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Figure 9. Q14. Do you have any requests for dentis...

Figure 9. Q14. Do you have any requests for dentists who practice implant treatment? Figure 9. Q14. Do you have any requests for dentists who practice implant treatment?

Figure 8. Q13. What are the frequently received re...

Figure 8. Q13. What are the frequently received repair requests for IODs? Figure 8. Q13. What are the frequently received repair requests for IODs?

Figure 7. Q12. What kind of creative steps do you ...

Figure 7. Q12. What kind of creative steps do you take in order to prevent veneer fracture and chipping in the molar region? Figure 7. Q12. What kind of creative steps do you take in order to prevent veneer fracture and chipping in the molar region?

Figure 6. Q11. What are the frequently received re...

Figure 6. Q11. What are the frequently received repair requests involving implant fixed prostheses? Figure 6. Q11. What are the frequently received repair requests involving implant fixed prostheses?

Figure 5. Q10. What are the main fabrication chall...

Figure 5. Q10. What are the main fabrication challenges faced? Figure 5. Q10. What are the main fabrication challenges faced?

Figure 4. Q8. What are the proportions of attachme...

Figure 4. Q8. What are the proportions of attachment types used with IODs? Figure 4. Q8. What are the proportions of attachment types used with IODs?

Figure 3. Q6. What types of implant fixed prosthes...

Figure 3. Q6. What types of implant fixed prostheses are used in the posterior region? Figure 3. Q6. What types of implant fixed prostheses are used in the posterior region?

Figure 2. Q5. What types of materials (i.e. veneer...

Figure 2. Q5. What types of materials (i.e. veneer, coping) are used to make implant prostheses in the anterior region? Figure 2. Q5. What types of materials (i.e. veneer, coping) are used to make implant prostheses in the anterior region?

Figure 1. Q4. What are the proportions of abutment...

Figure 1. Q4. What are the proportions of abutments used with cement-retained prostheses? Figure 1. Q4. What are the proportions of abutments used with cement-retained prostheses?

Table 4 Prosthetic complic...

Question   Values Q9. What are the main issues generally encountered? Compatibility precision issues 29.6% Aesthetic issues 33.2% ...

Table 3 Implant overdentur...

Question   Values Q7. The design of the implant overdenture: Decision made according to instructions of dentist 43.2% Work is left to technicians 19.3% ...

Table 2 Implant fixed pros...

Question   Values Q3. The percentages of implant fixed prostheses: Cement-retained 61.4% Screw-retained 38.6% ...

Table 1 Conditions charact...

Question   Values Q1. The years of experience working as a dental technician, and the number of dentists from whom job orders are received.   Mean (SD) 17.0 (6.8) years 36.5(12.4)/Lab. ...

About this article : Current status of implant pro...

Hagiwara, Y., Narita, T., Shioda, Y. et al. Current status of implant prosthetics in Japan: a survey among certified dental lab technicians. Int J Implant Dent 1, 4 (2015). https://doi.org/10.1186/s40729-015-0005-3 Download citation Received: 13 October 2014 Accepted: 22 January 2015 Published: 17 February 2015 DOI: https://doi.org/10.1186/s40729-015-0005-3

Rights and permissions : Current status of implant...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and in...

Additional information : Current status of implant...

The authors have declare that they have no competing interests. TN, YS, KI, TI and SN were compiled and aggregate of the questionnaire. YH and TS conceived of the study and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

Author information : Current status of implant pro...

Implant Dentistry, Nihon University School of Dentistry, Dental Hospital, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan Yoshiyuki Hagiwara, Tatsuya Narita, Yohei Shioda, Keisuke Iwasaki, Takayuki Ikeda & Shunsuke Namaki Department of Dental Specialties, Mayo Clinic, Mayo Clinic, 200 First Street SW, Rochester, MINN, 55905, USA Thomas J Salinas You can also search for this aut...

Acknowledgements : Current status of implant prost...

This paper was partially supported by a Grant-in-Aid for Scientific Research (C) (No. 24592935) from the Japan Society for the Promotion of Science.

References : Current status of implant prosthetics...

Larsson C. Vult von Steyern P. Five-year follow-up of implant-supported Y-TZP and ZTA fixed dental prostheses. A randomized, prospective clinical trial comparing two different material systems. Int J Prosthodont. 2010;23:555–61. Gonda T, Maeda Y. Why are magnetic attachments popular in japan and other asian countries? Jpn Dental Sci Rev. 2011;47:124–30. Carlsson GE, Kronström M, de Baat C, ...

References : Current status of implant prosthetics...

Andreiotelli M, Att W, Strub JR. Prosthodontic complications with implant overdentures: a systematic literature review. Int J Prosthodont. 2010;3:195–203. Cehreli MC, Karasoy D, Kokat AM, Akca K, Eckert SE. Systematic review of prosthetic maintenance requirements for implant-supported overdentures. Int J Oral Maxillofac Implants. 2010;25:163–80. Hatzikyriakos A, Petridis HP, Tsiggos N, Sakel...

References : Current status of implant prosthetics...

Gatten DL, Riedy CA, Hong SK, Johnson JD, Cohenca N. Quality of life of endodontically treated versus implant treated patients: a University-based qualitative research study. J Endocrinol. 2011;37:903–9. Johannsen A, Wikesjö U, Tellefsen G, Johannsen G. Patient attitudes and expectations of dental implant treatment—a questionnaire study. Swed Dent J. 2012;36:7–14. Pavel K, Seydlova M, Dos...

References : Current status of implant prosthetics...

Att W, Stappert C. Implant therapy to improve quality of life. Quintessence Int. 2003;34:573–81. Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res. 2012;91:242–8. Shumaker ND, Metcalf BT, Toscano NT, Holtzclaw DJ. Periodontal and periimplant maintenance: a critical factor in long-term treatment success. Compend C...

Conclusions : Current status of implant prosthetic...

This survey served to clarify the current status of implant prosthodontics, issues, and considerations in their fabrication, and the status of prosthetic complications and preventive initiatives, all from a laboratory perspective. Concerning implant treatment, it was concluded that dentists either play the leading role or work in collaboration with technicians, including in the formulation of tre...

Results and discussion : Current status of implant...

Finally, technicians gave voice to the several requests for dentists, who are their customers, as a result of their daily experiences accomplishing implant laboratory procedures (Q14) (Figure 9). These included asking dentists to use suitable implant location and orientation (31.8%), to allow technicians to participate and consult with technicians from the treatment planning stage (28.3%), to imp...

Results and discussion : Current status of implant...

The questionnaire revealed several creative steps, based on laboratory considerations, being taken to prevent veneer chipping and fractures, a frequent and problematic prosthetic complication (Q12) (Figure 7). Technicians were taking into account metal (including zirconia) coping designs (36.3%), covering only the distal-most part of the molar region with metal (24%), using veneering composite re...

