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Rare earth magnetic attachments are proving to be viable alternatives to conventional precision attachments or screw fixation for implant retained prostheses. These new attachments circumvent many of the problems encountered with traditional mechanical attachments. The Jackson attachments are economical, require few complex laboratory procedures, and are comparable in retention to mechanical attachments. Continuous maintenance is virtually eliminated and the effective retention does not decrease with wear as in more conventional systems. This new technology should greatly improve the art of implant-retained prostheses.
As experience with the Brånemark approach to osseointegration increases, variations of the conventional Swedish technique have evolved. Among these are the application of overdenture principles that have been necessitated by either economic considerations or patient compromise that would make the standard approach impractical. This article presents variations of clinical procedures for both the maxilla and mandible that may be applied to both the conventional edentulous and the functionally debilitated patient.
Reconstructive procedures for the severely resorbed mandibular edentulous ridge have historically involved the use of a variety of surgical procedures and biologic and nonbiologic materials with limited success. Since the introduction of osseointegrated fixtures to support tissue-integrated prostheses, the procedure has been applied to more complex clinical situations. The treatment of three patients with severe mandibular ridge resorption utilizing osseointegrated fixtures is described.
Use of the transitional denture for patients who will receive osseointegration treatment provides several distinct advantages. (1) As a diagnostic tool it is used to establish the correct occlusal vertical dimension, appropriate lip and cheek support, and to assess other esthetic and phonetic factors. (2) It functions as an interim prosthesis. (3) It provides guidelines via surgical guidestents for fixture location and angulation. (4) Also, it can become an integral part of the conversion prosthesis.
The effect of cis-Platinum on bone ingrowth into the fiber titanium (Ti6Al4V) implants of 36 medicated and 36 control rat tibias was assessed for the amount, composition, and mineralization rate. In this experiment, it was found that cis-Platinum, in therapeutic doses, reduces interfacial strength, inhibits bone ingrowth into the implants and also mineralization of the ingrown bone less than 10 weeks after completed medication.
Not all edentulous persons are candidates for dental implants. Criteria for the evaluation and selection of patients for restorative treatment utilizing tissue-integrated prostheses are presented. Successful treatment prognosis is directly related to selecting appropriate patients for management.
