Yoav Grossmann

Smoking, diabetes mellitus, periodontitis, and supportive periodontal treatment as factors associated with dental implant survival: a long-term retrospective evaluation of patients followed for up to 10 years.

Objectives:To evaluate the factors associated with long-term implant survival in a large cohort of patients in regular follow-up until data collection. Methods:The study population consisted of 475 patients who were referred to a private clinic limited to Periodontics and Implantology between November 1995 and July 2006. Data were collected from patient files with regards to smoking habits, periodontal condition, diabetes mellitus, implant survival, and time when implant failure occurred. Patients were divided into those who participated in a supportive periodontal program in the clinic and those who only attended the annual free-of-charge implant examination. Results:A total of 1626 implants were placed with a follow-up ranging from 1 to 114 months (average 30.82 ± 28.26 months). Overall, 77 (4.7%) implants were lost in 58 (12.2%) patients after a mean period of 24.71 ± 25.84 months. More than one-half of the patients (246; 51.7%) participated in a structured supportive periodontal program in the clinic, and 229 (48.3%) only attended to the annual free-of-charge implant examination. Smoking and attendance in a regular supportive periodontal program were statistically associated with implant survival. Patients with (treated) moderate-to-advanced chronic periodontal disease demonstrated higher implant failure rates but, this difference did not reach statistical significance. Diabetes mellitus was not related to implant survival in this patient cohort. Conclusions:Smoking and attendance in a regular supportive periodontal program were found to be strongly related to implant survival. Special attention should be given to continuous periodontal supportive programs to implant patients.

Clinical Effectiveness of Implant-Supported Removable Partial Dentures-A Review of the Literature and Retrospective Case Evaluation

PURPOSE To review the published data on the treatment outcomes of restoring the partially edentulous patient with implant-supported removable partial dentures (ISRPDs) and describe the concept of ISRPDs and the clinical guidelines for placing implants for ISRPDs, and evaluate case series results. MATERIALS AND METHODS For the review, a literature search was performed using the PubMed and Ovid databases. Reports in English from 1969 to 2008 were considered. Also, 35 patients have had their dentition restored with ISRPDs supported by 67 implants. These patients were evaluated in terms of implant and teeth survival. RESULTS The data from the published reports and the presented case series suggest that the incorporation of dental implants into removable partial dentures could be an optional treatment plan for the partially edentulous patient to improve function and patient satisfaction. CONCLUSIONS ISRPDs provide patients with stable, long-term predictable prostheses. This treatment alternative should be considered whenever fixed restorations are not a valid option. Strict maintenance and a follow-up protocol are recommended to obtain satisfactory results. Longitudinal clinical studies are required for evaluation of ISRPDs.

Third attempt to place implants in sites where previous surgeries have failed.

BACKGROUND a lower survival rate for re-implantation in previously failed sites was reported. A third implant attempt in sites where previous implants have failed twice is rare; however, it may be necessary where other treatment alternatives are unacceptable. The aim of the present report is to explore the survival of implants placed three times at the same site. METHODS patients in whom a third attempt of implant placement at sites where two implants failed previously were evaluated. Medical history and smoking were recorded. The implant dimension, characteristics and survival were documented. The same implant and surgeon were involved in all three attempts. RESULTS fifteen third attempt implants in 12 patients were evaluated. The average age of the patients at first implantation was 48.8 ± 14.1 years. Six of the 15 second re-do implants have failed (60.0% survival rate). Smoking was reported by two patients. The implants that survived were followed for 44.1 ± 35 months (range 4-86). The mean implant length and diameter did not vary between attempts: the mean implant width/lengths were 3.6 ± 0.3/12.2 ± 1.4, 3.7 ± 0.3/12.6 ± 1.5 and 3.80 ± 0.3/12.4 ± 1.6 mm for the first, second and third attempts, respectively (p>0.05). CONCLUSIONS a third attempt to place implants in sites where two implants had failed previously results in significantly lower survival rates compared with similar procedures in pristine sites.

A preplanned surgical obturator prosthesis for alternative resection lines in the anterior region.

A technique is described that enables adaptation of a surgical obturator to accommodate anterior teeth that may or may not be resected with the lesion at surgery. This is designed and fabricated by placing additional clasps on the teeth in question and providing for a clasp on one of the anterior teeth that can be determined at the time of surgery, thereby allowing anterior retention of the obturator immediately postoperatively. This technique is cost-effective and useful, especially if no prosthodontist is available at the time of surgery to perform obturator modifications.

The design and fabrication of a segmented cast-metal resin-bonded splint.

This article describes a technique for splinting periodontally compromised teeth and for preventing orthodontically treated teeth from relapsing. The fabrication of a segmented cast-metal resin-bonded splint, with nonrigid connection of the splinted teeth, eliminates the many problems of a conventional multi-unit resin-bonded splint.