Results and discussion : Current status of implant...

Looking at repair requests (i.e., complications) involving the superstructures of fixed implant prostheses (Q11) (Figure 6), facing damage and chipping accounted for more than half of all requests (54.5%). Generally speaking, there are many reports that indicate a high incidence of complications related to fixed prostheses involving abutment screw loosening, detachment of cement-retained crowns, ...

Results and discussion : Current status of implant...

Bar and clip attachments were most commonly used for IODs, followed by magnet, ball, and socket, and Locator attachments (Q8) (Figure 4). It is noteworthy among the questionnaire results that magnetic attachment use is highest in Asian countries, including Japan [43]. Additionally, it is thought that the low use of Locators (5.2%) is strongly influenced by Japan’s strict pharmaceutical regulati...

Results and discussion : Current status of implant...

Concerning the types of prostheses used in the posterior region (Q6) (Figure 3), PFM design accounts for about 40% of the total, although the questionnaire also revealed a trend (in 9.1% of all cases) toward metal occlusal designs to avoid fracture and chipping of the veneer material. The same trend is evident in indirect composite facing crowns, where metal occlusal designs are used in about 35%...

Results and discussion : Current status of implant...

Next, concerning the types of abutments used with cement-retained prostheses (Q4) (Figure 1), CAD/CAM abutments accounted for about one third of the total (titanium, 19.7%; zirconia, 12.1%), and custom UCLA-type abutments made from cast gold alloy accounted for about the same proportion. It is likely that this breakdown is because, in many cases, implant systems using fabricated crowns are not su...

Results and discussion : Current status of implant...

Dentists play a leading role in 39.3% of the time in implant treatment planning and prosthetic design, and dental technicians are consulted concerning cases and part usage 34.7% of the time, suggesting the approach to implants is driven by prosthetic considerations (by dentists) to some degree. However, because dental technicians indicated that they take the initiative 15% of the time, it is impos...

Results and discussion : Current status of implant...

Out of 120 surveys sent, 74 technicians responded, resulting in a response rate of 61.6%. A summary of the responses is provided in Tables 1, 2, 3, and 4 and Figures 1, 2, 3, 4, 5, 6, 7, 8, and 9. Because implant treatment (implant prostheses) requires a significant amount of specialized, high-precision laboratory procedures, this area of dental care exhibits slightly different trends than pros...

Methods : Current status of implant prosthetics in...

This cross-sectional questionnaire survey was performed among the certified dental technicians of JSOI from September to December in 2011. Selected were 120 out of 285 certified dental technicians of JSOI using a random number table and mailing each questionnaire directly to the participant. To facilitate coverage of a broad range of topics, the survey classified content into the following four ca...

Background : Current status of implant prosthetics...

This survey consists of a questionnaire targeting the certified dental technicians of the Japanese Society of Oral Implantology (JSOI) [32] who are primarily involved in fabricating dental implant restorations. It was formulated to clarify the current status of implant prostheses from a prosthetic and technician-oriented standpoint through questions addressing current trends among dental implant t...

Background : Current status of implant prosthetics...

Currently, dental implant treatment is evaluated on the basis not only of restoring masticatory function, but also a variety of other factors, including the implant and superstructure survival rate and psychological impacts [1-3]. Numerous factors must be taken into account, to offer highly predictable implant treatment, and there is no doubt that prosthetic-related factors such as the type and co...

Abstract : Current status of implant prosthetics i...

There are many implant cases in which dental technicians take initiative with regard to the design of implant prostheses, and to a certain extent, this area of care is one in which dentists do not necessarily play the leading role. Moreover, inadequate communication between dental technicians and dentists and insufficient instructions for technicians has been highlighted as issues in the past. The...

Fig. 7. The epithesis allows both prompt inspectio...

Fig. 7. The epithesis allows both prompt inspection of the resection site and makes daily care easier Fig. 7. The epithesis allows both prompt inspection of the resection site and makes daily care easier

Fig. 6. Frontal view of the patient after superior...

Fig. 6. Frontal view of the patient after superior overdenture and nasal prosthesis delivery Fig. 6. Frontal view of the patient after superior overdenture and nasal prosthesis delivery

Fig. 5. The intraoral bar crossing the palatal def...

Fig. 5. The intraoral bar crossing the palatal defect arising the nasal understructure Fig. 5. The intraoral bar crossing the palatal defect arising the nasal understructure

Fig. 4. A front view of the bar with the intraoral...

Fig. 4. A front view of the bar with the intraoral portion and the metal extension for epithesis attachment Fig. 4. A front view of the bar with the intraoral portion and the metal extension for epithesis attachment

Fig. 3. Postoperative panorex showing the symmetri...

Fig. 3. Postoperative panorex showing the symmetric distribution of the fixtures Fig. 3. Postoperative panorex showing the symmetric distribution of the fixtures

Fig. 2. The healing abutments positioned onto fixt...

Fig. 2. The healing abutments positioned onto fixtures and the oronasal communication Fig. 2. The healing abutments positioned onto fixtures and the oronasal communication

Fig. 1. Intraoperative view of the zygoma implants...

Fig. 1. Intraoperative view of the zygoma implants placed in the residual maxilla Fig. 1. Intraoperative view of the zygoma implants placed in the residual maxilla

About this article : Rehabilitation of a complex m...

Trevisiol, L., Procacci, P., D’Agostino, A. et al. Rehabilitation of a complex midfacial defect by means of a zygoma-implant-supported prosthesis and nasal epithesis: a novel technique. Int J Implant Dent 2, 7 (2016). https://doi.org/10.1186/s40729-016-0043-5 Download citation Received: 22 July 2015 Accepted: 23 March 2016 Published: 01 April 2016 DOI: https://doi.org/1...

Rights and permissions : Rehabilitation of a compl...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Additional information : Rehabilitation of a compl...

Francesca Ferrari, Pasquale Procacci, Lorenzo Trevisiol, Pier Francesco Nocini, Daniele De Santis and Antonio D’Agostino declare that they have no competing interests. FF was involved in revising the manuscript critically. PP was involved in drafting the manuscript. LT is another surgeon that belongs to surgery equipment. PFN, head professor and surgeon, operated the patient. DDeS was involved ...

Author information : Rehabilitation of a complex m...

Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134, Verona, Italy Lorenzo Trevisiol, Pasquale Procacci, Antonio D’Agostino, Francesca Ferrari, Daniele De Santis & Pier Francesco Nocini You can also search for this author in PubMed Google Sch...

References : Rehabilitation of a complex midfacial...

Karakoca S, Aydin C, Handan Y, Bal BT. Retrospective study of treatment outcomes with implant- retained extraoral prostheses: survival rates and prosthetic complications. J Prosthet Dent. 2010;103:118–26. Download references

References : Rehabilitation of a complex midfacial...

