Oral Surgeon Caesar C. Butura, D.D.S.

Years of Experience
Dental Implants Placed
Lives Changed

Originally from New York City, Dr. Butura obtained his degree from Columbia University School of Dental and Oral Surgery in 1992. While at Columbia University, he received numerous academic and research honors. He was awarded the Birnberg Research Award for his work in cellular physiology which produced several publications. In 1996 he completed the four year Oral and Maxillofacial Surgery program at the University of Illinois Medical Center in Chicago.

Caesar C. Butura, DDS - Selected topDentists - 2007-2018

Dr. Butura took the knowledge acquired in his studies to the University of Illinois Oral and Maxillofacial Surgery Department, where he served as Assistant Clinical Professor in addition to private practice. Private practice took him to Bismarck, ND where he became a partner in the Face and Jaw Surgery Center. While in North Dakota he served the specialty by holding numerous leadership positions on local and national levels. In 2003 he relocated to Phoenix AZ, and has been active in private practice, served as the Secretary/Treasurer and President of the Arizona Society of Oral and maxillofacial Surgeons. Dr. Butura received his board certification from the American Board of Oral and Maxillofacial Surgeons in 1999. He is a Diplomate of the American Board of Oral and Maxillofacial Surgeons, Fellow of the American Association of Oral and Maxillofacial Surgeons and International Association of Oral and Maxillofacial Surgeons. Dr. Butura is a member of the Academy of Osseointegration and International College of Implantologists.

Dr. Butura regularly attends national and international continuing education meetings and also lectures on aspects of dental implant surgery. He has authored multiple clinical papers that have been published in the Journal of Oral and Maxillofacial Surgery, Journal of the Academy of Osseointegration and the Oral and Maxillofacial Surgery Clinics of North America. He practices the full-scope of oral and maxillofacial surgery with an emphasis on dental implants and oral reconstruction. Dr. Butura has been named as one of America’s Top Dentists, in the specialty of Oral and Maxillofacial Surgery by the American Council on Excellence from 2007 to 2013.

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Biomechanial Rehabilitation of the Dental Cripple Symposium
May 2011
Comprehensive review of implant treatment options for patients with severely atrophic jaws.
2 authors: Caesar C. Butura, DDS and Daniel F Galindo, DDS
Surgical and restorative procedures for the edentulous patient using the Bar Attachment Denture treatment concept and Nobel Guide
October 2013
Guest speaker and clinical presenter
Nobel Biocare AAID Symposium, Phoenix AZ




Combined Immediate Loading of Zygomatic and Mandibular Implants: A Preliminary 2-Year Report of 19 Patients
Journal of Craniofacial and Tissue Engineering –

A retrospective study was performed to evaluate the feasibility of simultaneous use of immediately loaded zygomatic and mandibular implants for full maxillomandibular restoration. Materials and Methods: A total of 40 zygomatic and 112 conventional implants were placed in 19 edentulous and partially edentulous patients and restored with full-arch acrylic resin prostheses within 3 hours of surgery. Implant insertion torque values were between 35 and 45 Ncm. Results: During the 1-year follow-up period, none of the 19 patients experienced implant or prosthesis failures. The patients did not experience any sinus infections or any other surgical complications from the performed procedures. Conclusion: Zygomatic and conventional implants can be simultaneously placed in the maxilla and mandible and successfully loaded with an acrylic resin prosthesis using the Bar Attachment Denture concept. Oral Craniofac Tissue Eng 2012;2:58–65

2 authors: and


Mandibular Bar Attachment Denture Therapy Using Angled Implants: A Three-Year Clinical Study of 857 Implants in 219 Jaws
Oral Maxillofacial Clinics of North America –

Immediate function with Brånemark implants is well established for the mandible. This article describes a series of 857 implants placed consecutively in which very few implants failed or lost bone despite the dynamic healing conditions of simultaneous dental extractions and bone leveling. Though these findings are relatively early, 3 years or fewer, it appears that the immediate function Bar Attachment Denture procedure can be done with a high degree of confidence for the mandible—putting into question the need for additional implants.

2 authors: and


The Hour-Glass Mandibular Anatomic Mandibular Variant: Incidence and Treatment Considerations for the Bar Attachment Denture Implant Therapy
Journal Of Oral and Maxillofacial Surgery –

The purpose of this study was to determine the incidence and treatment of hour glass variant mandibles for
Bar Attachment Denture implant placement.

Materials and Methods
Cone beam CAT scans were analyzed for 719 patients to determine the incidence of alveolar constriction in the mandible. Ten patients with alveolar constriction were treated over a 2-year period and retrospectively studied after 1 year in function.

Of 719 mandibles studied, 28 have “hour glass” variants identified for an incidence of 3.89%. Treatment of these cases were variously done including the use of guided bone regeneration, the use of long implants, bone reduction, and angulation strategies.

The hour glass mandibular finding is a developmental or genetic variant that poses a significant anatomic difficulty for dental implant surgery for Bar Attachment Denture immediate function.

