ARTICLE INFO ABSTRACTThe goal of prosthetic dentistry is to restore patient's masticatory function and aesthetics along with preservation of the remaining intraoral structures. This can be achieved by preventive prosthodontics which is in compliance with Devan's dictum stating that "preservation of the remaining structure is more important than the replacement of what is missing". Preventive prosthodontics helps to improve retention and stability of the final prosthesis. Moreover, it preserves the alveolar bone and proprioception, providing psychological benefit to the patient, thereby enhancing the success rate of the treatment. This article presents a case report of rehabilitation of a partially edentulous patient incorporating the principles of preventive prosthodontics.
Background: In the rehabilitation of atrophic posterior maxilla, factors such as age, extraction of teeth result in loss of alveolar bone height together with increased pneumatization of sinus contradicting the implant surgery. Although adequate bone height can be achieved using various maxillary sinus augmentation techniques, these procedures have been practiced successfully. However, significant complications occur such as perforations or tearing. To maintain the integrity of Schneiderian membrane subsequently increasing the success rate a retrospective analysis is carried out on various techniques with complications which occur during and after treatment.Methods: A systematic online and manual review of the literature identified articles dealing with SFE. Applying rigid inclusion criteria, screening and data abstraction were performed independently by two reviewers. The follow-up of was a minimum of 6 months. The articles selected were carefully read and data of interest were tabulated. The identified articles were analyzed regarding implant outcome, with or without graft using different surgical techniques with complication rates using random-effects Poisson regression models to obtain summary estimates/ year proportions. This article reviews various sinus lift techniques for intact elevation of Schneiderian membrane based on advanced PUBMED, Medline, Cochrane database system search of English-language literature from the year 2004 to present in order to compare and evaluate the success rate with minimal complications selecting the most suitable which can fulfill the criteria of being non-invasive, less time-consuming, more reliable and less traumatic.Result:After reviewing various sinus elevation techniques; nasal suction technique(NaSucT), balloon antral elevation technique(BAOSFE), and Hydraulic Sinus Lift technique(HySiLift) emerges as more favourable among all these and can efficiently lift the Schneiderian membrane with minimal trauma. We must emphasize that these are new techniques and cannot replace the conventional techniques as a whole.
Aim:The success of implant therapy is of greatest concern for clinicians because a minor negligence can lead to ultimate failure of treatment. However, comprehensive and precise treatment planning can ensure high success rate of implant therapy. Cone-beam computed tomography (CBCT) is an innovation that allows clinicians to explore all related factors in details. This study was conducted to evaluate different preosteotomy determinants as affecting the success of implant therapy in the maxillary anterior region using CBCT. Materials and methods: This study was conducted on 98 partially or complete denture patients willing for artificial replacement of their missing teeth by implant or implant over-denture. Demographic details of participating patients were collected. Furthermore, comprehensive local examination was also done to finalize the site of placement of implant. Cone-beam computed tomography was attempted in all patients for determining accurate implant location, status of bone, and other interrelated determinants of implant success. Cone-beam computed tomography was also prescribed for patients so as to have presurgical idea of implant dimensions as shown in virtual placement of implant. To rule out any interobserver bias, the interpretations of CBCT images were completed by two independent experienced observers. Results: In the 98 studied patients, 61 were males and 37 were females. The study was restricted to the maxillary anterior region only. The studied preosteotomy determinants were available bone height and width in the edentulous region from ridge crest up to the maxillary sinus floor or the nasal fossa floor. A total of 107 implants were placed virtually (on CBCT) in the maxillary anterior region and compared quantitatively in postosteotomy phases. Implant placement sites were the maxillary central incisor region (39), the lateral incisor region (31), and canine (37). Authors also noticed that the relative length and width of virtual implant remained unaffected in 97% of the cases. Conclusion: Cone-beam computed tomography showed accurate status of various presurgical determinants like trabeculae, peri-ridiculer pathology, and amount of horizontal and vertical bone losses. Hence, it was further concluded that all these presurgical determinants greatly affect the final success rate of implant therapy. It is therefore deemed necessary to judiciously consider and clinically manage such factors before attempting implant in the maxillary anterior region. Clinical significance: Presurgical evaluation of factors associated with implant dimensions significantly assists clinicians in deciding the finest treatment option. All additional information provided by CBCT genuinely led to a change in the treatment plan that provides enhanced clinical outcome with lesser postoperative complications.
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