Prosthetic Management of Implants Placed In Anterior Maxilla: A Case Report (original) (raw)
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Prosthesis, 2021
The nature of immediate implant placement followed by an immediate restoration protocol makes it particularly suited to the anterior maxilla. In addition to saving treatment time and avoiding additional surgical procedures, this protocol has been reported to improve aesthetic outcomes by supporting the peri-implant tissues during the implant healing phase through the use of a provisional restoration. This case report documents the use of this protocol in a patient with a failing maxillary anterior tooth and reports on the soft and hard tissue changes over an observation period of 10 years. An implant was immediately placed after removal of a failing maxillary central incisor followed by the provision of a screw retained provisional crown on the same day. A definitive restoration was placed after a 3-month healing period. Not only did this protocol manage to maintain peri-implant bone levels over the 10-year follow-up period, excellent aesthetic outcomes and very limited soft tissue ...
Applied Sciences
This retrospective study was undertaken to determine survival rates and aesthetic outcomes of immediate placement of multiple implants at anterior maxilla sites. One hundred and eighteen implants placed in 39 patients (21 women and 18 men; average age 58.3 years) were immediately restored (24-72 h after placement). Aesthetic assessment, radiographic bone loss, and biological and prosthetic complications were evaluated. Data collection between 12 and 84 months (mean 32.2 ± 18) after final prosthetic installation revealed that no implants were lost, and that 106/118 (89.8%) implants had no more than 1.5 mm of bone loss by the end of the first year and an additional 0.2 mm for each successive year. The marginal bone loss was higher for extractions due to periodontitis compared to extractions due to caries (mean mesial loss of 1.37 mm vs. 1.01 mm, respectively, and mean distal loss of 1.37 mm and 0.99 mm, respectively, p = 0.001). The mesial papilla was present in 83/118 implants (70.3%), while the distal papilla was present in 76/118 implants (64.4%). The cervical metallic part of the abutment was exposed in 16/118 (13.5%) implants. There was a higher ratio of recessions and missing papillae in patients in whom the extractions were performed due to periodontal reasons. Within the limitations of the present study, aesthetic and radiographic parameters support immediate restoration of partially edentulous maxillae.
Clinical Oral Implants Research, 2011
Objectives: To evaluate immediate placement and immediate restoration of a novel implant with a 121-angled prosthodontic platform, in fresh extraction sockets of the aesthetic zone of the maxilla. Materials and methods: Tapered, roughened surface implants of 4 mm (n ¼ 15) or 5 mm (n ¼ 13) diameter were placed in 27 participants (mean age: 47.1 years; range: 21-71 years) requiring an immediate replacement of single anterior maxillary teeth. Provisional screw-retained all-ceramic crowns were placed within 4 h following optical impressions. At 8 weeks (baseline), definitive screwretained all-ceramic crowns were placed in occlusion. Results: Twenty-six of the 28 implants met the inclusion criteria at surgery. Marginal bone levels revealed bone gain between surgery and baseline, and between baseline and 1 year of 0.2 mm (SD 0.75) and 0.78 mm (SD 2.45). Mean mid-buccal mucosal margins showed gains of 0.2 mm (SD 0.44).
Clinical implant dentistry and related research, 2017
Immediate implant placement followed by an immediate restoration has proven to be a viable technique in the anterior maxillary region. This prospective study evaluated the mid-long term (2-5 years) tissue changes around immediately placed and restored implants in the anterior maxilla using flapless surgery and simultaneous hard tissue augmentation. Thirty AstraTech implants were immediately placed in 30 patients, followed by the delivery of an immediate provisional restoration on the same day. All participating 30 patients underwent the same treatment strategy that involved flapless removal of a failing maxillary anterior tooth, immediate implant placement, simultaneous augmentation with a deproteinized particulate xenograft, followed by the connection of a screw-retained provisional restoration. Radiographs and photographs were used to measure hard and soft tissue changes. Aesthetic evaluation was performed using the Pink Esthetic Score (PES). All implants remained osseointegrated ...
