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Purpose: To present clinical results with 9 years of follow-up of a protocol of immediately loaded implants with two different surfaces., Materials and Methods: A total of 44 patients received 66 Brånemark System TiUnite and 55 Brånemark machined implants, all immediately loaded. Control examinations were performed on the day of surgery and at 1-, 3-, and 9-year follow-up visits., Results: All implant sites had intact buccal and lingual bone walls. The prefabricated provisional restorations showed an excellent fit. Three TiUnite and 8 machined implants failed within 7 weeks of loading, resulting in a cumulative survival rate of 95.5% and 85.5% respectively after 9 years of load. The survival rate for implants in a partial prosthesis was 98.8% and 92.2% for single restorations in the TiUnite group, and 87.8% and 83.2%, respectively, for partial and single resorations in the control group. The marginal bone resorption in the first year was on average 0.9 mm in the TiUnite group and 1.0 mm in the machined group; at the third year it was 0.4 and 0.5 mm, respectively. On examination at 9 years, there was a general settlement of the bone, with a negligible further loss in height., Conclusions: The unchanged survival rate and the low bone loss after 9 years confirm the feasibility of an immediate loading protocol in the mandible, which included flapless surgery. TiUnite implants obtained a 10% higher success rate compared with machined fixtures .

Aim. The aim of this in vitro study was to compare the loading force at the fracture of monolitithic zirconia cantilever substructure in complete arch-prostheses supported by tilted or parallel implants. Material and methods. Ten anatomical models of edentulous mandible were fabricated. Five of these models had five screwtype implants embedded vertically in the intraforamica area (Brånemark protocols). The other five models had four screwtype implants in the intraforaminal area, two in front were placed vertically and two rear were tilted 30 degrees distally (All-on-4). Twelve superstructure in monolithic zirconia were fabricated, ten for the Brånemark protocols and ten All-on-4, with two cantilever for each superstructure. A static load was applied on the cantilever with a universal machine. The fracture load was monitored and the sites of fracture were identified. Results. No statistical significant difference was found between the two techniques. Mean fracture load values was 998 N (SD 83N) for Brånemark protocols while 905 N (SD 37N) for All-on-4. Most fractures occurred at the mesial connector attack to the last abutment. Conclusion. Zirconia cantilevered frameworks on vertical implants may tolerate higher occlusal forces before fracturing. [ABSTRACT FROM AUTHOR]

Various diseases and conditions can cause bony defects in the maxillofacial region. Since microvascular bone graft transfers were introduced in 1970, new possibilities in reconstructive surgery have arisen. Various methods of treatment have been described for severely atrophic mandibles. These methods are: (1) the placement of four endosteal implants of short length, (2) the placement of a trans-mandibular implant (3) the placement of endosteal implants in combination with vertical distraction osteogenesis or (4) the placement of endosteal implants in combination with an onlay or interpositional bone graft. The patient was operated on to harvest bone for dental implant insertion at the Galeazzi Institute (Milan, Italy) in August 2016. He presented high resorption of edentulous mandible. Bone from the anterior approach was harvested started with a saw, and then a chisel and mallet were used. After 6 months removal of the screws of synthesis (1 fractured is left in place). Insertion of endosseous implants After 3 months loading with mixed prosthesis (bar + overdenture) with locator. Several Authors have reported pain on walking, weakness of the abdominal wall, frank herniation, and disturbances of gait. A few other approaches have been suggested to reduce impairments at the donor site such as taking only the inner cortex, which will reduce the amount of bone available and its implantability. Others have suggested leaving the iliac crest and harvesting the underlying bone. It is concluded that in treatment combining an onlay graft and simultaneous implant placement in the extremely resorbed mandible, considerable graft resorption must be anticipated. [ABSTRACT FROM AUTHOR]