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This paper describes an aesthetic and functional treatment for the replacement of a failing bridge supported by blade implants where the patient refused further surgery.

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With the increased use of dental implant systems, an increase in the number of implants removed from patients has also been observed. This investigation attempted to elucidate some underlying causal determinants of implant failure employing light microscopic analyses. Valuable data can be obtained from implants retrieved from patients. Implant success is predicted on proper patient selection and treatment planning, careful surgical procedures, careful prosthodontic management, and continued oral hygiene maintenance.

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Intraosseous blade vent implants extend hitherto existing clinical methods of prosthetic treatment of some conditions of defective teeth by new possibilities. It is a method which can produce satisfactory and long-term results. One of the prerequisites is, however, that generally valid and local limitations for indication of the implantation will be respected, that the implantation will be implemented by reliable surgical technique along with high standard prosthetic treatment which in the course of recovery will carry the implant to its functional period. Results of our investigations revealed unequivocally that the use of implants with a low or predominantly low intraosseous part leads in the majority to unsatisfactory results of implantations.

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This study was conducted to determine whether fixed partial dentures supported by dental implants provide an acceptable alternative to conventional removable partial dentures in patients with Kennedy class I or class II edentulous conditions. The acceptability of the new treatment will be based on success rates, impact on the health of the remaining dentition, masticatory performance, patient satisfaction, and maintenance care and cost. The study was planned also to provide comparisons between two designs commonly used by dentists for fabricating removable partial dentures. The designs differed only in terms of the type of the retainer (clasp type) and tooth support (rest location). A total of 272 patients with Kennedy class I and class II edentulous conditions were assigned on a random basis to one of the treatment groups, 134 to receive a removable partial denture and 138 a fixed partial denture supported by a blade-vent implant. All of the patients were medically screened and met prespecified criteria for oral hygiene, bone support for abutment teeth, and size of the residual ridge. Thirty-four patients were eliminated from the study before completion of their treatment. An additional six patients with early implant failures were reentered in the study and followed up as a separate group. The remaining 232 patients received comprehensive dental care, including removable partial dentures for 118 and fixed partial dentures for 114 patients. A series of examinations, radiographs, masticatory performance tests, patient satisfaction, food selection questionnaires, and dietary history were completed before initiation of the treatment, 16 weeks after the insertion of an RPD or an implant, and thereafter at 6-, 18-, 36-, and 60-month intervals. In addition, patients were seen at 6-month intervals for a recall dental examination, oral prophylaxis, plaque instructions, radiographic survey of the implant, and any needed dental treatment. The randomization stratification approach produced two treatment groups with comparable age, number of remaining maxillary and mandibular teeth, type of opposing dentition, and percent of patients with Kennedy class I and class II edentulous conditions. The mean scores of bone support, tooth mobility, and sulcular depths of abutment teeth were also similar. Significant but comparable improvements in oral hygiene and sulcular depth occurred in the two groups after treatment. The periodontal health scores at the 16-week interval serve as the baseline to measure subsequent changes in periodontal health.(ABSTRACT TRUNCATED AT 400 WORDS)

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In order to provide longitudinal data for endosteal bladevent implants, a continuing study is being conducted from an original group of 49 implants in 32 patients placed 15 years ago. The present work evaluated 26 of these bladevent implants in 18 patients. Three basic patterns were observed 15 years postoperatively: (1) In 13 of 26 implants, there was clinical and radiographic evidence of health; (2) in 13 of 26 implants, there was a radiolucency 2- to 3-mm square around the neck and shoulder of the implants, along with sulcular depths capable of being probed and evidence of bleeding on probing; and (3) two implants showed evidence of settling deeper into the bone. These results indicate that bladevent endosteal implants can be maintained in the mouth for up to 15 years, and 50% can be free from periodontal disease.

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Plaque and gingival bleeding were scored and probing, radiography, and histologic methods were used to evaluate clinical methods for estimating alterations of supporting structures at functioning endosseous dental implants. Twelve implant abutment posts in three Labrador retriever dogs were assessed. The observation period was 3 months of submerged healing followed by 6 months in function. In the presence of daily gingival cleaning, both plaque and gingival bleeding scores were reduced on implant abutments. No correlation was found between gingival scores and the degree of bone resorption. The correlation between probing and radiographic measurements was studied by comparing 136 parallel measurements. The average difference was 0.4 mm. Discrepancies were observed when evaluating bone loss that reached the shoulder area. Better accordance was obtained when moderate (2 to 4 mm) or extensive (6 to 8 mm) resorption was assessed. Histologic evaluation indicated alternating regions of implant-bone contact and fibrous encapsulation. Progressive infiltrates were observed in the permucosal area, sometimes extending into the deeper parts of the supporting bone. A combination of probing and radiographic measurements seems to give the most reliable information about the level of bone support and is recommended to be included in routine control of implant abutments.

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In order to provide longitudinal data for endosteal bladevent implants, a continuing study is being conducted. The present work evaluated 32 bladevent implants in 22 patients for periods of 10 years or more. Two basic patterns were observed 10 years postoperatively: 1) In 14 of 32 implants, there was clinical and radiographic evidence of health; and 2) in 18 of 32 implants, there was a radiolucency 2 to 3 mm square around the neck and shoulder of the implants, sulcular depths capable of being probed and evidence of bleeding on probing. These results indicate that bladevent endosteal implants can be maintained in the mouth for periods of 10 years, although bony breakdown will be seen in approximately 50% of the implants.

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