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This article describes the use of osteotomes for the placement of plate-form implants. Comparison is made between the use of cylinders and the plate form as it relates to bone mass and resistant forces. It concludes by showing several cases in function.

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Para el tratamiento de pacientes que urgen de una rehabilitación bucal, sea dentaria y/o con implantes, es importante un proceso ordenado desde la primera cita, para poder diagnosticar correctamente la causa principal del por qué el paciente necesita una rehabilitación bucal para solucionar su problema. En este caso clínico específicamente se llega a determinar la necesidad de una rehabilitación bucal con implantes basándose en una historia clínica detallada, un examen clínico preciso, que incluye una reexaminación en el laboratorio a través de modelos de estudios correctamente articulados para una simulaciónn precisa, tanto en estática como en dinámica del paciente, complementada por exámenes auxiliares radiográficos. Igualmente, para el plan de tratamiento en este tipo de pacientes se necesita una esquematización adecuada de cada paso a seguir hasta el final del tratamiento

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After a brief revision of the anatomy of the posterior mandible and its natural resorption pattern, the ramus plate-form implant would be the implant of choice for the rehabilitation of this region. This "site specific" implant is inserted on the top of the crest and superficially impacted within the residual alveolar bone at the distal segment of the horizontal branch and guided to climb parallel to the anterior aspect of the ascending ramus. Its form and specific dimensions are perfectly compatible with the frequently limited quantity of available bone above the nerve canal in patients with advanced atrophy of the posterior mandible. It provides a predictable abutment for the implant-supported or dento-implant-supported prostheses of the posterior mandible.

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It is often thought that the insertion of laminar implants is imprecise, poorly standardized, and consequently, does not favour integration into the bone. We have been able to confirm that laminar implants are integrated into the bone in an experimental dog model and in pathology studies. To avoid the inconveniences often encountered, we developed a new concept laminar implant. Characteristics of the implant Body thickness = 1.2 mm; length = 20 and 16 mm; height of body = 6 or 8 mm; shaft : 3.25 mm diameter. The most important feature is that the upper part of the sheath around the collar does not overrun the upper border of the body by more than 1 mm. The total height is thus 7 or 9 mm. Insertion technique Discs are mounted on the counter-angle at increasing thicknesses. The third and last disc is 1.2 mm thick and has a radius corresponding to the 7 or 9 mm implant. The mandibular canal is perfectly protected with this technique. Indications Thin crests in the molar region of the mandible. Minimal bone between the crest and the mandibular canal. Subsinus implantation.

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To examine bone morphology associated with endosteal dental implants at various time intervals, we inserted 20 one-stage and 20 two-stage titanium blade implants and 20 one-stage and 20 two-stage titanium root-form implants into 30 dog mandibles. Sixteen implants in 6 control (c) dogs (in situ five months) did not receive bridgework. Sixty-four implants in 24 dogs supported bridges for six, 12, 18, or 24 months. The entire area of the mandible containing the implants was examined by routine light and Nomarski differential interference microscopy (NM) for bone morphology (including osteon orientation) at the implant surface and at regions away from the implant. Control root-form implants were apposed by woven bone, with homogenous compact bone in the cortical plate distant to the implant. After 6 mo of load, immature bone was predominant apposing the implant, but initial osteonal maturation was apparent. NM clearly demonstrated the interstitial and concentric lamellae of the bone. Surprisingly, compact bone formed internal to the cortical plate, an area where trabecular bone is expected. At later periods of load, more mature osteons were seen apposing the implants; however remodeling events were still apparent. These remodeling events extend further away from the implant than was expected if the events resulted only from surgical repair. Also, when the implant inclined so that half was totally in the cortical plate and half in the marrow (in trabecular patterns), osteonal bone appeared to remodel in both areas. Control blade implants and blades loaded for six months were apposed by immature osteons when the implant was placed into the cortical plate. A trabecular meshwork was inferior to the osteonal bone. At 12 mo of load, the bone internal to the cortical plate appeared similar to the lamina dura supporting teeth; however, no PDL existed; the lamina-dura-like pattern directly apposed the implant. Even after 24 mo of load, extensive bone remodeling was apparent adjacent to the implant, markedly different from the bone making up the existing cortical plate. From these data, remodeling activities to blade implants may involve the development of a lamina-dura-like bone morphology after longer periods of load. Osteonal bone was apparent, but only at regions where the implant was inserted into the cortical plate. Further, bone remodeling was apparent even after long periods of load.

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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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Zirconia was used in this study for implant dental roots because of its superior properties over other materials used as dental roots in mechanical strength, toughness, workability, and biocompatibility. Zirconia blades were formed by the slip casting method and tunnels were drilled in the laser processing. The results indicate that (1) the slip casting method has made it possible to form a complicated artificial dental root with an accurate shape and size; (2) the zirconia blade has adequate strength in occlusion; (3) the neodymium: yttrium-aluminum-garnet (Nd:YAG) laser machine can drill many tunnels of the same size in diameter by using it repeatedly under the same conditions of power, pulse width, and focus; (4) zirconia is a recommended material for laser processing from the standpoint of toughness and less heat conductivity; and (5) the opacity of zirconia to x-ray penetration presents better observation during and after implantation than other ceramics.

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O objetivo deste trabalho é apresentar uma técnica de colocação de lâmina na mandíbula, na ausência parcial ou total de osso alveolar sobre o canal mandibular. Como segurança, é feita a localização do canal e detecção da espessura de osso disponível bilateralmente a esse, fazendo-se a colocação da lâmina, que pode chegar até a basilar, se necessário for. Após seis anos de aplicação desta técnica, os autores têm comprovado seus benefícios com segurança. Seu emprego pode reduzir ou eliminar o uso dos justa-ósseos na mandíbula, ficando estes indicados para casos especiais de maxila

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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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At this writing, endosteal blade-vent implants have been used in clinical cases for over 17 years. At the last writing in the Dental Clinics of North America, we had just passed the 10-year mark. Many new systems for preprosthetic reconstructive surgery have gained the attention of the existing implantology community; and new systems have stimulated significant new levels of implant activity in the profession in general. Even with long-term research and clinical documentation with such modalities as the Brannemark, Swiss screw, and hollow cylinders, the blade-vent implant remains in the armamentarium of members of the profession active in implantology. Even with advances in design, no implant system can be placed in the extremely narrow or even knife-edge ridges still encountered in a significant percentage of patients, unless the practitioner is knowledgeable and skillful with (the narrow 1.2 mm buccolingual width of) this implant. I predict that the endosteal blade-vent implant will continue to hold a valued place in the implant field.

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