Osseointegrated implants for dental rehabilitation following ablative and reconstructive surgery

Author(s):  
Gerald Baker
2018 ◽  
Vol 2 (1) ◽  
pp. s-0038-1669466
Author(s):  
Paulo Domingos Ribeiro-Júnior ◽  
Rafael Zetehaku Araujo ◽  
Gabriel Cury Mendes ◽  
Luis Eduardo Padovan

The implant-supported rehabilitation of atrophic mandibles (AM) with severe bone resorption is challenging for both surgical and prosthetic procedures due to the high risk of mandible fracture during implant surgery and postoperatively due to the masticatory load. The aim of case presentations was to demonstrate treatment alternatives for patients with AM who required oral rehabilitation with osseointegrated implants (OIs) according to the residual mandibular bone volume. When bone is 9 mm in height, the ideal treatment is the use of narrow, short OIs. When the bone height is 5 to < 9 mm, mandibular reinforcement with reconstruction plates using the intraoral approach and simultaneous placement of osseointegrated implants are proposed. In cases where bone height is < 5 mm, the choice of treatment is mandibular reconstructive surgery with an autogenous bone graft and biomaterials. The fundamental principles of this protocol are to reduce the morbidity and complications associated with the surgical procedure, which would reduce both the time and cost of full dental rehabilitation. The choice of the technique for mandibular reconstruction should be indicated according to the magnitude of the atrophy.


2010 ◽  
Vol 43 (01) ◽  
pp. 092-096
Author(s):  
Sanjeev N. Deshpande ◽  
Vikas Kumar

ABSTRACTEctodermal dysplasia is a rare group of inherited disorders characterized by aplasia or dysplasia of tissues of ectodermal origin, such as hair, nails, teeth and skin. Dental manifestations include hypodontia, complete anodontia or malformed teeth. Oral rehabilitation is the major surgical challenge in such patients. It frequently requires alveolar reconstruction followed by dental implants. We report a case of hypohidrotic ectodermal dysplasia, which was managed with reconstruction of both the upper and the lower alveolus using free fibula flaps with dental rehabilitation using osseointegrated implants.


2010 ◽  
Vol 36 (5) ◽  
pp. 385-390 ◽  
Author(s):  
Amir H. Khatami ◽  
Joseph A. Toljanic ◽  
Alejandro Kleinman

Abstract Primary and secondary reconstruction of mandibular discontinuity defects with vascularized flap is currently the standard of care in many institutions. The most commonly used donor site for such flaps is fibula. Fibula provides enough bone length, allows 2-team approach, and has low donor site morbidity and abundant periosteal blood supply. The placement of endosseous implants in the vascularized fibula flap also facilitates functional dental rehabilitation. This clinical report describes the prosthetic rehabilitation and the complications of 2 mandibular discontinuity defects treated with vascularized fibula flap and implant-supported fixed prosthesis.


2021 ◽  
Author(s):  
Gabriela Lopes dos Santos ◽  
Kaique Preto Alberto ◽  
Silas Antonio Juvêncio de Freitas Filho ◽  
Kellen Cristine Tjioe ◽  
Denise Tostes Oliveira

Osseointegrated implants have been an optimal treatment option for dental rehabilitation of fully or partially edentulous patients. Although peri-implantitis remains as the most common local risk factor for dental implant failure, the development of oral cancer involving the soft tissue around the titanium may lead to early implants loss and impact the quality of life of the patient negatively. Oral squamous cell carcinoma (OSCC) is the most common malignancy among head and neck tumors. It has higher prevalence in men over 50 years old, and in tobacco and/or alcohol users. Unfortunately, oral cancer is often detected in advanced stages, when the treatment options are limited. Thus, OSCC typically has poor prognosis. Despite the recent advances in oral carcinogenesis understanding, the relationship between dental implants and the development of malignant lesions around them is not completely understood. It has been suggested that the titanium corrosion occurring at the top of dental implants causes the release of metal ions. These ions might lead to oral epithelial genetic damage and higher susceptibility of normal mucosa to malignant transformation. The aim of this chapter was to review the clinical characteristics, diagnosis, and the possible carcinogenic mechanisms involved in oral cancer around dental implants.


2013 ◽  
Vol 39 (4) ◽  
pp. 409-415
Author(s):  
Gilbert Tremblay

In the following case report, three osseointegrated implants placed in a dysfunctional and nonaesthetic position were successfully relocated with innovative surgical techniques were followed by a comprehensive dental rehabilitation. The goal of this report is to communicate the surgical techniques used to successfully relocate dental implants rather than replace them. Two techniques were used for these implants relocation. One technique consisted of displacing the integrated implant with some similarity to the alveolar distraction osteogenesis but without using the distraction device. The second surgical technique involved the displacement of the 2 adjacent implants, similarly to the first approach, except that an osseoinductive molecule, recombinant human bone morphogenetic protein-2, was used for guided bone growth. It was possible to relocate dental implants within bone blocs and rehabilitate them to adopt new dental abilities by complying with bone regeneration parameters. However, advanced treatment planning with computerized tomography scans, parametric software, and stereolithography models as well as guided surgery and bone regeneration products were used.


1989 ◽  
Vol 101 (1) ◽  
pp. 56-73 ◽  
Author(s):  
Mark L. Urken ◽  
Daniel Buchbinder ◽  
Hubert Weinberg ◽  
Carlin Vickery ◽  
Alan Sheiner ◽  
...  

The goal of mandibular reconstruction is to rehabilitate the patient by restoring occlusal relationships, lower facial contour, oral continence, and a denture-bearing surface. One of the major advantages of the use of vascularized bone over all other methods of mandibular reconstruction is its ability to achieve dental rehabilitation rapidly. The use of osseointegrated dental implants is a valuable adjunct in oral rehabilitation. It provides the most rigid form of stabilization to withstand the forces of mastication. In situations In which soft tissue reconstruction or the height of the alveolar ridge is not sufficient for a tissue-borne denture, implants offer the most suitable alternative. Mandibular reconstruction with free tissue transfer techniques is Ideally suited for the placement of implants. These can be inserted at the time of mandibular reconstruction. Four months after surgery, when the integration process has occurred, the implants are unroofed, loaded, and ready for prosthetic placement. We will present several representative patients who underwent mandibular reconstruction with microvascular free bone transfer who have been successfully rehabilitated by osseointegrated implants. The process of osseointegration, different types of dental implants, and issues regarding radiation and Implants are discussed. This is the first report of dental rehabilitation by primary placement of dental implants in patients undergoing microvascular mandibular reconstruction.


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