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
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