Joints 03, no. 02 (April 2015): 62–66. http://dx.doi.org/10.11138/jts/2015.3.2.062.
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Purpose: the aim of this study was to analyze complications of reverse total shoulder arthroplasty (RTSA) used to treat different shoulder diseases. Methods: from March 2000 to March 2013, 195 RTSA were implanted by the senior Author. The indications for reverse prosthesis surgery were secondary osteoarthritis (OA) in 49 cases, irreparable rotator cuff tear (RCT) in 48 cases, and complex humeral fractures in 75 cases, while 19 were patients requiring surgical revision for first prosthesis implant. We used different prostheses with different designs. Results: the clinical and radiological results of all the patients were analyzed retrospectively at an average follow-up of 7 years. The cases were divided into four groups on the basis of the diagnosis and complications were classified as perioperative, postoperative, or late. The mean total Constant score improved from 28 to 69 points in the OA group; from 21 to 70.8 points in the irreparable RCT group, to 76.4 in the fracture group, and from 16.6 to 59.8 points in the revision group. Scapular notching was observed in 59 cases (30.2%). Thirty-three other complications (16.9%) were observed, namely: hematomas (n=3), instability of the humeral component (n=1), scapular spine fractures (n=2), ulnar nerve deficit (n=2), long thoracic nerve palsy (n=2), deep infections (n=2), periprosthetic fractures (n=6), glenoid fractures (n=2), implant loosening (n=2), anterior deltoid muscle deficiency (n=2) and periarticular heterotopic calcifications (n=9). Conclusions: the rates of complications, especially fractures, reported in the present study were lower than those reported in the current literature. Level of evidence: Level IV, therapeutic case series.
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Radovanovic, Zoran, Milan Ranisavljevic, Dragana Radovanovic, Ferenc Vicko, Tatjana Ivkovic-Kapicl, and Nenad Solajic. "Nipple-Sparing Mastectomy with Primary Implant Reconstruction: Surgical and Oncological Outcome of 435 Breast Cancer Patients." Breast Care 13, no. 5 (2018): 373–78. http://dx.doi.org/10.1159/000489317.
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Background: This study aimed to examine the incidence of surgical complications associated with nipple-sparing mastectomy (NSM) with primary implant reconstruction, analyze risk factors for early and late surgical complications of NSM, and determine the incidence of local recurrences and the safety of sparing the nipple-areola complex (NAC). Methods: This retrospective cohort study included 435 patients with 441 NSM procedures over a period of 9 years (2004-2012). All surgical complications and the oncological outcome were recorded during follow-up. Results: The most common early surgical complication was skin flap ischemia/necrosis (26 patients, 5.9%). Prosthesis explantation due to complications was carried out in 11 (2.5%) cases. Neoadjuvant chemotherapy, implant size >500 ml, diabetes mellitus, body mass index > 25 kg/m2, and incisions other than lateral were risk factors for early complications (p < 0.001). The NAC excision rate was 5.4% (24 cases) due to confirmed presence of cancer cells in the subareolar tissue. Capsular contracture as a late complication occurred in 33 (7.48%) cases. Local relapse occurred in 32 (7.3%) patients. Distant metastases were diagnosed in 68 (15.6%) patients, and 53 (12.2%) patients died during the follow-up period. Conclusions: NSM with immediate implant reconstruction has an acceptable morbidity rate and is an oncologically and surgically appropriate treatment for most women requiring mastectomy.
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BARBIERI, Renato Lamounier, Suely de Fátima PARREIRA, Sarah do Valle STUDART, Aline Riquena DA-SILVA, Ivone da Silva DUARTE, and Pedro Luiz Squilacci LEME. "STEM CELLS HEMATOPOIETIC NICHES AND INFLAMMATORY RESPONSE TO DIFFERENT SYNTHETIC PROSTHESIS IMPLANTED IN RAT WITH INCISIONAL HERNIAS." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 30, no. 2 (June 2017): 108–13. http://dx.doi.org/10.1590/0102-6720201700020007.
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ABSTRACT Background: Extramedullary hematopoiesis depends on complex pathophysiological mechanisms linked to hematopoietic stem cells and the proteins considered mediators of the inflammation. The identification of hematopoietic cells outside bone marrow in the adult is an occurrence that can occasionally follows the inflammatory response, was considered a secondary occurrence, but current biomolecular studies have changed that concept. Aim: Describe the presence of clusters of precursor cells of platelets (megakaryocytes), and cells of the inflammatory response in the abdominal wall and spleen of rats with experimentally induced incisional hernias and repaired with different synthetic prostheses. Methods: Twenty-five rats with incisional hernias previously performed, were divided into groups of five animals each: Group 1, repair of the hernia defect without prosthetic implant; Group 2, repair with polypropylene prosthesis; Group 3, repair using polypropylene with low weight; Group 4, the use of polypropylene and polyglecaprone prosthesis; Group 5, of polypropylene and polyglactin prosthesis. All prostheses were cut in rhombus format with area 2,625 cm². The animals were reoperated after 10 days, the abdominal walls were removed with the viscera attached to them and the material was processed for histological study. Results: Megakaryocyte niches in the abdominal wall and spleen, occasionally removed together with the adhesions produced in animals with implantation of prostheses and significant inflammatory reaction. Conclusion: The intense inflammatory reaction due to the prostheses with polypropylene in their composition was disproportionate to the expected response, indicating that further studies should be accomplished including immunophenotyping evaluation and specific panels of monoclonal antibodies to better understand the findings.
