Sam E. Farish

The Influence of Preoperative Antibiotics on Success of Endosseous Implants Up to and Including Stage II Surgery: A Study of 2,641 Implants

According to the American College of Surgeons, complex oral surgical procedures, including the transoral placement of endosseous implants, are of the type that may require prophylactic antibiotics. However, the routine use of prophylactic antibiotics in the field of dental implantology continues to be controversial, and their utilization varies widely. No data from a randomized prospective clinical study of the prophylactic use of antibiotics in implant surgery have been previously published. As part of the comprehensive Dental Implant Clinical Research Group clinical implant study, the preoperative or postoperative use of antibiotics, the type used, and the duration of coverage was left to the discretion of the surgeon. These data were recorded and correlated with failure of osseointegration during healing (stage I) and at stage II surgery (uncovering). The results showed that significantly fewer failures occurred when preoperative antibiotics were used.

Bone Quality and Implant Design-Related Outcomes Through Stage II Surgical Uncovering of Spectra-System Root Form Implants

Failure rates at second-stage surgery were reported for the ongoing Dental Implant Clinical Research Group studies of the Spectra-System (Core-Vent Corporation, Las Vegas, NV) implants. As of May 1995, 69 implants failed out of 2,633 placed and uncovered. The overall failure rate was 2.6%, with 3.6% in bone quality 1 (BQ-1), 2.4% in BQ-2, 2.5% in BQ-3, and 3.1% in BQ-4. HA-coated cylinders had the lowest number of failures and titanium alloy baskets the highest. The basket design failed more often in the posterior jaw areas; 9 of 32 clinical centers (28%) accounted for 72% of these failures.

Peripheral ameloblastoma: A clinical and histologic study of 11 cases

Peripheral ameloblastoma (PA) is a rare odontogenic tumor. Previously, only 39 cases of PA had been reported in the English literature. In this article 11 additional cases of PA are presented. Concordance with previous cases was evident with regard to race, clinical appearance, and site of predilection. However, differences were observed with regard to age, sex distribution, and predominant histologic pattern. The average age in the current cases is younger, there is no male bias, and the most common histologic pattern is plexiform rather than follicular or acanthomatous. Recurrence following simple excision is rare, but has been reported. Long-term postoperative follow-up is recommended.

Intraoral manifestation of thromboangiitis obliterans (Buerger's disease)

A case of thromboangiitis obliterans (Buergers disease) showing vascular lesions in the oral cavity is presented. To our knowledge, this is the first report of involvement of branches of the external carotid artery with this disease. The clinical, radiographic, plethysmographic, and histologic features of Buergers disease are presented. Etiologic factors, pathogenesis, and treatment modalities are discussed.

Effect of stretching on the physical properties of stainless steel wire.

Stretching of 25-gauge stainless steel wire causes alterations in the physical properties of the wire. The yield strength and ultimate tensile strength are increased and the elasticity is decreased. These alterations make stretched wire more satisfactory for maxillofacial surgical applications than unstretched wire.

Modified technique for fixed mandibular implant placement

Advanced mandibular atrophy can frequently be treated satisfactorily by the placement of a fixed mandibular implant (Hall Surgical, Carpinteria, CA). This device replaced the original mandibular staple bone plate in 1987 and shares a 25-year history of a high degree of clinical success over a broad range of clinical applications.‘-4 A recent report evaluated the results of hydroxylapatite augmentation of the mandible followed by the placement of the mandibular staple and found excellent prosthetic stabilization and function, and a high degree of patient satisfaction.4 The success of the surgical procedure depends on parallel pin positioning and proper buccaMingua1 alignment, which is assured by a stable application of the drill guide clamping rack. The clamping rack is connected to the alveolar process by director rods when an acrylic stent is used or by anchoring jaws when a stent is not used. If the anchoring jaws are used, they are often difficult to position for proper emergence and can slip during drilling. If a stent is used on a flat ridge, it can also move during drilling and alter parallelism. With either technique, a prolonged time frequently needs to be spent in the oral cavity making adjustments, and this increases the exposure of the submental wound to contamination.