Application of Dense Hydroxylapatite-Metal Complex Artificial Root Implant to Maxillofacial Prosthetics

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Maxillofacial prosthesis is useful for treatment of speech and mastication difficulties after surgery for oral cancer, but is often difficult in patients who have had extensive portions of the jaw removed with few or no remaining teeth. Retention and stabilization of a maxillofacial porsthesis in such patients are important. We made apatite-titanium dental implants to treat patients for whom it was difficult to retain and stalilize a maxillofacial prosthesis, and evaluated their usefulness both clinically and in experimental animals. Several kinds of experimental dental implants were made, among which were one-piece, two-piece, apatite alone and apatite-titaniumcomplex. Metal parts were of the OP-anchor type and cylindrical type, which allowed easier preparation. The following dental implants were used for this study : cylindrical, discoidal and sandwich. Various dental implants were implanted in the jaws of dogs. One to three months after implantation, the surface of the apatite root was directly bound to the newly formed woven bone and 7 and a half months to 1 year after implantation the apatite root was directly bound to the newly formed lamellar bone, which provided strong bone integration. Of the dental implants tested, the two-piece apatite-titanium roots seemed to be most useful. The dental implants used in clinically were based on the finding from the experimental studies. Two-piece apatite-titanium complex dental implants were used in patients in whom prostheses made by the conventional method could not be satisfactorily retained or stabillized after surgery for oral cancer. A maxillofacial prostheses with OP-anchor type attachment was worn by each patient. In all cases in which we applied our dental implants some improvement of stabilization of the prosthesis and of chewing efficiency was revealed. From these studies we conclude that clinical application of our dental implant system in maxillofacial rehabilitation would be possible and beneficial.