Tag Archives: dental implants

Guided Implant Placement and Immediate Prosthesis Delivery Using Traditional Brånemark System Abutments: A Pilot Study of 23 Patients

Balshi SF, Wolfinger GJ, Balshi TJ

Implant Dent. 2008 Jun;17(2):128-135.

*Chief Operating Officer, CM Prosthetics; Director of Biomedical Engineering & Research, PI Dental Center, Institute for Facial Esthetics, Fort Washington, PA. †Prosthodontist, PI Dental Center, Institute for Facial Esthetics, Fort Washington, PA. ‡Founder and Prosthodontist, PI Dental Center, Institute for Facial Esthetics, Fort Washington, PA.

PURPOSE:: The aim of this study is to demonstrate the accuracy and clinical precision of a guided surgery protocol by using traditional Brånemark System abutments in conjunction with a prefabricated all-acrylic provisional prosthesis that is immediately installed after implant placement. MATERIALS:: All presurgical methods in this treatment follow the standard NobelGuide protocol with the exception of the laboratory phase. Once the master cast is retroengineered from the surgical template, traditional Brånemark System abutments were secured onto the implant replicas (master cast) and an all-acrylic provisional prosthesis was constructed at the abutment level. The typical abutments used with this protocol, adjustable Guided Abutments, were not used. RESULTS:: Twenty-three patients were treated in this pilot study. Via the surgical template, all implants were placed to the desired depth as planned in the virtual implant planning program. After the traditional Brånemark Abutments were installed, the provisional prosthesis was delivered and occlusion verified. The prosthesis fit was checked at abutment level clinically and radiographically. CONCLUSION:: This report shows the extreme accuracy of this guided surgery protocol. If each step of this protocol is followed precisely, it is possible to deliver a prefabricated prosthesis built to traditional Brånemark System Abutments, which is extremely favorable for long-term patient and prosthesis management.

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A Resonance Frequency Analysis Assessment of Maxillary and Mandibular Immediately Loaded Implants

Stephen F. Balshi MBE/Fred D. Allen PhD/Glenn J. Wolfinger DMD FACP/Thomas J. Balshi DDS FACP

Int J Oral Maxillofac Implants. 2005 Jul-Aug;20(4):584-94

PURPOSE This study evaluated the stability of implants in 51 patients following a clinical protocol of immediate functional loading. The stability during the first 3 months following implant placement was assessed according to bone type, implant location, and patient gender. MATERIALS AND METHODS: Twenty-two male and 29 female patients were treated with 344 Brånemark System implants placed in edentulous bone or extraction sites and put into functional loading using the Teeth in a Day protocol. Each implant was tested for primary stability with resonance frequency analysis (RFA) at the time of implant placement, and RFA was performed at examinations 30, 60, and 90 days following surgery. RESULTS: The analysis was based on the 276 implants that were successfully measured using RFA at all postoperative intervals. The clinical implant survival rate was 98.5% for the total population. RFA showed a decrease in bone-implant stability in the first month after implant placement from 70.35 +/- 0.5 to 66.38 +/- 0.50, followed by increases in stability in the second and third months (68.01 +/- 0.50 and 68.82 +/- 0.49, respectively), suggesting a process of adaptive bone remodeling around the implant. In general, lower initial stabilities were seen in softer bone types, in the posterior portions of the jaw compared to anterior areas, and in the female population. DISCUSSION AND CONCLUSION: The results of this study suggest an immediate loading protocol should have an undisturbed period of healing for the first 2 months following implant placement. The determination of “predictor” stability levels for different clinical conditions were based on multiple splinted implants, allowing a larger surface area to withstand the distribution of the load. The most significant “predictor” values from a surgical and prosthodontic perspective are those determined in soft bone, in reduced bone, or in areas where lever arms are created as a result of long spans between the implants.

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