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Implant-Supported Prosthetic Applications

Upon Development of Children and


Adolescents: A Pilot Study in Pigs
Ahmet Ersan Ersoy, DDS, PhD,* Demet Bendik Ellialti, DDS, PhD,† and Necdet Dogan, DDS, PhD‡

he type of prosthetic restora- Purpose: The purpose of this significant test of differences between

T tions that are applicable for the


loss and malformation of teeth
in childhood, adolescent, adult, and
study is the investigation of the ap-
plication of implant-supported pros-
thetic restorations using 2 implants
2 partners was used to evaluate them.
Results: The study suggested
that the implants showed alveolar
elder periods change due to some lim- supporting a fixed prosthesis during elevation by bone growth but could
itations. The application of fixed pros- the physical growth and the develop- not keep pace with the natural teeth
theses to children and adolescents is
ment period of growing pigs. eruptions and the bone growth in the
generally avoided due to limitations,
such as the eruption times of the teeth
Materials and Methods: This region.
and completion of their morphological study was carried out on 6 male farm Conclusion: Although the sagittal
development. However, there is a need pigs (1 as a control). The effect of the and transverse developments of the
for alternative therapy for the children 2 screw-type endosseous implants in- neighboring bone region are greater
who have congenitally missing teeth serted into the premolar area on the than the implant-inserted region, the
due to systemic diseases (ectodermal left mandibular arches of 5 farm pigs difference in this growth can be toler-
dysplasia, hyperpituitarism, hypopitu- upon the jaw was investigated during ated by corrections or modifications of
itarism, and hydrotropism) or loss of a 3.5– 8-month growth period using implant-supported superstructures.
teeth due to an accident or extensive cephalometric radiographs. The (Implant Dent 2006;15:412– 419)
carious lesions. A better understand- cephalographs were taken with a spe- Key Words: dental implants, implant
ing of the growth process has extended cially standardized cephalostat, and a prosthetics, growth and development
the application of fixed and implant-
supported prosthetic therapy to chil-
dren and adolescents. In children with This difference that occurs in the sary that they should be considered for
the loss of teeth, removable partial physical development can be tolerated restoration of wider areas by the use of
prostheses are used as space maintain- by the renewal or modification of the fixed prostheses.
ers or temporary treatments. The lim- prosthetic superstructure at certain pe- The aim of this study is the inves-
itations of fixed prostheses during the riods. This is certainly an advantage of tigation of the application of implant-
growth period increased the use of im- the prosthetic therapy over its limita- supported prosthetic therapy using 2
plant supports, especially in the treat- tions. When the studies concerned implants supported fixed prosthesis
ment of a single tooth. The use of with the effect of the implant support during the physical growth and devel-
single implant support has proven to during the physical growth period are opment period of growing pigs.
act differently than the natural teeth examined, it is seen that they predom-
neighboring it and cause the vertical inantly deal with the supports applied
bone development in the area of the for the treatment of a single tooth,1–5 MATERIALS AND METHODS
implantation to be retarded.1– 8 and the prosthetic structures contain- This study was carried out on
ing more than 1 implant support have growing pigs, which have a similar
not been investigated. The facts that metabolism to human beings with
*Professor, Department of Prosthetics, Faculty of Dentistry,
University of Ankara, Ankara, Türkiye.
implant-supported applications in den- rapid growth, having both a carnivo-
†Assistant Researcher, Department of Prosthetics, Faculty of
Dentistry, University of Ankara, Ankara, Türkiye.
tistry have shown great development rous and herbivorous chewing pattern
‡Assistant Professor, Department of Oral and Maxillofacial in recent years, their use in the treat- based upon primary and permanent
Surgery, Gulhane Military Medical Academy, Center of
Dentistry, Ankara, Türkiye. ment of a single tooth loss in children teeth and a pubertal change period of
and adolescents, and the technical im- 3.5– 8 months by the comparison of
ISSN 1056-6163/06/01504-412
Implant Dentistry provement of the implant material that the cephalometric radiographs.2 There
Volume 15 • Number 4
Copyright © 2006 by Lippincott Williams & Wilkins enables the changes and modification were 6 male farm pigs (Sus scrofa
DOI: 10.1097/01.id.0000243323.11666.38 in the implant structure made it neces- domesticus) used weighing 20 –25 kg.

412 IMPLANT-SUPPORTED PROSTHETIC APPLICATIONS UPON DEVELOPMENT OF CHILDREN AND ADOLESCENTS


The number of teeth of the specimens
was equal, and the dentition of the left
and right jaws was symmetrical. There
was no irritation or inflammation in
the oral mucosa. One of the pigs was
arbitrarily chosen as the control ani-
mal. The specimens were fed with
ready dry food and kept in their natu-
ral habitat.

