Osseointegrated silicone finger prosthesis using dental implants: a renovated technique.

Science.gov (United States)

Vinnakota, Dileep Nag; Sankar, V Vijay; Chirumamilla, Naveen; Reddy, V Vamsikrishna

2014-11-01

In clinical practice, we come across patients with traumatically amputated or congenitally missing partial or complete fingers that can be restored using microsurgical replantation or transplantation procedures. However, in some cases this might not be possible due to systemic or local factors and the lost or missing part has to be replaced prosthetically to offer psychological and functional wellbeing. These prostheses can be constructed with various materials like acrylics or silicone retained with the help of auxiliary aids. However, these prostheses cause some hindrance in performing functions like writing, typing, etc. The aim of the present trial was to ameliorate the existing design of implant supported finger prosthesis. Distal phalange of middle finger replaced with implant supported silicone finger prosthesis is modified by utilizing a metal framework to support silicone material to improve rigidity while working. We could achieve a good function, esthetics and tactile sensibility with this modified design. Whenever, feasible this design can improve the performance and patients feel a deep sense of satisfaction and improved self-esteem with this modified prosthesis.

Clinical Outcomes of Penile Prosthesis Implantation Surgery

Directory of Open Access Journals (Sweden)

Onur Dede

2016-06-01

Full Text Available Objective: We aimed to evaluating the outcomes of in­flatable penile prosthesis implantations and partner sat­isfaction. Methods: Data of 52 patients who underwent penile prosthesis implantation in single center between May 2010 and December 2015 were retrospectively analyzed. Types of prosthesis, complication and satisfaction rates of patients were recorded by EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire was used. Results: The mean age was 49.2±14.7 years for patients. The mean follow-up durations for 34.3±12.5 months. The mean hospital stay was 3.84±1.52 days. Evaluating of the couples satisfaction revealed that 44 (84% of the patient were very satisfied. There was not any complication and no patient need to underwent revision surgery. Conclusion: Inflatable penile prosthesis implants, with high levels of treatment success, patient and partner sat­isfaction, are effective and safe options for treatment of organic erectile dysfunction with acceptable complication and revision rates.

21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

Science.gov (United States)

2010-04-01

... implant). 872.3970 Section 872.3970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3970 Interarticular disc prosthesis (interpositional implant). (a) Identification. An interarticular disc prosthesis...

Penile prosthesis implant: scientific advances and technological innovations over the last four decades.

Science.gov (United States)

Chung, Eric

2017-02-01

Despite introduction of oral phosphodiesterase type 5 inhibitors and intracavernosal vasoactive agents, penile prosthesis implant remains a relevant and desired option with sales of penile prostheses continue to stay high, as many men became refractory to medical therapy and/or seeking a more effective and permanent therapy. There are two types of penile prosthesis implants: inflatable and non-inflatable types, and the inflatable penile implants can be subdivided into single-, two- and three-piece devices. Non-inflatable penile prosthesis (non-IPP) may be referred to as semi-rigid rod or malleable prosthesis. IPP is considered a superior option to malleable prosthesis as it produces penile rigidity and flaccidity that closely replicates a normal penile erectile function. Since the introduction of IPP by Scott in 1973, surgical landscape for penile prosthesis implantation has changed dramatically. Advances in prosthesis design, device technologies and surgical techniques have made penile prosthesis implant a more natural, durable and reliable device. The following article reviews the scientific advances and technological innovation in modern penile prosthesis implants over the last four decades.

Implant supported prosthesis in an edentulous boy with Hypohidrotic Ectodermal Dysplasia - "A happy boy"

DEFF Research Database (Denmark)

Gjørup, Hans; Nyhuus, Lone; Buhl, Jytte

2009-01-01

region. 3. At the age of 10 years a new set of dentures were made. This time the upper denture was made as an overdenture supported and retained by 4 implants and a Dolder bar. The surgical procedure included bone grafting from the anterior ramus mandibulae. The boy's subjective judgement of his oral......Implant supported prosthesis in an edentulous boy with Hypohidrotic Ectodermal Dysplasia - "A happy boy". Authors; Gjoerup,H1; Nyhuus,L2; Buhl,J3. 1) Center for Oral Health in Rare Conditions, Aarhus University Hospital 2) Prosthodontic Department, the Dental School, Aarhus University 3) Department...... by the patient and his family. Case presentation The boy was untreated until the age of 5 years. His oral functions were compromised in relation to speech and psychosocial aspects. In the following 6 years, he underwent prosthodontic treatment in three phases. 1. At the age of 5 years a set of complete dentures...

Comparative Evaluation of a Four-Implant-Supported Polyetherketoneketone Framework Prosthesis: A Three-Dimensional Finite Element Analysis Based on Cone Beam Computed Tomography and Computer-Aided Design.

Science.gov (United States)

Lee, Ki-Sun; Shin, Sang-Wan; Lee, Sang-Pyo; Kim, Jong-Eun; Kim, Jee-Hwan; Lee, Jeong-Yol

The purpose of this pilot study was to evaluate and compare polyetherketoneketone (PEKK) with different framework materials for implant-supported prostheses by means of a three-dimensional finite element analysis (3D-FEA) based on cone beam computed tomography (CBCT) and computer-aided design (CAD) data. A geometric model that consisted of four maxillary implants supporting a prosthesis framework was constructed from CBCT and CAD data of a treated patient. Three different materials (zirconia, titanium, and PEKK) were selected, and their material properties were simulated using FEA software in the generated geometric model. In the PEKK framework (ie, low elastic modulus) group, the stress transferred to the implant and simulated adjacent tissue was reduced when compressive stress was dominant, but increased when tensile stress was dominant. This study suggests that the shock-absorbing effects of a resilient implant-supported framework are limited in some areas and that rigid framework material shows a favorable stress distribution and safety of overall components of the prosthesis.

Photoelastic Stress Analysis Surrounding Implant-Supported Prosthesis and Alveolar Ridge on Mandibular Overdentures

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Dorival Pedroso da Silva

2010-01-01

Full Text Available The purpose of this research was to evaluate the maximum stress around osseointegrated implants and alveolar ridge, in a mandible with left partial resection through a photoelastic mandibular model. The first group consisted of two implants: traditional model (T, implants placed in the position of both canines; fulcrum model (F, implants placed in the position of left canine CL and right lateral incisor LiR. Both models linked through a bar and clips. The second group was consisted of three implants, with implants placed in the position of both canines (CR and CL and the right lateral incisor (LiR, which composed four groups: (1 model with 3 “O” rings, (2 model 2 ERAs, bar with clips, (3 model 2 ERAs bar without clips; (4 model “O” ring bar and ERA. An axial and an oblique load of 6.8 kgf was applied on a overdenture at the 1st Pm, 2nd Pm, and 1st M. Results showed that the area around the left canine (CL was practically free of stress; the left lateral incisor (LiL developed only small tensions, and low stress in all the other cases; the right canine tooth suffered the largest concentrations of stress, mainly with the ERA retention mechanism.

Post-operative hemimaxillectomy rehabilitation using prostheses supported by zygoma implants and remaining natural teeth

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Xing Zhou Qu

Full Text Available OBJECTIVES: This study aimed to evaluate the stability of prostheses supported by zygoma implants and remaining teeth for subjects who had undergone hemi-maxillectomy. METHODS: Ten patients were included in the study. Oral rehabilitation was performed using a temporary prosthesis that was supported by remaining teeth for the first three months. Then, a zygoma implant was placed to provide support for a final prosthesis in addition to the remaining teeth. Each prosthesis was tailor-made according to biomechanical three-dimensional finite element analysis results. The patients were assessed using the prosthesis functioning scale of the Memorial Sloan-Kettering Cancer Center. In addition, retention and bite force were recorded for both the temporary prosthesis and the final prosthesis. RESULTS: The mean bite force of the prosthetic first molar was increased to 69.2 N. The mean retentive force increased to 13.5 N after zygoma implant insertion. The bite force on the prosthetic first molar was improved to 229.3 N. CONCLUSION: Bite force increased significantly with the support of a zygoma implant. The use of zygoma implants in the restoration of maxillary defects improved functional outcome and patient satisfaction.

A mandibular implant-supported fixed complete dental prosthesis in a patient with Sjogren syndrome: case report.

Science.gov (United States)

Spinato, Sergio; Soardi, Carlo Maria; Zane, Anna Maria

2010-06-01

The article describes the treatment and 1 year follow-up of a patient with Sjogren syndrome, treated with 6 intraforaminal mandibular implants with delayed loading and an implant-retained fixed prosthesis. The maxillary arch has been treated with a complete denture. This made an enormous difference in comfort and function for the patient. Radiographic check-ups did not reveal any peri-implant bone loss after 1 year of loading.

A wide-field suprachoroidal retinal prosthesis is stable and well tolerated following chronic implantation.

Science.gov (United States)

Villalobos, Joel; Nayagam, David A X; Allen, Penelope J; McKelvie, Penelope; Luu, Chi D; Ayton, Lauren N; Freemantle, Alexia L; McPhedran, Michelle; Basa, Meri; McGowan, Ceara C; Shepherd, Robert K; Williams, Chris E

2013-05-01

The safety of chronic implantation of a retinal prosthesis in the suprachoroidal space has not been established. This study aimed to determine the safety of a wide-field suprachoroidal electrode array following chronic implantation using histopathologic techniques and electroretinography. A platinum electrode array in a wide silicone substrate was implanted unilaterally in the suprachoroidal space in adult cats (n = 7). The lead and connector were tunneled out of the orbit and positioned subcutaneously. Postsurgical recovery was assessed using fundus photography and electroretinography (ERG). Following 3 months of passive implantation, the animals were terminated and the eyes assessed for the pathologic response to implantation. The implant was mechanically stable in the suprachoroidal space during the course of the study. The implanted eye showed a transient increase in ERG response amplitude at 2 weeks, which returned to normal by 3 months. Pigmentary changes were observed at the distal end of the implant, near the optic disc. Histopathologic assessment revealed a largely intact retina and a thin fibrous capsule around the suprachoroidal implant cavity. The foreign body response was minimal, with sporadic presence of macrophages and no active inflammation. All implanted eyes were negative for bacterial or fungal infections. A midgrade granuloma and thick fibrous buildup surrounded the extraocular cable. Scleral closure was maintained in six of seven eyes. There were no staphylomas or choroidal incarceration. A wide-field retinal prosthesis was stable and well tolerated during long-term suprachoroidal implantation in a cat model. The surgical approach was reproducible and overall safe.

Rehabilitation of an edentulous cleft lip and palate patient with a soft palate defect using a bar-retained, implant-supported speech-aid prosthesis: a clinical report.

Science.gov (United States)

Hakan Tuna, S; Pekkan, Gurel; Buyukgural, Bulent

2009-01-01

Prosthetic rehabilitation of an edentulous cleft lip and palate patient with a combined hard and soft palate defect is a great challenge, due to the lack of retention of the obturator prosthesis as a result of its weight and the inability to obtain a border seal. Dental implants improve the retention, stability, and occlusal function of prostheses when used in carefully selected cleft lip and palate cases. This clinical report presents an edentulous unilateral cleft lip and palate patient who has hard and soft palate defects and an atrophied maxilla, treated with an implant-supported speech-aid prosthesis.

Three-dimensional finite element analysis of different implant configurations for a mandibular fixed prosthesis.

Science.gov (United States)

Fazi, Giovanni; Tellini, Simone; Vangi, Dario; Branchi, Roberto

2011-01-01

The distribution of stresses in bone, implants, and prosthesis were analyzed via three-dimensional finite element modeling in different implant configurations for a fixed implant-supported prosthesis in an edentulous mandible. A finite element model was created with data obtained from computed tomographic scans of a human mandible. Anisotropic characteristics for cortical and cancellous bone were incorporated into the model. Six different configurations of intraforaminal implants were tested, with the number of implants varying from three to five and the distal implants inserted either parallel to the other implants or tilted distally by 17 or 34 degrees. A prosthetic structure connecting the implants was designed, with 20-mm posterior cantilevers for the parallel implant configurations, and a load of 200 N was applied to the distal portion of the cantilevers. Stresses were measured at the level of the implant, the prosthetic structure, and the bone. Bone-level stresses were analyzed at the implant-bone interface, at the external cortical bone surface, distal to the terminal implant, and in the cancellous bone along the implant body. A three-parallel-implant configuration resulted in higher stress in the implant and bone than configurations with four or five parallel implants. Configurations with the distal implants tilted resulted in a more favorable stress distribution at all levels. In parallel-implant configurations for fixed implant-supported mandibular prostheses, four and five implants resulted in similar stress distribution in the bone, framework, and implants. A distribution of four implants with the distal implants tilted 34 degrees (ie, the "All-on-Four" configuration) resulted in a favorable reduction of stresses in the bone, framework, and implants.

21 CFR 874.3695 - Mandibular implant facial prosthesis.

Science.gov (United States)

2010-04-01

... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based alloy... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular implant facial prosthesis. 874.3695... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant...

Implant supported overdentures--the Copenhagen experience

DEFF Research Database (Denmark)

Gotfredsen, K

1997-01-01

OBJECTIVES: To evaluate the functional and biological effect of implant-supported overdenture treatment in the lower jaw. METHODS AND MATERIALS: Thirty-two patients were consecutively treated with Astra Tech implants in the lower jaw for retaining overdentures. All implants had a diameter of 3.5 mm...... and all but two of the implants were longer than 10 mm. For the implant supported overdentures two methods of attachment were used, a bar or a ball. RESULTS: One of 69 fixtures was lost during the 4-5 year observation period. The mean bone loss for all fixtures was less than 0.2 mm per year. Complications...... quality and quantity is sufficient, two implants can support an overdenture in the lower jaw, providing prosthesis which functions well....

Zygoma Implant-Supported Prosthetic Rehabilitation of a Patient After Bilateral Maxillectomy.

Science.gov (United States)

Celakil, Tamer; Ayvalioglu, Demet Cagil; Sancakli, Erkan; Atalay, Belir; Doganay, Ozge; Kayhan, Kivanc Bektas

2015-10-01

Maxillectomy defects may vary from localized to extensive soft and hard tissue loss. In addition to physical and psychologic damages, functional and aesthetic aspects must be restored. This clinical report describes the rehabilitation of a patient with a zygoma implant-supported obturator prosthesis caused by a subtotal bilateral maxillectomy due to a squamous oral cell carcinoma. Prosthetic rehabilitation of this patient was performed after zygoma implant surgery. A maxillary obturator prosthesis supported by 2 osseointegrated zygoma implants was fabricated. Despite limited mouth opening and anatomic deficiencies, the patient's aesthetic and functional demands were fulfilled.

Fracture analysis of randomized implant-supported fixed dental prostheses

Science.gov (United States)

Esquivel-Upshaw, Josephine F.; Mehler, Alex; Clark, Arthur E.; Neal, Dan; Anusavice, Kenneth J.

2014-01-01

Objective Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, and nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (1) presence of a tooth distal to the most distal retainer; (2) prosthesis loading either along the non-load bearing or load bearing areas; (3) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (4) magnitude of bite force on the occurrence of veneer ceramic fracture. Methods 89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1 to 3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts. Conclusion No significant relationship exists between the occurrence of fracture and: (1) the magnitude of bite force; (2) a tooth distal to the most distal retainer; and (3) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only. Clinical Significance This clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses because of the absence of a periodontal ligament. Implant supported prostheses should have minimal occlusion and

Self and partner satisfaction rates after 3 part inflatable penile prosthesis implantation.

Science.gov (United States)

Simsek, Abdulmuttalip; Kucuktopcu, Onur; Ozgor, Faruk; Ozkuvanci, Unsal; Baykal, Murat; Sarilar, Omer; Gurbuz, Zafer Gokhan

2014-09-30

To evaluate and present satisfaction rates of our patients and their partners after 3 part inflatable penile prosthesis implantation. We searched our hospital electronic data for patients who underwent inflatable penile prosthesis implantation between January 2008 and July 2013. Computer and archived file data were used to get information and reach the patients. We made telephone calls to patients and asked questionnaires about self and partner satisfaction rates. 36 patients underwent prosthesis implantation during the 5 year period. We were able to reach by telephone call 18 of them. The mean age of 18 patients was 55.7 ± 9.4 years and mean body mass index was 24.6 ± 2.1 kg/m2. The etiology was diabetes mellitus on 14 (77.8%) and radical pelvic surgery on 4 (22.2%) patients. 14 of 18 patients had penile Doppler ultrasound test. Doppler ultrasound demonstrated venous insufficiency in 8 and arterial insufficiency in 6 patients. Mean time from implantation to study was 20.8 ± 13.9 months. Out of 18 patients 2 had prosthesis removal operation because of infection in one patient and perforation in the other. Satisfaction rate was 88.9%, and recommendation rate was 94.4%. Causes of dissatisfaction were pain in one patient and insufficient rigidity plus shortening of the penis in the other one. Partner satisfaction rate was 94.4%. Penile Prosthesis Implantation (PPI) is the gold standard treatment of erectile dysfunction (ED) irresponsive to medical treatment. Infection and mechanical failure rates are going to be less according to the improvements in synthetic materials and coverings of the prosthesis, so patient and partner satisfaction rates will be higher.

A 2D panoramic surgical stent imaging: Complete arch mandibular implant fixed prosthesis along with bar supported maxillary over denture

Directory of Open Access Journals (Sweden)

Mukesh Kumar Singhal

2017-01-01

Full Text Available Successful rehabilitation of a patient should restore function, esthetic, and speech by prosthesis. Treatment modalities vary from patient to patient. Semi-precision attachments and implants offer several advantages over the traditional approach. The aim and objective of this report was to assess a case of a 55-year-old female patient who had lost all her teeth, except maxillary canines #13 and #23 and with severe bone loss in the mandible. Tooth-supported bar attachment was planned for maxilla, and a total of five dental implants were placed in the mandible using a flapless approach aided by radiographic gutta-percha surgical stents over panoramic two-dimensional imaging. Customized, radiographic stents help for the placement of implant in the view of paralleling and flapless surgery, completely. An immediate loading protocol is adopted as from day of the surgery to 6 weeks along with implant supported full arch fixed dentures after 4 months. The outcome of the treatment was impressive, and the patient gave a positive response with superb esthetics and functions.

Self and partner satisfaction rates after 3 part inflatable penile prosthesis implantation

Directory of Open Access Journals (Sweden)

Abdulmuttalip Simsek

2014-09-01

Full Text Available Objective: To evaluate and present satisfaction rates of our patients and their partners after 3 part inflatable penile prosthesis implantation. Materials and methods: We searched our hospital electronic data for patients who underwent inflatable penile prosthesis implantation between January 2008 and July 2013. Computer and archived file data were used to get information and reach the patients. We made telephone calls to patients and asked questionnaires about self and partner satisfaction rates. Results: 36 patients underwent prosthesis implantation during the 5 year period. We were able to reach by telephone call 18 of them. The mean age of 18 patients was 55.7 ± 9.4 years and mean body mass index was 24.6 ± 2.1 kg/m2. The etiology was diabetes mellitus on 14 (77.8% and radical pelvic surgery on 4 (22.2% patients. 14 of 18 patients had penile Doppler ultrasound test. Doppler ultrasound demonstrated venous insufficiency in 8 and arterial insufficiency in 6 patients. Mean time from implantation to study was 20.8 ± 13.9 months. Out of 18 patients 2 had prosthesis removal operation because of infection in one patient and perforation in the other. Satisfaction rate was 88.9%, and recommendation rate was 94.4%. Causes of dissatisfaction were pain in one patient and insufficient rigidity plus shortening of the penis in the other one. Partner satisfaction rate was 94.4%. Conclusion: Penile Prosthesis Implantation (PPI is the gold standard treatment of erectile dysfunction (ED irresponsive to medical treatment. Infection and mechanical failure rates are going to be less according to the improvements in synthetic materials and coverings of the prosthesis, so patient and partner satisfaction rates will be higher.

Fabricating a Mandibular Implant Supported Overdenture with a Suspended Framework

OpenAIRE

Ahuja, Swati; Jain, Vinay; Cagna, David; Wicks, Russell

2012-01-01

The introduction of implant-supported overdentures as a clinical alternative has improved the quality of life of the edentulous population. Implant-supported overdentures have diminished many of the problems associated with conventional dentures by providing improved retention, stability, function, esthetics and physical and emotional health. Greater support and stability of the implant borne prosthesis is associated with improved bite force and oral function for overdentures when compared to...

Adjuvant Maneuvers for Residual Curvature Correction During Penile Prosthesis Implantation in Men with Peyronie's Disease.

Science.gov (United States)

Berookhim, Boback M; Karpman, Edward; Carrion, Rafael

2015-11-01

The surgical treatment of comorbid erectile dysfunction and Peyronie's disease has long included the implantation of an inflatable penile prosthesis as well as a number of adjuvant maneuvers to address residual curvature after prosthesis placement. To review the various surgical options for addressing curvature after prosthesis placement, with specific attention paid to an original article by Wilson et al. reporting on modeling over a penile prosthesis for the management of Peyronie's disease. A literature review was performed analyzing articles reporting the management of penile curvature in patients undergoing implantation of an inflatable penile prosthesis. Reported improvement in Peyronie's deformity as well as the complication rate associated with the various surgical techniques described. Modeling is a well-established treatment modality among patients with Peyronie's disease undergoing penile prosthesis implantation. A variety of other adjuvant maneuvers to address residual curvature when modeling alone is insufficient has been presented in the literature. Over 20 years of experience with modeling over a penile prosthesis have proven the efficacy and safety of this treatment option, providing the surgeon a simple initial step for the management of residual curvature after penile implantation which allows for the use of additional adjuvant maneuvers in those with significant deformities. © 2015 International Society for Sexual Medicine.

Masticatory function with implant-supported overdentures

NARCIS (Netherlands)

van Kampen, FMC; van der Bilt, A; Cune, MS; Fontijn-Tekamp, FA; Bosman, F

The type of attachment that is used in implant-supported mandibular overdentures may influence the retention and stability of the prosthesis and, thus, masticatory function. In this within- subject cross- over clinical trial, we examined the hypothesis that greater retention and stability of the

Tardive Dyskinesia, Oral Parafunction, and Implant-Supported Rehabilitation

Directory of Open Access Journals (Sweden)

S. Lumetti

2016-01-01

Full Text Available Oral movement disorders may lead to prosthesis and implant failure due to excessive loading. We report on an edentulous patient suffering from drug-induced tardive dyskinesia (TD and oral parafunction (OP rehabilitated with implant-supported screw-retained prostheses. The frequency and intensity of the movements were high, and no pharmacological intervention was possible. Moreover, the patient refused night-time splint therapy. A series of implant and prosthetic failures were experienced. Implant failures were all in the maxilla and stopped when a rigid titanium structure was placed to connect implants. Ad hoc designed studies are desirable to elucidate the mutual influence between oral movement disorders and implant-supported rehabilitation.

Tardive Dyskinesia, Oral Parafunction, and Implant-Supported Rehabilitation.

Science.gov (United States)

Lumetti, S; Ghiacci, G; Macaluso, G M; Amore, M; Galli, C; Calciolari, E; Manfredi, E

2016-01-01

Oral movement disorders may lead to prosthesis and implant failure due to excessive loading. We report on an edentulous patient suffering from drug-induced tardive dyskinesia (TD) and oral parafunction (OP) rehabilitated with implant-supported screw-retained prostheses. The frequency and intensity of the movements were high, and no pharmacological intervention was possible. Moreover, the patient refused night-time splint therapy. A series of implant and prosthetic failures were experienced. Implant failures were all in the maxilla and stopped when a rigid titanium structure was placed to connect implants. Ad hoc designed studies are desirable to elucidate the mutual influence between oral movement disorders and implant-supported rehabilitation.

Esthetic Outcome of Implant Supported Crowns With and Without Peri-Implant Conditioning Using Provisional Fixed Prosthesis: A Randomized Controlled Clinical Trial.

Science.gov (United States)

Furze, David; Byrne, Ashley; Alam, Sonia; Wittneben, Julia-Gabriela

2016-12-01

Achieving an optimal esthetic result using dental implants is challenging. Fixed implant-supported provisional crowns are often used to customize the emergence profile and to individualize the surrounding peri-implant soft tissue. The objective of this study is to evaluate whether the use of a provisional implant-supported crown leads to an esthetic benefit on implants that are placed in the esthetic zone. The null hypothesis is that there is no-difference between the two study groups. Twenty single implants (Bone Level, Straumann AG, Basel, Switzerland) were inserted in consecutive patients. After reopening, a randomization process assigned them to either cohort group 1: a provisional phase with soft tissue conditioning using the "dynamic compression technique" or cohort group 2: without a provisional. Implants were finally restored with an all-ceramic crown. Follow-up examinations were performed at 3 and 12 months including implant success and survival, clinical, and radiographic parameters. After 1 year all implants successfully integrated, mean values of combined modPES and WES were 16.7 for group 1 and 10.5 for Group 2. This was statistically significant. Mean bone loss after 1 year was -0.09 and -0.08 for groups 1 and 2, respectively, without being statistically significant. A provisional phase with soft tissue conditioning does improve the final esthetic result. © 2016 Wiley Periodicals, Inc.

Modified cementless total coxofemoral prosthesis: development, implantation and clinical evaluation

Directory of Open Access Journals (Sweden)

S.A. Arias

2013-12-01

Full Text Available The aim of this study was to modify canine coxofemoral prostheses and the clinical evaluation of the implantation. Fifteen canine hips and femora of cadavers were used in order to study the surface points of modification in prostheses and develop a perforation guide. Femoral stems and acetabular components were perforated and coated with biphasic calcium phosphate layer. Twelve young adult male mongrel dogs were implanted with coxofemoral prostheses. Six were operated upon and implanted with cemented canine modular hip prostheses, establishing the control group. The remaining six were implanted with a novel design of cementless porous tricalcic phosphate-hydroxyapatite coated hip prostheses. Clinical and orthopedic performance, complications, and thigh muscular hypotrophy were assessed up to the 120th post-operatory day. After 120 days, animals with cementless prostheses had similar clinical and orthopedic performance compared to the cemented group despite the increased pain thigh hypotrophy. Animals that underwent cementless hip prosthesis evidenced more pain, compared to animals with cemented hip prosthesis that required longer recuperation time. No luxations, two fractures and two isquiatic neurapraxies were identified in the course of the study. Using both the cemented and the bioactive coated cementless model were suitable to dogs, showing clinical satisfactory results. Osseointegration and biological fixation were observed in the animals with the modified cementless hip prosthesis.

Influence of prosthesis type and material on the stress distribution in bone around implants: A 3-dimensional finite element analysis

Directory of Open Access Journals (Sweden)

Gökçe Meriç

2011-03-01

Conclusions: Prosthesis design and materials affect the load-transmission mechanism. Although additional experimental and clinical studies are needed, FRC FPDs can be considered a suitable alternative treatment choice for implant-supported prostheses. Within the limitations of the study, the 3-unit FPD supported by 2 implants with a cantilevered extension revealed acceptable stress distributions.

Bilateral implant-retained auricular prosthesis for a patient with congenitally missing ears. A clinical report.

Science.gov (United States)

Kumar, Preeti Satheesh; Satheesh Kumar, K S; Savadi, Ravindra C

2012-06-01

Microtia is a major congenital anomaly of the external ear. It includes a spectrum of deformities from a grossly normal but small ear to the absence of the entire external ear. These deformities account for three in every 10,000 births, with bilaterally missing ears seen in fewer than 10% of all cases. Congenital abnormalities of the ear are unlikely to result in the complete absence of the ears, but the patient presented in this article had bilateral congenitally missing ears. There was loss of anatomic landmarks and alteration of normal bony architecture. Minimal tissue was available for retention; therefore, conventional techniques could not be used for achieving retention. A two-implant-supported auricular prosthesis was planned, but the patient was found to have deficient bone in the implant site. Hence the implants were placed posterior to these sites, and the superstructure was modified to accommodate for this change in position of the implant to ensure the esthetic positioning of the prosthesis. © 2012 by the American College of Prosthodontists.

Masseter muscle fatigue during sustained clenching in subjects with complete dentures, implant-supported prostheses, and natural teeth.

Science.gov (United States)

Jacobs, R; van Steenberghe, D

1993-03-01

A sustained submaximal (50%) clenching effort was performed in four patient groups to establish whether implant-supported prosthetic reconstructions influence myoelectrical signal parameters. The first group consisted of patients with natural teeth in both jaws. The other three groups consisted of patients who were edentulous in both jaws: one group had complete dentures; one had an overdenture in the mandible on two implants connected by a bar; and the third had an implant-supported fixed prosthesis in either the maxilla or the mandible. Surface electromyography indicated an increased myoelectrical output level that paralleled a higher bite force level for implant-supported reconstructions compared with complete dentures. Power spectrum analysis revealed a downward shift of the mean power frequency during sustained clenching in all groups except the implant-supported fixed prosthesis. The absence of a spectral shift in the latter group probably reflected a fear of biting too hard and fracturing the prosthesis.

Rehabilitation of Posterior Maxilla with Obturator Supported by Zygomatic Implants

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Sankalp Mittal

2018-01-01

Full Text Available Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomatic implant-supported prosthesis. Zygomatic implants are an avant-garde to complex and invasive-free vascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany’s classification maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS. The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with two single-piece zygomatic implants. At 1-year follow-up, the patient was comfortable with the prosthesis, and no further complaints were recorded.

Transcatheter aortic valve prosthesis surgically replaced 4 months after implantation

DEFF Research Database (Denmark)

Thyregod, Hans Gustav; Lund, Jens Teglgaard; Engstrøm, Thomas

2010-01-01

Transcatheter aortic valve implantation is a new and rapidly evolving treatment option for high-risk surgical patients with degenerative aortic valve stenosis. Long-term results with these new valve prostheses are lacking, and potential valve dysfunction and failure would require valve replacemen....... We report the first case of surgical valve replacement in a patient with a dysfunctional transcatheter-implanted aortic valve prosthesis 4 months after implantation....

Rehabilitation with ear prosthesis linked to osseointegrated implants.

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Goiato, Marcelo C; dos Santos, Daniela M; Haddad, Marcela F; Moreno, Amália

2012-06-01

The absence of an ear, which can be the result of a congenital malformation, surgical tumour resection or traumatic injury, is a significant aesthetic problem. Attachment of ear prostheses with adhesives can cause local irritation for the wearer and affect the colour of the prostheses. Use of implants in craniofacial reconstruction can improve the retention and stability of prostheses giving to patient greater comfort and security relative to adhesive attachment. The aim of this report was to present a clinical case of a mutilated patient who was rehabilitated by means of installing an ear prosthesis fixed through osseointegrated implants. The patient had two implants installed in the mastoid region that were linked by a bar, and a clip-type system was used. The ear prosthesis was constructed from medical-use silicone, pigmented to match the patient's skin colour and linked to the retention system. The patient's rehabilitation was satisfactory from both a functional and an aesthetic point of view, making it possible for the patient to return to a normal social life and regain lost self-esteem. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

Survey on the Contemporary Management of Intraoperative Urethral Injuries During Penile Prosthesis Implantation.

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Sexton, Stephanie J; Granieri, Michael A; Lentz, Aaron C

2018-04-01

Intraoperative urethral injury is an uncommon event during the placement of a penile prosthesis, and alternative management strategies have been proposed with continuation of implantation after urethral injury. To evaluate surgeon practices in the management of intraoperative urethral injury. An online survey was sent to the society listservs of the Genitourinary Reconstructive Surgeons (GURS) and the Sexual Medicine Society of North America (SMSNA). Physicians were queried on their fellowship training, experience with penile prosthesis implantation, and management of urethral injuries during prosthesis placement. The response data were analyzed using SAS 9.4 (SAS Institute, Cary, NC, USA). The χ 2 test and Fisher exact test were used to determine associations between variables. Survey responses. 131 survey responses were analyzed. Of the responders, 41.2% were GURS fellowship trained, 19.1% were SMSNA trained, 30.5% were non-fellowship trained, and 9.2% were trained in other fellowships. 25.4% of participants performed more than 50 implantations per year, 37.7% performed 20 to 50 per year, and 36.9% performed fewer than 20 per year. Urethral injury during prosthesis implantation was uncommon, with 26.2% reporting 0 injury, 58.5% reporting 1 to 3 injuries, and 15.4% reporting more than 3 career injuries. Injuries were most commonly encountered during corporal dilation (71.1%) compared with corporal exposure (12.5%) or penile straightening maneuvers (7.0%). There was no statistically significant difference with aborting or continuing implantation among GURS-trained, SMSNA-trained, other fellowship-trained, and non-fellowship-trained surgeons. Of all responders, 55% would abort the procedure after distal urethral injury, whereas 45% would continue the procedure with unilateral or bilateral insertion of cylinders. Patient factors that increased likelihood of terminating the procedure in the case of urethral injury included immunosuppression, spinal cord injury, and

Inflatable penile prosthesis implant length with baseline characteristic correlations: preliminary analysis of the PROPPER study.

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Bennett, Nelson; Henry, Gerard; Karpman, Edward; Brant, William; Jones, LeRoy; Khera, Mohit; Kohler, Tobias; Christine, Brian; Rhee, Eugene; Kansas, Bryan; Bella, Anthony J

2017-12-01

"Prospective Registry of Outcomes with Penile Prosthesis for Erectile Restoration" (PROPPER) is a large, multi-institutional, prospective clinical study to collect, analyze, and report real-world outcomes for men implanted with penile prosthetic devices. We prospectively correlated co-morbid conditions and demographic data with implanted penile prosthesis size to enable clinicians to better predict implanted penis size following penile implantation. We present many new data points for the first time in the literature and postulate that radical prostatectomy (RP) is negatively correlated with penile corporal length. Patient demographics, medical history, baseline characteristics and surgical details were compiled prospectively. Pearson correlation coefficient was generated for the correlation between demographic, etiology of ED, duration of ED, co-morbid conditions, pre-operative penile length (flaccid and stretched) and length of implanted penile prosthesis. Multivariate analysis was performed to define predictors of implanted prosthesis length. From June 2011 to June 2017, 1,135 men underwent primary implantation of penile prosthesis at a total of 11 study sites. Malleable (Spectra), 2-piece Ambicor, and 3-piece AMS 700 CX/LGX were included in the analysis. The most common patient comorbidities were CV disease (26.1%), DM (11.1%), and PD (12.4%). Primary etiology of ED: RP (27.4%), DM (20.3%), CVD (18.0%), PD (10.3%), and Priapism (1.4%), others (22.6%). Mean duration of ED is 6.2¡À4.1 years. Implant length was weakly negatively correlated with White/Caucasian (r=-0.18; Pprosthesis length is negatively correlated with some ethnic groups, prostatectomy, and incontinence. Positive correlates include CV disease, preoperative stretched penile length, and flaccid penile length.

Pseudo-capsule “coffin effect”: How to prevent penile retraction after implant of three-piece inflatable prosthesis

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Enrico Caraceni

2014-06-01

Full Text Available Objective: Following three-component implantation of a penile prosthesis, some patients are dissatisfied with their penile length. This may be due to the procedure by itself or pre-existing risk factors or psychological reasons. We supposed that formation of a restricted pseudo-capsule due to a late prosthesis activation can inhibit later system expansion. We aimed to identify the presence or absence of penile retraction after implant and to prevent it by immediate prosthesis activation after implantation. Material and methods. Forty-six patients operated with three-piece inflatable penile prosthesis (AMS 700 CX o LGX were enrolled. In 27 patients prosthesis was first activated four weeks after surgery (NEA group and in 19 patients prosthesis was activated immediately after surgery (DEA group. Length and girth of the penis was evaluated before (in DEA group and after the surgical procedure. Results. The average post implant dorsal length of the erect penis in group NEA was found 3.28 cm shorter than in group with early activation (DEA. In DEA group there was no lenght difference between pre-operative stretching (14.57 cm and post operative erection (14.98 cm. When early activation was not performed, the clinical result was a smaller penis in erect phase. Conclusion. Reduced lenght of the penis after implantation can be caused by the presence of a pseudo-capsule that limits the elongation of the prosthesis and of the penis (“coffin effect”. Timing of first activation seems to be the key in order to prevent the risk of penile retraction after implantation. Early activation is identified as the best measure to maintain the length of the pre implant erect penis after the prosthetic hydraulic implant.

Amputation and prosthesis implantation shape body and peripersonal space representations.

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Canzoneri, Elisa; Marzolla, Marilena; Amoresano, Amedeo; Verni, Gennaro; Serino, Andrea

2013-10-03

Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearing or not wearing their prosthesis. When patients performed the tasks on the amputated limb, without the prosthesis, the perception of arm length shrank, with a concurrent shift of PPS boundaries towards the stump. Conversely, wearing the prosthesis increased the perceived length of the stump and extended the PPS boundaries so as to include the prosthetic hand, such that the prosthesis partially replaced the missing limb.

Patient-prosthesis mismatch and left ventricular remodelling after implantation of Shelhigh SuperStentless aortic valve prostheses.

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Germing, A; Lindstaedt, M; Holt, S; Reber, D; Mügge, A; Laczkovics, A; Fritz, M

2008-08-01

Aortic valve replacement is a standard procedure for the treatment of severe aortic valve stenosis. Due to lower flow velocities stentless valves are associated with a more effective regression of left ventricular hypertrophy in comparison to stented valves. However, mismatch between body surface area and valve size supports unfavourable hemodynamic results. The aim of the study was to analyze hemodynamic parameters by echocardiography after implantation of the Shelhigh SuperStentless bioprosthesis and to analyze the occurrence of patient-prosthesis mismatch and left ventricular remodelling in this specific valve type. A total of 20 patients with severe aortic stenosis underwent implantation of a Shelhigh Super Stentless prosthesis. Clinical and echocardiographic assessment was done prior to, immediate after and six months after surgery. All surgical procedures were successful, no surgery-related complication was documented perioperatively. One patient died after development of multiorgan failure. Echocardiography during the first eight days after surgery showed mean gradients of 16 mmHg, mean valve orifice areas of 1.8 cm(2) and indexed effective orifice areas at 0.95 cm(2)/m(2). Six-months follow-up data were obtained in 19/20 patients. There were no relevant changes in echocardiographic hemodynamic findings at the time of follow-up measurements. Significant regression of left ventricular hypertrophy was shown (P=0.0088). A patient-prosthesis mismatch occurred in one patient (0.54 cm(2)/m(2)). No recurrent symptoms were documented. Patient-prosthesis mismatch after implantation of SuperStentless Shelhigh prosthesis is rare. A significant regression of left ventricular hypertrophy could be shown after six months. Hemodynamic valve function assessed by echocardiography may be predicted early after surgery.

The Metal-Zirconia Implant Fixed Hybrid Full-Arch Prosthesis: An Alternative Technique for Fabrication.

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Stumpel, Lambert J; Haechler, Walter

2018-03-01

The metal-resin hybrid full-arch prosthesis has been a traditionally used type of restoration for full-arch implant fixed dentures. A newer development has centered around the use of monolithic zirconia or zirconia veneered with porcelain. Being a ceramic, zirconia has the potential for fracture. This article describes a technique that utilizes a metal substructure to support a chemically and mechanically resinbonded shell of zirconia. The workflow is discussed, ranging from in-office master cast fabrication to the CAD/ CAM production of the provisional and the definitive metal-zirconia prosthesis. The article also highlights the advantages and disadvantages of various materials used for hybrid prostheses.

Prevalence of Peri-Implant Mucositis and Peri-Implantitis in Patients Treated with a Combination of Axial and Tilted Implants Supporting a Complete Fixed Denture

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Nicolò Cavalli

2015-01-01

Full Text Available Objectives. The aim of this retrospective study was to assess the incidence and prevalence of peri-implant mucositis and peri-implantitis in patients with a fixed full-arch prosthesis supported by two axial and two tilted implants. Materials and Methods. Sixty-nine patients were included in the study. Each patient received a fixed full-arch prosthesis supported by two mesial axial and two distal tilted implants to rehabilitate the upper arch, the lower arch, or both. Three hundred thirty-six implants for 84 restorations were delivered. Patients were scheduled for follow-up visits every 6 months in the first 2 years and yearly after. At each follow-up visit peri-implant mucositis and peri-implantitis were diagnosed if present. Results. The overall follow-up range was from 12 to 130 months (mean 63,2 months. Three patients presented peri-implantitis. The prevalence of peri-implant mucositis ranged between 0 and 7,14% of patients (5,06% of implants while the prevalence of peri-implantitis varied from 0 to 4,55% of patients (3,81% of implants. Conclusions. The prevalence and incidence of peri-implant mucositis and peri-implantitis are lower than most of the studies in literature. Therefore this kind of rehabilitation could be considered a feasible option, on the condition of adopting a systematic hygienic protocol.

3D Metal Printing - Additive Manufacturing Technologies for Frameworks of Implant-Borne Fixed Dental Prosthesis.

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Revilla León, M; Klemm, I M; García-Arranz, J; Özcan, M

2017-09-01

An edentulous patient was rehabilitated with maxillary metal-ceramic and mandibular metal-resin implant-supported fixed dental prosthesis (FDP). Metal frameworks of the FDPs were fabricated using 3D additive manufacturing technologies utilizing selective laser melting (SLM) and electron beam melting (EBM) processes. Both SLM and EBM technologies were employed in combination with computer numerical control (CNC) post-machining at the implant interface. This report highlights the technical and clinical protocol for fabrication of FDPs using SLM and EBM additive technologies. Copyright© 2017 Dennis Barber Ltd.

New protocol for construction of eyeglasses-supported provisional nasal prosthesis using CAD/CAM techniques.

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Ciocca, Leonardo; Fantini, Massimiliano; De Crescenzio, Francesca; Persiani, Franco; Scotti, Roberto

2010-01-01

A new protocol for making an immediate provisional eyeglasses-supported nasal prosthesis is presented that uses laser scanning, computer-aided design/computer-aided manufacturing procedures, and rapid prototyping techniques, reducing time and costs while increasing the quality of the final product. With this protocol, the eyeglasses were digitized, and the relative position of the nasal prosthesis was planned and evaluated in a virtual environment without any try-in appointment. This innovative method saves time, reduces costs, and restores the patient's aesthetic appearance after a disfiguration caused by ablation of the nasal pyramid better than conventional restoration methods. Moreover, the digital model of the designed nasal epithesis can be used to develop a definitive prosthesis anchored to osseointegrated craniofacial implants.

[Total cervical disk replacement--implant-specific approaches: keel implant (Prodisc-C intervertebral disk prosthesis)].

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Korge, Andreas; Siepe, Christoph J; Heider, Franziska; Mayer, H Michael

2010-11-01

Dynamic intervertebral support of the cervical spine via an anterolateral approach using a modular artificial disk prosthesis with end-plate fixation by central keel fixation. Cervical median or mediolateral disk herniations, symptomatic cervical disk disease (SCDD) with anterior osseous, ligamentous and/or discogenic narrowing of the spinal canal. Cervical fractures, tumors, osteoporosis, arthrogenic neck pain, severe facet degeneration, increased segmental instability, ossification of posterior longitudinal ligament (OPLL), severe osteopenia, acute and chronic systemic, spinal or local infections, systemic and metabolic diseases, known implant allergy, pregnancy, severe adiposity (body mass index > 36 kg/m2), reduced patient compliance, alcohol abuse, drug abuse and dependency. Exposure of the anterior cervical spine using the minimally invasive anterolateral approach. Intervertebral fixation of retainer screws. Intervertebral diskectomy. Segmental distraction with vertebral body retainer and vertebral distractor. Removal of end-plate cartilage. Microscopically assisted decompression of spinal canal. Insertion of trial implant to determine appropriate implant size, height and position. After biplanar image intensifier control, drilling for keel preparation using drill guide and drill bit, keel-cut cleaner to remove bone material from the keel cut, radiologic control of depth of the keel cut using the corresponding position gauge. Implantation of original implant under lateral image intensifier control. Removal of implant inserter. Functional postoperative care and mobilization without external support, brace not used routinely, soft brace possible for 14 days due to postoperative pain syndromes. Implantation of 100 cervical Prodisc-C disk prostheses in 78 patients (average age 48 years) at a single center. Clinical and radiologic follow-up 24 months postoperatively. Significant improvement based on visual analog scale and Neck Disability Index. Radiologic

Bar versus ball attachments for implant-supported overdentures in complete edentulism: A systematic review.

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Anas El-Wegoud, Marwah; Fayyad, Ahmed; Kaddah, Amal; Nabhan, Ashraf

2018-04-01

Implant-supported overdenture is one of the most predictable treatment options used in complete edentulism. However, differences have been reported between bar and ball attachments used to retain overdentures in terms of patient satisfaction and prosthesis retention. The purpose of this study is to compare the effectiveness of bar and ball attachments for conventionally loaded implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention. We conducted the review according to the Cochrane methods and following MECIR standards. We searched Cochrane Oral Health Group Trial register, Cochrane Central Register of Controlled Trials, MEDLINE, and the WHO ICTRP (March 31, 2017). Two review authors assessed trials for inclusion and risk of bias, extracted data, and checked for accuracy. We have expressed results as risk ratio or mean differences, together with their 95% confidence intervals. We included 10 trials (465 participants). After 5 y, one trial reported higher patient satisfaction when bar attachment was used (MD 1.30, 95% CI 0.20-2.40), and reported no difference between both systems in prosthesis retention (MD -0.90, 95% CI -1.90 to 0.10). Two trials reported no implant failures after 1 and 5 y in both attachments. Downgrading of evidence was based on the unclear risk of bias of included studies and the wide CI crossing the line of no effect. There is insufficient evidence to support bar or ball attachment to be used with implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention (PROSPERO 2014:CRD42014014594). © 2017 Wiley Periodicals, Inc.

Effect of implant number and distribution on load transfer in implant-supported partial fixed dental prostheses for the anterior maxilla: A photoelastic stress analysis study.

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Lee, Jae-In; Lee, Yoon; Kim, Yu-Lee; Cho, Hye-Won

2016-02-01

The 4-, 3- or even 2-implant-supported partial fixed dental prosthesis (PFDP) designs have been used to rehabilitate the anterior edentulous maxilla. The purpose of this in vitro study was to compare the stress distribution in the supporting tissues surrounding implants placed in the anterior maxilla with 5 PFDP designs. A photoelastic model of the human maxilla with an anterior edentulous region was made with photoelastic resin (PL-2; Vishay Micro-Measurements), and 6 straight implants (OsseoSpeed; Astra Tech AB) were placed in the 6 anterior tooth positions. The 5 design concepts based on implant location were as follows: model 6I: 6 implants; model 2C2CI: 4 implants (2 canines and 2 central incisors); model 2C2LI: 4 implants (2 canines and 2 lateral incisors); model 2C1CI: 3 implants (2 canines and 1 central incisor); and model 2C: 2 canines. A load of 127.4 N was applied on the cingulum of 3 teeth at a 30-degree angle to the long axis of the implant. Stresses that developed in the supporting structure were recorded photographically. The 6-implant-supported PFDP exhibited the most even and lowest distribution of stresses in all loading conditions. When the canine was loaded, the 2- or 3-implant-supported PFDP showed higher stresses around the implant at the canine position than did the 4- or 6-implant-supported PFDP. When the central incisor or lateral incisor was loaded, the two 4-implant-supported PFDPs exhibited similar levels of stresses around the implants and showed lower stresses than did the 2- or 3-implant-supported PFDP. Implant number and distribution influenced stress distribution around the implants in the anterior maxilla. With a decrease in implant number, the stresses around the implants increased. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA.

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Qamheya, Ala Hassan A; Yeniyol, Sinem; Arısan, Volkan

2015-01-01

Many people have life-long problems with their dentures, such as difficulties with speaking and eating, loose denture, and sore mouth syndrome. The evolution of dental implant supported prosthesis gives these patients normal healthy life for their functional and esthetic advantages. This case report presents the fabrication of maxillary implant supported hybrid prosthesis by using Nanofilled Composite (NFC) material in teeth construction to rehabilitate a complete denture wearer patient.

Complications and Clinical Considerations of the Implant-Retained Zirconia Complete-Arch Prosthesis with Various Opposing Dentitions.

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Gonzalez, Jorge; Triplett, Robert G

To evaluate the performance of the implant-retained zirconia complete-arch prosthesis with various opposing dentitions. The 40 patients included in this retrospective case series study were treated with one or two implant-retained zirconia complete-arch prostheses (ZIRCAP) using the Zirkonzahn protocol. Prettau zirconia frames were created with strategic cutbacks in the structure to extend zirconia incisal coverage of the esthetic anterior sextants and complete monolithic zirconia in the molar areas; subsequent layers of porcelain were applied to nonfunctional and esthetic areas. Patients had three possible occlusal scenarios: (1) maxillary ZIRCAP and mandibular ZIRCAP, (2) maxillary ZIRCAP and mandibular natural dentition, and (3) maxillary ZIRCAP and mandibular conventional hybrid prosthesis. Complications were recorded during follow-up appointments 3, 6, and 12 months after definitive prosthesis delivery. The mean treatment observation period was 33 months. Eight prosthetic complications were noted for the 40 implant-retained zirconia complete-arch prostheses (18.18%), including six cases of minor porcelain chipping and two cases of debonding of the metal insert from the zirconia framework. Maxillary ZIRCAP opposing mandibular ZIRCAP and maxillary ZIRCAP opposing mandibular natural dentition occlusal scenarios presented the same complication ratio of 4. No complications were seen in the maxillary ZIRCAP opposing mandibular conventional hybrid prosthesis group, yet 16 complications were found as denture tooth fractures in 12 mandibular conventional hybrid prostheses (ratio of 0.75). The results indicate that the implant-retained zirconia complete-arch prosthesis offers acceptable performance for use as an alternative to the conventional titanium framework acrylic veneer prosthesis for complete edentulism with a lower incidence of prosthetic complications and fewer maintenance appointments. Chipping of veneering porcelain was the most common complication, but a

An animal model to evaluate skin-implant-bone integration and gait with a prosthesis directly attached to the residual limb.

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Farrell, Brad J; Prilutsky, Boris I; Kistenberg, Robert S; Dalton, John F; Pitkin, Mark

2014-03-01

Despite the number of advantages of bone-anchored prostheses, their use in patients is limited due to the lack of complete skin-implant integration. The objective of the present study was to develop an animal model that would permit both detailed investigations of gait with a bone-anchored limb prosthesis and histological analysis of the skin-implant-bone interface after physiological loading of the implant during standing and walking. Full-body mechanics of walking in two cats were recorded and analyzed before and after implantation of a percutaneous porous titanium pylon into the right tibia and attachment of a prosthesis. The rehabilitation procedures included initial limb casting, progressively increasing loading on the implant, and standing and locomotor training. Detailed histological analysis of bone and skin ingrowth into implant was performed at the end of the study. The two animals adopted the bone-anchored prosthesis for standing and locomotion, although loads on the prosthetic limb during walking decreased by 22% and 62%, respectively, 4months after implantation. The animals shifted body weight to the contralateral side and increased propulsion forces by the contralateral hindlimb. Histological analysis of the limb implants demonstrated bone and skin ingrowth. The developed animal model to study prosthetic gait and tissue integration with the implant demonstrated that porous titanium implants may permit bone and skin integration and prosthetic gait with a bone-anchored prosthesis. Future studies with this model will help optimize the implant and prosthesis properties. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Study of satisfaction of testicular prosthesis implantation in children].

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Martínez, Y; Millán, A; Gilabert, R; Delgado, L; De Agustín, J C

2012-01-01

Testicular absence may cause psychological trauma in children. It can be avoided by placing testicular prosthesis (TP). However there is no consensus on the optimal age of implantation. We evaluate the results of TP implantation and their complications, as well as patient and family satisfaction. This is a retrospective study of TP implanted between 2004-2010 in our center. Variables analyzed are: age, size and side, indication, surgical technique, complications and comorbidity. Telephone survey was done by a single interviewer to 50 families. general family satisfaction, characteristics of the prosthesis (size, shape, location and consistency), body image and psychological situation of the child, duration of analgesia after surgery, reoperation rate, and family advice to other parents. Statistical analysis with SPSS-18.0. 107 prostheses were placed (4 bilateral, 64 left and 35 rights) at a mean age of 70,10 +/- 58,6 months. The most common indication was cryptorchidism (48.2%). Initial inguinal approach in 69%, and simultaneous contralateral orchidopexy in 29.9%. Only one patient refused the prostheses. In 71% the mother was interviewed. Parents consider size, shape and position appropriate in 55.6%, 66.7% and 82.22% respectively. Hard consistency of TP was considered in 82.3% of the patients. Psychological problems were absent in 86.7%. Nighty five percent would be willing to replace when it was necessary. Parents would recommend the intervention to parents in the same situation in 86.7%. Testicular prosthesis avoids psychological trauma. The lack of satisfaction regarding to the small size and hardness makes necessary to replace the TP in adulthood. An open question remains whether we should consider the placement of TP in early ages, or if we should establish some indications based on a more rational communication with the family.

Zinc phosphate as a definitive cement for implant-supported crowns and fixed dentures

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Flanagan D

2017-11-01

Full Text Available Dennis Flanagan Private Practice, Willimantic, CT, USA Abstract: Implant-supported dental prostheses can be retained by a screw or cement. Implant-supported fixed partial dentures have a passive fit. A passive fit means there is an internal gap between the abutment surface and the intaglio of the retainer to insure that there is no lateral pressure on the supporting implants or friction upon seating of the prosthesis. This gap is filled with cement for retention of the prosthesis. Any lateral pressure may cause marginal bone loss or periimplantitis. Also, there is usually a microscopic gap at the margin of a crown retainer that exposes the cement to oral fluids. The solubility of zinc phosphate (ZOP cement is a definite liability due to the risk for cement dissolution. In fixed prostheses, the dissolution of the cement of one or more retainers would cause a transfer of the occlusal load to the retained unit(s. The resulting rotation and lifting of the cement-retained implants from occlusal and parafunctional loads could cause loss of osseointegration of the abutment-retained implant(s. ZOP cement may not be indicated for implant-supported fixed partial dentures or splints. Cement dissolution in single unit probably only involves re-cementation, if the patient does not swallow or aspirate the crown. Keywords: passive fit, retention, film thickness, fixed, marginal gap 

Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA

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Ala Hassan A. Qamheya

2015-01-01

Full Text Available Many people have life-long problems with their dentures, such as difficulties with speaking and eating, loose denture, and sore mouth syndrome. The evolution of dental implant supported prosthesis gives these patients normal healthy life for their functional and esthetic advantages. This case report presents the fabrication of maxillary implant supported hybrid prosthesis by using Nanofilled Composite (NFC material in teeth construction to rehabilitate a complete denture wearer patient.

Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation.

