The Dent-Liner
Volume 6 Issue 1
Winter 2002
A BULLETIN DEALING WITH ISSUES FOR DENTAL HEALTH PROFESSIONALS
An
Alternative Approach to Implant Loading
Implant
therapy is a standard treatment for the restoration of fully and partially
edentulous patients. Implants are subjected to the masticatory process
which is influenced by occlusal load, primary or secondary occlusal trauma
and tissue reaction due to adverse clinical conditions. The greatest masticatory
forces are generated when the maxillary and mandibular occlusal surfaces
are in contact. Although the periods of occlusal contact are of very short
duration, while chewing the accumulative result on a daily basis can add
up as much as 30 minutes of actual contact loading. Bruxers and TMJ suffers
can subject the implants to much higher loads. It is this type of abuse
that can result in degenerative changes to the periodontal tissue, alveolar
bone and muscle attachment. Axial and horizontal loading results in implant
movements in all directions. Measurement of these movements has shown that
patients with implant borne dentures have a stronger ultimate bite force
than those with conventional dentures. Clinically mobility is either reversible
or irreversible. The removal of inflammation or negative forces may result
in the elimination of mobility. Surgical procedures can be utilised to
try and improve the implant longevity but these procedures are both time
consuming and have questionable results. The recent introduction of the
Bredent Vario-Stud Snap OC-RS Implant Abutments is an alternative retention
method, since the plastic retentive inserts are resilient and have a built
in "shock absorber". The Bredent implant stud abutments fit Branemark,
Steri-Oss, Replace and 3i external hex platforms. During mastication forces
averaging 8 kg of axial loading starts the shock absorber to compress to
a depth of 0.5mm. In this way it provides a "buffering" action during
the masticatory process to reduce the loading responsible for premature
failure of implants. With the availability of the Bredent Implant abutments
it is now possible to have an advantage over conventional attachments.
Studies show an incidence of implant failure due to surgical trauma, bio-mechanical
loading, and misfitting over dentures. The resilient retentive inserts
may tentatively provide adequate cushioning there by reducing resorbtion
and micro fractures to the implant bone interface. This will provide patients
with an alternative retention system that has not been an option until
now. The laboratory procedures and fabrication begins after the healing
phase has elapsed. A proper abutment is selected and screwed in to place.
The impression is made and the dental laboratory is provided with a transfer
analogue. After the completion of the master model the denture is waxed
for fit and the axle analogues are placed over the transfer analogue studs
to check the divergence. This divergence should not exceed 15 degrees on
each abutment. The titanium housing and retention sleeve is placed on to
the analogues and is held in position with the parallel mandrel to determine
the path of insertion. The off set is filled with plaster to ensure the
position. The waxed denture is placed on the model and finished to the
standards of practice. A pick up technique interorally can also be utilized.
The resilient retention sleeves can be exchanged for a higher friction,
chair side if need be. Source; Peter T. Pontsa RDT. With special
thanks to Dr. Isaac Barzilay for assisting on the clinical aspects.
References; 1. Dr. Angelo Caputo & Dr. Robert Wylie. Force
Generation & Reaction Within The Periodontium UCLA Lecture 2000. 2.
W. Niedermer, Occlusion & Periodontal Reaction, Zahnheilkunde 1993.
3. Drs. L. Lindquirst, G. Carsson, .T. Jemet, A Prospective 15 Year
Follow-Up Study of Mandibular Fixed Prosthesis,Clinical Results. Clinical
Oral Implant Research 1996.
Bredent's
Master Pin / Master-Split Model System
Bredent
introduces the Master Pin System designed by Thomas H. Wendler MDT. The
system is a brass pin and plastic sleeve which has the smallest drilling
depth of all pins of 4.5 mm. The advantage of a short drill hole means
no perforation of the arch during drilling. The Master Pin and Sleeve can
be easily assembled because of the taper and the rounding of the end of
the pin. The overall length of the pin is 11.7 mm, which provides a low
profile master model.The unilateral flattening of the Master Pin sleeves
prevents rotation in the base stone and can be placed closer together in
narrow areas. There is a special surface design of the plastic wall of
the sleeve which assures a soft friction while providing maximum precision
and stability. Drill holes are prepared, two for each die. Beginning from
the buccal direction the first one is in the centre of the fissure and
the second drill hole is approximately 2 to 3 mm away toward the lingual
direction or palatally. The pin system is complimented by the Master Model
System which is used to prepare the base for the arch. It consists of base
former and magnetic plate which sits on the bottom. The prepared arch is
placed in the model former and the base is filled. Once hard the model
can be pressed out and dies cut. The Model System helps to save plaster
which has one plate for all three model sizes. There is more retention
due to the octagon platform around the integrated magnet. It is reusable,
color coded and inexpensive to use. For further information call 1-800-250-5111
or
email us at info@dent-line.com
Landmark
Implant Study Published
Patients and periodontist are scrambling to learn more about an innovative
procedure using dental implants since a landmark study conducted by Drs.
Jeffery Ganeles, Marvin M. Rosenburg, Robert L. Holt and Linda M. Reichman
RDH was published in the prestigious International Journal of Oral &
Maxiofacial Implants. The group based at the Florida Institute for Periodontics
and Dental Implants, presented their findings in the May/June issue of
the peer reviewed journal. In it they revealed their dramatic conclusions
on their technique called Teeth Today™ a procedure that reduces
the time required for patients to receive fixed replacement teeth
with implants from six months to a mere 24 hours. Statistics reveal that
procedures like Teeth Today™ are in high demand. According to the National
Institutes of Health, 67 million Americans suffer from periodontal disease,
the leading cause of adult tooth loss in the country. At least 113 million
Americans are missing one or more teeth. Source; Infodent No. 26/2001.
Publishers' Note:
On a personal note I find this study quite remarkable and hope that
it will be more than just a good story. Both component strength and bone
potency are biomechanical aspects that have to be taken into consideration
in treatment planning. We will report further updates on this study when
more information becomes available.
Peter T. Pontsa, R.D.T.
Technorama
2002, Exhibition and Seminars
Dent-line of Canada would like to remind you that Technorama 2002 will
be held Friday, March 22nd and Saturday, March 23rd at the International
Plaza Conference Centre at 655 Dixon Rd., Toronto, Ontario, M9W 1J4. We
will also be sponsoring a one hour seminar called; An Alternative Approach
to Loading of Implants and Root Borne Removable Restorations. It will
be presented by Peter T. Pontsa RDT and continuing education credits will
apply. We encourage you to also visit our booth to see the newest products
from bredent and meet the customer service people that do their
best to get the products you need for your laboratory.
The Dent-Liner; Vol. 6, No. 1
Publisher: Peter T. Pontsa RDT
Editor: A. Van Breemen BA
E-Mail: info@dent-line.com
