This article describes a fully digital method of verifying and increasing the accuracy of the position of implants in extensive prosthetic restorations. This cost-effective, timesaving, and versatile procedure uses a laboratory scanner, a scannable implant analog, and a printed interim implant-supported prosthesis to refine the virtual definitive cast.
PURPOSE OF THE STUDY Cranioplasty is currently the most common neurosurgical procedure. The purpose of this study is to describe the first experience with successful use of the Cranio-Oss (PEEK) custom implant for cranioplasty. MATERIAL AND METHODS In the period 2012 to 2013, a total of 26 cranioplasties were performed. In fourteen patients, their own bone flap was used for reconstruction. In four cases, a synthetic Cranio-Oss bone implant made of PEEK was used. In six patients, the defect was covered by an intraoperatively-made Palacos implant and in two cases, minor defects were covered with a titanium mesh. The patients were followed up for at least five years. Cranio-Oss is a cranial implant made from polyetheretherketone (PEEK), a synthetic biocompatible material. The implant is created using the CAD/CAM method in the shape of the bone defect based on the CT scan. Creating optimal roughness of the implant surface and of the surface of the contact area attached to the bone bed is controlled and included already in the strategy for machining individual areas of the implant during its manufacturing at a 5-axis machining centre. RESULTS The Cranio-Oss implant was used in four younger patients to cover larger and complex-shaped defects. The mean age of patients in this group was 47 years. The implant was fixed to the skull by micro-plates. In all the cases the wound healed well with good cosmetic results without the necessity of revision with respect to the used implant. The follow-up CT scans always showed the implant in situ with no signs of malposition. DISCUSSION Autologous bone flap is the most suitable material for defect reconstruction after craniectomy. This option is affordable and represents one of the best methods of reconstruction of defects after craniectomy in terms of cosmetic results. In some cases, the original skull cannot be used for cranioplasty (e.g. if destructed by tumourous process, infected or in comminuted fractures). In such cases, the defect needs to be managed using a synthetic implant. In case of extensive defects, the most suitable option is a custom made implant from advanced biomaterials. CONCLUSIONS Authors prefer using autologous bone flaps during cranioplasty. In cases where this method is unavailable, a synthetic bone substitute has to be used. The first medium-term experience with the use of a Cranio-Oss implant made of PEEK showed that it is a suitable alternative to the patient's own bone. No complications associated with this synthetic implant were reported and its use to manage skull defects can be strongly recommended. With respect to legal and accreditationrelated difficulties connected with bone fragments storage and thanks to the continuous cost reduction of synthetic implants will their importance grow in the future. Key words: decompressive craniectomy, bone substitute, craniotrauma.
- MeSH
- biokompatibilní materiály aplikace a dávkování MeSH
- ketony aplikace a dávkování MeSH
- lebka chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- polyethylenglykoly aplikace a dávkování MeSH
- protézy a implantáty MeSH
- retrospektivní studie MeSH
- zákroky plastické chirurgie přístrojové vybavení metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The objectives of this study were to evaluate osseointegration of dental implant in the jaw bone in the young and elderly population and comparing the results to assess indicators and risk factors as age for the success or failure of dental implants. A retrospective study of 107 implants (Impladent, LASAK, Czech Republic) was prepared. The patients at implants surgery were divided in three groups. The patients were followed-up for a 7-year period. We evaluated osseointegration from long term point of view as a change of marginal bone levels close to dental implant. Marginal bone levels were recorded and analysed with regard to different patient- and implant-related factors. An influence of chronological age on change of marginal bone levels during 6-year retrospective study vas evaluated. The study examined 47 patient charts and 107 implants from the Second Faculty of Medicine, Charles University and University Hospital Motol. We proved that young healthy patients with long bridges or Branemarks have the same progression of marginal bone levels changes. The chronological age hasn't therefore direct influence on the osseointegration from long term point of view. But we found that the length of dental suprastrucure-prosthetic construction negatively influences marginal bone changes, though these results weren't statistically significant. More extensive dental implant suprastrucure undergoes smaller osseointegration. On the other hand the length of dental suprastrucure (prosthetic construction) negatively influences dental osseointegration in both groups of patient.
- MeSH
- čelist bezzubá diagnóza MeSH
- dospělí MeSH
- endoseální implantace zubů statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- osteointegrace fyziologie MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- zubní implantáty statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- biokompatibilní potahované materiály MeSH
- diagnostické zobrazování metody MeSH
- dospělí MeSH
- endoseální implantace zubů metody MeSH
- lidé MeSH
- nanostruktury chemie MeSH
- okamžité zatížení zubního implantátu * MeSH
- osteointegrace MeSH
- povrchové vlastnosti MeSH
- prospektivní studie MeSH
- titan * chemie MeSH
- výsledek terapie MeSH
- zubní implantáty * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- MeSH
- lidé MeSH
- zubní implantáty * MeSH
- zubní materiály * klasifikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
PURPOSE: To monitor the development of stability of immediately loaded implants during early healing. MATERIALS AND METHODS: A total of 90 interforaminally placed implants with an alkali-treated surface were considered. The stability of each implant was examined at placement and 1, 2, 3, 4, 5, 6, 8, and 10 weeks after the surgery using resonance frequency analysis (RFA) and damping capacity measurement. The development of implant stability, focusing on the decrease in stability (as measured by implant stability quotient [ISQ]) and the interplay of primary (ISQ0) and secondary implant stability, was evaluated. The implants were divided into three groups based on primary stability: group L (ISQ0 < 68), group M (ISQ0 68 to72), and group H (ISQ0 > 72). Stability curves for each group were created and analyzed statistically. Implant stability measurement results gained with RFA and damping capacity were compared employing the Wilcoxon paired test, correlation coefficients, and regression analysis. The threshold for statistical significance was set at P < .05. RESULTS: The most pronounced decrease in ISQ values occurred 1 week after implant placement (mean decrease of 2.2 ISQ). During the 10-week experiment, mean ISQ rose by 5.5 in group L and by 1.3 in group M and dropped by 1.8 in group H (P < .001). The coefficient of determination R2 = 0.06 showed a weak dependence of RFA on the damping capacity (P < .001). CONCLUSIONS: Implants with low primary stability showed a significant increase in stability during healing. In contrast, implants with high primary stability lost some stability over time.
- MeSH
- endoseální implantace zubů metody MeSH
- hojení ran MeSH
- lidé středního věku MeSH
- lidé MeSH
- mandibula chirurgie MeSH
- neparametrická statistika MeSH
- okamžité zatížení zubního implantátu MeSH
- osteointegrace MeSH
- povrchové vlastnosti MeSH
- prospektivní studie MeSH
- regresní analýza MeSH
- retence zubní protézy MeSH
- senioři MeSH
- vibrace MeSH
- zubní implantáty MeSH
- zubní protéza - design MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- MeSH
- čelist bezzubá terapie MeSH
- design s pomocí počítače trendy využití MeSH
- dospělí MeSH
- financování organizované MeSH
- lidé MeSH
- mandibula MeSH
- okamžité zatížení zubního implantátu trendy využití MeSH
- vzorové postupy ve stomatologii MeSH
- zubní implantáty trendy využití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
