Book Reviews

Dental Implants:
The Art and
Science
Edited by Charles A. Babbush, DDS, MscD. W.B. Saun-
ders Co., Philadelphia, PA, 2001: ISBN0-7216-7747-9,
552 pages; 1112 mostly color illustrations; price $205
The editor of this book has attempted to com-
municate a large amount of information regard-
ing treatment planning, surgical placement, pros-
thetic treatment, maintenance and hygiene, and a
future vision of the cyber ofce regarding dental
implants. The broad approach does not target a
specic audience, however, and this tone might
best be used as a supplemental atlas or reference
for the general practitioner. Because the editor
and principal author is an oral surgeon, the bulk
of this text (11 of the 25 chapters) is devoted to
surgical techniques. Dr. Babbush has previously
written two well-known textbooks, Surgical Atlas
of Dental Implant Techniques, and Dental Implants:
Principles and Practice.
The text of 532 pages includes three fore-
words and a Preface and Acknowledgements by
Dr. Babbush. The index is 25 pages, and each
chapter has an extensive reference list. There
are 33 authors, and the book is divided into
5 sections: Case Selection and Evaluation (5
chapters), Surgical Techniques (11 chapters),
Prosthetics (3 chapters), Maintenance and Hy-
giene (3 chapters), and The Cyber Ofce (3
chapters).
Dr. Babbush states in the preface, If the pa-
tient does not comprehend or cooperate in the
daily home care process and return for the pro-
fessional visitation and evaluation, the long-range
favorable prognoses of these cases are seriously
compromised. The rst chapter, written by Dr.
Babbush, continues with the premise of poor oral
hygiene and its effect on treatment selection. For
example, a gure is presented with the following
text: Patient is a poor potential candidate for
implant reconstruction. Hopeless teeth should be
removed, area is temporized, and patient is placed
on a vigorously controlled program of oral hy-
giene.Members of theProsthodontics community
reading this text may note that inappropriate
descriptive terminology is often used, such as the
reference to an omnivac suck-down splint, when
perhaps a more correct use of accepted dental
nomenclature suchas a diagnostic vacuformtem-
plate would be more pleasing to an audience of
trained Specialists.
The home care concept again surfaces in
Chapter 6B, Implant Periabutment Tissue, by
Dr. Donald Callan. He merges literature on pe-
riodontal and implant concepts regarding at-
tached tissue and his own experience with state-
ments such as, Rather, implants fail because of
the patients inability to clean properly around
the implants and because of possible develop-
ment of perimucocitis. In the opinion of this
reviewer and many colleagues, there is presently
no clear scientic evidence relating patient
home care and the loss of dental implants.
The author goes on to state, however, There-
fore it is logical to establish a region of at-
tached keratinized gingival around the dental
implant to create a more functional soft tissue
barrier, citing Drs. Garnick and Silverstein.
1
In the chapter summary, the author states, Soft
tissue maintenance is the primary line of defense
in protecting against bacterial infection around
teeth and, especially, dental implants. The au-
thor promotes use of acellular dermal matrix to
increase the width of attached keratinized tissue
around implants. He cites several published non
peer-reviewedpapers andcontinues the home care
Journal of Prosthodontics, Vol 13, No 4 ( December), 2004: pp 279-285 279
280 Book Reviews
mantra of the previous chapters with statements
such as Bacterial plaque is a prime etiologic
contributor to the loss of dental implants. Like gin-
givitis, peri-implant mucositis is reversible once
the etiologic agent bacterial plaque is re-
moved. If allowed to progress, peri-implantitis
may ensue, and, If the patient has a retrievable
superstructure, it should be removed every 18
24 months and placed in an ultrasonic cleaning
solution.
2
Section III, Prosthetics, begins with a brief
survey by Dr. Peter S. Wohrle entitled Principles
of Aesthetic Implant Dentistry. It is followed by
Efcient Implant Prosthodontic Therapy by Dr.
Kenneth W. M. Judy, in which the author stresses
the importance of unbroken models and the use
of cast verication jigs and cast corrective reduc-
tion copings to ensure efcient and rapid com-
pletion of implant prostheses, which invariably
seem to be cement-retained. The nal chapter,
Transitional Phase: Patient Management With
Transitional Implants by Dr. Paul S. Petrungaro,
a periodontist, is comprised primarily of an em-
phasis upon the surgical aspects of this treatment
modality.