ANTERIOR IMPLANT RESTORATIONS –CHALLENGE AND COMPROMISE. A CASE REPORT
Aim: to present implant restorative treatment and retreatment in light of patient feedback. Summary: A patient with extensive restorative treatment including implant supported fixed prosthodontics is presented as not satisfied with the definitive restorations, which were ultimately rejected and removed. Communication with patient was affected by the fact that he could not use his native language during discussion with the dentists involved in the treatment. Moreover, the majority of dentists who participated in the treatment could not use their native languages. After a number of unsuccessful provisional restorations, decision is made to start over the prosthetic design approach from wax-up stage. Lately, precedence has been given to improved esthetics and lip support, while compromising on other desirable features, such as a smooth, easy to clean emergence profile. The patient was happy with the final outcome and agreed to spend extra time with hygiene measures, while benefiting from better esthetics and lip support. Key learning points: 1. Patient expectations are paramount for treatment success and should be identified early on during evaluation phases. 2. Implant restorations are not without limitations and compromises may be necessary in order to provide an acceptable prosthesis. 3. Definitive restorations should only be fabricated and delivered after assurance that the design provided by provisionals was tried and accepted by the patient. Keywords: implant, emergence profile, lip support
Clinical Implant Dentistry and Related Research, 2007
Background: Conventional implant protocols advocate a two-stage technique with a load-free, submerged healing period. Recent studies suggest that immediate restoration of single implants may be a viable treatment option.Purpose: The purpose of this study was to evaluate prosthodontic and aesthetic peri-implant mucosal outcomes of immediately restored, Southern single-tapered implants in the anterior maxilla after 1 year.Materials and Methods: Participants (mean age: 43.25 years; range: 23–71 years) satisfying specified inclusion criteria were randomly allocated to conventional two-stage restoration (control group; n=14) and immediate restoration groups (test group; n =14) in a randomized controlled clinical trial. Tapered, roughened-surface Southern implants were placed using a standardized technique, and implant level bone impressions were made. Provisional screw-retained crowns, out of occlusion, were placed at second-stage surgery after 26 weeks for the conventional restoration group, and within 4 hours of implant placement for the immediate restoration group. Both groups had definitive screw-retained metal-ceramic crowns placed in occlusion 8 weeks later. Peri-implant mucosal response and papilla index were recorded 4 weeks after definitive crown placement to allow for mucosal maturation and at 1 year. Prosthodontic and aesthetic outcomes were assessed using established criteria.Results: There were no significant differences within, or between, the control and test groups for age, gender, bone quality or quantity, implant stability measurements at surgery, or implant length. There were no significant differences in the implant success rate as determined by radiographic bone loss and stability tests after 1 year. There were no significant differences in prosthodontic maintenance, peri-implant mucosal response, and papilla index between the two groups over 1 year.Conclusions: Tapered, roughened-surface implants immediately restored with single provisional crowns at surgery and definitive crowns 8 weeks later were as prosthodontically and aesthetically successful as conventionally restored two-stage implants during the first year of service. Restoring single implants immediately with screw-retained crowns is an efficient procedure, but the short-term outcome is by no means superior to a conventional two-stage approach.
Objectives:To assesswhich surgical and restorative alternatives obtainbest esthetics outcomesfor single implant restorations in the anterior maxilla.Methods. Studies were identified with MEDLINE/pubmed, SCOPUS, Web of Science (WOS) and Cochrane CENTRAL. Twoindependent reviewers conducted the study selection, data extraction and evaluation of results.Results:46 articles were included; the review had been recruited 3,641 patients with 3,880 implants, 2,897 implants were immediate, of which 2,029 were flapless and 868 with full-thickness flap. Conventional placement was performed in 1,297 implants, 248 with flapless surgery and 584 with a mucoperiosteal flap. 465 implants placement technique were not specified, immediate provisional restorations were delivered on 2,166 cases while conventional loadings, placed after an average of 4 months from implant placement, were carried out on 2,028 cases. The highest mean pink esthetic score (PES), white esthetic score (WES)values (9.80) were obtained with conventional implant placement with bone grafts, similar to immediate implant placement with grafts reporting PES/WES values (9.70).Conclusions:Considering the patient's individual characteristics, the literature seems to indicate that the best aesthetic results can be achieved by placing an immediate implant with immediate loading and bone substitute augmentation, platelet-rich plasma (PRP membrane and connective tissue graft.
Médecine Buccale Chirurgie Buccale
Introduction: In recent years, the immediate loading procedure for the rehabilitation of edentulous jaws has gained popularity among patients and practitioners. The purpose of this study was to evaluate implant and prosthetic success rates for the rehabilitation of edentulous maxillae using tilted distal implants and immediate loading of prostheses, after 2 years. Material and method: Patients included in the study received a complete prosthesis of the upper arch, attached to 4, 5 or 6 implants. The provisional prosthesis was fixed the same day the implants were placed. After a period of osseointegration, the provisional prosthesis was replaced by a definitive prosthesis with a titanium framework made using computer-aided design/computer-assisted manufacturing (CAD/ CAM) technology. Judgment criteria were the implant success rate, the provisional prosthesis success rate, and the definitive prosthetic success rate. Results: Two hundred and forty-two implants were placed in 48 patients. Five implants were lost, resulting in an implant survival at 2 years of 97.9%. Two provisional fixed prosthesis had to be temporarily replaced by a removable solution, resulting in a provisional prosthesis success rate of 95.8%. The definitive prosthesis success rate was 100%. Discussion: Use of a provisional prosthesis during the osseointegration period is essential, both for the preparation of the final prosthesis as well as for proper management of potential implant failures. Implant failures are more easily managed if at least five implants were originally placed.
Implant versus tooth-implant supported prostheses in the posterior maxilla: a 2-year report
Clinical Oral Implants Research, 2001
When implants are used for restoration of a jaw with a residual dentition, the possibility of combining implants with natural abutments may be considered. In a longitudinal comparative study, 26 patients (15 women & 11 men, age 49-84 years) with residual anterior dentitions were treated with two different designs of fixed partial dentures bilaterally in the posterior maxilla. On one side the reconstruction was supported by implants only, while on the contralateral side an implant and a tooth in combination were used. The patients were followed at intervals of 3, 6, 12 and 24 months after loading of the implants. 95 implants were placed, of which 11 non-loaded. A total of 10 implants failed, 7 prior to loading and three within the first three months of service (88.0∫SE 6.7% cumulative survival for tested implants after two years' followup). There was no difference in failure rate for the implants in the two different prosthesis designs. The total mean loss of marginal bone height close to the implants was within acceptable standards, but was more pronounced at the implants not combined with teeth. The results indicate a correlation between the prosthesis design and the loss of marginal bone.