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Wenger, Markus; Markwalder, Thomas-Marc

2016-04-01

This case report presents a 37-year-old man with clinical signs of myelopathy almost 9 years after implantation of a Bryan disc prosthesis (Medtronic Sofamor Danek, Memphis, TN, USA) for C5/C6 soft disc herniation. As demonstrated on MRI and CT scan, spinal cord compression was caused by bony spurs due to heterotopic ossification posterior to the still moving prosthesis. The device, as well as the ectopic bone deposits, had to be removed because of myelopathy and its imminent aggravation. Conversion to anterior spondylodesis was performed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neuromuscular coordination of masticatory muscles in subjects with two types of implant-supported prostheses.

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Ferrario, Virgilio F; Tartaglia, Gianluca M; Maglione, Michele; Simion, Massimo; Sforza, Chiarella

2004-04-01

To compare the electromyographic (EMG) characteristics of masticatory muscles in patients with fixed implant-supported prostheses and implant overdentures. Nineteen subjects aged 45-79 years were examined. Fourteen were edentulous and had been successfully rehabilitated with (a) maxillary and mandibular implant-supported fixed prostheses (seven patients); (b) mandibular implant overdentures and maxillary complete dentures (seven patients). Five control subjects had natural dentition or single/partial (no more than two teeth) tooth or implant fixed dentures. Surface EMG of the masseter and temporal muscles was performed during unilateral gum chewing and during maximum teeth clenching. To reduce biological and instrumental noise, all values were standardized as percentage of a maximum clenching on cotton rolls. During clenching, temporal muscle symmetry was larger in control subjects and fixed implant-supported prosthesis patients than in overdenture patients (analysis of variance, P=0.005). No differences were found in masseter muscle symmetry or in muscular torque. Muscle activities (integrated areas of the EMG potentials over time) were significantly larger in control subjects than in implant-supported prosthesis patients (P=0.014). In both patient groups, a poor neuromuscular coordination during chewing, with altered muscular patterns, and a smaller left-right symmetry than in control subjects were found (P=0.05). No differences in masticatory frequency were found. Surface EMG analysis of clenching and chewing showed that fixed implant-supported prostheses and implant overdentures were functionally equivalent. Neuromuscular coordination during chewing was inferior to that found in subjects with natural dentition.

Titanium Implant Impairment and Surrounding Muscle Cell Death Following High-Salt Diet: An In Vivo Study.

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Mathieu Lecocq

Full Text Available High-salt consumption has been widely described as a risk factor for cardiovascular, renal and bone functions. In the present study, the extent to which high-salt diet could influence Ti6Al4V implant surface characteristic, its adhesion to rat tibial crest, and could modify muscle cell viability of two surrounding muscles, was investigated in vivo. These parameters have also been assessed following a NMES (neuro-myoelectrostimulation program similar to that currently used in human care following arthroplasty.After a three-week diet, a harmful effect on titanium implant surface and muscle cell viability was noted. This is probably due to salt corrosive effect on metal and then release of toxic substance around biologic tissue. Moreover, if the use of NMES with high-salt diet induced muscles damages, the latter were higher when implant was added. Unexpectedly, higher implant-to-bone adhesion was found for implanted animals receiving salt supplementation.Our in vivo study highlights the potential dangerous effect of high-salt diet in arthroplasty based on titanium prosthesis. This effect appears to be more important when high-salt diet is combined with NMES.

Prosthesis-guided implant restoration of an auricular defect using computed tomography and 3-dimensional photographic imaging technologies: a clinical report.

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Wang, Shuming; Leng, Xu; Zheng, Yaqi; Zhang, Dapeng; Wu, Guofeng

2015-02-01

The concept of prosthesis-guided implantation has been widely accepted for intraoral implant placement, although clinicians do not fully appreciate its use for facial defect restoration. In this clinical report, multiple digital technologies were used to restore a facial defect with prosthesis-guided implantation. A simulation surgery was performed to remove the residual auricular tissue and to ensure the correct position of the mirrored contralateral ear model. The combined application of computed tomography and 3-dimensional photography preserved the position of the mirrored model and facilitated the definitive implant-retained auricular prosthesis. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Penile prosthesis implant with bi-triangular excision and graft for surgical therapy of Peyronie’s disease: A case report

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Alexandre de Freitas Miranda

2016-01-01

Full Text Available We present a case of a 65-year-old man, who presented with moderate erectile dysfunction and a dorsal penile deviation of 60° caused by Peyronie’s disease. The patient underwent bi-triangularshaped plaque excision, followed by grafting and implantation of inflatable penile prosthesis. Complete penile straightening, without mechanical or geometric abnormalities, was achieved using bi-triangular excision and grafting. Postoperatively, the patient reported high satisfaction with the results and could perform sexual intercourse naturally. This novel technique corrects any degree of penile curvature, permits malleable and semi-rigid penile prosthesis implantation, avoids penile length loss, and eliminates additional incisions. To our knowledge, this case is the first in the literature in which the bi-triangular technique was successfully used for penile prosthesis implantation secondary to Peyronie’s disease. This new technique appears to be a good solution to correct penile curvature during penile prosthesis implantation for the treatment of Peyronie’s disease associated with erectile dysfunction.

Implant support for removable partial overdentures: a case report.

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Halterman, S M; Rivers, J A; Keith, J D; Nelson, D R

1999-01-01

Functional stability and the preservation of remaining alveolar bone are primary, and often elusive, goals when restoring the partially edentulous arch. The incorporation of dental implants for the partial support of removable prostheses offers a practical adjunct in the fulfillment of these objectives. Planning for complex courses of treatment that include dental implants requires close coordination between the surgeon and the restorative dentist. Decisions that deal with type, location, size, number of implant fixtures, and design of the prosthesis are critical. All of these areas must be discussed and established as acceptable to the patient and each clinician before the initiation of treatment. In this report, we present a course of patient treatment in which a removable partial denture is supported by natural remaining teeth in conjunction with osseointegrated implants.

Penile prosthesis implantation in Chinese patients with severe erectile dysfunction: 10-year experience

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Song, Wei-Dong; Yuan, Yi-Ming; Cui, Wan-Shou; Wu, Alex K; Zhu, Yi-Chen; Liu, Jing; Wang, Lin; Bai, Guang-Yi; Peng, Jing; Zhang, Zhi-Chao; Gao, Bing; Guo, Ying-Lu; Lue, Tom F; Xin, Zhong-Cheng

2013-01-01

We retrospectively evaluated the clinical outcome of penile prosthesis implantation (PPI) in Chinese patients with severe erectile dysfunction (SED). From July 2000 to December 2011, 224 patients (mean age: 35.9±11.8 years, range: 20–75 years) with SED underwent PPI by experienced surgeon according to standard PPI procedure at our centre. A malleable prosthesis (AMS 650) was implanted in 45 cases (20.1%), and a three-piece inflatable prosthesis (AMS 700 CXM or AMS 700 CXR) was implanted in 179 cases (79.9%). Surgical outcomes, including postoperative complications, clinical efficacy and couple satisfaction, were evaluated over than 6 months postoperatively using medical record abstraction, IIEF-5, quality of life (QoL) scores, and the patient/partner sexual satisfaction score proposed by Bhojwani et al. Of the 224 patients eligible for the study, 201 subjects (89.7%) completed follow-up. All of patients could perform sexual intercourse post PPI with the mean postoperative IIEF-5 and QoL scores were 20.02±2.32 and 5.28±0.76, respectively, which were significantly improved compared with the preoperative scores (6.29±1.5 and 2.13±0.84, Preported by 178 men (88.6%), and overall satisfaction with the PPI surgery was reported by 89.0% of men and 82.5% of partners. Patient satisfaction in the three-piece inflatable prosthesis group was higher than in the malleable prosthesis group (P<0.05). Satisfaction, however, between the types of prostheses, did not differ in the partner survey. PPI is a safe and effective treatment option for Chinese patients with SED and experienced surgeon perform PPI according to standard PPI procedure could reduce the postoperative complications of PPI and could improve patient satisfaction ratio and QoL. PMID:23872664

Dual jaw treatment of edentulism using implant-supported monolithic zirconia fixed prostheses.

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Altarawneh, Sandra; Limmer, Bryan; Reside, Glenn J; Cooper, Lyndon

2015-01-01

This case report describes restoration of the edentulous maxilla and mandible with implant supported fixed prostheses using monolithic zirconia, where the incisal edges and occluding surfaces were made of monolithic zirconia. Edentulism is a debilitating condition that can be treated with either a removable or fixed dental prosthesis. The most common type of implant-supported fixed prosthesis is the metal acrylic (hybrid), with ceramo-metal prostheses being used less commonly in complete edentulism. However, both of these prostheses designs are associated with reported complications of screw loosening or fracture and chipping of acrylic resin and porcelain. Monolithic zirconia implant-supported fixed prostheses have the potential for reduction of such complications. In this case, the CAD/CAM concept was utilized in fabrication of maxillary and mandibular screw-retained implant-supported fixed prostheses using monolithic zirconia. Proper treatment planning and execution coupled with utilizing advanced technologies contributes to highly esthetic results. However, long-term studies are required to guarantee a satisfactory long-term outcome of this modality of treatment. This case report describes the clinical and technical procedures involved in fabrication of maxillary and mandibular implant-supported fixed prostheses using monolithic zirconia as a treatment of edentulism, and proposes the possible advantages associated with using monolithic zirconia in eliminating dissimilar interfaces in such prostheses that are accountable for the most commonly occurring technical complication for these prostheses being chipping and fracture of the veneering material. © 2015 Wiley Periodicals, Inc.

Prosthetic rehabilitation with an implant-supported fixed prosthesis using computer-aided design and computer-aided manufacturing dental technology for a patient with a mandibulectomy: A clinical report.

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Yoon, Hyung-In; Han, Jung-Suk

2016-02-01

The fabrication of dental prostheses with computer-aided design and computer-aided manufacturing shows acceptable marginal fits and favorable treatment outcomes. This clinical report describes the management of a patient who had undergone a mandibulectomy and received an implant-supported fixed prosthesis by using additive manufacturing for the framework and subtractive manufacturing for the monolithic zirconia restorations. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Technique for systematic bone reduction for fixed implant-supported prosthesis in the edentulous maxilla.

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Bidra, Avinash S

2015-06-01

Bone reduction for maxillary fixed implant-supported prosthodontic treatment is often necessary to either gain prosthetic space or to conceal the prosthesis-tissue junction in patients with excessive gingival display (gummy smile). Inadequate bone reduction is often a cause of prosthetic failure due to material fractures, poor esthetics, or inability to perform oral hygiene procedures due to unfavorable ridge lap prosthetic contours. Various instruments and techniques are available for bone reduction. It would be helpful to have an accurate and efficient method for bone reduction at the time of surgery and subsequently create a smooth bony platform. This article presents a straightforward technique for systematic bone reduction by transferring the patient's maximum smile line, recorded clinically, to a clear radiographic smile guide for treatment planning using cone beam computed tomography (CBCT). The patient's smile line and the amount of required bone reduction are transferred clinically by marking bone with a sterile stationery graphite wood pencil at the time of surgery. This technique can help clinicians to accurately achieve the desired bone reduction during surgery, and provide confidence that the diagnostic and treatment planning goals have been achieved. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Immediately loaded implants supporting fixed prostheses in the edentulous maxilla: a preliminary clinical and radiologic report.

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Bergkvist, Göran; Sahlholm, Sten; Karlsson, Ulf; Nilner, Krister; Lindh, Christina

2005-01-01

To evaluate the survival rate of immediately loaded ITI sand-blasted, large-grit, acid-etched (SLA) solid-screw dental implants in the edentulous maxilla after 8 months of loading. Twenty-eight patients (mean age 63 years) with edentulous maxillae each received 6 implants and 1 implant-supported fixed provisional prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patient received a definitive, screw-retained, implant-supported fixed prosthesis. A total of 168 implants were placed. Clinical parameters were registered after 1 month of loading with the implant-supported fixed prostheses as well as 8 months after implant placement. Radiologic examinations and assessments were made at implant placement and after 8 months. The mean marginal bone level at implant placement was 1.6 mm (range 0 to 5.1; SD 1.1) apical of the reference point (the implant shoulder). The mean marginal bone level at the 8-month follow-up was 3.2 mm (range 0.4 to 5.9; SD 1.1) apical of the reference point. Three implants failed during the healing period. The improved results in the present study might be a result of the positive effect of splinting the implants immediately after placement. ITI SLA solid-screw implants immediately loaded (ie, loaded within 24 hours of placement) and supporting fixed prostheses had successful survival rates after 8 months. The present results constitute a solid baseline for future follow-up studies.

Tubing erosion of an inflatable penile prosthesis long after implantation.

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Morales, Alvaro

2014-06-01

Erosion through skin of connecting tubing of an inflatable penile prosthesis (IPP) has not been previously reported. The aim of this study was to present a case of tubing erosion, review the pertinent literature, and discuss the possible causes and management options, including preservation of the device and its components. A 42-year-old male failing to respond to medical treatment for erectile dysfunction underwent insertion of an AMS 700 IPP in 1986. Six years later, a revision was necessary because of a leak in the right cylinder and 4 years after, the pump was replaced. Fourteen years after the original implant, he presented with a portion of the tube connecting the pump to the right cylinder eroding through the skin. There was no infection. The skin area involved was resected and the original pump and tubing were buried in a new scrotal pocket after thorough irrigation. The IPP remained in place, allowing vaginal penetration and without infection for another 11 years. Three years later, it was de-functionalized, converted into a fixed volume device. It eventually was replaced 25 years after originally implanted with a semirigid prosthesis because it did not provide sufficient rigidity and because of concerns about the presence of "screws" detected during pelvic imaging. Mechanical failures in the early IPP models, as illustrated in this case, were expected. However, the long survival of the device is remarkable. Erosion of the connecting tubing through the skin is unique and, under exceptional circumstances, may be managed conservatively without replacing components of the IPP. Clinicians unfamiliar with procedures involving inflatable devices need to be aware of "foreign bodies" visible in radiological examinations in men who have had revisions of an IPP. Morales A. Tubing erosion of an inflatable penile prosthesis long after implantation. Sex Med 2014;2:103-106.

The role of prosthetic abutment material on the stress distribution in a maxillary single implant-supported fixed prosthesis

International Nuclear Information System (INIS)

Peixoto, Hugo Eduardo; Bordin, Dimorvan; Del Bel Cury, Altair A.; Silva, Wander José da; Faot, Fernanda

2016-01-01

Purpose: Evaluate the influence of abutment's material and geometry on stress distribution in a single implant-supported prosthesis. Materials and Methods: Three-dimensional models were made based on tomographic slices of the upper middle incisor area, in which a morse taper implant was positioned and a titanium (Ti) or zirconia (ZrN) universal abutments was installed. The commercially available geometry of titanium (T) and zirconia (Z) abutments were used to draw two models, TM1 and ZM1 respectively, which served as control groups. These models were compared with 2 experimental groups were the mechanical properties of Z were applied to the titanium abutment (TM2) and vice versa for the zirconia abutment (ZM2). Subsequently, loading was simulated in two steps, starting with a preload phase, calculated with the respective friction coefficients of each materials, followed by a combined preload and chewing force. The maximum von Mises stress was described. Data were analyzed by two-way ANOVA that considered material composition, geometry and loading (p 0.05). Conclusion: The screw was the piece most intensely affected, mainly through the preload force, independent of the abutment's material. - Highlights: • The abutment's screw was the most impaired piece of the dental implant system. • The highest stress was located at first thread of the abutment's screw. • The preload is the main factor in the abutment's screw stress. • Abutment configuration and material can have a positive contribution for the stress distribution

Cross-pinning: the philosophy of retrievability applied practically to fixed, implant-supported prostheses.

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Gervais, M J; Hatzipanagiotis, P; Wilson, P R

2008-03-01

Biologic and technical complications are widely reported in the dental literature and often compromise the functional and/or aesthetic features of fixed, implant-supported prostheses. Managing complications without damaging or destroying a restoration is an obvious advantage of implant-based dentistry where the option of prosthetic retrievability is almost always available. The technique of cross-pinning uses a transverse screw to secure a prosthesis to a milled implant abutment, allowing prosthetic retrievability irrespective of dental implant alignment. This study presents guidelines for cross-pinning implant-supported prostheses based on resistance form, screw mechanics and natural tooth contours. The technical aspects of cross-pinning are also discussed using examples from four implant systems.

Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation.

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Anele, Uzoma A; Le, Brian V; Burnett, Arthur L

2014-12-01

Urethral injury is an uncommon surgical complication of penile prosthesis (PP) surgery. Conventional dogma requires abortion of the procedure if the adjacent corporal body is involved or delayed implantation to avert device infection associated with urinary extravasation. Besides the setback of the aborted surgery, this management approach also presents the possible difficulty of encountering corporal fibrosis at the time of reoperation. We report an approach using primary urethral repair and temporary suprapubic cystostomy for the management of incidental urethral injuries in a cohort of patients allowing for successful completion of unaborted PP implantation. We performed a retrospective analysis of all patients receiving PPs from 1990 to 2014 in which incidental urethral injuries were repaired and PP implantation was completed with suprapubic cystostomy (suprapubic tube [SPT] insertion). After allowing for urethral healing and urinary diversion via SPT for 4-8 weeks, the PP was activated. Successful management was determined by the absence of perioperative complications within 6 months of implantation. We identified four cases, all receiving inflatable PPs, managed with temporary suprapubic cystostomy. These patients sustained urethral injuries during corporal dissection (one patient), corporal dilation (one patient), and penile straightening (two patients). All patients were managed safely and successfully. Primary urethral repair followed by temporary suprapubic cystostomy offers a surgical approach to complete PP implantation successfully in patients who sustain urethral injury complications, particularly for complex PP surgeries. Anele UA, Le BV, and Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation.

The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis.

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Chun, June Sang; Har, Alix; Lim, Hyun-Pil; Lim, Hoi-Jeong

2016-02-01

This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10(th) year after the treatment, and more cost-effective regardless of the WTP from 20(th) year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10(th) year after the prosthodontic treatment, more than 35,000 won at the 20(th) year after prosthodontic treatment. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10(th) year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.

Using individual two-posterior short implants with two-anterior standard implants in mandibular implant-supported-overdenture to enhance the patient satisfaction: A clinical report

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Mehran Bahrami

2017-01-01

Full Text Available Introduction: Many clinical cases and the literature review have revealed implant-supported-overdentures’ (ISOs treatment success and predictability in elderly patients. According to the previous studies, all the mandibular ISOs used 2–4 implants anterior to mental foramen to retain the denture. Case Report: In this clinical report, two individual anterior standard implants and two individual posterior short implants were used to support the mandibular ISO, as well as to prevent further posterior bone resorption. This treatment option permits the patient to insert more implants in the future, and could be upgraded to implant-supported-fixed prosthesis. Discussion: The patient was completely satisfied about the final result, especially for upgrading the mastication efficiency. The patient was followed-up for more than 2 years without complication. The panoramic X-ray showed the preserved bone in the posterior region. This technique could be considered to be innovative, and more clinical cases are required to be documented as a predictable modality.

Bone density around the fixture after function of implant molar prosthesis using CBCT

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Jung, Jae Hyun; Hwang, In Taik; Jung, Byung Hyun; Kim, Jae Duk; Kang, Dong Wan [School of Dentistry, Oral Biology Research Institute, Chosun University, Gwangju (Korea, Republic of)

2010-03-15

The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0TM, and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.

Comparison of three-implant-supported fixed dentures and two-implant-retained overdentures in the edentulous mandible: a pilot study of treatment efficacy and patient satisfaction.

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De Kok, Ingeborg J; Chang, Kuang-Han; Lu, Tsui-Shan; Cooper, Lyndon F

2011-01-01

The mandibular two-implant overdenture has been shown to be a highly successful treatment. However, overdenture patients who desire a fixed prosthesis may not be satisfied with a removable overdenture. This prospective study sought to compare prosthetic outcomes, patient satisfaction, and survival rates of implants between two-implant-supported overdentures (IODs) and three-implant-supported fixed dentures (ISFDs). Twenty completely edentulous patients were randomly and equally assigned to two groups. New conventional complete dentures were made, and the mandibular denture was used as a surgical guide during implant placement. Implants were placed in one stage, followed by a mandibular denture soft reline (provisional loading). Ball attachments were inserted at 8 weeks, and ISFDs were delivered at 16 weeks. IODs were connected to the attachments at 8 weeks, using each patients's existing denture. The definitive ISFDs were fabricated using computer-aided design/computer-assisted manufacture milled titanium frameworks and acrylic resin base and teeth. Patient satisfaction and panoramic radiographs were investigated at 6 and 12 months. Both treatments had significant and positive effects on patient satisfaction and quality of life. None of the 50 implants placed had failed at 12 months of follow-up; therefore, the implant survival rate was 100%. Prosthetic complications were generally rare and easily manageable. Both the treatment modalities-the ISFD supported by three implants and the IOD supported by two implants-significantly and similarly improved patient satisfaction and oral health-related quality of life, and prosthetic complications were relatively rare for both treatments. Three implants can be used to support a mandibular fixed prosthesis; however, a longer observation period is needed to validate this treatment modality.

The psychosocial benefits of secondary hydroxyapatite orbital implant insertion and prosthesis wearing for patients with anophthalmia.

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Wang, Junming; Zhang, Hong; Chen, Wei; Li, Guigang

2012-01-01

Anophthalmia is associated with a range of psychosocial difficulties and hydroxyapatite orbital implant insertion and prosthesis wearing is the predominant rehabilitation therapy for anophthalmia. However, few articles have compared preoperative and postoperative psychosocial outcomes using standardized questionnaires. This study aimed to investigate the psychosocial benefits of hydroxyapatite orbital implant insertion and prosthesis wearing in this patient population. In all, 36 participants were tested preoperatively and 6-months postoperatively using standardized measures of anxiety and depression (Hospital Anxiety and Depression Scale), social anxiety and social avoidance (Derriford Appearance Scale-Short Form), and quality of life (World Health Organization Quality of Life Scale-Short Form). Before treatment, levels of depression were comparable with population norms; however, levels of general anxiety were slightly raised, levels of social anxiety, social avoidance, and quality of life were significantly poorer than population norms. Treatment resulted in significant improvement in psychosocial adjustment with improvements in all study variables for the participant group as a whole. Hydroxyapatite orbital implant insertion and prosthesis wearing offers significant improvements in psychological and physical functioning for patients with anophthalmia.

Stent valve implantation in conventional redo aortic valve surgery to prevent patient-prosthesis mismatch.

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Ferrari, Enrico; Franciosi, Giorgio; Clivio, Sara; Faletra, Francesco; Moccetti, Marco; Moccetti, Tiziano; Pedrazzini, Giovanni; Demertzis, Stefanos

2017-03-01

The goal was to show the technical details, feasibility and clinical results of balloon-expandable stent valve implantation in the aortic position during conventional redo open-heart surgery in selected obese patients with a small aortic prosthesis and severe patient-prosthesis mismatch. Two symptomatic overweight patients (body mass index of 31 and 38), each with a small aortic prosthesis (a 4-year-old, 21-mm Hancock II biological valve and a 29-year-old, 23-mm Duromedic mechanical valve), increased transvalvular gradients (59/31 and 74/44 mmHg) and a reduced indexed effective orifice area (0.50 and 0.43 cm 2 /m 2 ) underwent implantation of two 26-mm balloon-expandable Sapien 3 valves during standard on-pump redo valve surgery. Using full re-sternotomy, cardiopulmonary bypass and cardioplegic arrest, the two balloon-expandable stent valves were implanted under direct view using a standard aortotomy, after prosthesis removal and without annulus enlargement. Aortic cross-clamp times were 162 and 126 min; cardiopulmonary bypass times were 178 and 180 min; total surgical times were 360 and 318 min. At discharge, echocardiograms showed transvalvular peak and mean gradients of 13/9 and 23/13 mmHg and indexed effective orifice areas of 0.64 and 1.08 cm 2 /m 2 . The 3-month echocardiographic follow-up showed transvalvular peak and mean gradients of 18/9 and 19/11 mmHg and indexed effective orifice areas of 0.78 cm 2 /m 2 and 0.84 cm 2 /m 2 , with improved symptoms (New York Heart Association class 1). Implantation of a balloon-expandable stent valve during redo aortic valve surgery is feasible in selected cases and prevents patient-prosthesis mismatch in obese patients without need for aortic annulus enlargement. Moreover, in the case of stent valve degeneration, this approach permits additional valve-in-valve procedures with large stent valves and prevents re-redo surgery. © The Author 2016. Published by Oxford University Press on behalf of the

A novel knee prosthesis model of implant-related osteo- myelitis in rats

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Søe, Niels H.; Jensen, Nina Vendel; Nürnberg, Birgit Meinecke

2012-01-01

There have been numerous reports of animal models of osteomyelitis. Very few of these have been prosthesis models that imitate human conditions. We have developed a new rat model of implant-related osteomyelitis that mimics human osteomyelitis, to investigate the pathology of infection after...

Implant retained auricular prosthesis with a modified hader bar: a case report.

Science.gov (United States)

Lovely, M; Dathan, Pradeep C; Gopal, Dinesh; George, Biji Thomas; Chandrasekharan Nair, K

2014-06-01

Auricular prostheses for defects of external ear are retained either by mechanical means or implants. All implant retained prostheses are retained by various means such as bar and clip, magnetic attachments or a combination of bar, clip and magnets. The commonest problem encountered with the bar and clip system is loosening of the clip after 3-4 months. When magnets are used as retaining component they tend to corrode over a period of time. So various alternative retention methods which possess good retentive qualities, ease of reparability and patient friendly were tried. In the present case a newly modified Hader bar design which can act as an additional retentive feature apart from the clip is employed to increase retention. The major advantages in the modified Hader bar system were that only two implants were employed, the additional loops in the Hader bar prevented micro movements and the retentive acrylic locks were easy to repair if broken. The modified Hader bar has anti-rotational slots which prevents the sliding or rotation of the prosthesis which gave new confidence to the patient who was otherwise worried of inadvertent displacement of the ear prosthesis while playing.

The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis

Directory of Open Access Journals (Sweden)

Clifford AG

2013-05-01

Full Text Available Anton G Clifford,1 Stefan M Gabriel,1 Mary O’Connell,1 David Lowe,1 Larry E Miller,2,3 Jon E Block31Moximed, Inc, Hayward, CA, USA; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USAAbstract: Symptomatic medial compartment knee osteoarthritis (OA is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA.Keywords: KineSpring, knee, medial, osteoarthritis, prosthesis

Sequential provisional implant prosthodontics therapy.

Science.gov (United States)

Zinner, Ira D; Markovits, Stanley; Jansen, Curtis E; Reid, Patrick E; Schnader, Yale E; Shapiro, Herbert J

2012-01-01

The fabrication and long-term use of first- and second-stage provisional implant prostheses is critical to create a favorable prognosis for function and esthetics of a fixed-implant supported prosthesis. The fixed metal and acrylic resin cemented first-stage prosthesis, as reviewed in Part I, is needed for prevention of adjacent and opposing tooth movement, pressure on the implant site as well as protection to avoid micromovement of the freshly placed implant body. The second-stage prosthesis, reviewed in Part II, should be used following implant uncovering and abutment installation. The patient wears this provisional prosthesis until maturation of the bone and healing of soft tissues. The second-stage provisional prosthesis is also a fail-safe mechanism for possible early implant failures and also can be used with late failures and/or for the necessity to repair the definitive prosthesis. In addition, the screw-retained provisional prosthesis is used if and when an implant requires removal or other implants are to be placed as in a sequential approach. The creation and use of both first- and second-stage provisional prostheses involve a restorative dentist, dental technician, surgeon, and patient to work as a team. If the dentist alone cannot do diagnosis and treatment planning, surgery, and laboratory techniques, he or she needs help by employing the expertise of a surgeon and a laboratory technician. This team approach is essential for optimum results.

A Simple Technique for Accurate Transfer of Secondary Copings in a Tooth-Supported Telescopic Prosthesis.

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Shankargouda, Swapnil B; Sidhu, Preena; Kardalkar, Swetha; Desai, Pooja M

2017-02-01

Residual ridge resorption is a rapid, progressive, irreversible, and inevitable process of bone resorption. Long-standing teeth and implants have been shown to have maintained the bone around them without resorption. Thus, overdenture therapy has been proven to be beneficial in situations where few remaining teeth are present. In addition to the various advantages seen with tooth-supported telescopic overdentures, a few shortcomings can also be expected, including unseating of the overdenture, increased bulk of the prosthesis, secondary caries, etc. The precise transfer of the secondary telescopic copings to maintain the spatial relationship, without any micromovement, remains the most critical step in ensuring the success of the tooth-supported telescopic prosthesis. Thus, a simple and innovative technique of splinting the secondary copings was devised to prevent distortion and micromovement and maintain its spatial relationship. © 2015 by the American College of Prosthodontists.

CNC-milled titanium frameworks supported by implants in the edentulous jaw: a 10-year comparative clinical study.

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Örtorp, Anders; Jemt, Torsten

2012-03-01

No long-term clinical studies covering more than 5 years are available on Computer Numeric Controlled (CNC) milled titanium frameworks. To evaluate and compare the clinical and radiographic performance of implant-supported prostheses provided with CNC titanium frameworks in the edentulous jaw with prostheses with cast gold-alloy frameworks during the first 10 years of function. Altogether, 126 edentulous patients were by random provided with 67 prostheses with titanium frameworks (test) in 23 maxillas and 44 mandibles, and with 62 prostheses with gold-alloy castings (control) in 31 maxillas and 31 mandibles. Clinical and radiographic 10-year data were collected for the groups and statistically compared on patient level. The 10-year prosthesis and implant cumulative survival rate was 95.6% compared with 98.3%, and 95.0% compared with 97.9% for test and control groups, respectively (p > .05). No implants were lost after 5 years of follow-up. Smokers lost more implants than nonsmokers after 5 years of follow-up (p .05), respectively. One prosthesis was lost in each group due to loss of implants, and one prosthesis failed due to framework fracture in the test group. Two metal fractures were registered in each group. More appointments of maintenance were needed for the prostheses in the maxilla compared with those in the mandible (p CNC-milled titanium frameworks are a viable alternative to gold-alloy castings for restoring patients with implant-supported prostheses in the edentulous jaw. © 2009 Wiley Periodicals, Inc.

Effect of breast augmentation after breast-conserving surgery for breast cancer on radiation dose. Silicone prosthesis and changes in radiation dose

International Nuclear Information System (INIS)

Tonari, Ayako; Nako, Yasunobu; Ikezaki, Hiromi; Maruyama, Yasushi; Ikeda, Ikuo; Kusuda, Junko; Harii, Kiyonori; Takayama, Makoto

2008-01-01

The results of a study simulating postoperative radiation therapy of remaining breast tissue with a silicone bag prosthesis implanted to examine the effects of the prosthesis on radiation dosage and surrounding tissue are reported. The evaluation was conducted in two stages: a water phantom was used to evaluate scattering effects of a prosthesis installed inside the phantom using glass rod detector (GRD) set around the prosthesis. Measurements were conducted on both entrance and rear sides of the prosthesis. A Rand phantom was used to measure radiation doses around the prosthesis. The first evaluation resulted in a less than 5.4% reduction in dose at the rear side of the prosthesis whereas the second evaluation, for opposing portal irradiation used with breast-conserving surgical treatment, showed the effects of the prosthesis on radiation dosage being within ±2%, the permitted treatment range. In conclusion, for treating breast cancer, combining surgical treatment of the cancer with implanting of prosthesis for breast reconstruction followed by radiation treatment appears feasible as no effects on dosage were observed on treatment effectiveness. (author)

Fracture of the delivery balloon shaft during balloon-expandable prosthesis alignment during implantation of an Edwards SAPIEN 3.

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Arai, Takahide; Hovasse, Thomas; Chevalier, Bernard

2018-04-01

The expandable sheath was designed with a lower profile in order to reduce the incidence of vascular complications of transcatheter aortic valve implantation using transfemoral approach. However, once the prosthesis has crossed the sheath, it could be difficult to retrieve it from the body. This is the first case of successful bail-out in an instance of delivery balloon shaft malfunction subsequent to the crossing of an expandable sheath during implantation of an Edwards SAPIEN 3 prosthesis. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Removable Partial Denture Supported by Implants with Prefabricated Telescopic Abutments - A Case Report

Science.gov (United States)

Sehgal, Komal

2014-01-01

Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy—biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. PMID:25121066

Removable partial denture supported by implants with prefabricated telescopic abutments - a case report.

Science.gov (United States)

Kumar, Lalit; Sehgal, Komal

2014-06-01

Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy-biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs.

21 CFR 872.3960 - Mandibular condyle prosthesis.

Science.gov (United States)

2010-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the human...

In vivo operation of the Boston 15-channel wireless subretinal visual prosthesis

Science.gov (United States)

Shire, Douglas B.; Doyle, Patrick; Kelly, Shawn K.; Gingerich, Marcus D.; Chen, Jinghua; Cogan, Stuart F.; Drohan, William A.; Mendoza, Oscar; Theogarajan, Luke; Wyatt, John; Rizzo, Joseph F.

2010-02-01

This presentation concerns the engineering development of the Boston visual prosthesis for restoring useful vision to patients blind with degenerative retinal disease. A miniaturized, hermetically-encased, 15-channel wirelessly-operated retinal prosthetic was developed for implantation and pre-clinical studies in Yucatan mini-pig animal models. The prosthesis conforms to the eye and drives a microfabricated polyimide stimulating electrode array having sputtered iridium oxide electrodes. This array is implanted into the subretinal space using a specially-designed ab externo surgical technique; the bulk of the prosthesis is on the surface of the sclera. The implanted device includes a hermetic titanium case containing a 15-channel stimulator chip; secondary power/data receiving coils surround the cornea. Long-term in vitro pulse testing was also performed on the electrodes to ensure their stability over years of operation. Assemblies were first tested in vitro to verify wireless operation of the system in biological saline using a custom RF transmitter circuit and primary coils. Stimulation pulse strength, duration and frequency were programmed wirelessly using a computer with a custom graphical user interface. Operation of the retinal implant was verified in vivo in 3 minipigs for more than three months by measuring stimulus artifacts on the eye surface using contact lens electrodes.

Sexual Function and Quality of Life Before and After Penile Prosthesis Implantation Following Radial Forearm Flap Phalloplasty.

Science.gov (United States)

Young, Ezekiel E; Friedlander, Daniel; Lue, Kathy; Anele, Uzoma A; Khurgin, Jacob L; Bivalacqua, Trinity J; Burnett, Arthur L; Redett, Richard J; Gearhart, John P

2017-06-01

To provide sexual function and quality of life outcomes in patients with severe penile deficiency who underwent radial forearm flap phalloplasty with and without penile prosthesis implantation. Patients with history of severe penile deficiency who underwent microsurgical radial forearm flap phalloplasty with and without penile prosthesis implantation between 2007 and 2014 were identified. They completed a set of web-based validated questionnaires including the International Index of Erectile Function, the Pediatric Penile Perception Score, the Sexual Quality of Life for Men, and several items addressing general quality of life. Outcomes were compared between groups. Nine of the 12 identified patients who had prosthesis after phalloplasty and 4 out of the 7 phalloplasty-only patients completed the survey, resulting in an overall response rate of 68%. Among the phalloplasty-prosthesis patients, 66% reported current sexual activity and 78% reported regular masturbation, whereas 1 of the 4 phalloplasty-only patients reported both. Prosthesis patients scored notably higher in all domains of the International Index of Erectile Function except for sexual desire. In contrast, they demonstrated similar scores of penile perception, as well as general and sexual quality of life. Among patients who have undergone flap phalloplasty, the subsequent placement of penile prosthesis appears to effectively allow for both intercourse and masturbation, resulting in measurable improvements in orgasmic function, intercourse satisfaction, and overall sexual satisfaction. Despite these important benefits, prosthesis placement does not appear to result in improvements in penile perception scores, or general or sexual quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

A Multidisciplinary Approach for Rehabilitation of Enucleated Sockets: Ocular Implants with Custom Ocular Prosthesis.

Science.gov (United States)

Choudhury, Minati; Banu, Fathima; Natarajan, Shanmuganathan; Kumar, Anand; Tv, Padmanabhan

2018-02-16

Interdisciplinary prosthodontics goes beyond our imagination into fields that have a direct effect on our total body health and quality of life. Removal of an eye has a detrimental effect on the psychology of the patient. Enucleation involves removal of the eyeball proper and leads to an enophthalmic socket with a shrunken eye, which has a crippling effect on patient's emotional and social life. Custom-made eye prosthesis simulates the characteristics of the companion eye and helps in restoring the normal facial appearance. Restoration of saccadic eye movements occurring during speech is desirable because this greatly contributes to a normal facial expression. This can be achieved by an orbital implant, which helps in orbital volume replacement and restoration of prosthesis movement and comfort. This article describes prosthodontic rehabilitation of enucleated eye sockets with orbital implants for two patients.

Bone mineral density after implantation of a femoral neck hip prosthesis--a prospective 5 year follow-up.

Science.gov (United States)

Steens, Wolfram; Boettner, Friedrich; Bader, Rainer; Skripitz, Ralf; Schneeberger, Alberto

2015-08-12

Bone resorption in the proximal femur due to stress shielding has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to prospectively investigate the in vivo changes of bone-mineral density as a parameter of bone remodeling around a short, femoral neck prosthesis over the first 5 years following implantation. The secondary goal was to report on its clinical outcome. We are reporting on the changes of bone mineral density of the proximal femur and the clinical outcome up to five years after implantation of a short femoral neck prosthesis. Bone mineral density was determined using dual energy x-ray absorptiometry, performed 10 days, three, 12 and 60 months after surgery. 20 patients with a mean age of 47 years (range 17 to 65) were clinically assessed using the Harris Hip Score. The WOMAC was used as a patient-relevant outcome-measure. In contrast to conventional implants DEXA-scans overall revealed a slight increase of bone mineral density in the proximal femur in the 12 months following the implantation. The Harris Hip Score improved from an average preoperative score of 46 to a postoperative score at 12 months of 91 points and 95 points at 60 months, the global WOMAC index from 5.3 preoperatively to 0.8 at 12 months and 0.6 at 60 months postoperatively. At 60 months after implantation of a short femoral neck prosthesis, all regions except one (region of interest #5) showed no significant changes in BMD compared to baseline measurements at 10 days which is less to the changes in bone mineral density seen in conventional implants.

Distal corporoplasty for distal cylinders extrusion after penile prosthesis implantation.

Science.gov (United States)

Carrino, Maurizio; Chiancone, Francesco; Battaglia, Gaetano; Pucci, Luigi; Fedelini, Paolo

2017-02-03

Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in "Distal corporoplasty" technique. We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an "AMS 700 inflatable penile prosthesis (LGX)" from January 2013 to November 2015 at our hospital. All procedures were performed by a single surgical team. Intraoperative and postoperative complications have been classified and reported according to Satava6 and Clavien-Dindo (CD) system.7 Mean values with standard deviations (±SD) were computed and reported for all items. Mean age of the patients was 53.61 (±11.90) years. Mean body max index (BMI) was 24.22 (±2.51). Mean operative time was 85.2 (±13.1) minutes. Blood losses were minimal. No intraoperative complications are reported according to Satava classification. Four out of 18 patients (22.22%) experienced postoperative complications according to CD system. All patients had sexual intercourse for the first time postsurgery after a mean of 59.11 ± 2.08 days. Mean follow-up was 22.11 (±9.95). Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Distal corporoplasty was first described by Mulcahy. He reported a series of 14 patients with a follow-up of about 2 years with optimal functional outcomes. Moreover, distal corporoplasty resulted in shorter operative time, better function, less pain, and fewer recurrences than Gortex windsock repair.10 In our experience, distal corporoplasty is a simple and safe procedure in the treatment of distal cylinders extrusion when the prosthetic material is not exposed to the exterior.

Implant rehabilitation in bruxism patient

Science.gov (United States)

Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas

2014-01-01

A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported. PMID:24907215

A three-dimensional finite element analysis for overdenture attachments supported by teeth and/or mini dental implants.

Science.gov (United States)

Fatalla, Abdalbseet A; Song, Ke; Du, Tianfeng; Cao, Yingguang

2012-12-01

The aim of this study was to establish the optimum design and attachment combination to support an overdenture with minimal stress and flexing produced in the alveolar bone surrounding any natural teeth and/or mini dental implants. Twelve models were included in the study: the six main models (A, B, C, D, E, and F) were categorized according to the support designs of the overdenture prosthesis, and each model was further subdivided according to the attachment combinations into model 1: with Dalbo elliptic and/or O-ring attachments only and model 2: with flexible acrylic attachments. Vertical loads (35 N) and 17.5 N lateral loads under static conditions were applied to the models to simulate the occlusal forces following the concept of lingualized occlusion. All conditions were created using a finite element software program. Maximum von Mises stress at the level of the attachments and at the bone support foundation interfaces were compared in all 12 models. The flexing of the mandible and the attachments were also compared qualitatively. Stress on these models was analyzed after the given loading condition. The results showed that the model with three freestanding mini dental implants and flexible acrylic attachments showed the lowest von Mises stress and flexing, while the models with four freestanding mini dental implants and O-ring attachments showed the highest von Mises stress. Three freestanding mini dental implants with flexible acrylic attachment systems supporting an overdenture were better choices than four mini dental implants with O-ring attachment systems, which showed the maximum flexing and stress values in this qualitative comparison. © 2012 by the American College of Prosthodontists.

Dorsal Phalloplasty to Preserve Penis Length after Penile Prosthesis Implantation

Directory of Open Access Journals (Sweden)

Osama Shaeer

2017-03-01

Full Text Available Objectives: Following penile prosthesis implantation (PPI, patients may complain of a decrease in visible penis length. A dorsal phalloplasty defines the penopubic junction by tacking pubic skin to the pubis, revealing the base of the penis. This study aimed to evaluate the efficacy of a dorsal phalloplasty in increasing the visible penis length following PPI. Methods: An inflatable penile prosthesis was implanted in 13 patients with severe erectile dysfunction (ED at the Kamal Shaeer Hospital, Cairo, Egypt, from January 2013 to May 2014. During the surgery, nonabsorbable tacking sutures were used to pin the pubic skin to the pubis through the same penoscrotal incision. Intraoperative penis length was measured before and after the dorsal phalloplasty. Overall patient satisfaction was measured on a 5-point rating scale and patients were requested to subjectively compare their postoperative penis length with memories of their penis length before the onset of ED. Results: Intraoperatively, the dorsal phalloplasty increased the visible length of the erect penis by an average of 25.6%. The average length before and after tacking was 10.2 ± 2.9 cm and 13.7 ± 2.8 cm, respectively (P <0.002. Postoperatively, seven patients (53.8% reported a longer penis, five patients (38.5% reported no change in length and one patient (7.7% reported a slightly shorter penis. The mean overall patient satisfaction score was 4.9 ± 0.3. None of the patients developed postoperative complications. Conclusion: A dorsal phalloplasty during PPI is an effective method of increasing visible penis length, therefore minimising the impression of a shorter penis after implantation.

Ten-Year Follow-up of a Blind Patient Chronically Implanted with Epiretinal Prosthesis Argus I.

Science.gov (United States)

Yue, Lan; Falabella, Paulo; Christopher, Punita; Wuyyuru, Varalakshmi; Dorn, Jessy; Schor, Paulo; Greenberg, Robert J; Weiland, James D; Humayun, Mark S

2015-12-01

The Argus I implant is the first-generation epiretinal prosthesis approved for an investigational clinical trial by the United States Food and Drug Administration. Herein we report testing results obtained from a 10-year follow-up to study the physiologic effects of the bioelectronic visual implant after prolonged chronic electrical stimulation. Case report. One man, 55 years of age when enrolled in the study, underwent surgical implantation of the Argus I in June 2004, followed by periodic tests from July 2004 through June 2014, spanning a total of 10 years. The decade-long follow-up consisted of implant system performance tests, subject visual function evaluation, and implant-retina interface analysis. Changes in electrode impedance and perceptual threshold over the time course; subject's performance on visual function task, orientation, and mobility tests; and optical coherence tomography data, fundus imaging, and fluorescein angiography results for the assessment of subject's implant-retina physical interface. Electrically elicited phosphenes were present 10 years after implantation of an epiretinal stimulator. The test subject not only was able to perceive phosphenes, but also could perform visual tasks at rates well above chance. This decade-long follow-up report provides further support for the use of retinal prostheses as a long-lasting treatment for some types of blindness. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Prosthetic misfit of implant-supported prosthesis obtained by an alternative section method

Science.gov (United States)

Falcão-Filho, Hilmo Barreto Leite; de Aguiar, Fábio Afrânio; Rodrigues, Renata Cristina Silveira; de Mattos, Maria da Gloria Chiarello; Ribeiro, Ricardo Faria

2012-01-01

PURPOSE Adequate passive-fitting of one-piece cast 3-element implant-supported frameworks is hard to achieve. This short communication aims to present an alternative method for section of one-piece cast frameworks and for casting implant-supported frameworks. MATERIALS AND METHODS Three-unit implant-supported nickel-chromium (Ni-Cr) frameworks were tested for vertical misfit (n = 6). The frameworks were cast as one-piece (Group A) and later transversally sectioned through a diagonal axis (Group B) and compared to frameworks that were cast diagonally separated (Group C). All separated frameworks were laser welded. Only one side of the frameworks was screwed. RESULTS The results on the tightened side were significantly lower in Group C (6.43 ± 3.24 µm) when compared to Groups A (16.50 ± 7.55 µm) and B (16.27 ± 1.71 µm) (Plaser welding showed significant improvement in the levels of misfit of the frameworks (Group A, 58.66±14.30 µm; Group B, 39.48±12.03 µm; Group C, 23.13±8.24 µm) (P<.05). CONCLUSION Casting diagonally sectioned frameworks lowers the misfit levels. Lower misfit levels for the frameworks can be achieved by diagonally sectioning one-piece frameworks. PMID:22737313

Maxillary implant-retained partial overdenture with Dolder bar attachment: a clinical report.

Science.gov (United States)

Kim, Hyeongil; Buhite, Robert J; Monaco, Edward A

2015-03-01

This article describes a technique for maintaining a maxillary Kennedy III partial removable dental prosthesis design in a patient who had non-restorable failing abutments by replacing the abutments with dental implants. Two implants were placed immediately after extraction of the abutment teeth in the anterior maxilla. After the implants were fully integrated, a Dolder bar attachment was fitted onto the implants. A new maxillary partial removable dental prosthesis was fabricated using the implants and the remaining natural teeth as abutments to restore function and esthetics. With the aid of dental implants, this Kennedy III maxillary removable dental prosthesis design could provide additional retention and support by promoting cross-arch stability and tissue, implant and tooth support. The patient's satisfaction was significantly increased.

Amputation and prosthesis implantation shape body and peripersonal space representations

OpenAIRE

Canzoneri, Elisa; Marzolla, Marilena; Amoresano, Amedeo; Verni, Gennaro; Serino, Andrea

2013-01-01

Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearin...

Surgical Templates for Dental Implant Positioning; Current ...

African Journals Online (AJOL)

prosthodontics; however, designing an implant‑supported prosthesis with function .... template where a provisional fixed restoration bridges the implant site. Pesun and ... in single implant therapy or short‑span implant‑supported prostheses.

Characterisation by PIXE RBS of metallic contamination of tissues surrounding a metallic prosthesis on a knee

Science.gov (United States)

Guibert, G.; Irigaray, J. L.; Moretto, Ph.; Sauvage, T.; Kemeny, J. L.; Cazenave, A.; Jallot, E.

2006-09-01

Implants used as biomaterials have to fulfill conditions of functionality, compatibility and sometimes bioactivity. There are four main families of biomaterials: metals and metal alloys, polymers, bioceramics and natural materials. Because of corrosion and friction in the human body, implants generate debris. This debris may develop toxicity, inflammation and prosthetic unsealing by osseous dissolution. Nature, size, morphology and amount of debris are the parameters influencing the tissue responses. In this paper, we characterised metallic contamination produced by knee prosthesis, composed with TiAl 6V 4 or Co-Cr-Mo alloys, into surrounding capsular tissue by depth migration, in vivo behaviour, content, size and nature of debris by PIXE (Particle Induced X-ray Emission) method associated with RBS (Rutherford Backscattering Spectroscopy). Debris distribution in the whole articulation is very heterogeneous. Debris migrates several thousand micrometers in tissues, with a characteristic decrease. Solid metallic particles of about micrometer size are found in the most polluted samples, in both alloys TiAl 6V 4 and Cr-Co-Mo. In the mean volume analysed by PIXE, the concentration mass ratios [Ti]/[V] and [Co]/[Cr] confirm the chemical stability of TiAl 6V 4 debris and show the chemical evolution of Cr-Co-Mo debris. Development of a protocol to prepare thin targets permits us to correlate PIXE and histological analysis in the same zone. The fibrous tissue (collagen fibres, fibroblasts) and macrophage cells are observed with optical microscope in polluted areas. This protocol could locate other pathologies in ppm contamination range, thanks to the great sensitivity of the PIXE method.

Prosthesis-patient mismatch after transcatheter aortic valve implantation using the Edwards SAPIEN™ prosthesis.

Science.gov (United States)

Van Linden, Arnaud; Kempfert, Jörg; Blumenstein, Johannes; Rastan, Ardawan; Holzhey, David; Lehmann, Sven; Mohr, Friedrich W; Walther, Thomas

2013-08-01

Prosthesis-patient mismatch (PPM) is defined as a too small effective orifice area (EOA) of the prosthetic valve in relation to the patient's body size and has been documented to be related to adverse outcomes after conventional aortic valve replacement (AVR). Aim of this study was to analyze the incidence of PPM after transcatheter aortic valve implantation (T-AVI) using the Edwards SAPIEN prosthesis and its relation to postoperative outcome. 200 consecutive high-risk patients underwent transapical aortic valve implantation (TA-AVI) between February 2006 and January 2009 and fulfilled 1 year follow-up were included. Severe PPM was defined as indexed EOA (EOAi) <0.65 cm2/m2 and moderate PPM as EOAi = 0.65-0.85 cm2/m2, EOA was calculated from transthoracic echocardiographic (TTE) measurements using the continuity equation. Total 112 patients with sufficient postoperative TTE image quality formed the study group. EOAi increased from 0.3 ± 0.1 cm2/m2 (preoperatively) to 1.1 ± 0.4 cm2/m2 after TA-AVI (p < 0.001). According to the standard definitions, PPM was seen in 38.4% of the patients and 9.8% presented with severe PPM. The occurrence of PPM had neither an effect on clinical outcome in terms of NYHA class nor on survival. Patients with PPM had significantly higher postoperative transprosthetic gradients (mean gradient 10.4 ± 4.1 versus 7.1 ± 3.0 mm Hg, p < 0.001). Based on the in vitro EOA data obtained from pulse duplicator measurements, however, none of the patients was judged to have PPM. Transcatheter AVI provides good antegrade hemodynamic function and EOAi improves significantly. According to standardized evaluations PPM occurs after TA-AVI, but it is not associated with adverse outcomes. Thus use of the continuity equation may not adequately reflect the situation after T-AVI or the current definition of PPM is not suitable for T-AVI prostheses. Georg Thieme Verlag KG Stuttgart · New York.

Development and clinical application of a new testicular prosthesis.

Science.gov (United States)

Ning, Ye; Cai, Zhikang; Chen, Huixing; Ping, Ping; Li, Peng; Wang, Zhong; Li, Zheng

2011-11-01

A new type of testicular prosthesis made of silastic with an elliptical shape to mimic a normal testis was developed by our team and submitted for patenting in China. The prosthesis was produced in different sizes to imitate the normal testis of the patient. To investigate the effects and safety of the testicular prosthesis, 20 patients receiving testicular prosthesis implantation were recruited for this study. Follow-up after 6 months revealed no complications in the patients. All the patients answered that they were satisfied with their body image and the position of the implants, 19 patients were satisfied with the size and 16 patients were satisfied with the weight. These results show that the testicular prosthesis used in this study can meet patient's expectations. Patients undergoing orchiectomy should be offered the option to receive a testicular prosthesis implantation. The dimensions and weight of the available prosthetic implants should be further addressed to improve patient satisfaction.

Breast cancer in a patient with silicone breast implants after 13 years.

Science.gov (United States)

Bingham, H G; Copeland, E M; Hackett, R; Caffee, H H

1988-03-01

The patient described in this article is a 45-year-old woman who developed an infiltrating ductal carcinoma in her left breast next to a Silastic mammary implant that had been used for augmentation some 13 years previously. She underwent a modified radical mastectomy and removal of the silicone prosthesis with an axillary lymph node dissection. Twenty-six axillary lymph nodes were negative for metastatic disease. The 165-gram silicone gel prosthesis was surrounded by a thin fibrous capsule with an attached 1-cm carcinoma that did not invade the fibrous capsule. It appeared that the capsule presented a barrier to the invading ductal carcinoma. The fibrous capsule surrounding the Silastic implant may have altered the spread of the breast cancer without being related to its genesis.

Description of the condition of the implant-prosthesis system: a transverse study

International Nuclear Information System (INIS)

Salazar Salgado, Walter

2008-01-01

Current condition of the implant-prosthesis system of the patients attended in the Facultad de Odontologia de la Universidad de Costa Rica is described, in the included period from January 2001 to December 2006. Parameters of comparison will be established for future evaluations. An appointment was scheduled with each patient to review. A radiovisiograph was used for digital radiography with parallel technique and radiographic positioners, for anterior and posterior sector. In addition, a questionnaire was applied to all patients. The percentage of survival of the implants placed in the years 2001-2006, is 95.2 % and 92.4 % of the patients are satisfied with the aesthetic aspect of their restoration [es

Identification of the critical level of implantation of an osseointegrated prosthesis for above-knee amputees.

Science.gov (United States)

Andrango Castro, Elder Michael; Konvickova, Svatava; Daniel, Matej; Horak, Zdenek

2017-11-01

The aim of our study was to identify potential critical levels of implantation of an osseointegrated prosthesis for above-knee amputees. The implant used was the OPRA system. It was inserted in the femur at four different amputation heights, characterized by their residual limb ratios (0.299, 0.44, 0.58 and 0.73). The stress and strain distribution was evaluated in the bone-implant system during walking, considering a body mass of 100 kg. Considerably high stimulus (11,489 με) in the tissue near the tip was found at the highest implantation level. All models presented small non-physiologic stress values in the tissue around the implant. The results revealed that the implantation level has a decisive effect on bone-implant performance. Mainly, the analysis indicates adverse biomechanical conditions for implantations in very short residual limbs.

A review of clinical and technical considerations for fixed and removable implant prostheses in the edentulous mandible.

