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Diabetes mellitus, a prevalent disorder worldwide, is associated with systemic adverse sequelae, such as wound healing alterations, which may affect osseointegration of dental implants. This prospective multicenter study assessed the success of 2-stage endosseous root-form implants (3 different implant systems) placed in the mandibular symphysis of 89 male type 2 diabetic subjects. The implants were uncovered approximately 4 months after placement, restored with an implant-supported, Hader bar clip-retained overdenture, and maintained at scheduled follow-up data collection examinations for 60 months after loading. Sixteen (9.0%) of the 178 implants failed. Life table methods calculated implant survival at approximately 88%, from prosthesis placement through the 60-month follow-up, and at approximately 90% from implant placement through the observation period. No implants failed between surgical placement and uncovering, 5 failed at uncovering, 7 failed after uncovering before prosthesis placement, and 4 failed after prosthesis placement. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) values were determined before implant placement (baseline) and approximately 4 months later at surgical uncovering (follow-up). The 5-year implant outcomes (successes versus failures) were analyzed against the following predictor variables: (1) baseline and follow-up FPG values, (2) baseline and follow-up HbA1c values, (3) subject age, (4) duration of diabetes (years), (5) baseline diabetic therapy, (6) smoking history, and (7) implant length. Regression analysis found only duration of diabetes (P < .025) and implant length (P < .001) to be statistically significant predictors of implant failure. There was no statistically significant difference in failure rates between the 3 different implant systems used. This study supports the use of dental implants in type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

This clinical report describes an apparent change in the position of a metal ceramic crown cemented, for approximately 1 decade, on a single anterior implant. The continuing growth of the adult facial bones is presented as a plausible explanation for this clinical scenario.

Achieving proper contour of an implant-supported crown is essential for an esthetic result, particularly in the maxillary anterior area. Development of the soft tissue profile prior to the initiation of laboratory procedures is the ideal approach. This article describes a procedure that makes use of a soft tissue cast to permit crown fabrication prior to intraoral soft tissue customization.

Extensive research has shown that the removable implant overdenture is a suitable treatment modality for edentulism, which may be particularly advantageous in the older patient. Clinical studies, treatment planning considerations, complications and maintenance of the implant overdenture are discussed in this paper. Clinical examples that illustrate several common applications of this prosthesis are presented.

A successful implant restoration is dependent on proper implant position. Correct implant placement is more predictable when a surgical stent is used. This article describes the fabrication of a surgical stent for the edentulous mandible using a denture with acceptable adaptation and tooth arrangement as a given.