The aim of this study was to carry out a review of all available literature addressing the tooth-implant connection and evidencebased understanding of the management of tooth-implantretained restorations. Connecting teeth to osseointegrated implants presents a biomechanical challenge. This is due to the implant being rigidly fixed to the bone and the tooth being attached to the bone with a periodontal ligament. This ligament acts as a shock absorber and allows teeth to take less stresses than implants. This leads to biomechanical failure of implants over a period of time. In order to overcome this problem, various connection types such as rigid and nonrigid have been proposed. However, the mechanism of attachment and the perceived problem of the differential support provided by the implant and the tooth have been discussed by many authors, and the ideal connection type is still controversial. Literature published was searched through science direct, Google and PubMed. The most relevant articles were evaluated, selected and systematically analyzed.

Implant retained over denture (IRO) is a satisfactory treatment modality for edentulous patient with problems with their lower denture. There are good reasons why this treatment should be selected in preferences to using tissue supported dentures. There are certain rules that provide a method to control the mechanical environment, addressing factors effecting implant and prosthesis longevity, including magnitude of forces, resistance of prosthesis against theses forces, and the biology of bone and its ability to respond to loading environments. Materials and methods: Ten edentulous patients were selected for implant retained prosthesis for the mandible, with minimum four implants in parasymphysis region and prosthesis were delivered after period of 3 months. Conclusion: Certain important points needs consideration for successful prosthesis and its longevity.

The direct sinus lift approach is a well-established technique for implant placement in the deficient maxilla. The need to provide efficacious treatment to patients while minimizing procedure-associated morbidity lead to the introduction to bone substitutes as alternative to autogenous bone grafting for bone augmentation in the sinus. Calcium phosphosilicate biomaterial is the form of morsels that have been recently introduced for use in oral surgery. The osteostimulative properties of this biomaterial makes it an excellent bone substitute for indications that have been traditionally treated with autogenous bone graft. A case is presented where implant rehabilitation was planned in left maxillary posterior region with pre-existent significant pneumatization of the sinus. Under local anesthesia direct sinus lift technique was employed. The results were highly satisfactory showing regeneration up to approximately 13 mm of bone height that allowed successful implant placement of appropriately sized implant fixtures. The present case-study is a proof-of-principle study of the efficacy of morsels in direct sinus lift. Use of morsels for sinus augmentation provides successful outcomes with minimal morbidity for the patient and significant decrease in chair-side time that would be required for harvest of an autograft.

Necessity of the width of keratinized mucosa around implants has been a topic of much controversy. There have been reports both supporting and against the idea. This is a case report describing an EdlanMejchar vestibular deepening procedure done with respect to a mandibular anterior failing implant. The procedure helped in increasing the keratinized mucosa around the implant thus rendering a harmonious soft tissue for healing of the peri-implant mucosa. Based on the findings of the present case it can be concluded that keratinized mucosa around the implant is detrimental in the success of the implant.

Background: According to previous studies, persons wearing implant-retained prostheses may create bite forces comparable to those possessing natural dentition and it has been suggested that the risk for combination syndrome increases in persons wearing mandibular implant-retained prostheses opposed to maxillary complete dentures. Aim: This article presents the fabrication of a maxillary conventional complete denture opposing a mandibular implant retained fixed prosthesis and evaluates the changes in the edentulous maxilla and prostheses over a period of 2 years. Case description: A comprehensive treatment included a conventional removable complete denture for the upper arch and a six implant supported fixed prosthesis for the lower arch. Conclusion: This article reports on the fabrication of a maxillary conventional complete denture opposing a mandibular implantretained full fixed prosthesis. Occlusion and articulation were found to be good over a period of 2 years. Retention and stability were found to be good uptill the 18 months review and moderate at the 24 months review. Clinical significance: To preserve anterior maxillary bone, a balanced occlusal concept has been recommended for implantretained mandibular prostheses opposing a tissue supported conventional maxillary complete denture. In this case, the patient was rehabilitated with a balanced occlusion without anterior tooth contact in maximal intercuspation.

Background: Augmentation of the bone is done to create the sufficient bone volume for ideal implant placement. This case report presents the effective augmentation of the socket using corticocancellous graft and AlloDerm. Methods: Failing 47 was extracted. Socket had a severe buccal dehiscence extending and a thin keratinized mucosa around. After through debridement, socket walls were decorticated and corticocancellous graft and allograft GBR was tacked over the socket. Mucoperiosteal flap was sutured with 5-0 nylon sutures (Ethicon) Bone core biopsy was done for histologic assessment and site was restored with screw-retained implant prosthesis. Results: Histologic assessment revealed ingrowth of new bone around the bone graft. Stable soft and hard tissue results have been seen with 2 years follow-up of the case. Conclusion: Results indicated that ridge preservation using corticocancellous graft and AlloDerm prevented the ridge resorption and helped in enhancement of bone fill and soft tissue volume.

The posterior maxilla presents with a common problem clinically following tooth extraction or crestal bone loss resulting in loss of osseous height sufficient to place implants. Resorptive patterns in some patients along with sinus enlargement result in minimal bone that can accommodate implant placement. Maxillary sinus augmentation over the past 18 years with various bone graft materials has become routine treatment. Numerous studies have reported highly successful implant survival rates when placed into the augmented sinus. The most common complication of the lateral sinus elevation approach is typically tearing of the Schneiderian membrane which could allow for bacterial contamination or loose particles to gain access to the sinus cavity. A safer lateral window approach sinus augmentation procedure will be discussed using specialized safe cutting end drills with vertical stoppers for osseous window formation and subsequent membrane elevation.