Science.gov (United States)

Zitzmann, Nicola Ursula; Marinello, Carlo Paolo

2002-01-01

The aim of the present article is to review some of the technical treatment options for implant prostheses restoring the edentulous mandible, mainly based on the Brånemark system. Clinical and technical aspects are discussed for the three established concepts: (1) implant-supported fixed prosthesis, (2) removable implant-supported overdenture, and (3) combined implant-retained and soft tissue-supported overdenture prosthesis. The framework of an implant-supported fixed screw-retained prosthesis can be processed in gold, Co-Cr alloy, or titanium with casting, laser-welding, or milling techniques. To improve the stability and retention of a conventional complete denture, one to four implants are indicated, and unsplinted (single attachments) or splinted designs (bar systems) can be applied. The design of the overdenture prosthesis must be carefully planned according to the requirements to ensure adequate stability and optimal form, contour, and esthetics, and the patient's best comfort. A large variety of different treatment modalities exist for both the fixed and removable mandibular implant prosthesis. Clinical and technical aspects should be considered at the beginning of the treatment to: (1) select the optimal implant position, (2) establish an adequate number of functional units, (3) select the appropriate retainers, and (4) apply the best technique for framework processing and veneering.

Use of the frontal process of the maxillary bone for implant placement to retain a nasal prosthesis: a clinical report.

Science.gov (United States)

Proussaefs, Periklis

2004-01-01

Implant placement to provide support and retention for nasal prostheses has been described in the literature. The anatomic sites that have been utilized for implant placement are the nasal bones, the premaxillary area through the nasal fossae, and the anterior wall of the frontal sinus. In the patient described, after a presurgical computerized tomography scan to determine adequacy of bone volume, 1 conventional threaded hydroxyapatite-coated root-form implant, created for intraoral use, was placed in the frontal process of the maxillary bone and 2 additional conventional implants were placed in the premaxillary area through the nasal fossa. Six months after implant placement, second-stage surgery was completed. A single bar connecting the 3 implants was fabricated. The removable nasal prosthesis was retained on the bar with 2 clips. An examination 1 year postsurgery revealed no clinical signs of pathosis. Long-term clinical follow-up of this case should continue and a sufficient number of additional cases should be investigated before use of the frontal process of the maxillary bone for implant retention can be recommended on a routine basis.

Establishing the maxillary occlusal plane as a requisite for placement of an immediate implant-supported fixed prosthesis in the mandible: a case report

Directory of Open Access Journals (Sweden)

Milton Edson Miranda

Full Text Available INTRODUCTION: In patients with Bruxism, the attrition can result in excessive occlusal wear that exceeds the compensatory mechanism and loss of occlusion vertical dimension occurs. OBJECTIVE: The purpose of this article is to show the importance of re-establishing an adequate occlusal plane for the non treated arch by means of a fixed acrylic overlay, compatible with the prosthetic treatment of the arch to be rehabilitated. An upper maxillary fixed acrylic overlay restored the patient’s occlusal plane in an appropriate vertical dimension of occlusion together with a fixed prosthesis in the mandible, supported by five dental implants. CONCLUSION: When there is severe wear due to dental attrition in one of the arches, it is important to re-establish the occlusal plane and compensation curves in conjunction with the prosthetic treatment of the arch to be rehabilitated.

Maxillary arch rehabilitation using implant-supported computer-assisted design-computer-assisted manufacturing-milled titanium framework

Directory of Open Access Journals (Sweden)

Tulika S Khanna

2017-01-01

Full Text Available Esthetic and functional rehabilitation of completely edentulous maxillary arch with fixed implant supported prosthesis is a challenging task. Newer technologies such as computer assisted design computer assisted manufacturing (CAD CAM and cone beam conventional tomography play an important role in achieving predictable results. Full mouth porcelain fused to metal (PFM individual crowns on CAD CAM milled titanium framework provides positive esthetic and functional outcome. This is a case report of rehabilitation of partially edentulous maxillary arch patient. Staged rehabilitation of this patient was planned. In the first stage, root canal treatment of key abutment teeth was done, nonsalvageable teeth were removed, and immediate interim overdenture was provided. In the second stage, five Nobel Biocare dental implants were placed. After integration impressions were made, CAD CAM milled titanium bar was fabricated. Individual PFM crowns were made and cemented. This method gives better esthetic compared to acrylic fused to metal hybrid prosthesis with the advantage of retrievability just like screw retained prosthesis. Hence, this technique is good for rehabilitation of patients with high esthetic demands.

Incidence and impact of prosthesis-patient mismatch after transcatheter aortic valve implantation.

Science.gov (United States)

Bleiziffer, Sabine; Hettich, Ina; Hutter, Andrea; Wagner, Anke; Deutsch, Marcus-André; Piazza, Nicolo; Lange, Rüdiger

2013-05-01

The study aim was to investigate the incidence of patient-prosthesis mismatch (PPM) with new catheter valves, and its influence on the patients' clinical state. At present, few echocardiographic data are available on the incidence and impact of PPM with the CoreValve and Sapien prostheses for transcatheter aortic valve implantation (TAVI). The reliability of effective orifice area (EOA) measurements was assured by awaiting an interval of six months after TAVI. Of 256 survivors after TAVI, 149 complete echocardiographic data sets were available for the assessment of the indexed EOA (iEOA). In total, 106 CoreValve prostheses and 43 Sapien prostheses were implanted in this high-risk cohort (mean age 81 +/- 6 years, mean logistic EuroSCORE 20 +/- 13%). The overall incidence of PPM (iEOA body surface area were more likely to develop PPM (p = 0.001), while the prosthesis type, native annulus diameter, preoperative EOA, gender and prosthesis size had no influence. The mean aortic gradient was significantly higher in patients with PPM. A reduction in the left ventricular end-diastolic diameter was seen in all patients, without significant differences between groups. There were no differences in postoperative NYHA class or self-assessed health state between patients with or without PPM. PPM was common after TAVI in the presented cohort, presumably because the native calcium masses narrow the outflow area available for blood flow. As expected for low gradients, there was no impairment of left ventricular dimension regression or clinical state of the patients, even if severe PPM was present. Based on the presented data, it is assumed that PPM might be less relevant in TAVI patients.

Clinical follow-up of unilateral, fixed dental prosthesis on maxillary implants.

Science.gov (United States)

Wahlström, Monica; Sagulin, Gun-Britt; Jansson, Leif E

2010-11-01

The aims of the present study were to evaluate (1) the success rate of unilateral maxillary fixed dental prosthesis (FDPs) on implants in patients at a periodontal clinic referred for periodontal treatment, (2) the prevalence of varying mechanical and biological complications and (3) effects of potential risk factors on the success rate. Fifty consecutive patients were invited to participate in a follow-up. The patients had received FDPs on implants between November 2000 and December 2003 after treatment to achieve optimal peridontal health, and the FDPs had been in function for at least 3 years. A questionnaire was sent to the patients before the follow-up examination. Forty-six patients with 116 implants were examined. The follow-up comprised clinical and radiographic examinations and evaluations of treatment outcome. Before implant treatment, 13% of the teeth were extracted; of these, 80% were extracted due to periodontal disease. No implants had been lost before implant loading. One implant in one patient fractured after 3 years of functional loading and three implants in another patient after 6.5 years. The most frequent mechanical complications were veneer fractures and loose bridge screws. Patients with peri-implant mucositis had significantly more bleeding on probing around teeth and implants. Patients with peri-implantitis at the follow-up had more deep periodontal pockets around their remaining teeth compared with individuals without peri-implantitis, but these differences were not significant. Smokers had significantly fewer teeth, more periodontal pockets ≥ 4mm and a tendency towards greater marginal bone loss at the follow-up, compared with non-smokers. In the short term, overloading and bruxism seem more hazardous for implant treatment, compared with a history of periodontitis.

Characterization of a Polymer-Based, Fully Organic Prosthesis for Implantation into the Subretinal Space of the Rat.

Science.gov (United States)

Antognazza, Maria Rosa; Di Paolo, Mattia; Ghezzi, Diego; Mete, Maurizio; Di Marco, Stefano; Maya-Vetencourt, José Fernando; Maccarone, Rita; Desii, Andrea; Di Fonzo, Fabio; Bramini, Mattia; Russo, Angela; Laudato, Lucia; Donelli, Ilaria; Cilli, Michele; Freddi, Giuliano; Pertile, Grazia; Lanzani, Guglielmo; Bisti, Silvia; Benfenati, Fabio

2016-09-01

Replacement strategies arise as promising approaches in case of inherited retinal dystrophies leading to blindness. A fully organic retinal prosthesis made of conjugated polymers layered onto a silk fibroin substrate is engineered. First, the biophysical and surface properties are characterized; then, the long-term biocompatibility is assessed after implantation of the organic device in the subretinal space of 3-months-old rats for a period of five months. The results indicate a good stability of the subretinal implants over time, with preservation of the physical properties of the polymeric layer and a tight contact with the outer retina. Immunoinflammatory markers detect only a modest tissue reaction to the surgical insult and the foreign body that peaks shortly after surgery and progressively decreases with time to normal levels at five months after implantation. Importantly, the integrity of the polymeric layer in direct contact with the retinal tissue is preserved after five months of implantation. The recovery of the foreign-body tissue reaction is also associated with a normal b-wave in the electroretinographic response. The results demonstrate that the device implanted in nondystrophic eyes is well tolerated, highly biocompatible, and suitable as retinal prosthesis in case of photoreceptor degeneration. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Electromyographic evaluation of implant-supported prostheses in hemimandibulectomy-reconstructed patients.

Science.gov (United States)

Dellavia, Claudia; Romeo, Eugenio; Ghisolfi, Marco; Chiapasco, Matteo; Sforza, Chiarella; Ferrario, Virgilio F

2007-06-01

To assess the clinical conditions, patient's satisfaction and functional outcomes in oral neoplasia patients with hemimandibulectomy, bone reconstruction and implant-supported prosthesis. Twelve patients after mandibular resection (with and without condyle), reconstruction and successful fixed implant-supported prosthesis rehabilitation were examined. Patients underwent clinical evaluation and filled in a questionnaire about their satisfaction toward oral functions. Surface electromyography (EMG) of the masticatory muscles was performed during a 15-s unilateral gum chewing test. EMG potentials were standardized as percentage of a maximum clench on cotton rolls and compared with reference data obtained from 20 healthy subjects. Excellent clinical and radiological parameters were found. Patients stated a decreased post-rehabilitation satisfaction toward mastication and phonetics, but an increased attention to oral care. Only patients with condylar resection reported augmented esthetic scores. In both the resected and the remaining sides, chewing frequency was higher in the patients than in the reference group (Wilcoxon's rank-sum test, Pchewing were more variable in the reconstructed patients than in control subjects; the difference was significant only in the non-operated side (P<0.01). Post-rehabilitation median scores of the questionnaire indicated a positive judgment of the treatment. EMG analysis showed that functional recovery in hemimandibulectomy patients was satisfactory, although some alterations were observed in the non-operated side of mastication.

Microfabrication of an Implantable silicone Microelectrode array for an epiretinal prosthesis

Energy Technology Data Exchange (ETDEWEB)

Maghribi, Mariam Nader [Univ. of California, Davis, CA (United States)

2003-06-10

Millions of people suffering from diseases such as retinitis pigmentosa and macular degeneration are legally blind due to the loss of photoreceptor function. Fortunately a large percentage of the neural cells connected to the photoreceptors remain viable, and electrical stimulation of these cells has been shown to result in visual perception. These findings have generated worldwide efforts to develop a retinal prosthesis device, with the hope of restoring vision. Advances in microfabrication, integrated circuits, and wireless technologies provide the means to reach this challenging goal. This dissertation describes the development of innovative silicone-based microfabrication techniques for producing an implantable microelectrode array. The microelectrode array is a component of an epiretinal prosthesis being developed by a multi-laboratory consortium. This array will serve as the interface between an electronic imaging system and the human eye, directly stimulating retinal neurons via thin film conducting traces. Because the array is intended as a long-term implant, vital biological and physical design requirements must be met. A retinal implant poses difficult engineering challenges due to the size of the intraocular cavity and the delicate retina. Not only does it have to be biocompatible in terms of cytotoxicity and degradation, but it also has to be structurally biocompatible, with regard to smooth edges and high conformability; basically mimicking the biological tissue. This is vital to minimize stress and prevent physical damage to the retina. Also, the device must be robust to withstand the forces imposed on it during fabrication and implantation. In order to meet these biocompatibility needs, the use of non-conventional microfabrication materials such as silicone is required. This mandates the enhancement of currently available polymer-based fabrication techniques and the development of new microfabrication methods. Through an iterative process, devices

Characterisation by PIXE-RBS of metallic contamination of tissues surrounding a metallic prosthesis on a knee

Energy Technology Data Exchange (ETDEWEB)

Guibert, G. [Laboratoire de Physique Corpusculaire de Clermont-Ferrand, IN2P3/CNRS UMR 6533, Universite Blaise Pascal, 63177 Aubiere Cedex (France)]. E-mail: geoffroy.guibert@he-arc.ch; Irigaray, J.L. [Laboratoire de Physique Corpusculaire de Clermont-Ferrand, IN2P3/CNRS UMR 6533, Universite Blaise Pascal, 63177 Aubiere Cedex (France); Moretto, Ph. [Centre d' Etudes Nucleaires de Bordeaux-Gradignan, IN2P3/CNRS UMR 5797, Le Haut Vigneau, BP 120, 33175 Gradignan Cedex (France); Sauvage, T. [Centre d' Etudes et de Recherches par Irradiation, CNRS Orleans France, 3A rue de la ferollerie, 45071 Orleans Cedex 2 (France); Kemeny, J.L. [CHU, Service d' Anatomie et de Cytologie Pathologiques, Universite d' Auvergne, 63100 Clermont-Ferrand (France); Cazenave, A. [Institut Calot, 62608 Berck sur Mer Cedex (France); Jallot, E. [Laboratoire de Physique Corpusculaire de Clermont-Ferrand, IN2P3/CNRS UMR 6533, Universite Blaise Pascal, 63177 Aubiere Cedex (France)

2006-09-15

Implants used as biomaterials have to fulfill conditions of functionality, compatibility and sometimes bioactivity. There are four main families of biomaterials: metals and metal alloys, polymers, bioceramics and natural materials. Because of corrosion and friction in the human body, implants generate debris. This debris may develop toxicity, inflammation and prosthetic unsealing by osseous dissolution. Nature, size, morphology and amount of debris are the parameters influencing the tissue responses. In this paper, we characterised metallic contamination produced by knee prosthesis, composed with TiAl{sub 6}V{sub 4} or Co-Cr-Mo alloys, into surrounding capsular tissue by depth migration, in vivo behaviour, content, size and nature of debris by PIXE (Particle Induced X-ray Emission) method associated with RBS (Rutherford Backscattering Spectroscopy). Debris distribution in the whole articulation is very heterogeneous. Debris migrates several thousand micrometers in tissues, with a characteristic decrease. Solid metallic particles of about micrometer size are found in the most polluted samples, in both alloys TiAl{sub 6}V{sub 4} and Cr-Co-Mo. In the mean volume analysed by PIXE, the concentration mass ratios [Ti]/[V] and [Co]/[Cr] confirm the chemical stability of TiAl{sub 6}V{sub 4} debris and show the chemical evolution of Cr-Co-Mo debris. Development of a protocol to prepare thin targets permits us to correlate PIXE and histological analysis in the same zone. The fibrous tissue (collagen fibres, fibroblasts) and macrophage cells are observed with optical microscope in polluted areas. This protocol could locate other pathologies in ppm contamination range, thanks to the great sensitivity of the PIXE method.

A comparison of laser-welded titanium and conventional cast frameworks supported by implants in the partially edentulous jaw: a 3-year prospective multicenter study.

Science.gov (United States)

Jemt, T; Henry, P; Lindén, B; Naert, I; Weber, H; Bergström, C

2000-01-01

The purpose of this prospective multicenter study was to evaluate and compare the clinical performance of laser-welded titanium fixed partial implant-supported prostheses with conventional cast frameworks. Forty-two partially edentulous patients were provided with Brånemark system implants and arranged into 2 groups. Group A was provided with a conventional cast framework with porcelain veneers in one side of the jaw and a laser-welded titanium framework with low-fusing porcelain on the other side. The patients in group B had an old implant prosthesis replaced by a titanium framework prosthesis. The patients were followed for 3 years after prosthesis placement. Clinical and radiographic data were collected and analyzed. Only one implant was lost, and all prostheses were still in function after 3 years. The 2 framework designs showed similar clinical performance with few clinical complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%) fractured. Four prostheses experienced loose gold screws (6%). In group A, marginal bone loss was similar for both designs of prostheses, with a mean of 1.0 mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was observed on average in group B. No significant relationship (P > 0.05) was observed between marginal bone loss and placement of prosthesis margin or prosthesis design. The use of laser-welded titanium frameworks seems to present similar clinical performance to conventional cast frameworks in partial implant situations after 3 years.

Complete Transversal Disc Fracture in a Björk-Shiley Delrin Mitral Valve Prosthesis 43 Years After Implantation.

Science.gov (United States)

González-Santos, Jose María; Arnáiz-García, María Elena; Dalmau-Sorlí, María José; Sastre-Rincón, Jose Alfonso; Hernández-Hernández, Jesús; Pérez-Losada, María Elena; Sagredo-Meneses, Víctor; López-Rodríguez, Javier

2016-10-01

A patient who underwent previous implantation of a mitral valve replacement with a Björk-Shiley Delrin (BSD) mitral valve prosthesis during infancy was admitted to our institution 43 years later after an episode of syncope and cardiac arrest. Under extreme hemodynamic instability, a mitral valve prosthetic dysfunction causing massive mitral regurgitation was identified. The patient underwent an emergent cardiac operation, and a complete disc fracture with partial disc migration was found. Exceptional cases of mechanical prosthetic heart valve fracture exist. We report the first case of complete transversal disc rupture of a BSD mitral valve prosthesis after the longest period of implantation ever reported in that position. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Safety and efficacy outcome of mentor alpha-1 inflatable penile prosthesis implantation for impotence treatment.

Science.gov (United States)

Goldstein, I; Newman, L; Baum, N; Brooks, M; Chaikin, L; Goldberg, K; McBride, A; Krane, R J

1997-03-01

We investigated safety and efficacy outcome pertaining to the Mentor Alpha-1, 3-piece inflatable penile prosthesis for impotence treatment. A 2-phase, multi-institutional, large scale retrospective study, with independently analyzed medical record (phase I) and questionnaire (phase II) data from consecutive eligible patients of 7 physician investigators was performed from March to October 1993. In phase I there were no morbidities of any type in 394 of the 434 patients (90.8%) (mean age 61 years, range 24 to 88) who underwent Alpha-1 implantation (mean followup 22.2 months, range 0.67 to 44.5). The risk of prosthesis malfunction (fluid leak and auto-inflation) was 2.5%. No cylinder aneurysms were reported. A total of 93.1% of Alpha-1 devices was free from explantation (4.4%) or revision surgery (2.5%) for approximately 2 years from the original implant date. Kaplan-Meier actuarial analyses revealed that cumulative survival of the Alpha-1 prostheses at 12, 24 and 36 months was 98 +/- 1%, 93 +/- 2% and 85 +/- 7% until device malfunction, and 91 +/- 2% 83 +/- 4% and 75 +/- 7% until surgical intervention (revision or explantation). In phase II 89% of the men claimed fulfilled expectations with the Alpha-1 prosthesis as impotence treatment. Satisfaction responses 80% or greater were noted with regard to intercourse ability and confidence, and device rigidity and function. Implantation did not result in greater than 80% satisfaction in partner relationships or feelings (as judged by the patient), social or work confidence, or intercourse frequency. Factors adversely affecting satisfaction included partner feelings of dissatisfaction (as judged by the patient), specific physician investigators and need for explantation/revision surgery. In 1 of the largest multi-institutional implant outcome studies thus far performed, safety and efficacy data concerning the Alpha-1 contemporary inflatable device were found markedly improved over earlier inflatable prostheses and now

A Sequential Approach to Implant-Supported Overdentures.

Science.gov (United States)

Kosinski, Timothy

2016-03-01

Fabrication of implant-supported maxillary or mandibular overdentures can seem to be difficult procedures. Many things could go wrong and/or unnoticed until the fabrication has been completed. Implants must be correctly surgically placed in viable bone at the proper angulation and spacing within an arch. The type of attachment must be considered and future treatment of the appliance should be simple and efficient. The appliance must function not only initially but also for many years to come. The author has found the use of the GPS attachment to be an ideal tool to achieve the goals of retention and stability. Careful planning is the most important part of this process, and understanding the benefits and risks of creating overdentures should be well understood by the dentists. By sequentially planning and treating these types of cases, the patient is able to function reasonably during the stages of implant healing. The final prosthesis is created and remaining teeth that held the transitional appliance in place are remove on the day of final seating. This is an excellent simplified retentive system option for those patients who are anxious about losing their teeth, even those teeth that are diseased and ugly.

Failed total carpometacarpal joint prosthesis of the thumb

DEFF Research Database (Denmark)

Hansen, Torben Bæk; Homilius, Morten

2010-01-01

Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis. T...... in eight of 10 patients, but the mean Disabilities of the arm, shoulder, and hand (DASH) scores, self-reported pinch-grip-related function, and pain were comparable with our earlier published results with the Elektra carpometacarpal total joint prosthesis.......Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis....... The male:female ratio was 1:4 and the mean duration of observation 32 months (range 6-52). In three patients the revised implant was a MOJE uncemented carpometacarpal joint prosthesis and in seven patients an Elektra uncemented one. At follow-up grip strength was reduced to less than 90% of the other hand...

Malrotation of the McGhan Style 510 prosthesis.

NARCIS (Netherlands)

Schots, J.M.; Fechner, M.R.; Hoogbergen, M.M.; Tits, H.W.H.J.

2010-01-01

BACKGROUND: Anatomically shaped cohesive silicone breast implants are frequently used in aesthetic and reconstructive surgery. After successful results with the Style 410 prosthesis, McGhan (Natrelle, Allergan) introduced the Style 510 prosthesis. After using this novel prosthesis, the authors

PIXE characterization of tissues surrounding metallic prostheses coated with biological glasses

International Nuclear Information System (INIS)

Barbotteau, Y.; Irigaray, J.L.; Moretto, Ph.

2004-01-01

Biological glasses can be used as coatings for metallic prostheses in order to prevent corrosion. According to their composition, these glasses have different properties. We studied, in vivo, two glasses referred to as BVA and BVH. They are used as coatings of Ti6Al4V metallic implant. BVA glass disappears after 3 months of implantation and is replaced by bone. Prostheses initially coated by this glass have a larger osseous contact perimeter compared to the uncoated prostheses. This ensures a better anchoring of the implant and limits the micro-motions which cause wear debris. BVH glass keeps a constant composition during implantation and it is used like a layer which isolates metal implant from biological environment. In order to characterize the bony environment surrounding implants, we have used PIXE and RBS methods. This paper shows results of the behavior of bony tissue under micro-beam, the quality tests of new bone which replaces the BVA glass coating and the evaluation of corrosion effects. Titanium release in bony tissues begins when the metal surface of the prosthesis is exposed to biological fluids. After a few months of implantation, the titanium contamination is stabilized and remains localized within the first tens of micrometers of surrounding bone

Conduction Abnormalities and Pacemaker Implantations After SAPIEN 3 Vs SAPIEN XT Prosthesis Aortic Valve Implantation.

Science.gov (United States)

Husser, Oliver; Kessler, Thorsten; Burgdorf, Christof; Templin, Christian; Pellegrini, Costanza; Schneider, Simon; Kasel, Albert Markus; Kastrati, Adnan; Schunkert, Heribert; Hengstenberg, Christian

2016-02-01

Transcatheter aortic valve implantation is increasingly used in patients with aortic stenosis. Post-procedural intraventricular conduction abnormalities and permanent pacemaker implantations remain a serious concern. Recently, the Edwards SAPIEN 3 prosthesis has replaced the SAPIEN XT. We sought to determine the incidences of new-onset intraventricular conduction abnormalities and permanent pacemaker implantations by comparing the 2 devices. We analyzed the last consecutive 103 patients undergoing transcatheter aortic valve implantation with SAPIEN XT before SAPIEN 3 was used in the next 105 patients. To analyze permanent pacemaker implantations and new-onset intraventricular conduction abnormalities, patients with these conditions at baseline were excluded. Electrocardiograms were recorded at baseline, after the procedure, and before discharge. SAPIEN 3 was associated with higher device success (100% vs 92%; P=.005) and less paravalvular leakage (0% vs 7%; Ppacemaker implantations was 12.6% (23 of 183) with no difference between the 2 groups (SAPIEN 3: 12.5% [12 of 96] vs SAPIEN XT: 12.6% [11 of 87]; P=.99). SAPIEN 3 was associated with a higher rate of new-onset intraventricular conduction abnormalities (49% vs 27%; P=.007) due to a higher rate of fascicular blocks (17% vs 5%; P=.021). There was no statistically significant difference in transient (29% [20 of 69] vs persistent 19% [12 of 64]; P=.168) left bundle branch blocks (28% [19 of 69] vs 17% [11 of 64]; P=.154) when SAPIEN 3 was compared with SAPIEN XT. We found a trend toward a higher rate of new-onset intraventricular conduction abnormalities with SAPIEN 3 compared with SAPIEN XT, although this did not result in a higher permanent pacemaker implantation rate. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

The role of prosthetic abutment material on the stress distribution in a maxillary single implant-supported fixed prosthesis

Energy Technology Data Exchange (ETDEWEB)

Peixoto, Hugo Eduardo, E-mail: hugo.e.peixoto@hotmail.com [Implantology Team, Latin American Institute of Research and Education in Dentistry, Curitiba, Paraná (Brazil); Bordin, Dimorvan, E-mail: dimorvan_bordin@hotmail.com [Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Limeira avenue, 901-Vila Rezende, Piracicaba, SP 13414-903 (Brazil); Del Bel Cury, Altair A., E-mail: altcury@fop.unicamp.br [Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Limeira avenue, 901-Vila Rezende, Piracicaba, SP 13414-903 (Brazil); Silva, Wander José da, E-mail: wanderjose@fop.unicamp.br [Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Limeira avenue, 901-Vila Rezende, Piracicaba, SP 13414-903 (Brazil); Faot, Fernanda, E-mail: fernanda.faot@gmail.com [Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves, 457, 2nd floor, Pelotas, Rio Grande do Sul 96015-560 (Brazil)

2016-08-01

Purpose: Evaluate the influence of abutment's material and geometry on stress distribution in a single implant-supported prosthesis. Materials and Methods: Three-dimensional models were made based on tomographic slices of the upper middle incisor area, in which a morse taper implant was positioned and a titanium (Ti) or zirconia (ZrN) universal abutments was installed. The commercially available geometry of titanium (T) and zirconia (Z) abutments were used to draw two models, TM1 and ZM1 respectively, which served as control groups. These models were compared with 2 experimental groups were the mechanical properties of Z were applied to the titanium abutment (TM2) and vice versa for the zirconia abutment (ZM2). Subsequently, loading was simulated in two steps, starting with a preload phase, calculated with the respective friction coefficients of each materials, followed by a combined preload and chewing force. The maximum von Mises stress was described. Data were analyzed by two-way ANOVA that considered material composition, geometry and loading (p < 0.05). Results: Titanium and zirconia abutments showed similar von Mises stresses in the mechanical part of the four models. The area with the highest concentration of stress was the screw thread, following by the screw body. The highest stress levels occurred in screw thread was observed during the preloading phase in the ZM1 model (931 MPa); and during the combined loading in the TM1 model (965 MPa). Statistically significant differences were observed for loading, the material × loading interaction, and the loading × geometry interaction (p < 0.05). Preloading contributed for 77.89% of the stress (p < 0.05). There were no statistically significant differences to the other factors (p > 0.05). Conclusion: The screw was the piece most intensely affected, mainly through the preload force, independent of the abutment's material. - Highlights: • The abutment's screw was the most impaired piece of the

Patient’s satisfaction after 2-piece inflatable penile prosthesis implantation: An Italian multicentric study

Directory of Open Access Journals (Sweden)

Giorgio Gentile

2016-03-01

Full Text Available Introduction: Penile prosthesis implant represents a valuable solution for pts with severe erectile dysfunction (ED, non-responders to medical management. The aim of our study was to evaluate the satisfaction of patients (pts after 2-pieces inflatable penile prosthesis (IPP. Aim of the study: to evaluate safety, reliability and post-operative patient’s satisfaction after implantation of two-pieces IPP. Materials and Methods: This retrospective multicentric analysis concerns a group of 42 patients undergone 2-pieces IPP implantation from November 2005 to November 2013, in four Centers of proven experience. As a first step, a detailed review of all clinical reports was performed. Secondly, every patient was asked to fill the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS specifically modified, in order to assess their own satisfaction after surgery and, its impact on patient’s quality of sexual life. Results: 42 pts were evaluated (AMS-Ambicor: 28; Coloplast- Excell: 14; mean age, at time of operation: 60,7 years; mean follow up: 27,6 months; etiology of ED: vascular 23,8%, diabetes 19%, La Peyronie D. 7,1%, consequence of radical prostatectomy 31%, consequence of other pelvic surgery 11,9%, spinal trauma 7%. Mean operative time: 117 ± 58 min, mean postoperative hospital stay 3 ± 1,6 days. Post operative short-term complications: 4 pts (9,5%. Post operative long-term complications: 4 pts (9,5%. Long-term functional results (Questionnaire: 71% of pts (30 reported regular use of the prosthesis, at least 1 time/week, the satisfaction was good in 42% of pts (18, quite good in 33,3% (14, quite bad in 2,4% (1, very bad in 7,1% (3, 6 pts (14,4% didn’t answer. Conclusions: 2 pieces IPP appears to be associated with a low complication rate and good satisfaction of pts especially in the elderly. It also assures satisfactory rates of aesthetics and functional results.

21 CFR 872.3950 - Glenoid fossa prosthesis.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the temporomandibular...

Autoinflation Leading to Failure of Two-Piece Ambicor Implantable Penile Prosthesis: An Outcome from a Methodical Treatment of Recalcitrant Stuttering Priapism

Directory of Open Access Journals (Sweden)

R. Charles Welliver

2014-01-01

Full Text Available Introduction. We present the case of a patient who received a two-piece Ambicor penile prosthesis for idiopathic recurrent “stuttering” priapism refractory to other treatment options. The patient returned unable to deflate the device due to an interesting anatomically induced mechanical failure. Aims. To describe the method and findings of this inflatable prosthesis failure. Results. Prosthesis failure occurred due to restrictive corporal diameter and the unique characteristics of fluid reservoir location in the two-piece inflatable prosthesis. The patient was successfully converted to a semirigid prosthesis with resolution of the pain that was due to his prosthesis autoinflation. Conclusion. Stuttering priapism remains a challenging clinical problem. Penile implantation is a reasonable long-term solution in a patient refractory to less invasive options. In patients with fibrotic corpora, a malleable device should be considered (at least temporarily if unable to dilate comfortably to 13 mm.

Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures

Directory of Open Access Journals (Sweden)

Carlo Luigi Augusto Negro

2016-01-01

Full Text Available Implantation of an inflatable penile prosthesis (IPP is a well-established definitive solution for erectile dysfunction when conservative treatments fail. Penile implants may shorten the penis. The AMS 700 LGX IPP is in common use but reports on its mechanical reliability, medium-term postsurgical patient satisfaction, and mean penile length preservation are lacking. We investigate the mean penile length, mechanical reliability, and patient satisfaction at 6 and 12 months after implantation of the AMS 700 LGX. This prospective study consecutively enrolled men undergoing first-time IPP implant surgery from February 2009 to April 2012. Stretched flaccid penile length, penile length at 50% and 100% of stiffness (P50 and P100 and International Index of Erectile Function (IIEF and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS scores, were measured at 6 and 12 months postsurgery. Of 45 patients who underwent AMS 700 LGX implantation (median age 61 years and completed 6 months′ follow-up, 36 (80% completed the study. A significant difference in stretched flaccid penile length was seen between 6 and 12 months (P = 0.033. P100 was also significantly increased at 6 and 12 months, with a mean 10% increase (1.3 ± 0.4 cm from baseline to 12 months. Differences in mean IIEF scores at 6 and 12 months were significant for the desired domain (P = 0.0001 and for overall satisfaction (P = 0.002; however, mean EDITS scores at 6 and 12 months were not significantly improved. AMS 700 LGX is a powerful tool for preserving penile length in men undergoing penile prosthesis implantation.

Implant-supported rehabilitation after treatment of atrophic mandibular fractures: report of two cases.

Science.gov (United States)

Oliveira, Leandro Benetti de; Gabrielli, Marisa Aparecida Cabrini; Gabrielli, Mario Francisco Real; Pereira-Filho, Valfrido Antonio Pereira

2015-12-01

The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (fractures. Two patients who sustained fractures in severely atrophic mandibles with less than 10 mm of bone height were treated by open reduction and internal fixation through a transcervical access. Internal fixation was obtained with 2.4-mm locking reconstruction plates. The first patient presented satisfactory bone height at the area between the mental foramens and after 2 years, received flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.

Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery

Directory of Open Access Journals (Sweden)

Sampa Ray (Bhattacharya

2015-01-01

Full Text Available Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis.

Arthroplasty knee registry of Catalonia: What scientific evidence supports the implantation of our prosthesis?

Science.gov (United States)

Samaniego Alonso, R; Gaviria Parada, E; Pons Cabrafiga, M; Espallargues Carreras, M; Martinez Cruz, O

2018-02-28

In our environment, it is increasingly necessary to perform an activity based on scientific evidence and the field of prosthetic surgery should be governed by the same principles. The national arthroplasty registries allow us to obtain a large amount of data in order to evaluate this technique. The aim of our study is to analyse the scientific evidence that supports the primary total knee arthroplasties implanted in Catalonian public hospitals, based on the Arthoplasty Registry of Catalonia (RACat) MATERIAL AND METHODS: A review of the literature was carried out on knee prostheses (cruciate retaining, posterior stabilized, constricted and rotational) recorded in RACat between the period 2005-2013 in the following databases: Orthopedic Data Evaluation Panel, PubMed, TripDatabase and Google Scholar. The prostheses implanted in fewer than 10 units (1,358 prostheses corresponding to 62 models) were excluded. 41,947 prostheses (96.86%) were analysed out of 43,305 implanted, corresponding to 74 different models. In 13 models (n = 4,715) (11.24%) no clinical evidence to support their use was found. In the remaining 36 models (n = 13,609) (32.45%), level iv studies were the most predominant evidence. There was a significant number of implanted prostheses (11.24%) for which no clinical evidence was found. The number of models should be noted, 36 out of 110, with fewer than 10 units implanted. The use of arthroplasty registries has proved an extremely useful tool that allows us to analyse and draw conclusions in order to improve the efficiency of this surgical technique. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Influence of Implant Position on Stress Distribution in Implant-Assisted Distal Extension Removable Partial Dentures: A 3D Finite Element Analysis.

Science.gov (United States)

Memari, Yeganeh; Geramy, Allahyar; Fayaz, Amir; Rezvani Habib Abadi, Shirin; Mansouri, Yasaman

2014-09-01

Distal extension removable partial denture is a prosthesis with lack of distal dental support with a 13-fold difference in resiliency between the mucosa and the periodontal ligament, resulting in leverage during compression forces. It may be potentially destructive to the abutments and the surrounding tissues. The aim of this study was to assess the effect of implant location on stress distribution, in distal extension implant assisted removable partial dentures. Three-dimensional models of a bilateral distal extension partially edentulous mandible containing anterior teeth and first premolar in both sides of the arch, a partial removable denture and an implant (4×10mm) were designed. With the aid of the finite element program ANSYS 8.0, the models were meshed and strictly vertical forces of 10 N were applied to each cusp tip. Displacement and von Mises Maps were plotted for visualization of results. When an implant was placed in the second premolar region, the highest stress on implant, abutment tooth and cancellous bone was shown. The lowest stress was shown on implant and bone in the 1(st) molar area. Implants located in the first molar area showed the least distribution of stresses in the analyzed models.

Problems encountered during the development and implantation of the Baylor-Rice orthotopic cardiac prosthesis

International Nuclear Information System (INIS)

Ross, J.N. Jr.; Akers, W.W.; O'Bannon, W.; Spargo, W.J.; Serrato, M.A.; Fuqua, J.M. Jr.; Ruark, B.S.; Wieting, D.W.; Kennedy, J.H.; DeBakey, M.E.

1972-01-01

The problems associated with the development of an artificial heart are enumerated. In a series of 24 calf implantations, several of the animals stood unassisted and reacted normally, but all eventually died with deteriorating circulatory and pulmonary systems. The problems caused by pump size and geometry represented the most important deterrents to long-term survival. A new prosthesis, though not yet tested in animals, is believed to minimize these problems. (auth)

Horizontal alveolar ridge expansion followed by immediate placement of implants and rehabilitation with zirconia prosthesis

Directory of Open Access Journals (Sweden)

Tatiana Miranda Deliberador

2017-01-01

Full Text Available In recent years, there have been a growing number of procedures involving dental implants. Most cases, though, are characterized by bone atrophy, especially horizontal atrophy. This clinical case aims to report a technique for the expansion of the horizontal alveolar ridge. A longitudinal fracture was created in the alveolar ridge to expand the bone, followed by immediate insertion of dental implants along with a particulate allogeneic bone graft. Eight implants were placed in the maxilla, and after 12 months, a surgical reopening was performed, along with rehabilitation with a protocol-type prosthesis, for which a zirconia infrastructure was made. The patient was observed during a 10-month follow-up period in which an effective osseointegration of all implants was achieved as a result of such a technique. The split-crest technique followed by the immediate placement of implants and a particulate allogeneic bone graft proved to be effective, with a predictable osseointegration.

Full Contoured Tooth-Implant Supported 3-Pointic All-Ceramic Denture During Occlusal Load Transfer in Lateral Region

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Żmudzki J.

2016-06-01

Full Text Available Implant and a tooth supported dentures are avoided by dentists because of uneven distribution of occlusal loads between a stiffer implant and a more pliable tooth. The hypothesis was that a 3-point all-ceramic bridge supported on a natural second premolar tooth and a two-pieces typical implant bears safely mastication loads. The finite element analysis showed that the implant splinted by all-ceramic zirconium bridge with the second premolar was safe under lateral mastication load, but there was found an overload at wide zone of bone tissue around the implant under the load of 800 N. The patients can safely masticate, but comminution of hard food should be avoided and they should be instructed that after such an indiscretion they need to contact a dental professional, because, in spite of integrity of the prosthesis, the bone tissue around the implant may fail and there is a hazard of intrusion of the tooth.

Various Techniques to Increase Keratinized Tissue for Implant Supported Overdentures: Retrospective Case Series

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Ahmed Elkhaweldi

2015-01-01

Full Text Available Purpose. The purpose of this retrospective case series is to describe and compare different surgical techniques that can be utilized to augment the keratinized soft tissue around implant-supported overdentures. Materials and Methods. The data set was extracted as deidentified information from the routine treatment of patients at the Ashman Department of Periodontology and Implant Dentistry at New York University College of Dentistry. Eight edentulous patients were selected to be included in this study. Patients were treated for lack of keratinized tissue prior to implant placement, during the second stage surgery, and after delivery of the final prosthesis. Results. All 8 patients in this study were wearing a complete maxillary and/or mandibular denture for at least a year before the time of the surgery. One of the following surgical techniques was utilized to increase the amount of keratinized tissue: apically positioned flap (APF, pedicle graft (PG, connective tissue graft (CTG, or free gingival graft (FGG. Conclusions. The amount of keratinized tissue should be taken into consideration when planning for implant-supported overdentures. The apical repositioning flap is an effective approach to increase the width of keratinized tissue prior to the implant placement.

Clinical evaluation of immediate loading of electroeroded screw-retained titanium fixed prostheses supported by tilted implant: a multicenter retrospective study.

Science.gov (United States)

Acocella, Alessandro; Ercoli, Carlo; Geminiani, Alessandro; Feng, Changyong; Billi, Mauro; Acocella, Gabriele; Giannini, Domenico; Sacco, Roberto

2012-05-01

Immediate occlusal loading of dental implants in the edentulous mandible has proven to be an effective, reliable, and predictable treatment protocol. However, there is limited long-term data available in the literature, when an electroeroded definitive cast-titanium fixed prosthesis is used for this treatment protocol. The aim of this study was to evaluate the clinical effectiveness of dental implants (Astra Tech Dental, Mölndal, Sweden) in the edentulous mandible immediately loaded with an electroeroded cast-titanium screw-retained fixed prosthesis. Forty-five patients received five implants each in the interforaminal area. All the implants were inserted with torque up to 40 Ncm and the distal implants were distally tilted approximately 20 to 30 degrees to minimize the length of posterior cantilevers. Implants were loaded within 48 hours of placement with an acrylic resin-titanium screw-retained prosthesis fabricated by electroerosion. Two of the 225 inserted implants failed after 3 and 16 months of healing, respectively, with a cumulative survival rate of 99.1% and a prosthetic survival rate of 97.8%. Immediate loading of tilted dental implants inserted in the edentulous mandible with a screw-retained titanium definitive prosthesis fabricated with electrical discharge machining provide reliable and predictable results. © 2011 Wiley Periodicals, Inc.

CT-angiography-based evaluation of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI-predictive value and optimal thresholds for major anatomic parameters.

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Florian Schwarz

Full Text Available BACKGROUND/OBJECTIVES: To evaluate the predictive value of CT-derived measurements of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI and to calculate optimal cutoff values for the selection of various prosthesis sizes. METHODS: The local IRB waived approval for this single-center retrospective analysis. Of 441 consecutive TAVI-patients, 90 were excluded (death within 30 days: 13; more than mild aortic regurgitation: 10; other reasons: 67. In the remaining 351 patients, the CoreValve (Medtronic and the Edwards Sapien XT valve (Edwards Lifesciences were implanted in 235 and 116 patients. Optimal prosthesis size was determined during TAVI by inflation of a balloon catheter at the aortic annulus. All patients had undergone CT-angiography of the heart or body trunk prior to TAVI. Using these datasets, the diameter of the long and short axis as well as the circumference and the area of the aortic annulus were measured. Multi-Class Receiver-Operator-Curve analyses were used to determine the predictive value of all variables and to define optimal cutoff-values. RESULTS: Differences between patients who underwent implantation of the small, medium or large prosthesis were significant for all except the large vs. medium CoreValve (all p's<0.05. Furthermore, mean diameter, annulus area and circumference had equally high predictive value for prosthesis size for both manufacturers (multi-class AUC's: 0.80, 0.88, 0.91, 0.88, 0.88, 0.89. Using the calculated optimal cutoff-values, prosthesis size is predicted correctly in 85% of cases. CONCLUSION: CT-based aortic root measurements permit excellent prediction of the prosthesis size considered optimal during TAVI.

Relation between bruxism and dental implants

OpenAIRE

TORCATO,Leonardo Bueno; ZUIM,Paulo Renato Junqueira; BRANDINI,Daniela Atili; FALCÓN-ANTENUCCI,Rosse Mary

2014-01-01

OBJECTIVE: The aim of this study was to gather information and discuss the predictability of implant-supported prostheses in patients with bruxism by performing a literature review.METHODS: In order to select the studies included in this review, a detailed search was performed in PubMed and Medlinedatabases, using the following key words: bruxism, dental implants, implant supported prosthesis, and dental restoration failure. Items that were included are: case reports, randomized controlled tr...

Macroscopic and microscopic evaluation of a new implant design supporting immediately loaded full arch rehabilitation

OpenAIRE

Tetè, Stefano; Zizzari, Vincenzo; De Carlo, Alessandro; Sinjari, Bruna; Gherlone, Enrico

2012-01-01

The purpose of this study is to evaluate macroscopic and microscopic appearance of a new implant design, with particular emphasis given to the type of prosthesis connection. Two dental implants of the same type (Torque Type®, WinSix®, BioSAFin. S.r.l. - Ancona, Italy), with sandblasted and acid etched surfaces (Micro Rough Surface®), but differing from each other for the prosthesis connection system, were examined by scanning electron microscope (SEM) analysis at different magnifications: TTI...

Management of aggressive periodontitis patient with implant supported prosthesis

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Garima Jain

2015-01-01

Full Text Available Aggressive periodontitis (AgP comprises a group of rare, often severe, rapidly progressive forms of periodontitis which is characterized by an early age of clinical manifestations. It usually affects people under 30 years of age, but patients may be older. Microbiota associated are Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. The presence of highly pathogenic bacteria, severe periodontal bone destruction and the refractory nature of this disease tends to deter the clinician from placing implants in these patients. This case report demonstrates the placement of implants in a patient with AgP with successful 18 months follow-up.

Immediate implant-supported oral rehabilitation using a photocurable plastic skull model and laser welding. A technical note on the screw-retained type: Part 1.

Science.gov (United States)

Tomotake, Yoritoki; Ishida, Osamu; Kanitani, Hideo; Ichikawa, Tetsuo

2002-01-01

This article describes a new procedure for immediate implant-supported oral rehabilitation using a photocurable resin skull model and a laser-welding apparatus. Preoperatively, the framework was fabricated on a photocurable resin skull model produced from a CT scan and individually designed guide template. The implants were immediately placed using the guide template; laser welding connected the components of framework. Despite the custom-made prosthesis, the total treatment from implant placement to superstructure placement can be completed within only 1 day. This procedure for immediate implant-supported oral rehabilitation using a photocurable resin skull model and a laser-welding apparatus may be useful for any implant system and patient.

Just-in-time Design and Additive Manufacture of Patient-specific Medical Implants

Science.gov (United States)

Shidid, Darpan; Leary, Martin; Choong, Peter; Brandt, Milan

Recent advances in medical imaging and manufacturing science have enabled the design and production of complex, patient-specific orthopaedic implants. Additive Manufacture (AM) generates three-dimensional structures layer by layer, and is not subject to the constraints associated with traditional manufacturing methods. AM provides significant opportunities for the design of novel geometries and complex lattice structures with enhanced functional performance. However, the design and manufacture of patient-specific AM implant structures requires unique expertise in handling various optimization platforms. Furthermore, the design process for complex structures is computationally intensive. The primary aim of this research is to enable the just-in-time customisation of AM prosthesis; whereby AM implant design and manufacture be completed within the time constraints of a single surgical procedure, while minimising prosthesis mass and optimising the lattice structure to match the stiffness of the surrounding bone tissue. In this research, a design approach using raw CT scan data is applied to the AM manufacture of femoral prosthesis. Using the proposed just-in-time concept, the mass of the prosthesis was rapidly designed and manufactured while satisfying the associated structural requirements. Compressive testing of lattice structures manufactured using proposed method shows that the load carrying capacity of the resected composite bone can be recovered by up to 85% and the compressive stiffness of the AM prosthesis is statistically indistinguishable from the stiffness of the initial bone.

CT-angiography-based evaluation of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI)-predictive value and optimal thresholds for major anatomic parameters.

Science.gov (United States)

Schwarz, Florian; Lange, Philipp; Zinsser, Dominik; Greif, Martin; Boekstegers, Peter; Schmitz, Christoph; Reiser, Maximilian F; Kupatt, Christian; Becker, Hans C

2014-01-01

To evaluate the predictive value of CT-derived measurements of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI) and to calculate optimal cutoff values for the selection of various prosthesis sizes. The local IRB waived approval for this single-center retrospective analysis. Of 441 consecutive TAVI-patients, 90 were excluded (death within 30 days: 13; more than mild aortic regurgitation: 10; other reasons: 67). In the remaining 351 patients, the CoreValve (Medtronic) and the Edwards Sapien XT valve (Edwards Lifesciences) were implanted in 235 and 116 patients. Optimal prosthesis size was determined during TAVI by inflation of a balloon catheter at the aortic annulus. All patients had undergone CT-angiography of the heart or body trunk prior to TAVI. Using these datasets, the diameter of the long and short axis as well as the circumference and the area of the aortic annulus were measured. Multi-Class Receiver-Operator-Curve analyses were used to determine the predictive value of all variables and to define optimal cutoff-values. Differences between patients who underwent implantation of the small, medium or large prosthesis were significant for all except the large vs. medium CoreValve (all p'sprosthesis size for both manufacturers (multi-class AUC's: 0.80, 0.88, 0.91, 0.88, 0.88, 0.89). Using the calculated optimal cutoff-values, prosthesis size is predicted correctly in 85% of cases. CT-based aortic root measurements permit excellent prediction of the prosthesis size considered optimal during TAVI.

Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement: a review.

Science.gov (United States)

Scotti, Roberto; Pellegrino, Gerardo; Marchetti, Claudio; Corinaldesi, Guiseppe; Ciocca, Leonardo

2010-01-01

To test if using a CAD/CAM system might reduce the necessity of bone augmentation in patients with atrophic maxillary arches before implant therapy. Twenty male and female patients consecutively scheduled for bone augmentation of the jaw before implant surgery were included in this study, with a total of 29 jaws (maxillary and mandibular) to analyze for the implant-supported fixed prosthesis group and 19 maxillary arches for the implant-supported removable prosthesis group. NobelGuide System (Nobel Biocare), Autocad System (Autodesk), and routine manual CT measurements of available bone were used in this study. The total results of the mean values of the fixed prosthesis group plus the mean values of the removable prosthesis group showed a statistically significant difference between the NobelGuide intervention score and both manual (P = .004) and Autocad (P = .001) measurements. The NobelGuide System represents a viable diagnostic device to reduce the entity or avoid bone reconstructive surgery before implant placements in the atrophic maxilla and mandible.

Percutaneous aortic valve implantation of the Medtronic CoreValve self-expanding valve prosthesis via left subclavian artery access: the first case report in Greece.

Science.gov (United States)

Karavolias, George K; Georgiadou, Panagiota; Houri, Mazen; Sbarouni, Eftihia; Thomopoulou, Sofia; Tsiapras, Dimitrios; Smirli, Anna; Balanika, Marina; Voudris, Vassilis

2010-01-01

This case report describes a percutaneous aortic valve implantation with the Medtronic CoreValve selfexpanding valve prosthesis in a patient with severe aortic stenosis. The approach was made via the left subclavian artery because of the lack of femoral vessel access. The patient was a 78-year-old female with breathlessness on minimal effort, a recent hospitalisation due to pulmonary oedema, and frequent episodes of pre-syncope; surgical valve replacement had been ruled out. The prosthetic valve was successfully implanted with mild paravalvular aortic regurgitation. At 30 days, the patient's clinical condition had significantly improved, with excellent functioning of the aortic valve prosthesis.

Consensus report - reconstructions on implants. The Third EAO Consensus Conference 2012

DEFF Research Database (Denmark)

Gotfredsen, Klaus; Wiskott, Anselm

2012-01-01

This group was assigned the task to review the current knowledge in the areas of implant connections to abutments/reconstructions, fixation methods (cement vs. screw retained) for implant-supported reconstructions, as well as the optimal number of implants for fixed dental prosthesis and implant...

A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface

DEFF Research Database (Denmark)

Gotfredsen, K; Karlsson, U

2001-01-01

PURPOSE: The aim of the present study was to evaluate whether there was a difference between machined and TiO(2)-blasted implants regarding survival rate and marginal bone loss during a 5-year observation period. MATERIALS AND METHODS: A total of 133 implants (Astra Tech Dental Implants; Astra Tech...... AB, Mölndal, Sweden) were placed in 50 patients at 6 centers in 4 Scandinavian countries. Forty-eight implants were installed in the maxilla and 85 implants in the mandible. A randomization and a stratification were done, so that each fixed partial prosthesis was supported by at least 1 machined...... and 1 TiO(2)-blasted implant. The implant-supported fixed partial prostheses (ISFPP) were fabricated within 2 months after postoperative healing. A total of 52 ISFPP (17 maxillary, 35 mandibular) were inserted. The patients were clinically examined once a year for 5 years. At the annual follow...

Scattering of the radiofrequency electromagnetic field by orthopedic bone support frame implants

International Nuclear Information System (INIS)

Mohsin, S.A.; Sheikh, N.M.

2009-01-01

The interaction of the fields in MRI (Magnetic Resonance Imaging) with orthopedic implants is investigated. The primary interaction is the scattering of the MRI RF (Radiofrequency) field by the implants. As a specific case study, the scattel-cd field due to a bone support frame implant is computed by the finite-element-method. The support frame has steel pins of significant length embedded in tissue. The induced surface current distributions on the steel pins and the spatial electric field distributions in the surrounding tissue have been obtained. (author)

Successful Rehabilitation of Partial Edentulous Maxilla and Mandible with New Type of Implants: Molecular Precision Implants

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Matteo Danza

2014-01-01

Full Text Available The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. Atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. The immediate load of implants is a universally practiced procedure; nevertheless a successful procedure requires expertise in both the clinical and the reconstructive stages using a solid implant system. Excellent primary stability and high bone-implant contact are only minimal requirements for any type of implant procedure. In this paper we present a case report using a new type of implants. The new type of implants, due to its sophisticated control system of production, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.

Influence of laser-welding and electroerosion on passive fit of implant-supported prosthesis.

Science.gov (United States)

Silva, Tatiana Bernardon; De Arruda Nobilo, Mauro Antonio; Pessanha Henriques, Guilherme Elias; Mesquita, Marcelo Ferraz; Guimaraes, Magali Beck

2008-01-01

This study investigated the influence of laser welding and electroerosion procedure on the passive fit of interim fixed implant-supported titanium frameworks. Twenty frameworks were made from a master model, with five parallel placed implants in the inter foramen region, and cast in commercially pure titanium. The frameworks were divided into 4 groups: 10 samples were tested before (G1) and after (G2) electroerosion application; and another 10 were sectioned into five pieces and laser welded before (G3) and after (G4) electroerosion application. The passive fit between the UCLA abutment of the framework and the implant was evaluated using an optical microscope Olympus STM (Olympus Optical Co., Tokyo, Japan) with 0.0005mm of accuracy. Statistical analyses showed significant differences between G1 and G2, G1 and G3, G1 and G4, G2 and G4. However, no statistical difference was observed when comparing G2 and G3. These results indicate that frameworks may show a more precise adaptation if they are sectioned and laser welded. In the same way, electroerosion improves the precision in the framework adaptation.