Certainly, Dr. Babbush has made an effort to
transfer a large amount of knowledge regard-
ing implantology in this text and has succeeded
in this regard when the topic is mostly surgi-
cally oriented. I cannot recommend this book
for Prosthodontists, however, as the information
relating to dental restoration with implants is
minimal.
Kenneth S. Kurtz, DDS
Clinical Associate Professor, International Program
in Prosthodontics, New York University College of
Dentistry, New York, NY and Assistant Professor,
Departments of Dentistry and Otolaryngology,
Monteore Medical Center/Albert Einstein College of
Medicine, The Bronx, NY
References
1. Garnick J, Silverstein L: Periodontal probing: What
does it mean?. Clarks Clinical Dentistry 1996;
3:1
2. Meffert R: Implantology and the dental hygienists role.
J Pract Hyg 1995;4:12
Implant
Overdentures:
The Standard of
Care for
Edentulous
Patients
Editors: Jocelyne S. Feine, Gunnar E. Carlsson.
Quintessence Publishing Co. Inc., Carol Stream, IL,
2003: ISBN 0-86715-430-6, 162 pp., 62 illustrations
(many black/white tables/graphs/radiographs, many color
images and illustrations); price $58, soft cover
This book is written to provide the evidence-
based information to both the student and
the experienced clinician for treating edentu-
lous patients with anterior mandible two-implant
overdentures. A symposium on the two-implant
overdenture held at McGill University, Montreal,
Quebec, Canada in May 2002 produced a consen-
sus statement that the two-implant overdenture
should become the rst choice of treatment for
the edentulous mandible.
The editors, Drs. Gunnar E. Carlsson and
Jocelyne S. Feine, arranged the 14 chapters in
a logical order to build support for the con-
sensus statement. The rst half of the book is
devoted to providing evidence to support the
use of two-implant retained overdentures. The
latter half of the text addresses issues of two-
implant overdenture treatment. Throughout the
text, the editors do an excellent job of ensuring
that the authors adhere to a recurring theme:
adopting a patient-centered approach to treating
edentulism.
The text begins with a succinct discussion by
Dr. Philippe Mojon of past, current, and future
trends in edentulism and the necessity of prepar-
ing for the continued treatment of the edentu-
lous patient. At the patient level, consideration is
given to the effects of age, gender, income, health,
lifestyle, and socioeconomic and psychosocial fac-
tors on edentulismrates. The effects of a countrys
December 2004, Volume 13, Number 4 281
economic development, urban versus rural set-
ting, and density of dentists provide a broader
perspective on the rate of edentulism. The reader
needs to pay close attention to the data sources,
as it can be confusing when comparing statistics
for different countries. This discussion ends with a
very clear summary and concise conclusion, which
supports the future need for treatment of the
edentulous patient for the next 1020 years.
The second chapter serves to explain the in-
terrelationship between the masticatory process,
nutrition, and edentulism. Correlation is made
between implant prostheses, conventional den-
tures, chewing ability, and food selection patterns.
A thorough review of the literature is presented
to illustrate the relationship between number
of teeth and nutrient intake. Although the au-
thors (Drs. J. A. Morais and J. M. Thomason)
state that there is no data to date suggesting
that changes in eating patterns from implant-
supported prostheses will result in changes in pa-
tients nutritional status, they present the results
of a pilot study indicating that a mandibular two-
implant overdenture improves nutritional status,
as evidenced by improved blood and anthropomet-
ric measures at 6 months posttreatment when
compared to the conventional complete denture
group. The authors of this chapter are careful
to indicate that these initial ndings need to be
conrmed with larger randomized clinical trials.
This chapter left the impression that the patient
will benet from the two-implant mandibular
overdenture.
Dr. Michael MacEntee reiterates the expected
trend for edentulism during the next quarter
century, but addresses edentulism from the pa-
tients perspective of psychosocial and quality of
life issues. He suggests that edentulism affects
patients quality of life, and discusses this from
4 perspectives: psychologic health and function,
socioeconomic status, life satisfaction, and self-
esteem. Implant overdentures can help alleviate
the suffering from dysfunction, pain, low self-
esteem, and a reduced QOL.
Dr. Manal A. Awad observes the need to
evaluate the success of treatment with more
patient-centered criteria rather than just clini-
cal outcomes. He cites literature to support the
poor association between clinical excellence and
patients satisfaction with their prostheses, and a
stronger association between patients perceived
masticatory ability and satisfaction with their
prostheses. This precedes a good discussion of the
interrelationship between patients expectations
of outcome, knowledge, preferences, and percep-
tions of treatment.