Parel SM, Branemark PI, Ohrnell LO, Svensson B. Remote implant anchorage for the rehabilitation of maxillary defects. J Prosthet Dent. 2001;86:377–81. Bowden JR, Flood TR, Downie IP. Zygomaticus implants for retention of nasal prostheses after rhinectomy. Br J Oral Maxillofac Surg. 2006;44:54–6. D’Agostino A, Procacci P, Ferrari F, Trevisiol L, Nocini PF. Zygoma implant-supported prostheti...

Consent : Rehabilitation of a complex midfacial de...

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Conclusions : Rehabilitation of a complex midfacia...

Implant-supported prosthesis is a valid method to restore resected oral and head cancer patients and offers a good chance to social reintegration. The aesthetic result and facial camouflage are more achievable by means of dentures and epithesis than with several reconstructive interventions. Furthermore, due to the high risk of recurrences, it is sometime mandatory to keep the defect inspectionabl...

Case presentation : Rehabilitation of a complex mi...

Rethinking globally of the possible indications to the adoption of this technique and its advantages compared to reconstructive microsurgery, the use of zygoma-implant-supported prosthesis may be suitable for patients whose systemic conditions are poor. The duration of surgery and of the postoperative recovery would be remarkably shortened avoiding the complications related to the harvesting of a ...

Case presentation : Rehabilitation of a complex mi...

As far as prosthetic design is concerned, it is mandatory to avoid or, if not possible, limit as much as possible distal cantilever: given the absence of the premaxilla, an anterior cantilever is already present. Implant splintage is recommended [1, 8], and the bar design must respect technical data (implant-to-implant distance, cross-arch stabilization avoiding to cover oronasal communication and...

Case presentation : Rehabilitation of a complex mi...

Patients with advanced orofacial cancer may require extensive surgical resection; the wider and more evident is the amputated region, the more this condition is generating inability for patients [6]. Visible head site mutilation and functional impairment in speech prevent social reintegration, and abnormal self-perception leads patients to depression [6]. Even if modern surgery offers many techni...

Case presentation : Rehabilitation of a complex mi...

Cortical steroids were administered for the first two postoperative days. A postoperative 10-day cycle of antibiotic therapy (amoxicillin 1000 mg TID) was administered. Analgesics were administered as required. Sutures were removed 15 days after surgery. A soft diet was recommended for the first 2 weeks. Three months afterwards, healing abutments were connected (Fig. 2) [4]. Approximately 4...

Case presentation : Rehabilitation of a complex mi...

The patient, a male 46 years old at the time of our visit, underwent surgical resection of nasal pyramid and premaxilla including the whole upper jaw teeth sparing nasal bones. When the patient came to our clinic, apart from the defect resulting from the resection, he presented with a retraction scar crossing the upper lip from the floor of the nasal defect through the filtrum. The surgical resec...

Background : Rehabilitation of a complex midfacial...

The use of zygoma implants in the rehabilitation of patients who underwent surgical resection for oral cancer has been widely described [1–3]. There are several possibilities that can be considered when evaluating the possibility of surgical reconstruction after the first cancer resection, such as microvascular free flaps or rotation flaps, but it is sometimes necessary to monitor the healing pr...

Abstract : Rehabilitation of a complex midfacial d...

Several authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis. The patient pres...

Fig. 17. The appearance of the case shown in Fig. ...

Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants

Fig. 16. Another ZIP flap case demonstrating the u...

Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase

Fig. 15. Facial appearance 18 months following tr...

Fig. 15. Facial appearance 18 months following treatment Fig. 15. Facial appearance 18 months following treatment

Fig. 14. Intra-oral view of perforated flap 3 wee...

Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy

Fig. 13. Panoramic dental radiograph showing the p...

Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis

Fig. 12. Provisional acrylic fixed dental prosthes...

Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery

Fig. 11. Intra-oral view of the soft tissue flap a...

Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants

Fig. 10. Radial forearm flap inset and sutured int...

Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments

Fig. 9. Inter-occlusal registration using the pre-...

Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps

Fig. 8. Abutment level impression utilising light-...

Fig. 8. Abutment level impression utilising light-cured acrylic tray material Fig. 8. Abutment level impression utilising light-cured acrylic tray material

Fig. 7. Conventional zygomatic implant insertion o...

Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty

Fig. 6. Zygomatic oncology implants sited in the r...

Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla

Fig. 5. Left-sided maxillary resection (Brown clas...

Fig. 5. Left-sided maxillary resection (Brown class 2b) Fig. 5. Left-sided maxillary resection (Brown class 2b)

Fig. 4. Panoramic dental radiograph showing dental...

Fig. 4. Panoramic dental radiograph showing dental status at presentation Fig. 4. Panoramic dental radiograph showing dental status at presentation

Fig. 3. Staging CT scan confirming maxillary destr...

Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor

Fig. 2. Staging MRI scan showing destructive lesio...

Fig. 2. Staging MRI scan showing destructive lesion left maxilla Fig. 2. Staging MRI scan showing destructive lesion left maxilla

Fig. 1. Clinical view of left-sided maxillary tumo...

Fig. 1. Clinical view of left-sided maxillary tumour at presentation Fig. 1. Clinical view of left-sided maxillary tumour at presentation

Table 1 Patient-reported quality of life outcomes ...

Domain Score Activity 100 (“I am as active as I have ever been”) Anxiety 100 (“...

About this article : The zygomatic implant perfora...

Butterworth, C.J., Rogers, S.N. The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy. Int J Implant Dent 3, 37 (2017). https://doi.org/10.1186/s40729-017-0100-8 Download citation Received: 14 May 2017 Accepted: 23 July 2017 Published: 29 July 2017 DOI: https...

Rights and permissions : The zygomatic implant per...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Ethics declarations : The zygomatic implant perfor...

Consent has been obtained from the patient for the use and publication of all images. Chris Butterworth and Simon Rogers declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : The zygomatic implant perfora...

Department of Oral & Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK C. J. Butterworth & S. N. Rogers You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar CB devised the treatment concept and undertook all implant surgeries and prostho...

References : The zygomatic implant perforated (ZIP...

Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63. Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Implants. 2013;28(5):e221...

Conclusions : The zygomatic implant perforated (ZI...

The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function and restored f...

Case presentation : The zygomatic implant perforat...

Whilst technically, it would be possible to construct and fit the prosthesis on the same day or even a week later, the need for microvascular flap monitoring in the immediate post-operative period, together with the significant recovery period required by the patient following surgery has lead the authors to delay the fitting of the prosthesis at the 4 to 6-week period post-operatively. In terms o...

Case presentation : The zygomatic implant perforat...