Placement of the Implants


All operations were carried out in
sterile medium with the animal under
general anesthesia. The anesthesia was
administrated by the intravenous and
intramuscular injection of 1 mg/kg xy-
lazine hydrochloride (Rompun, Al-
fasan, Turkey) and 1 mg/kg Ketamine
(Alfamine, Alfasan, Turkey). Local
anesthetic (Ultracaine, Roche, Tur-
key) was applied for the control of
bleeding.
The first and second premolar Fig. 1. Initial radiography.
teeth in the mandibula were extracted, Fig. 2. Radiograph taken after placement of implants.
and the sockets were made suitable for Fig. 3. Superstructures cemented into mouth.
the implants. Standard burs were used Fig. 4. Radiograph with superstructure.
to prepare the areas where the im-
plants were to be placed. The distal
root hole of the second premolars of implants were placed, forming holes at taking the radiographs on the fifth or
pig Nos. 2, 4, and 6 were prepared for the back. sixth postoperative day (Fig. 2). The
the posterior implant. There was a A single postoperative dose of second control graph was taken at the
hole formed in the distal of temporary Sulfadoxine Trimethoprim solution 30th or 35th postoperative day in order
canine for the anterior implant. There (Borgal Bayer, Germany) was intra- to evaluate the tissue and bone
was no bone support due to the conical muscularly applied for prophylaxis changes around the implants. Second-
shape of the extraction hole. However, purposes. The sutured region was stage surgery followed at the 30th post-
the alveolar bone was observed to sup- washed with glycerin for 10 days after operative day, and measuring analogs
port the implants to establish os- the operation until the sutures were were mounted. The measurements were
seointegration in deeper zones. The removed. The condition of the mouth taken with irreversible hydrocolloid us-
SBM surface implants (TSVB 10; Par- was monitored postoperatively, show- ing occlusal plates.
agon, Core Vent, Las Vegas, NV), ing care to the mucogingival health The models were prepared and su-
with a length of 10 mm and diameter and dentition. In order to make a sen- perstructures obtained by the standard
of 3.7 mm, were placed in accordance sitive evaluation, it was decided to use method casting with a Cr-Co alloy
with application rules of the system. lateral cephalograms. A cephalo- (Sandental, Bulgaria). The superstruc-
The implants were placed at the ex- graphic unit was prepared on stabile tures were prepared ready to be ce-
traction holes distal root hole of the radiography equipment to take the ra- mented. The superstructures were
second premolar and mesial root hole diographs of living specimens. The ra- placed into the mouth 1 week later
of first premolar due to lack buccolin- diographs were taken with the animal (Fig. 3).
gual bone thickness necessary for under anesthesia at a distance of 70 cm The specimens were fed normally
anterior implants (immediate implan- and irradiation period of 1.05 seconds. after the placement of the superstruc-
tation). There were screw-shaped The equipment used was a 10 mA, tures into the mouth. The radiographs
metal markers placed at the opposite 70-kVp radiography device, keeping of the specimens were taken as the
arch of the mandible, and the first and conditions the same each time. There superstructures were firmly in place.
second premolar regions in order to were 24 ⫻ 6 cm film cassettes used The definitive radiographs were taken
compare the alveolar development. due to the head size of the specimens. at the 100th postoperative day (Fig. 4).
The mucoperiosteal flap was closed The initial radiographs of the speci-
with 6 or 8 sutures by the use of 0 – 4 mens were taken prior to teeth extrac- Evaluation of the Radiographs
silk suture material. The anterior im- tions (Fig. 1). The reference points of the radio-
plants of both pig Nos. 4 and 6 were Radiographs were also taken after graphs are the distances between the
not in their place when the sutures placement of the implants. The condi- points, which were related to each
were removed one week later. New tions of the implants were monitored, other (Table 1).