Drs. Jocelyne S. Feine and Guido Heydecke
stress the importance of recognizing the priorities
of complete denture patients rather than evaluat-
ing the success of treatment with the traditional
clinical parameters. They present literature to
support the two-implant overdenture in provid-
ing an improved quality of life, oral health, and
function as compared to conventional complete
dentures.
Thus far, the reader has been furnished in-
formation to support the use of the two-implant
overdenture as an improvement over conventional
complete dentures, but the question of expense
and affordability has not been described. Drs.
J. R. Penrod and Yoshiaki Takanashi recognize
that since edentulous patients tend to come from
households of below-average income, if implant-
retained overdentures are to become the standard
of care for the edentulous patient, more afford-
able, cost-effective implant treatments need to
be developed. The rst step in this process is to
identify the costs for implant care through year
one as compared to conventional complete den-
ture therapy. The authors review the cost analysis
of two-implant overdentures compared to conven-
tional complete dentures in conjunction with a
randomizedcontrolledclinical trial comparing the
efcacy of two-implant overdentures to conven-
tional dentures. The overdenture/conventional
complete denture cost ratio (using direct costs
only) is studied to facilitate the comparison of
their data with studies from other countries.
The authors specically identify the shortcomings
in their study that make comparison to other
cited studies impossible. They emphasize the
need for long-term data for a complete economic
evaluation.
Assuming the demand for implant overden-
tures increases in the coming decade, one might
also assume the number of implant systems in
the marketplace will increase. Corporate claims of
improved performance, ease-of-use and cost effec-
tiveness may further confuse the selection of the
best implant system for patient care. The editors
expert clinical insight is evidenced by including
a chapter (by Dr. T. W. Head) with guidelines
on simplifying the process of selecting an implant
system for clinical practice. Suggestions are given
282 Book Reviews
on developing a system to evaluate and select the
most appropriate implant system for the patient.
The remaining text focuses more directly on
the implant overdenture strategies withcontinued
reinforcement of the need to evaluate total treat-
ment result, which includes patient satisfaction,
amount of aftercare, and clinical performance of
the different implant treatment strategies. Drs. D.
Wismeijer and G. T. Stoker review a randomized
controlled clinical trial (Breda Implant Overden-
ture Study) and make recommendations for the
implant overdenture strategy they deem best. As
seeninprevious chapters, the authors indicate fur-
ther long-term evaluation is necessary to conrm
their suggestions.
The predictable implant overdenture treat-
ment depends on thorough treatment planning
and following sound complete denture principles.
Dr. T. D. Taylor offers practical guidelines for
treatment planning overdentures with dental im-
plants. The author suggests offering dental im-
plants as a means of increasing patient satisfac-
tion and improving the quality of life with an
extremely thorough and systematic approach to
treatment planning from consultation to surgery.
Excellent color illustrations and intraoral images
compliment the text. The indications for specic
radiographic surveys in the anterior mandible are
described, and high-quality radiographic images
clarify the treatment planning process. The pearl
in this chapter is in the authors contingency plan-
ning for the implant sites at the treatment plan-
ning stage. A description of the fabrication of the
surgical guide and its importance in ensuring the
predictable placement of the implants concludes
the chapter.
Following the discussion on treatment plan-
ning, Dr. R. Mericske-Stern (in Chapter 10) re-
views the clinical considerations in overdenture
therapy. Topics considered are xed prostheses
versus overdentures, number of implants, splinted
or unsplinted implants, resilient or rigid reten-
tion, and overdenture success and implant sur-
vival. Once again, we see the recommendation
that treatment outcomes be measured by patient-
related factors rather than just implant and pros-
thetic survival.
Dr. Ignace Naert addresses the inuence of
attachment systems (bars, balls, and magnets) on
clinical outcomes by reviewing a clinical trial in
Chapter 11. He concludes that the splinting of
implants with a bar is not a prerequisite for the
long-term survival or prognosis of implants in the
mandible.
Loading strategies for mandibular implant
overdentures are discussed through review of a
clinical overdenture study involving 4 implant sys-
tems with different healing times prior to loading.