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Efe, Turgay, Philip P. Roessler, Thomas J. Heyse, Carsten Hauk, Caroline Pahrmann, Alan Getgood, and Jan Schmitt. "Mid-term results after implantation of rotating-hinge knee prostheses: primary versus revision." Orthopedic Reviews 4, no. 4 (December 11, 2012): 35. http://dx.doi.org/10.4081/or.2012.e35.
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The aim of the study was to evaluate the mid-term clinical results and survivorship of a rotating-hinge knee prosthesis (LINK® Endo-Model) in difficult primary and complex revision situations. Results after primary implantation were compared with those of revision procedures. Forty-nine prostheses in 45 patients were reviewed clinically during follow up. Twenty-one of these were implanted in primary and 28 in revision situations. Outcome was evaluated using commonly used scores (Knee Society, UCLA Activity, Lequesne) and a visual analog scale after a mean follow up of 56±37 months for 49 prostheses. Implant survival was analyzed using the Kaplan-Meier method. There were no significant differences in clinical examination and evaluation scores between the two groups (P>0.05). Survival rates at final follow up were 95% after primary implantation and 76% in revision procedures. The risk of prosthesis loss (odds ratio 5.7) was significantly higher after revision procedures (P=0.004). These data suggest that rotating-hinge knee prostheses provided good clinical and functional results in selected cases of advanced primary gonarthrosis associated with severe bone loss, ligamentous instability or comminuted fractures. They also provide good results in revision situations. However, the failure rate was significantly higher in cases of revision surgery.
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De Paolis, Massimiliano, Alessio Biazzo, Carlo Romagnoli, Nikolin Alì, Sandro Giannini, and Davide Maria Donati. "The Use of Iliac Stem Prosthesis for Acetabular Defects following Resections for Periacetabular Tumors." Scientific World Journal 2013 (2013): 1–8. http://dx.doi.org/10.1155/2013/717031.
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Introduction. The management of pelvic tumors is a challenge for orthopaedic oncologists due to the complex anatomy of the pelvis and the need to have extensive exposure. Various reconstructive techniques have been proposed with poor functional results and a high percentage of complications. Our purpose is to determine the functional results and the rate of complications of iliac stem prosthesis for acetabular defects following resections for periacetabular tumors.Materials and Methods. Between 1999 and 2012, 45 patients underwent pelvic resections for periacetabular bone tumors followed by reconstruction with stem cup prosthesis. The most common diagnosis was CS (chondrosarcoma, 29 cases), followed by OS (osteosarcoma, 9 cases) and metastasis (3 cases). In 33 cases, this implant was associated with massive bone allografts. Minimum follow-up required to evaluate functional outcome was 2 years. We classified pelvic resections according to Enneking and Dunham’s classification and we used MSTS (musculoskeletal tumor system) score to evaluate functional outcomes.Results and Discussion. Sixteen patients died of their disease, three were lost to follow-up, four are alive with disease, and twenty-two are alive with no evidence of disease. Fifteen patients had local recurrence. Sixteen patients had bone or lung metastasis. We have had 6 infections, 2 aseptic loosening, and 2 cases of hip dislocation. Iliac sovracetabular osteotomy was fused in all cases at 10 months from surgery. Functional results were good or excellent in 25 of 31 patients with long-term follow-up (77%), with a percentage similar to that reported in the literature.Conclusion. The use of iliac stem prosthesis is a simple reconstructive technique that reduces operative times and risk of infection. It allows having good results and low rate of complications, but it should be performed in selected cases and centres of reference.
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Kim, Du-Han, Beom-Soo Kim, Chung-Sin Baek, and Chul-Hyun Cho. "Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up." Clinics in Shoulder and Elbow 23, no. 1 (March 1, 2020): 20–26. http://dx.doi.org/10.5397/cise.2020.00045.
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Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63–85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12–65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7o of flexion, 13.8o of extension, 73.3o of pronation, and 74.4o of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed.Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.