IMPLANT DENTISTRY / VOLUME 15, NUMBER 4 2006 413


Table 1. The Reference Points of
Radiographs
1. The mesial tubercle peak point of the
tooth neighboring the implant
2. Foramen mental central point
3. The tip of the first screw marker
4. The superomedial point of the
implant in 1 premolar region
5. The inferomedial point of the implant
in 1 premolar region
6. The superodistal point of the implant
in 2 premolar region
7. The inferodistal point of the implant in
2 premolar region
8. The tip of the second screw marker
9. Lower molar alveolar tip
10. The root furcation point of the 1 Fig. 5. Cephalometric points determined.
premolar tooth at the opposite
mandibular arch
11. The root furcation point of the 2 Table 2. Data Obtained From Control Animal (pig No. 1)
premolar tooth at the opposite
mandibular arch Pig No. 1 1 Graphy (mm) 2 Graphy (mm) Amount of Increase (mm)
1–2 22.90 26.20 3.3
2–9 61.84 69.55 7.71
1–9 63.69 73.87 10.18
An electronic ruler (Mıilotoyo/ 10⫺11 10.11 10.67 0.56
Absulote, Japan) was used to measure 2–8 22.54 25.41 2.87
the points related to each other on the 2–3 8.26 11.09 2.83
cephalometric drawings. The implant
sizes in the radiography were compared
with the actual sizes for magnification. eruption and bone growth. In the con- However, in the case of anomalies
There were also measurements made trol animal, which had no implant, with early teeth loss or related to the
on the preoperative and postoperative the distance between the tubercle basal section of the jaws, the use of
models obtained from the specimens, peak of the 1 molar tooth and the prostheses as both teeth loss preven-
as well as the cephalometric evalua- foramen mental was in the same or- tive tools and treatment appliances are
tions (Fig. 5). An electronic ruler was der (1–2) with that of the experimen-
used to measure the canine-canine dis- important in order to obviate the un-
tal specimens. desirable effects in the jaws and the
tance in the maxilla, and canine-canine The distance between the 1 and 2
and first molar-canine distances in the joint as a result of excessive teeth loss.
temporary premolar furcation points at These include the correction of the
mandibula. the opposite arch and the tips of the aesthetic and phonation, renewal of
metal screws (3–11 and 8 –10) were the chewing function, elimination of
RESULTS measured as approximately 4.012 mm. feeding problem, and avoiding any de-
The approximate distance be- lay in the eruption and deviation of
The cephalometric data obtained tween the mesial tubercle peak point permanent teeth.9,10
from the control animal (pig No. 1) of the tooth neighboring the implant
and other specimens are tabulated in Tylman11 found the application of
and the alveolar peak point of the fixed prostheses to children and youth
Tables 2 and 3. The differences be- lower molar (1–9) was found as 10.4
tween the tubercle tip of the tooth as being contraindicative due to the
mm. The corresponding distance in
neighboring the implant and the su- fact that the teeth were not fully
the control animal was 10 mm.
perodistal tip of the implant in the erupted, and the pulps are very large,
second premolar region (1– 6), the me- which may cause various complica-
sial tubercle point of the tooth neigh- DISCUSSION tions. He states that the age of the
boring the implant and foramen mental When the prosthetic therapy on application of prosthesis is 17 years.
point (1–2) and foramen mental cen- children and adolescents is examined, Finn10 also advised that one should
tral point, and the superodistal point of it can be seen that, although protective refrain from the application of a pros-
the implant at the second premolar and operative treatments are empha- thesis until the age of 14 –16 years,
region (2– 6) revealed that the natural sized, the prosthetic appliances are not when the pulp is narrow and canines are
temporary 1 molar teeth and implant- given equal importance. According to about to erupt. However, he stated that
supported prosthetic structure were el- recent belief, the application of pros- the case should be decided according to
evated in the same direction. However, theses to children and adolescents is the gender, the amount of physical ac-
elevation of the natural teeth was more not indicated, and it may cause dam- tivities and social contacts, as well as the
significant due to the effect of the age by retarding growth. age of the patient.