In contrast, the use of a soft tissue flap such as the RFFF or antero-lateral thigh flap can often be safely employed in elderly patients with peripheral vascular disease without unduly lengthening the operation too significantly with two-team operating. In addition, the predictability of these flaps with their excellent pedicle lengths is ideal for closure of the resulting oro-nasal surgical defe...

Case presentation : The zygomatic implant perforat...

In low-level maxillectomy (Brown class II), the need for bony reconstruction is questionable depending on the horizontal component. With the preservation of the orbital floor, zygomatic prominence and some bony support for the nose, facial appearance, in the experience of the authors and, as demonstrated by this case, is not significantly worsened despite low-level removal of the maxilla. The key ...

Case presentation : The zygomatic implant perforat...

In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in the unit. Once the flap was perforated, a 2-mm thick p...

Case presentation : The zygomatic implant perforat...

The implant positions were then accurately registered by utilising light-cured resin tray material (Individo® Lux, Voco Gmbh, Germany) and abutment level impression copings. The resin material was applied in sections around the impression copings and cured incrementally to ensure a rigid splinting of the impression copings (Fig. 8). Abutment protection caps were then placed over all four abutment...

Case presentation : The zygomatic implant perforat...

A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruction of the lateral m...

Background : The zygomatic implant perforated (ZIP...

The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment include effec...

Abstract : The zygomatic implant perforated (ZIP) ...

This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease. The technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap (ZIP flap) fo...

Fig. 6. Cumulative survival rate of complication-f...

Fig. 6. Cumulative survival rate of complication-free prostheses by a gender (p = 0.1220) and b type of prostheses (p 

Fig. 5. Kaplan-Meier cumulative survival rate of c...

Fig. 5. Kaplan-Meier cumulative survival rate of complication-free prostheses at 10, 15, and 25 years after the prosthesis setting Fig. 5. Kaplan-Meier cumulative survival rate of complication-free prostheses at 10, 15, and 25 years after the prosthesis setting

Fig. 4. Cumulative incidence of peri-implantitis b...

Fig. 4. Cumulative incidence of peri-implantitis by a gender (p = 0.0221), b implant type (p = 0.0128), c implant position (p = 0.2470), d presence of additional soft tissue management (p = 0.2488), and e width of keratinized mucosa around implant (p = 0.0045). Log rank test was used for assessing statistical significance Fig. 4. Cumulative incidence of peri-implantitis by a gender ...

Fig. 3. Cumulative incidence of peri-implantitis :...

Fig. 3. Cumulative incidence of peri-implantitis Fig. 3. Cumulative incidence of peri-implantitis

Fig. 2. Kaplan-Meier cumulative survival rates by ...

Fig. 2. Kaplan-Meier cumulative survival rates by a gender (p = 0.1049), b implant type (p = 0.6259), c implant position (p 

Fig. 1. Kaplan-Meier cumulative survival rate at 1...

Fig. 1. Kaplan-Meier cumulative survival rate at 10, 15, and 25 years after the prosthesis setting Fig. 1. Kaplan-Meier cumulative survival rate at 10, 15, and 25 years after the prosthesis setting

Table 7 Cox regression analyses for cumulative sur...

  Hazard ratio 95% confidence interval p value Gender (male) 1.82 0.946~3.487 ...

Table 6 Cox regression analyses for cumulative inc...

  Hazard ratio 95% confidence interval p value Gender (male) 2.38 1.138~5.362 ...

Table 5 Cox regression analyses for implant surviv...

  Hazard ratio 95% confidence interval p value Gender (male) 1.99 0.538~8.201 ...

Table 4 Distribution of implants by length and loc...

Dia. (mm) Maxilla anterior Maxilla posterior Mandible anterior Mandible posterior Tot...

Table 3 Distribution of implants by diameter and l...

Dia. (mm) Maxilla anterior Maxilla posterior Mandible anterior Mandible posterior Tot...

Table 2 Distribution of implants in situ (n = 22...

Position 1 2 3 4 5 6 ...

Table 1 Age and gender distributions (n = 92) : ...

Age/gender Male Female Total 20–29 3 ...

About this article : Retrospective cohort study of...

Horikawa, T., Odatsu, T., Itoh, T. et al. Retrospective cohort study of rough-surface titanium implants with at least 25 years’ function. Int J Implant Dent 3, 42 (2017). https://doi.org/10.1186/s40729-017-0101-7 Download citation Received: 26 April 2017 Accepted: 28 August 2017 Published: 05 September 2017 DOI: https://doi.org/10.1186/s40729-017-0101-7

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Ethics declarations : Retrospective cohort study o...

Tadashi Horikawa, Tetsurou Odatsu, Takatoshi Itoh, Yoshiki Soejima, Hutoshi Morinaga, Naruyoshi Abe, Naoyuki Tsuchiya, Toshikazu Iijima, and Takashi Sawase declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Retrospective cohort study of...

You can also search for this author in PubMed Google Scholar TH, TO, and TS initiated and designed the retrospective study and drafted the manuscript including the preparation of figures and tables. TH, TAI, YS, HM, NA, NT, and TOI reviewed the medical records and collected the data. All authors revised the manuscript and approved the final manuscript. Correspondence to...

Author information : Retrospective cohort study of...

Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan Tadashi Horikawa, Takatoshi Itoh, Yoshiki Soejima, Hutoshi Morinaga, Naruyoshi Abe, Naoyuki Tsuchiya, Toshikazu Iijima & Takashi Sawase Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan Tetsurou Odatsu & Takash...

References : Retrospective cohort study of rough-s...

Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res. 2012;23(Suppl 6):22–38. Dorner S, Zeman F, Koller M, Lang R, Handel G, Behr M. Clinical performance of complete dentures: a retrospective study. Int J Prost...

References : Retrospective cohort study of rough-s...

Duda M, Matalon S, Lewinstein I, Harel N, Block J, Ormianer Z. One piece immediately loading implants versus 1 piece or 2 pieces delayed: 3 years outcome. Implant Dent. 2016;25:109–13. Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: a systematic review. Clin Oral Implants Res. 2009;20(Suppl 4):172–84. Teughels W, Van Assche N, Sliepen I, Quirynen M. E...

References : Retrospective cohort study of rough-s...

Dahlin C, Linde A, Gottlow J, Nyman S. Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg. 1988;81:672–6. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6. Hellem S, Karlsson U, Almfeldt I, Brunell G, Hamp SE, Astrand P. Nonsubmerged implants in the treatment of the edentulous lower jaw: a 5-year pro...

References : Retrospective cohort study of rough-s...

Brånemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3:81–100. Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol. 2017;73:7–21. Ekelund JA, Lindquist LW, Carlsson GE, ...

Conclusions : Retrospective cohort study of rough-...