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Pesqueira, Aldiéris Alves, Marcelo Coelho Goiato, Humberto Gennari Filho, Douglas Roberto Monteiro, Daniela Micheline dos Santos, Marcela Filié Haddad, and Eduardo Piza Pellizzer. "Use of Stress Analysis Methods to Evaluate the Biomechanics of Oral Rehabilitation With Implants." Journal of Oral Implantology 40, no. 2 (April 1, 2014): 217–28. http://dx.doi.org/10.1563/aaid-joi-d-11-00066.
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Because the biomechanical behavior of dental implants is different from that of natural tooth, clinical problems may occur. The mechanism of stress distribution and load transfer to the implant/bone interface is a critical issue affecting the success rate of implants. Therefore, the aim of this study was to conduct a brief literature review of the available stress analysis methods to study implant-supported prosthesis loading and to discuss their contributions in the biomechanical evaluation of oral rehabilitation with implants. Several studies have used experimental, analytical, and computational models by means of finite element models (FEM), photoelasticity, strain gauges and associations of these methods to evaluate the biomechanical behavior of dental implants. The FEM has been used to evaluate new components, configurations, materials, and shapes of implants. The greatest advantage of the photoelastic method is the ability to visualize the stresses in complex structures, such as oral structures, and to observe the stress patterns in the whole model, allowing the researcher to localize and quantify the stress magnitude. Strain gauges can be used to assess in vivo and in vitro stress in prostheses, implants, and teeth. Some authors use the strain gauge technique with photoelasticity or FEM techniques. These methodologies can be widely applied in dentistry, mainly in the research field. Therefore, they can guide further research and clinical studies by predicting some disadvantages and streamlining clinical time.
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Mohamed Kassim, Zethy Hanum, Abdul Latif Abdul Hamid, Nadhirah Ghazali, and Puvanendran Balasingham. "A Rehabilitation of Missing Maxillary Anterior Teeth in a Severe Skeletal Class III Malocclusion Patient Requiring Implants." Annals of Dentistry 28 (February 16, 2021): 8–14. http://dx.doi.org/10.22452/adum.vol28no2.
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Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion, treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic rehabilitation of the missing teeth using an i-FDP.
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Beckers, Gautier, David Mazy, Philippe Tollet, and Olivier Van Nieuwenhove. "Knee mega-prosthesis in the management of complex knee fracture of the elderly : a case series and review of the literature." Acta Orthopaedica Belgica 87, no. 2 (June 30, 2021): 347–51. http://dx.doi.org/10.52628/87.2.21.
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The management of complicated distal femur fractures (DFF) of the elderly continues to pose a challenge. Knee mega-prosthesis are mostly used for Total knee arthroplasty revision and tumor resection surgery but they can be used for the treatment of complex knee fractures. The purpose of the present study is to examine the short- to mid- term outcomes of their use for complex DFF of the elderly. We retrospectively identified 4 patients with DFF AO33C3 on osteoporotic bone treated by total knee arthroplasty from September 2015 to October 2019. The average age at the time of the surgery was 79,5 years (range, 69 to 95 years). All patients were females and underwent a total knee replacement by one senior surgeon, with the OSS TM Orthopaedic Salvage System (Zimmer Biomet, Warsaw, Indiana, USA). Outcome measures included clinical outcome scores, radiological analyses, reoperation rate and complications. At an average follow-up of 2,3 years (range, 0,6 to 4,2 years), the average Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) was 17,25 (range, 7 to 37), the average Oxford knee score was 35,25 (range, 25 to 41) and the average pain Numerical Rating Scale (NRS) was 0,5 (range, 0 to 1). 3 Patients had postoperative anemia but no implant related complications has been reported. Complex DFF of the elderly treated with mega knee arthroplasty exhibit good clinical outcomes scores. The patients should be selected carefully as the complication rate found in the literature remains high.
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Apriawan, Tedy, Khrisna Rangga Permana, Ditto Darlan, Muhammad Reza Arifianto, Fitra Fitra, Asra Alfauzi, and Abdul Hafid Bajamal. "Polylactic Acid Implant for Cranioplasty with 3-dimensional Printing Customization: A Case Report." Open Access Macedonian Journal of Medical Sciences 8, no. C (November 10, 2020): 151–55. http://dx.doi.org/10.3889/oamjms.2020.5156.
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BACKGROUND: Cranioplasty is aimed to restore the structure and function of the lost portion of the skull defect. Many materials can be used for cranioplasty, such as the bones of the patient (autograft), the bones of other patients (allograft), bones of animals (xenograft), or synthetic materials such as acrylic or titanium mesh. These materials are quite expensive and sometimes require complex processes. Manual shaping of material for cranioplasty is also quite time-consuming and prone to cause esthetic dissatisfaction. The author will discuss the case of using polylactic acid (PLA) implant with 3-dimensional (3D) printing customization as a cheap and accurate cosmetic solution for cranioplasty procedures.