414 IMPLANT-SUPPORTED PROSTHETIC APPLICATIONS UPON DEVELOPMENT OF CHILDREN AND ADOLESCENTS


Table 3. Data Obtained After Significance Test of Differences Between 2 Partners
Preoperative Postoperative Mean
Distance Between Points Measurement ⫾ SD Measurement ⫾ SD Difference ⫾ SD T P
1–2 17.67 ⫾ 3.93 21.85 ⫾ 4.36 4.18 ⫾ 1.75 6.86 ⬍0.01*
1–6 7.11 ⫾ 3.42 10.44 ⫾ 6.0 3.36 ⫾ 2.71 2.74 ⬎0.05
6–4 21.01 ⫾ 9.69 20.69 ⫾ 9.66 0.316 ⫾ 0.16 0.23 ⬎0.05
7–5 20.14 ⫾ 10.99 20.03 ⫾ 10.97 ⫺0.114 ⫾ 0.09 0.34 ⬎0.05
1–9 64.17 ⫾ 3.77 74.57 ⫾ 2.60 10.4 ⫾ 1.46 15.9 ⬍0.01*
6–9 59.42 ⫾ 6.58 69.02 ⫾ 5.91 9.59 ⫾ 1.66 12.88 ⬍0.01*
4–9 38.83 ⫾ 10.59 54.79 ⫾ 14.95 15.95 ⫾ 4.35 8.19 ⬍0.01*
7–9 56.92 ⫾ 6.51 67.45 ⫾ 6.23 12.538 ⫾ 2.44 11.47 ⬍0.01*
5–9 36.618 ⫾ 12.03 52.22 ⫾ 17.15 15.61 ⫾ 5.12 6.80 ⬍0.01*
2–7 7.574 ⫾ 3.11 14.91 ⫾ 7.08 7.34 ⫾ 4.02 4.07 ⬍0.05*
2–5 24.75 ⫾ 9.83 21.94 ⫾ 8.72 ⫺2.802 ⫾ 1.11 5.65 ⬍0.02*
2–3 7.66 ⫾ 3.703 10.076 ⫾ 5.017 2.408 ⫾ 1.39 3.88 ⬍0.05*
2–8 20.77 ⫾ 6.054 23.51 ⫾ 6.954 2.736 ⫾ 0.91 6.72 ⬍0.01*
3–7 7.24 ⫾ 1.567 14.07 ⫾ 2.11 6.82 ⫾ 1.47 10.34 ⬍0.01*
3–11 16.82 ⫾ 2.78 20.83 ⫾ 3.69 4.012 ⫾ 0.96 9.33 ⬍0.01*
8–5 12.006 ⫾ 4.46 7.652 ⫾ 2.84 4.354 ⫾ 1.61 6.02 ⬍0.01*
8–10 16.13 ⫾ 1.95 19.97 ⫾ 5.43 3.84 ⫾ 0.81 10.66 ⬍0.01*
2–6 23.34 ⫾ 2.75 26.28 ⫾ 4.23 2.95 ⫾ 0.97 5.35 ⬍0.02*
2–9 60.92 ⫾ 2.90 69 ⫾ 2.74 8.076 ⫾ 4.70 3.84 ⬍0.05*
10⫺11 11.18 ⫾ 0.47 11.17 ⫾ 1.024 ⫺0.01 ⫾ 0.81 0.027 ⬎0.05
*Results are statistically significant.

SD is standard deviation.

Johnston et al12 advocated the ap- teeth to compensate for skeletal bone alveoli, but the neighboring tissues
plication of short fixed partial dentures change4 – 8 in growth. Also, possible continued their 3-dimensional growth
to the young patients after the closure complications of the placement of im- and that was why the artificial teeth
of the permanent teeth, even if they plants in adolescents include the sub- upon the osseointegrated implant re-
have no temporary teeth congenitally. merging of an implant into the jaw, mained in lower positions in occlusion
They stated that the patients should be resulting in a prosthetic infra- due to continued eruption of the neigh-
subjected to routine controls in occlusion, loss of support for the im- boring teeth. They recommended no
3-month periods for accurate balanc- plant, and potential for interference such therapy in either anterior or pos-
ing of the fixed partial dentures, and with normal growth of the jaws.7 Since terior alveolar segment if there is no
monitoring and correction of the oc- there is more vertical growth in the intention of changing the artificial
clusion because of the rapidly chang- posterior regions of the maxilla and teeth or modifying the prosthesis in
ing relations in jaws. mandible during childhood and ado- order to rectify the deficiencies of the
Croll13 followed the patients with lescence, implants placed distal to the prosthesis.
crown restorations for 8 years and ob- canines present more complications.14 The radiographic and biometric
served that the treated molars contin- Particularly in the maxilla, the apices results in the studies of Ödman1 and
ued to erupt, and the crown margins of implants may become exposed in Thilander2 et al revealed the fact that
came to a supragingival position by the nasal or antral cavities, and ante- after 165 days of an experimental pe-
that time. That is why he described rior implants can be lost entirely due riod, osseointegrated implants showed
stainless steel crowns as intermediate to remodeling. Also, Oesterle et al7 sagittal and transversal displacement
restorations. He asserted that the pa- discussed the possible restriction of and did not act as natural teeth. In
tients could be treated with noble transverse growth of the maxilla when another study, Iseri and Solow4 empha-
metal restoration after the termination a fixed implant-supported prosthesis is sized that the implants did not affect the
of the major effect of the physical placed across the mid-palatal suture in development of the neighboring tissues.
growth. a growing patient. Lederman et al16 applied 42 os-
The implant-supported prosthetic Iseri and Solow15 investigated the seointegrated implants to 34 patients
therapies as alternatives to traditional eruption of incisor and molar teeth between 9 and 18 years of age. In
treatments are preferred on adults. using the metallic implant method. these patients for whom growth and
There are also orthodontic studies con- They stated that the mandibular rota- development periods were not com-
cerned with the fact whether os- tion and eruption of the teeth were plete, the other teeth were observed to
seointegrated implants directly placed related, and there might be some indi- continue their eruption up to their final
into the jaw bone can follow the erup- vidual differences. They also men- positions. As a result of this, the im-
tion of the teeth as a natural tooth, and tioned that there was no development plants were observed to remain in the
act similarly to ankylosed teeth and, in the alveolar bone after integration persistent position, and this was recti-
therefore, lack the ability of natural of the implant with bone in a growing fied by the preparation of new crowns.