In conclusion, our analyses revealed a cumulative survival rate of 89.8% of TPS-surface implants with at least 25 years of functioning. The survival rate of maxillary positioned implants was significantly lower than that of mandibulary positioned implants. The patient gender, implant location, and width of keratinized mucosa affected the rate of peri-implantitis, resulting in late failure. Implan...

Discussion : Retrospective cohort study of rough-s...

We also observed that the tooth-implant-supported prostheses had a lower complication-free rate than implant-supported fixed prostheses due to caries, periodontitis, or the root fracture of abutment teeth. Lang et al. reported that the survival rates of tooth implant-supported fixed partial dentures were 94.1% after 5 years and 77.8% after 10 years of functioning [31], and these results were alm...

Discussion : Retrospective cohort study of rough-s...

Regarding the width of keratinized mucosa, many studies and a review have indicated that the presence of a sufficient width of keratinized mucosa is necessary for maintaining healthy peri-implants [26,27,28,29]. In the present study, when 2 mm of keratinized mucosa was used as the adequate width, the p value was 0.053 (data not shown). This also showed the tendency of the availability of keratini...

Discussion : Retrospective cohort study of rough-s...

Peri-implantitis is the major reason for late failure [13, 14]. The consensus report of the Sixth European Workshop on Periodontology described peri-implant mucositis in approx. 80% of subjects restored with implant, and peri-implantitis in 28–56% of subjects [15]. In the present study, the cumulative incidence of peri-implantitis was 9.5, 15.3, 21.0, and 27.9% at 5, 10, 15, and 25 years after ...

Discussion : Retrospective cohort study of rough-s...

Although all implants used in this study were withdrawn from the market about 20 years before, the longitudinal clinical outcomes over decades will help to better understand potential factors leading to implant failure or complications and assess the safe and predictable use of dental implant. Our analyses revealed a 25-year cumulative survival rate of 89.8% after the prosthesis setting, which se...

Results : Retrospective cohort study of rough-surf...

A total of 48 implants were eventually accompanied by a peri-implant infection: the cumulative incidence of peri-implantitis was 9.5, 15.3, 21.0, and 27.9% at 5, 10, 15, and 25 years after the prosthesis delivery, respectively (Fig. 3). After stepwise backward selection, the gender, implant type, and width of keratinized mucosa showed the significant difference in the cumulative survival rate (T...

Results : Retrospective cohort study of rough-surf...

A total of 92 patients (38 men, 54 women; mean age 54.3 years, range 20–78) received implant-supported prostheses (at the seven private practices) between 1984 and 1990. The distribution of patients by age and gender is presented in Table 1. Fifty-seven patients (140 implants) were considered dropouts due to the fact that no data were obtained at the endpoint, but 25 years had passed since th...

Methods : Retrospective cohort study of rough-surf...

This retrospective observational study was approved by the ethical committee of Nagasaki University (No. 1512). The cases of all of the patients who underwent dental implant treatment with a TPS-surfaced solid-screw implant and whose prosthesis was set in the years 1984–1990 at seven private practices were analyzed. All inserted implants were either a TPS-type (TPS-type, Institute Straumann, Bas...

Background : Retrospective cohort study of rough-s...

Dental implant treatment based on the concept of osseointegration [1] is now a widely accepted restorative treatment for fully and partially edentulous patients. In the earliest days of the use of osseointegrated implants, two different topographies were applied on the implant surfaces: a machined minimally rough titanium surface such as the Brånemark system and a rough microporous titanium plasm...

Abstract : Retrospective cohort study of rough-sur...

The longitudinal clinical outcomes over decades contribute to know potential factors leading to implant failure or complications and help in the decision of treatment alternatives. The cases of all patients who received dental implants treated with titanium plasma-sprayed surfaces and whose prostheses were set in the period 1984–1990 at seven private practices were retrospectively analyzed. The...

Table 7 Cox regression analyses for cumulative sur...

  Hazard ratio 95% confidence interval p value Gender (male) 1.82 0.946~3.487 ...

Table 6 Cox regression analyses for cumulative inc...

  Hazard ratio 95% confidence interval p value Gender (male) 2.38 1.138~5.362 ...

Table 5 Cox regression analyses for implant surviv...

  Hazard ratio 95% confidence interval p value Gender (male) 1.99 0.538~8.201 ...

Table 4 Distribution of implants by length and loc...

Dia. (mm) Maxilla anterior Maxilla posterior Mandible anterior Mandible posterior Tot...

Table 3 Distribution of implants by diameter and l...

Dia. (mm) Maxilla anterior Maxilla posterior Mandible anterior Mandible posterior Tot...

Table 2 Distribution of implants in situ (n = 22...

Position 1 2 3 4 5 6 ...

Table 1 Age and gender distributions (n = 92)

Age/gender Male Female Total 20–29 3 ...

References: Retrospective cohort study of rough-su...

References Brånemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3:81–100. Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol. 2017;73:7–...

Conclusions: Retrospective cohort study of rough-s...

Conclusions In conclusion, our analyses revealed a cumulative survival rate of 89.8% of TPS-surface implants with at least 25 years of functioning. The survival rate of maxillary positioned implants was significantly lower than that of mandibulary positioned implants. The patient gender, implant location, and width of keratinized mucosa affected the rate of peri-implantitis, resulting in l...

Results: Retrospective cohort study of rough-surfa...

A total of 48 implants were eventually accompanied by a peri-implant infection: the cumulative incidence of peri-implantitis was 9.5, 15.3, 21.0, and 27.9% at 5, 10, 15, and 25 years after the prosthesis delivery, respectively (Fig. 3). After stepwise backward selection, the gender, implant type, and width of keratinized mucosa showed the significant difference in the cumulative survival rate (T...

Results: Retrospective cohort study of rough-surfa...

Results Patient cohort A total of 92 patients (38 men, 54 women; mean age 54.3 years, range 20–78) received implant-supported prostheses (at the seven private practices) between 1984 and 1990. The distribution of patients by age and gender is presented in Table 1. Fifty-seven patients (140 implants) were considered dropouts due to the fact that no data were obtained at the endpoint, bu...

Methods: Retrospective cohort study of rough-surfa...

Methods Study design This retrospective observational study was approved by the ethical committee of Nagasaki University (No. 1512). The cases of all of the patients who underwent dental implant treatment with a TPS-surfaced solid-screw implant and whose prosthesis was set in the years 1984–1990 at seven private practices were analyzed. All inserted implants were either a TPS-type (TPS-t...

Background: Retrospective cohort study of rough-su...

Background Dental implant treatment based on the concept of osseointegration [1] is now a widely accepted restorative treatment for fully and partially edentulous patients. In the earliest days of the use of osseointegrated implants, two different topographies were applied on the implant surfaces: a machined minimally rough titanium surface such as the Brånemark system and a rough micropor...

Retrospective cohort study of rough-surface titani...