Peri-implant evaluation of osseointegrated implants subjected to orthodontic forces: results after three years of functional loading

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Bruna de Rezende Marins

2016-04-01

Full Text Available ABSTRACT Objective: The objective of this study was to clinically and radiographically assess the peri-implant conditions of implants used as orthodontic anchorage. Methods: Two groups were studied: 1 a test group in which osseointegrated implants were used as orthodontic anchorage, with the application of 200-cN force; and 2 a control group in which implants were not subjected to orthodontic force, but supported a screw-retained prosthesis. Clinical evaluations were performed three, six and nine months after prosthesis installation and 1- and 3-year follow-up examinations. Intraoral periapical radiographs were obtained 30 days after surgical implant placement, at the time of prosthesis installation, and one, two and three years thereafter. The results were compared by Kruskal-Wallis test. Results: There was no statistically significant difference in clinical probing depth (p = 0.1078 or mesial and distal crestal bone resorption (p = 0.1832 during the study period. After three years of follow-up, the mean probing depth was 2.21 mm for the control group and 2.39 mm for the test group. The implants of the control group showed a mean distance between the bone crest and implant shoulder of 2.39 mm, whereas the implants used as orthodontic anchorage showed a mean distance of 2.58 mm at the distal site. Conclusion: Results suggest that the use of stable intraoral orthodontic anchorage did not compromise the health of peri-implant tissues or the longevity of the implant.

Treatment Outcome and Patient Satisfaction with Two Adjacent Implant-Supported Restorations in the Esthetic Zone

NARCIS (Netherlands)

Tymstra, Nynke; Meijer, Henny J. A.; Stellingsma, Kees; Raghoebar, Gerry M.; Vissink, Arjan

2010-01-01

The purpose of this study was to evaluate the clinical and radiographic parameters as well as the esthetic outcome of two adjacent implant-supported restorations and the surrounding peri-implant mucosa in the maxillary esthetic zone. Ten patients were treated with two adjacent implants in the

The impact of diabetes mellitus on penile length in men undergoing inflatable penile prosthesis implantation.

Science.gov (United States)

Akın, Yiğit; Şahiner, İlker Fatih; Usta, Mustafa Faruk

2013-09-01

To evaluate the changing cavernosal length of patients with diabetes mellitus (DM) and organic erectile dysfunction (ED) who were treated with inflatable, three-piece penile prostheses, a current surgical treatment option in our clinic, over the course of 12 years. Between April 2000 and December 2012, we retrospectively investigated data from patients who were diagnosed with organic ED and undergone penile prosthesis implantation (PPI). Of the 239 patients, 235 of them were included in the study. Four patients who were operated on for trans-sexuality were excluded from the study. All patients were divided into two groups as those with (Group 1) or without DM (Group 2). Data, including age, body mass index (BMI) in kg/m(2), surgical history, comorbidities, International Index of Erectile Function (IIEF) questionnaire scores, combined intracavernous injection and stimulation (CIS) test results, length of corpus cavernosum while implanting the penile prosthesis, complications, operative times, mean hospital stay, and satisfaction of the patient and partner, were recorded. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. A p-value of 0.05). The length of the corpus cavernosum and the destruction of cavernosal tissues do not depend only on DM. We conclude that these features may have multifactorial causes.

Transition from failing dentition to complete-arch implant rehabilitation with a staged approach: a 3-year clinical report.

Science.gov (United States)

Papaspyridakos, Panos; Chronopoulos, Vasilios

2014-09-01

The transition of patients from failing dentition to complete-arch implant rehabilitation often means that the patient is rendered edentulous and has to wear a removable complete denture for a time. Many patients find this objectionable. A staged treatment approach provides a fixed interim prosthesis for use throughout the rehabilitation process, allowing patient comfort and prosthodontic control. This clinical report describes a staged approach protocol with a new type of interim prosthesis. The prosthesis is supported by hopeless teeth and the soft tissues of the maxillary tuberosities and mandibular retromolar pads for the complete-arch implant rehabilitation of a patient with failing dentition. This protocol allows for a fixed interim prosthesis with combined tooth and mucosa or implant support during the entire rehabilitation process, thus avoiding the use of complete dentures. The implants and prostheses were functioning successfully after 3 years of clinical service. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Longitudinal forces acting at side-to-end and end-to-side anastomoses when a knitted polyester arterial prosthesis is implanted in the dog.

Science.gov (United States)

Dadgar, L; Downs, A R; Deng, X; Marois, Y; King, M W; Martin, L; Guidoin, R

1995-01-01

In a previous study, which investigated the tensions at the proximal and distal end-to-end anastomoses of a vascular prosthesis, no significant differences were found in the longitudinal forces between the two anastomotic sites after different periods of implantation. The present follow-up study was devised to study the longitudinal forces at a proximal side-to-end and a distal end-to-side anastomosis using a warp knitted polyester prosthesis implanted as a canine thorocoabdominal bypass. The external surface of the prosthesis contained a specially printed "tension indicator" design, which enabled changes in length to be assessed photographically at the two anastomoses at the time of implantation and at sacrifice. The longitudinal force at each site was then calculated using a relationship obtained experimentally between the total longitudinal force and the changes in length of the virgin graft in vitro. The in vitro measurements on the prosthesis were performed using a computer-controlled laser calibration system. Although the results showed a tendency toward a gradual loss in longitudinal force at both anastomoses over 7 months in situ, statistical analysis showed no significant difference in the longitudinal force at the two anastomotic sites after any period of implantation. Histopathological and textile analysis also showed that the characteristics of the prostheses were similar at both anastomotic sites. This does not mean, however, that the intramural stress concentrations experienced by the two sites were the same. While comparing the level of the longitudinal forces measured in this study with those observed in the previous thoracic aorta study using end-to-end anastomoses, no significant differences were observed due to the different types of anastomoses. It would appear that the longitudinal force is not one of the main etiological factors that cause the formation and localization of anastomotic failure.

Endoscope-Assisted and Controlled Argus II Epiretinal Prosthesis Implantation in Late-Stage Retinitis Pigmentosa: A Report of 2 Cases.

Science.gov (United States)

Özmert, Emin; Demirel, Sibel

2016-01-01

Several different approaches for restoring sight in subjects who are blind due to outer retinal degeneration are currently under investigation, including stem cell therapy, gene therapy, and visual prostheses. Although many different types of visual prostheses have shown promise, to date, the Argus II Epiretinal Prosthesis System, developed in a clinical setting over the course of 10 years, is the world's first and only retinal prosthesis that has been approved by the United States Food and Drug Administration (FDA) and has been given the CE-Mark for sale within the European Economic Area (EEA). The incidence of serious adverse events from Argus II implantation decreased over time after minor changes in the implant design and improvements in the surgical steps used for the procedure had been made. In order to further decrease the scleral incision-related complications and enhance the assessment of the tack position and the contact between the array and the inner macular surface, we used an ophthalmic endoscope during the regular course of Argus II implantation surgery in 2 patients with late-stage retinitis pigmentosa in an attempt to improve the anatomical and functional outcomes.

Endoscope-Assisted and Controlled Argus II Epiretinal Prosthesis Implantation in Late-Stage Retinitis Pigmentosa: A Report of 2 Cases

Directory of Open Access Journals (Sweden)

Emin Özmert

2016-12-01

Full Text Available Several different approaches for restoring sight in subjects who are blind due to outer retinal degeneration are currently under investigation, including stem cell therapy, gene therapy, and visual prostheses. Although many different types of visual prostheses have shown promise, to date, the Argus II Epiretinal Prosthesis System, developed in a clinical setting over the course of 10 years, is the world’s first and only retinal prosthesis that has been approved by the United States Food and Drug Administration (FDA and has been given the CE-Mark for sale within the European Economic Area (EEA. The incidence of serious adverse events from Argus II implantation decreased over time after minor changes in the implant design and improvements in the surgical steps used for the procedure had been made. In order to further decrease the scleral incision-related complications and enhance the assessment of the tack position and the contact between the array and the inner macular surface, we used an ophthalmic endoscope during the regular course of Argus II implantation surgery in 2 patients with late-stage retinitis pigmentosa in an attempt to improve the anatomical and functional outcomes.

Influence of Implant Position on Stress Distribution in Implant-Assisted Distal Extension Removable Partial Dentures: A 3D Finite Element Analysis.

Directory of Open Access Journals (Sweden)

Yeganeh Memari

2014-10-01

Full Text Available Distal extension removable partial denture is a prosthesis with lack of distal dental support with a 13-fold difference in resiliency between the mucosa and the periodontal ligament, resulting in leverage during compression forces. It may be potentially destructive to the abutments and the surrounding tissues. The aim of this study was to assess the effect of implant location on stress distribution, in distal extension implant assisted removable partial dentures.Three-dimensional models of a bilateral distal extension partially edentulous mandible containing anterior teeth and first premolar in both sides of the arch, a partial removable denture and an implant (4×10mm were designed. With the aid of the finite element program ANSYS 8.0, the models were meshed and strictly vertical forces of 10 N were applied to each cusp tip. Displacement and von Mises Maps were plotted for visualization of results.When an implant was placed in the second premolar region, the highest stress on implant, abutment tooth and cancellous bone was shown. The lowest stress was shown on implant and bone in the 1(st molar area.Implants located in the first molar area showed the least distribution of stresses in the analyzed models.

Percutaneous closure of paravalvular leaks after transcatheter aortic valve implantation with Edwards SAPIEN prosthesis: a report of two cases.

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Estévez-Loureiro, Rodrigo; Salgado-Fernández, Jorge; Vázquez-González, Nicolás

2013-02-01

Significant periprosthetic aortic regurgitation after transcatheter aortic valve implantation with Edwards SAPIEN prosthesis has become a major concern of this technique given its association with impaired survival. We report the successful closure of such defects using vascular occlusion devices with significant improvement in clinical status of patients.

Tackling the Issue of High Postoperative Pacemaker Implantation Rates in Sutureless Aortic Valve Replacement: Should Balloon Inflation be Removed from the Implantation Method of the Perceval Prosthesis?

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Charles Blouin, Mathieu; Bouhout, Ismail; Demers, Philippe; Carrier, Michel; Perrault, Louis; Lamarche, Yoan; El-Hamamsy, Ismail; Bouchard, Denis

2017-05-01

Sutureless aortic valve replacement (AVR) is an emerging alternative to standard AVR in elderly and high-risk patients. This procedure is associated with a high rate of postoperative permanent pacemaker implantation (PPI). The study aim was to assess the impact on the rate of PPI of implanting the Perceval prosthesis without using balloon inflation. A total of 159 patients who underwent sutureless AVR using the Perceval prosthesis was included. Balloon inflation was used in 132 patients (Balloon group) and not used in the remaining 27 (No-Balloon group). Clinical, echocardiographic and electrocardiographic outcomes were assessed. There was no significant difference in PPI rate between the two groups (26% for Balloon group versus 22% in No-Balloon group; p = 0.700). Balloon inflation had no significant impact on the incidence of paravalvular leaks (p = 0.839), or on the need to return to cardiopulmonary bypass (CPB) intraoperatively due to paravalvular leak or unsatisfactory deployment (p >0.999). Mean and peak transaortic pressure gradients were similar between the two groups (p = 0.417 and p = 0.522, respectively). Cross-clamp and CPB times were shorter in the No-Balloon group (49.6 ± 15.9 min versus 61.1 ± 25.6 min and 64.1 ± 26.3 min versus 79.6 ± 35.4 min, respectively; p = 0.027 and p = 0.012, respectively). The two groups had similar postoperative PPI rates. Implanting the Perceval prosthesis without balloon inflation is safe and had no impact on paravalvular leaks, intraoperative complications or hemodynamic results. Reductions in aortic cross-clamp time and CPB time were observed when the balloon was not used.

Use of an Implant O-Ring Attachment for the Tooth Supported Mandibular Overdenture: A Clinical Report

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Guttal, Satyabodh S.; Tavargeri, Anand K.; Nadiger, Ramesh K.; Thakur, Srinath L.

2011-01-01

Retention of a mandibular denture can be achieved by an implant-retained or natural tooth-retained 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. PMID:21769276

Use of an implant o-ring attachment for the tooth supported mandibular overdenture: a clinical report.

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Guttal, Satyabodh S; Tavargeri, Anand K; Nadiger, Ramesh K; Thakur, Srinath L

2011-07-01

Retention of a mandibular denture can be achieved by an implant-retained or natural tooth-retained 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.

The Amount of Wear in Attachment of Implant-Supported Overdentures in Mandible

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Fariborz Vafaee

2016-10-01

Full Text Available Background and objectives: One of the simplest and cheapest attachments for overdentures, is the ball-type attachment, however, keeping it during the first year of prosthesis delivery and after that is one of the main concerns of dentists. The present study aimed to assess the wear of matrix in overdentures attachment supported by one, two and three implants in the mandible. Materials and methods: Thirty edentulous patients were randomly divided into three groups: the first group received a single implant in the midline of the lower mandible, the second group two implants in areas B and D, and the third group three implants in areas B, C, and D. The attachment used in patients’ prosthetic with single and two implants was O-ball/ring attachment and for patients with three implants, the treatment plan was ball bar-supported attachments. After placing the new matrix implant for each patient and obtaining their consent, the matrix wear was measured with CMM (Coordinate Measuring Machine device. To compare matrix wear after six months and one year, measurements were repeated. Data analysis, using ANOVA and multiple comparisons was down by Tukey Test. variance with repeated measures and Tukey test were used to compare the groups two-by-two. P.value less than 0.05 was set statistical significant. SPSS 16 software was used for data analysis. Results: The data obtained from the CMM device showed that the lowest mean matrix wear in the maximum single implant and maximum mean were in group two. Conclusion: Both time and the number of implants had a significant effect on the wear of the O-ring.

Treatment planning of implants in posterior quadrants.

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Jivraj, S; Chee, W

2006-07-08

Differences in anatomy and biomechanics make treatment of posterior quadrants with dental implants substantially different to that of anterior areas. Without implants, when posterior teeth were lost, treatment options included a long span fixed partial denture or a removable prosthesis, especially when no terminal abutment was available. Today, with the use of implants, options are available that allow preservation of unrestored teeth.(1) When teeth are missing, implant supported restorations can be considered the treatment of choice from the perspective of occlusal support, preservation of adjacent teeth and avoidance of a removable partial denture.

Full mouth rehabilitation with retrievable metal-ceramic implant-supported fixed prostheses for a young patient with atrophic jaws: a clinical report.

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Ameri, Narges; Alikhasi, Marzieh; Rezayani, Vida

2017-09-01

Treatment of atrophic edentulous jaws with implant-supported fixed prostheses is one of the most complicated challenges in dentistry. This clinical report describes the prosthesis which consists of screw retained frameworks with individual cement retained crowns which combines the advantages of the screw retained restoration with the advantage of cement retained.

Effect of surface contamination on osseointegration of dental implants surrounded by circumferential bone defects.

LENUS (Irish Health Repository)

Mohamed, Seif

2010-05-01

This study was designed to evaluate the effect of surface contamination on osseointegration of dental implants surrounded by a circumferential bone defect and to compare osseointegration around Osseotite with that around Nanotite implants.

A prospective dual-energy X-ray absorptiometry study of bone remodeling after implantation of the Nanos short-stemmed prosthesis.

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Zeh, Alexander; Pankow, Franziska; Röllinhoff, Marc; Delank, Stefan; Wohlrab, David

2013-04-01

The aim of this study was to analyze the bone remodeling around the Nanos stem (Smith & Nephew, Marl, Germany) after primary total hip arthroplasty for coxarthrosis. In 25 patients (15 male, 10 female, mean age 59.9 years) with the diagnosis of coxarthrosis, a DEXA scan was performed immediately after surgery, 97 days (SD 6.1 days) and 368 days (SD 6.2 days) after implantation of a Nanos prosthesis. Plain radiographs were analyzed digitally for radiolucent lines, varus-valgus femoral stem alignment, measurement of stem migration and changes in varus-valgus femoral stem alignment. The position of the center of rotation (COR) and the offset were assessed pre- and postoperatively. Harris Hip Score was used to evaluate the clinical outcome. The DEXA scan showed a significant and relevant increase in BMD (Bone Mineral Density) in Gruen-Zone 6 (12%) and a decrease in Zone 1 (15%), 2 (5%) and 7 (12%), which was interpreted as reflecting a distal load transfer in the metaphysis of the femur. There was no clinically relevant migration or tilting of the Nanos stem. Radiolucent lines were noted in 12 cases, mainly at the polished tip area of the prosthesis; this was not regarded as a sign of impaired osseointegration. There was no significant difference between the position of the COR and the pre- and postoperative offset. The absence of stem migration, angulation, or relevant radiolucent lines is seen as evidence for an unimpaired osseointegration of the Nanos stem approximately 12 months after implantation. It is concluded that the Nanos prosthesis can reduce loss of BMD of the proximal femur composed with conventional stems or other short-stemmed implants.

The stereognostic ability of natural dentitions versus implant-supported fixed prostheses or overdentures.

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Jacobs, R; Bou Serhal, C; van Steenberghe, D

1997-06-01

A stereognostic ability test was performed in 60 patients. Forty patients were rehabilitated by means of osseointegrated implants. One group consisted of 20 patients with fixed prostheses on implants in both the upper and lower jaws. The other 20 patients had a maxillary denture while in the mandible an overdenture was retained by means of two implants connected by a bar. They were compared to a group of 20 subjects (controls) with a non-restored natural dentition. For the stereognostic ability test, subjects had to recognise ten different test pieces by manipulating them with two antagonistic incisor teeth, avoiding any contact with other oral structures. Both response time and percentage accuracy of recognition were evaluated. The present findings indicated that subjects with an overdenture on implants did not score significantly different from those with an implant-supported fixed prosthesis. In contrast, subjects with teeth had a significantly better stereognostic ability. The percentage of correct responses was 52% for overdentures, 56% for fixed prostheses on implants and 75% for natural dentitions. From these results, it could be concluded that the stereognostic ability is impaired in subjects rehabilitated with osseointegrated implants by about one-third to one-quarter compared to subjects with natural teeth.

Impact of implant-supported prostheses on nutritional status and oral health perception in edentulous patients.

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El Osta, Nada; El Osta, Lana; Moukaddem, Farah; Papazian, Tatiana; Saad, Robert; Hennequin, Martine; Rabbaa Khabbaz, Lydia

2017-04-01

Improvement of nutritional status and perception of oral health are supposed to be different with complete conventional denture or implant-supported fixed or removable prostheses. Since no study has been conducted in Lebanon, the aim of our study was to assess the nutritional status and oral heath related quality of life (OHRQoL) in totally edentulous patients after treatment with complete denture or implant supported-prostheses. This was an observational clinical prospective study. A convenient sample of Lebanese people aged 60 years or more was selected between September 2013 and July 2015 from the Departments of removable and fixed prosthesis at Saint-Joseph University of Beirut. The treatment options included complete denture, implant-supported complete denture and implant-supported fixed prostheses. Nutritional status and OHRQoL were assessed with the Mini-Nutritional Assessment Index (MNA) and the Geriatric Oral Health Assessment Index (GOHAI) respectively at Baseline (first visit before treatment), 2-3 weeks after treatment (t1), 3 months (t2) and 6 months (t3) after treatment. Fifty-one participants (mean age: 69.39 ± 7.164 years) were included. The results have shown an improvement over time in nutritional status and OHRQoL for all treatment groups. However, 2-3 weeks after treatment the number of participants at risk of malnutrition was higher with complete removable denture, intermediate with implant-supported complete denture and lower with implant-supported fixed prostheses (p-value = 0.049). Moreover, the mean GOHAI score was significantly lower over time with complete removable denture compared to implant-supported prostheses (p-value nutritional status for implant supported-prostheses compared to conventional removable dentures. Therefore, it is fundamental that dentists communicate with their patients about implant treatment to understand their expectations, to explain the outcomes and achieve the desired clinical result. Copyright © 2017

Implant-supported Oral Rehabilitation in Child with Ectodermal Dysplasia - 4-year Follow-up.

Science.gov (United States)

Cezária Triches, Thaisa; Ximenes, Marcos; Oliveira de Souza, João Gustavo; Rodrigues Lopes Pereira Neto, Armando; Cardoso, Antônio Carlos; Bolan, Michele

2017-01-01

Ectodermal dysplasia (ED) is an anomaly determined by genetic factors that alter ectodermal structures such as skin, hair, nails, glands, and teeth. Children affected by this condition require extensive, comprehensive, and multidisciplinary treatment. An 8-year-old female patient visited the Dentistry Clinic of the Federal University of Santa Catarina with the chief complaint of multiple missing teeth. The mother reported that the patient had ED. Clinical and radiographic examination revealed the congenital absence of several primary and permanent teeth and tooth germs. Subsequent oral rehabilitation comprised the application of a maxillary denture and mandibular implant-supported fixed prosthesis. The child was also supplied with a wig for further enhancement of esthetics aimed at improving her emotional wellbeing. Psychological follow-up and speech therapy were also provided. After 4 years of follow-up, implant-supported oral rehabilitation has proved to be a satisfactory treatment option, allowing restoration of masticatory, phonetic, and esthetic function, as well as an improvement in the patient's self-esteem and social wellbeing.

Alveolar nerve repositioning with rescue implants for management of previous treatment. A clinical report.

Science.gov (United States)

Amet, Edward M; Uehlein, Chris

2013-12-01

The goal of modern implant dentistry is to return patients to oral health in a rapid and predictable fashion, following a diagnostically driven treatment plan. If only a limited number of implants can be placed, or some fail and the prosthetic phase of implant dentistry is chosen to complete the patient's treatment, the final outcome may result in partial patient satisfaction and is commonly referred to as a "compromise." Previous All-on-4 implant treatment for the patient presented here resulted in a compromise, with an inadequate support system for the mandibular prosthesis and a maxillary complete denture with poor esthetics. The patient was unable to function adequately and also was disappointed with the resulting appearance. Correction of the compromised treatment consisted of bilateral inferior alveolar nerve elevation and repositioning without bone removal for lateral transposition, to gain room for rescue implants for a totally implant-supported and stabilized prosthesis. Treatment time to return the patient to satisfactory comfort, function, facial esthetics, and speech was approximately 2 weeks. The definitive mandibular prosthesis was designed for total implant support and stability with patient retrievability. Adequate space between the mandibular bar system and the soft tissue created a high water bridge effect for self-cleansing. Following a short interim mandibular healing period, the maxillary sinuses were bilaterally grafted to compensate for bone inadequacies and deficiencies for future maxillary implant reconstruction. © 2013 by the American College of Prosthodontists.

A comparison of 500 prefilled textured saline breast implants versus 500 standard textured saline breast implants: is there a difference in deflation rates?

Science.gov (United States)

Stevens, W Grant; Hirsch, Elliot M; Stoker, David A; Cohen, Robert

2006-06-01

This study provides the first large-volume (1000 implant) comparison of the deflation rates of Poly Implant Prosthesis prefilled textured saline breast implants versus a control group of Mentor Siltex textured saline implants. A consecutive series of 500 Poly Implant Prosthesis prefilled textured saline breast implants was compared with a consecutive series of 500 Mentor Siltex breast implants. Each breast implant was evaluated for a 4-year period, and the annual deflation rate (number of deflations during a given year divided by the total number of implants) and cumulative deflation rate (cumulative total of deflations through a given year divided by the total number of implants) were recorded. Statistical significance was calculated using the Fisher's exact test at year 1 and the chi-square analysis at years 2 through 4. The cumulative deflation rates of the Poly Implant Prosthesis implants was as follows: year 1, 1.2 percent; year 2, 5.6 percent; year 3, 11.4 percent; and year 4, 15.4 percent. The cumulative deflation rates of the Mentor implants was: year 1, 0.2 percent; year 2, 0.6 percent; year 3, 1.6 percent; and year 4, 4.4 percent. At year 1, the difference between deflation rates was not statistically significant (Fisher's exact test, p > 0.05). However, at year 2 (chi-square, 13.29; p deflation rates of Poly Implant Prosthesis prefilled textured saline breast implants and Mentor Siltex breast implants at year 2, year 3, and year 4. After 4 years, the 15.56 percent cumulative deflation rate of Poly Implant Prosthesis implants was over 3.5 times higher than the 4.31 percent deflation rate of the Mentor Siltex implants. There may be several factors contributing to the higher deflation rate seen in Poly Implant Prosthesis implants, including possible in vitro deflation before implantation and silicone shell curing technique. Nevertheless, this statistically significant deflation difference must be taken into account when balancing the risks and benefits of

Carbon-carbon composites for orthopedic prosthesis and implants. CRADA final report

Energy Technology Data Exchange (ETDEWEB)

Burchell, T D; Klett, J W; Strizak, J P [Oak Ridge National Lab., TN (United States); Baker, C [FMI, Biddeford, ME (United States)

1998-01-21

The prosthetic implant market is extensive. For example, because of arthritic degeneration of hip and knee cartilage and osteoporotic fractures of the hip, over 200,000 total joint replacements (TJRs) are performed in the United States each year. Current TJR devices are typically metallic (stainless steel, cobalt, or titanium alloy) and are fixed in the bone with polymethylacrylate (PMMA) cement. Carbon-carbon composite materials offer several distinct advantages over metals for TJR prosthesis. Their mechanical properties can be tailored to match more closely the mechanical properties of human bone, and the composite may have up to 25% porosity, the size and distribution of which may be controlled through processing. The porous nature of carbon-carbon composites will allow for the ingrowth of bone, achieving biological fixation, and eliminating the need for PMMA cement fixation.

Influence of Abutment Angle on Implant Strain When Supporting a Distal Extension Removable Partial Dental Prosthesis: An In Vitro Study.

Science.gov (United States)

Hirata, Kiyotaka; Takahashi, Toshihito; Tomita, Akiko; Gonda, Tomoya; Maeda, Yoshinobu

This study evaluated the impact of angled abutments on strain in implants supporting a distal extension removable partial denture. An in vitro model of an implant supporting a distal extension removable partial denture was developed. The implant was positioned with a 17- or 30-degree mesial inclination, with either a healing abutment or a corrective multiunit abutment. Levels of strain under load were compared, and the results were compared using t test (P = .05). Correcting angulation with a multiunit angled abutment significantly decreased strain (P abutment. An angled abutment decreased the strain on an inclined implant significantly more than a healing abutment when loaded under a distal extension removable partial denture.

Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors.

Science.gov (United States)

Catanzariti, Francesco; Polito, Benedetta; Polito, Massimo

2016-10-05

We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation). We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Body Exposure during Sexual Activities Questionnaire (BESAQ), the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. The questionnaires completed by patients didn't show statistically significant changes for erectile dysfunction (p > 0.05) and premature ejaculation (p > 0.05). On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001) and the Body Esteem Scale (p < 0.001), but not for the Rosenberg Self-Esteem Scale (p > 0,05). A total of 15 patients (22.37%) were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94%) was that the prosthesis was firmer than the normal testis. Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don't influence sexual activity and they aren't able to cause erectile dysfunction or premature ejaculation.

Multidisciplinary approach for in-deep assessment of joint prosthesis failure.

Science.gov (United States)

Tessarolo, F; Caola, I; Piccoli, F; Dorigotti, P; Demattè, E; Molinari, M; Malavolta, M; Barbareschi, M; Caciagli, P; Nollo, G

2009-01-01

In spite of advancement in biomaterials and biomechanics, in development of new osteo-integrative materials and coatings, and in macro- micro- component design, a non negligible fraction of the implanted prosthesis fails before the expected lifetime. A prospective observational clinical study has been conducted to define and apply a set of experimental techniques to in-deep assess the failure of joint prosthesis. Microbiological, histological and micro-structural techniques were implemented to specifically address phenomena occurring at the tissue-implant interface. Results obtained from 27 cases of prosthetic joint failure are discussed in terms of sensitivity and specificity. A procedural flow-chart is finally proposed for the assessment of joint prosthesis failure.

Stretch due to Penile Prosthesis Reservoir Migration

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E. Baten

2016-03-01

Full Text Available A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch.

Ultrastructural study of tissues surrounding replanted teeth and dental implants.

Science.gov (United States)

Shioya, Kazuhiro; Sawada, Takashi; Miake, Yasuo; Inoue, Sadayuki; Yanagisawa, Takaaki

2009-03-01

The aim of this study was to describe the ultrastructure of the dentogingival border at replanted teeth and implants. Wistar rats (8 weeks old) were divided into groups for replantation and implantation experiments. In the former, the upper right first molars were extracted and then immediately replanted. In the latter, pure titanium implants were used. All tissues were fixed, demineralized and embedded in epoxy resin for ultrastructural observations. One week after replantation, the junctional epithelium was lost, and the oral sulcular epithelium covered the enamel surface. The amount of the epithelium increased in 2 weeks, and resembled the junctional epithelium, and the internal basal lamina and hemidesmosomes were formed in 4 weeks. One week after implantation, peri-implant epithelium was formed, and in 2 and 4 weeks, this epithelium with aggregated connective tissue cells were observed. In 8 weeks, the peri-implant epithelium receded, and aligned special cells with surrounding elongated fibroblasts and bundles of collagen fibers appeared to seal the implant interface. In replantation of the tooth, the internal basal lamina remained at the surface of the enamel of the replanted tooth, which is likely to be related to regeneration of the junctional epithelium and the attachment apparatus at the epithelium-tooth interface. Following implantation, a layer of cells with characteristics of connective tissue cells, but no junctional epithelium and attachment apparatus, was formed to seal the site of the implant.

Maxillary and mandibular immediately loaded implant-supported interim complete fixed dental prostheses on immediately placed dental implants with a digital approach: A clinical report.

Science.gov (United States)

Lewis, Ryan C; Harris, Bryan T; Sarno, Robert; Morton, Dean; Llop, Daniel R; Lin, Wei-Shao

2015-09-01

This clinical report describes the treatment of maxillary and mandibular immediate implant placement and immediately loaded implant-supported interim complete fixed dental prostheses with a contemporary digital approach. The virtual diagnostic tooth arrangement eliminated the need for a customized radiographic template, and the diagnostic data collection required for computer-guided surgery (digital diagnostic impressions, digital photographs, and a cone beam-computed tomography [CBCT] scan) was completed in a single visit with improved workflow efficiency. Computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated surgical templates and interim prosthesis templates were made in a dental laboratory to facilitate computer-guided surgery and the immediate loading process. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Implant Supported Prosthesıs in a Patıent wıth Progerıa: Case Report

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Gözlem Ceylan

2009-08-01

Full Text Available Prosthodontic rehabilitation can be accomplished with fixed, overdenture, complete, or implant-retained prostheses. Dental treatment overcomes the patient’s functional, psychological, esthetic and phonation problems. Remaining healthy teeth may allow the dentist to fabrícate a removable partial overdenture, fixed partial prosthesis or implant - supported prosthesis. The retention of a number of abutments helps maintain a positive ridge form with greater height and volume of the alveolar bone, improving masticatory performance, as well as providing a more stable prostheses. Dental patients who have medical problems need many treatment procedures. Multidisciplinary treatment planning is invaluable for patient’s dental health. Progeria is a rare genetic condition where symptoms resembling aspects of aging are manifested at an early age. characteristic clinical findings of Progeria disease include abnormalities of the skin and hair in conjunction with char-acteristic facial features and skeletal abnormalities. The characteristic facies show protruding ears, beaked nose, thin lips with centrofacial cyanosis, prominent eyes, frontal and parietal bossing with pseudohydrocephaly, midface hypoplasia with micrognathia and large anterior fontanel. The other reported anomalies are dystrophic nails, hypertrophic scars and hypoplastic nipples. The findings that are nearly interested in dentistry are delayed dentition, anodontia, hypodontia, or crowding of teeth. This article presents the multidisciplinary dental treatment planning includes surgical, endodontic and prosthetic treatment of a patient with a history of progeria. In this case complete-arch fixed prostheses in both maxilla and mandible, supported by a combination of im-plants and teeth are reported.

The success rate of narrow body implants used for supporting immediate provisional restorations: a pilot feasibility study.

Science.gov (United States)

Wang, Hom-Lay; Okayasu, Kozue; Fu, Jia-Hui; Hamerink, Howard A; Layher, Mary G; Rudek, Ivan Elimar

2012-12-01

Implants were first designed to be used in the reconstruction of edentulous mandibles. However, with the technological advancement, enormous changes were made to improve the implant design and surface characteristics leading to the wide use of implants in the replacement of missing teeth. During the transition from an edentulous span to a fixed prosthesis, narrow body implants (NBIs) have been proposed to enhance patient comfort and function. Therefore, this study was aimed at investigating the survival and success rates of NBIs used for supporting immediately nonfunctional loaded provisional fixed partial denture (PFPD). Either 2.2- or 2.4-mm-diameter dental implants were placed transmucosally into the edentulous ridges of 10 partially edentulous patients. PFPD of self-cured bis-acryl composite material were made using either a vacuform template chairside or a relined prefabricated PFPD. Occlusal adjustments were made to ensure that there was no functional loading on the provisional restorations before they were secured onto the transitional implants. At 1 year, the implant success and survival rates were 38.7% and 93.5%, respectively, with a mean percentage of bone loss of 9.46% (0%-40%) and a mean bone loss of 1.19 mm (range: 0-3.5 mm). With a favorable implant survival rate, the use of NBIs to support provisional restorations seemed to be a feasible treatment option. In addition, there is merit for research on the long-term use of NBIs-supported final prostheses.

Rehabilitation of amputed thumb with a silicone prosthesis

OpenAIRE

Asnani, Pooja; Shivalingappa, Chandu Giriyapura; Mishra, Sunil Kumar; Somkuwar, Kirti; Khan, Faisal

2015-01-01

Creating prosthesis, having realistic skin surface and seamless visual integration with the surrounding tissues, requires both artistic and technical skill. Anatomical design, thin margins, lifelike fingernails and realistic color/contours are essential for patient satisfaction. Prosthesis is especially useful in case of lost body parts, as reconstructive surgery cannot fully restore aesthetics. This case report describes a simple technique for fabricating silicon finger prosthesis for a pati...

Numerical analysis of the biomechanical complications accompanying the total hip replacement with NANOS-Prosthetic: bone remodelling and prosthesis migration

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Almohallami A.

2015-09-01

Full Text Available Aseptic loosening of the prosthesis is still a problem in artificial joint implants. The ýloosening can be caused by the resorption of the bone surrounding ýthe prosthesis according to stress shielding. A numerical model was developed and validated by means of DEXA-studies in order to ýanalyse the bone remodelling process in the periprosthetic bone. A total loss of about 3.7% of the bone density in the periprosthetic Femur with NANOS is computed. The bone remodelling calculation was validated by means of a DEXA-study with a 3-years-follow-up. The model was further developed in order to be able to calculate and consider the migration of the implants. This method was applied on the ýNANOS-implant with a computed total migration of about 0.43 mm. These calculations showed good results in comparison with a 2-year-follow-up clinical study, whereby a RSA-method was used to determine the stem migration in the bone. In order to ýstudy the mutual influence between the implant migration and the hip contact forces ý, a software is developed by our scientific group to couple a multi body simulation (MBS of human lower limps with the FEA of the periprosthetic Femur.

Light localization with low-contrast targets in a patient implanted with a suprachoroidal-transretinal stimulation retinal prosthesis.

Science.gov (United States)

Endo, Takao; Fujikado, Takashi; Hirota, Masakazu; Kanda, Hiroyuki; Morimoto, Takeshi; Nishida, Kohji

2018-04-20

To evaluate the improvement in targeted reaching movements toward targets of various contrasts in a patient implanted with a suprachoroidal-transretinal stimulation (STS) retinal prosthesis. An STS retinal prosthesis was implanted in the right eye of a 42-year-old man with advanced Stargardt disease (visual acuity: right eye, light perception; left eye, hand motion). In localization tests during the 1-year follow-up period, the patient attempted to touch the center of a white square target (visual angle, 10°; contrast, 96, 85, or 74%) displayed at a random position on a monitor. The distance between the touched point and the center of the target (the absolute deviation) was averaged over 20 trials with the STS system on or off. With the left eye occluded, the absolute deviation was not consistently lower with the system on than off for high-contrast (96%) targets, but was consistently lower with the system on for low-contrast (74%) targets. With both eyes open, the absolute deviation was consistently lower with the system on than off for 85%-contrast targets. With the system on and 96%-contrast targets, we detected a shorter response time while covering the right eye, which was being implanted with the STS, compared to covering the left eye (2.41 ± 2.52 vs 8.45 ± 3.78 s, p trial: Feb. 20, 2014 Date of registration: Jan. 4, 2014 Trial registration number: UMIN000012754 Registration site: UMIN Clinical Trials Registry (UMIN-CTR) http://www.umin.ac.jp/ctr/index.htm.

Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors

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Francesco Catanzariti

2016-10-01

Full Text Available Purpose: We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation. Materials and Methods: We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5, the Premature Ejaculation Diagnostic Tool (PEDT, the Body Exposure during Sexual Activities Questionnaire (BESAQ, the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. Results: The questionnaires completed by patients didn’t show statistically significant changes for erectile dysfunction (p > 0.05 and premature ejaculation (p > 0.05. On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001 and the Body Esteem Scale (p < 0.001, but not for the Rosenberg Self-Esteem Scale (p > 0,05. A total of 15 patients (22.37% were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94% was that the prosthesis was firmer than the normal testis. Conclusions: Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don’t influence sexual activity and they aren’t able to cause erectile dysfunction or premature ejaculation.

Transapical aortic valve implantation in Rouen: four years' experience with the Edwards transcatheter prosthesis.

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Litzler, Pierre-Yves; Borz, Bogdan; Smail, Hassiba; Baste, Jean-Marc; Nafeh-Bizet, Catherine; Gay, Arnaud; Tron, Christophe; Godin, Matthieu; Caudron, Jerome; Hauville, Camille; Dacher, Jean-Nicolas; Cribier, Alain; Eltchaninoff, Hélène; Bessou, Jean-Paul

2012-03-01

The first French transapical transcatheter aortic valve implantation (TAVI) was performed in July 2007 in our department. To report 4-year outcomes of transapical implantation with the Edwards transcatheter bioprosthesis. We prospectively evaluated consecutive patients who underwent transapical implantation with an Edwards transcatheter bioprosthesis between July 2007 and October 2011. Patients were not suitable for conventional surgery (due to severe comorbidities) or transfemoral implantation (due to poor femoral access). Among 61 patients (59.0% men), mean logistic EuroSCORE was 27.5 ± 14.9% and mean age was 81.0 ± 6.8 years. Successful valve implantation was achieved in 59/61 patients (96.7%) of patients. The other two patients required conversion to conventional surgery due to prosthesis embolization and died. Six additional patients died in the postoperative period. Causes of perioperative death were two septic shocks (one of peritonitis), two multi-organ failure, one ventricular fibrillation and one respiratory insufficiency. Intraprocedural stroke was not observed in any patient. The actuarial survival rates at 1, 2 and 4 years were 73.8%, 67.2% and 41.0%. During this 4-year period, four patients died of cardiovascular events, but no impairment of transprosthesis gradient was observed. Our series of 61 patients who underwent transapical implantation of the Edwards transcatheter bioprosthesis shows satisfactory results, similar to other reports, considering the high level of severity of patients referred for this method. Transapical access is a reliable alternative method for patients that cannot benefit from a transfemoral approach. Copyright © 2012. Published by Elsevier Masson SAS.

An alternative section method for casting and posterior laser welding of metallic frameworks for an implant-supported prosthesis.

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de Aguiar, Fábio Afrânio; Tiossi, Rodrigo; Rodrigues, Renata Cristina Silveira; Mattos, Maria de Gloria Chiarello; Ribeiro, Ricardo Faria

2009-04-01

The aim of this study was to compare the accuracy of fit of three types of implant-supported frameworks cast in Ni-Cr alloy: specifically, a framework cast as one piece compared to frameworks cast separately in sections to the transverse or the diagonal axis, and later laser welded. Three sets of similar implant-supported frameworks were constructed. The first group of six 3-unit implant-supported frameworks were cast as one piece, the second group of six were sectioned in the transverse axis of the pontic region prior to casting, and the last group of six were sectioned in the diagonal axis of the pontic region prior to casting. The sectioned frameworks were positioned in the matrix (10 N.cm torque) and laser welded. To evaluate passive fit, readings were made with an optical microscope with both screws tightened and with only one-screw tightened. Data were submitted to ANOVA and Tukey-Kramer's test (p screws were tightened, no differences were found between the three groups (p > 0.05). In the single-screw-tightened test, with readings made opposite to the tightened side, the group cast as one piece (57.02 +/- 33.48 mum) was significantly different (p 0.05) from the group transversally sectioned (31.42 +/- 20.68 microm). On the tightened side, no significant differences were found between the groups (p > 0.05). Results of this study showed that casting diagonally sectioned frameworks lowers misfit levels of prosthetic implant-supported frameworks and also improves the levels of passivity to the same frameworks when compared to structures cast as one piece.

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year.

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Gargari, M; Prete, V; Pujia, M; Ceruso, F M

2012-10-01

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Forty-three patients were selected from the out patient clinic, Department of Dentistry "Fra G.B. Orsenigo Ospedale San Pietro F.B.F.", Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. DISCUSSION AND RESULT: The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn't difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven't difficulty in removal and insertion of the denture and in oral hygiene. They haven't in both groups problems related to fractures.

Retrospective study investigating the clinical success of two provisional implant systems

OpenAIRE

Hotz, Nadine

2011-01-01

The use of dental implants allows a reliable stabilisation of prosthesis. Usually, definitive implants can´t be used for fixation of prosthesis during their healing period. Therefore, in many cases it is not possible to follow the demand of patients of an immediate loading of definitive implants to avoid a unfixed dental prosthesis. This is one domain of provisional dental implants. The present study of two provisional implant systems approves the benefit of provisional implants during...

Numerical analysis of an osseointegrated prosthesis fixation with reduced bone failure risk and periprosthetic bone loss

NARCIS (Netherlands)

Tomaszewski, P. M.; van Diest, M.; Bulstra, S. K.; Verdonschot, N.; Verkerke, G. J.

2012-01-01

Currently available implants for direct attachment of prosthesis to the skeletal system after transfemoral amputation (OPRA system. Integrum AB, Sweden and ISP Endo/Exo prosthesis, ESKA Implants AG, Germany) show many advantages over the conventional socket fixation. However, restraining

[Longterm results of cervical arthroplasty with disc prosthesis. A literature review].

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Fransen, P; Schils, F

2014-01-01

Cervical arthroplasty has now been performed for over 10 years. Despite the large number of implanted artificial discs, the quality of the published studies is weak, and very few report a follow up exceeding two years. We reviewed the literature on cervical total disc replacement, focusing on publications reporting a follow-up of more than two years. The selection of patients, the type of implant and the surgical technique seem to influence greatly the quality of the clinical and radiological results. The occurrence of heterotopic ossifications around the implant seems to be the rule rather than the exception. Wear debris are likely to be observed in the vicinity of the prosthesis. Most long term studies also report a progressive decrease in the range of motion of the prosthesis, although without influence on the clinical evolution. It seems reasonable to say that cervical disc prosthesis is not inferior to discectomy and fusion, and that these implants allow a short term preservation of cervical mobility, but the efficacy in preventing adjacent segment disease or a favourable costleffectiveness ratio have yet to be demonstrated. A more widespread use of cervical disc prosthesis can only be suggested when these questions have been answered by long term follow-up studies.

Immediate versus early loading of two implants placed with a flapless technique supporting mandibular bar-retained overdentures: a single-blinded, randomised controlled clinical trial.

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Cannizzaro, Gioacchino; Leone, Michele; Esposito, Marco

2008-01-01

To evaluate the efficacy of immediate loading versus early loading at 6 weeks of bar-retained mandibular overdentures supported by two implants placed with a flapless technique. Sixty patients were randomised: 30 to the immediately loaded group and 30 to the early loaded group. To be immediately loaded, implants had to be inserted with a minimum torque > 48 Ncm. Outcome measures were prosthesis and implant failures, biological and biomechanical complications, patient satisfaction, and Implant Stability Quotient (ISQ) assessed with a resonance frequency analysis instrument. Sixty implants were placed in each group. Flaps had to be raised in nine patients to check drill direction or to better visualise the area after multiple teeth extraction. Two implants in two patients did not reach the planned insertion torque and were immediately replaced by larger diameters ones. After 1 year no drop out occurred and two early loaded implants failed in two patients. There were no statistically significant differences between groups for prosthesis failures, implant losses, complications, and mean ISQ values; however, patients in the immediately loaded group were significantly more satisfied than those loaded early. When comparing mean ISQ values taken 6 weeks after placement with 1-year data within each group, values decreased significantly. Mandibular overdentures can be successfully loaded the same day of implant placement with a minimally invasive surgery, increasing patient satisfaction while decreasing treatment time and patient discomfort. No apparent advantages were seen when loading the overdentures at 6 weeks.

Provisional prostheses during ridge augmentation and implant dentistry.

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Livada, Rania; Hottel, Timothy L; Shiloah, Jacob

2013-01-01

Recent advancements in ridge augmentation and bone regeneration have expanded the pool of patients that could benefit from dental implants. However, providing the patient with a temporary prosthesis during the wound healing phase without impairing the process is a challenging task. This article summarizes available information pertaining to provisional prostheses, both tooth-supported and soft tissue-supported, that may meet the patient needs. The advantages and disadvantages of each class of prosthesis, along with indications and contraindications, were taken into consideration to aid the restorative dentist in choosing the optimal provisional for their patients.

Distinguishing Failure to Cure From Complication After Penile Prosthesis Implantation.

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Pineda, Miguel; Burnett, Arthur L

2017-05-01

A successful penile prosthesis implantation (PPI) surgery can be defined by outcomes beyond the absence of complications. To introduce the concept of failure to cure (FTC) in the context of PPI to more accurately gauge postoperative outcomes after PPI. Consecutive patients from our sexual function registry who underwent PPI from January 2011 to December 2013 were analyzed. Demographics, previous treatment of erectile dysfunction, comorbidities, social history, postoperative problems (POPs), and surgical outcomes were tabulated. Patients completed the International Index of Erection Function (IIEF) and the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaires. We defined a complication, according to the Clavien-Dindo classification, as any deviation from the ideal postoperative course that is not inherent in the procedure and does not constitute an FTC. FTC was defined as a POP that was not a complication. The χ 2 tests, t-tests, or Wilcoxon rank-sum tests were used. Patient-reported and objective outcomes after PPI. Our enrollment consisted of 185 patients, and we contacted 124 (67%). Of these, 16 (12.9%) had a POP requiring reoperation. Eight patients developed surgical complications (three infections, four erosions, and one chronic pain). Eight patients had FTC (four malpositions and four malfunctions). Factors that correlated with POPs were previous PPI, body mass index higher than 30 kg/m 2 , and previous treatment with intracorporal injections (P .05 for all comparisons). POPs after PPI surgery can be more accurately categorized using the Clavien-Dindo classification of surgical complications to more clearly distinguish surgical complications from FTC. Limitations of our study include its retrospective approach. Our series included a large proportion of patients treated for prostate cancer, which limits the generalizability of our findings. We also had a relatively short median follow-up time of 27 months. Patient-reported outcome

Experimental substantiation of the design of a prosthetic heart valve for «valve-in-valve» implantation

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K. Yu. Klyshnikov

2017-01-01

Full Text Available The aim of the study was to perform a series of in vitro tests of a prototype of the developing heart valve prosthesis to evaluate its functional characteristics. Materials and methods. In this work we have used the frames and full prototypes of the prosthesis, consisting of a stent-like stainless steel support frame with mounted biological leaflets and cover. The authors evaluated the calculated and experimental forces necessary for the displacement of the sutureless implanted prosthesis using the test machine under uniaxial tension. The risk of defects and damages to the supporting framework as a result of implantation was evaluated by scanning electron microscopy. The hydrodynamic characteristics of the prosthesis were investigated under physiological conditions and «valvein-valve» implantation. Evaluation of the ergonomics and applicability of the proposed construction on the cadaver heart model of cattle was carried out. Results. As a result of the forces assessment, it was found that the force required to shear the prosthesis was 3.12 ± 0.37 N, while the calculated value was 1.7 N, which is significantly lower than the obtained value. The comparison of the images obtained with small and large magnifications demonstrated the absence of critical surface defects. Additional analysis under the super-large magnifications also did not reveal problem areas. During the hydrodynamic study, it was shown that the average transplant gradient increased slightly from 2.8–3.4 to 3.2–4.5 mm Hg for the initial prosthesis and the «valve-in-valve» complex, respectively. The decrease of the effective orifice area was 6–9% relative to the initial one. Evaluation of the implantation technique demonstrated the consistency of the approach: the use of the developed holder in combination with the balloon implantation system made it possible to position the prosthesis throughout the procedure. Conclusion. The series of tests demonstrates the consistency

Stress distribution in dental prosthesis under an occlusal combined dynamic loading

International Nuclear Information System (INIS)

Merdji, A.; Bachir Bouiadjra, B.; Ould Chikh, B.; Mootanah, R.; Aminallah, L.; Serier, B.; Muslih, I.M.

2012-01-01

Highlights: ► The mechanical stress reaches the highest in areas of cortical bones. ► The mechanical stress in the cancellous bone reaches greatest in the bottom of the dental implant. ► Implant with low-volume bone might cause increased stress concentration in the cortical bone. -- Abstract: The biomechanical behavior of osseointegrated dental prostheses systems plays an important role in its functional longevity inside the bone. Simulation of these systems requires an accurate modeling of the prosthesis components, the jaw bone, the implant–bone interface, and the response of the system to different types of applied forces. The purpose of this study was to develop a new three-dimensional model of an osseointegrated molar dental prosthesis and to carry out finite element analysis to evaluate stress distributions in the bone and the dental prosthesis compounds under an occlusal combined dynamic load was applied to the top of the occlusale face of the prosthesis crown. The jaw bone model containing cortical bone and cancellous bone was constructed by using computer tomography scan pictures and Computer Aided Design tools. The dental prosthesis compounds were constructed, simulating the commercially available cylindrical implant of 4.8 mm diameter and 10 mm length. Both finite element models were created in Abaqus finite element software. All materials used in the models were considered to be isotropic, homogeneous and linearly elastic. The elastic properties, loads and constraints used in the model were taken from published data. Results of our finite element analyses, indicated that the maximum stresses were located around the mesial neck of the implant, in the marginal bone. Thus, this area should be preserved clinically in order to maintain the bone–implant interface structurally and functionally.

Percutaneous implantation of the first repositionable aortic valve prosthesis in a patient with severe aortic stenosis.

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Buellesfeld, Lutz; Gerckens, Ulrich; Grube, Eberhard

2008-04-01

Percutaneous aortic valve replacement is a new less-invasive alternative for high-risk surgical candidates with aortic stenosis. However, the clinical experience is still limited, and the currently available 'first-generation devices' revealed technical shortcomings, such as lack of repositionability and presence of paravalvular leakages. We report the first-in-man experience with the new self-expanding Lotus Valve prosthesis composed of a nitinol frame with implemented bovine pericardial leaflets which is designed to address these issues, being repositionable and covered by a flexible membrane to seal paravalvular gaps. We implanted this prosthesis in a 93-year old patient presenting with severe symptomatic aortic stenosis (valve area: 0.6 cm(2)). Surgical valve replacement had been declined due to comorbidities. We used a retrograde approach for insertion of the 21-French Lotus catheter loaded with the valve prosthesis via surgical cut-down to the external iliac artery. Positioning of the valve was guided by transesophageal echo and supra-aortic angiograms. The prosthesis was successfully inserted and deployed within the calcified native valve. Echocardiography immediately after device deployment showed a significant reduction of the transaortic mean pressure gradient (32 to 9 mmHg; final valve area 1.7 cm(2)) without evidence of residual aortic regurgitation. The postprocedural clinical status improved from NYHA-IV to NYHA-II. These results remained unchanged up to the 3 month follow-up. Successful percutaneous aortic valve replacement can be performed using the new self-expanding and repositionable Lotus valve for treatment of high-risk patients with aortic valve stenosis. Further studies are mandatory to assess device safety and efficacy in larger patient populations. Copyright 2008 Wiley-Liss, Inc.

Esthetic Evaluation of Implant Crowns and Peri-Implant Soft Tissue in the Anterior Maxilla: Comparison and Reproducibility of Three Different Indices.

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Tettamanti, Sandro; Millen, Christopher; Gavric, Jelena; Buser, Daniel; Belser, Urs C; Brägger, Urs; Wittneben, Julia-Gabriela

2016-06-01

A successful implant reconstruction with optimal esthetics consists of a visually pleasing prosthesis and complete and healthy surrounding soft tissue. In the current literature, numerous indices used to qualitatively assess esthetics have been described. However, studies comparing the indices and their reproducibility are scarce. The aim of this study was to compare three different esthetic indices for the evaluation of single implant-supported crowns. A total of 10 prosthodontists (P), 10 orthodontists (O), 10 general dentists (G), and 10 lay people (L) independently performed the same assessment using 30 photographs and corresponding casts with three different esthetic indices (Peri-Implant and Crown Index [PICI], Implant Crown Aesthetic Index [ICAI], "Pink Esthetic Score/White Esthetic Score [PES/WES]) and repeated the evaluations 4 weeks later. The PES/WES and the PICI showed significantly higher esthetic scores (pink, white, total) and clinical acceptance compared with the ICAI in all four groups and in both assessments. The highest intraobserver agreement was achieved using the PES/WES and the least with the ICAI. The mean Kappa per group ranged from 0.18 (group L with ICAI) to 0.63 (group G with PICI). In comparison with the ICAI, the PES/WES and PICI were more reproducible. Therefore, PES/WES and PICI seem to be more suitable as esthetic indices for single implant crowns. © 2015 Wiley Periodicals, Inc.

Experimental Assessment of a New Type of Carbon-Coated ARTECOR® Vascular Prosthesis in Sheep

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Jiří Podlaha

2009-01-01

Full Text Available The aim of the study was to test and verify the characteristics of a new type of carbon-coated ARTECOR® vascular prosthesis developed at the Knitting Research Institute, a.s. Brno. Eight healthy Merino sheep, aged between 2 and 3 years, were implanted four types (A, B, C with diamond-like carbon (DLC coating and D as a control without DLC of vascular prostheses. The site of implantation was the common carotid artery; the length of the implant was 7 cm. All sheep received antibiotics prophylactically in accordance with the theory of the so-called “protected coagulum”. Doppler ultrasound examination was performed before finishing the operation to verify the patency of each prosthesis. During the study period the animals were closely observed. Prostheses were extirpated on day +/- 100 in 6 sheep and on day 182 in 2 sheep. Type B prosthesis showed better results according to its postoperative patency. The implant lumen was constantly 7 mm, whereas the use of other types resulted in lumen narrowing. Type B prosthesis has a deposition of DLC coating of a thickness of 20 nm with a high content of sp3 bonds (more diamond-like ones. The experimental type B of prosthesis ARTECOR® appears to be the most successful of the tested prostheses (at the end of the study all B-type prostheses remained patent. This prosthesis appears to better satisfy the rheologic characteristics for healing.