IMPLANT DENTISTRY / VOLUME 15, NUMBER 4 2006 415


They said that they obtained a 90% suc- to monitor the continuous eruption of The measurement of the mesial
cess rate after a 79-month follow-up pe- the teeth and changes in the bone tubercle peak point of the tooth neigh-
riod. They stated that the earliest time structure. Owing to the difficulties in- boring the implant and the alveolar
when the implants could be used was volved in the determination of the nat- peak point of the lower molar of the
11 years of age for the girls and 13 ural reference structures, the implants experimental and control animals led
years of age for the boys. were used as the reference as well as to the idea that the region of the
Korn and Baumrind17 proved that determining the natural reference implant-supported structure was not
mandibular development takes place points, as was done by Björk.19,20 He affected in an anteroposterior direc-
as a movement in localized vertical used metallic implants, especially in tion. This finding, which supports the
axis in the symphysis region of the the maxilla. Titanium screw markers idea that the development of the bone
mandible, as well as apposition and were placed in the opposing arches as takes place by differentiation and the
resorption in both jaws. Iseri and So- the supportive reference points. growth of the bone by appositional
low18 applied the implants in both The vertical progression of the al- and resorption formations,1,2,4,15 shows
sides and investigated whether there veolar processes is particularly rapid that the amount of bone in the implant-
was any increase in the bone width in during the eruption of teeth. In addi- supported region does not increase but
mandible related to age. They mea- tion, the erupting teeth are subjected to that the growth in its surroundings
sured the width between the implants a secondary displacement in sagittal or continues, and there is interstitial
at both sides using posteroanterior transversal directions based upon re- growth in this region.
radiography and determined a statisti- modeling. The osseointegrated im-
cally insignificant but important in- plants placed are in constant contact CONCLUSIONS
crease. Although the mechanism of with the bone and act more or less as
this increase was not fully known, Clarification of the data regarding
ankylosed teeth. In accordance with physical development and growth, and
they stated that the increase in chew- the findings of the studies reporting
ing occlusal forces might affect the the fact that osseointegrated implants
that there was no development in the have become routine applications have
endosteal restructuring in the mandib- alveolar bone after the integration of a
ular corpus. made implant-supported applications
single implant with bone in a growing an alternative treatment of tooth loss
Thilander et al 3 inserted os-
alveoli but the neighboring tissues during the physical growth and devel-
seointegrated implants in 15 adoles-
continued their 3-dimensional growth opment period. As have previous stud-
cents aged 3–18 years in places of
and that was why the artificial teeth ies carried out on implants applied for
tooth loss as a result of traumatic or
upon the osseointegrated implant re- single tooth loss or anchorage purposes,
congenital reasons. After a clinical
mained in lower position in occlusion this study revealed that the prosthetic
and radiological follow-up period of 3
years, they found vertical level differ- due to continued eruption of the neigh- structures mounted on implant supports
ences and decrease in the marginal boring teeth,4,5,18 it was determined do not act as the natural teeth and ele-
bone toward apical in the anteriorly that the prosthesis fixed on 2 implants vate in a vertical direction as a result of
mounted implants in 4 of 15 patients. acts as single implants in the alveolar the growth of the alveolar structure upon
They reported that a clinically and ra- structure. They remained behind the which they are inserted. However, they
diological determined difference in the neighboring temporary teeth as re- remained behind the natural teeth erup-
levels of incisal edges was 0 –1.6 mm. gards to vertical level. tions and development of the bone struc-
The investigators stated that the pa- It was observed that the natural ture in that region.
tients’ chronologic ages, and comple- temporary 1 molar teeth and implants Although the sagittal and trans-
tion of the eruption of premolars and supported prosthetic structure were el- verse development of the neighboring
molars are not sufficient criteria for evated in the same direction, but the bone region is greater than the
the implant applications. They attrib- elevation of the natural teeth was more implant-inserted region, this differ-
uted this to the fact that the individuals significant due to the effect of the ence can be tolerated by periodical
were at different stages of their skele- eruption and bone growth. Therefore, modifications of superstructures when
tal development. However, they indi- the implant-supported structure ele- single tooth and 1 side short-fixed par-
cated that gaining enough space for vated a little bit with the growth but tial implant-supported prosthetic res-
the implant in mesiodistal direction remained lower than the natural teeth. torations are applied.
was important to obviate the risk of In the control animal, which had no As in the case of fixed partial den-
marginal bone loss. implant, the distance between the tu- tures in the growth and developmental
Although there have been studies bercle peak of the 1 molar tooth and period, it was concluded that the
carried out with the use of single the foramen mental was in the same implant-supported prostheses should
implant-supported therapy,1,3 there is no order with that of the experimental not be used in long-span bilateral fixed
study related to multi-implant support specimens. This supports the idea that prostheses.
prostheses. It is believed that this study the development of the implant
is the first of its kind regarding the fact mounted region continued. The Disclosure
that it contains 2 implant supports. amount of vertical increase in the op- The authors claim to have no finan-
There is a need to have natural or posite arch and the implant region was cial interest in any company or any of
artificial reference structures in order approximately the same. the products mentioned in this article.

