[Show abstract][Hide abstract] ABSTRACT: Abstract An implant periapical lesion (IPL) is an infectious-inflammatory alteration surrounding an implant apex, and can be caused by a number of situations. The diagnosis is based on the clinical manifestations and radiological findings. A 42-year-old female patient underwent the placement of a screw-shaped titanium dental implant in the anterior region of the left maxilla. Six months after implant insertion, the patient presented with a persistent pain resistant to medications anda fistula was present at the apical region in the clinical intraoral examination. Presence of lesion was confirmed by radiographic images.In the present study, alone surgical debridment with regenerative treatment could not achieve resolution of the lesion. Due to the refractory infection,a surgical approach with apical resection of the affected implant thatsupported with regenerative treatment combinated with platelet rich fibrin is suggested. Our experience was that partially resected oral implants remain osseointegrated and also function well clinically.
Preview · Article · Aug 2014 · Journal of Oral Implantology
[Show abstract][Hide abstract] ABSTRACT: Aim:
The use of endosseous dental implants (DI) has become a successful treatment alternative. However, providing periimplant tissue health and achieving a natural esthetic look are important topics in this treatment. The aim of the present study was to evaluate periodontal and esthetic parameters around DI and natural teeth (NT) and also to analyze myeloperoxidase (MPO) levels in gingival crevicular fluid (GCF) and peri-implant sulcus fluid (PISF).
Materials and methods:
Twenty DI supported fixed prosthesis and contralateral 20 NT were enrolled to the present study. Clinical periodontal parameters (probing depth, clinical attachment level, gingival bleeding time index and gingival index) were recorded and GCF/PISF samples were obtained from mesial (mesiobuccal and mesiolingual) and distal (distobuccal and distolingual) sites of DI and NT. MPO levels were spectrophotometrically determined. Additionally clinical photographs were obtained and esthetical evaluations were performed by using Jemt papilla index. The parameters belong to DI and NT were compared and correlations were evaluated using statistical analysis.
A total of 40 samples were evaluated. No statistically significant differences were detected between groups in all periodontal parameters and MPO levels from mesial and distal sites. Jemt papilla index scores were slightly higher in NT however, this difference was not statistically significant (p > 0.05). Total PES score were similiar in DI and NT groups. Significant correlations were detected between MPO and gingival index values as expected.
These results suggest that DI and NT have similar inflammatory conditions and esthetics, representing DI as a predictable treatment option.
Dental implants are satisfactory treatments, they provide patient esthetic natural looking, phonetic and masticatory functions.
No preview · Article · Apr 2013 · The journal of contemporary dental practice
[Show abstract][Hide abstract] ABSTRACT: Abstract Ameloblastomas are benign odontogenic tumors that develop from the epithelial rests of Malassez. This case reports the multi-disciplinary treatment of an extensive ameloblastoma including reconstruction with free bone flaps and dental implants and acellular dermal matrix graft. Segmental mandibular resection followed by reconstruction with free iliac crest bone flap was performed. Following six months of healing, 7 dental implants were performed. After six months, clinical examinations revealed existence of a mucogingival problem associated with lack of keratinized tissue at the peri-implant region and acellular dermal matrix graft was performed prior to second stage surgery. Following healing of 3 months, second stage surgery was performed and dental implant supported fixed prosthesis was delivered.The patient tolerated the procedures well. At 3rd month and 6th month follow-ups, clinical and radiographic examinations revealed favorable soft tissue and bone health. Following delivery of prosthesis, the patient was competent about the aesthetic and functional results achieved. Multidisciplinary treatment of extensive ameloblastomas with radical resection, free iliac crest bone flap and dental implants increase the quality of life for patients at both aesthetic and functional aspects. Frequent maintenance procedures and increasing the keratinized tissue at the peri-implant region are suggested for long term success of dental implants placed in reconstructed sites.
Preview · Article · Mar 2013 · Journal of Oral Implantology
[Show abstract][Hide abstract] ABSTRACT: Implant-supported mandibular overdentures have recently become a popular treatment alternative for edentulous patients desiring increased retention of complete dentures. The goal of this study was to evaluate and present treatment outcomes of mandibular overdentures retained by two unsplinted, early-loaded implants and compare these results with those for delayed-loaded implants.
Twenty-six edentulous patients had two interforaminal implants placed with a one-stage protocol. The patients were each treated with a mandibular overdenture supported by ball abutments. In the test group, the overdenture was loaded 1 week after surgery and in the control group, the overdenture was loaded 3 months after surgery. Standardized clinical and radiographic parameters were recorded at surgery, and after 3, 6, 12, and 18 months, and 2, 3, 4, 5, and 7 years.
Because two patients did not make the 7-year recall, only 24 patients (48 implants) were evaluated in this study. No implants were lost, and 1.31 ± 0.2 mm marginal bone resorption was noted for all implants after 7 years. Implant stability measurements, clinical peri-implant parameters and marginal bone levels exhibited no statistically significant differences between the two groups over 7 years.
The results of this clinical trial show that there is no significant difference in the clinical and radiographic outcomes of patients treated with mandibular overdentures supported by TiUnite implants that are either early or delayed loaded.
No preview · Article · Jul 2011 · Clinical Implant Dentistry and Related Research
[Show abstract][Hide abstract] ABSTRACT: Objective: Resection of oro-facial tumors and traumas are the most common causes of mandibular defects. The mandibular ameloblastoma is a benign locally aggressive odontogenic tumor that may cause facial deformity. As well as conservative techniques, resection followed by the transplantation of a bone graft is another method used to reconstruct the affected site.
Achieving a successful esthetics and function are the most critical factors that directly affect the patient's life-style after reconstruction of the mandibular defect. Dental rehabilitation including dental implant surgery and prosthodontic rehabilitation are very important in order to achieve a successful outcome in this reconstruction.
Methods: The present 3 cases represent the treatment of advanced stage mandibular ameloblastoma via hemimandibulectomy, followed by transplantation of vascularized free iliac crest grafts, placement of endosseous implants and finally prosthodontic rehabilitation.
Results: The dental rehabilitations were completed in all patients within six months after the hemimandibular reconstruction. Step by step therapy period with long term successful esthetic and functional results were presented. Further, peri-implant parameters and resonance frequency analysis values are also demonstrated for the whole treatment period.
Conclusion: Vascularized free iliac crest flap is a safe and reliable method to achieve a functional and esthetic mandibular reconstruction. However, dental implant placement followed by the fabrication of an appropriate prosthesis provides significantly improved outcome for the patients. Thus, it may be suggested that preserving the patient's quality of life by using a multi-disciplinary reconstructive treatment protocol has a significant value.
Figure Legend: In every line, a case is depicted with the preoperative view, preoperative panoramic mandibular graphy, hemimandibulectomy specimen with the vascularized iliac graft ex-vivo, postoperative dental restoration and postoperative view (from left to right)