Abstract Background The longitudinal clinical outcomes over decades contribute to know potential factors leading to implant failure or complications and help in the decision of treatment alternatives. Methods The cases of all patients who received dental implants treated with titanium plasma-sprayed surfaces and whose prostheses were set in the period 1984–1990 at seven...

Figure 17. polythene “washer”

  Figure 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants

Figure 15. Facial appearance 18 months following ...

Figure 15. Facial appearance 18 months following treatment Figure 15. Facial appearance 18 months following treatment

Figure 14. Intra-oral view of perforated flap 3 we...

Figure 14. Intra-oral view of perforated flap 3 weeks following radiotherapy

Figure 13. Panoramic dental radiograph showing the...

  Figure 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis

Figure 12. Provisional acrylic fixed dental prosth...

  Figure 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery

Figure 11. Intra-oral view of the soft tissue flap

Figure 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants

Figure 10. Radial forearm flap inset and sutured i...

Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments

Figure 9. Inter-occlusal registration using the pr...

  Figure 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps

Figure 8. Abutment level impression utilising ligh...

Figure 8. Abutment level impression utilising light-cured acrylic tray material

Figure 7. Conventional zygomatic implant insertion

  Figure 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty

Figure 6. Zygomatic oncology implants sited in the...

Figure 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla

Figure 5. Left-sided maxillary resection (Brown cl...

Figure 5. Left-sided maxillary resection (Brown class 2b)  

Figure 4. Panoramic dental radiograph showing dent...

  Figure 4. Panoramic dental radiograph showing dental status at presentation

Figure 3. Staging CT scan confirming maxillary des...

  Figure 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor

Figure 2. Staging MRI scan showing destructive les...

Figure 2. Staging MRI scan showing destructive lesion left maxilla

Figure 1. Clinical view of left-sided maxillary tu...

Figure 1. Clinical view of left-sided maxillary tumour at presentation

Table 1 Patient-reported quality of life outcomes ...

Table 1 Patient-reported quality of life outcomes following ZIP flap procedure From: The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy Domain Score Activity 100 (“I am as active as I have ever been”) Anxiety 100 (“I am not anxious about ...

References: The zygomatic implant perforated (ZIP)...

References Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63. Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Impl...

Conclusions: The zygomatic implant perforated (ZIP...

Conclusions The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function...

Discussion: The zygomatic implant perforated (ZIP)...

Immediate/early loading of zygomatic [8] and dental implants [9] have been well demonstrated already within the literature with very high implant survival rates. In the oncology setting, Boyes-Varley et al. [4] lost no zygomatic/oncology implants in their series of 20 patients restored with implant-retained obturators, 6 of whom received radiotherapy post-operatively. The case reported...

Discussion: The zygomatic implant perforated (ZIP)...

The use of soft tissue flaps to close a typical hemi-maxillectomy defect is an effective way of dealing with the oro-nasal communication, but in isolation, this technique works against dental rehabilitation as the bulk of the flap provides a very poor moveable foundation for a subsequent removable prosthesis. The move towards the use of composite reconstruction (especially the fibula flap) h...

Discussion: The zygomatic implant perforated (ZIP)...

Discussion In order to reduce intra-operative time, the soft tissue free flap is harvested at the same time as the implant placement and prosthodontic procedures. On raising a skin island, it is appropriate to make it a little over-sized for the required defect to ensure that tension and possible dehiscence at the surgical margins during healing is reduced. In low-level maxillectomy (Brown...

Procedural modifications to the ZIP flap technique

Procedural modifications to the ZIP flap technique In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in th...

The ZIP flap technique (2)

The radial forearm free flap (RFFF) was then disconnected from the arm and inset into the maxillary defect after creating a tunnel down into the left neck for the pedicle. The flap was carefully perforated over the zygomatic implant abutment protection caps using a short incision just through the skin layer followed by blunt dissection to allow the abutment and cap to perforate the flap ensuring a...

The ZIP flap technique (1)

The ZIP flap technique The patient underwent tracheostomy, a limited left-sided selective neck dissection for node sampling and vessels preparation. The maxillary tumour was excised in a standard manner via an intra-oral approach with preservation of the left orbital floor (Fig. 5). The resection extended to the maxillary alveolar midline in the incisor region with extension posteriorly just into...

Case : The zygomatic implant perforated (ZIP) flap

Case presentation A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruc...

Background : The zygomatic implant perforated (ZIP...

Background The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment...

The zygomatic implant perforated (ZIP) flap

The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy Abstract This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prost...

Figure 9. a Mandibular implant-fixed prosthesis i...

  Figure 9. a Mandibular implant-fixed prosthesis inserted into the mouth.

Figure 8. Periapical radiographs of the implants

  Figure 8. Periapical radiographs of the implants. a Postoperative, 1 year. b Postoperative, 16 years

Figure 7. a Intraoral photograph. b Gold Dolder...

  Figure 7. a Intraoral photograph. b Gold Dolder bar and screws; marked wear of a prosthetic screw (arrow)

Figure 6. a Mandibular implant-supported overdent...

Figure 6. a Mandibular implant-supported overdenture inserted into the mouth. b Panoramic radiograph after insertion of the prosthesis

Figure 5. Preoperative intraoral photograph of imp...


Figure 3. Photomicrographs of the biopsy specimen

  Figure 3. Photomicrographs of the biopsy specimen showing the intermingling of (a), (b), and (c). a Moderately differentiated epidermoid tumor cells with a duct-like structure (hematoxylin and eosin [H&E], original magnification × 100). b Intermediate cells (H&E, original magnification × 100). c Clear cells (H&E, original magnification × 100)

Figure 4. Intraoperative photograph of resection o...

  Figure 4. a Intraoperative photograph of resection of the alveolar ridge and bilateral upper neck dissection. b Transplantation of a lateral tongue flap to cover the alveolar ridge defect. c Surgical specimen

Figure 2. Panoramic radiograph showing notable alv...

  Figure 2. Panoramic radiograph showing notable alveolar bone resorption in the left mandibular premolar region and slight resorption in the right mandibular canine region (arrows)

Figure 1. Intraoral photograph

Figure 1. Intraoral photograph showing diffuse tumor formation on the alveolar gingiva (arrows)  

Conclusion : Dental implant treatment in a young w...

We inserted an implant-supported overdenture on a gold bar retainer splinting four implants. However, the patient was not satisfied with this prosthesis because of the mucosal pain and discomfort that developed over time. In such cases, prosthetic loading of atrophic mucosa is often not well tolerated. As such, we proposed replacement with an implant-fixed prosthesis. Initially, the patient ...

Conclusion : Dental implant treatment in a young w...

