Implant loading protocols for partially edentulous maxillary posterior sites

PURPOSE: To evaluate early and immediate loading of implants in the posterior maxilla and to investigate whether there is a difference in success rates, survival rates, and peri-implant parameters, including marginal bone level changes. MATERIALS AND METHODS: A comprehensive systematic review of the literature was conducted. The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by two reviewers. RESULTS: Twelve papers were identified on early loading (two randomized controlled clinical trials [RCTs] and 10 prospective case series studies). Six papers were found on immediate loading (one RCT, four prospective case series, and one retrospective study). CONCLUSIONS: Under certain circumstances it is possible to successfully load dental implants in the posterior maxilla early or immediately after their placement in selected patients. The success rate appears to be technique sensitive, although no study has directly assessed this. A high degree of primary implant stability (high value of insertion torque) and implant surface characteristics play an important role. It is not possible to draw evidence-based conclusions concerning contraindications, threshold values for implant stability, bone quality and quantity needed, or impact of occlusal loading forces. As for the impact of the surgical technique on implant outcome in different bone densities, no studies prove significant superior results with one technique over another. Well-designed RCTs with a large number of patients are necessary to make early/immediate loading protocols in posterior maxilla evidence based, but ethical and practical considerations may limit the real possibility of such studies in the near future.

Quantifying the influence of bone density and thickness on resonance frequency analysis: an in vitro study of biomechanical test materials

PURPOSE: Resonance frequency analysis (RFA) offers the opportunity to monitor the osseointegration of an implant in a simple, noninvasive way. A better comprehension of the relationship between RFA and parameters related to bone quality would therefore help clinicians improve diagnoses. In this study, a bone analog made from polyurethane foam was used to isolate the influences of bone density and cortical thickness in RFA. MATERIALS AND METHODS: Straumann standard implants were inserted in polyurethane foam blocks, and primary implant stability was measured with RFA. The blocks were composed of two superimposed layers with different densities. The top layer was dense to mimic cortical bone, whereas the bottom layer had a lower density to represent trabecular bone. Different densities for both layers and different thicknesses for the simulated cortical layer were tested, resulting in eight different block combinations. RFA was compared with two other mechanical evaluations of primary stability: removal torque and axial loading response. RESULTS: The primary stability measured with RFA did not correlate with the two other methods, but there was a significant correlation between removal torque and the axial loading response (P < .005). Statistical analysis revealed that each method was sensitive to different aspects of bone quality. RFA was the only method able to detect changes in both bone density and cortical thickness. However, changes in trabecular bone density were easier to distinguish with removal torque and axial loading than with RFA. CONCLUSIONS: This study shows that RFA, removal torque, and axial loading are sensitive to different aspects of the bone-implant interface. This explains the absence of correlation among the methods and proves that no standard procedure exists for the evaluation of primary stability.

The use of extraoral implants for distal-extension removable dentures: a clinical evaluation up to 8 years

PURPOSE: This retrospective study reports the clinical outcome following placement of extraoral implants in severely resorbed posterior ridges to support distal-extension removable dentures. MATERIAL AND METHODS: Consecutively treated patients with partially or completely edentulous ridges, with available bone height in the posterior region of 6 mm or less, were included in the study. Implants originally intended for extraoral use (Straumann) were placed in second molar regions and allowed to heal for 4 to 6 months before abutment connection. At recall appointments, the peri-implant hard and soft tissues were evaluated. Complications with implant components, as well as mechanical and structural failures of the prostheses, were recorded. Two-year survival rates were calculated and life table analyses undertaken. RESULTS: Twenty-nine patients (19 women and 10 men; average age 61.2 years, range, 44 to 75 years) were included in the study. Forty-seven extraoral implants in 26 patients were placed in the second molar site of the mandible. Two extraoral implants in 2 patients failed during the osseointegration phase, yielding an 8-year cumulative success rate of 91.8%. The mean distance from the extraoral implants to the most distal tooth/implant was 28.1 mm (range, 16.7 to 39.2 mm). Twenty-three extraoral implants were restored with magnets, 18 with ball anchors, and 4 with conical cylinders. Replacement of abutments and retention elements was necessary in 2 patients. Four abutments in 2 patients were disconnected from the restorations. CONCLUSIONS: Within the limits of the employed research design, extraoral implants may be used successfully to provide support for distal-extension removable dentures in severely resorbed posterior alveolar ridges.