The authors(Drs. A. G. T. Payne, A. Tawse-Smith,
W. M. Thomson, and W. J. Duncan) description
of bone quality and quantity is different than that
proposedby LekholmandZarb,
1
but is not a source
of confusion for the reader. The results of this
clinical study can be used as a guide in selecting
a loading strategy for unsplinted ball-retained
overdentures. High-quality color intraoral images
and radiographs illustrate the different anchor
systems and clarify the treatment of the intaglio
denture surface for loading.
Drs. P. Boudrias and A. Chehade present a
step-by-step overview of the procedures from ini-
tial clinical assessment, through surgery, to ball-
attachment activation in Chapter 13. The au-
thors 49 clinical color/radiographic images are of
high quality and provide a concise and thorough
summary. Although this chapter better serves
the novice, the clinical images clarify the loading
strategy mentioned in the previous chapter. The
authors surgical guide provides a lingual access
for the surgical drill. It would be informative for
the authors to include either an explanation or a
clinical viewof a surgical guide restricting surgical
drill access to one path of placement.
The nal chapter provides a complete overview
of the text with a realistic appraisal of the current
overdenture status, its future, and areas for con-
tinued research. The author (Dr. G. E. Carlsson)
suggests that although the trend for increasing
use of implant-retained overdentures will proba-
bly continue, conventional complete dentures will
remain a realistic and necessary alternative for
many edentulous patients.
For both the student and the experienced clin-
ician, this text offers a philosophy for successful
treatment of edentulism by utilizing a patient-
centered approach and the two-implant mandibu-
lar overdenture. It provides thorough evidence-
based documentation in a quality bound soft
cover with heavy paper stock, excellent supportive
tables, graphs, illustrations, radiographs, and in-
traoral color images. The editors have done an
excellent job of directing the 23 contributing
authors to create a cohesive vision throughout
the text, including the provision of a realistic
December 2004, Volume 13, Number 4 283
assessment of the current status of the implant-
retained overdenture in clinical practice and sug-
gestions for future research. The authors also
suggest a patient-based treatment approach. This
will be a valuable text for all students or clini-
cians wishing to incorporate the two-implant over-
denture into their treatment philosophy. It pro-
vides evidence-based information to guide both
the care-provider and the patient in making treat-
ment decisions.
Richard A. Williamson, DDS, MS
Assistant Professor, Department of Prosthodontics,
The University of Iowa College of Dentistry, Iowa
City, IA
References
1. Lekholm U, Zarb GA: Patient selection and preparation.
In Branemark PI, Zarb GA, Albrektsson T (eds): Tissue-
Integrated Prosthesis. Chicago, IL, Quintessence Publish-
ing Co., 1985, pp 199-208
Implants in
Clinical
Dentistry
Editors: Richard M. Palmer, Brian J. Smith, Leslie C.
Howe, Paul J. Palmer. Martin Dunitz Publishers, Ltd.,
Thieme, New York, NY, 2002: ISBN 1-85317-805-5,
256 pages; 600 photos (mostly color, 50 b/w); price $89.95,
hardcover
This book was written to provide comprehen-
sive information on the prosthetic and surgical
phases of implant dentistry, and is intended for
use by general practitioners, prosthodontists, and
oral surgeons alike. This book is divided into 5
parts. Part 1 reviews the success criteria of os-
seointegration and discusses patient factors such
as age, untreated dental disease, severe mucosal
lesions, and smoking. Other factors, such as im-
plant biomechanics, including implant length, di-
ameter, shape, and surface characteristics, are
also discussed. Additionally, submerged and non-
submerged protocols, different loading conditions,
and guidelines for choosing various implant sys-
tems are covered in Part 1.
Part 2 is divided into 5 chapters covering treat-
ment planning of single anterior and posterior
teeth, xed bridge planning, and diagnosis and
treatment planning for implant dentures. This
section provides an overall viewof treatment plan-
ning. It discusses general esthetic principles with
emphasis on comprehensive clinical data collec-
tion, including clinical examination, radiographic
screening, study casts, diagnostic set up, and basic
treatment sequencing. The authors discuss single
implant tooth planning in the anterior region in
detail. They emphasize that in order to achieve
ideal esthetic results, the complete evaluation of
the status of the adjacent teeth, the ridge and
soft tissue prole, planning and precise implant
placement, sympathetic surgical handling of the
soft tissue, and a high standard of prosthetics are
all needed. The authors suggest the use of differ-
ent implant options for the single tooth implant
and, as an alternative, the use of wide diameter
implants whenever necessary.