Debridement, antibiotics, irrigation, and retention (DAIR) of the prosthesis after hip hemiarthroplasty infections. Does it work?

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Kazimoglu, Cemal; Yalcin, Nadir; Onvural, Burak; Akcay, Serkan; Agus, Haluk

2015-08-01

Debridement, antibiotic, and implant retention (DAIR) is an attractive treatment modality after hip hemiarthroplasty (HA) infections. Data about the success of the procedure after acute onset infections is lacking. The aim of this study was to analyze the clinical outcome and associated risk factors. A multicenter, retrospective cohort study was designed, including 39 patients with acute onset prosthetic infection who had undergone debridement and irrigation with prosthesis retention. The primary outcome measure was infection eradication without prosthesis removal. We also analyzed how the success rate was influenced by the length of the interval between implantation of the prosthesis and the beginning of the treatment. The overall success rate was 41%. Sedimentation rate over 60 mm/h and the longer duration (2 weeks) after prosthesis implantation were found as factors negatively influencing the success rate. Our results indicated limited success to DAIR- treated patients with infected HA. The high failure rate of DAIR treatment after 2 weeks from the implantation should be taken into consideration.

Staged Hard and Soft Tissue Reconstruction Followed by Implant Supported Restoration in the Aesthetic Zone: A Case Report.

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Parthasarathy, Harinath; Ramachandran, Lakshmi; Tadepalli, Anupama; Ponnaiyan, Deepa

2017-04-01

Alveolar ridge deficiency is a common clinical consequence following tooth loss due to chronic periodontitis complicating ideal implant placement. Advanced hard and soft tissue augmentation procedures have been developed in the recent past with predictable clinical outcomes. A male patient presented with a Grade III mobile upper right central incisor associated with advanced bone loss and soft tissue deficit. Following extraction of tooth #11, socket augmentation was done using an autogenous cortico-cancellous block graft and subsequent soft tissue augmentation was done with palatal connective tissue graft. At the end of six months, a tapered self tapping implant fixture was placed with adequate primary stability and after eight weeks, second stage implant surgery was done with the Misch technique in order to recreate papillae and the implant was prosthetically restored. The alveolar ridge was adequately recontoured following the staged surgical protocol. The implant was well integrated at the end of 15 months. Execution of sequential surgical procedures in a highly deficient edentulous site made it possible to achieve of optimal pink and white aesthetics with stable implant supported fixed prosthesis.

Rehabilitation of Nose following Chemical Burn Using CAD/CAM Made Substructure for Implant Retained Nasal Prosthesis: A Clinical Report

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Saurabh Chaturvedi

2017-01-01

Full Text Available Insufficient knowledge of medical chemicals and their improper use have destructive effects. Accidental exposure to chemicals on facial tissue may result in large facial defect. For ages the tradition of piercing nose is common but improper use of unknown chemical for piercing has deleterious effect. Mostly rhinectomy defects are acquired caused by trauma or malignant diseases. Prosthetic rehabilitation is the preferred treatment of choice for any large rhinectomy defects as medical and surgical interventions are ineffective in developing esthetics. Main concern with the prosthesis for such defects is retention. This article describes rehabilitation of a patient with large size nasal defect created by chemical burn in childhood during piercing. Implant retained customized silicone nasal prosthesis was fabricated using simple O-ring attachments and innovative modified polyamide acrylic resin substructure acting as skeleton.

Estudo experimental do implante transcateter de prótese valvada autoexpansível na via de saída do ventrículo direito em porcos Transcatheter implantation of self-expandable valved prosthesis in outlet right ventricle an experimental study in pigs

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José Cícero Stocco Guilhen

2011-09-01

right heart failure with clinical deterioration. These children require multiple interventions throughout their lives, which impose a high rate of morbidity and mortality. OBJECTIVE: To develop a less invasive technique for implantation of a valved prosthesis through the right ventricle. METHODS: The valved prosthesis consists of an auto expanding metal stent built with nitinol, surrounded with polyester, where the three leaflets of bovine pericardium were mounted. Twelve pigs were used to perform the implants. Echocardiographic control was performed immediately after implantation and one, four, eight and 12 weeks. RESULTS: One animal showed reflux of moderate to severe and three mild reflux. Transvalvular gradients measured before implantation ranged from 3 to 6 mmHg and that soon after the implant was increased, ranging from 7 to 45 mmHg. There was a decrease in these gradients during follow up and in only four of the twelve animals the gradients were above 20 mmHg. Thrombus formation occurred in the prosthesis of six animals, and this was the most frequent complication. CONCLUSION: These findings highlight the need for studies with the use of anticoagulants and antiplatelet, an attempt to reduce this event. The study aims to contribute for the start of the use of prosthetic heart valves that could be implanted through minimally invasive techniques without the use of cardiopulmonary bypass

Smartphone supported upper limb prosthesis

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Hepp D.

2015-09-01

Full Text Available State of the art upper limb prostheses offer up to six active DoFs (degrees of freedom and are controlled using different grip patterns. This low number of DoFs combined with a machine-human-interface which does not provide control over all DoFs separately result in a lack of usability for the patient. The aim of this novel upper limb prosthesis is both offering simplified control possibilities for changing grip patterns depending on the patients’ priorities and the improvement of grasp capability. Design development followed the design process requirements given by the European Medical Device Directive 93/42 ECC and was structured into the topics mechanics, software and drive technology. First user needs were identified by literature research and by patient feedback. Consequently, concepts were evaluated against technical and usability requirements. A first evaluation prototype with one active DoF per finger was manufactured. In a second step a test setup with two active DoF per finger was designed. The prototype is connected to an Android based smartphone application. Two main grip patterns can be preselected in the software application and afterwards changed and used by the EMG signal. Three different control algorithms can be selected: “all-day”, “fine” and “tired muscle”. Further parameters can be adjusted to customize the prosthesis to the patients’ needs. First patient feedback certified the prosthesis an improved level of handling compared to the existing devices. Using the two DoF test setup, the possibilities of finger control with a neural network are evaluated at the moment. In a first user feedback test, the smartphone based software application increased the device usability, e.g. the change within preselected grip patterns and the “tired muscle” algorithm. Although the overall software application was positively rated, the handling of the prosthesis itself needs to be proven within a patient study to be

Numerical evaluation of bone remodelling and adaptation considering different hip prosthesis designs.

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Levadnyi, Ievgen; Awrejcewicz, Jan; Gubaua, José Eduardo; Pereira, Jucélio Tomás

2017-12-01

The change in mechanical properties of femoral cortical bone tissue surrounding the stem of the hip endoprosthesis is one of the causes of implant instability. We present an analysis used to determine the best conditions for long-term functioning of the bone-implant system, which will lead to improvement of treatment results. In the present paper, a finite element method coupled with a bone remodelling model is used to evaluate how different three-dimensional prosthesis models influence distribution of the density of bone tissue. The remodelling process begins after the density field is obtained from a computed tomography scan. Then, an isotropic Stanford model is employed to solve the bone remodelling process and verify bone tissue adaptation in relation to different prosthesis models. The study results show that the long-stem models tend not to transmit loads to proximal regions of bone, which causes the stress-shielding effect. Short stems or application in the calcar region provide a favourable environment for transfer of loads to the proximal region, which allows for maintenance of bone density and, in some cases, for a positive variation, which causes absence of the aseptic loosening of an implant. In the case of hip resurfacing, bone mineral density changes slightly and is closest to an intact femur. Installation of an implant modifies density distribution and stress field in the bone. Thus, bone tissue is stimulated in a different way than before total hip replacement, which evidences Wolff's law, according to which bone tissue adapts itself to the loads imposed on it. The results suggest that potential stress shielding in the proximal femur and cortical hypertrophy in the distal femur may, in part, be reduced through the use of shorter stems, instead of long ones, provided stem fixation is adequate. Copyright © 2017 Elsevier Ltd. All rights reserved.

Short Implants: New Horizon in Implant Dentistry.

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Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan

2016-09-01

The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.

Retention Strength of Conical Welding Caps for Fixed Implant-Supported Prostheses.

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Nardi, Diego; Degidi, Marco; Sighinolfi, Gianluca; Tebbel, Florian; Marchetti, Claudio

This study evaluated the retention strength of welding caps for Ankylos standard abutments using a pull-out test. Each sample consisted of an implant abutment and its welding cap. The tests were performed with a Zwick Roell testing machine with a 1-kN load cell. The retention strength of the welding caps increased with higher abutment diameters and higher head heights and was comparable or superior to the values reported in the literature for the temporary cements used in implant dentistry. Welding caps provide a reliable connection between an abutment and a fixed prosthesis without the use of cement.

Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin.

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Wilson, S K; Carson, C C; Cleves, M A; Delk, J R

1998-05-01

Elevation of glycosylated hemoglobin above levels of 11.5 mg.% has been considered a contraindication to penile prosthesis implantation in diabetic patients. We determine the predictive value of glycosylated hemoglobin A1C in penile prosthesis infections in diabetic and nondiabetic patients to confirm or deny this prevalent opinion. We conducted a 2-year prospective study of 389 patients, including 114 diabetics, who underwent 3-piece penile prosthesis implantation. All patients had similar preoperative preparation without regard to diabetic status, control or glycosylated hemoglobin A1C level. Risk of infection was statistically analyzed for diabetics versus nondiabetics, glycosylated hemoglobin A1C values above and below 11.5 mg.%, insulin dependent versus oral medication diabetics, and fasting blood sugars above and below 180 mg.%. Prosthesis infections developed in 10 diabetics (8.7%) and 11 nondiabetics (4.0%). No increased infection rate was observed in diabetics with high fasting sugars or diabetics on insulin. There was no statistically significant increased infection risk with increased levels of glycosylated hemoglobin A1C among all patients or among only the diabetics. In fact, there was no meaningful difference in the median or mean level of glycosylated hemoglobin A1C in the infected and noninfected patients regardless of diabetes. Use of glycosylated hemoglobin A1C values to identify and exclude surgical candidates with increased risk of infections is not proved by this study. Elevation of fasting sugar or insulin dependence also does not increase risk of infection in diabetics undergoing prosthesis implantation.

Iris reconstruction using artificial iris prosthesis for management of aniridia.

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Mostafa, Yehia S; Osman, Amr A; Hassanein, Dina H; Zeid, Ashraf M; Sherif, Ahmed M

2018-01-01

To discuss the limitations and benefits of the BrightOcular prosthetic artificial iris device in management of aniridia associated with aphakia or cataract. This is a retrospective study including 5 eyes of 4 patients who underwent implantation of the BrightOcular iris prosthesis (Stellar Devices) for total or partial aniridia. The cases included 2 eyes of 1 patient with congenital aniridia associated with congenital cataract and 3 eyes with traumatic aniridia: 1 with subluxated cataractous lens and 2 with aphakia. In all cases, the iris prosthesis was implanted after a 3-piece acrylic intraocular lens was implanted. We evaluated the clinical course with a minimum follow-up period of 6 months, the intraoperative and postoperative complications, and the cosmetic satisfaction of patients. All patients had improved uncorrected distance visual acuity and best-corrected distance visual acuity. All patients had a transient corneal edema that resolved within the first postoperative week. Only the patient with congenital aniridia had a permanent increase in intraocular pressure and developed a band keratopathy throughout a 2-year follow-up period. The prosthesis was well-centered in all eyes except for one case that required scleral suture fixation after 3 months. All patients had a satisfactory cosmetic appearance. BrightOcular iris prosthesis is a safe and useful tool to correct aniridia associated with pseudophakia or aphakia. Being foldable, it is easy to be implanted through a small incision and placed in the ciliary sulcus without sutures when properly sized. Cosmetic results are satisfactory. Sizing methods should be improved.

Macroscopic and microscopic evaluation of a new implant design supporting immediately loaded full arch rehabilitation.

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Tetè, Stefano; Zizzari, Vincenzo; De Carlo, Alessandro; Sinjari, Bruna; Gherlone, Enrico

2012-04-01

The purpose of this study is to evaluate macroscopic and microscopic appearance of a new implant design, with particular emphasis given to the type of prosthesis connection. Two dental implants of the same type (Torque Type(®), WinSix(®), BioSAFin. S.r.l. - Ancona, Italy), with sandblasted and acid etched surfaces (Micro Rough Surface(®)), but differing from each other for the prosthesis connection system, were examined by scanning electron microscope (SEM) analysis at different magnifications: TTI implant, with a hexagonal internal connection, and TTX implant, with a hexagonal external connection. SEM analysis showed that the Torque Type(®) implant is characterized by a truncated cone shape with tapered tips. The implant body showed a double loop thread and double pitch with blunt tips. For both types of connection, the implant neck was 0.7 mm in height with a 3% taper. This implant design may be able to guarantee osteotomic properties at the time of insertion in a surgical site suitably prepared, a facilitated screwing, thanks to the thread pitch and to the broad and deep draining grooves, thereby ensuring a good primary stability. The different connection design appears defined and precise, in order to ensure a good interface between the fixture and the prosthetic components. Therefore, this design appears to be particularly suitable in cases where a good primary stability is necessary and a precise coupling between endosseous and prosthetic components, as it allows an easy insertion of the fixture even in conditions of reduced bone availability, and in cases of immediately loaded full-arch rehabilitations.

Influence of prosthesis design and implantation technique on implant stresses after cementless revision THR

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Duda Georg N

2011-05-01

Full Text Available Abstract Background Femoral offset influences the forces at the hip and the implant stresses after revision THR. For extended bone defects, these forces may cause considerable bending moments within the implant, possibly leading to implant failure. This study investigates the influences of femoral anteversion and offset on stresses in the Wagner SL revision stem implant under varying extents of bone defect conditions. Methods Wagner SL revision stems with standard (34 mm and increased offset (44 mm were virtually implanted in a model femur with bone defects of variable extent (Paprosky I to IIIb. Variations in surgical technique were simulated by implanting the stems each at 4° or 14° of anteversion. Muscle and joint contact forces were applied to the reconstruction and implant stresses were determined using finite element analyses. Results Whilst increasing the implant's offset by 10 mm led to increased implant stresses (16.7% in peak tensile stresses, altering anteversion played a lesser role (5%. Generally, larger stresses were observed with reduced bone support: implant stresses increased by as much as 59% for a type IIIb defect. With increased offset, the maximum tensile stress was 225 MPa. Conclusion Although increased stresses were observed within the stem with larger offset and increased anteversion, these findings indicate that restoration of offset, key to restoring joint function, is unlikely to result in excessive implant stresses under routine activities if appropriate fixation can be achieved.

Implant rehabilitation of partial maxillectomy edentulous patien

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Mahesh E Gowda

2013-01-01

Full Text Available Edentulous patients with maxillectomy defects present a significant challenge for prosthetic rehabilitation and the adaptive capabilities of the patient as retention is highly compromised. Hence, the option of using endosseous implants to increase obturator retention has been used. A patient of mucormycosis of the left maxilla was treated with surgical excision. After satisfactory healing, definitive implant supported magnet retained prosthesis was fabricated for the patient. Implants with magnetic units offer a practical method of improving the retention of obturators provided acceptable prosthetic protocols are followed for the rehabilitation.

Implant rehabilitation of partial maxillectomy edentulous patient

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Gowda, Mahesh E.; Mohan, Murali S.; Verma, Kamal; Roy, I. D.

2013-01-01

Edentulous patients with maxillectomy defects present a significant challenge for prosthetic rehabilitation and the adaptive capabilities of the patient as retention is highly compromised. Hence, the option of using endosseous implants to increase obturator retention has been used. A patient of mucormycosis of the left maxilla was treated with surgical excision. After satisfactory healing, definitive implant supported magnet retained prosthesis was fabricated for the patient. Implants with magnetic units offer a practical method of improving the retention of obturators provided acceptable prosthetic protocols are followed for the rehabilitation. PMID:24124314

Transcatheter aortic valve implantation in patients with a mitral prosthesis; single center experience and review of literature.

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Asil, Serkan; Şahiner, Levent; Özer, Necla; Kaya, E Barış; Evranos, Banu; Canpolat, Uğur; Yorgun, Hikmet; Karagöz, Heves; Aytemir, Kudret

2016-10-15

Following the encouraging results of several registries and trials, transcatheter aortic valve implantation (TAVI) has been recognized as a valid option in patients with severe aortic stenosis deemed at high or prohibitive risk for surgical treatment. Good procedural success and good clinical outcomes have been showed and very limited data exist on TAVI in the setting of a preexisting mitral prosthesis regarding the technique, potential complications, and outcomes. Here, we report six cases of transfemoral TAVI with a self-expanding bioprosthesis (CoreValve; Medtronic, Inc) in patients who had previously undergone mitral valve replacement. Preprocedural, intraprocedural ve postprocedural outcome and data were analyzed and a brief literature review is also presented. Our experiences show that transfemoral CoreValve implantation can be performed successfully in patients with mechanical and bioprosthetic mitral valves. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

SU-F-T-374: Dosimetric Effects of Irradiation Through a Bilateral Hip Prosthesis in a MRI Linac

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Wronski, M; Sarfehnia, A; Sahgal, A; Keller, B; Ahmad, S

2016-01-01

Purpose: To evaluate the interface effects when irradiating through a hip prosthesis in the presence of an orthogonal 1.5 T magnetic field using Monte Carlo simulations. Methods: A 20×20×38 cm virtual phantom with two 5×5×5 cm sections of bilateral titanium hip prosthesis was created in GPU-based Monte Carlo (MC) algorithm (GPUMCD, Elekta AB, Stockholm Sweden). The lateral prosthesis spacing was based on a representative patient CT scan. A treatment SAD of 143.5 cm was chosen, corresponding to the Elekta AB MRI Linac and the beam energy distribution was sampled from a histogram representing the true MRI Linac spectrum. A magnetic field of 1.5 T was applied perpendicular to the plane of irradiation. Dose was calculated, in voxels of side 1 mm, for 2×2, 5×5, and 10×10 cm treatment field sizes with normal beam incidence (gantry at 90° or 270°) and at 5° and 10° from normal, representing the range of incidence through the bilateral prosthesis. Results: With magnetic field ON (B-On) and normal beam incidence the backscatter dose at the interfaces of proximal and distal implants is reduced for all the field sizes compared to the magnetic field OFF (B-Off) case. The absolute reduction in doses at the interface was in the range of 12.93% to 13.16% for the proximal implant and 13.57% to 16.12% for the distal implant. Similarly for the oblique incidences of 5o and 10o the dose in the plane adjacent to the prosthetic implants is lower when the magnetic field is ON. Conclusion: The dosimetric effects of irradiating through a hip prosthesis in the presence of a transverse magnetic field have been determined using MC simulation. The backscatter dose reduction translates into significantly lower hot spots at the prosthetic interfaces, which are otherwise substantially high in the absence of the magnetic field. This project was supported through funding provided by ElektaTM.

SU-F-T-374: Dosimetric Effects of Irradiation Through a Bilateral Hip Prosthesis in a MRI Linac

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Wronski, M; Sarfehnia, A; Sahgal, A; Keller, B [Sunnybrook Odette Cancer Center, Toronto (Canada); University of Toronto, Department of Radiation Oncology, Toronto (Canada); Ahmad, S [Sunnybrook Odette Cancer Center, Toronto (Canada)

2016-06-15

Purpose: To evaluate the interface effects when irradiating through a hip prosthesis in the presence of an orthogonal 1.5 T magnetic field using Monte Carlo simulations. Methods: A 20×20×38 cm virtual phantom with two 5×5×5 cm sections of bilateral titanium hip prosthesis was created in GPU-based Monte Carlo (MC) algorithm (GPUMCD, Elekta AB, Stockholm Sweden). The lateral prosthesis spacing was based on a representative patient CT scan. A treatment SAD of 143.5 cm was chosen, corresponding to the Elekta AB MRI Linac and the beam energy distribution was sampled from a histogram representing the true MRI Linac spectrum. A magnetic field of 1.5 T was applied perpendicular to the plane of irradiation. Dose was calculated, in voxels of side 1 mm, for 2×2, 5×5, and 10×10 cm treatment field sizes with normal beam incidence (gantry at 90° or 270°) and at 5° and 10° from normal, representing the range of incidence through the bilateral prosthesis. Results: With magnetic field ON (B-On) and normal beam incidence the backscatter dose at the interfaces of proximal and distal implants is reduced for all the field sizes compared to the magnetic field OFF (B-Off) case. The absolute reduction in doses at the interface was in the range of 12.93% to 13.16% for the proximal implant and 13.57% to 16.12% for the distal implant. Similarly for the oblique incidences of 5o and 10o the dose in the plane adjacent to the prosthetic implants is lower when the magnetic field is ON. Conclusion: The dosimetric effects of irradiating through a hip prosthesis in the presence of a transverse magnetic field have been determined using MC simulation. The backscatter dose reduction translates into significantly lower hot spots at the prosthetic interfaces, which are otherwise substantially high in the absence of the magnetic field. This project was supported through funding provided by ElektaTM.

Multi-body simulation of various falling scenarios for determining resulting loads at the prosthesis interface of transfemoral amputees with osseointegrated fixation.

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Welke, Bastian; Schwarze, Michael; Hurschler, Christof; Calliess, Tilman; Seehaus, Frank

2013-07-01

Conventionally, transfemoral amputees are treated with a shaft prosthesis fitted over the residual limb. To improve the quality of life of such patients, in particular those with complications relating to conventional attachment (e.g., skin irritation, stump ulcers, and poor motor-control with short stumps), osseointegrated prosthesis fixation implants have been developed and implanted in a limited population of patients. To assess possible damage to the implant/prosthesis during falling scenarios, the loads in high-risk situations were estimated using a multi-body simulation of motion. Five falling scenarios were identified and performed by healthy volunteer wearing safety equipment. Kinematic data and ground reaction forces were captured as input for the inverse-dynamics-based simulations, from which the forces and moments at a typical implant-prosthesis interface location were computed. The estimated peak loads in all five scenarios were of a magnitude that could lead to bone fracture. The largest peak force observed was 3274 ± 519 N, with an associated resultant moment of 176 ± 55 Nm on the prosthesis-implant interface. A typical femur is prone to fracture under this load, thus illustrating the need for a safety-release element in osseointegrated prosthesis fixation. Copyright © 2013 Orthopaedic Research Society.

INSIST-ED: Italian Society of Andrology registry on penile prosthesis surgery. First data analysis

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Edoardo Pescatori

2016-07-01

Full Text Available Objectives: The Italian Society of Andrology, i.e. “Società Italiana di Andrologia” (S.I.A., launched on December 2014 a prospective, multicenter, monitored and internal review board approved Registry for penile implants, the “INSIST-ED” (Italian Nationwide Systematic Inventarisation of Surgical Treatment for ED Registry. Purpose of this first report is to present a baseline data analysis of the characteristics of penile implant surgery in Italy. Material and methods: The INSIST-ED Registry is open to all surgeons implanting penile prostheses (all brands, all models in Italy, providing anonymous patient, device, surgical procedure, outcome, follow-up data, for both first and revision surgeries. A Registry project Board overviews all the steps of the project, and a Registry Monitor interacts with the Registry implanting surgeons. Results: As by April 8, 2016, 31 implanting surgeons actively joined the Registry, entering 367 surgical procedures in its database, that comprise: 310 first implants, 43 prosthesis substitutions, 14 device explants without substitution. Implanted devices account for: 288 three-component devices (81,3%, 20 two-component devices (5,4%, 45 non-hydraulic devices (12,3%. Leading primary ED etiologies in first implant surgeries resulted: former radical pelvic surgery in 111 cases (35,8%, Peyronie’s disease in 66 cases (21,3%, diabetes in 39 cases (12,6%. Two intraoperative complications have been recorded. Main reasons for 57 revision surgeries were: device failure (52,6%, erosion (19,3%, infection (12,3%, patient dissatisfaction (10,5%. Surgical settings for patients undergoing a first penile implant were: public hospitals in 251 cases (81%, private environments in 59 cases (19%. Conclusions: The INSIST-ED Registry represents the first European experience of penile prosthesis Registry. This baseline data analysis shows that: three-pieces inflatable prosthesis is the most implanted device, leading etiology of

Comparison of efficacy and satisfaction profile, between penile prosthesis implantation and oral PDE5 inhibitor tadalafil therapy, in men with nerve-sparing radical prostatectomy erectile dysfunction.

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Megas, Georgios; Papadopoulos, Georgios; Stathouros, Georgios; Moschonas, Dimitrios; Gkialas, Ioannis; Ntoumas, Konstantinos

2013-07-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Erectile dysfunction after nerve-sparing radical retropubic prostatectomy constitutes a challenge to the urologist. The mainstay of medical treatment after radical prostatectomy to restore spontaneous erectile function remains phosphodiesterase (PDE5) inhibitors, despite the fact that data from animal studies suggesting that PDE5 inhibitors can prevent smooth muscle apoptosis and fibrosis have not yet been extrapolated to humans because of a lack of standardized protocols. If the above treatment fails, second-line therapies such as intraurethral prostaglandins, penile injection therapy and vacuum devices are offered. When less invasive therapies are ineffective, interventions that preserve sexual function such as penile prosthesis implantation become the treatment of choice. Our study reveals the alternative of penile prosthesis implantation as first-line treatment in erectile dysfunction after nerve-sparing radical prostatectomy. It also highlights its superiority to the oral PDE5 inhibitor treatment, regarding the erection, frequency, firmness, maintenance and penetration ability. This suggests that a concept of an early penile intervention in the future would be promising for those patients who wish to remain sexually active without depending on oral formulations with doubtful and delayed results. To evaluate the outcome of penile prosthesis surgery in comparison to oral phosphodiesterase type 5 (PDE5) inhibitor administration, in men with erectile dysfunction after nerve-sparing radical prostatectomy, as early penile intervention therapy. A total of 174 patients treated by nerve-sparing retropubic radical prostatectomy (RRP) for clinically localized prostate cancer, between January 2006 and September 2009 enrolled in the study, 153 patients fulfilled the inclusion criteria, and 69 (45%) patients presented with post-RRP erectile dysfunction 6 months after primary surgery. Fifty-four patients were disease

Three-Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques.

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Maló, Paulo; de Araújo Nobre, Miguel; Lopes, Armando

2016-07-01

The aim of this prospective clinical study was to evaluate the 3-year outcome of fixed partial prostheses supported by implants with immediate provisionalization without occlusal contacts inserted in predominantly soft bone with flap and flapless protocols. Forty-one patients partially rehabilitated with 72 NobelSpeedy implants (51 maxillary; 21 mandibular) were consecutively included and treated with a flapless surgical protocol (n = 20 patients; 32 implants) and flapped surgical protocol (n = 21 patients; 40 implants). Primary outcome measure was implant survival; secondary outcome measures were marginal bone resorption (comparing the bone levels at 1 and 3 years with baseline) and the incidence of biological, mechanical, and esthetic complications. Survival was computed through life tables; descriptive statistics were applied to the remaining variables of interest. Eight patients with eight implants dropped out of the study. One implant failed in one patient (flapless group) giving an overall cumulative survival rate (CSR) of 98.6%. No failures were noted with the flapped protocol (CSR 100%), while for the implants placed with the flapless surgical technique, a 96.9% CSR was registered. The overall average marginal bone resorption at 3 years was 1.37 mm (SD = 0.94 mm), with 1.14 mm (SD = 0.49 mm) and 1.60 mm (SD = 1.22 mm) for the flap and flapless groups, respectively. Mechanical complications occurred in nine patients (n = 5 patients in the flapless group; n = 4 patients in the flap group). Implant infection was registered in three implants and three patients (flapless group), who exhibited inadequate oral hygiene levels. Partial edentulism rehabilitation through immediate provisionalization fixed prosthesis supported by dental implants inserted through flap or flapless surgical techniques in areas of predominantly soft bone was viable at 3 years of follow-up. The limitations and risks of the "free-hand" method in flapless surgery should be considered when

Results of endoprosthetic hip joint replacement with the aluminum ceramic-metal composite prosthesis "Lindenhof".

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Stock, D; Diezemann, E D; Gottstein, J

1980-01-01

The first clinical results of the Lindenhof ceramic-metal composite prosthesis implanted in our hospital in Freiburg are presented. We observed that same favorable early results as the conventional prostheses in a correct position. The implants are incorporated into the bone within 8-12 weeks. The radiographic films show the adaptation of the supporting bone around the ceramic socket. We explain the failures due to our initial lack of technical experience and/or anatomical deformation of the pelvic bone. complications caused by the post-operative treatment during the 12 weeks following surgery did not occur. The combination of a cemented metal femoral component with a ceramic head seems to be a reasonable compromise to use the favorable physical and biochemical properties of the bioceramic material as long as there is no satisfactory solution for a stable cementless fixation of the femoral stem in to the bone. The advantages of the Lindenhof prosthesis predominate the disadvantages: expensive instruments and a post-operative treatment of several months.

Dosimetric influence of hip prosthesis during radiotherapeutic treatment

International Nuclear Information System (INIS)

Gschwind, R.; Buffard, E.; Masset, H.; Makovicka, L.; David, C.; David, C.; Buffard, E.

2008-01-01

As the population become aged, many patients with hip prosthesis are treated for a pelvic cancer. The recommended ballistic must avoid to pass in the prosthesis, but sometimes it is inevitable. So it is essential to quantify with accuracy the dose modifications linked to the presence of metallic implant. The aim of this study is to analyze by Monte Carlo method these modifications in simple and complex models (anthropomorphic phantom) which take into account the geometry and the composition of the prosthesis and its coatings. Then, this methodology was used to study the behaviour of a treatment planning system in theses extreme conditions. (authors)

Unusual Etiology and Diagnosis of Oroantral Communication due to Late Implant Failure

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Rabah Nedir

2017-01-01

Full Text Available Oroantral communication (OAC rarely occurs long after implant placement. The present report describes the rare etiology and the difficulty of the diagnosis of an uncommon OAC occurring 10 years after the implant placement in the posterior maxilla. The difficulty of the diagnosis lies in the absence of clinical symptoms of sinusitis and presence of multiunit prosthesis hiding implant failure. This case report supports the need for sinus check-up during a routine implant examination.

Measurement of elastic modulus and Vickers hardness of surround bone implant using dynamic microindentation--parameters definition.

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Soares, Priscilla Barbosa Ferreira; Nunes, Sarah Arantes; Franco, Sinésio Domingues; Pires, Raphael Rezende; Zanetta-Barbosa, Darceny; Soares, Carlos José

2014-01-01

The clinical performance of dental implants is strongly defined by biomechanical principles. The aim of this study was to quantify the Vicker's hardness (VHN) and elastic modulus (E) surround bone to dental implant in different regions, and to discuss the parameters of dynamic microindantion test. Ten cylindrical implants with morse taper interface (Titamax CM, Neodent; 3.5 mm diameter and 7 mm a height) were inserted in rabbit tibia. The mechanical properties were analyzed using microhardness dynamic indenter with 200 mN load and 15 s penetration time. Seven continuous indentations were made distancing 0.08 mm between each other perpendicularly to the implant-bone interface towards the external surface, at the limit of low (Lp) and high implant profile (Hp). Data were analyzed by Student's t-test (a=0.05) to compare the E and VHN values obtained on both regions. Mean and standard deviation of E (GPa) were: Lp. 16.6 ± 1.7, Hp. 17.0 ± 2.5 and VHN (N/mm2): Lp. 12.6 ± 40.8, Hp. 120.1 ± 43.7. No statistical difference was found between bone mechanical properties of high and low profile of the surround bone to implant, demonstrating that the bone characterization homogeneously is pertinent. Dynamic microindantion method proved to be highly useful in the characterization of the individual peri-implant bone tissue.

Malignant esophageal stenosis: treatment with the Wallsten ''TM prosthesis

International Nuclear Information System (INIS)

Paul, L.; Pinto, I.

1998-01-01

To discuss the technical aspects and adders the clinical results of treatment of malignant esophaged dysphagia by placement of a Wallstent prosthesis under fluoroscopic guidance. Over the past six years, we have implanted 63 Wallstent metallic prostheses in 40 patients with un operable malignant dysphagia of esophaged origin. The consisted of 36 men and 6 women with a mean age of 72 years. Seven of the neoplasms were associated with fistula.Six involved recurrent tumors at the point of the surgical anastomosis. Following implantation, the patients were evaluated clinically and radiologically at postoperative hour 48 and periodically thereafter until their death or until the study was completed in September 1996. The placement of the prostheses was achieved in all the patients. Immediate technical problems (malposition or failure to expand) in 27.5% of cases. Forty percent of the patients complained of plain, and there was one death due to massive hematemesis. A clear improvement in dysphagia was obtained was obtained in 79% of and only one of the 7 fistulas was closed. During follow-up, the main complication was obstruction of prosthesis (25%) as a result of tumor overgrowth (9 episodes in 8 patients) or due to food impaction (4 episodes in 3 patients). The rate of retreatment was 27.5%. The mean survival time after prosthesis implantation was 132 ±207 days and 62.5% of the devices were still permeable when the patient died. Implantation of Wallstent prosthesis in cases of malignant esophageal stenosis is easy and safe, and constitutes an effective treatment of dysphagia. Nevertheless, thorough knowledge of the technical aspects ensures better results and the strict assessment of the indications guarantees an improved cost-benefit ratio for this technique. (Author) 23 refs

An analysis of observer-rated functional vision in patients implanted with the Argus II Retinal Prosthesis System at three years.

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Geruschat, Duane R; Richards, Thomas P; Arditi, Aries; da Cruz, Lyndon; Dagnelie, Gislin; Dorn, Jessy D; Duncan, Jacque L; Ho, Allen C; Olmos de Koo, Lisa C; Sahel, José-Alain; Stanga, Paulo E; Thumann, Gabriele; Wang, Vizhong; Greenberg, Robert J

2016-05-01

The purpose of this analysis was to compare observer-rated tasks in patients implanted with the Argus II Retinal Prosthesis System, when the device is ON versus OFF. The Functional Low-Vision Observer Rated Assessment (FLORA) instrument was administered to 26 blind patients implanted with the Argus II Retinal Prosthesis System at a mean follow-up of 36 months. FLORA is a multi-component instrument that consists in part of observer-rated assessment of 35 tasks completed with the device ON versus OFF. The ease with which a patient completes a task is scored using a four-point scale, ranging from easy (score of 1) to impossible (score of 4). The tasks are evaluated individually and organised into four discrete domains, including 'Visual orientation', 'Visual mobility', 'Daily life and 'Interaction with others'. Twenty-six patients completed each of the 35 tasks. Overall, 24 out of 35 tasks (69 per cent) were statistically significantly easier to achieve with the device ON versus OFF. In each of the four domains, patients' performances were significantly better (p vision-related tasks with the device ON versus OFF. © 2016 The Authors Clinical and Experimental Optometry published by John Wiley & Sons Australia, Ltd on behalf of Optometry Australia.

Replacement of missing tooth in esthetic zone with implant-supported fixed prosthesis

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Sunil Kumar Mishra

2017-01-01

Full Text Available In the anterior region, the common reason for tooth loss is due to traumatic injury or congenital anomaly. Loss of a single tooth may cause functional and esthetic deficits to the patient. There are different treatment options available for replacing a missing incisor. Implant dentistry should be considered as first treatment alternative for replace a missing tooth. This case report presents the replacement of a missing maxillary left central incisor in a compromised site with dental implants along with bone graft followed by frenectomy to obtain a good clinical result and for better function and esthetics of the patient.

Pterygoid implants for maxillofacial rehabilitation of a patient with a bilateral maxillectomy defect.

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Bidra, Avinash S; May, George W; Tharp, Greggory E; Chambers, Mark S

2013-02-01

Bilateral maxillectomy is known to have serious esthetic and functional consequences. The retention and support of a maxillary obturator prosthesis in these patients is particularly challenging. Surgical placement of implants is also challenging because of the lack of available bone. Therefore, implant placement into remote sites such as zygoma has been advocated. Very few articles in the literature have discussed the use of pterygoid/pterygomaxillary implants in patients undergoing maxillectomy. This case report describes the maxillofacial rehabilitation of an elderly man who underwent a bilateral subtotal maxillectomy due to basaloid squamous cell carcinoma of the hard palate. After initial healing, the patient had a pterygoid implant placed on each side of the oral cavity. Zygomatic implants were also attempted, but they failed to osseointegrate. Both pterygoid implants showed successful osseointegration. These 2 implants significantly helped to retain a hollow maxillary obturator prosthesis that aided in improved swallowing, speech, and esthetics. To the authors' knowledge, this is the first report in the literature that describes usage of pterygoid implants for rehabilitation of a patient undergoing bilateral maxillectomy.

Extraocular surgery for implantation of an active subretinal visual prosthesis with external connections: feasibility and outcome in seven patients.

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Besch, D; Sachs, H; Szurman, P; Gülicher, D; Wilke, R; Reinert, S; Zrenner, E; Bartz-Schmidt, K U; Gekeler, F

2008-10-01

Due to low energy levels in microphotodiode-based subretinal visual prostheses, an external power supply is mandatory. We report on the surgical feasibility and the functional outcome of the extraocular part of an approach to connect a subretinal prosthesis to an extracorporeal connector in the retro-auricular space via a trans-scleral, transchoroidal cable. Seven volunteers with retinitis pigmentosa received an active subretinal implant; energy was supplied by gold wires on a trans-sclerally, transchoroidally implanted polyimide foil leading to the lateral orbital rim where it was fixated and connected to a silicone cable. The cable was implanted subperiostally beneath the temporal muscle using a trocar to the retro-auricular space where it penetrated the skin for connection to a stimulator. To avoid subretinal movement of the implant, three tension relief points have been introduced. All implantations were performed as planned without complications, and no serious adverse events occurred in the postoperative period. Fixation of the implants was stable throughout the entire study duration of 4 weeks; permanent skin penetration proved to be uncomplicated. Motility was minimally restricted in downgaze and ab-/adduction. Explantation was uneventful. The above-described procedure provides a method for stable fixation of a subretinal device with a trans-scleral, transchoroidal cable connection to an extracorporeal connector.

Diagnostic Imaging for Dental Implant Therapy

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Aishwarya Nagarajan

2014-01-01

Full Text Available Dental implant is a device made of alloplastic (foreign material implanted into the jaw bone beneath the mucosal layer to support a fixed or removable dental prosthesis. Dental implants are gaining immense popularity and wide acceptance because they not only replace lost teeth but also provide permanent restorations that do not interfere with oral function or speech or compromise the self-esteem of a patient. Appropriate treatment planning for replacement of lost teeth is required and imaging plays a pivotal role to ensure a satisfactory outcome. The development of pre-surgical imaging techniques and surgical templates helps the dentist place the implants with relative ease. This article focuses on various types of imaging modalities that have a pivotal role in implant therapy.

21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle...

Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction.

Science.gov (United States)

Lledó-García, Enrique; Jara-Rascón, José; Moncada Iribarren, Ignacio; Piñero-Sánchez, Javier; Aragón-Chamizo, Juan; Hernández-Fernández, Carlos

2015-07-01

Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Prosthesis replacement has become an accepted procedure in the event of device malfunction or complications, but to our knowledge, there are no data regarding the impact of implant replacement on patients and partner satisfaction. The aim of our study was to assess and to compare the level of satisfaction, with a first or second penile prosthesis implantation (PPI), in men with refractory erectile dysfunction and their partners. A survey study based on a five-item questionnaire was carried out at our center between January 1999 and January 2012. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after PPI. Of the 190 eligible patients, 149 (78%) completed the survey (110 underwent a first implant and 39 a reimplant). Seventy-nine percent of first-time implanted patients and 80% of the reimplanted patients (P > 0.05; not significant [ns]) reported satisfactory sexual intercourse (very or moderately satisfied), while 74% and 80% of their partners reported satisfactory intercourses, respectively (P > 0.05; ns). Overall, 73.7% of first implants and 70% of second implants reported that they would undergo the procedure again if the PPI failed (P > 0.05; ns). With regards to cosmetic aspects, 13% of the first implants' and 15% of second implants' partners reported either penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of first implants and 1% of reimplanted patients expressed difficulty in manipulating the device. PPI is successful in returning the ability for satisfactory sexual intercourse to both first implant and reimplanted patients and their respective partners. © 2015 International Society for Sexual Medicine.

Imaging and dosimetric considerations for titanium prosthesis implanted within the irradiated region by high photon beams

International Nuclear Information System (INIS)

Indogo, V.

2014-07-01

The aim of this research was to observe dose distributions in the vicinity of titanium prosthetic implants during radiotherapy procedures. Data were obtained using a locally fabricated tissue equivalent phantom CT images, and in blue water phantom with titanium prosthesis which was irradiated with 60 Co gamma radiation and Elekta Platform photon beams. Images obtained were loaded into Prowess Panther and Oncentra treatment planning systems (TPSs) for dose simulations. Prowess TPS (1.25 MeV) estimated lesser errors whilst Oncentra (6 and 15 MV) dose simulations yielded large variations. Proximal ends of the metal recorded slight increase in doses as a rcsult of backscatter with dose increment below acceptable tolerance of ±3%. Doses measured decreases on the distal side of the prosthesis at a distance less than d max from the plate on each beam energy. Beyond certain depth along the axis, depth doses increased slightly mainly due to increase in electron fluence by portions receiving unperturbed dose. An increase in the plate thickness showed a corresponding decrease on percentage depth dose. A reduction in the above trend was also noticed with an increase in beam energy primarily because scattered photons are more forwardly directed. Prowess TPS (convolution superposition algorithm) was found to be better at reducing dose variation than OMP (collapse cone algorithm) when correction for artifact. Manual calculations on blue phantom data agree with results from Prowess. Oncentra is not capable of simulating dose around titanium prosthesis as its range of densities, 0.00121 to 2.83, excludes titanium density (rED for titanium is 3.74). (au)

Fixed prosthesis with a milled bar for correcting misangled implants: a clinical report.

Science.gov (United States)

Lee, Jae-Hoon; Frias, Val; Woo, Changwoo; Maiberg, Roman

2007-03-01

The fabrication of fixed implant-supported prostheses for edentulous maxillae may result in esthetic and functional problems due to the unfavorable angulations of the supporting implants. This article presents a technique that uses a metal mesosubstructure prepared with a conventional milling technique and palatal set screws to compensate for an unfavorable implant position, thereby providing a more esthetically acceptable and functional result.

Use of transitional implants for immediate loading in mandibular complete dentures- A case report

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Seema Bhoosreddy

2009-01-01

Full Text Available After the placement of implants in areas in which several teeth have been lost, both the clinician and the patient face many difficulties, particularly during healing. If no prosthesis is provided, the patient′s quality of life suffers. If a removable prosthesis is provided for optimum mastication and speech, many complicated adjustments of the denture may become necessary during healing, and the possibility of osseointegration failure increases. It has been reported that for implants to become osseointegrated, they must heal in the absence of functional loads for 4 to 6 months. To address the need for undisturbed healing and patient demand for uninterrupted immediate function and esthetics, the transitional implant system has been developed. This case report describes the use of transitional implants to support a removable mandibular overdenture. The transitional implant system is a sound and economical method of immediate patient restoration that allows for the protected healing of submerged implants.

Early Loaded Single Implant Reinforced Mandibular Overdenture

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K. Nischal

2016-01-01

Full Text Available Rehabilitating atrophied mandible with two-implant supported denture is a common treatment modality for implant retained removable overdenture in mandible. This paper aims to design a treatment modality where single implant reinforced overdenture is fabricated for a severely atrophied mandibular ridge with early loading protocol. Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. Midline fracture of the prosthesis is the most common complication related to single implant and two-implant retained mandibular overdentures. To manage such complication, a thin metal mesh is used to reinforce the overdenture and also to make the prostheses lighter and cost effective as compared to conventional cast metal framework.

The Influence of Artificial Cervical Disc Prosthesis Height on the Cervical Biomechanics: A Finite Element Study.

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Yuan, Wei; Zhang, Haiping; Zhou, Xiaoshu; Wu, Weidong; Zhu, Yue

2018-05-01

Artificial cervical disc replacement is expected to maintain normal cervical biomechanics. At present, the effect of the Prestige LP prosthesis height on cervical biomechanics has not been thoroughly studied. This finite element study of the cervical biomechanics aims to predict how the parameters, like range of motion (ROM), adjacent intradiscal pressure, facet joint force, and bone-implant interface stress, are affected by different heights of Prestige LP prostheses. The finite element model of intact cervical spine (C3-C7) was obtained from our previous study, and the model was altered to implant Prestige LP prostheses at the C5-C6 level. The effects of the height of 5, 6, and 7 mm prosthesis replacement on ROM, adjacent intradiscal pressure, facet joint force, as well as the distribution of bone-implant interface stress were examined. ROM, adjacent intradiscal pressure, and facet joint force increased with the prosthesis height, whereas ROM and facet joint force decreased at C5-C6. The maximal stress on the inferior surface of the prostheses was greater than that on the superior surface, and the stresses increased with the prosthesis height. The biomechanical changes were slightly affected by the height of 5 and 6 mm prostheses, but were strongly affected by the 7-mm prosthesis. An appropriate height of the Prestige LP prosthesis can preserve normal ROM, adjacent intradiscal pressure, and facet joint force. Prostheses with a height of ≥2 mm than normal can lead to marked changes in the cervical biomechanics and bone-implant interface stress. Copyright © 2018 Elsevier Inc. All rights reserved.

Strategy to avoid patient-prosthesis mismatch: aortic root enlargement.

Science.gov (United States)

Srivastava, Dharmendra Kumar; Sanki, Prokash; Bhattacharya, Subhankar; Siddique, Javed Veqar

2014-02-01

The choice of a valve with an effective orifice area matching the body surface area and providing efficient hemodynamics is an important factor affecting mortality and morbidity in patients undergoing aortic valve replacement. Our preventative strategy was to implant a larger prosthetic valve by aortic root enlargement using the Nunez procedure in 17 patients between February 2010 and January 2011. The decision to enlarge the aortic root was taken when the 19-mm sizer could not be negotiated easily through the aortic root, or on the basis of body surface area of the patient or type of prosthesis available. Postoperative reductions in peak and mean pressure gradients across aortic valve of 12.8-16.5 and 10.2-12.6 mm Hg, respectively, were observed. Postoperative effective orifice areas of the aortic valves were 1.1-1.5 cm(2). By upsizing the aortic valve, we were able to eliminate patient-prosthesis mismatch in 5 patients, and reduce severe patient-prosthesis mismatch to moderate in 11. Aortic root enlargement is a safe procedure. Therefore, cardiac surgeons should not be reluctant to enlarge the aortic root with an autologous pericardial patch to permit implantation of an adequate size of aortic valve prosthesis, with minimal additional aortic crossclamp time and no added cost.

First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve stenosis.

Science.gov (United States)

Grube, Eberhard; Laborde, Jean C; Zickmann, Bernfried; Gerckens, Ulrich; Felderhoff, Thomas; Sauren, Barthel; Bootsveld, Andreas; Buellesfeld, Lutz; Iversen, Stein

2005-12-01

Percutaneous aortic valve replacement is a new technology for the treatment of patients with significant aortic valve stenosis. We present the first report on a human implantation of a self-expanding aortic valve prosthesis, which is composed of three bovine pericardial leaflets inserted within a self-expanding nitinol stent. The 73-year-old woman presented with severe symptomatic aortic valve stenosis (mean transvalvular gradient of 45 mmHg; valve area of 0.7 cm2). Surgical valve replacement had been declined for the patient because of comorbidities, including previous bypass surgery. A retrograde approach via the common iliac artery was used for valve deployment. The contralateral femoral vessels were used for a temporary extracorporal circulation, unloading the left ventricle during the actual stent expansion. Clinical, hemodynamic, and echocardiographic outcomes were assessed serially during the procedure. Clinical and echocardiographic follow-up at day 1, 2, and 14 post procedure was performed to evaluate the short-term outcome. The prosthesis was successfully deployed within the native aortic valve, with accurate and stable positioning and with no impairment of the coronary artery or vein graft blood flow. 2D and doppler echo immediately after device deployment showed a significant reduction in transaortic mean pressure gradient (from 45 to 8 mmHg) without evidence of aortic or mitral valve insufficiency. The clinical status has then significantly improved. These results remained unchanged up to the day 14 follow-up. This case report demonstrates a successful percutaneous implantation of a self-expanding aortic valve prosthesis with remarkable functional and clinical improvements in the acute and short-term outcome. Copyright (c) 2005 Wiley-Liss, Inc.

99m technetium-MDP bone scintigraphy in evaluation of painful joint prosthesis

International Nuclear Information System (INIS)

Milosevic, D.; Jaukovic, M.; Jaukovic, Lj.; Ajdinovic, B.

2004-01-01

In addition of clinical evaluation and x-ray radiography, the diagnosis of a loose joint prosthesis is often made by nuclear medicine imaging techniques. Differentiation between loosening and infected prosthesis is important for better treatment of those patients. Aim: The aim of this study was to reevaluate the scintigraphic patterns in patients with painful hip of knee arthroplasty. Material and Method: From 1996. to 2003. forty patients aged 49-78 years were referred for evaluation of possible loosening/infection joint prosthesis: 36 pts with 39 total/ partial hip prosthesis, 1 pt with knee prosthesis and 3 pts with history of previously extracted hip prosthesis due to infection. Whole body acquisition had been performed with a single head gamma camera three hours after the injection of 740 MBq 99m Tc-MDP. Scans were classified as: positive for loosening if abnormal uptake was shown at the tip of the prosthesis; positive for infection if diffuse abnormal uptake was shown around the implant; negative and indeterminate scans. Scintigraphic findings were compared to clinical follow up, histology or cultures. Results: Positive findings were found in 17 bone scans strongly suggesting loosening in 10 cases, infection of prosthesis in 4 cases and both loosening/infection in 3 cases. Bone scintigraphy was normal in 11pts. Scans of three pts with previously extracted hip prosthesis and scheduled for reimplatation, showed inhomogeneously and mildly increased uptake in femur. Most of scans classified as indeterminate (n=12) showed slightly increased tracer uptake in region of acetabular roof, greater or lesser tho chanter, suggesting bone remodeling due to the presence of implant, rather than loosening. Conclusion: 99m Tc-MDP bone scintigraphy had a significant role in assessing the painful joint prosthesis. Complementary diagnostic procedures should be considered in indeterminate scintiscans. (authors)

21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint tibial (hemi-knee) metallic resurfacing... Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be implanted...

Adhesive strength of hydroxyl apatite(HA coating and biomechanics behavior of HA-coated prosthesis:an experimental study

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Tian-yang ZHANG

2011-05-01

Full Text Available Objective To explore the influence of adhesive strength of hydroxyapatite(HA coating on the post-implantation stability of HA-coated prosthesis.Methods The adhesive strength and biomechanics behavior of HA coating were studied by histopathological observation,material parameters and biomechanical testing,the titanium(Ti-coated prosthesis was employed as control.Results Scratch test showed that the adhesive strength of HA coating was significantly lower than that of Ti coating(P < 0.01.Histopathological examination and bone morphometry showed that,at the early stage of prosthesis implantation,the bony growth around HA-coated prosthesis was significantly higher than that around Ti-coated prosthesis(P < 0.01,but the ultimate shear strength of HA-coated prosthesis was much lower than that of Ti-coated prosthesis(P < 0.01.After the push-out test with prosthesis,histopathological observation showed that there were accumulations of clump-and strip-like granular residues on the surface of bones that newly grew around the HA-coated prosthesis,and surface energy-dispersive X-ray spectroscopy(EDX analysis also confirmed that the shear stress induced HA decohesion from the substrate of prosthesis.Conclusions Although HA coating showed a satisfactory effect on early bone formation and prosthetic stability,due to the deficiencies of adhesive strength,the early stability of prosthesis may be gradually destroyed by the shear loads of human body and coating degradation.

Construction of an implant-retained auricular prosthesis with the aid of contemporary digital technologies: a clinical report.

Science.gov (United States)

Hatamleh, Muhanad M; Watson, Jason

2013-02-01

Implant-retained auricular prostheses are a successful treatment modality for children with microtia. They involve only minor surgical intervention of implant placement and result in an esthetically pleasing outcome. Integration of digital technologies (DT) in the prosthetic reconstruction process is a new approach toward enhancing outcomes. In this report we present a case of auricular prosthetic reconstruction following two implant placements in the right mastoid region. The ear prosthesis was constructed with the aid of various DTs. A structured light laser scanner was used to digitize the nondefect patient ear. The digitized 3D ear was then manipulated in specialist software, mirrored to reflect the opposing side, and a Rapid Prototyping (RP) machine (Z-Corp) was used to manufacture the soft tissue required. This RP-mirrored ear model allows very accurate reproduction to replicate missing soft tissue. A color Spectrometer was used to accurately reproduce skin tones. The use of these technologies is now routine practice at our unit. They enhance prosthetic outcomes and esthetics, save the prosthetist's time, and are digitally stored and subsequently readily available and reproducible. © 2012 by the American College of Prosthodontists.

Fabrication of a Cranial Prosthesis Combined with an Ocular Prosthesis Using Rapid Prototyping: A Case Report

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Gayatri Shankaran

2016-08-01

Full Text Available Rapid prototyping (RP is a technique of manufacturing parts by the additive layer manufacturing technology; where, a three-dimensional (3D model created in a computer aided design (CAD system is sectioned into 2D profiles, which are further constructed by RP layer by layer. Its use is not limited to industrial or engineering fields and has extended to the medical field for the manufacturing of custom implants and prostheses, the study of anatomy and surgical planning. Nowadays, dentists are more frequently encountered with the individuals affected with craniofacial defects due to trauma. In such cases, the cranio-maxillofacial rehabilitation is a real challenge to bring the patients back to society and promote their well-being. The conventional impression technique for facial prosthesis fabrication has the disadvantage of deforming the soft tissue and causing discomfort for the patient. Herein, we describe the fabrication of a cranial prosthesis combined with an ocular prosthesis with RP and stereolithography.

Fabrication of a Cranial Prosthesis Combined with an Ocular Prosthesis Using Rapid Prototyping: A Case Report.

Science.gov (United States)

Shankaran, Gayatri; Deogade, Suryakant Chhagan; Dhirawani, Rajesh

2016-01-01

Rapid prototyping (RP) is a technique of manufacturing parts by the additive layer manufacturing technology; where, a three-dimensional (3D) model created in a computer aided design (CAD) system is sectioned into 2D profiles, which are further constructed by RP layer by layer. Its use is not limited to industrial or engineering fields and has extended to the medical field for the manufacturing of custom implants and prostheses, the study of anatomy and surgical planning. Nowadays, dentists are more frequently encountered with the individuals affected with craniofacial defects due to trauma. In such cases, the craniomaxillofacial rehabilitation is a real challenge to bring the patients back to society and promote their well-being. The conventional impression technique for facial prosthesis fabrication has the disadvantage of deforming the soft tissue and causing discomfort for the patient. Herein, we describe the fabrication of a cranial prosthesis combined with an ocular prosthesis with RP and stereolithography.