416 IMPLANT-SUPPORTED PROSTHETIC APPLICATIONS UPON DEVELOPMENT OF CHILDREN AND ADOLESCENTS


ACKNOWLEDGMENTS GR, et al. Using endosseous dental im- 15. Iseri H, Solow B. Continued eruption
plants for patients with ectodermal dyspla- of maxillary incisors and first molars in girls
The Scientific and Technical Re- sia. J Am Dent Assoc. 1991;122:59–62. from 9 to 25 years, studied by the implant
search Council of Turkey (Tubitak), 7. Oesterle LJ, Cronin RJ Jr, Ranly DM. method. Eur J Orthod. 1996;18:245–256.
Health Sciences Research Committee sup- Maxillary implants and the growing patient. Int 16. Lederman P, Hassell T, Hefti A. Os-
ported this work (Project No 101S040). J Oral Maxillofac Implants. 1993;8:377–387. seointegrated dental implants as alternative
8. Wood MR, Vermilyea SG. A review therapy to bridge construction or orthodontics
of selected dental literature on evidence- in young patients. Seven years of clinical expe-
REFERENCES based treatment planning for dental rience. Pediatr Dent. 1993;15:327–333.
1. Ödman J, Grondahl K, Lekholm U, implants: Report of the Committee on Re- 17. Korn EL, Baumrind S. Transverse
et al. The effect of osseointegrated im- search in Fixed Prosthodontics of the development of the human jaws between
plants on the dentoalveolar development. Academy of Fixed Prosthodontics. J Pros- the ages of 8.5 and 15.5 years, studied
A clinical and radiographic study in grow- thet Dent. 2004;92:447–462. longitudinally with use of implants. J Dent
ing pigs. Eur J Orthod. 1991;13:279–286. 9. Koch WM, Yoo GH, Goodstein ML, Res. 1990;69:1298–1306.
2. Thilander B, Ödman J, Grondahl K, et al. Advantages of mandibular recon- 18. Iseri H, Solow B. Change in the
et al. Aspects on osseointegrated implants struction with the titanium hollow screw width of the mandibular body from 6 to 23
inserted in growing jaws. A biometric and osseointegrating reconstruction plate. years of age: An implant study. Eur
radiographic study in young pigs. Eur Laryngoscope. 1994;104:545–552. J Orthod. 2000;22:229–238.
J Orthod. 1992;14:99–109. 10. Finn SB. In: Clinical Pedodontics: Re- 19. Björk A. Sutural growth of the up-
3. Thilander B, Ödman J, Gröndahl K, movable Partial Dentures for Children. 4th ed. per face studied by the implant method.
et al. Osseointegrated implants in adoles- Philadelphia, PA: Saunders; 2003:271–285. Acta Odontol Scand. 1966;24:109–127.
cents. An alternative in replacing missing 11. Tylman SD. In: Theory and Practice of 20. Björk A. The use of metallic im-
teeth? Eur J Orthod. 1994;16:84–95. Crown and Fixed Partial Prosthodontics plants in the study of facial growth in
4. Iseri H, Solow B. Average surface (Bridge). 6th ed. Saint Louis, MO: Mosby; children: Method and application. Am J
remodeling of the maxillary base and the 1970:13–51. Phys Anthropol. 1968;29:243–254.
orbital floor in female subjects from 8 to 25 12. Johnston JF, Phillips RW, Dykema
years. An implant study. Am J Orthod RW. In: Modern Practice in Crown and
Dentofacial Orthop. 1995;107:48–57. Bridge Prosthodontics. Philadelphia, PA: Reprint requests and correspondence to:
5. Solow B, Iseri H. Maxillary growth Saunders; 1980:3–19. Ahmet Ersan Ersoy, DDS, PhD
revisited: An update based on recent implant 13. Croll TP. Restorative dentistry for University of Ankara
studies. In: Davidovitch Z, ed. The Biological preschool children. Dent Clin North Am. Faculty of Dentistry
Mechanism of Tooth Movement and Cranio- 1995;39:737–770. Besevler/Ankara/Türkiye 06500
facial Adaptation. Birmingham, AL: L.A. 14. Bryant SR. The effects of age, jaw site, Phone: (00) 90 –312-2126250
Norton: EBSCO Media; 1996:507–527. and bone condition on oral implant outcomes. Fax: (00) 90 –312-2123954
6. Guckes AD, Brahim JS, McCarthy Int J Prosthodont. 1998;11:470–490. E-mail: ersoy@dentistry.ankara.edu.tr

