Thomas J. Balshi

Immediate loading of Brånemark implants in edentulous mandibles: a preliminary report.

A study involving the immediate loading of Brånemark implants in the edentulous mandibles of 10 patients is reported. The design involved the immediate loading of four widely distributed implants with a transitional fixed implant-supported prosthesis at first-stage surgery, avoiding the need for a removable prosthesis. A sufficient number of additional implants are allowed to heal in the conventional manner to provide sufficient support for a definitive fixed prosthesis even if all of the immediately loaded implants fail. Preliminary results have been favorable, with all patients functioning with a fixed implant prosthesis from the day of first-stage surgery. (Implant Dent 1997;6:83–88)

Dental Implants in the Diabetic Patient: A Retrospective Study

It has become increasingly common for controlled diabetic patients to be considered as candidates for dental implants. This study reports on the results of placing implants in 34 patients with diabetes who were treated with 227 Brånemark implants. At the time of second-stage surgery, 214 of the implants had osseointegrated, a survival rate of 94.3%. Only one failure was identified among the 177 implants followed through final restoration, a clinical survival rate of 99.9%. Screening for diabetes and trying to ensure that implant candidates are in metabolic control are recommended to increase the chances of successful osseointegration. Antibiotic protection and avoidance of smoking should also be considered.

Guided implant placement and immediate prosthesis delivery using traditional Brånemark System abutments: a pilot study of 23 patients.

Purpose:The aim of this study is to demonstrate the accuracy and clinical precision of a guided surgery protocol by using traditional Brånemark System abutments in conjunction with a prefabricated all-acrylic provisional prosthesis that is immediately installed after implant placement. Materials:All presurgical methods in this treatment follow the standard NobelGuide protocol with the exception of the laboratory phase. Once the master cast is retroengineered from the surgical template, traditional Brånemark System abutments were secured onto the implant replicas (master cast) and an all-acrylic provisional prosthesis was constructed at the abutment level. The typical abutments used with this protocol, adjustable Guided Abutments, were not used. Results:Twenty-three patients were treated in this pilot study. Via the surgical template, all implants were placed to the desired depth as planned in the virtual implant planning program. After the traditional Brånemark Abutments were installed, the provisional prosthesis was delivered and occlusion verified. The prosthesis fit was checked at abutment level clinically and radiographically. Conclusion:This report shows the extreme accuracy of this guided surgery protocol. If each step of this protocol is followed precisely, it is possible to deliver a prefabricated prosthesis built to traditional Brånemark System Abutments, which is extremely favorable for long-term patient and prosthesis management.

Facial and oral reconstruction following trauma and failed chin implant: a case report.

Functional and esthetic reconstruction of a patient with microgenia who sustained traumatic injury was successfully accomplished using Brånemark System osseointegrated implants (Nobel Biocare USA, Inc., Yorba Linda, CA) to support a permanent dental prosthesis following mechanical and biologic reconstruction of the anterior mandible and chin. A 25-year-old glycine chin implant previously used for facial esthetic enhancement had eroded the anterior cortical plate and migrated through the medullary bone, compressing the periosteum into the apex of the anterior tooth roots. Further destruction of the lingual cortexwith risk of fracture was imminent. After removal of the chin implant, a cancellous bone graft was held in place with a titanium mesh frame. The prosthetic rehabilitation consisted of two phases of mandibular implant placement followed by the construction of a porcelain-fused-to-gold implant-supported fixed prosthesis, restoring the occlusal vertical dimension as well as appropriate lip support. Restoration of function was superior to the pretreatment condition.