CASE REPORT ABOUT THE PROSTHETICS WITH INTRAOSSEOUS IMPLANTS OF THE MAXILLA

During the rehabilitation of patients with the atrophic maxilla, the dental medicine doctor may faced before the challenge of achieving the exact placing of the intraosseous implants. We would like to present you the case of a 33-year woman with a prosthetic of implants after a Rehermanns plastic. The clinical and radiographic examinations show an absorbed maxilla with the horizontal and vertical bone deficit. The patient used a placeholder till the complete bone restoration after the surgical intervention. She did not want a final rehabilitation of the defect using a bridge-like structure due to the necessary intervention of the teeth neigboring the defect. The decision about the placing of intraosseous implants was made after the CBCT examination. The control examinations made after 6 months, 1 year, 3 years, and 5 years show satisfying results in regard to the function and aesthetics, and also the lack of subjective sensation for the patient.

Esthetic Assessment Succeeding Anterior Atrophic Maxilla Augmentation with Cancellous Bone-Block Allograft and Late Restoration Loading

Background: Various conditions may lead to bony deficiency in the anterior maxilla. The present study evaluated esthetic (PES—pink esthetic score and WES—white esthetic score) results after augmentation of the anterior atrophic maxilla using cancellous bone-block allograft followed by implant placement and late (conventional) loading. Methods: Cohort study that included 33 patients with missing teeth in the upper anterior region characterized by extensive bone loss. Allogeneic cancellous bone-blocks were used for augmentation. Six months later, a dental implant was inserted. After a waiting time of an additional six-months, implant exposure and reconstruction were performed. The mean follow-up period was 62.93 ± 17.37 months (range 19–82 months). Results: The mean value of PES/WES was 17.8 ± 2.78. All patients had a PES/WES value above 12 (threshold value defined as clinically acceptable esthetics). The mean value of PES was 9.0 ± 1.79 and the mean value of WES was 8.8 ±1.84. Conclusions: Bone augmentation of the anterior atrophic maxilla using cancellous block-allograft and late loading supports achievement of a predictable esthetic result with long-term stability of soft and hard tissues around implant-supported reconstructions.

PROSTHETIC REHABILITATION OF MISSING ANTERIOR TOOTH WITH A NARROW DIAMETER – CUSTOMISED ABUTMENT IMPLANT: A CASE REPORT

A 54-year-old female patient reported with missing anterior front tooth since past one year and wanted its replacement. After considering all factors, she was advised for an implant supported prosthesis with respect to the missing tooth. Moreover, the anterior atrophic maxilla represents a challenge for the dentist which often require hard and soft tissue augmentation procedures. Currently custom abutments are reported in having functional and esthetic advantages over prefabricated abutments. In this case report , a maxillary anterior tooth has been replaced using a narrow diameter implant using a custom abutment followed by a DMLS prosthesis placement.

Radiographic Evaluation of Bone Remodeling after Additively Manufactured Subperiosteal Jaw Implantation (AMSJI) in the Maxilla: A One-Year Follow-Up Study

Additively manufactured subperiosteal jaw implants (AMSJI) are patient-specific, 3D-printed, titanium implants that provide an alternative solution for patients with severe maxillary bone atrophy. The aim of this study was to evaluate the bony remodeling of the maxillary crest and supporting bone using AMSJI. Fifteen patients with a Cawood–Howell Class V or greater degree of maxillary atrophy were evaluated using (cone beam) computed tomography scans at set intervals: one month (T1) and twelve months (T2) after definitive masticatory loading of bilateral AMSJI implants in the maxilla. The postoperative images were segmented and superimposed on the preoperative images. Fixed evaluation points were determined in advance, and surface comparison was carried out to calculate and visualize the effects of AMSJITM on the surrounding bone. A total mean negative bone remodeling of 0.26 mm (SD 0.65 mm) was seen over six reference points on the crest. Minor bone loss (mean 0.088 mm resorption, SD 0.29 mm) was seen at the supporting bone at the wings and basal frame. We conclude that reconstruction of the severely atrophic maxilla with the AMSJI results in minimal effect on supporting bone. Reduced stress shielding with a biomechanically tuned subperiosteal implant does not induce radiographically significant crestal bone atrophy.

Techniques of hollow maxillary dentures: a literature review

Clinically, the management of severy atrophic maxilla might represent a significant challenge for the attending dentists and surgeons to successfully perform and achieve fabricated complete maxillary dentures. Making a hollow denture base for these defects has also been previously reported as a valid approach that can be used to decrease the weight of the maxillary prosthesis. Many modalities have been proposed for these procedures with favorable outcomes, and variable events of disadvantages and adverse events. This literature review aims to collect enough evidence regarding the different reported techniques of the hollow maxillary denture, according to the different studies. Many techniques have been previously reported as using magnets, using implants, intramucosal inserts, springs, suction disks, lightweight dentures, and modified impression techniques. Many materials have been previously used with the 3D spacers of the lightweight denture techniques as dental stone, silicon putty, cellophane-wrapped asbestos, light-body coated gauze, modeling clay, salt, thermocol, caramel, and glycerine soap. Favoring one of the modalities over the other requires the inauguration of future studies with an adequate sample size to validate the efficacy and safety of these modalities. All of this information is furtherly discussed within the manuscript based on the collected evidence from the different studies in the literature.