Abstract Translations
tatgestützter Prothetiklösungen ab, bei denen zwei Implantate als
GERMAN / DEUTSCH Halterung für eine feste Prothese während der physischen
AUTOR(EN): Ahmet Ersan Ersoy, DDS, PhD*, Demet Wachstums- sowie Entwicklungsphase von Jungschweinen
Bendik Ellialti, DDS, PhD**, Necdet Dogan, DDS, PhD***. dienen. Materialien und Methoden: Die Versuchsreihe wurde
*Professor, Abteilung für Prothetik, zahnmedizinische Fakul- an sechs männlichen Zuchtschweinen durchgeführt, wobei ein
tät, Universität von Ankara, Ankara/Türkei. **Assistent im Tier zur Kontrolle unbehandelt blieb. In einem Wachstumszei-
Forschungsteam, Abteilung für Prothetik, zahnmedizinische traum von 3,5 bis 8 Monaten wurde mittels kephalometrischer
Fakultät, Universität von Ankara, Ankara/Türkei. ***Assis- Röntngenaufnahmen untersucht, welche Auswirkung die beiden
tenzprofessor, Abteilung für Gesichts- und Kieferchirurgie, Knochengewebsintegrierenden Schraubimplantate hatten, die 5
Gulhane medizinische Militärakademie, zahnmedizinisches Zuchtschweinen im Bereich der Prämolaren im linken Unterk-
Zentrum, Ankara, Türkei. Schriftverkehr: Ahmet Ersan Ersoy, ieferbogen einpflanzt worden waren. Die Kephalogramme wur-
Prof. Dr., Universität von Ankara, zahnmedizinische Fakul- den mit einem Standardkephalostaten durchgeführt. Die Bewertung
tät, Besevler/Ankara/Türkei 06500. Telefon: 00 90 312 erfolgte anhand maßgeblicher Unterscheidungsprüfung zwischen
2126250, Fax: 00 90 312 2123954. e-Mail: ersoy@dentistry. zwei Teilnehmern. Ergebnisse: Die Studie weist aus, dass die
ankara.edu.tr Implantate klare Anzeichen einer alveolären Anhebung
Implantat-gestützte Protheseanwendungen im Entwick- durch Knochenwachstum zeigten, dabei aber nicht mit dem
lungsstadium für Kinder und Heranwachsende: eine Pilot- normalen Zahndurchbruch und dem Knochengewebswach-
studie mit Schweinen als Versuchsobjekte stum in diesem Bereich Schritt halten konnten.
Schlussfolgerung: Die Unterschiede bei diesen Wachstums-
ZUSAMMENFASSUNG: Zielsetzung: Die vorliegende tendenzen können durch Veränderungen der Implantatstrukturen
Studie zielt auf eine Untersuchung der Anwendbarkeit Implan- aufgefangen werden.