CASE REPORT: We report 2 cases of skull defect underwent cranioplasty. The first case, female, 20-year-old, had a history of severe traumatic brain injury (TBI) and epidural hematoma. She underwent decompression craniotomy on the left frontotemporoparietal region of her skull. The second case, male, 46-year-old, had a history of spontaneous intracerebral hemorrhage due to arteriovenous malformation (AVM). He underwent decompression craniotomy on the right frontotemporoparietal region of her skull. Both the data of computerized tomography (CT) scan were reconstructed to get 3D model of skull defect. Prosthesis was made by 3D printer accordingly using PLA as material. There was no complication reported postoperatively and cosmetic satisfaction was obtained on both cases.
CONCLUSION: The use of PLA implant with 3D printing customization was proved to be cost-effective and good cosmetic satisfaction with no complication reported following cranioplasty procedure.
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MARCU, Teodora, Adrian GAL, Cristian MARTONOS, Vasile RUS, Aurel DAMIAN, Viorel MICLĂUȘ, and Augustin T. MIHAI. "Chemical Fixation Importance of Histologic Samples for Staining of Proliferated Bone During Implant Osseointegration." Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. Veterinary Medicine 77, no. 2 (November 22, 2020): 123. http://dx.doi.org/10.15835/buasvmcn-vm:2020.0034.
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This study aimed to obtain as much and as accurate information as possible about the process of osseointegration of titanium implants, through histological processing. For this purpose, the combination of a mercury chloride fixator (Stieve mixture) and a complex staining method (Goldner’s trichrome) was used, which can highlight the microscopic structures in several colors and shades. The Stieve mixture proved to have distinguished qualities both in the preservation of basophilic and acidophilic structures and especially in the chemical preparation of the substrate for the binding of each structural component with a specific acidophilic dye. On the substrate thus prepared, the acidophilic dyes used in the Goldner’s trichrome staining highlighted the structural components in different colors and shades, offering the possibility of high precision assessment of the newly proliferated bone, in different stages of proliferation, consolidation and reshaping. Complex information was obtained, which allows the appreciation of osseointegration for endosseous implants and the amount of proliferated bone at the bone-implant interface, the stage of proliferation, consolidation and reshaping of the mature bone, the degree of fixation to deep bone structures. The possibility of complex assessment of the osseointegration process for endosseous implants at a given time is of great practical importance for correct assessment of the waiting time required for safe installation of prosthesis. The combination of Stieve fixator mixture with Goldner’s trichrome staining method has proven to be very effective in histology, highlighting on excellent level the existing structural components of each stage, in which the osseointegration process goes through. A very important role in this combination was achieved by mercury chloride mixture, which prepared the substrate for specific reaction with dyes. Regarding the results obtained, we recommend this combination for histological investigations aimed on bone proliferation and repair.
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Đorđević, Aleksandar, Mirko Mikić, Jelena Stanišić, and Filip Đorđević. "Modern Trends in Prosthetic Implant Rehabilitation of Patients: Case Report with 5-Year Follow-Up." Balkan Journal of Dental Medicine 23, no. 1 (March 1, 2019): 40–44. http://dx.doi.org/10.2478/bjdm-2019-0008.
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SummaryBackground/Aim: Implant treatment expands extensively the possibilities of prosthetic treatment, which provide benefits, bigger comfort as well as general improvement of the patient’s life quality. In cases with no possibility of implantation, it is possible to improve conditions by using modern methods for bone tissue repair. One of factors important for the long-term success is proper oral hygiene, as well as raising awareness of its importance to patients. The aim of the paper is to present a patient rehabilitated with multiple implants and followed-up for a five-year period, and to point out the importance of raising patient’s awareness and motivation in order to preserve the results of the treatment.Case Report: A 31-year-old patient was admitted to the oral surgery clinic for rehabilitation of a poor oral health status. After taking history, clinical examination and additional analysis, the following treatment plan was suggested: to remove impacted upper canines and to put an implant supported by fixed prosthesis in the upper jaw, to make two implants supported by bridges laterally and one dental supported by bridge in the inter-canine sector in the lower jaw. The treatment was carried out in several stages that involved extraction of residual roots and impacted teeth, augmentation of bone defects with bone substitutes and bio-absorbable membranes, placing implant, and prosthetic rehabilitation. By verbal communication with the patient, we pointed out the importance of proper oral hygiene and regular check-ups. The five year follow-up showed the absence of factors that could adversely affect the success of the treatment, and the patient was still highly motivated to maintain proper oral hygiene.Conclusions: It is possible to achieve predictable results in complex cases by using a multiphase prosthetic treatment supported by implants. Concerning a long-term success, motivation, proper information and patient’s willingness to cooperate play an important role.