The remaining chapters discuss the treatment
planning for multiple implants. They cover the
planning of the numbers of implants to be placed,
as well as their distribution. Also presented is
a treatise on choosing between xed bridges or
multiple single units with a presentation of dif-
ferent prosthodontic options for implant retained
dentures. These chapters are well written, and the
diagrams andphotographs are of highquality. The
information is up-to-date and would be extremely
benecial for all members of the implant team, but
especially those who are involved inthe restorative
phase.
Part 3 is divided into 6 chapters, which dis-
cuss the basic factors in implant surgery, in-
cluding heat generation during implant place-
ment, primary stability of implants, implant po-
sition, preoperative care, anesthesia and analge-
sia, ap design and soft tissue handling, surgi-
cal placement of the single tooth implant in the
anterior maxillae, implant placement for xed
bridgework, and immediate and early replace-
ment implants. Additional emphasis is placed
on treatment planning and interdisciplinary ap-
proach, in order to achieve the best esthetic and
functional results.
284 Book Reviews
Part 4 of the text is divided into 3 chap-
ters covering single tooth implant prosthodon-
tics, xed bridge prosthodontics, and implant
denture prosthodontics. These chapters discuss
various types of implant abutments, their advan-
tages and disadvantages, along with indications
and contraindications for each. Again discussed
are impressions of the implant platform, as well as
abutment level impressions, shade selection, and
a reviewof laboratory techniques. Acomparison of
screw-retained versus cement-retained prostheses
with their accompanying advantages and disad-
vantages is well presented. This section of the
book provides excellent, comprehensive, easy-to-
read coverage of restorative implant dentistry and
can be a great benet to both the general dentist
and the prosthodontist.
Part 5, the last section of the text, dis-
cusses both surgical and prosthetic complications,
their cause, and how to manage such complica-
tions. A detailed list of routine hygiene mainte-
nance requirements for single tooth restorations,
xed bridges, and removable prostheses is also
presented.
This book is a valuable resource for clini-
cians and educators. The authors present a great
amount of timely information on aspects of both
prosthetic and surgical implant dentistry. A va-
riety of information is presented in a clear, con-
cise, and easy-to-read manner. The authors of
this text deserve a good deal of credit for pro-
ducing such a well-written and comprehensive
text.
Raed Ajlouni, DDS
Assistant Professor, Department of General Dentistry,
Baylor College of Dentistry, Dallas, TX
Implant
Dentistry:
From Failure
to Success
Editors: Ira D. Zinner, Francis Panno, Stanley Small,
Lloyd Landa. Quintessence Publishing Co., Inc., Carol
Stream, IL, 2004: ISBN0-86715-438-1, 212 pages; 365
illustrations (mostly in color); price $124, hardcover
Eleven contributing authors and four editors
produced this text, which includes 13 chapters
and a forward by Dr. George Zarb. The purpose
of the text, as suggested by the title, is a review
of the use of implant-supported prostheses in the
management of failed conventional and implant-
supported oral rehabilitations. Special emphasis is
placed on understanding the causes of failures and
methods for avoiding potential problems and com-
plications. The editors and authors continuously
stress the need for a team approach to prosthet-
ically direct implant therapy. Many complex fail-
ures withsubsequent rehabilitations are discussed
andillustratedthroughout the text, whichappears
to be written for highly experienced clinicians and
specialists.
The book begins with an overview of the au-
thors concepts of managing patients with failed or
failing prostheses. The next chapter, Diagnosis
and Treatment Planning for Implant-Supported
Fixed Prosthodontics, is a standard overview of
treatment planning for implant dentistry. Com-
puterized tomography (CT) is briey mentioned,
but a comprehensive review of the role of CT
scans with radiographic templates in planning
complex rehabilitations is conspicuously absent.
Also, screw-retained restorations are strongly ad-
vocatedinthis chapter andthroughout the text de-
spite the current trend toward the use of cement-
retained implant-supported xed restorations.
1
The third chapter, Presurgical Prosthodon-
tics, describes the authors approach to the use
of surgical templates, surgical index copings, and
provisional prostheses. All procedures are compre-
hensively illustrated in a series of 10 cases. The
text then reviews problems that can occur before,
during, and after implant surgery, along with so-
lutions to these problems. Seven cases illustrat-
ing the authors use of metal-reinforced, implant-
supported provisional restorations are illustrated
in the subsequent chapter, Second-Stage Screw-
Retained Provisional Prostheses.