Conclusions Prosthetic rehabilitation of edentulous patients after surgical management of oral cancer is difficult and therefore often avoided. However, adequate prosthetic rehabilitation is a pivotal factor for patients to regain oral function. In terms of the masticatory rehabilitation of these patients, the application of a removable prosthesis unsupported by implants may be difficult or...

Case presentation : Dental implant treatment in a ...

However, she was not satisfied with the prosthesis; she experienced denture discomfort and developed a decubital ulcer in the tongue flap area, and she gradually ceased use of the denture. The patient was followed for more than 10 years on a regular basis to examine recurrence or metastasis of the gingival carcinoma. Mild erythema and swelling of the mandibular and implant-surrounding mucosa secon...

Case presentation : Dental implant treatment in a ...

Case presentation A 16-year-old female patient developed slight tenderness of the gingiva in the left mandibular premolar region, and her dentist referred her to our clinic in April 1992. Oral examination showed erythematous granular swellings that bled easily on the alveolar gingiva involving the area extending from the right second premolar to the left second molar (Fig. 1). The lesion showed...

Background : Dental implant treatment in a young w...

Background Surgical treatment of oral cancer may lead to significant disability, including facial deformity, loss of hard and soft tissue, and impaired function of speech, swallowing, and mastication. Bone resection because of surgical treatment of a large mandibular tumor can cause long-term defects. Rehabilitation with a removable prosthesis can be difficult or impossible due to the distorted...

Dental implant treatment in a young woman

Dental implant treatment in a young woman after marginal mandibulectomy for treatment of mandibular gingival carcinoma: a case report Abstract Dental implants play an important role in postoperative rehabilitation after surgical treatment of oral cancer through the provision of prosthetic tooth replacement. Two major implant prosthesis designs are available: fixed implant-supported prostheses ...

Figure 9. Do you have any requests for dentists wh...

Figure 9. Do you have any requests for dentists who practice implant treatment?

Figure 8. What are the frequently received repair ...

Figure 8. What are the frequently received repair requests for IODs?

Figure 7. Creative steps to prevent veneer fractur...

  Figure 7. Creative steps to prevent veneer fracture and chipping in the molar region

Figure 6. the frequently received repair requests ...

Figure 6. the frequently received repair requests involving implant fixed prostheses

Figure 5. The main fabrication challenges faced

Figure 5. The main fabrication challenges faced

Figure 4. The proportions of attachment types used...

Figure 4. The proportions of attachment types used with IODs

Figure 3. Types of implant fixed prostheses are us...

Figure 3. Types of implant fixed prostheses are used in the posterior region

Figure 2. Types of materials used to make implant ...

Figure 2. Types of materials used to make implant prostheses in the anterior region

Figure 1. The proportions of abutments used with c...

Figure 1. The proportions of abutments used with cement-retained prostheses    

Conclusions: Current status of implant prosthetics...

  This survey served to clarify the current status of implant prosthodontics, issues, and considerations in their fabrication, and the status of prosthetic complications and preventive initiatives, all from a laboratory perspective. Concerning implant treatment, it was concluded that dentists either play the leading role or work in collaboration with technicians, inc...

Result & discussion: Current status of implant pro...

While the literature includes reports of frequent IOD-related prosthetic complications such as attachment-related compromised retention, detachment or fracturing of denture teeth, relining, and attachment damage, this survey showed a somewhat different trend. It can be inferred that these results differ from actual complication trends because they constitute responses to cases sent to ...

Result & discussion: Current status of implant pro...

The questionnaire revealed several creative steps, based on laboratory considerations, being taken to prevent veneer chipping and fractures, a frequent and problematic prosthetic complication (Q12) (Figure 7). Technicians were taking into account metal (including zirconia) coping designs (36.3%), covering only the distal-most part of the molar region with metal (24%), using veneering composi...

Result & discussion: Current status of implant pro...

Looking at repair requests (i.e., complications) involving the superstructures of fixed implant prostheses (Q11) (Figure 6), facing damage and chipping accounted for more than half of all requests (54.5%). Generally speaking, there are many reports that indicate a high incidence of complications related to fixed prostheses involving abutment screw loosening, detachment of cement-retained cro...

Result & discussion: Current status of implant pro...

This number was lower than in any of the other nine countries, and future changes in IOD use in Japan are a topic that remains interesting. 4. Prosthetic complications (Table 4) According to Papaspyridakos et al., indicators such as implant level (the relationship between the implant and bone) and the state of soft tissue around the implant are the most frequently used indices of implant s...

Result & discussion: Current status of implant pro...

There is also a greater possibility of direct (in-mouth) repair of failed veneering materials and greater shock-absorbing potential relative to occlusal force in comparison with porcelain. The trend to adhere resin materials instead of porcelain, from Brånemark and colleagues’ recommendations for acrylic resin as an occlusal surface material in the early 1980s, also cannot be ignored. All...

Result & discussion: Current status of implant pro...

There is a low risk of facing damage and chipping for prostheses in the anterior region. Nonetheless, the questionnaire revealed the unexpected result that indirect composite facing crowns accounted for 21.3% of the total. This may be because there are many indirect composite resins (Estenia, Ceramage, etc.) available in Japan, and crowns and bridges in the anterior region (natural abutment ...

Result & discussion: Current status of implant pro...

Our questionnaire indicated a distribution of 61.4% cement-retained versus 38.6% screw-retained prostheses (Q3), suggesting that cement retention is used more frequently in Japan. Unfortunately, the fabrication-oriented focus of this survey prevented clarification of the types of cement used for cement retention and the breakdown between provisional and definitive cement. Next, ...

Result & discussion: Current status of implant pro...

Dentists play a leading role in 39.3% of the time in implant treatment planning and prosthetic design, and dental technicians are consulted concerning cases and part usage 34.7% of the time, suggesting the approach to implants is driven by prosthetic considerations (by dentists) to some degree. However, because dental technicians indicated that they take the initiative 15% of the time, it is...

Result & discussion: Current status of implant pro...

Results and discussion Out of 120 surveys sent, 74 technicians responded, resulting in a response rate of 61.6%. A summary of the responses is provided in Tables 1, 2, 3, dan 4 dan Gambar 1, 2, 3, 4, 5, 6, 7, 8, dan 9. Because implant treatment (implant prostheses) requires a significant amount of specialized, high-precision laboratory procedures, this area of dental care exhibits slight...

Table 4 Prosthetic complications

Question   Values Q9. What are the main issues generally encountered? Compatibility precision issues 29.6% Aesthetic issues 33.2% Occlusal issues 37.2% Q10. What are the main fabrication challenges faced? Poor implant location and orientation 42.4% Inadequate consideration of occlusion 17.0% Defects and inaccuracies in impression and bite registrat...

