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Osseointegrated dental implants have now become an accepted form of treatment for patients with a fully or partially missing dentition. The purpose of this study was to evaluate the performance of 3i threaded and cylindrical implants. During a 5-year period, a total of 1969 3i endosseous implants were placed at 6 centers in the United States and 2 elsewhere in the edentulous and partially edentulous jaws of 653 consecutive patients ranging in age from 18 to 82 years. Of the total number of implants placed, 1341 were commercially pure titanium threaded implants and 628 were titanium plasma-sprayed implants with a cylindrical configuration. A total of 28 patients with 110 implants were lost to follow-up. Implants in these patients were considered neither a success nor a failure. Success was predicated on the osseointegration of each and every implant followed in this analysis rather than the persistence of prosthetic function. Confirmed bone anchorage was considered essential for success. A total of 625 patients with 1871 implants remain in the study with a follow-up period ranging from 6 to 60 months. A total of 93 implants (5.0% of the total implants followed) were considered as failures. A mean implant survival rate was 95.0% for both the threaded and the cylindrical implant was calculated. The success rate of threaded implants was 97.0% in the mandible and 93.8% in the maxilla. The success rate for the 3.3-mm cylindrical implants was 96.0% in the mandible and 95.5% in the maxilla, and the success rate of 4.0-mm-diameter cylindrical implants was 95% in the mandible and 92.0% in the maxilla. Causes of failure consisted of loss of osseointegration (2.3%), crestal bone loss requiring periodontal therapy after the first year of function (1.7%) had mechanical problems associated with the prosthesis (0.9%). This retrospective analysis of the 3i endosseous implant system is comparable to previous reports on other implant systems in terms of implant survival and prosthesis stability. It is demonstrated that 3i implants are predictable and can provide lasting osseointegration leading to improvement of oral function if the recommended surgical and restorative protocol is followed.

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This article is the last of a series of four. This article describes in detail the fabrication of a crown connected to a Brånemark implant.

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This article is the second of a series of four. This article describes in detail the fabrication of a complete fixed-removable prosthesis connected to a dolder bar.

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This article is the first of a series of four. Each one summarizes the clinical and technical prosthetic stages of different types of restorations. This article describes in detail the fabrication of a complete fixed prosthesis using screw type osseointegrated implants.

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This study examined long-term (up to 27 days) effects of maintained vision reversal on (i) smooth visual tracking with head still, (ii) oculomotor response to actively, generated head oscillation and (iii) "spontaneous" saccades. Dove prism goggles produced horizontal, but not vertical (sagittal plane), vision reversal. Eye movements were recorded by EOG; head movements by an electro-magnetic search coil. Both visual tracking and saccade dynamics remained unchanged throughout. In contrast, both the ocular response to active head oscillations (goggles off and subject looking at a stationary target) and associated retinal image blur showed substantial and retained adaptive changes, akin to those previously found in the vestibulo-ocular reflex as tested in darkness at 0.17 Hz. However, several addition unexpected results emerged. First, in the fully adapted state smooth eye movements tended to be of reversed phase in the range 0.5-1.0 Hz (in spite of normal vision during tests), but of normal phase from about 2 Hz and above (in spite of negligible visual tracking in this upper range). Second, after permanent removal of the inverting goggles, this peculiar frequency response of the fully adapted state quickly (36 h) reverted to a dynamically simpler condition manifest as retained (2-3 weeks) attenuation of gain (eye vel./head vel.) which, as in control conditions, was monotonically related to frequency. From these two findings it is inferred that the fully adapted state may have comprised two separate components: (i) A "simple element of monotonic and long-lasting gain attenuation and (ii) a "complex", frequency labile, element which could be quickly rejected. Dynamic characteristics of the putative "complex" element were estimated by vectorial subtraction of the "simple" one from that of the fully adapted condition. The outcome suggests that the inferred "complex" condition might represent a predictive element. Two further findings are reported: (i) Substantially different vectors of the adapted response were obtained with normal and reversed vision at 3.0 Hz head oscillation, indicating a novel visual tracking. (ii) During head oscillation in the vesicle sagittal plane (in which vision was not reversed) there was never any image blur, indicating high geometric specificity in the adaptive process.

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Patients suffering from acute dental pain were treated with ice massage of the web between the thumb and index finger of the hand on the same side as the painful region. Control groups received tactile massage alone or with explicit suggestion that the massage was intended to alleviate their pain. Changes in pain intensity produced by the procedures were measured with the McGill Pain Questionnaire. Ice massage decreased the intensity of the dental pain by 50% or more in the majority of patients. Furthermore, the pain reductions produced by ice massage were significantly larger than those produced by tactile massage alone or with explicit suggestion. The results indicate that ice massage has pain-reducing effects comparable to those of transcutaneous electrical stimulation and acupuncture. The fact that cold signals are transmitted to the spinal cord exclusively by A-delta fibres and not by C fibres provides a potential method for differentiating the various feedback systems that mediate analgesia produced by different forms of intense sensory input. Ice massage provides a simple method for the palliative control of pain in dental clinics.