The chapter titled Occlusal Considerations
to Prevent Prosthesis and Component Com-
plications contains common-sense advice for
managing the occlusion with implant-supported
prostheses, such as the avoidance of cantilevers.
Nevertheless, the authors advocate the routine use
of screw-retained restorations with acrylic resin
December 2004, Volume 13, Number 4 285
occlusal surfaces for shock absorption. In this
reviewers experience, occlusal stability can be lost
rapidly with acrylic resin occlusal surfaces because
of accelerated wear, especially with complete-
arch rehabilitations. Also, the concept of using
acrylic resin as a shock absorber was based on
conjecture in the 1980s, during the professions
early clinical experiences with implant-supported
prostheses; the validity of this assumption has
not been proven scientically. The authors also
suggest that the occlusal scheme should direct
occlusal contacts over the centers of the prosthetic
platforms of the implants. Developing centric oc-
clusal contacts over the center of the implants is
difcult with screw-retained prostheses because of
the locationof the screw-access holes.
1
The section
on screw mechanics and occlusion in this chapter
implies that tightening torque force for a screw
is synonymous with the term preload. Preload is
the initial load in tension on the screw producing
a clamping force that results from the tension
between the threads of the screw and the screw
head.
2
The preload that is developed is the result
of the applied torque and is usually proportional
to the tightening torque, commonly described in
Ncm. It should be noted that these two terms are
related, but are not exactly synonymous.
2
The next two chapters provide an excellent
analysis of maxillary sinus grafting. Surgical pro-
cedures andprosthetic management are reviewed,
along with the anatomy and pathophysiology of
the sinuses. Together, these two chapters provide
a comprehensive and concise overviewof the topic.
The text then proceeds to highlight the me-
chanical aspects of fabricating implant-supported
prostheses with a chapter titled Technical Con-
siderations to Optimize Prosthetic Success. This
chapter appears tailored to the dentist only, be-
cause it is not sufciently detailedto guide a dental
laboratory technician. The laboratory procedures
described and illustrated relate to screw-retained
restorations, and many of the laboratory proce-
dures for developing screw retention appear un-
necessarily complicated. The section on auxiliary
screw devices is especially difcult to follow, and
illustrations of the techniques described would be
helpful to the reader.
The standard approach to verifying passive t
of a screw-retained prosthesis is described. The
problems of screw loosening and screw fractures
are addressed, along with other complications
related to damage or mechanical failure of im-
plant components. An entire chapter is devoted
to various approaches for managing failures in
totally edentulous patients treated with implant-
supported prostheses. This chapter, Salvaging a
Failed Implant-Supported Fixed Prosthesis in the
Completely Edentulous Patient, is extremely well
written and illustrated. Avery brief and unimpres-
sive overviewof esthetics follows. The nal chapter
of the text, Legal Aspects of Implant Practice, is
an excellent review of the legal ramications of
implant dentistry, and should be of interest to all
dentists.
This text is handsomely bound and printed on
excellent quality paper stock. All 365 illustrations
are of exceptional quality. The overall writing
style is clear and concise, although at times the
authors do not use current terminology as dened
in the 7th edition of The Glossary of Prosthodon-
tic Terms.
3
For example, centric occlusion is
used when the authors obviously imply maximal
intercuspal position, and the term appliance is
often used as a synonym for prosthesis. This
text does provide a wealth of information not
currently available in a single source, based upon
the authors comprehensive knowledge and vast
experience. It would be a welcome addition to
the library of any dentist involved in the care of
patients requiring complex rehabilitations with
implant-supported prostheses.
Steven M. Morgano, DMD
Professor of Restorative Sciences and Biomaterials,
Director, Division of Postdoctoral Prosthodontics,
Boston University School of Dental Medicine, Boston,
MA
References
1. Hebel KS, Gajjar RC: Cement-retained versus screw-
retained implant restorations: Achieving optimal occlu-
sion and esthetics in implant dentistry. J Prosthet Dent
1997;77:28-35
2. Alkan I, Sertgoz A, Ekici B: Inuence of occlusal forces
on stress distribution in preloaded dental implant screws.
J Prosthet Dent 2004;91:319-325
3. VanBlarcomCW, Campbell SD, Carr AB, et al: The glossary
of prosthodontic terms. J Prosthet Dent 1999;81:48-110