IMPLANT DENTISTRY / VOLUME 15, NUMBER 4 2006 417


SCHLÜSSELWÖRTER: Zahnimplantate, Implantatges-
tützte Prothetik, Wachstum und Entwicklung
PORTUGUESE / PORTUGUÊS
AUTOR(ES): Ahmet Ersan Ersoy, Cirurgião-Dentista, PhD*,
Demet Bendik Ellialti, Cirugião-Dentista, PhD**, Necdet
SPANISH / ESPAÑOL Dogan, Cirurgião-Dentista, PhD***. *Professor, Departa-
AUTOR(ES): Ahmet Ersan Ersoy, DDS, PhD*, Demet Bendik mento de Prótese, Faculdade de Odontologia, Universidade de
Ellialti, DDS, PhD**, Necdet Dogan, DDS, PhD***. *Profesor, Ankara, Ankara/Turquia. **Pesquisador-Assistente: Departa-
Departamento de Prostética, Facultad de Odontologı́a, Univer- mento de Prótese, Faculdade de Odontologia, Universidade de
sidad de Ankara, Ankara, Turquı́a. **Investigador Asistente, De- Ankara, Ankara/Turquia. ***Professor-Assistente, Departa-
partamento de Prostética, Facultad de Odontologı́a, Universidad mento de Cirurgia Oral e Maxilofacial, Academia Médico-
de Ankara, Ankara, Turquı́a. ***Profesor Asistente, Departamento Militar, Gulhane, Centro de Odontologia, Ankara, Turquia.
de Cirugı́a Oral y Maxilofacial, Academia Médica Militar Gul- Correspondência para: Ahmet Ersan Ersoy, Prof. Dr., Uni-
hane, Centro de Odontologı́a, Ankara, Turquı́a. Correspondencia versity of Ankara, Faculty of Dentistry, Besevler/Ankara/
a: Ahmet Ersan Ersoy, Prof. Dr., University of Ankara, Faculty of Türkiye 06500. Telefone #: 00 90 312 2126250, Fax #: 00 90
Dentistry, Besevler/Ankara/Türkiye 06500. Teléfono: 00 90 312 312 2123954. E-mail: ersoy@dentistry.ankara.edu.tr
2126250, Fax: 00 90 312 2123954. Correo electrónico: Aplicações Protéticas Suportadas por Implantes no Desen-
ersoy@dentistry.ankara.edu.tr volvimento de Crianças e Adolescentes: Estudo-Piloto em
Aplicaciones prostética apoyadas con implantes ante el de- Porcos
sarrollo de niños y adolescentes: Estudio piloto en cerdos
RESUMO: Objetivo: O objetivo deste estudo é a pesquisa da
ABSTRACTO: Propósýto: El propósito de este estudio es la aplicação de restaurações protéticas suportadas por implantes
investigación de la aplicación de restauraciones prostéticas usando dois implantes suportando uma prótese fixa durante o
apoyadas con implantes usando dos implantes que apoyan una crescimento fı́sico e o perı́odo de desenvolvimento de porcos
prótesis fija durante el crecimiento fı́sico y el perı́odo de desar- em crescimento. Materiais e Métodos: Este estudo foi real-
rollo de cerdos. Materýales y métodos: Este estudio se llevó a izado em seis porcos machos de fazenda (um como controle).
cabo en seis cerdos machos de granja (uno como control). Se
O efeito dos dois implantes endósseos tipo parafuso inseridos
investigó el efecto de los dos implantes endoóseos tipo tornillo
na região dos pré-molares e nos arcos mandibulares esquer-
insertados en el área premolar en los arcos izquierdos de la
dos na mandı́bula de cinco porcos de fazenda foi pesquisado
mandı́bula de cinco cerdos de granja durante un perı́odo de
durante o perı́odo de crescimento de 3,5– 8 meses pelo uso de
crecimiento de 3,5 a 8 meses usando radiógrafos cefalométricos.
Los cefalógrafos se tomaron con un cefalostato especialmente radiografias cefalométricas. As cefalografias foram tiradas com
estandarizado y fueron evaluados por una prueba de significan- um cefalotasto especialmente padronizado e foram avaliadas
cia de la diferencia entre dos compañeros. Resultados: El estu- mediante teste significativo de diferença entre dois parceiros.
dio sugirió que los implantes demostraron elevación alveolar a Resultados: O estudo sugeriu que os implantes mostravam
través del crecimiento del hueso pero no pudieron mantener el elevação alveolar pelo crescimento do osso, mas não podia
mismo ritmo de la aparición de los dientes naturales y el crec- acompanhar a erupção natural dos dentes e o crescimento do
imiento de hueso en al región. Conclusýón: La diferencia en osso na região. Conclusão: A diferença neste crescimento
este crecimiento puede tolerarse a través de modificaciones en pode ser tolerada por modificações de estruturas suportadas
las estructuras apoyadas por implantes. por implantes.

PALABRAS CLAVES: Implantes dentales, prostética del PALAVRAS-CHAVE: Implantes dentários, próteses de im-
implante, crecimiento y desarrollo plantes, crescimento e desenvolvimento

418 IMPLANT-SUPPORTED PROSTHETIC APPLICATIONS UPON DEVELOPMENT OF CHILDREN AND ADOLESCENTS


JAPANESE /

CHINESE /

IMPLANT DENTISTRY / VOLUME 15, NUMBER 4 2006 419