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1. Two sets of experiments have examined the vestibulo-ocular response (VOR) to repeated sinusoidal rotation (A) in the dark and (B) after attempting visual tracking of a mirror-reversed image of the visual surround.2. In both A and B a horizontal sinusoidal rotational stimulus of 1/6 Hz and 60 degrees /sec angular velocity amplitude was employed, specifically chosen to lie within the presumed range of natural stimulation of the semicircular canals.3. In A each of seven subjects underwent ten 2-min runs of the standard stimulus in the dark on each of three consecutive days, with 3-min rest periods between runs. Using d.c. electro-oculography (EOG) the VOR gain was measured throughout as eye velocity/head velocity. Mental arousal was maintained by competitive mental arithmetic. Constancy of EOG gain was assured by 50 min dark adaptation before experimentation.4. The results of A showed no consistent change of VOR gain over the three times scales of a run, a day and the 3-day experiment.5. In B the same subjects underwent a similar pattern of vestibular stimulation, but during eight of the 2-min daily runs they attempted the reversed visual tracking task. VOR gain was measured during the 1st, 6th and last runs which were conducted in the dark for this purpose. Constancy of EOG gain was maintained by using red light throughout.6. The results of B showed a substantial (approx. 25%) and highly significant (P << 0.001) reduction of VOR gain attributable solely to the 16 min of reversed visual tracking attempted during the 50 min daily experiment. In addition the pre-test control gain was lower on day 3 than on day 1 (approx. 10% attenuation, P < 0.01) indicating a small cumulative effect from beginning to end of the 3-day experiment.7. It is concluded (A) that the repeated vestibular stimulus did not itself cause significant attenuation of VOR gain, but (B) that superposition of a reversed visual tracking task did induce retained VOR attenuation which was solely due to the antagonistic visual stimulus.8. In conjunction with other experimental evidence it is inferred that this attenuation probably represents an adaptive change in the VOR induced at least in part by retinal image slip.

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1. These experiments investigated plastic changes in the vestibulo-ocular reflex (VOR) of human subjects consequent to long-term optical reversal of vision during free head movement. Horizontal vision-reversal was produced by head-mounted dove prisms. Four normal adults were continuously exposed to these conditions during 2, 6, 7 and 27 days respectively.2. A sinusoidal rotational stimulus, previously shown to be nonhabituating (1/6 Hz; 60 degrees /sec amplitude), was used to test the VOR in the dark at frequent intervals both during the period of vision-reversal and an equal period after return to normal vision. D.c. electro-oculography (EOG) was used to record eye movement, taking care to avoid changes of EOG gain due to light/dark adaptation of the retina.3. All subjects showed substantial reduction of VOR gain (eye velocity/head velocity) during the first 2 days of vision-reversal. The 6-, 7- and 27-day subjects showed further reduction of gain which reached a low plateau at about 25% the normal value by the end of one week. At this time the attenuation of some EOG records was so marked as to defy extraction of a meaningful sinusoidal signal.4. After removal of the prisms VOR gain recovered along a time course which approximated that of the original adaptive attenuation.5. In the 27-day experiment large changes of phase developed in the VOR during the second week of vision-reversal. These changes generally progressed in a lagging sense, to reach 130 degrees phase lag relative to normal by the beginning of the third week. Accompanying this was a considerable restoration of gain from 25 to 50% the normal value. These adapted conditions, which approximate functional reversal of the reflex, were then maintained steady, even overnight, until return to normal vision on the 28th day.6. Thereafter, whereas VOR phase returned to near-normal in 2 hr, restoration of gain occupied a further 2-3 weeks.7. There was a highly systematic relation between instantaneous gain and phase, even during periods of widely fluctuating change associated with transition from one steady state to another. During such transition there was a tendency for directional preponderance to occur in the VOR.8. All the observed changes were highly specific to the plane of vision-reversal, no VOR changes being observed in the sagittal plane.9. VOR changes were adaptive, in the sense that they were always goal-directed towards the requirements of retinal image stabilization during head movement. They were plastic to the extent that there was extensive and retained remodelling of the reflex towards this goal.10. It is inferred that all the observed changes in gain and phase are compatible with a simple neural network employing known vestibulo-ocular projections via brainstem and cerebellar pathways, providing that the reversed visual tracking task can produce plastic modulation of efficacy in the cerebellar pathway and that this pathway exhibits a dynamic characteristic producing moderate phase lead in a sinusoidal signal at 1/6 Hz.

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