Table 3 Implant overdentures (IODs)

Question   Values Q7. The design of the implant overdenture: Decision made according to instructions of dentist 43.2% Work is left to technicians 19.3% Decided upon through consultation with each other 37.5% Q8. What are the proportions of attachment types used with IODs? Bar and clip 35.6% Magnet 30.2% Ball and socket 19.0% Locator 5.2% ...

Table 2 Implant fixed prostheses

Question   Values Q3. The percentages of implant fixed prostheses: Cement-retained 61.4% Screw-retained 38.6% Q4. What are the proportions of abutments used with cement-retained prostheses? CAD/CAM (titanium) 19.7% CAD/CAM (zirconia) 12.1% Custom abutments (UCLA-type abutment + gold alloy) 33.2% Two-piece-type titanium (prepable type) 28.3% ...

Table 1 Conditions characterizing implant laborato...

Question   Values Q1. The years of experience working as a dental technician, and the number of dentists from whom job orders are received.   Mean (SD) 17.0 (6.8) years 36.5(12.4)/Lab. Q2. Who takes the leading role in treatment planning and prosthetic design (initiative with regard to prostheses)? Dentists mainly exercise initiative 39.3% Technicians mai...

Methods : Current status of implant prosthetics in...

Methods This cross-sectional questionnaire survey was performed among the certified dental technicians of JSOI from September to December in 2011. Selected were 120 out of 285 certified dental technicians of JSOI using a random number table and mailing each questionnaire directly to the participant. To facilitate coverage of a broad range of topics, the survey classified content into the follow...

Background : Current status of implant prosthetics...

However, because understanding the status of these complications is based on the results of surveys targeting dentists, information is needed on the situation as seen from the standpoint of implant technicians, to clarify the causes of these complications and the techniques for dealing with them. Issues including inadequate communication between dental technicians and dentists and insufficient ins...

Background : Current status of implant prosthetics...

Background Currently, dental implant treatment is evaluated on the basis not only of restoring masticatory function, but also a variety of other factors, including the implant and superstructure survival rate and psychological impacts. Numerous factors must be taken into account, to offer highly predictable implant treatment, and there is no doubt that prosthetic-related factors such as the typ...

Current status of implant prosthetics in Japan

Abstract Background There are many implant cases in which dental technicians take initiative with regard to the design of implant prostheses, and to a certain extent, this area of care is one in which dentists do not necessarily play the leading role. Moreover, inadequate communication between dental technicians and dentists and insufficient instructions for technicians has been highlighte...

Factors influencing post-extraction ridge atrophy

Many factors have been suggested as having an influence on post-extraction ridge atrophy. Among these, the most significant are: pre-existing pathological processes that have damaged the bone prior to extraction; excessive pressure from a removable prosthesis; the presence of a thin bone phenotype; the number of missing teeth, that is, the more teeth that are missing, the greater the atrophy...

Factors influence tissue atrophy

Figure 39. Alveolar atrophy The amount of tissue atrophy can also be influenced by factors such as pre-existing pathological processes and excessive pressure from a removable prosthesis.

Ridge alterations following tooth extraction

Figure 37. Alveolar atrophy Following multiple- or single-tooth extraction and the subsequent loss of masticatory function, the alveolar ridge will present a series of adaptive alterations known as alveolar atrophy. The alveolar atrophy is characterized by a reduction in the dimensions of the alveolar ridge that is a combination of hard and soft tissue changes.

Discussion: Short implants in maxillary and mandib...

The present report showed that short implants may achieve optimal clinical and radiographic outcomes at the 1-year follow-up when used for single restoration or when connected with other implants in substituting for more than one tooth. There was no difference in outcomes between mandibular and maxillary restorations even though a higher quantity of bone volume was required in mandibular restora...

Weton: Implant pendek dalam rehabilitasi rahang at...

Weton Sebaran panjang dan diameter implant ditampilkan dalam Tabel 1. Tabel 2 merinkes posisi implant dan ciri prostetik. Rerata tinggi tulang sisa adalah 6.21 ± 1.05 mm di rahang atas dan 10.73 ± 1.63 mm di rahang bawah. Perbedaan di antara 2 rahang itu signifikan (P < 0.05). Tidak ada komplikasi bedah atau pasca bedah yang dilaporkan. Tabel 2. Posisi implant dan ciri prostetik; implant ante...

Results: Short implants in maxillary and mandibula...

Implant length and diameter distribution are shown in Table 1. Table 2 summarizes implant positions and prosthetic characteristics. Mean residual bone height was 6.21 ± 1.05 mm in the upper jaw and 10.73 ± 1.63 mm in the mandible, and it was significantly different between the 2 jaws (P < .05). No surgical or postsurgical complications were reported. Table 2. Implant positions and prostheti...

Data analysis: Short implants in maxillary and man...

In this ad interim report, 1-year data regarding bone resorption were assessed. Implant survival and success rates were evaluated by comparing maxillary and mandibular implants, splinted and single implants, and implants of different lengths. A Student t test was used to compare bone resorption between mandibular and maxillary implants and splinted and single implants. Analysis of variance was u...

Clinical and radiological evaluation: Short implan...

Clinical evaluation was performed every 6 months for the first 2 years then yearly. Survival and success rates were evaluated and recorded, following the definitions and parameters described elsewhere. Any surgical, prosthetic, or clinical complication was recorded. Prosthetic success was evaluated as follows: prosthesis in function, without mobility and pain, even if in the face of the loss of o...

Surgical and prosthetic procedure: Short Implants ...

Antibiotic prophylaxis with amoxicillin 2 g was administered to all patients 1 hour before surgery in all patients. All implants were placed in healed sites and the bone socket was prepared using a standard atraumatic technique with a sequence of drills of increasing diameter at the decided length. The implant site was always underprepared, taking in consideration the bone density. All implants ...

Materials & methods: Short implants in maxillary a...

This prospective single-cohort study was designed and conducted following the principles of the World Medical Association Helsinki Declaration of 1975 for biomedical research involving human subjects, as revised in 2000. Ethical approval for the study was obtained by the review board of the IRCCS Istituto Ortopedico Galeazzi. All patients were informed about the study aims and design and gave w...

Introduction: Short implants in maxillary and mand...

Introduction Implant rehabilitation in the posterior regions of the maxilla and mandible can be complicated in cases of reduced bone volume due to bone resorption after teeth extraction or to particular anatomic conditions. In fact, reduced bone height can prevent long implants (>10 mm long) from being placed because of the risk of involving anatomic structures, such as ...

Abstract: Short implants in maxillary and mandibul...

Short Implants in Maxillary and Mandibular Rehabilitations: Interim Results (6 to 42 Months) of a Prospective Study  J Oral Implantol (2015) 41 (1): 50–55. https://doi.org/10.1563/AAID-JOI-D-12-00206 The aim of this single-cohort study was to evaluate clinical survival and success of partial rehabilitation supported by reduced-length implants in maxilla and ...