Impact of patient-prosthesis mismatch after transcatheter aortic valve-in-valve implantation in degenerated bioprostheses.

Science.gov (United States)

Seiffert, Moritz; Conradi, Lenard; Baldus, Stephan; Knap, Malgorzata; Schirmer, Johannes; Franzen, Olaf; Koschyk, Dietmar; Meinertz, Thomas; Reichenspurner, Hermann; Treede, Hendrik

2012-03-01

Transcatheter valve-in-valve implantation is evolving as an alternative to reoperative valve replacement in high-risk patients with degenerated bioprostheses. Nevertheless, hemodynamic performance is limited by the previously implanted xenograft. We report our experience with patient-prosthesis mismatch (PPM) after valve-in-valve implantation in the aortic position. Eleven patients (aged 79.3 ± 6.1 years) received transapical implantation of a balloon-expandable pericardial heart valve into a degenerated bioprosthesis (size, 23.9 ± 1.6 mm; range, 21-27 mm) in the aortic position. All patients were considered high risk for surgical valve replacement (logistic European System for Cardiac Operative Risk Evaluation, 31.8% ± 24.1%). Severe PPM was defined as an indexed effective orifice area less than 0.65 cm(2)/m(2), determined by discharge echocardiography. Severe PPM was evident in 5 patients (group 1) and absent in 6 patients (group 2). Mean transvalvular gradients decreased from 29.2 ± 15.4 mm Hg before implantation to 21.2 ± 9.7 mm Hg at discharge (group 1) and from 28.2 ± 9.0 mm Hg before implantation to 15.2 ± 6.5 mm Hg at discharge (group 2). Indexed effective orifice area increased from 0.5 ± 0.1 cm(2)/m(2) to 0.6 ± 0.1 cm(2)/m(2) and from 0.6 ± 0.3 cm(2)/m(2) to 0.8 ± 0.3 cm(2)/m(2). Aortic regurgitation decreased from grade 2.0 ± 1.1 to 0.4 ± 0.5 overall. No differences in New York Heart Association class improvement or survival during follow-up were observed. One patient required reoperation for symptomatic PPM 426 days after implantation. Valve-in-valve implantation can be performed in high-risk surgical patients to avoid reoperation. However, PPM frequently occurs, making adequate patient selection crucial. Small bioprostheses (body surface area less than 1.8 m(2). Larger prostheses seem to carry a lower risk for PPM. Although no delay in clinical improvement was seen at short-term, 1 PPM-related surgical intervention raises concern regarding

Percutaneous Revision of a Testicular Prosthesis is Safe, Cost-effective, and Provides Good Patient Satisfaction

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Eugene B. Cone

2015-09-01

Full Text Available Office-based percutaneous revision of a testicular prosthesis has never been reported. A patient received a testicular prosthesis but was dissatisfied with the firmness of the implant. In an office setting, the prosthesis was inflated with additional fluid via a percutaneous approach. Evaluated outcomes included patient satisfaction, prosthesis size, recovery time, and cost savings. The patient was satisfied, with no infection, leak, or complication after more than 1 year of follow-up, at significantly less cost than revision surgery. Percutaneous adjustment of testicular prosthesis fill-volume can be safe, inexpensive, and result in good patient satisfaction.

Towards a Completely Implantable, Light-Sensitive Intraocular Retinal Prosthesis

National Research Council Canada - National Science Library

Humayun, M

2001-01-01

An electronic retinal prosthesis is under development to treat retinitis pigmentosa and age-related macular degeneration, two presently incurable diseases of the outer retina that afflict millions world-wide...

New 3D technologies applied to assess the long-term clinical effects of misfit of the full jaw fixed prosthesis on dental implants.

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Jokstad, Asbjørn; Shokati, Babak

2015-10-01

To assess implant:suprastructure misfit in patients with an edentulous jaw restored by an implant-retained fixed dental prosthesis (FDP) and its association with biologic and mechanical adverse events over an extensive period. Thirty patients with an edentulous mandible treated with implant-supported prosthetics before 2000 were examined clinically in 2012. Each patient had received 4 to 6 implants to retain a FDP made from acrylic and three different metal alloys, that is, Ag-Pd, Pd-Ag, and Au type IV. The implant intra-oral locations were recorded digitally by use of an intra-oral scanner, and the intaglio surface of the detached FDP was recorded using a desktop scanner. The fit was estimated by digital matching of the STL files using industrial metrological software. The average misfit was correlated with the average marginal bone loss and the prevalence of screw loosening or fractures, using the patient as the statistical unit. Over an average of 19 years (range 12 to 32), 5 implants had been lost in 4 participants (96.7% implant survival) and 8 eight prostheses (26.7%) had been remade. Anaverage misfit was 150 μm (SD 35, range 95-232, CI 138-163). An average marginal bone loss of 2.2 mm (SD = 0.7) had occurred (range 0.6 to 5.8 mm) for individual implants. The correlation between framework misfit and marginal bone loss was weak (R² = 0.04) (P = 0.29). The prostheses with a history of screw-related adverse events showed average misfit of 169 μm (SD = 32) vs. those with no history of screw-related adverse events, that is, 134 μm (SD = 30) (P = 0.005, Student's t-test). Fourteen of the 30 participants had experienced at least one incidence of screw loosening or fracture of prosthetic or abutment screw(s) over the period of follow-up. The occurrence among the frameworks fabricated with different metal alloys did not differ (P > 0.05, Fisher's exact test). Combining STL files with best-fit algorithms to appraise misfit is feasible using

Mini-implants: alternative for oral rehabilitation of a child with ectodermal dysplasia.

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Mello, Bianca Zeponi Fernandes; Silva, Thiago Cruvinel; Rios, Daniela; Machado, Maria Aparecida Andrade Moreira; Valarelli, Fabrício Pinelli; Oliveira, Thais Marchini

2015-01-01

Ectodermal dysplasia is a rare congenital disease that affects several structures of ectodermal origin. The most commonly related oral characteristics are hypodontia, malformed teeth and underdeveloped alveolar ridges. New alternative treatments are needed due to the failure of the conventional prosthesis retention. This case report outlines the oral rehabilitation treatment of a 9-year-old girl with ectodermal dysplasia. The treatment was performed with conventional prosthesis upon mini-implants. The mini-implants provided prosthetic retention. The patient reported a good adaptation of the dental prosthesis and satisfaction with the treatment. The increased self-esteem improved the socialization skills of the girl. In this case report, use of prosthesis with mini-implants was satisfactory for prosthetic retention. However, clinical studies with long-term follow-up are needed to test the mini-implants as an alternative for oral rehabilitation of children with ectodermal dysplasia.

Single vs two implant-retained overdentures for edentulous mandibles: a systematic review.

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Alqutaibi, Ahmed Yaseen; Esposito, Marco; Algabri, Radwan; Alfahad, Adnan; Kaddah, Amal; Farouk, Mohammed; Alsourori, Ali

To compare prosthesis and implant failure, patient satisfaction, prosthetic complications and peri-implant marginal bone loss of mandibular overdentures (IOD) supported by a single or two implants. Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomised controlled trials, without language restriction, comparing single vs two implant supported mandibular overdentures. Two investigators extracted data independently. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs. Six publications corresponding to four RCTs were identified. Three RCTs (corresponding to five publications) were included and one trial was excluded. Follow-ups in function were 1, 3 and 5 years after loading. All included studies were considered to be at a high risk of bias. The pooled result revealed more prosthesis failures at overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02), however, there were non-significant differences at 3 years (two trials) (P = 0.22; Risk Difference: -0.32, 95% CI: -0.83, 0.19) and at 5 years (one trial) (P = 0.95; Risk Difference: 0.01, 95% CI: -0.22, 0.24). Regarding implant failures, there were more implant losses in overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02) and at 5 years (one trial) (P = 0.95; Risk Difference: -0.15, 95% CI: -0.28, -0.02), however, there were non-significant difference at 3 years (two trials) (P = 0.2; Risk Difference: -0.33, 95% CI: -0.84, 0.18). After 5 years in function, meta-analyses revealed that there were non-significant differences regarding overall prosthetic complications when mandibular overdentures supported by a single implant were compared with overdentures supported by two implants (P = 0.43; RD: 0.04, 95% CI: -0.06, 0.15). Mandibular overdentures retained by a single implant

Comparison of orbital prosthesis motility following enucleation or evisceration with sclerotomy with or without a motility coupling post in dogs.

Science.gov (United States)

Yi, Na Young; Park, Shin Ae; Jeong, Man Bok; Kim, Won Tae; Kim, Se Eun; Kim, Ji Youn; Chae, Je Min; Jang, Kyoung Jin; Seong, Je Kyung; Seo, Kang Moon

2009-01-01

To evaluate motility of silicone orbital implants and corneoscleral prostheses, with and without use of a motility coupling post (MCP) in dogs. Eighteen mixed-breed dogs. The motility of an orbital silicone implant and corneoscleral prosthesis after enucleation (n = 6), evisceration (n = 6), or use of a MCP with evisceration (n = 6) in dogs were compared. One eye from each dog had surgery whereas the opposite eye was used as a control. Clinical evaluations were performed three times a week. Histopathology of the orbital tissues was performed 8 and 12 weeks after surgery. Implant motility in dogs with evisceration (vertical movement [VM] 8.04 +/- 2.13; horizontal movement [HM] 11 +/- 3.05) and evisceration with MCP (VM 9.61 +/- 1.59); HM was significantly greater than the enucleation group (VM 0.51 +/- 0.5; HM 1.22 +/- 0.68) (P dogs with evisceration with MCP was significantly greater than in dogs with evisceration; dogs with evisceration had significantly greater motility than dogs with enucleation (P dogs. This study supports the use of MCP in silicone orbital implants to enhance corneoscleral prosthesis motility and cosmetics in dogs.

21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be implanted...

Towards a Completely Implantable, Light-Sensitive Intraocular Retinal Prosthesis

National Research Council Canada - National Science Library

Humayun, M

2001-01-01

.... Previous studies have established the feasibility of the retinal prosthesis. Short-term tests in blind humans have shown that degenerated retina will respond to light in a way that is consistent with form vision...

Mandibular implant-supported overdentures: Prosthetic overview

Directory of Open Access Journals (Sweden)

Fahad A Al-Harbi

2018-01-01

Full Text Available Implant-supported overdentures are becoming the treatment of choice for the completely edentulous mandible. They significantly improve the quality of life in edentulous patients. For this review article, the literature was searched to identify pertinent studies. No meta-analysis was conducted because of high heterogeneity within the literature. Accordingly, in this review article, the author provides an update on implant-supported mandible overdentures with regard to the number of implants, type of loading, stress–strain distribution, mode of implant-to-denture attachment, occlusal considerations and complications.

Improvements in vision-related quality of life in blind patients implanted with the Argus II Epiretinal Prosthesis.

Science.gov (United States)

Duncan, Jacque L; Richards, Thomas P; Arditi, Aries; da Cruz, Lyndon; Dagnelie, Gislin; Dorn, Jessy D; Ho, Allen C; Olmos de Koo, Lisa C; Barale, Pierre-Olivier; Stanga, Paulo E; Thumann, Gabriele; Wang, Yizhong; Greenberg, Robert J

2017-03-01

The purpose of this analysis is to report the change in quality of life (QoL) after treatment with the Argus II Epiretinal Prosthesis in patients with end-stage retinitis pigmentosa. The Vision and Quality of Life Index (VisQoL) was used to assess changes in QoL dimensions and overall utility score in a prospective 30-patient single-arm clinical study. VisQoL is a multi-attribute instrument consisting of six dimensions (injury, life, roles, assistance, activity and friendship) that may be affected by visual impairment. Within each dimension, patients were divided into two groups based on how much their QoL was affected by their blindness at baseline (moderate/severe or minimal). Outcomes were compared within each dimension sub-group between baseline and the combined follow-up periods using the Friedman test. In addition, data from the six dimensions were combined into a single utility score, with baseline data compared to the combined follow-up periods. Overall, 80 per cent of the patients reported difficulty in one or more dimensions pre-implant. Composite VisQoL utility scores at follow-up showed no statistically significant change from baseline; however, in three of the six VisQoL dimensions (injury, life and roles), patients with baseline deficits showed significant and lasting improvement after implantation with Argus II. In two of the three remaining dimensions (assistance and activity), data trended toward an improvement. In the final VisQoL dimension (friendship), none of the patients reported baseline deficits, suggesting that patients had largely adjusted to this attribute. Patients whose vision negatively affected them with respect to three VisQoL dimensions (that is, getting injured, coping with the demands of their life and fulfilling their life roles) reported significant improvement in QoL after implantation of the Argus II retinal prosthesis. Furthermore, the benefit did not deteriorate at any point during the 36-month follow-up, suggesting a long

Effect of macro-design of immediately loaded implants on micromotion and stress distribution in surrounding bone using finite element analysis.

Science.gov (United States)

Fazel, Akbar; Aalai, Shima; Rismanchian, Mansour

2009-08-01

Macro-design influences the initial stability of implant and reduces micromotions. The aim of this study was to determine and compare micromotions and stress distribution in the bone around immediately loaded Maestro and Xive implants using finite element analysis. In this experimental study, accurate, clear photos were prepared of Xive and Maestro implants 12 and 13 mm long and 4 and 3.8 mm in diameter, respectively, using a Nikon Digital Camera with a resolution 5.24-megapixels with 8x Optical Zoom and 4x Digital Zoom. After accurate measurements, 3-D models of the implants inside the lower mandible (D2) were processed in Solidworks Version 2003 environment and transferred into Ansys for finite element analysis. After loading of 500 N angled at 70 degrees from the horizontal plane, the micromotion of the implant and Von Misses stresses around the bone were measured. The measured micromotion in Maestro implant was 148 mum and that in Xive was 284 mum. Stress distribution in the bone surrounding Maestro implant was better than Xive, but maximum stress surrounding Xive implants (30 MPa) was lower than Maestro (33 MPa). Based on the results obtained in the present study, maximum micromotion in maestro was less than that in Xive implants. This finding can guarantee the application of maestro implants for immediate loading.

Influence of patient position and implant material on the stress distribution in an artificial intervertebral disc of the lumbar vertebrae

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Karpiński Robert

2017-01-01

Full Text Available The aim of this paper was to determine the effect of using cobalt and titanium-based alloys as implant materials for the lumbar vertebrae with an artificial intervertebral disc on the stress distribution. The lumbar vertebrae were chosen for the study because they carry considerably higher loads, especially while standing or sitting. Finite element method (FEM simulations were conducted for three standard loads reflecting three patient's positions: recumbent, standing and sitting. The FEM analysis was performed using the SolidWorks Simulation module. Artificial units containing a pair of vertebrae with a prosthesis between them were designed by the Solid Edge software, based on micro-computed tomography CT scans of the patient's spine. The implant model was designed with its shape based on the geometry of surrounding vertebrae, consisting of an upper pad, a bottom pad and an insert (intervertebral disc. Two implant material configurations were studied. One involved the use of titanium alloy for the upper and bottom pads, while in the other, these pads were made of cobalt alloy. In both cases, a polyethylene insert was used. The FEM results demonstrate that both material configurations meet the requirements for prosthesis design. In both material configurations, the maximum stresses in each prosthesis element are almost twice higher in a sitting posture than in a recumbent position.

Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position.

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Jensen, Charlotte; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

2016-12-01

To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. Copyright © 2016

The Talar Body Prosthesis: Results at Ten to Thirty-six Years of Follow-up.

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Harnroongroj, Thos; Harnroongroj, Thossart

2014-07-16

Satisfactory results of implantation of the talar body prosthesis were reported in 1997, although some complications associated with the initial design were noted. The present study evaluated outcomes of treatment with a modified talar body prosthesis. Of the thirty-six talar body prostheses implanted with use of a transmalleolar surgical approach from 1974 to 2011, thirty-three were available for follow-up at ten to thirty-six years or had failed prior to that time. The indication for implantation had been osteonecrosis in twenty-three patients, a comminuted talar fracture in eight, and a talar body tumor in two. Twenty-eight of the thirty-three prostheses were still in place at the time of final follow-up and five had failed prior to five years. The duration of follow-up was ten to twenty years in eight patients, twenty to thirty years in eleven, and thirty to thirty-six years in nine. The AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot score did not differ significantly among these three groups. Patients over sixty-five years of age with underlying disease that impeded walking ability had lower AOFAS scores. Early prosthesis failure occurred as a result of size mismatch in two patients, tumor recurrence in one, infection in one, and osteonecrosis of the talar head and neck in one. These failures, which occurred at eight to fifty-seven months, were treated with tibiotalar arthrodesis in three patients, prosthesis revision in one, and below-the-knee amputation in one. Although early prosthesis failure may occur, survival of the talar body prosthesis can provide satisfactory ankle and foot function. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Five-year outcome of a retrospective cohort study on the rehabilitation of completely edentulous atrophic maxillae with immediately loaded zygomatic implants placed extra-maxillary.

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Maló, Paulo; Nobre, Miguel de Araújo; Lopes, Armando; Ferro, Ana; Moss, Steven

2014-01-01

To report retrospectively on the 5-year follow-up results of the rehabilitation of complete edentulous atrophied maxillae, using extra-maxillary zygomatic implants alone or in combination with conventional implants. This retrospective report includes an initial cohort of 39 patients (30 women and 9 men), with a mean age of 53 years, followed for 5 years. The patients were rehabilitated with 39 fixed prostheses and 169 implants (92 zygomatic implants inserted extra-maxillary and 77 conventional dental implants). A provisional prosthesis was manufactured and attached via multiunit abutments secured to the implants on the same day as implant placement. According to patient desires and each clinical situation, either an acrylic resin, a metal-acrylic or metal-ceramic final prosthesis was inserted approximately 6 months after implant placement. Outcome measures were: prosthesis success; implant success; complications; probing pocket depths; marginal bleeding; and marginal bone levels (only for conventional implants). Data were analysed with descriptive statistics. Two patients died after 8 and 30 months of follow-up due to causes unrelated to their oral rehabilitations, and 5 patients dropped out of the study. No prosthesis was lost; one zygomatic implant was removed after 46 months of follow-up, giving cumulative success rates of 97% and 98.8% (patient and implant related, respectively). Twelve complications occurred in 12 patients: 5 sinus infections in 5 patients, all with a previous history of sinusitis and whose sinus membrane was disrupted during surgery; one oroantral communication (leading to removal of the implant), 2 all acrylic resin prostheses fractures, 1 ceramic crown fracture (on a metal-ceramic prosthesis); and 3 screw loosenings. Bleeding on probing was recorded in 6 patients (13 implants). Probing pocket depths >4 mm were present in 13 patients (23 implants) at 5 years of follow-up. The average (standard deviation) marginal bone loss on conventional

Bone-Implant Contact around Crestal and Subcrestal Dental Implants Submitted to Immediate and Conventional Loading

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Ana Emília Farias Pontes

2014-01-01

Full Text Available The present study aims to evaluate the influence of apicocoronal position and immediate and conventional loading in the percentage of bone-implant contact (BIC. Thus, 36 implants were inserted in the edentulous mandible from six dogs. Three implants were installed in each hemimandible, in different positions in relation to the ridge: Bone Level (at crestal bone level, Minus 1 (one millimeter apical to crestal bone, and Minus 2 (two millimeters apical to crestal bone. In addition, each hemimandible was submitted to a loading protocol: immediate (prosthesis installed 24 hours after implantation or conventional (prosthesis installed 120 days after implantation. Ninety days after, animals were killed, and implant and adjacent tissues were prepared for histometric analysis. BIC values from immediate loaded implants were 58.7%, 57.7%, and 51.1%, respectively, while conventional loaded implants were 61.8%, 53.8%, and 68.4%. Differences statistically significant were not observed among groups (P=0.10, ANOVA test. These findings suggest that different apicocoronal positioning and loading protocols evaluated did not interfere in the percentage of bone-implant contact, suggesting that these procedures did not jeopardize osseointegration.

Implant-retained skull prosthesis to cover a large defect of the hairy skull resulting from treatment of a basal cell carcinoma: A clinical report.

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Hoekstra, Jitske; Vissink, Arjan; Raghoebar, Gerry M; Visser, Anita

2017-05-01

Skin carcinoma, particularly basal cell carcinoma, and its treatment can result in large defects of the hairy skull. A 53-year-old man is described who was surgically treated for a large basal cell carcinoma invading the skin and underlying tissue at the top of the hairy skull. Treatment consisted of resecting the tumor and external part of the skull bone. To protect the brain and to cover the defect of the hairy skull, an acrylic resin skull prosthesis with hair was designed to mask the defect. The skull prosthesis was retained on 8 extraoral implants placed at the margins of the defect in the skull bone. The patient was satisfied with the treatment outcome. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique

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Issam Saliba

2018-01-01

Full Text Available Objective: To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S and a new fat interposition total ossicular replacement prosthesis (TORP-F in pediatric and adult patients and to assess the complication and the undesirable outcome. Study design: This is a retrospective study. Methods: This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes’ head as a partial ossicular replacement prosthesis. Results: The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52 compared with 40% in the TORP-S group (n = 29. However, the adult cohort shows 79.3% in the TORP-F group (n = 52 compared with 43.75% in the TORP-S group (n = 25. These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group ( P  = .03. Conclusions: The interposition of a fat graft between the legs of the titanium implants (TORP-F provides superior hearing results compared with a standard procedure (TORP-S in pediatric and adult populations because of its better stability in the oval window niche.

Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique.

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Saliba, Issam; Sabbah, Valérie; Poirier, Jackie Bibeau

2018-01-01

To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S) and a new fat interposition total ossicular replacement prosthesis (TORP-F) in pediatric and adult patients and to assess the complication and the undesirable outcome. This is a retrospective study. This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA) to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes' head as a partial ossicular replacement prosthesis. The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52) compared with 40% in the TORP-S group (n = 29). However, the adult cohort shows 79.3% in the TORP-F group (n = 52) compared with 43.75% in the TORP-S group (n = 25). These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group ( P  = .03). The interposition of a fat graft between the legs of the titanium implants (TORP-F) provides superior hearing results compared with a standard procedure (TORP-S) in pediatric and adult populations because of its better stability in the oval window niche.

Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses

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Schuhbaeck, Annika; Weingartner, Christina; Arnold, Martin; Schmid, Jasmin; Pflederer, Tobias; Marwan, Mohamed; Rixe, Johannes; Nef, Holger; Schneider, Christian; Lell, Michael; Uder, Michael; Ensminger, Stephan; Feyrer, Richard; Weyand, Michael; Achenbach, Stephan

2015-01-01

Highlights: • Post-implant geometry of catheter-based aortic valve prostheses is influenced by aortic valve calcification. • Balloon-expandable prostheses are more circular as compared to self-expanding prostheses. • The impact of post-implant geometry on valve function needs to be investigated. - Abstract: Introduction: The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses. Methods: Eighty consecutive patients with severe aortic valve stenosis (mean age 82 ± 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed. Results: Aortic annulus eccentricity was reduced in patients after TAVI (0.21 ± 0.06 vs. 0.08 ± 0.06, p < 0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 ± 0.05 vs. 0.15 ± 0.07, p < 0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium. Conclusions: Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification

Visual BOLD Response in Late Blind Subjects with Argus II Retinal Prosthesis.

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E Castaldi

2016-10-01

Full Text Available Retinal prosthesis technologies require that the visual system downstream of the retinal circuitry be capable of transmitting and elaborating visual signals. We studied the capability of plastic remodeling in late blind subjects implanted with the Argus II Retinal Prosthesis with psychophysics and functional MRI (fMRI. After surgery, six out of seven retinitis pigmentosa (RP blind subjects were able to detect high-contrast stimuli using the prosthetic implant. However, direction discrimination to contrast modulated stimuli remained at chance level in all of them. No subject showed any improvement of contrast sensitivity in either eye when not using the Argus II. Before the implant, the Blood Oxygenation Level Dependent (BOLD activity in V1 and the lateral geniculate nucleus (LGN was very weak or absent. Surprisingly, after prolonged use of Argus II, BOLD responses to visual input were enhanced. This is, to our knowledge, the first study tracking the neural changes of visual areas in patients after retinal implant, revealing a capacity to respond to restored visual input even after years of deprivation.

Prosthetic implant treatment of the edentulous maxilla with overdenture.

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Inversini, M

2006-10-01

The literature concerning the success of prosthetic implant treatment with maxillary overdenture is reviewed, and variables affecting treatment from the implant and prosthetic standpoint are analysed. Guidelines for the fabrication of maxillary overimplants comparable to those for mandibular overimplants are still lacking, as are evidence-based prosthetic design concepts. Individual methods and techniques have been described, but evaluation standards for the outcome of maxillary prosthetic-implant treatment are lacking or individually interpreted. The biomechanics involved in the proposed system are described, together with the advantages of telescopic crowns for the retention of removable partial prosthesis supported by maxillary implants. The positive influence, in terms of long-term prognosis, of the perio-protective design of removable partial prostheses supported by maxillary overimplants is also discussed. The proposed system not only provides stability, support and retention for removable partial prostheses supported by maxillary implants, but also enables implant survival rates to be improved, both for biomechanical reasons and due to improved oral hygiene. The simplification of fabrication procedures, repair, rebasing and re-operating also reduce the cost of follow-up and improve the cost/benefit ratio. However, additional studies are needed to clarify the number and most appropriate distribution of implants, as well as the most favourable prosthetic designs for maxillary overimplants.

Restoration-Guided Implant Rehabilitation of the Complex Partial Edentulism: a Clinical Report

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Nikitas Sykaras

2010-01-01

Full Text Available Background: The hard and soft tissue deficiency is a limiting factor for the prosthetic restoration and any surgical attempt to correct the anatomic foundation needs to be precisely executed for optimal results. The purpose of this paper is to describe the clinical steps that are needed to confirm the treatment plan and allow its proper execution.Methods: Team work and basic principles are emphasized in a step-by-step description of clinical methods and techniques. This clinical report describes the interdisciplinary approach in the rehabilitation of a partially edentulous patient. The importance of the transitional restoration which sets the guidelines for the proper execution of the treatment plan is especially emphasized along with all the steps that have to be followed.Results: The clinical report describes the diagnostic arrangement of teeth, the ridge augmentation based on the diagnostic evaluation of the removable prosthesis, the implant placement with a surgical guide in the form of the removable partial denture duplicate and finally the special 2-piece design of the final fixed prosthesis.Conclusions: Clinical approach and prosthesis design described above offers a predictable way to restore partial edentulism with a fixed yet retrievable prosthesis, restoring soft tissue and teeth and avoiding an implant supported overdenture.

Implant-supported auricular prosthesis

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Aditi Nanda

2011-01-01

Full Text Available Differences in the balance of shape, size, and position of body organs are immediately perceived as "looking wrong" and this perception can subject the individual to significant peer ridicule and social ostracism, often expressing as intense shame and anguish in the attitude of the afflicted. Rehabilitation of such patients can be remarkably beneficial on the individual′s self-esteem and body image. The onus of the deed lies in the hands of a team that combines artistic excellence with surgical expertise, by combining the skills of anaplastologists, surgeons, and prosthodontists. This is a review of a few surgical and prosthetic considerations in the management of auricular defect and a case description of management of a patient of microtia following similar guidelines in fabrication of the epithesis.

Rehabilitación sobre implantes oseointegrados A case with rehabilitation on boneintegrated implants

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Leticia María Lemus Cruz

2009-03-01

Full Text Available Se presenta un caso de un paciente rehabilitado en la consulta de Implantología de la Facultad de Estomatología de Ciudad de La Habana. La historia de la implantología moderna se remonta a principios de los años 60, cuando Per-Ingvar Branemark sienta las bases de la osteointegración y describe los primeros implantes de titanio con forma de tornillo. Aunque antigua, es la prótesis más moderna. Si la meticulosidad es obligada en la elaboración de todo tipo de prótesis, en los trabajos de implantes no se admite el más mínimo fallo, desde la planificación del caso hasta la implantación de la prótesis en boca. Para obtener buenos resultados, las técnicas y los procesos han de observarse escrupulosamente. En nuestra Facultad se ha creado el Grupo de Implantología, que es el encargado de la colocación de implantes y la rehabilitación prótesica de estos. Para ello han sido utilizado diferentes tipos de implantes comercializados y patentizados al nivel mundial. Se reafirma que la rehabilitación sobre implantes mejora la calidad estética y funcional de los pacientes.A case of rehabilitation patient is presented seen in Implantation Science consulting room of Stomatology Faculty of Havana City. History of implantation science dates back to at the beginning of 60s, when Per-Ingvar Branemark creates the bases of bone-integration and to describe the firsts titanium implants in a screw form. Although ancient, it is the more modern prosthesis. If meticulousness if mandatory in elaboration of all type of prosthesis, in implants works it inadmissible the minimum of failure, from the case planning until prosthesis implantation in mouth. To achieve good results, techniques and processes has to be scrupulously observed. In our Faculty it has been created a group of Implantation Science, which is in charge of implants placement, and of the prosthetic rehabilitation of these. Thus, we used different types of marketed and showed at world level. It

[The endo-exo prosthesis for patients with a problematic amputation stump].

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Frölke, Jan Paul M; van de Meent, Henk

2010-01-01

Following lower limb amputation, quality of life is highly related to the ability to use a prosthetic limb. The conventional way to attach a prosthetic limb to the body is with a socket. Many patients experience serious discomfort wearing a conventional prosthesis because of pain, instability during walking, pressure sores, bad smell or skin irritation. In addition, sitting is uncomfortable and pelvic and lower back pain due to unstable gait is often seen in these patients. The main disadvantage of the current prosthesis is the attachment of a rigid prosthesis socket to a soft and variable body. The socket must fit tightly for stability during walking but should also be comfortable for sitting. The implantation of an osseointegrated, intramedullary, transcutaneously conducted prosthesis is a new procedure for attaching a limb prosthesis to the human body without the disadvantages of the conventional prosthesis. The intramedullary prosthesis is designed with a rough surface resembling cancellous bone to enable a secure solid integration with the long bone. We treated two patients with this new prosthesis, a 44-year-old man after a transfemoral amputation, and a 32-year-old woman after a lower leg amputation; both amputations were necessary because of trauma. Those two patients are now, more than one year after the operation, showing excellent functional results without infectious complications. We assume that endo-exo prosthesis may be a promising option for selected patients unable to use a conventional prosthesis because of a problematic amputation stump.

Early postoperative dislocation of the anterior Maverick lumbar disc prosthesis: report of 2 cases.

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Gragnaniello, Cristian; Seex, Kevin A; Eisermann, Lukas G; Claydon, Matthew H; Malham, Gregory M

2013-08-01

The authors report on 2 cases of anterior dislocation of the Maverick lumbar disc prosthesis, both occurring in the early postoperative period. These cases developed after experience with more than 50 uneventful cases and were therefore thought to be unrelated to the surgeon's learning curve. No similar complications have been previously reported. The anterior Maverick device has a ball-and-socket design made of cobalt-chromium-molybdenum metal plates covered with hydroxyapatite. The superior and inferior endplates have keels to resist translation forces. The patient in Case 1 was a 52-year-old man with severe L4-5 discogenic pain; and in Case 2, a 42-year-old woman with disabling L4-5 and L5-S1 discogenic back pain. Both patients were without medical comorbidities and were nonsmokers with no risk factors for osteoporosis. Both had undergone uneventful retroperitoneal approaches performed by a vascular access surgeon. Computed tomography studies on postoperative Day 2 confirmed excellent prosthesis placement. Initial recoveries were uneventful. Two weeks postoperatively, after stretching (extension or hyperextension) in bed at home, each patient suffered the sudden onset of severe abdominal pain with anterior dislocation of the Maverick prosthesis. The patients were returned to the operating room and underwent surgery performed by the same spinal and vascular surgeons. Removal of the Maverick prosthesis and anterior interbody fusion with a separate cage and plate were performed. Both patients had recovered well with good clinical and radiological recovery at the 6- and 12-month follow-ups. Possible causes of the anterior dislocation of the Maverick prosthesis include the following: 1) surgeon error: In both cases the keel cuts were neat, and early postoperative CT confirmed good placement of the prosthesis; 2) equipment problem: The keel cuts may have been too large because the cutters were worn, which led to an inadequate press fit of the implants; 3) prosthesis

Influence of Manufacturing Methods of Implant-Supported Crowns on External and Internal Marginal Fit: A Micro-CT Analysis.

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Moris, Izabela C M; Monteiro, Silas Borges; Martins, Raíssa; Ribeiro, Ricardo Faria; Gomes, Erica A

2018-01-01

To evaluate the influence of different manufacturing methods of single implant-supported metallic crowns on the internal and external marginal fit through computed microtomography. Forty external hexagon implants were divided into 4 groups ( n = 8), according to the manufacturing method: GC, conventional casting; GI, induction casting; GP, plasma casting; and GCAD, CAD/CAM machining. The crowns were attached to the implants with insertion torque of 30 N·cm. The external (vertical and horizontal) marginal fit and internal fit were assessed through computed microtomography. Internal and external marginal fit data ( μ m) were submitted to a one-way ANOVA and Tukey's test ( α = .05). Qualitative evaluation of the images was conducted by using micro-CT. The statistical analysis revealed no significant difference between the groups for vertical misfit ( P = 0.721). There was no significant difference ( P > 0.05) for the internal and horizontal marginal misfit in the groups GC, GI, and GP, but it was found for the group GCAD ( P ≤ 0.05). Qualitative analysis revealed that most of the samples of cast groups exhibited crowns underextension while the group GCAD showed overextension. The manufacturing method of the crowns influenced the accuracy of marginal fit between the prosthesis and implant. The best results were found for the crowns fabricated through CAD/CAM machining.

Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial.

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Kumar, Vinay V; Ebenezer, Supriya; Kämmerer, Peer W; Jacob, P C; Kuriakose, Moni A; Hedne, Naveen; Wagner, Wilfried; Al-Nawas, Bilal

2016-11-01

The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants. Success rates of the implants were evaluated at 3 months, 6 months and 12 months following implant loading using marginal bone level changes as well as peri-implant indices (Buser et al., 1990). 52 patients were randomized into two treatment groups (26 each), out of which 18 patients (36 implants) of Group-I and 17 patients (68 implants) of Group-II were evaluated. One implant in Group-I was lost due to infective complications and one patient in the same group had superior barrel necrosis. There was a statistically significant increase at both time points (p = 0.03, p = 0.04 at 6 months, 12 months) in the amount of marginal bone loss in Group-I (0.4 mm, 0.5 mm at 6 months, 12 months) as compared to Group-II (0.1 mm, 0.2 mm at 6 months, 12 months). There were no clinically significant changes peri-implant parameters between both groups. Peri-implant soft tissue hyperplasia was seen in both groups, 32% of implants at 3-months, 26% at 6-months and 3% at 12-months follow-up. The results of this study show that patients with 2-implant-supported-overdentures had higher marginal bone loss as compared to patients with 4-implant-supported-overdentures. There were no clinically significant differences in peri-implant soft tissue factors in patients with 2- or 4-implant-supported-overdentures. Hyperplastic peri-implant tissues are common in the early implant

Prosthetic rehabilitation of intentionally malpositioned implants in a patient with squamous cell carcinoma of the external auditory canal: a clinical report.

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Bagherpour, Reza; Mirfazaelian, Ali; Mangoli, Amir A; Alikhasi, Marzieh

2009-08-01

This clinical report describes the rehabilitation of a patient with a compromised temporal bone anatomy caused by resection of bone due to squamous cell carcinoma of external auditory canal. Tumor resection was followed by placement of three implants. The implants were intentionally malpositioned in the anterior-posterior plane due to the lack of temporal bone. Prosthodontic treatment included customized implant bar-supported auricular prosthesis.

Insidious strut fractures in a DeBakey-Surgitool aortic valve prosthesis.

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Scott, S M; Sethi, G K; Paulson, D M; Takaro, T

1978-04-01

Recent reports of cage wear occurring in DeBakey-Surgitool aortic valve prostheses prompted us to examine with image intensification all our patients who have had this type of prosthesis implanted. One patient, who was asymptomatic, was discovered to have a prosthesis with two fractured struts. This patient's prosthetic valve was replaced successfully with a stented porcine heterograft prosthesis. Including the valve removed from this patient, 8 DeBakey-Surgitool aortic valves with structural defects have been reported to the manufacturer. In the absence of a catastrophic event, patients with valves having fractured or worn struts may be totally asymptomatic, and routine periodic roentgenographic examination may be the only way of detecting strut wear or fracture.

Biomechanical comparison of two different collar structured implants supporting 3-unit fixed partial denture: a 3-D FEM study.

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Meriç, Gökçe; Erkmen, Erkan; Kurt, Ahmet; Eser, Atilim; Ozden, Ahmet Utku

2012-01-01

The purpose of the study was to compare the effects of two distinct collar geometries of implants on stress distribution in the bone as well as in the fixture-abutment complex, in the framework and in the veneering material of 3-unit fixed partial denture (FPD). The 3-dimensional finite element analysis method was selected to evaluate the stress distribution in the system composed of 3-unit FPD supported by two different dental implant systems with two distinct collar geometries; microthread collar structure (MCS) and non-microthread collar structure (NMCS). In separate load cases, 300 N vertical, 150 N oblique and 60 N horizontal, forces were utilized to simulate the multidirectional chewing forces. Tensile and compressive stress values in the cortical and cancellous bone and von Mises stresses in the fixture-abutment complex, in the framework and veneering material, were simulated as a body and investigated separately. In the cortical bone lower stress values were found in the MCS model, when compared with NMCS. In the cancellous bone, lower stress values were observed in the NMCS model when compared with MCS. In the implant-abutment complex, highest von Mises stress values were noted in the NMCS model; however, in the framework and veneering material, highest stress values were calculated in MCS model. MCS implants when compared with NMCS implants supporting 3-unit FPDs decrease the stress values in the cortical bone and implant-abutment complex. The results of the present study will be evaluated as a base for our ongoing FEA studies focused on stress distribution around the microthread and non-microthread collar geometries with various prosthesis design.

Rehabilitation of orbital cavity after orbital exenteration using polymethyl methacrylate orbital prosthesis

Directory of Open Access Journals (Sweden)

Sumeet Jain

2016-01-01

Full Text Available Squamous cell carcinoma of the eyelid is the second most common malignant neoplasm of the eye with the incidence of 0.09 and 2.42 cases/100 000 people. Orbital invasion is a rare complication but, if recognized early, can be treated effectively with exenteration. Although with advancements in technology such as computer-aided design and computer-aided manufacturing, material science, and retentive methods like implants, orbital prosthesis with stock ocular prosthesis made of methyl methacrylate retained by anatomic undercuts is quiet effective and should not be overlooked and forgotten. This clinical report describes prosthetic rehabilitation of two male patients with polymethyl methacrylate resin orbital prosthesis after orbital exenteration, for squamous cell carcinoma of the upper eyelid. The orbital prosthesis was sufficiently retained by hard and soft tissue undercuts without any complications. The patients using the prosthesis are quite satisfied with the cosmetic results and felt comfortable attending the social events.

Comparative three-dimensional finite element analysis of implant-supported fixed complete arch mandibular prostheses in two materials.

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Tribst, João Paulo Mendes; de Morais, Dayana Campanelli; Alonso, Alexandre Abhdala; Piva, Amanda Maria de Oliveira Dal; Borges, Alexandre Luis Souto

2017-01-01

The increase of requests for implant-supported prosthesis (ISP) with zirconia as infrastructure has attracted a lot of attention due to its esthetics, biocompatibility, and survival rate similar to metallic infrastructure. The aim of this study was to evaluate the influence of two different framework materials on stress distribution over a bone tissue-simulating material. Two ISP were modeled and divided into two infrastructure materials: titanium (Ti) and zirconia. Then, these bars were attached to a modeled jaw with polyurethane properties to simulate bone tissue. An axial load of 200 N was applied on a standardized area for both systems. Maximum principal stress (MPS) on solids and microstrain (MS) generated through the jaw were analyzed by finite element analysis. According to MS, both models showed strains on peri-implant region of the penultimate (same side of the load application) and central implants. For MPS, more stress concentration was slightly higher in the left posterior region for Ti's bar. In prosthetic fixation screws, the MPS prevailed strongly in Ti protocol, while for zirconia's bar, the cervical of the penultimate implant was the one that highlighted larger areas of possible damages. The stress generated in all constituents of the system was not significantly influenced by the framework's material. This allows suggesting that in cases without components, the use of a framework in zirconia has biomechanical behavior similar to that of a Ti bar.

Managing peri-implant bone loss: current understanding.

Science.gov (United States)

Aljateeli, Manar; Fu, Jia-Hui; Wang, Hom-Lay

2012-05-01

With the improved macro- and micro-designs, dental implants enjoy a high survival rate. However, peri-implant bone loss has recently emerged to be the focus of implant therapy. As such, researchers and clinicians are in need of finding predictable techniques to treat peri-implant bone loss and stop its progression. Literature search on the currently available treatment modalities was performed and a brief description of each modality was provided. Numerous techniques have been proposed and none has been shown to be superior and effective in managing peri-implant bone loss. This may be because of the complex of etiological factors acting on the implant-supported prosthesis hence the treatment approach has to be individually tailored. Due to the lack of high-level clinical evidence on the management of peri-implant bone loss, the authors, through a literature review, attempt to suggest a decision tree or guideline, based on sound periodontal surgical principles, to aid clinicians in managing peri-implantitis associated bone loss. © 2011 Wiley Periodicals, Inc.

Functional evaluation of a CAD/CAM prosthesis for immediate defect repair after total maxillectomy: a case series of 18 patients with maxillary sinus cancer.

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Jiang, Fei-Fei; Hou, Yan; Lu, Li; Ding, Xiao-Xu; Li, Wei; Yan, Ai-Hui

2015-01-01

To evaluate the facial profiles and functional recovery of 18 patients treated by a computer-aided designed/manufactured hollow obturator prosthesis (CAD/CAM prosthesis) after total maxillectomy for malignant maxillary sinus tumor. A retrospective observational study was performed to evaluate the facial profiles and functional recovery of 18 patients with T3-4a N0 M0 maxillary sinus cancer, who were treated by total maxillectomy and simultaneous implantation of a computer-aided designed/manufactured hollow obturator prosthesis (CAD/CAM prosthesis). Follow-ups were performed 1, 3, 6, and 12 months after surgery. Facial measurements, speech intelligibility, and chewing and swallowing functions were examined. Thirteen patients converted to a permanent prosthesis 6 months after surgery. Comparisons were made between patients with and without the CAD/CAM or permanent prosthesis at various times using SPSS13.0 statistical software (SPSS Inc., Chicago, IL, USA). Speech intelligibility, facial depression, and eyeball prolapse results showed improvements with prosthesis use at 1, 3, and 6 months after surgery (p maxillectomy. This surgical treatment of maxillary sinus cancer is applied rarely in China, but it has a good effect based on our observation. Simultaneous CAD/CAM prosthesis implantation after total maxillectomy can recover the facial profile, enhance the speaking, swallowing, and chewing functions, and improve the quality of life of patients. Tumor recurrence can be detected by direct observation of the postoperative maxillary cavity. This technique avoids the need for dental implants because the bottom part of the prosthesis contains a palatal plate with dentures. © 2014 Wiley Periodicals, Inc.

Improving the fit of implant prosthetics: an in vitro study.

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Yannikakis, Stavros; Prombonas, Anthony

2013-01-01

Accurate and passive fit between a prosthesis and its supporting implants has been considered a prerequisite for successful long-term osseointegration. The objective of this in vitro study was to evaluate the strain development during tightening of a five-unit screw-retained superstructure constructed using five different methods. Five-unit screw-retained fixed partial prostheses (n = 25) were fabricated on three implants embedded in an epoxy resin block using five different methods: (1) cobalt-chromium (Co-Cr), plastic cylinders, one-piece cast; (2) Co-Cr, plastic cylinders, framework sectioned, preceramic laser-welding soldering; (3) gold-platinum (Au-Pt), gold cylinders, one-piece cast; (4) Au-Pt, gold cylinders, framework sectioned, preceramic laser-welding soldering; (5) Co-Cr, one-piece cast, and cementation to "passive abutments" (Southern Implants) after final finishing and polishing. Strain gauges (SG) were attached to the fixed partial prosthesis (FPP) and to the resin block to measure the stress created during screw tightening. The combination of Co-Cr alloy and plastic cylinders in a one-piece cast showed such an inadequate fit among the fabricated methods that this group was excluded from the remainder of the experiment. Specimens of Au-Pt cast on gold cylinders in one piece showed higher strain development than the other groups used in this study, with strains ranging from 223.1 to 2,198.1 Μm/m. Sectioning and soldering significantly improved the overall fit. FPPs of Co-Cr in a one-piece cast cemented to "passive abutments" produced the best level of fit, with the least strain development in the prosthesis and the resin block (59 to 204.6 Μm/m). Absolute fit of superstructures on implants is not possible using conventional laboratory procedures. Cementing FPPs onto prefabricated cylinders directly onto the implants significantly reduces strain development compared to the other fabrication methods.

Implant-supported mandibular removable partial dentures: Functional, clinical and radiographical parameters in relation to implant position.

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Jensen, Charlotte; Speksnijder, Caroline M; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

2017-06-01

Patients with a Kennedy class I situation often encounter problems with their removable partial denture (RPD). To assess the functional benefits of implant support to RPDs, the clinical performance of the implants and teeth and to determine the most favorable implant position: the premolar (PM) or molar (M) region. Thirty subjects received 2 PM and 2 M implants. A new RPD was made. Implant support was provided 3 months later. In a cross-over model, randomly, 2 implants (PM or M) supported the RPD during 3 months. Masticatory performance was assessed using the mixing ability index (MAI). Clinical and radiographic parameters were assessed. Non-parametric statistical analysis for related samples and post hoc comparisons were performed. Masticatory performance differed significantly between the stages of treatment (P < .001). MAI-scores improved with implant support although the implant position had no significant effect. No complications to the implants or RPD were observed and clinical and radiographical parameters for both implants and teeth were favorable. Higher scores for bleeding on probing were seen for molar implants. Implant support to a Kennedy class I RPD significantly improves masticatory function, regardless of implant position. No major clinical problems were observed. © 2017 Wiley Periodicals, Inc.

Long-term hearing result using Kurz titanium ossicular implants.

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Hess-Erga, Jeanette; Møller, Per; Vassbotn, Flemming Slinning

2013-05-01

Titanium implants in middle ear surgery were introduced in the late 90s and are now frequently used in middle ear surgery. However, long-term studies of patient outcome are few and have only been published in subgroups of patients. We report the long-term effect of titanium middle ear implants for ossicular reconstruction in chronic ear disease investigated in a Norwegian tertiary otological referral centre. Retrospective chart reviews were performed for procedures involving 76 titanium implants between 2000 and 2007. All patients who underwent surgery using the Kurz Vario titanium implant were included in the study. Audiological parameters using four frequencies, 0.5, 1, 2, and 3 kHz, according to AAO-HNS guidelines, was assessed pre and postoperatively. Otosurgical procedures, complications, revisions, and extrusion rates were analyzed. The study had no dropouts. The partial ossicular replacement prosthesis (PORP) was used in 44 procedures and the total ossicular replacement prosthesis (TORP) in 32 procedures, respectively. Mean follow-up was 5.2 years (62 months). The ossiculoplasties were performed as staging procedures or in combination with other chronic ear surgery. The same surgeon performed all the procedures. A postoperative air-bone gap of ≤ 20 dB was obtained in 74 % of the patients, 82 % for the Bell (PORP) prosthesis, and 63 % for the Arial (TORP) prosthesis. The extrusion rate was 5 %. We conclude that titanium ossicular implants give stable and excellent long-term hearing results.

Excessive strut wear allowing ball-poppet embolization in a DeBakey-Surgitool aortic valve prosthesis.

Science.gov (United States)

Sutherland, R D; Guynes, W A; Nichols, C T; Martinez, H E

1982-01-01

Excessive cage strut wear allowing ball-poppet embolization caused the sudden death of a 47 year old lady in whom a DeBakey-Surgitool aortic prosthesis had been implanted nine years earlier. Patients with this type of prosthesis should have periodic valvular cine fluoroscopy with image intensification to allow visualization of significant strut wear or fracture, and appropriate prosthetic valve replacement.

All on Four® fixed implant support rehabilitation: a masticatory function study.

Science.gov (United States)

De Rossi, Moara; Santos, Carla Moreto; Migliorança, Reginaldo; Regalo, Simone Cecílio Hallak

2014-08-01

Fixed implant-supported prostheses according to All-on-Four® (Nobel Biocare, Goteborg, Sweden) principles have become an accepted treatment modality in totally edentulous patients, whereas the functional effect of this therapy is limited. The purpose of this study was to evaluate the muscular function of patients totally rehabilitated with All-on-Four. This study evaluated 63 patients. Twenty-one patients were successfully rehabilitated with maxillary and mandibular All-on-Four (no dropout implants, satisfactory aesthetic and function demands prosthesis), 21 patients were dentate, and 21 were rehabilitated with double complete dentures. Electromyography was carried out during clenching, nonhabitual and habitual chewing, and rest. All values were standardized as percentage of a maximum voluntary contraction. Data were analyzed by ANOVA to compare groups and paired t-test was used for comparison between sides within each group. All groups presented symmetric muscular activity. The All-on-Four and dentate groups had a similar muscles surface electromyography (sEMG) contraction pattern, that is, a higher sEMG activity of masseter than temporalis muscles, differing (p ≤ .05) from those of denture group. Not one statistical difference was found between All-on-Four and dentate groups. The muscular function similarity of All-on-Four and dentate patients shows that this treatment concept may be considered as a good option for oral rehabilitation in edentulous patients. © 2013 Wiley Periodicals, Inc.

Carbon/PEEK composite materials as an alternative for stainless steel/titanium hip prosthesis: a finite element study.

Science.gov (United States)

Rezaei, Farshid; Hassani, Kamran; Solhjoei, Nosratollah; Karimi, Alireza

2015-12-01

Total hip replacement (THR) has been ranked within the most typical surgical processes in the world. The durability of the prosthesis and loosening of prosthesis are the main concerns that mostly reported after THR surgeries. In THR, the femoral prosthesis can be fixed by either cement or cementless methods in the patient's bones. In both procedures, the stability of the prosthesis in the hosted bone has a key asset in its long-term durability and performance. This study aimed to execute a comparative finite element simulation to assess the load transfer between the prosthesis, which is made of carbon/PEEK composite and stainless steel/titanium, and the femur bone. The mechanical behavior of the cortical bone was assumed as a linear transverse isotropic while the spongy bone was modeled like a linear isotropic material. The implants were made of stainless steel (316L) and titanium alloy as they are common materials for implants. The results showed that the carbon/PEEK composites provide a flatter load transfer from the upper body to the leg compared to the stainless steel/titanium prosthesis. Furthermore, the results showed that the von Mises stress, principal stress, and the strain in the carbon/PEEK composites prosthesis were significantly lower than that made of the stainless steel/titanium. The results also imply that the carbon/PEEK composites can be applied to introduce a new optimum design for femoral prosthesis with adjustable stiffness, which can decrease the stress shielding and interface stress. These findings will help clinicians and biomedical experts to increase their knowledge about the hip replacement.

Implantes eletrônicos para restabelecimento da visão em cegos Electronic implants to restore vision in blind patients

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Eduardo Büchele Rodrigues

2004-04-01

Full Text Available O sucesso recente no desenvolvimento de uma prótese eletrônica coclear para surdos estimulou vários grupos de cientistas ao desenvolvimento de próteses visuais. A maioria dos protótipos de próteses visuais está baseada em estimulação elétrica neuronal em diferentes localizações do sistema visual até o sistema nervoso central. Atualmente os esforços estão concentrados em três localizações de implantes visuais: retina, nervo óptico e córtex. Implantes de retina e do nervo óptico têm o potencial de restabelecer a visão em pacientes com degenerações retinianas progressivas por meio de estimulação elétrica de neurônios do sistema visual. Próteses corticais podem beneficiar um número maior de pacientes cegos devido à sua localização mais posterior no sistema visual. Apesar dos grandes avanços, torna-se ainda necessária a elucidação de questões importantes na avaliação do funcionamento, em longo prazo, dos vários implantes eletrônicos para cegos, em estudo. Neste artigo analisamos os motivos que justificam o início dos experimentos nas três posições mencionadas e os desafios advindos de tal decisão.Recent success in the development of a prosthesis for the deaf patient encouraged several groups of scientists to develop and investigate a visual prosthesis. Visual prosthesis are based on neuronal electrical stimulation at different locations along the visual pathways, and three localizations of visual prosthesis are being researched, retina, optic nerve, and cortex. Retina and optic nerve implants may restore vision in patients with progressive retinal degenerations by means of electrical stimulation of visual pathway neurons. Cortex prosthesis may restore vision in a greater number of blind patients due to the more posterior location in the visual pathway. While major advances have been made in the field of visual prosthesis for the blind, a number of key questions remain to render a visual prosthesis

Implant Failure After Motec Wrist Joint Prosthesis Due to Failure of Ball and Socket-Type Articulation-Two Patients With Adverse Reaction to Metal Debris and Polyether Ether Ketone.

Science.gov (United States)

Karjalainen, Teemu; Pamilo, Konsta; Reito, Aleksi

2018-04-21

We describe 2 cases of articulation-related failures resulting in revision surgery after a Motec total wrist arthroplasty: one with an adverse reaction to metal debris and the other with an adverse reaction to polyether ether ketone. In the first patient, blood cobalt and chrome levels were elevated and magnetic resonance imaging showed clear signs of a pseudotumor. The other patient had an extensive release of polyether ether ketone particles into the surrounding synovia due to adverse wear conditions in the cup, leading to the formation of a fluid-filled cyst sac with a black lining and diffuse lymphocyte-dominated inflammation in the synovia. We recommend regular follow-up including x-rays, monitoring of cobalt and chrome ion levels, and a low threshold for cross-sectional imaging in patients who have undergone total wrist arthroplasty with a Motec joint prosthesis. Wear-related problems can also develop in implants in which polyether ether ketone is the bulk material. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

[Guided and computer-assisted implant surgery and prosthetic: The continuous digital workflow].