New York, N.Y. and vicinity, 1961 : Plainfield, N.J.-N.Y. (8 Sheet Set) (Raster Image)

This layer is a georeferenced raster image of the United States Geological Survey 7.5 minute topographic sheet map entitled: New York and vicinity : Plainfield, N.J.-N.Y., 1956. It is part of an 8 sheet map set covering the metropolitan New York City area. It was published in 1961. Scale 1:24,000. The source map was prepared by the Geological Survey from 1:24,000-scale maps of Roselle 1955, Chatham 1955, Plainfield 1955, and Perth Amboy 1956 7.5 minute quadrangles compiled by the Army Map Service. Culture revised by the Geological Survey. Hydrography compiled from USC&GS charts 286 (1954) and 375 (1953). The image inside the map neatline is georeferenced to the surface of the earth and fit to the Universal Transverse Mercator (UTM) Zone 18N NAD27 projection. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. USGS maps are typical topographic maps portraying both natural and manmade features. They show and name works of nature, such as mountains, valleys, lakes, rivers, vegetation, etc. They also identify the principal works of humans, such as roads, railroads, boundaries, transmission lines, major buildings, etc. Relief is shown with standard contour intervals of 10 and 20 feet; depths are shown with contours and soundings. Please pay close attention to map collar information on projections, spheroid, sources, dates, and keys to grid numbering and other numbers which appear inside the neatline. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

The history and religion of the Samaritans /

"Reprinted from Bibliotheca sacra for July, 1906."

Mount Gerizim, the one true sanctuary /

"Reprinted from the Bibliotheca Sacra for July, 1907."

Tongue-ticklers from Austria; being a book of choice recipes,

Mode of access: Internet.

Draft phase two report : "peer review and technical assistance of nine facilities, a move to improve" : technical assistance and staff training for intermediate care facilities for the developmentally disabled (ICFDD) and for those ICFDD for fifteen or fewer persons.

"August, 1988."

Dixon Developmental Center : a program and administrative review.

Cover title.

Police communications manual /

Mode of access: Internet.

Lieutenant William Barton of Morris County, New Jersey, and his descendants.

Privately printed.

Abraham Lincoln from New Salem.

Program from the dedication of the Lincoln Statue at New Salem State Park, June 21, 1954.

Ljus öfver de sista dagarna; eller, Enkla framställningar öfver Uppenbarelseboken.

Translation of Light on the last days.

The investigation of edge effects within ragmented forest islands in Short Hills Provincial Park

It has been well documented, within the field of landscape ecology, that terrestrial fragmentation contributes to increased heterogeneity at the landscape level. It has also been observed that elevated areas of edge habitat occur within fragmented landscapes. Spatial and temporal edge effects were investigated in four areas designated as Nature Reserve Zones within Short Hills Provincial Park, near St. Catharines, Ontario. Random sampling along exposed edges was performed on trees and saplings, at 5 and 25 ill edge depths, using the point-centred quarter method. Diameter at breast height (dbh) and distance from point measurements were used to establish relative density, dominance, frequency and importance value. One-way analyses of variance were used on dbh measurements of tree species and Chi-Square contingency tables were used on size class distributions of saplings species to determine significant differences between 5 and 25 metres. Qualitative comparisons of importance values were also used to determine differences between 5 and 25 metres as well as between trees and saplings. These statistical and qualitative comparisons suggest that a significant overall spatial edge effect is currently exhibited by fragmented wooded islands within the park. The major species of the park, Acersaccharuln, may be exhibiting a temporal edge effect. The heterogeneous nature of the park may be of importance in understanding this area as a complex, ecological system. It is possible that the remaining forest tracts of the park have been affected, and continue to be affected by previous disturbances. Based on these findings, recommendations are made to the Ontario Ministry of Natural Resources concerning the management of Short Hills Provincial Park in accordance with their 1990 proposed Management Plan.

Ecological distribution of stream macroalgal communities from a drainage basin in the Serra da Canastra National Park, Minas Gerais, Southeastern Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)