الفهرس 
Patient selection
Construction of surgical stentOnly 14 pages are availabe for public view
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Abstract
Fourteen completely edentulous patients were selected from
out clinic of Ain Shams University. All patients were systematically
free. Medical and dental history for all patients was recorded. Extra
oral examination was carried out to detect any facial disfigurement.
TMJ was examined for any clicking, crepitus, or shift in movement.
Intra oral examination was carried out to detect any signs of
inflammation, swelling or flappy tissue. Radiographic examination to
detect any bony pathosis.
Conventional complete denture was constructed for all
patients. Lower denture was duplicated in a clear acrylic stent to be
used as radiographic stent and surgical stent after that. Panoramic
radiograph was taken for all patients to detect the position of mental
foramen using the radiographic stent with two metal spheres placed
inside.
Three holes were made in a surgical stent corresponding to
the further position of the dental implants. The surgical stent was
placed in patient mouth and the position of each implant was marked
using suitable marker. Tissue punch was used to cut out the mucosa
at the position of the implant marked previously. 1.8 mm drill was
used to penetrate the bone to about one half of the threaded portion
of the implant, implant was placed in the drilled site using its cap,
then thumb wrench was used for more insertion force, finally torque
wrench was used to finish the procedure. Suitable antibiotic and
analgesic was prescribed to control any post-operative pain or
infection.Later on, patients were recalled modifying their lower denture
to fit over the implants. The patients were divided equally into two
group.
group I, patients in this group were rehabilitated by
immediately loaded implant retained mandibular overdenture within
48 hours of implant placement.
group II, patients in this group were rehabilitated by early loaded
implant retained mandibular overdenture six weeks after implant
placement.
Panoramic radiograph was taken for each patient at time of
insertion, at 6 months and at one year follow up intervals.
Marginal bone height change around the implants was
evaluated using the linear measurement software system supplied with
the panoramic radiographs. The bone height was measured by
measuring the distance from the alveolar crest to the implant apex.
Values of linear measurements were recorded in the patient
chart at every follow-up visit and from these data mean value of bone
height change were calculated.
Although more peri-implant bone height change for both mesial and
distal aspects was detected for group I (immediate loading) compared to
group II (early loading) the difference was statistically insignificant p>0.05.