Science.gov (United States)

Pascual, D; Vaysse, J

2016-02-01

New continuous digital workflow protocols of guided and computer-assisted implant surgery improve accuracy of implant positioning. The design of the future prosthesis is based on the available prosthetic space, gingival height and occlusal relationship with the opposing and adjacent teeth. The implant position and length depend on volume, density and bone quality, gingival height, tooth-implant and implant-implant distances, implant parallelism, axis and type of the future prosthesis. The crown modeled on the software will therefore serve as a guide to the future implant axis and not the reverse. The guide is made by 3D printing. The software determines surgical protocol with the drilling sequences. The unitary or plural prosthesis, modeled on the software and built before surgery, is loaded directly after implant placing, if needed. These protocols allow for a full continuity of the digital workflow. The software provides the surgeon and the dental technician a total freedom for the prosthetic-surgery guide design and the position of the implants. The prosthetic project, occlusal and aesthetic, taking the bony and surgical constraints into account, is optimized. The implant surgery is simplified and becomes less "stressful" for the patient and the surgeon. Guided and computer-assisted surgery with continuous digital workflow is becoming the technique of choice to improve the accuracy and quality of implant rehabilitation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Hip arthroplasty. Part 1: prosthesis terminology and classification

International Nuclear Information System (INIS)

Pluot, E.; Davis, E.T.; Revell, M.; Davies, A.M.; James, S.L.J.

2009-01-01

Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion.

Can the Hydroxyapatite-Coated Skin-Penetrating Abutment for Bone Conduction Hearing Implants Integrate with the Surrounding Skin?

Science.gov (United States)

van Hoof, Marc; Wigren, Stina; Duimel, Hans; Savelkoul, Paul H M; Flynn, Mark; Stokroos, Robert Jan

2015-01-01

Percutaneous implants, such as bone conduction hearing implants, suffer from complications that include inflammation of the surrounding skin. A sealed skin-abutment interface can prevent the ingress of bacteria, which should reduce the occurrence of peri-abutment dermatitis. It was hypothesized that a hydroxyapatite (HA)-coated abutment in conjunction with soft tissue preservation surgery should enable integration with the adjacent skin. Previous research has confirmed that integration is never achieved with as-machined titanium abutments. Here, we investigate, in vivo, if skin integration is achievable in patients using a HA-coated abutment. One titanium abutment (control) and one HA-coated abutment (case) together with the surrounding skin were surgically retrieved from two patients who had a medical indication for this procedure. Histological sections of the skin were investigated using light microscopy. The abutment was qualitatively analyzed using scanning electron microscopy. The titanium abutment only had a partial and thin layer of attached amorphous biological material. The HA-coated abutment was almost fully covered by a pronounced thick layer of organized skin, composed of different interconnected structural layers. Proof-of-principle evidence that the HA-coated abutment can achieve integration with the surrounding skin was presented for the first time.

Histologic analysis of a retrieved hydroxyapatite-coated femoral prosthesis

DEFF Research Database (Denmark)

Søballe, K; Gotfredsen, K; Brockstedt-Rasmussen, H

1991-01-01

A hydroxyapatite-coated hip hemi-prosthesis was retrieved from a 98-year-old osteoporotic woman 12 weeks after implantation. Histologic analysis revealed bone and fibrous tissue almost evenly distributed around the surface of the implant circumference. Quantitative histologic analysis showed...... that 48% of the hydroxyapatite surface was covered by bone. Fibrous tissue covered 30% of the prosthetic surface, and 20% of the surface had no tissue coverage. Scanning electron microscopy showed direct contact without any clear boundary between the newly formed bone and the hydroxyapatite ceramic....

Electron beam irradiation after reconstruction with silicone gel implant in breast cancer

International Nuclear Information System (INIS)

Krishnan, L.; Krishnan, E.C.

1986-01-01

Irradiation for breast cancer in the presence of a silicone gel breast prosthesis is sometimes necessary. There is a concern among radiation and other oncologists as to whether the presence of the prosthetic implant would interfere with delivery of the needed irradiation doses. Electron beams, with their finite penetration and rapid fall-off, offer a mode of adequately treating the recurrence and minimizing the radiation to the underlying normal structures, such as the lung and the heart. The dose distribution using 9-20 MeV electrons in the presence of a breast prosthesis is compared to the dose distribution without the implant in a tissue equivalent water phantom. The results reveal no significant difference in the dose delivered due to the presence of the prosthesis. Clinical verification of the dosimetry in the presence of the prosthesis confirmed that the presence of the silicone gel implant does not compromise treatment by irradiation in the management of breast cancer

Treatment planning: implant-supported partial overdentures.

Science.gov (United States)

Chee, Winston W L

2005-04-01

When multiple anterior teeth are missing, many options of replacement are available. Traditionally, the choice was between a fixed or removable prostheses. Today, with the predictability of dental implants, the options of tooth replacement range from removable partial dentures to implant-supported fixed prostheses. The choice of which restoration that will best provide occlusion and esthetics depends on multiple factors including the number and location of missing teeth, the residual ridge form in relation to the replacement teeth, the relationship of the maxillary and mandibular anterior teeth, the condition of teeth adjacent to the edentulous span, the amount of bone available for implant placement, the patients "smile line" and display of teeth, lip support, and financial constraints. When there is minimal loss of the ridge contour, restorations that emerge from the ridge are the most functional and esthetic restorations, adhesive-type fixed partial dentures, conventional fixed partial dentures, and implant-supported restorations can be indicated with the choice of restoration dependent on a risk benefit and cost benefit analysis. When there is a loss of ridge contour due to residual ridge resorption or trauma, the decision becomes more complex as not only does the tooth structure need to be replaced, the ridge form also has to be replaced. (Figures 1 and 2). This can be assessed clinically as illustrated by Figures 1 and 2 where a dis crepancy in arch form and ridge form in relation to the adjacent teeth and/or opposing arch can be observed. Other considerations are lip support and display of the teeth when smiling. This article presents a case and rationale for implant-supported par tial overdentures. Many authors have written on the merits of com plete overdentures. The complete overdenture has proven to be an improvement over conventional complete prostheses with respect to chewing efficiency, patient comfort and satisfaction. In partial edentulism, the

Long-Term Symptoms Onset and Heterotopic Bone Formation around a Total Temporomandibular Joint Prosthesis: a Case Report

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Luca Guarda-Nardini

2014-04-01

Full Text Available Background: The literature on total alloplastic temporomandibular joint (TMJ reconstructions is encouraging, and studies on total alloplastic TMJ replacements outcomes showed acceptable improvements in terms of both pain levels and jaw function. Nevertheless, some adverse events, such as heterotopic bone formation around the implanted prosthesis, may occur. In consideration of that, the present manuscript describes a case of heterotopic bone formation around a total temporomandibular joint prosthesis, which occurred several years after the implant. Methods: The present manuscript describes a case of heterotopic bone formation around a total TMJ prosthesis, which occurred several years after the implant in patients, who previously underwent multiple failed TMJ surgeries. Results: Ten years after the surgical TMJ replacement to solve an ankylotic bone block, the patient came to our attention again referring a progressive limitation in mouth opening. A computerized tomography showed evidence of marked heterotopic bone formation in the medial aspects of the joint, where a new-born ankylotic block occupied most part of the gap created by resecting the coronoid process at the time of the TMJ prosthesis insertion. Conclusions: Despite this adverse event has been sometimes described in the literature, this is the first case in which its occurrence happened several years after the temporomandibular joint replacement. It can be suggested that an accurate assessment of pre-operative risk factors for re-ankylosis (e.g., patients with multiple failed temporomandibular joint surgeries and within-intervention prevention (e.g., strategies to keep the bone interfaces around the implant separated should be better standardized and define in future studies.

Immediate prostheses on one-piece trans-mucosal implants in flapless surgical procedures Case Series Report. Part I: full arch rehabilitations

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Aris Petros Tripodakis

2012-06-01

Full Text Available Aim: The aim of the present case series report is to illustrate a clinical technique and present the application of onepiece transmucosal implants in flapless surgical procedures, supporting full arch immediate prostheses. Materials and methods: A total of 294 implants (Xive TG, Friadent, Germany have been used to support full arch immediate prostheses, over the last six years and have been in function for at least one year. The surgical placement of five or more implants per case involved immediate extraction and intrasocket flapless placement, combined with minimal flap elevation in the areas of healed extraction sites (43 mandibular and 7 maxillary arches. In all cases immediate provisionalization followed. Detailed three-dimensional cone-beam localized volumetric tomography preceeded the surgical procedures. The delivery of the final ceramo-metal prostheses was accomplished within a 20 day period. Materials and methods: Results Six implants failed to osseointegrate. All other implants are still successfully bearing the final prosthesis for the time that they have been followed. Soft tissue reaction was favorable from both the biologic and esthetic point of view. Conclusion: The flapless placement of one piece implants into edentulous healed sites is a predictable procedure in the presence of abundance of supporting bone as confirmed by 3-D imaging. On the other hand, immediate extraction placement of one piece implants allows the engagement of sound bone located deeper into the socket and provides adequate mechanical support of the soft tissue architecture that is preserved predictably. In all cases the prosthetic procedures are accomplished without disturbing the hardsoft tissue interface as the abutment-prosthesis interface is coronally elevated by the virtual design of the implant.

Precision of fit between implant impression coping and implant replica pairs for three implant systems.

Science.gov (United States)

Nicoll, Roxanna J; Sun, Albert; Haney, Stephan; Turkyilmaz, Ilser

2013-01-01

The fabrication of an accurately fitting implant-supported fixed prosthesis requires multiple steps, the first of which is assembling the impression coping on the implant. An imprecise fit of the impression coping on the implant will cause errors that will be magnified in subsequent steps of prosthesis fabrication. The purpose of this study was to characterize the 3-dimensional (3D) precision of fit between impression coping and implant replica pairs for 3 implant systems. The selected implant systems represent the 3 main joint types used in implant dentistry: external hexagonal, internal trilobe, and internal conical. Ten impression copings and 10 implant replicas from each of the 3 systems, B (Brånemark System), R (NobelReplace Select), and A (NobelActive) were paired. A standardized aluminum test body was luted to each impression coping, and the corresponding implant replica was embedded in a stone base. A coordinate measuring machine was used to quantify the maximum range of displacement in a vertical direction as a function of the tightening force applied to the guide pin. Maximum angular displacement in a horizontal plane was measured as a function of manual clockwise or counterclockwise rotation. Vertical and rotational positioning was analyzed by using 1-way analysis of variance (ANOVA). The Fisher protected least significant difference (PLSD) multiple comparisons test of the means was applied when the F-test in the ANOVA was significant (α=.05). The mean and standard deviation for change in the vertical positioning of impression copings was 4.3 ±2.1 μm for implant system B, 2.8 ±4.2 μm for implant system R, and 20.6 ±8.8 μm for implant system A. The mean and standard deviation for rotational positioning was 3.21 ±0.98 degrees for system B, 2.58 ±1.03 degrees for system R, and 5.30 ±0.79 degrees for system A. The P-value for vertical positioning between groups A and B and between groups A and R was <.001. No significant differences were found for

Implant loading protocols for edentulous patients with fixed prostheses: a systematic review and meta-analysis.

Science.gov (United States)

Papaspyridakos, Panos; Chen, Chun-Jung; Chuang, Sung-Kiang; Weber, Hans-Peter

2014-01-01

To report on the effect of immediate implant loading with fixed prostheses compared to early and conventional loading on implant and prosthesis survival, failure, and complications. An electronic and manual search was conducted to identify randomized controlled clinical trials (RCTs) as well as prospective and retrospective studies involving rough surface implants and implant fixed complete dental prostheses for edentulous patients. The 62 studies that fulfilled the inclusion criteria featured 4 RCTs, 2 prospective case-control studies, 34 prospective cohort studies, and 22 retrospective cohort studies. These studies yielded data from 2,695 patients (2,757 edentulous arches) with 13,653 implants. Studies were grouped according to the loading protocol applied; 45 studies reported on immediate loading, 8 on early loading, and 11 on conventional loading. For the immediate loading protocol with flap surgery, the implant and prosthesis survival rates ranged from 90.1% to 100% and 93.75% to 100%, respectively (range of follow-up, 1 to 10 years). When immediate loading was combined with guided flapless implant placement, the implant survival rates ranged from 90% to 99.4%. For the early loading protocol, the implant and prosthesis survival rates ranged from 94.74% to 100% and 93.75% to 100%, respectively (range of follow-up, 1 to 10 years). For the conventional loading protocol, the implant and prosthesis survival rates ranged from 94.95% to 100% and 87.5% to 100%, respectively (range of follow-up, 2 to 15 years). No difference was identified between maxilla and mandible. When selecting cases carefully and using dental implants with a rough surface, immediate loading with fixed prostheses in edentulous patients results in similar implant and prosthesis survival and failure rates as early and conventional loading. For immediate loading, most of the studies recommended a minimal insertion torque of 30 Ncm. The estimated 1-year implant survival was above 99% with all three

Influence of Manufacturing Methods of Implant-Supported Crowns on External and Internal Marginal Fit: A Micro-CT Analysis

Directory of Open Access Journals (Sweden)

Izabela C. M. Moris

2018-01-01

Full Text Available Aim. To evaluate the influence of different manufacturing methods of single implant-supported metallic crowns on the internal and external marginal fit through computed microtomography. Methods. Forty external hexagon implants were divided into 4 groups (n=8, according to the manufacturing method: GC, conventional casting; GI, induction casting; GP, plasma casting; and GCAD, CAD/CAM machining. The crowns were attached to the implants with insertion torque of 30 N·cm. The external (vertical and horizontal marginal fit and internal fit were assessed through computed microtomography. Internal and external marginal fit data (μm were submitted to a one-way ANOVA and Tukey’s test (α=.05. Qualitative evaluation of the images was conducted by using micro-CT. Results. The statistical analysis revealed no significant difference between the groups for vertical misfit (P=0.721. There was no significant difference (P>0.05 for the internal and horizontal marginal misfit in the groups GC, GI, and GP, but it was found for the group GCAD (P≤0.05. Qualitative analysis revealed that most of the samples of cast groups exhibited crowns underextension while the group GCAD showed overextension. Conclusions. The manufacturing method of the crowns influenced the accuracy of marginal fit between the prosthesis and implant. The best results were found for the crowns fabricated through CAD/CAM machining.

Assessment of psychosexual adjustment after insertion of inflatable penile prosthesis.

Science.gov (United States)

Tefilli, M V; Dubocq, F; Rajpurkar, A; Gheiler, E L; Tiguert, R; Barton, C; Li, H; Dhabuwala, C B

1998-12-01

To evaluate the psychosexual benefit obtained from multicomponent penile implant surgery in patients with erectile dysfunction. A psychosexual questionnaire was given to 35 patients undergoing penile prosthesis implantation before surgery and at 3 months, 6 months, and 1 year after surgery. The questionnaire consisted of 13 questions scored on a scale from 1 through 5. Results of the questionnaire were statistically analyzed for differences among the preoperative, 3-month postoperative, 6-month postoperative, and 1-year postoperative period. The general linear model evaluation showed a significant difference for each overall combination of the following pairs: preoperative versus 3 months postoperative (P=0.0005) and 3 months postoperative versus 6 months postoperative (P=0.002). There was no overall difference between psychosexual total score at 6 months after surgery and 1 year after prosthesis implantation (P=0.85). The patients perceived improvement in their erectile ability and libido. Concern about obtaining and maintaining an erection during intercourse was significantly alleviated. There was an increase in the frequency of sexual activity and an improvement in satisfaction with sex life. A decrease in feelings of sadness, depression, anxiety, anger, frustration, and embarrassment related to sexual activity was also noted. The current study demonstrates significant improvement in the psychosexual well being of multicomponent penile implant recipients, with attainment of a high level of patient satisfaction up to 1 year after surgery.

The Use of Implants to Improve Removable Partial Denture Function.

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Pimentel, Marcele Jardim; Arréllaga, Juan Pablo; Bacchi, Ataís; Del Bel Cury, Altair A

2014-12-01

The oral rehabilitation with conventional removable partial dentures in Kennedy class I patients allows continuous bone resorption, dislodgment of the prosthesis during the mastication caused by the resilience of the mucosa, and rotation of the prosthesis. Thus, the associations of distal implants become an attractive modality of treatment for these patients. This case report presented an association of removable partial dentures, milled crowns and osseointegrated implants to rehabilitate a partial edentulous patient. A removable partial denture associated with implants and metal-ceramic milled crowns can offer excellent esthetics, and will improve function and biomechanics, at a reduced cost.

Implant rehabilitation in fibula-free flap reconstruction: A retrospective study of cases at 1-18 years following surgery.

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Sozzi, Davide; Novelli, Giorgio; Silva, Rebeka; Connelly, Stephen T; Tartaglia, Gianluca M

2017-10-01

To determine the dental implant and prostheses success rate in a cohort of patients who underwent a vascularized fibula-free flap (FFF) for maxillary or mandibular reconstruction. The investigators implemented a retrospective cohort study composed of patients who had undergone primary or secondary FFF reconstruction jaw surgery plus placement of 2-6 implants in the reconstructed arch, which were restored with an implant-supported prosthesis. The sample was composed of all patients who underwent FFF surgery between 1998 and 2012 and had either simultaneous or secondary dental implant placement. A total of 28 patients met inclusion criteria. Of these, 22 patients participated in the retrospective review. Patients were examined by an independent observer between January-December 2015. In addition, all patients completed a questionnaire to access satisfaction with the implant-supported prosthesis. The patient cohort consisted of 12 males and 10 females, age 12-70 years. A total of 100 implants were placed, 92 implants in fibular bone and 8 implants in native bone. In the maxilla, 35 implants were placed into fibular bone and 4 into native bone (11 in irradiated patients and 28 in non-irradiated patients). In the mandible, 57 implants were placed into fibular bone and 4 into native bone (15 in irradiated patients and 46 in non-irradiated patients). The mean follow-up after implant loading was 7.8 years (range 1.3-17.5 years). The implant survival rate was 98% (95% CI: 92.2%-99.5%). No statistically significant difference was found in implant success between maxillary and mandibular implants, or between radiated and non-radiated bone. The prostheses success rate, determined by clinical exam and patient satisfaction, was 100%. The results of this study suggest that implant survival is high and implant-supported prostheses are a reliable rehabilitation option in patients whose jaws have been reconstruction with a FFF. Copyright © 2017. Published by Elsevier Ltd.

Dose distribution perturbation due to a Co-Cr-Mo prosthesis

International Nuclear Information System (INIS)

Castro Novais, J.; Rodriguez Rodriguez, C.; Cabello Murillo, E.; Fernandez Leton, P.; Perez Moreno, J. M.; Lopez Fernandez, A.; Ferrando Sanchez, A.; Martinez Gomez, L. C.

2009-01-01

Knowledge of the attenuation and interface effects when irradiating metallic prosthesis is necessary for the radiotherapy treatment of patients with this kind of implants. This report studies the dose distribution of a 6 MV photon beam in the vicinity of a 1,5 cm diameter Co-Cr-Mo prosthesis. Measurements with Gafchromic EBT radiochromic films have been made. Two blocks of cut films have been placed next to the prosthesis, one in each side. Forty two films reaching a height of 1 cm have been piled up in each block. A spatial resolution equal to the thickness of one film (0,24 mm) is achieved. The results show 28% attenuation and the production of a 42% overdose at the entrance interface, 12% and 3% at 1 mm and 2 mm away from the prosthesis respectively. A 5 mm build-up region is originated in the exit interface, where the under dose is less than 10%. The knowledge of the transmission factor and the interface effects allows us to assess the dose calculated by the treatment planning system. (Author) 11 refs.

Implant and prosthodontic survival rates with implant fixed complete dental prostheses in the edentulous mandible after at least 5 years: a systematic review.

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Papaspyridakos, Panos; Mokti, Muizzaddin; Chen, Chun-Jung; Benic, Goran I; Gallucci, German O; Chronopoulos, Vasilios

2014-10-01

The treatment of mandibular edentulism with implant fixed complete dental prostheses (IFCDPs) is a routinely used treatment option. The study aims to report the implant and prosthodontic survival rates associated with IFCDPs for the edentulous mandible after an observation period of a minimum 5 years. An electronic MEDLINE/PubMED search was conducted to identify randomized controlled clinical trials and prospective studies with IFCDPs for the edentulous mandible. Clinical studies with at least 5-year follow-up were selected. Pooled data were statistically analyzed and cumulative implant- and prosthesis survival rates were calculated by meta-analysis, regression, and chi-square statistics. Implant-related and prosthesis-related factors were identified and their impact on survival rates was assessed. Seventeen prospective studies, including 501 patients and 2,827 implants, were selected for meta-analysis. The majority of the implants (88.5% of all placed implants) had been placed in the interforaminal area. Cumulative implant survival rates for rough surface ranged from 98.42% (95% confidence interval [CI]: 97.98-98.86) (5 years) to 96.86% (95% CI: 96.00-97.73) (10 years); smooth surface implant survival rates ranged from 98.93% (95% CI: 98.38-99.49) (5 years) to 97.88% (95% CI: 96.78-98.98) (10 years). The prosthodontic survival rates for 1-piece IFCDPs ranged from 98.61% (95% CI: 97.80-99.43) (5 years) to 97.25% (95% CI: 95.66-98.86) (10 years). Treatment with mandibular IFCDPs yields high implant and prosthodontic survival rates (more than 96% after 10 years). Rough surface implants exhibited cumulative survival rates similar to the smooth surface ones (p > .05) in the edentulous mandible. The number of supporting implants and the antero-posterior implant distribution had no influence (p > .05) on the implant survival rate. The prosthetic design and veneering material, the retention type, and the loading protocol (delayed, early, and immediate) had no

Microstructural characterization of titanium dental implants by electron microscopy and mechanical tests; Caracterizacao microestrutural de implantes dentarios de titanio por microscopia eletronica e ensaios mecanicos

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Helfenstein, B.; Muniz, N.O.; Dedavid, B.A., E-mail: bruhelfenstein@hotmail.co [Pontificia Univ. Catolica do Rio Grande do Sul (FE/PUC/RS), Porto Alegre, RS (Brazil). Fac. de Engenharia; Gehrke, S.A. [Universidade Federal de Santa Maria (FE/UFSM), RS (Brazil). Fac. de Engenharia; Vargas, A.L.M. [Parque Tecnologico da PUCRS (TECNOPUC/GEPSI), Porto Alegre, RS (Brazil). Grupo de Estudos de Propriedades de Superficies e Interfaces

2010-07-01

Mini screw types for titanium implants, with differentiated design, were tested for traction and torsion for behavior analysis of the shape relative to the requirements of ASTM F136. All implants showed mechanical tensile strength above by the standard requirement, being that 83.3% of them broke above the doughnut, in support of the prosthesis. Distinct morphologies in ruptured by mechanical tests, were obtained. However, both fracture surfaces showed fragile comportments. Metallographic tests, x-ray diffraction (XRD) and microhardness were used for microstructural characterization of material, before and after heat treatment. The presences of {beta} phase in screw surface after quenching treatment proves that the thermal treatment can contribute for mechanical resistance in surface implants. (author)

The Development of Skull Prosthesis Through Active Contour Model.

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Chen, Yi-Wen; Shih, Cheng-Ting; Cheng, Chen-Yang; Lin, Yu-Cheng

2017-09-09

Skull defects result in brain infection and inadequate brain protection and pose a general danger to patient health. To avoid these situations and prevent re-injury, a prosthesis must be constructed and grafted onto the deficient region. With the development of rapid customization through additive manufacturing and 3D printing technology, skull prostheses can be fabricated accurately and efficiently prior to cranioplasty. However, an unfitted skull prosthesis made with a metal implant can cause repeated infection, potentially necessitating secondary surgery. This paper presents a method of creating suitably geometric graphics of skull defects to be applied in skull repair through active contour models. These models can be adjusted in each computed tomography slice according to the graphic features, and the curves representing the skull defect can be modeled. The generated graphics can adequately mimic the natural curvature of the complete skull. This method will enable clinical surgeons to rapidly implant customized prostheses, which is of particular importance in emergency surgery. The findings of this research can help surgeons provide patients with skull defects with treatment of the highest quality.

Axial displacements in external and internal implant-abutment connection.

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Lee, Ji-Hye; Kim, Dae-Gon; Park, Chan-Jin; Cho, Lee-Ra

2014-02-01

The purpose of this study was to evaluate the axial displacement of the abutments during clinical procedures by the tightening torque and cyclic loading. Two different implant-abutment connection systems were used (external butt joint connection [EXT]; internal tapered conical connection [INT]). The master casts with two implant replicas, angulated 10° from each other, were fabricated for each implant connection system. Four types of impression copings were assembled and tightened with the corresponding implants (hex transfer impression coping, non-hex transfer impression coping, hex pick-up impression coping, non-hex pick-up impression coping). Resin splinted abutments and final prosthesis were assembled. The axial displacement was measured from the length of each assembly, which was evaluated repeatedly, after 30 Ncm torque tightening. After 250 N cyclic loading of final prosthesis for 1,000,000 cycles, additional axial displacement was recorded. The mean axial displacement was statistically analyzed (repeated measured ANOVA). There was more axial displacement in the INT group than that of the EXT group in impression copings, resin splinted abutments, and final prosthesis. Less axial displacement was found at 1-piece non-hex transfer type impression coping than other type of impression copings in the INT group. There was more axial displacement at the final prosthesis than resin splinted abutments in the INT and the EXT groups. After 250 N cyclic loading of final prosthesis, the INT group showed more axial displacement than that of the EXT group. Internal tapered conical connection demonstrated a varying amount of axial displacement with tightening torque and cyclic loading. © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

Transapical JenaValve in a patient with mechanical mitral valve prosthesis.

LENUS (Irish Health Repository)

O' Sullivan, Katie E

2014-01-29

We report the first case of transcatheter aortic valve replacement implantation using JenaValve™ in a patient with mechanical mitral valve prosthesis. We believe that the design features of this valve may be particularly suited for use in this setting. © 2014 Wiley Periodicals, Inc.

Osseointegrated implants and auricular defects: a case series study.

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Wright, Robert F; Zemnick, Candice; Wazen, Jack J; Asher, Eric

2008-08-01

The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment. Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow-up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance. Thirty-nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction. The survival rate for bone-anchored titanium implants and prostheses was 100%. Bone-anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of

[Dynamic analysis of the rigid fixed bridge and related tissue after intrusion of abutment with micro screw implant].

Science.gov (United States)

Zhu, Lin; Xu, Pei-cheng; Lu, Liu-lei

2013-08-01

To study the variety of mechanical behavior of fixed bridge after abutments being intruded by micro screw implant and to provide theoretical principles for clinical practice of teeth preparation after intrusion of abutments under dynamic loads. Two-dimensional images of maxilla, teeth and supporting tissues of healthy people were scanned by spiral CT and were synthesized by Mimics10.01, Ansys13.0, etc. The three-dimensional finite element mathematical model of rigid fixed bridge repairing on double end of maxillary molar was developed. Under the condition of 10% simulative abutment alveolar absorption, vertical and oblique dynamic forces were applied in a circle of mastication(0.875 s) to build mathematical model after the abutment had been intruded for 0.5, 1.0, 1.5 and 2.0 mm. Stress variety of prosthesis, teeth, periodontal ligaments and supporting tissues were compared before and after intrusion of abutments. Stress variety of the prosthesis occurred, which had close relationship with the structure of prosthesis and teeth, the areas of periodontal ligaments increased, stress on the whole decreased along with the increase of the length of intrusion. With time accumulating, the stress value in prosthesis, teeth, periodontal ligaments and supporting tissues increased gradually and loads in oblique direction induced peak value stress in a masticatory cycle. Some residual stress left after unloading. By preparing the fixed bridge after abutment intrusion by micro screw implant, the service life of abutment and fixed bridge prosthesis can be reduced. The abutment and its related tissue have time-dependent mechanical behaviors during one mastication. The influence of oblique force on stress was greater than vertical force. There is some residual stress left after one mastication period. With the increase of the intrusion on abutment, residual stress reduced.

Frequent complications and severe bone loss associated with the repiphysis expandable distal femoral prosthesis.

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Cipriano, Cara A; Gruzinova, Irina S; Frank, Rachel M; Gitelis, Steven; Virkus, Walter W

2015-03-01

The treatment of choice for distal femur malignancies in skeletally immature patients remains controversial. An expandable endoprosthesis device (Repiphysis Limb Salvage System; Wright Medical Technology, Arlington, TN, USA) allows for limb preservation and noninvasive lengthening but has been associated with significant complications; however, the extent and implications of bone loss associated with this implant have not been reported. Our goals were to report (1) the 2-year minimum clinical outcomes after placement of the Repiphysis expandable prosthesis for pediatric distal femur malignancies; (2) the complications associated with this prosthesis; (3) the failure rate of this prosthesis; and (4) the revision alternatives available for salvage procedures. Between 2002 and 2010, one surgeon (SG) treated all skeletally immature patients (mean age, 10.1 years; range, 4.7-13.6 years) with distal femoral osteosarcoma using a Repiphysis expandable prosthesis. Of the 12 patients who met these criteria, two were excluded for death from disease before 2 years, and mean followup for the remaining 10 was 72 months (range, 26-119 months). Medical records were retrospectively reviewed for complications and clinical outcomes, as assessed by the Musculoskeletal Tumor Society (MSTS) scoring system. Radiographs at final followup were reviewed for bone loss and analyzed by the two senior authors (SG, WWV) to determine reconstruction options available for future revisions. MSTS scores averaged 67%, and we observed 37 implant-related complications requiring a total of 15 reoperations. Six patients underwent implant revisions with aseptic loosening being the predominant mode of failure; ultimately, four of these were converted to adult modular oncology prostheses, and two underwent total femoral replacements. Bone loss in this series was severe in terms of femoral length, cortical thinning, and metadiaphyseal compromise, and most patients will not have sufficient bone stock to permit

Implant prostheses for convertibility, stress control, esthetics, and hygiene.

Science.gov (United States)

Garfield, R E

1988-07-01

A method of connecting "fixed partial denture" prostheses to osseointegrated implant fixtures has been described. The advantages of this system of restoration for partially and fully edentulous mouths are that it is more effective in addressing the problems of (1) stress-control on abutments, (2) a back-up system for abutment failures, (3) esthetics, and (4) control of bacterial plaques around abutments. To accomplish this procedure, the application of convertible periodontal prosthesis techniques with modifications to some existing implant systems is undertaken. The disadvantages of this method seem insignificant when one considers the complexities and risks involved with the present array of implant prosthesis alternatives. Some patients and dentists might consider the necessity of the prosthesis being detachable as one disadvantage. In reality, the prosthesis can be used as a fixed restoration until the patient has fully adapted to the new proprioception and appearance. A large percentage of patients feel uncomfortable with the word "removable" because it immediately creates a perception of unsightly metallic clasp display, palatal coverage, tongue interference, and negative body image. The use of the term "detachable" coupled with the doctor's offer to perform this task for the patient "whenever necessary" will usually relieve the patient's anxiety and allow the treatment to proceed. Once neuromuscular and esthetic adaptation have occurred and the patient has accepted the prosthesis, daily detaching and home-care hygiene by the patient will follow without incident. Esthetic improvement is obvious (Fig. 3).

Sutureless implantation of the perceval s aortic valve prosthesis through right anterior minithoracotomy.

Science.gov (United States)

Gilmanov, Daniyar; Miceli, Antonio; Bevilacqua, Stefano; Farneti, Pierandrea; Solinas, Marco; Ferrarini, Matteo; Glauber, Mattia

2013-12-01

Many new, less invasive strategies are proposed for aortic valve operation in elderly patients. Rapid deployment sutureless aortic valve prosthesis has been recently introduced. We analyzed our experience with a sutureless valve implanted through a minimally invasive approach. A retrospective observational study with prospectively registered data was conducted on 137 patients undergoing aortic valve replacement through a right anterior minithoracotomy. Between April 2011 and January 2013, 137 consecutive patients underwent aortic valve replacement with a recently introduced, rapid deployment, sutureless pericardial valve in minithoracotomy access (47 men; mean age, 76.6 ± 7.1 years). There were 35 obese patients with a body mass index of more than 30 kg/m(2). Mean logistic EuroSCORE I was 10.0; 74 (54%) patients were in New York Heart Association functional class III and IV. In all, 19 (13.9%), 45 (32.8%), and 73 (53.3%) patients received 21-, 23-, and 25-mm valve prostheses, respectively. The mean aortic cross-clamp and cardiopulmonary bypass times were 59.3 ± 19 min and 92.3 ± 27 min, respectively. No operative mortality occurred. Median stay in the intensive care unit was 1 day, with assisted ventilation necessary for a median of 6 hours. Three cases of postoperative ischemic stroke were observed (1 patient with a previous history of an ischemic cerebral event). Median hospital length of stay was 6 days. A sutureless valve for minimally invasive aortic valve replacement is a feasible, effective, and safe tool. Ultimately amplifying indications for less invasive aortic valve replacement in a high surgical risk subset of patients, it can become a valid alternative for transcatheter aortic valve implantation. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

CLINICAL AND FUNCTIONAL ASSESSMENT OF THE BIOLOGICAL PROSTHESIS “ASPIRE” FOR SURGICAL CORRECTION OF MITRAL VALVE DISEASE

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S. G. Esin

2015-01-01

Full Text Available Aim: To assess clinical and functional efficacy of implanted biological prosthesis “ASPIRE” (manufactured by Vascutek for correction of mitral valve disease.Materials and methods: From October 2008 to December 2013, biological prostheses “ASPIRE” (Vascutek were implanted to 34 patients with mitral valve disease (mean age 63.59 ± 4.96 years, 79.4% female. From these, 24 patients had mitral stenosis and 10 patients had mitral insufficiency. 73.5% of all patients had heart failure Strazhesko-Vasilenko IIA grade and 85.3% of patients had chronic heart failure NYHA III. Isolated mitral valve replacement was performed only in 8 (23.5% of patients. In 22 (64.7% of cases mitral valve replacement was combined with tricuspid valvuloplasty in various modifications. Duration of cardiopulmonary bypass and of aortic clamping was 88.09 ± 25.95 and 65.68 ± 25.51 minutes, respectively. Before and after surgery all patients underwent echocardiographic assessment and clinical assessment of their general status.Results: In-hospital mortality was 5.88% (n = 2 and was related to multiorgan failure in the early postoperative period. All 32 (94.12% surviving patients improved with decrease or complete disappearance of heart failure. Postoperative complications were typical for cardiac surgery. There were no episodes of embolism, structural dysfunction, thrombosis of the prosthesis and endocarditis of the prosthesis in the early postoperative period. Pressure gradients across prosthetic valves were not high and corresponded to good clinical and hemodynamic results in the early postoperative period.Conclusion: Taking into account good immediate results of mitral valve replacement, as well as no need in lifelong anticoagulation in patients with multiple concomitant disorders, implantation of the biological prosthesis “ASPIRE” (Vascutek could become a procedure of choice for correction of valve abnormalities in patients above 65 years. For more comprehensive

Management of long span partially edentulous maxilla with fixed removable denture prosthesis.

Science.gov (United States)

Jeyavalan, Mahilan I; Narasimman, M; Venkatakrishnan, C J; Philip, Jacob M

2012-07-01

Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

Occlusal wear of provisional implant-supported restorations.

Science.gov (United States)

Santing, Hendrik J; Kleverlaan, Cornelis J; Werner, Arie; Feilzer, Albert J; Raghoebar, Gerry M; Meijer, Henny J A

2015-02-01

Implant-supported provisional restorations should be resistant to occlusal wear. The purpose of this laboratory study was to evaluate three-body wear of three indirect laboratory composite resins, five chair side bis-acryl resin-based materials, and two chair side methacrylate-based materials used to fabricate provisional implant-supported restorations. The materials were handled and cured according to the manufacturers' instructions. The three-body wear was measured 1 day, 3 days, 7 days, 4 weeks, and 8 weeks after curing using the ACTA wear device. Wear rate decreased significantly after 8 weeks compared with the first day for all tested materials, except for Estenia C&B. The three-body wear of two indirect laboratory composite resins, that is, Estenia C&B and Solidex, was significantly less compared with all other tested materials used for fabricating provisional implant-supported restorations. Of the chair side materials, the wear rate of Protemp Crown Paste was significantly less compared with the others materials used to fabricate chair side provisional implant-supported restorations. The methacrylate-based materials, Temdent Classic and Trim, showed extreme high wear rates. Based on the results of this laboratory study on long-term wear, the use of indirect composite resin is preferred over chair side methacrylate-based materials when the provisional implant-supported restoration has to be in service for a long period of time. Of the investigated materials, only Estenia C&B and Solidex showed wear rate comparable with posterior resin composites. © 2013 Wiley Periodicals, Inc.

Elements of implant-supported rehabilitation planning in patients with bruxism.

Science.gov (United States)

Sarmento, Hugo Ramalho; Dantas, Raquel Venâncio Fernandes; Pereira-Cenci, Tatiana; Faot, Fernanda

2012-11-01

The rehabilitation of partial or completely edentulous patients with implant-supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to revise the literature and identify risk factors in implant-supported rehabilitation planning in subjects with bruxism. Available literature was searched through Medline, with no time limit, including only studies in English. Topics discussed were etiology of bruxism and its implications on dental implants, biomechanical considerations regarding the overload on dental implants, and methods to prevent the occurrence of overloads in implant-supported prostheses. The rehabilitation of bruxers using implant-supported prostheses, using implants with adequate length and diameter, as well as proper positioning seems to be a reliable treatment, with reduced risks of failure. Bruxism control through the use of a nightguard by rigid occlusal stabilization appliance relieved in the region of implants is highly indicated. Although it is clear that implant-supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

A unique method of retaining orbital prosthesis with attachment systems - a clinical report.

Science.gov (United States)

Guttal, Satyabodh S; Akash, N R; Prithviraj, D R; Lekha, K

2014-06-01

Diminution of the orbital contents post-surgical removal of a malignant tumor can have a severe psychological impact on the patient in terms of function and esthetics. Therefore, esthetic remedy should be planned subsequently, since tumor obliteration precedes cosmetic concern. A convenient option for successful rehabilitation in such patients is a simple, user-friendly, removable orbital prosthesis. Retention of the prosthesis is one of the key factors for the successful rehabilitation. Spectacle frame, conformers, adhesives, osseointegrated implants, magnets or buttons have been used to impart retention to the prosthesis. The use of semi precision attachments in maxillofacial prostheses is limited to the osseointegrated prostheses. This case report describes a conventional spectacle frame technique, to retain the silicone orbital prosthesis using two different types of stud attachments viz., dalla bona and O-ring attachment systems. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Randomized clinical trial of implant-supported ceramic-ceramic and metal-ceramic fixed dental prostheses: preliminary results.

Science.gov (United States)

Esquivel-Upshaw, Josephine F; Clark, Arthur E; Shuster, Jonathan J; Anusavice, Kenneth J

2014-02-01

The aim of this study was to determine the survival rates over time of implant-supported ceramic-ceramic and metal-ceramic prostheses as a function of core-veneer thickness ratio, gingival connector embrasure design, and connector height. An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study involving 55 patients missing three teeth in either one or two posterior areas. These patients (34 women; 21 men; age range 52-75 years) were recruited for the study to receive a three-unit implant-supported fixed dental prosthesis (FDP). Two implants were placed for each of the 72 FDPs in the study. The implants (Osseospeed, Astra Tech), which were made of titanium, were grit blasted. A gold-shaded, custom-milled titanium abutment (Atlantis, Astra Tech), was secured to each implant body. Each of the 72 FDPs in 55 patients were randomly assigned based on one of the following options: (1) A. ceramic-ceramic (Yttria-stabilized zirconia core, pressable fluorapatite glass-ceramic, IPS e.max ZirCAD, and ZirPress, Ivoclar Vivadent) B. metal-ceramic (palladium-based noble alloy, Capricorn, Ivoclar Vivadent, with press-on leucite-reinforced glass-ceramic veneer, IPS InLine POM, Ivoclar Vivadent); (2) occlusal veneer thickness (0.5, 1.0, and 1.5 mm); (3) curvature of gingival embrasure (0.25, 0.5, and 0.75 mm diameter); and (4) connector height (3, 4, and 5 mm). FDPs were fabricated and cemented with dual-cure resin cement (RelyX, Universal Cement, 3M ESPE). Patients were recalled at 6 months, 1 year, and 2 years. FDPs were examined for cracks, fracture, and general surface quality. Recall exams of 72 prostheses revealed 10 chipping fractures. No fractures occurred within the connector or embrasure areas. Two-sided Fisher's exact tests showed no significant correlation between fractures and type of material system (p = 0.51), veneer thickness (p = 0.75), radius of curvature of gingival embrasure (p = 0.68), and connector height (p = 0

Reading visual braille with a retinal prosthesis.

Science.gov (United States)

Lauritzen, Thomas Z; Harris, Jordan; Mohand-Said, Saddek; Sahel, Jose A; Dorn, Jessy D; McClure, Kelly; Greenberg, Robert J

2012-01-01

Retinal prostheses, which restore partial vision to patients blinded by outer retinal degeneration, are currently in clinical trial. The Argus II retinal prosthesis system was recently awarded CE approval for commercial use in Europe. While retinal prosthesis users have achieved remarkable visual improvement to the point of reading letters and short sentences, the reading process is still fairly cumbersome. This study investigates the possibility of using an epiretinal prosthesis to stimulate visual braille as a sensory substitution for reading written letters and words. The Argus II retinal prosthesis system, used in this study, includes a 10 × 6 electrode array implanted epiretinally, a tiny video camera mounted on a pair of glasses, and a wearable computer that processes the video and determines the stimulation current of each electrode in real time. In the braille reading system, individual letters are created by a subset of dots from a 3 by 2 array of six dots. For the visual braille experiment, a grid of six electrodes was chosen out of the 10 × 6 Argus II array. Groups of these electrodes were then directly stimulated (bypassing the camera) to create visual percepts of individual braille letters. Experiments were performed in a single subject. Single letters were stimulated in an alternative forced choice (AFC) paradigm, and short 2-4-letter words were stimulated (one letter at a time) in an open-choice reading paradigm. The subject correctly identified 89% of single letters, 80% of 2-letter, 60% of 3-letter, and 70% of 4-letter words. This work suggests that text can successfully be stimulated and read as visual braille in retinal prosthesis patients.

Optimization of dental implantation

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Dol, Aleksandr V.; Ivanov, Dmitriy V.

2017-02-01

Modern dentistry can not exist without dental implantation. This work is devoted to study of the "bone-implant" system and to optimization of dental prostheses installation. Modern non-invasive methods such as MRI an 3D-scanning as well as numerical calculations and 3D-prototyping allow to optimize all of stages of dental prosthetics. An integrated approach to the planning of implant surgery can significantly reduce the risk of complications in the first few days after treatment, and throughout the period of operation of the prosthesis.

Autologous Chondrocyte Implantation in Osteoarthritic Surroundings

DEFF Research Database (Denmark)

Ossendorff, Robert; Grad, Sibylle; Stoddart, Martin J

2018-01-01

BACKGROUND: Autologous chondrocyte implantation (ACI) fails in up to 20% of cases. Advanced intra-articular degeneration paired with an inflammatory environment may be closely related to implantation failure. Certain cytokines have been identified to play a major role during early osteoarthritis....... PURPOSE: To investigate the effects of tumor necrosis factor α (TNFα) and its potential inhibition by adalimumab on cartilage regeneration in an in vitro model of ACI. STUDY DESIGN: Controlled laboratory study. METHODS: Bovine articular chondrocytes were cultivated and transferred at passage 3 to fibrin...

[Dislocated fracture of the lesser trochanter with malrotation of the stem after robot assisted implantation of a cementless hip prosthesis: a casuistic report].

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Prymka, M; Hassenpflug, J

2003-08-01

This paper presents the case of a 63 year old female with a severe coxarthrosis. She got a robot assited implantation of a cementless hip prosthesis (Osteolock, Stryker-Howmedica, Mühlheim). As operation robot the CASPAR-System (Orto-Maquet, Rastatt) was used. Initially, the clinical progress of the patient was fine. She was nearly painfree within 14 days and showed an acceptable range of motion in the operated joint (flexion/ extension 90 degrees /05 degrees /00 degrees ). She was mobilized with crutches and 15 kg weight bearing at the operated leg. 3 weeks postoperative the patient complaint about increasing pain without trauma or intensification of the weight bearing. X-rays showed not only a dislocated fracture of the lesser trochanter, but also a sinking combined with a malrotation of the stem. A revision operation was necessary,where we implanted a cemented stem. Now clinical progress was completely satisfying.

Cranioplasty prosthesis manufacturing based on reverse engineering technology

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Chrzan, Robert; Urbanik, Andrzej; Karbowski, Krzysztof; Moskała, Marek; Polak, Jarosław; Pyrich, Marek

2012-01-01

Summary Background Most patients with large focal skull bone loss after craniectomy are referred for cranioplasty. Reverse engineering is a technology which creates a computer-aided design (CAD) model of a real structure. Rapid prototyping is a technology which produces physical objects from virtual CAD models. The aim of this study was to assess the clinical usefulness of these technologies in cranioplasty prosthesis manufacturing. Material/Methods CT was performed on 19 patients with focal skull bone loss after craniectomy, using a dedicated protocol. A material model of skull deficit was produced using computer numerical control (CNC) milling, and individually pre-operatively adjusted polypropylene-polyester prosthesis was prepared. In a control group of 20 patients a prosthesis was manually adjusted to each patient by a neurosurgeon during surgery, without using CT-based reverse engineering/rapid prototyping. In each case, the prosthesis was implanted into the patient. The mean operating times in both groups were compared. Results In the group of patients with reverse engineering/rapid prototyping-based cranioplasty, the mean operating time was shorter (120.3 min) compared to that in the control group (136.5 min). The neurosurgeons found the new technology particularly useful in more complicated bone deficits with different curvatures in various planes. Conclusions Reverse engineering and rapid prototyping may reduce the time needed for cranioplasty neurosurgery and improve the prosthesis fitting. Such technologies may utilize data obtained by commonly used spiral CT scanners. The manufacturing of individually adjusted prostheses should be commonly used in patients planned for cranioplasty with synthetic material. PMID:22207125

Implant-retained overdenture as a standard treatment modality for severely resorbed mandibular ridges

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Angleena Y Daniel

2017-01-01

Full Text Available Edentulous patients are a diverse group comprised those who are anatomically deficient, medically compromised, economically depressed, geriatric as well as the general population that, for a number of other reasons have been rendered edentulous. Satisfying a completely edentulous patient is always considered a difficult task. Various treatment options for rehabilitation of a completely edentulous patient are available: conventional complete dentures, overdentures, implant-supported overdenture, and full arch fixed implant-supported prosthesis. While the conventional denture may meet the needs of many patients, others require more retention, stability, function, and esthetics, especially in the mandible. With the continued advancements in dental implant therapy, it is becoming increasingly easier for the clinician to provide treatment solutions that can effectively meet functional, economic, and social expectations of each individual patient. This paper presents a case report of prosthetic rehabilitation of a completely edentulous patient with implant-retained overdenture.

Management of long span partially edentulous maxilla with fixed removable denture prosthesis

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Mahilan I Jeyavalan

2012-01-01

Full Text Available Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

Microstructural characterization of titanium dental implants by electron microscopy and mechanical tests

International Nuclear Information System (INIS)

Helfenstein, B.; Muniz, N.O.; Dedavid, B.A.; Gehrke, S.A.; Vargas, A.L.M.

2010-01-01

Mini screw types for titanium implants, with differentiated design, were tested for traction and torsion for behavior analysis of the shape relative to the requirements of ASTM F136. All implants showed mechanical tensile strength above by the standard requirement, being that 83.3% of them broke above the doughnut, in support of the prosthesis. Distinct morphologies in ruptured by mechanical tests, were obtained. However, both fracture surfaces showed fragile comportments. Metallographic tests, x-ray diffraction (XRD) and microhardness were used for microstructural characterization of material, before and after heat treatment. The presences of β phase in screw surface after quenching treatment proves that the thermal treatment can contribute for mechanical resistance in surface implants. (author)

Evidence of echoic memory with a multichannel cochlear prosthesis.

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Jerger, S; Watkins, M J

1988-10-01

Short-term memory was examined in a subject with a multichannel cochlear prosthesis. Serial recall for lists of digits revealed what are widely regarded as the principal hallmarks of echoic memory, namely the recency effect and the suffix effect. Thus, probability of recall increased for the last one or two digits, except when a nominally irrelevant but spoken item was appended to the to-be-remembered list. It appears, therefore, that a multichannel cochlear implant can give rise to not only the perception of, but also an echoic memory for, speech. As with normal subjects, the suffix effect did not occur with a nonspeech suffix, implying that the echoic memory from the prosthesis shows normal sensitivity to the distinction between speech and nonspeech.

Biomechanics and load resistance of small-diameter and mini dental implants: a review of literature.

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Hasan, Istabrak; Bourauel, Christoph; Mundt, Torsten; Stark, Helmut; Heinemann, Friedhelm

2014-02-01

In recent years, the application of small-diameter and mini dental implants to support removable and fixed prosthesis has dramatically increased. However, the success of these implants under functional biting forces and the reaction of the bone around them need to be analyzed. This review was aimed to present studies that deal with the fatigue life of small-diameter and mini dental implants under normal biting force, and their survival rate. The numerical and experimental studies concluded that an increase in the risk of bone damage or implant failure may be assumed in critical clinical situations and implants with <3 mm diameter have a risk of fracture in clinical practice. The survival rate of the small-diameter and mini dental implants over 5 years was 98.3-99.4%.

Immediate implant placement into posterior sockets with or without buccal bone dehiscence defects: A retrospective cohort study.

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Hu, Chen; Gong, Ting; Lin, Weimin; Yuan, Quan; Man, Yi

2017-10-01

To evaluate bone reconstruction and soft tissue reactions at immediate implants placed into intact sockets and those with buccal bone dehiscence defects. Fifty-nine internal connection implants from four different manufacturers were immediately placed in intact sockets(non-dehiscence group, n=40), and in alveoli with buccal bone dehiscence defects: 1) Group 1(n= N10), the defect depth measured 3-5 mm from the gingival margin. 2) Group 2(n=9), the depth ranged from 5mm to 7mm. The surrounding bony voids were grafted with deproteinized bovine bone mineral (DBBM) particles. Cone beam computed tomography(CBCT) was performed immediately after surgery (T1), and at 6 months later(T2). Radiographs were taken at prosthesis placement and one year postloading(T3). Soft tissue parameters were measured at baseline (T0), prosthesis placement and T3. No implants were lost during the observation period. For the dehiscence groups, the buccal bone plates were radiographically reconstructed to comparable horizontal and vertical bone volumes compared with the non-dehiscence group. Marginal bone loss occurred between the time of final restoration and 1-year postloading was not statistically different(P=0.732) between groups. Soft tissue parameters did not reveal inferior results for the dehiscence groups. Within the limitations of this study, flapless implant placement into compromised sockets in combination with DBBM grafting may be a viable technique to reconstitute the defected buccal bone plates due to space maintenance and primary socket closure provided by healing abutments and bone grafts. Immediate implants and DBBM grafting without using membranes may be indicated for sockets with buccal bone defects. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bioelectronic retinal prosthesis

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Weiland, James D.

2016-05-01

Retinal prosthesis have been translated to clinical use over the past two decades. Currently, two devices have regulatory approval for the treatment of retinitis pigmentosa and one device is in clinical trials for treatment of age-related macular degeneration. These devices provide partial sight restoration and patients use this improved vision in their everyday lives to navigate and to detect large objects. However, significant vision restoration will require both better technology and improved understanding of the interaction between electrical stimulation and the retina. In particular, current retinal prostheses do not provide peripheral visions due to technical and surgical limitations, thus limiting the effectiveness of the treatment. This paper reviews recent results from human implant patients and presents technical approaches for peripheral vision.

In vitro evaluation of resonance frequency analysis values to different implant contact ratio and stiffness of surrounding material.

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Kwak, Mu-Seung; Kim, Seok-Gyu

2013-11-01

The present study was aimed to evaluate the influence of implant contact ratio and stiffness of implant-surrounding materials on the resonance frequency analysis (RFA) values. Seventy resin blocks that had the different amounts (100, 50, 30, 15%) of resin-implant contact (RIC) were fabricated. Ten silicone putty blocks with 100% silicone-implant contact were also made. The implants with Ø5.0 mm × 13.0 mm were placed on eighty specimen blocks. The RFA value was measured on the transducer that was connected to each implant by Osstell Mentor. Kruskal-Wallis and Scheffe's tests (α=.05) were done for statistical analysis. The control resin group with 100% RIC had the highest RFA value of 83.9, which was significantly different only from the resin group with 15% RIC among the resin groups. The silicone putty group with 100% contact had the lowest RFA value of 36.6 and showed statistically significant differences from the resin groups. Within the limitations of this in vitro study, there was no significant difference in the RFA values among the resin groups with different RIC's except when the RIC difference was more than 85%. A significant increase in the RFA value was observed related to the increase in stiffness of material around implant.

Active Bone Conduction Prosthesis: BonebridgeTM

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Zernotti, Mario E.

2015-10-01

Full Text Available Introduction Bone conduction implants are indicated for patients with conductive and mixed hearing loss, as well as for patients with single-sided deafness (SSD. The transcutaneous technology avoids several complications of the percutaneous bone conduction implants including skin reaction, skin growth over the abutment, and wound infection. The Bonebridge (MED-EL, Austria prosthesis is a semi-implantable hearing system: the BCI (Bone Conduction Implant is the implantable part that contains the Bone Conduction-Floating Mass Transducer (BC-FMT, which applies the vibrations directly to the bone; the external component is the audio processor Amadé BB (MED-EL, Austria, which digitally processes the sound and sends the information through the coil to the internal part. Bonebridge may be implanted through three different approaches: the transmastoid, the retrosigmoid, or the middle fossa approach. Objective This systematic review aims to describe the world́s first active bone conduction implant system, Bonebridge, as well as describe the surgical techniques in the three possible approaches, showing results from implant centers in the world in terms of functional gain, speech reception thresholds and word recognition scores. Data Synthesis The authors searched the MEDLINE database using the key term Bonebridge. They selected only five publications to include in this systematic review. The review analyzes 20 patients that received Bonebridge implants with different approaches and pathologies. Conclusion Bonebridge is a solution for patients with conductive/mixed hearing loss and SSD with different surgical approaches, depending on their anatomy. The system imparts fewer complications than percutaneous bone conduction implants and shows proven benefits in speech discrimination and functional gain.

Effect of prosthesis endplate lordosis angles on L5-S1 kinematics after disc arthroplasty.

Science.gov (United States)

Tsitsopoulos, Parmenion P; Wojewnik, Bartosz; Voronov, Leonard I; Havey, Robert M; Renner, Susan M; Zelenakova, Julia; McIntosh, Braden; Carandang, Gerard; Abjornson, Celeste; Patwardhan, Avinash G

2012-06-01

We hypothesized that L5-S1 kinematics will not be affected by the lordosis distribution between the prosthesis endplates. Twelve cadaveric lumbosacral spines (51.3 ± 9.8 years) were implanted with 6° or 11° prostheses (ProDisc-L) with four combinations of superior/inferior lordosis (6°/0°, 3°/3°, 11°/0°, 3°/8°). Specimens were tested intact and after prostheses implantation with different lordosis distributions. Center of rotation (COR) and range of motion (ROM) were quantified. Six-degree lordosis prostheses (n = 7) showed no difference in flexion-extension ROM, regardless of design (6°/0° or 3°/3°) (p > 0.05). In lateral bending (LB), both designs reduced ROM (p lordosis prostheses (n = 5) showed no difference in flexion-extension ROM for either design (p > 0.05). LB ROM decreased with distributed lordosis prostheses (3°/8°) (p lordosis distribution among the two prosthesis endplates. The ProDisc-L prosthesis design where all lordosis is concentrated in the superior endplate yielded COR locations that were anterior and caudal to intact controls. The prosthesis with lordosis distributed between the two endplates yielded a COR that tended to be closer to intact. Further clinical and biomechanical studies are needed to assess the long-term impact of lordosis angle distribution on the fate of the facet joints.

[Silastic implant and synovitis].

Science.gov (United States)

Sennwald, G

1989-07-22

The silastic implant based on siloxane polymere induces granulomatous synovitis in certain predisposed individuals, a reaction which may continue even after removal of the implant. This is also true of a prosthesis of the trapezium in two of our patients, though to a lesser degree. This is probably the reason why the problem has not yet been widely recognized. The hypothesis is put forward that an enzymatic predisposition may allow chemical degradation of the fragmented silastic implant into a toxic component responsible for the pathologic condition. The slow progression of the lesions is a challenge for the future and puts in question the further use of silastic implants.

Impact of obesity on long-term survival after aortic valve replacement with a small prosthesis.

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Wang, Biao; Yang, Hongyang; Wang, Tao; Zhang, Xiquan; Zhu, Wenjie; Cao, Guangqing; Wu, Shuming

2013-07-01

Although many studies have evaluated the impact of obesity on various medical treatments, it is not known whether obesity is related to late mortality with implantation of small aortic prostheses. This study evaluated the effect of obesity on the late survival of patients after aortic valve replacement (AVR) with implantation of a small aortic prosthesis (size ≤ 21 mm). From January 1998 to December 2008, 307 patients in our institution who underwent primary AVR with smaller prostheses survived 30 days after surgery. Patients were categorized as normal weight if body mass index (BMI) was prosthesis. Obesity or/and overweight may also affect the NYHA classification, even in the longer term. EOAI should be improved where possible, as it may reduce late mortality and improve quality of life in obese or overweight patients.

A Case Series of Patients Who Underwent Laparoscopic Extraperitoneal Radical Prostatectomy with the Simultaneous Implant of a Penile Prosthesis: Focus on Penile Length Preservation

Science.gov (United States)

2018-01-01

Purpose There are many grey areas in the field of penile rehabilitation after radical prostatectomy (RP). The preservation of the full dimensions of the penis is an important consideration for improving patients' compliance for the treatment. We present the first case series of patients treated by laparoscopic extraperitoneal RP and simultaneous penile prosthesis implantation (PPI) in order to preserve the full length of the penis and to improve patients' satisfaction. Materials and Methods From June 2013 to June 2014, 10 patients underwent simultaneous PPI (with an AMS InhibiZone prosthesis) and RP. Patients were evaluated by means of urological visits, questionnaires, and objective measurements before surgery, at discharge from the hospital, on postoperative days 21 to 28, each 3 months for the first year, and each 6 months thereafter. The main outcome measures were biochemical recurrence-free rate, penile length, and quality of life. Results Ten patients (mean age of 61 years; completed the study follow-up period (median, 32.2 months). No difference was found between the time of surgery and the 2-year follow-up evaluation in terms of penile length. The pre-surgery 36-Item Short Form Health Survey (SF-36) median score was 97. Patients were satisfied with their penile implants, and couples' level of sexual satisfaction was rated median 8. The median postoperative SF-36 score was 99 at 3 months follow-up. Conclusions Laparoscopic extraperitoneal RP surgery with simultaneous PPI placement seems to be an interesting possibility to propose to motivated patients for preserving the length of the penis and improving their satisfaction. PMID:29623695

Evaluation of Satisfaction Level in Patients With Mandibular Implant Supported Overdentures

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Masoumeh khoshhal

2016-01-01

Full Text Available Background Implant-supported overdentures could have many benefits for patients, especially in the lower jaws. As a matter of fact, the most common reason for prescribing mandibular overdenture is dissatisfaction of patients with mandibular dentures usually because of a lack of retention, stability and function and speech difficulties. On the other hand, patients' expectations of overdenture treatments are their main disadvantage. Objectives The aim of this study was to evaluate the satisfaction of patients who had received mandibular implant supported overdenture treatment with different number of implants. Patients and Methods This study was a descriptive cross-sectional study. Twenty-five patients with a mean age of 62.7 years who had received mandibular implant supported overdenture treatment at the dental school of Hamadan University of Medical Sciences were enrolled. Among these patients, six had overdentures supported by one implant, nine had overdentures supported by two implants, two had overdentures supported by three implants, five had overdentures supported by four implants and three had overdentures supported by five implants. The visual analogue scale (VAS questionnaire was used to evaluate the general satisfaction, comfort, esthetic, fitness, satisfaction of chewing and social communication, and the data was analyzed by the analysis of variance (ANOVA test. Results All patients in all five groups were satisfied with their overdentures; however there was no significant relationship between the number of implants and fitness (P = 0.446, esthetic (P = 0.843, comfort (P = 0.805, satisfaction of chewing (P = 0.133, social communication (P = 0.322 and general satisfaction (P = 0.493. Conclusions There was no difference in satisfaction level of patients who had received mandibular overdentures with different number of implants.

Multidisciplinary approach of ectodermal dysplasia with implant retained fixed prosthesis

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Vishnu Priya

2013-01-01

Full Text Available Ectodermal dysplasia represents a group of rare inherited conditions in which two or more ectodermally derived anatomical structures fail to develop. Early dental intervention can improve patient′s appearance, thereby minimizing associated emotional and psychological problems in these patients. Treatment requires a teamwork by medical personnel along with dental professionals of various specialties. Here, a rare case of a young female patient is presented with prosthetic management with implant supported fixed partial denture.

Optimization of Visual Information Presentation for Visual Prosthesis

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Fei Guo

2018-01-01

Full Text Available Visual prosthesis applying electrical stimulation to restore visual function for the blind has promising prospects. However, due to the low resolution, limited visual field, and the low dynamic range of the visual perception, huge loss of information occurred when presenting daily scenes. The ability of object recognition in real-life scenarios is severely restricted for prosthetic users. To overcome the limitations, optimizing the visual information in the simulated prosthetic vision has been the focus of research. This paper proposes two image processing strategies based on a salient object detection technique. The two processing strategies enable the prosthetic implants to focus on the object of interest and suppress the background clutter. Psychophysical experiments show that techniques such as foreground zooming with background clutter removal and foreground edge detection with background reduction have positive impacts on the task of object recognition in simulated prosthetic vision. By using edge detection and zooming technique, the two processing strategies significantly improve the recognition accuracy of objects. We can conclude that the visual prosthesis using our proposed strategy can assist the blind to improve their ability to recognize objects. The results will provide effective solutions for the further development of visual prosthesis.

Optimization of Visual Information Presentation for Visual Prosthesis

Science.gov (United States)

Gao, Yong

2018-01-01

Visual prosthesis applying electrical stimulation to restore visual function for the blind has promising prospects. However, due to the low resolution, limited visual field, and the low dynamic range of the visual perception, huge loss of information occurred when presenting daily scenes. The ability of object recognition in real-life scenarios is severely restricted for prosthetic users. To overcome the limitations, optimizing the visual information in the simulated prosthetic vision has been the focus of research. This paper proposes two image processing strategies based on a salient object detection technique. The two processing strategies enable the prosthetic implants to focus on the object of interest and suppress the background clutter. Psychophysical experiments show that techniques such as foreground zooming with background clutter removal and foreground edge detection with background reduction have positive impacts on the task of object recognition in simulated prosthetic vision. By using edge detection and zooming technique, the two processing strategies significantly improve the recognition accuracy of objects. We can conclude that the visual prosthesis using our proposed strategy can assist the blind to improve their ability to recognize objects. The results will provide effective solutions for the further development of visual prosthesis. PMID:29731769

Mandibular implant-supported overdentures: attachment systems, and number and locations of implants--Part I.

Science.gov (United States)

Warreth, Abdulhadi; Alkadhimi, Aslam Fadel; Sultan, Ahmed; Byrne, Caroline; Woods, Edel

2015-01-01

The use of dental implants in replacing missing teeth is an integral part of restorative dental treatment. Use of conventional complete dentures is associated with several problems such as lack of denture stability, support and retention. However, when mandibular complete dentures were used with two or more implants, an improvement in the patients' psychological and social well-being could be seen. There is general consensus that removable implant-supported overdentures (RISOs) with two implants should be considered as the first-choice standard of care for an edentulous mandible. This treatment option necessitates the use of attachment systems that connect the complete denture to the implant. Nevertheless, each attachment system has its inherent advantages and disadvantages, which should be considered when choosing a system. The first part of this article provides an overview on options available to restore the mandibular edentulous arch with dental implants. Different types of attachment systems, their features and drawbacks are also reviewed.

Metabolic Pattern of Asymptomatic Hip-Prosthesis by 18F-FDG-Positron-Emission-Tomography

International Nuclear Information System (INIS)

Beslic, Nermina; Heber, Daniel; Walter Lipp, Rainer; Sonneck-Koenne, Charlotte; Knoll, Peter; Mirzaei, Siroos

2015-01-01

Joint replacement is a procedure with a major impact on the quality of life of patients with joint degenerative disease or traumatic injuries. However, some patients develop symptoms after the intervention caused by mechanical loosening or infection. Metabolic imaging by 18F-FDG-PET investigated in these patients isoften hampered by low specificity for diagnosis of possible septic vs. mechanical loosening. The reason for this shortcoming is to our opinion the unawareness of physiological remodeling processes that could be seen in asymptomatic patients. In order to overcome this drawback, we aimed to find out the physiological metabolic functional pattern in asymptomatic patients with implanted hip prosthesis Twelve patients (6 males, 6 females); mean age 73 ± 7 (range 58 - 91) years were prospectively enrolled in the study. The patients were admitted to our department for oncological referral with implanted hip prostheses. All patients explained no symptoms with regard to their implanted prosthesis. The attenuation corrected images were used for analysis. Fourteen hip prostheses in 12 patients were visually analyzed. Seven out of 14 prostheses among 12 patients showed focal periprosthetic enhanced metabolism, two of which showed two sites of enhanced uptake; whereas, the remaining five prostheses showed singular hypermetabolic areas within the periprosthetic site. The remaining seven prostheses in the other five patients showed no periprosthetic-enhanced uptake. Of the asymptomatic patients investigated, 58% showed focal enhanced periprosthetic glucose metabolism. This finding should be taken into consideration as a more probable unspecific metabolic pattern for correct interpretation of 18F-FDG-PET studies in patients with suspected septic loosening of the hip prosthesis

Evaluation of 4 mm implants in mandibular edentulous patients with reduced bone height. Surgical preliminary results

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J.L. Calvo-Guirado

2014-06-01

Full Text Available Aim: Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this short comunication was to evaluate the clinical use of implants < 10 mm in length and to determine short implant-supported prosthesis success in the atrophic jaw. Materials and methods: Six women and three men were recruited for the treatment of edentulous mandibles. A total of 6 implants were inserted in each patient: two anterior implants of conventional lenght and four posterior 4 mm Titanium Zirconium (TiZr implants. The insertion torque and bone denisty were evaluated. Results: The mean insertion torque for the 4 mm implants was lower than for conventional ones, without any statistical difference. Moreover, most of the patients (88% showed a D2 bone type. Conclusion: The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

Early implant placement for a patient with ectodermal dysplasia: Thirteen years of clinical care.

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Knobloch, Lisa A; Larsen, Peter E; Saponaro, Paola C; L'Homme-Langlois, Emilie

2017-11-29

Patients with ectodermal dysplasia have abnormalities of 2 or more structures that originate from the ectoderm. The oral manifestations often include the congenital absence of teeth and malformed teeth. This clinical report describes the interdisciplinary care from childhood through the definitive dental rehabilitation completed at skeletal maturation to replace the missing teeth in a patient with ectodermal dysplasia. Treatment began at 9 years of age with an implant-assisted mandibular overdenture to improve function and replace the missing mandibular teeth. Orthodontic treatment for the consolidation of space, composite resin restorations, and interim removable dental prostheses were provided to improve esthetics and replace the missing maxillary teeth. Skeletal growth was monitored, and orthognathic surgery was performed at the cessation of growth. The definitive rehabilitation consisted of a mandibular fixed dental prosthesis supported by dental implants and a maxillary removable dental prosthesis to restore the patient to esthetics and function. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Short dental implants versus standard dental implants placed in the posterior jaws: A systematic review and meta-analysis.

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Lemos, Cleidiel Aparecido Araujo; Ferro-Alves, Marcio Luiz; Okamoto, Roberta; Mendonça, Marcos Rogério; Pellizzer, Eduardo Piza

2016-04-01

The purpose of the present systematic review and meta-analysis was to compare short implants (equal or less than 8mm) versus standard implants (larger than 8mm) placed in posterior regions of maxilla and mandible, evaluating survival rates of implants, marginal bone loss, complications and prosthesis failures. This review has been registered at PROSPERO under the number CRD42015016588. Main search terms were used in combination: dental implant, short implant, short dental implants, short dental implants posterior, short dental implants maxilla, and short dental implants mandible. An electronic search for data published up until September/2015 was undertaken using the PubMed/Medline, Embase and The Cochrane Library databases. Eligibility criteria included clinical human studies, randomized controlled trials and/or prospective studies, which evaluated short implants in comparison to standard implants in the same study. The search identified 1460 references, after inclusion criteria 13 studies were assessed for eligibility. A total of 1269 patients, who had received a total of 2631 dental implants. The results showed that there was no significant difference of implants survival (P=.24; RR:1.35; CI: 0.82-2.22), marginal bone loss (P=.06; MD: -0.20; CI: -0.41 to 0.00), complications (P=.08; RR:0.54; CI: 0.27-1.09) and prosthesis failures (P=.92; RR:0.96; CI: 0.44-2.09). Short implants are considered a predictable treatment for posterior jaws. However, short implants with length less than 8 mm (4-7 mm) should be used with caution because they present greater risks to failures compared to standard implants. Short implants are frequently placed in the posterior area in order to avoid complementary surgical procedures. However, clinicians need to be aware that short implants with length less than 8mm present greater risk of failures. Copyright © 2016. Published by Elsevier Ltd.

SU-E-J-230: Effect of Metal Hip Prosthesis On the Accuracy of Electromagnetic Localization and Tracking

International Nuclear Information System (INIS)

Butler, W; Merrick, G; Kurko, B; Bittner, N

2014-01-01

Purpose: To quantify the effect of metal hip prosthesis on the ability to track and localize electromagnetic transponders. Methods: Three Calypso transponders were implanted into two prostate phantoms. The geometric center of the transponders were identified on computed tomography and set as the isocenter. With the phantom stationary on the treatment table and the tracking array 14-cm above the isocenter, data was acquired by the Calypso system at 10 Hz to establish the uncertainty in measurements. Transponder positional data was acquired with unilateral hip prostheses of different metallic compositions and then with bilateral hips placed at variable separation from the phantom. Results: Regardless of hip prosthesis composition, the average vector displacement in the presence of a unilateral prosthesis was < 0.5 mm. The greatest contribution to overall vector displacement occurred in the lateral dimension. With bilateral hip prosthesis, the average vector displacement was 0.3 mm. The displacement in the lateral dimension was markedly reduced compared with a unilateral hip, suggesting that there was a countervailing effect with bilateral hip prosthesis. The greatest average vector displacement was 0.6 mm and occurred when bilateral hip prostheses were placed within 4 cm of the detector array. Conclusion: Unilateral and bilateral hip prostheses did not have any meaningful effect on the ability to accurately track electromagnetic transponders implanted in a prostate phantom. At clinically realistic distances between the hip and detection array, the average tracking error is negligible

Prosthesis-patient mismatch after transcatheter aortic valve implantation: impact of 2D-transthoracic echocardiography versus 3D-transesophageal echocardiography.

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da Silva, Cristina; Sahlen, Anders; Winter, Reidar; Bäck, Magnus; Rück, Andreas; Settergren, Magnus; Manouras, Aristomenis; Shahgaldi, Kambiz

2014-12-01

To investigate the role of 2D-transthoracic echocardiography (2D-TTE) and 3D-transesophageal echocardiography (3D-TEE) in the determination of aortic annulus size prior transcatheter aortic valve implantation (TAVI) and its' impact on the prevalence of patient prosthesis mismatch (PPM). Echocardiography plays an important role in measuring aortic annulus dimension in patients undergoing TAVI. This has great importance since it determines both eligibility for TAVI and selection of prosthesis type and size, and can be potentially important in preventing an inadequate ratio between the prosthetic valvular orifice and the patient's body surface area, concept known as prosthesis-patient mismatch (PPM). A total of 45 patients were studied pre-TAVI: 20 underwent 3D-TEE (men/women 12/8, age 84.8 ± 5.6) and 25 2D-TTE (men/women 9/16, age 84.4 ± 5.4) in order to measure aortic annulus diameter. The presence of PPM was assessed before hospital discharge and after a mean period of 3 months. Moderate PPM was defined as indexed aortic valve area (AVAi) ≤ 0.85 cm(2)/m(2) and severe PPM as AVAi 3D-TEE and 2D-TTE respectively p value = n.s) and severe PPM occurred in 10 % of the patients who underwent 3D-TEE and in 20 % in those with 2D-TTE (p value = n.s). The echocardiographic evaluation 3 months post-TAVI showed 25 % moderate PPM in the 3D-TEE group compared with 24 % in the 2D-TTE group (p value = n.s) and no cases of severe PPM in the 3DTEE group comparing to 20 % in the 2D-TTE group (p = 0.032). Our results indicate a higher incidence of severe PPM in patients who performed 2DTTE compared to those performing 3DTEE prior TAVI. This suggests that the 3D technique should replace the 2DTTE analysis when investigating the aortic annulus diameter in patients undergoing TAVI.

Antibiotic use at dental implant placement.

Science.gov (United States)

Veitz-Keenan, Analia; Keenan, James R

2015-06-01

Cochrane Oral Health Groups Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID and EMBASE via OVID. Databases were searched with no language or date restrictions. Two authors independently reviewed the titles and the abstracts for inclusion. Disagreements were resolved by discussion. If needed, a third author was consulted. Included were randomised clinical trials with a follow-up of at least three months which evaluated the use of prophylactic antibiotic compared to no antibiotic or a placebo and examined different antibiotics of different doses and durations in patients undergoing dental implant placement. The outcomes were implant failure (considered as implant mobility, removal of implant due to bone loss or infection) and prosthesis failure (prosthesis could not be placed). Standard Cochrane methodology procedures were followed. Risk of bias was completed independently and in duplicate by two review authors. Results were expressed as risk ratios (RRs) using a random-effects model for dichotomous outcomes with 95% confidence intervals (CI). The statistical unit was the participant and not the prosthesis or implant. Heterogeneity including both clinical and methodological factors was investigated. Six randomised clinical trials with 1162 participants were identified for the review. Three trials compared 2 g of preoperative amoxicillin versus placebo (927 participants). One trial compared 3 g of preoperative amoxicillin versus placebo (55 participants). Another trial compared 1 g of preoperative amoxicillin plus 500 mg four times a day for two days versus no antibiotic (80 participants). An additional trial compared four groups: (1) 2 g of preoperative amoxicillin; (2) 2 g of preoperative amoxicillin plus 1 g twice a day for seven days; (3) 1 g of postoperative amoxicillin twice a day for seven days and (4) no antibiotics (100 participants). The overall body of the evidence was considered moderate.The meta-analysis of the

Fracture Resistance and Mode of Failure of Ceramic versus Titanium Implant Abutments and Single Implant-Supported Restorations.

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Sghaireen, Mohd G

2015-06-01

The material of choice for implant-supported restorations is affected by esthetic requirements and type of abutment. This study compares the fracture resistance of different types of implant abutments and implant-supported restorations and their mode of failure. Forty-five Oraltronics Pitt-Easy implants (Oraltronics Dental Implant Technology GmbH, Bremen, Germany) (4 mm diameter, 10 mm length) were embedded in clear autopolymerizing acrylic resin. The implants were randomly divided into three groups, A, B and C, of 15 implants each. In group A, titanium abutments and metal-ceramic crowns were used. In group B, zirconia ceramic abutments and In-Ceram Alumina crowns were used. In group C, zirconia ceramic abutments and IPS Empress Esthetic crowns were used. Specimens were tested to failure by applying load at 130° from horizontal plane using an Instron Universal Testing Machine. Subsequently, the mode of failure of each specimen was identified. Fracture resistance was significantly different between groups (p Empress crowns supported by zirconia abutments had the lowest fracture loads (p = .000). Fracture modes of metal-ceramic crowns supported by titanium abutments included screw fracture and screw bending. Fracture of both crown and abutment was the dominant mode of failure of In-Ceram/IPS Empress crowns supported by zirconia abutments. Metal-ceramic crowns supported by titanium abutments were more resistant to fracture than In-Ceram crowns supported by zirconia abutments, which in turn were more resistant to fracture than IPS Empress crowns supported by zirconia abutments. In addition, failure modes of restorations supported by zirconia abutments were more catastrophic than those for restorations supported by titanium abutments. © 2013 Wiley Periodicals, Inc.

Adhesive strength of hydroxyl apatite(HA) coating and biomechanics behavior of HA-coated prosthesis:an experimental study

OpenAIRE

Tian-yang ZHANG; Yong-hong DUAN; Shu ZHU; Jin-yu ZHU; Qing-sheng ZHU

2011-01-01

Objective To explore the influence of adhesive strength of hydroxyapatite(HA) coating on the post-implantation stability of HA-coated prosthesis.Methods The adhesive strength and biomechanics behavior of HA coating were studied by histopathological observation,material parameters and biomechanical testing,the titanium(Ti)-coated prosthesis was employed as control.Results Scratch test showed that the adhesive strength of HA coating was significantly lower than that of Ti coating(P < 0.01).Hist...

One-year results of maxillary overdentures supported by 2 titanium-zirconium implants - implant survival rates and radiographic outcomes.

Science.gov (United States)

Zembic, Anja; Tahmaseb, Ali; Jung, Ronald E; Wismeijer, Daniel

2017-07-01

To assess implant survival rates and peri-implant bone loss of 2 titanium-zirconium implants supporting maxillary overdentures at 1 year of loading. Twenty maxillary edentulous patients (5 women and 15 men) being dissatisfied with their complete dentures were included. In total, 40 diameter-reduced titanium-zirconium implants were placed in the anterior maxilla. Local guided bone regeneration (GBR) was allowed if the treatment did not compromise implant stability. Following 3 to 5 months of healing, implant-supported overdentures were inserted on two ball anchors. Implants and overdentures were assessed at 1, 2, 4, and 8 weeks after implant insertion and 2, 4, and 12 months after insertion of overdentures (baseline). Standardized radiographs were taken at implant loading and 1 year. Implant survival rates and bone loss were the primary outcomes. Nineteen patients (1 dropout) with 38 implants were evaluated at a mean follow-up of 1.1 years (range 1.0-1.7 years). One implant failed resulting in an implant survival rate of 97.3%. There was a significant peri-implant bone loss of the implants at 1 year of function (mean, 0.7 mm, SD = 1.1 mm; median: 0.48 mm, IQR = 0.56 mm). There was a high 1-year implant survival rate for edentulous patients receiving 2 maxillary implants and ball anchors as overdenture support. However, several implants exhibited an increased amount of bone loss of more than 2 mm. Overdentures supported by 2 maxillary implants should thus be used with caution as minimally invasive treatment for specific patients encountering problems with their upper dentures until more long-term data is available. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Survival Rate of Dental Implants in Patients with History of Periodontal Disease: A Retrospective Cohort Study.

Science.gov (United States)

Correia, Francisco; Gouveia, Sónia; Felino, António Campos; Costa, Ana Lemos; Almeida, Ricardo Faria

To evaluate the differences between the survival rates of implants placed in patients with no history of periodontal disease (NP) and in patients with a history of chronic periodontal disease (CP). A retrospective cohort study was conducted in which all consenting patients treated with dental implants in a private clinic in Oporto, Portugal, from November 2, 2002 through February 11, 2011 were included. All patients were treated consecutively by the same experimental operator. This study aimed to analyze how the primary outcomes (presence of disease, time of placement, and time of loading) and the secondary outcomes (severity-generalized periodontitis, brand, implant length, prosthesis type, prosthesis metal-ceramic extension) influence the survival rate of dental implants. The survival analysis was performed through the Kaplan-Meier method, and the equality of survival distributions for all groups was tested with the log-rank test with a significance level of .05 for all comparisons. The sample consisted of 202 patients (47% NP and 53% CP) and 689 implants (31% NP and 69% CP). The survival rate in the NP and CP groups showed no statistically significant differences (95.8% versus 93.1%; P ≥ .05). Implants were lost before loading in 54.9% of the cases. The majority of the implants were lost in the first year and stabilized after the second year. Survival rates in the NP and CP patients showed no statistically significant differences when comparing the following factors: subclassification of the disease, implant brands, implant length (short/standard), type of prosthesis, extension of the prosthesis metal-ceramic, and time of placement and loading (P ≥ .05). This work disclosed no statistically significant differences in terms of survival rates when compared with the control group. Placing implants in patients with a history of periodontal disease appears to be viable and safe.

Voxel-based registration of simulated and real patient CBCT data for accurate dental implant pose estimation

Science.gov (United States)

Moreira, António H. J.; Queirós, Sandro; Morais, Pedro; Rodrigues, Nuno F.; Correia, André Ricardo; Fernandes, Valter; Pinho, A. C. M.; Fonseca, Jaime C.; Vilaça, João. L.

2015-03-01

The success of dental implant-supported prosthesis is directly linked to the accuracy obtained during implant's pose estimation (position and orientation). Although traditional impression techniques and recent digital acquisition methods are acceptably accurate, a simultaneously fast, accurate and operator-independent methodology is still lacking. Hereto, an image-based framework is proposed to estimate the patient-specific implant's pose using cone-beam computed tomography (CBCT) and prior knowledge of implanted model. The pose estimation is accomplished in a threestep approach: (1) a region-of-interest is extracted from the CBCT data using 2 operator-defined points at the implant's main axis; (2) a simulated CBCT volume of the known implanted model is generated through Feldkamp-Davis-Kress reconstruction and coarsely aligned to the defined axis; and (3) a voxel-based rigid registration is performed to optimally align both patient and simulated CBCT data, extracting the implant's pose from the optimal transformation. Three experiments were performed to evaluate the framework: (1) an in silico study using 48 implants distributed through 12 tridimensional synthetic mandibular models; (2) an in vitro study using an artificial mandible with 2 dental implants acquired with an i-CAT system; and (3) two clinical case studies. The results shown positional errors of 67+/-34μm and 108μm, and angular misfits of 0.15+/-0.08° and 1.4°, for experiment 1 and 2, respectively. Moreover, in experiment 3, visual assessment of clinical data results shown a coherent alignment of the reference implant. Overall, a novel image-based framework for implants' pose estimation from CBCT data was proposed, showing accurate results in agreement with dental prosthesis modelling requirements.

Utilization of 3D/Dental software for precise implant site selection: clinical reports.

Science.gov (United States)

Kraut, R A

1992-01-01

Preoperative planning is an essential aspect of endosteal implant placement. Three-dimensional imaging allows the surgeon and restorative dentist to accurately visualize potential implant receptor sites relative to adjacent vital structures. This information is correlated with the planned occlusion, and transferred to the patient by means of a surgical prosthetic guide, which is developed on the diagnostic cast. The steps involved in planning and placing implants in an atrophic mandible in the first case illustrates the value of three-dimensional scanning in treating patients with limited bone volume. The second case presented with a mandibular bilateral distal extension partial denture, which was ultimately replaced with two implant-supported fixed prostheses. The use of three-dimensional imaging showed the location of the inferior alveolar neurovascular bundle which allowed utilization of all of the bone above it without encroaching on the nerve. The third case illustrates an edentulous maxilla where visualization of the osseous contour allowed for implant placement at an optimal angulation to provide support for the planned prosthesis.

Wear Particles Promote Reactive Oxygen Species-Mediated Inflammation via the Nicotinamide Adenine Dinucleotide Phosphate Oxidase Pathway in Macrophages Surrounding Loosened Implants

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Weishen Chen

2015-03-01

Full Text Available Background/Aims: Prosthesis loosening is closely associated with chronic inflammatory cytokine secretion by macrophages, which are activated by wear particles or inflammatory stimulants such as lipopolysaccharide (LPS. Reactive oxygen species (ROS are critical regulators of inflammation, but their enzymatic sources in response to wear particles and their effects on peri-implant LPS-tolerance remain unclear. Methods: Three ROS-related enzymes—nicotinamide adenine dinucleotide phosphate oxidase (NOX-1 and -2 and catalase—were investigated in interface membrane tissues and in titanium (Ti particle-stimulated macrophages in vitro. The generation of ROS and downstream inflammatory effects were measured with or without pre-incubation with apocynin, an NOX inhibitor. Results: Pre-exposure to Ti particles attenuated NF-κB activation in LPS-stimulated macrophages, indicating that wear particles suppress immune response, which may lead to chronic inflammation. NOX-1 and -2 were highly expressed in aseptically loosened interface membranes and in macrophages stimulated with Ti particles; the particles induced a moderate amount of ROS generation, NF-κB activation, and TNF-a secretion in macrophages, and these effects were suppressed by apocynin. Conclusion: Wear particles induce ROS generation through the NOX signaling pathway, resulting in persistent inflammation and delayed loosening. Thus, the suppression of NOX activity may be a useful strategy for preventing prosthesis loosening.

A fully organic retinal prosthesis restores vision in a rat model of degenerative blindness

Science.gov (United States)

Maya-Vetencourt, José Fernando; Ghezzi, Diego; Antognazza, Maria Rosa; Colombo, Elisabetta; Mete, Maurizio; Feyen, Paul; Desii, Andrea; Buschiazzo, Ambra; di Paolo, Mattia; di Marco, Stefano; Ticconi, Flavia; Emionite, Laura; Shmal, Dmytro; Marini, Cecilia; Donelli, Ilaria; Freddi, Giuliano; Maccarone, Rita; Bisti, Silvia; Sambuceti, Gianmario; Pertile, Grazia; Lanzani, Guglielmo; Benfenati, Fabio

2017-06-01

The degeneration of photoreceptors in the retina is one of the major causes of adult blindness in humans. Unfortunately, no effective clinical treatments exist for the majority of retinal degenerative disorders. Here we report on the fabrication and functional validation of a fully organic prosthesis for long-term in vivo subretinal implantation in the eye of Royal College of Surgeons rats, a widely recognized model of retinitis pigmentosa. Electrophysiological and behavioural analyses reveal a prosthesis-dependent recovery of light sensitivity and visual acuity that persists up to 6-10 months after surgery. The rescue of the visual function is accompanied by an increase in the basal metabolic activity of the primary visual cortex, as demonstrated by positron emission tomography imaging. Our results highlight the possibility of developing a new generation of fully organic, highly biocompatible and functionally autonomous photovoltaic prostheses for subretinal implants to treat degenerative blindness.

Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study

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Nicolò Cavalli

2012-01-01

Full Text Available Purpose. The aims of this study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants in the edentulous maxilla and to evaluate the incidence of biological and prosthetic complications. Materials and Methods. Thirty-four patients (18 women and 16 men were included in the study. Each patient received a maxillary full-arch fixed bridge supported by two axial implants and two distal tilted implants. A total of 136 implants were inserted. Loading was applied within 48 hours of surgery and definitive restorations were placed 4 to 6 months later. Patients were scheduled for followup at 6, 12, 18, and 24 months and annually up to 5 years. At each followup plaque level and bleeding scores were assessed and every complication was recorded. Results. The overall follow-up range was 12 to 73 months (mean 38.8 months. No implant failures were recorded to date, leading to a cumulative implant survival rate of 100%. Biological complications were recorded such as alveolar mucositis (11.8% patients, peri-implantitis (5.9% patients, and temporomandibular joint pain (5.9% patients. The most common prosthetic complications were the fracture or detachment of one or multiple acrylic teeth in both the temporary (20.6% patients and definitive (17.7% patients prosthesis and the minor acrylic fractures in the temporary (14.7% patients and definitive (2.9% patients prosthesis. Hygienic complications occurred in 38.2% patients. No patients’ dissatisfactions were recorded. Conclusions. The high cumulative implant survival rate indicates that this technique could be considered a viable treatment option. An effective recall program is important to early intercept and correct prosthetic and biologic complications in order to avoid implant and prosthetic failures.

Design and Control of a Pneumatically Actuated Transtibial Prosthesis.

Science.gov (United States)

Zheng, Hao; Shen, Xiangrong

2015-04-01

This paper presents the design and control of a pneumatically actuated transtibial prosthesis, which utilizes a pneumatic cylinder-type actuator to power the prosthetic ankle joint to support the user's locomotion. The pneumatic actuator has multiple advantages over the traditional electric motor, such as light weight, low cost, and high power-to-weight ratio. The objective of this work is to develop a compact and lightweight transtibial prosthesis, leveraging the multiple advantages provided by this highly competitive actuator. In this paper, the design details of the prosthesis are described, including the determination of performance specifications, the layout of the actuation mechanism, and the calculation of the torque capacity. Through the authors' design calculation, the prosthesis is able to provide sufficient range of motion and torque capacity to support the locomotion of a 75 kg individual. The controller design is also described, including the underlying biomechanical analysis and the formulation of the finite-state impedance controller. Finally, the human subject testing results are presented, with the data indicating that the prosthesis is able to generate a natural walking gait and sufficient power output for its amputee user.

The Efficacy of Supportive Peri-Implant Therapies in Preventing Peri-Implantitis and Implant Loss: a Systematic Review of the Literature

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Ausra Ramanauskaite

2016-09-01

Full Text Available Objectives: To study the efficacy of supportive peri-implant therapies in preventing clinical and radiological signs of peri-implantitis and implant loss. Material and Methods: Longitudinal human studies, published between January 1, 2006, and February 1, 2016, were included based on an electronic search using MEDLINE and EMBASE databases and complemented by a manual search. Articles were included only if 1 they comprised a group of patients involved in/adhering to regular supportive peri-implant therapies (SPTs and a control group without such therapies or with poor adherence to them, 2 the protocol of the SPTs was clearly described and 3 the outcome was indicated by means of clinical/radiological changes or implant loss. Results: After initially identifying a total of 710 titles and abstracts, 12 full text articles were selected for eligibility assessment. Seven studies, three prospective and four retrospective, fulfilled the inclusion criteria for this review. The frequency of recall visits varied between the studies from a minimum of one visit every three months to an individually tailored regimen. In all the studies a lack of SPTs or poor adherence to them resulted in significantly higher frequencies of sites with mucosal bleeding, deepened peri-implant pockets or alveolar bone loss. In line with the above, a lack of/poor adherence to SPTs was associated with higher implant loss. Conclusions: To prevent peri-implantitis, an individually tailored supportive programme based on patient motivation and re-instruction in oral hygiene measures combined with professional implant cleaning seem to be crucial.

Immediate occluding definitive partial fixed prosthesis versus non-occluding provisional restorations - 4-month post-loading results from a pragmatic multicenter randomised controlled trial.

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Heinemann, Friedhelm; Grufferty, Brendan; Papavasiliou, George; Dominiak, Marzena; García, Jaime Jiménez; Trullenque-Eriksson, Anna; Esposito, Marco

2016-01-01

To compare the clinical outcome of dental implants restored with definitive occluding partial fixed prostheses within 1 week, after implant placement with immediate non-occluding provisional restorations, which were to be replaced by definitive prostheses after 4 months. Fifty partially edentulous patients treated with one to three dental implants, at least 8.5 mm long and 4.0 mm wide inserted with a torque of at least 35 Ncm, were randomised in two groups of 25 patients each, to be immediately loaded with partial fixed prostheses. Patients of one group received one definitive screw-retained metal-ceramic prosthesis in occlusion within 1 week after placement. Patients of the other group received one non-occluding provisional acrylic reinforced prosthesis within 24 h after implant placement. Provisional prostheses were replaced after 4 months by definitive ones. The follow-up for all patients was 4-months post-loading. Outcome measures were prosthesis and implant failures, any complications, peri-implant marginal bone level changes, aesthetic evaluation by a clinician, patient satisfaction, chair time and number of visits at the dental office from implant placement to delivery of definitive restorations. No patient dropped out. Two immediately occlusally loaded implants with their related definitive prostheses (8%) failed early (difference in proportions = 0.08; 95% CI: -0.03 to 0.19; P = 0.490). Four complications occurred in the occlusal group versus one in the non-occlusal group; (difference in proportions = 0.12; 95% CI: -0.04 to 0.28; P = 0.349). Four months after loading, patients subjected to non-occlusal loading lost an average of 0.72 mm of peri-implant bone versus 0.99 mm of patients restored with occluding definitive partial fixed prostheses. There were no statistically significant differences for marginal bone level changes between the two groups (mean difference = -0.27 mm; 95% CI: -0.84 to 0.30; P = 0.349). The differences for aesthetic scores showed

Noninvasive radioisotopic technique for detection of platelet deposition in mitral valve prosthesis and renal microembolism in dogs

International Nuclear Information System (INIS)

Dewanjee, M.K.; Kaye, M.P.; Fuster, V.; Rao, S.A.

1980-01-01

At 24 hrs after implantation of Bjoerk-Shiley mitral prosthesis in 5 dogs, in vivo images were obtained with a gamma camera after intravenous administration (0.5-0.6 mCi) one hour postoperatively of autologous Indium-111-labeled platelets. The site of platelet deposition in the teflon ring and perivascular damaged cardiac tissue is clearly delineated in the scintiphoto. In vitro biodistribution (mean % +/- SD of injected dose) at 24 hrs after injection of the 5 implanted and 7 normal dogs performed with a gamma counter demonstrated that (45.1 +/- 10.6)% and (0.7 +/- 0.4)% were in blood and kidneys in normal dogs and (28.5 +/- 6.8)%, (1.6 +/- 0.6)%, (0.3 +/- 0.1)%, and (0.2 +/- 0.1)% were in blood, kidneys, teflon rings, and perivascular damaged cardiac tissue, respectively. The strut and pyrolytic carbon-coated disc retained only (0.0033 +/- 0.0004)% and (0.0031 +/- 0.0003)%, respectively. There was a 2.3-fold increase of labeled platelets in kidneys of implanted dogs due to renal trapping of microembolism. Also, three- to fivefold increase in ratios of lung, brain, cardiac, and skeletal muscle to blood indicates that internal organs and whole body work as filter for microembolism generated by cardiovascular surgery and mitral prosthesis. Twenty percent of the administered platelets are consumed in surgical repair of damaged tissue. Indium-111-labeled platelets thus provide a sensitive marker for noninvasive imaging of Bjoerk-Shiley mitral prosthesis, thromboembolism after implantation of prosthetic device, and in vitro quantitation of surgical consumption

A Medical Wireless Measurement System for Hip Prosthesis Loosening Detection Based on Vibration Analysis

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Sebastian Sauer

2013-01-01

Full Text Available Vibration analysis is a promising approach in order to detect early hip prosthesis loosening, with the potential to extend the range of diagnostic tools currently available in clinical routine. Ongoing research efforts and developments in the area of multi-functional implants, which integrate sensors, wireless power supply, communication and signal processing, provide means to obtain valuable in vivo information otherwise not available. In the current work a medical wireless measurement system is presented, which is integrated in the femoral head of a hip prosthesis. The passive miniaturized system includes a 3-axis acceleration sensor and signal pre-processing based on a lock-in amplifier circuit. Bidirectional data communication and power supply is reached through inductive coupling with an operating frequency of 125 kHz in accordance with the ISO 18000-2 protocol standard. The system allows the acquisition of the acceleration frequency response of the femur-prosthesis system between 500 to 2500 Hz. Applied laboratory measurements with system prototypes on artificial bones and integrated prostheses demonstrate the feasibility of the measurement system approach, clearly showing differences in the vibration behavior due to an implant loosening. In addition a possibility to evaluate the non-linear mechanic system behavior is presented.

Manufacturing Implant Supported Auricular Prostheses by Rapid Prototyping Techniques

OpenAIRE

Karatas, Meltem Ozdemir; Cifter, Ebru Demet; Ozenen, Didem Ozdemir; Balik, Ali; Tuncer, Erman Bulent

2011-01-01

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadv...

Effect of different types of prosthetic platforms on stress-distribution in dental implant-supported prostheses

Energy Technology Data Exchange (ETDEWEB)

Minatel, Lurian [Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, USC, 10–50 Irmã Armindal, Jardim Brasil, Bauru, 17011–160, SP (Brazil); Verri, Fellippo Ramos [Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, 1193 José Bonifácio Street, Vila Mendonça, Araçatuba 16015–050 (Brazil); Kudo, Guilherme Abu Halawa [Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, USC, 10–50 Irmã Armindal, Jardim Brasil, Bauru, 17011–160, SP (Brazil); Faria Almeida, Daniel Augusto de; Souza Batista, Victor Eduardo de; Aparecido Araujo Lemos, Cleidiel; Piza Pellizzer, Eduardo [Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, 1193 José Bonifácio Street, Vila Mendonça, Araçatuba 16015–050 (Brazil); and others

2017-02-01

A biomechanical analysis of different types of implant connections is relevant to clinical practice because it may impact the longevity of the rehabilitation treatment. Therefore, the objective of this study is to evaluate the Morse taper connections and the stress distribution of structures associated with the platform switching (PSW) concept. It will do this by obtaining data on the biomechanical behavior of the main structure in relation to the dental implant using the 3-dimensional finite element methodology. Four models were simulated (with each containing a single prosthesis over the implant) in the molar region, with the following specifications: M1 and M2 is an external hexagonal implant on a regular platform; M3 is an external hexagonal implant using PSW concept; and M4 is a Morse taper implant. The modeling process involved the use of images from InVesalius CT (computed tomography) processing software, which were refined using Rhinoceros 4.0 and SolidWorks 2011 CAD software. The models were then exported into the finite element program (FEMAP 11.0) to configure the meshes. The models were processed using NeiNastram software. The main results are that M1 (regular diameter 4 mm) had the highest stress concentration area and highest microstrain concentration for bone tissue, dental implants, and the retaining screw (P < 0.05). Using the PSW concept increases the area of the stress concentrations in the retaining screw (P < 0.05) more than in the regular platform implant. It was concluded that the increase in diameter is beneficial for stress distribution and that the PSW concept had higher stress concentrations in the retaining screw and the crown compared to the regular platform implant. - Highlights: • The external hexagon implants was unfavorable biomechanical. • The Morse taper implant presented the best biomechanical result. • Platform switching concept increased stress in screw-retained prostheses.

Effect of different types of prosthetic platforms on stress-distribution in dental implant-supported prostheses

International Nuclear Information System (INIS)

Minatel, Lurian; Verri, Fellippo Ramos; Kudo, Guilherme Abu Halawa; Faria Almeida, Daniel Augusto de; Souza Batista, Victor Eduardo de; Aparecido Araujo Lemos, Cleidiel; Piza Pellizzer, Eduardo

2017-01-01

A biomechanical analysis of different types of implant connections is relevant to clinical practice because it may impact the longevity of the rehabilitation treatment. Therefore, the objective of this study is to evaluate the Morse taper connections and the stress distribution of structures associated with the platform switching (PSW) concept. It will do this by obtaining data on the biomechanical behavior of the main structure in relation to the dental implant using the 3-dimensional finite element methodology. Four models were simulated (with each containing a single prosthesis over the implant) in the molar region, with the following specifications: M1 and M2 is an external hexagonal implant on a regular platform; M3 is an external hexagonal implant using PSW concept; and M4 is a Morse taper implant. The modeling process involved the use of images from InVesalius CT (computed tomography) processing software, which were refined using Rhinoceros 4.0 and SolidWorks 2011 CAD software. The models were then exported into the finite element program (FEMAP 11.0) to configure the meshes. The models were processed using NeiNastram software. The main results are that M1 (regular diameter 4 mm) had the highest stress concentration area and highest microstrain concentration for bone tissue, dental implants, and the retaining screw (P < 0.05). Using the PSW concept increases the area of the stress concentrations in the retaining screw (P < 0.05) more than in the regular platform implant. It was concluded that the increase in diameter is beneficial for stress distribution and that the PSW concept had higher stress concentrations in the retaining screw and the crown compared to the regular platform implant. - Highlights: • The external hexagon implants was unfavorable biomechanical. • The Morse taper implant presented the best biomechanical result. • Platform switching concept increased stress in screw-retained prostheses.

Retention systems for extraoral maxillofacial prosthetic implants: a critical review.

Science.gov (United States)

Cobein, M V; Coto, N P; Crivello Junior, O; Lemos, J B D; Vieira, L M; Pimentel, M L; Byrne, H J; Dias, R B

2017-10-01

We describe the techniques available for retention of implant-supported prostheses: bar-clips, O-rings, and magnets. We present reported preferences and, although this is limited by the heterogeneity of methods used and patients studied, we hope we have identified the best retention systems for maxillofacial prosthetic implants. If practitioners know the advantages and disadvantages of each system, they can choose the most natural and comfortable prosthesis. We searched the PubMed and Scopus databases, and restricted our search to papers published 2001-13. MeSH terms used were Maxillofacial prosthesis and Craniofacial prosthesis OR Craniofacial prostheses. We found a total of 2630 papers, and after duplicates had been removed we analysed the rest and found 25 papers for review. Of these, 12 were excluded because they were case reports or non-systematic reviews. Of the remaining 13, 10 described group analyses and seemed appropriate to find practitioner's choices, as cited in the abstract (n=1611 prostheses). Three papers did not mention the type of prosthetic connection used, so were excluded. The most popular choices for different conditions were analysed, though the sites and retention systems were not specified in all 10 papers. The bar-clip system was the most used in auricular (6/10 papers) and nasal prostheses (4/10). For the orbital region, 6/10 favoured magnets. Non-osseointegrated mechanical or adhesive retention techniques are the least expensive and have no contraindications. When osseointegrated implants are possible, each facial region has a favoured system. The choice of system is influenced by two factors: standard practice and the abilities of the maxillofacial surgeon and maxillofacial prosthetist. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Removal of a Dental Implant Displaced into the Maxillary Sinus by Means of the Bone Lid Technique

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Pietro Fusari

2013-01-01

Full Text Available Background. Rehabilitation of edentulous jaws with implant-supported prosthesis has become a common practice among oral surgeons in the last three decades. This therapy presents a very low incidence of complications. One of them is the displacement of dental implants into the maxillary sinus. Dental implants, such as any other foreign body into the maxillary sinus, should be removed in order to prevent sinusitis. Methods. In this paper, we report a case of dental implant migrated in the maxillary sinus and removed by means of the bone lid technique. Results and Conclusion. The migration of dental implants into the maxillary sinus is rarely reported. Migrated implants should be considered for removal in order to prevent possible sinusal diseases. The implant has been removed without any complications, confirming the bone lid technique to be safe and reliable.

A three-dimensional finite element analysis of a passive and friction fit implant abutment interface and the influence of occlusal table dimension on the stress distribution pattern on the implant and surrounding bone

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Sarfaraz, Hasan; Paulose, Anoopa; Shenoy, K. Kamalakanth; Hussain, Akhter

2015-01-01

Aims: The aim of the study was to evaluate the stress distribution pattern in the implant and the surrounding bone for a passive and a friction fit implant abutment interface and to analyze the influence of occlusal table dimension on the stress generated. Materials and Methods: CAD models of two different types of implant abutment connections, the passive fit or the slip-fit represented by the Nobel Replace Tri-lobe connection and the friction fit or active fit represented by the Nobel active conical connection were made. The stress distribution pattern was studied at different occlusal dimension. Six models were constructed in PRO-ENGINEER 05 of the two implant abutment connection for three different occlusal dimensions each. The implant and abutment complex was placed in cortical and cancellous bone modeled using a computed tomography scan. This complex was subjected to a force of 100 N in the axial and oblique direction. The amount of stress and the pattern of stress generated were recorded on a color scale using ANSYS 13 software. Results: The results showed that overall maximum Von Misses stress on the bone is significantly less for friction fit than the passive fit in any loading conditions stresses on the implant were significantly higher for the friction fit than the passive fit. The narrow occlusal table models generated the least amount of stress on the implant abutment interface. Conclusion: It can thus be concluded that the conical connection distributes more stress to the implant body and dissipates less stress to the surrounding bone. A narrow occlusal table considerably reduces the occlusal overload. PMID:26929518

Patients' perceptions of implant placement surgery, the post-surgical healing and the transitional implant prostheses: a qualitative study.

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Kashbour, Wafa A; Rousseau, Nikki; Thomason, J Mark; Ellis, Janice S

2017-07-01

This study aimed to explore patients' thoughts, feelings about, and experiences of, implant placement surgery (IPS), the post-surgical healing stage and the immediate post-surgical transitional implant prosthesis (TIP) (fixed and removable). A qualitative study design was chosen and 38 semi-structured telephone and face-to-face interviews were conducted with 34 patients at different stages of implant treatment. The interviews were transcribed verbatim; the data collection and coding process followed the principles of thematic analysis, which was facilitated through the use of NVivo10. Patients anticipated that surgery would be painful and unpleasant but were prepared to accept this temporary discomfort for the expected benefits of implant treatment. However, a key finding was that patients felt they had overestimated the trauma of surgery but underestimated the discomfort and difficulties of the healing phase. A number of difficulties were also identified with the TIP phase following implant surgery. Existing research has tended to focus on the longer term benefits of dental implant treatment. This qualitative study has investigated in-depth patients' perceptions of dental implant surgery, including their experiences related to sedation, and of transitional implant restoration. While patients felt their concerns were overestimated in relation to the implant surgery, they experienced greater morbidity than they expected in the healing phase. Recommendations are made for relatively small changes in care provision which might improve the overall patient experience. Partial dentate patients treated with a fixed transitional prosthesis experienced advantages more quickly than patients with an overdenture. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Mitral valve replacement in infants and children 5 years of age or younger: Evolution in practice and outcome over three decades with a focus on supra-annular prosthesis implantation

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Tierney, Elif Seda Selamet; Pigula, Frank A.; Berul, Charles I.; Lock, James E.; del Nido, Pedro J.; McElhinney, Doff B.

2014-01-01

Objective Successful mitral valve replacement in young children is limited by the lack of small prosthetic valves. Supra-annular prosthesis implantation can facilitate mitral valve replacement with a larger prosthesis in children with a small annulus, but little is known about its effect on the outcomes of mitral valve replacement in young children. Methods One hundred eighteen children underwent mitral valve replacement at 5 years of age or younger from 1976–2006. Mitral valve replacement was supra-annular in 37 (32%) patients. Results Survival was 74% ± 4% at 1 year and 56% ± 5% at 10 years but improved over time (10-year survival of 83% ± 7% from 1994–2006). Factors associated with worse survival included earlier mitral valve replacement date, age less than 1 year, complete atrioventricular canal, and additional procedures at mitral valve replacement, but not supra-annular mitral valve replacement. As survival improved during our more recent experience, the risks of supra-annular mitral valve replacement became apparent; survival was worse among patients with a supra-annular prosthesis after 1991. A pacemaker was placed in 18 (15%) patients within 1 month of mitral valve replacement and was less likely in patients who had undergone supra-annular mitral valve replacement. Among early survivors, freedom from redo mitral valve replacement was 72% ± 5% at 5 years and 45% ± 7% at 10 years. Twenty-one patients with a supra-annular prosthesis underwent redo mitral valve replacement. The second prosthesis was annular in 15 of these patients and upsized in all but 1, but 5 required pacemaker placement for heart block. Conclusions Supra-annular mitral valve replacement was associated with worse survival than annular mitral valve replacement in our recent experience. Patients with supra-annular mitral valve replacement were less likely to have operative complete heart block but remained at risk when the prosthesis was subsequently replaced. PMID:18954636

Prosthetic Rehabilitation of Mandibular Defects with Fixed-removable Partial Denture Prosthesis Using Precision Attachment: A Twin Case Report.

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Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath

2017-01-01

The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.

When Not to Go SOLO? Contraindications Based on Implant Experience

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Wollersheim, Laurens W.; Li, Wilson W.; Kaya, Abdullah; van Boven, Wim J.; van der Meulen, Jan; de Mol, Bas A.

2016-01-01

Because of the design and specific implantation technique of the stentless Freedom SOLO bioprosthesis, patient selection is crucial. The aim of the study was to discuss the contraindications to this prosthesis based on the authors' implant experience. Between April 2005 and February 2015, one

Penile prosthesis surgery in out-patient setting: Effectiveness and costs in the “spending review” era

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Nicola Mondaini

2014-09-01

Full Text Available Introduction: Penile implant patients are required to remain in the hospital after the operation for monitoring, antibiotic and analgesia administration. Cost containment, however, has resulted in the increased use of ambulatory surgery settings for many surgical procedures. Few studies have studied the feasibility of performing penile prosthesis insertion in an outpatient setting. The results are controversial and nowadays, in the most of centers that deal with prosthetic surgery, patients are still hospitalized. Aim: The aim of our investigation was to compare the feasibility of the performance as well as the complication profiles of penile implant surgery performed in an in-patient and an outpatient setting at a single center by a single surgeon. Methods: From January 2009 to June 2014, 50 patients of the same uro-andrological unit underwent penile prosthesis implantation performed by a single surgeon (N.M.. Twenty implantations were performed in an ambulatory day surgery setting. Main outcome measures: Effectiveness and costs of outpatient setting versus the in-patient setting of the penile prosthesis surgery. Results: There were some differences between the two groups in the intra-operative parameters, such as, operating time. Time lost from work was similar in both groups approximating 14 days. The mean number of analgesic pills ingested by the patients post-operatively was similar in both groups, averaging just under 25 pills per patient. There weren’t post-operative complications in the outpatient group. Cost were 17% less in outpatient clinic. Conclusions: The outpatient setting for this surgery is safe and effective even in patients with comorbidities or in case of secondary procedures. Costs are reduced by 17%.