2 authors: and


Macrovascular and Microvascular Endothelium During Long Term Hypoxia: Alterations in Cell Growth, Monolayer Permeability and Cell Surface Coagulant Properties
Journal of Cellular Physiology –

In bovine aortic or capillary endothelial cells (ECs) incubated under hypoxic conditions, cell growth was slowed in a dose-dependent manner at lower oxygen concentrations, as progression into S phase from G1 was inhibited, concomitant with decreased thymidine kinase activity. Monolayers grown to confluence in ambient air, wounded, and then transferred to hypoxia showed decreased ability to repair the wound, as a result of both decreased motility and cell division. Hypoxic ECs demonstrated a ≈3-fold increase in the total number of high-affinity fibroblast growth factor receptors, and levels of endogenous FGF were suppressed. Consistent with the presence of functional FGF receptors, addition of basic FGF overcame, at least in part, hypoxia-mediated suppression of EC growth, and enhanced wound repair in hypoxia, stimulating both motility and cell division. Despite slower growth in hypoxia, ECs could achieve confluence, and the monolayers consisted of larger cells with altered assembly of the actin-based cytoskeleton and small gaps between contiguous cells. The permeability of these hypoxic EC monolayers to macromolecules and lower molecular weight solutes was increased. Cell surface coagulant properties were also perturbed: the anticoagulant cofactor thrombomodulin was suppressed, and a novel Factor X activator appeared on the EC surface. These data indicate that micro- and macrovascular ECs can grow and be maintained at low oxygen tensions, but hypoxic endothelium exhibits a range of altered functional properties which can potentially contribute to the pathogenesis of vascular lesions.

2 authors: and


Hypoxia Induces Endothelial Cell Synthesis of Novel Membrane Associated Proteins
Proceedings of the National Academy of Science –

Hypoxemia is associated with a prothrombotic tendency. In this study we report the purification and partial characterization of an activator of a central coagulation component, factor X, induced in endothelium by exposure to hypoxia (hypoxia-induced factor X activator or Xact). Expression of Xact occurred in a reversible manner when endothelial cell cultures were exposed to hypoxia or sodium azide but not in response to a variety of other alterations in the cellular milieu, such as heat shock or glucose deprivation. The activity of Xact, which was not detected in normoxic endothelial cells, was maximal under acidic conditions, pH 6.0-6.8, which often coexist with hypoxia in an ischemic milieu. By sequential isoelectric focusing and preparative SDS/PAGE of endothelial membrane-rich fractions, Xact was purified approximately 19,000-fold and found to be a single-chain, approximately 100-kDa polypeptide with pI approximately 5.0. Activation of factor X by purified Xact was not affected by blocking antibodies to other coagulation proteins or by phenylmethylsulfonyl fluoride or leupeptin but was prevented by mercury chloride or iodoacetamide. In addition to the induction of Xact, two-dimensional gel analysis of membrane fractions from metabolically labeled hypoxic endothelial cultures revealed two groups of approximately 10 additional spots: (i) a group for which expression was maximal after 24 hr and (ii) a group for which expression continued to increase up to 48 hr. The pattern of hypoxia-mediated modulation of protein expression was distinct from that seen with other cellular stimuli but could be duplicated, in part, by sodium azide. These results indicate that hypoxia elicits a specific biosynthetic response, including the expression of endothelial cell-surface molecules that can alter cellular function and may potentially serve as markers of hypoxemic vessel-wall injury.

2 authors: and


Immediately Loaded Mandibular Fixed Implant Prostheses Using the Bar Attachment Denture Protocol: A Report of 183 Consecutively Treated Patients with 1 Year of Function in Definitive Prostheses
Journal of the Academy of Osseointegration –

The purpose of this study was to evaluate a specific protocol using four implants to support immediately loaded fixed prostheses to restore edentulous and partially edentulous mandibles and report on the outcome after 1 year of function with the definitive prostheses. Materials and Methods: A retrospective study was conducted of all patients who were treated between June 2008 and December 2010 with fixed prostheses that were loaded immediately after placement of implants. The provisional prostheses were later replaced with computer-aided design/computer-assisted manufacture titanium frames supporting acrylic resin and denture teeth in the definitive prosthesis. All patients were followed for a minimum of 12 months and were assessed for implant survival and prosthetic performance, with descriptive statistics utilized to demonstrate results. Results: One hundred eighty-three consecutive patients received immediately loaded axial and tilted implants according to the defined protocol. One implant failed, resulting in a 99.86% implant success rate. There were two catastrophic prosthetic failures (fracture of the titanium framework), for a 98.9% prosthetic success rate. Three patients (1.6%) presented with fracture of a prosthetic mandibular incisor tooth. No prosthetic screw loosening or fractures were seen. Radiographic evaluation revealed no major bone loss around dental implants. Conclusions: Based on this retrospective study, the following conclusions can be drawn: (1) this technique appears to provide a highly predictable implant performance; (2) it is necessary to critically evaluate framework design, especially around the connectors for cantilever extensions around the most distal implants; and (3) minor complications related to acrylic resin tooth fracture may be anticipated during the early phases of prosthetic treatment. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:628–633.

2 authors: and


Implant Placement in Alveolar Composite Defects Regenerated with rhBMP-2, Anorganic Bovine Bone, and Titanium Mesh: A Report of Eight Reconstructed
Oral & Craniofacial Tissue Engineering –

To present a retrospective report of eight significant alveolar defects in which the alveolus was regenerated with recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with anorganic bovine bone and contoured using titanium mesh to facilitate implantsupported restorations. Materials and Methods: A total of seven patients underwent extractions and debridement of the compromised alveolar sites with simultaneous grafting using a mixture of rhBMP-2 and anorganic bovine bone. The three-dimensional contour of the compromised alveolus was reestablished using titanium mesh with rigid screw fixation. Implants were placed a minimum of 6 months after healing and subsequently were restored. Results: The treated defects were successfully regenerated and did not require any additional surgery prior to implant placement or prosthetic restoration. A total of 14 implants were placed and restored with fixed single or multiple restorations. Thirteen of the 23 treated sites were in the anterior esthetic zone. Conclusion: Vertical and horizontal alveolar bone defects can be predictably regenerated by grafting with a combination of rhBMP-2 and anorganic bovine bone contained by titanium mesh to successfully accommodate implant placement. Oral Craniofac Tissue Eng 2012;2:207–214

2 authors: and


Immediate Loading of Dental Implants in the Esthetic Region Using Computer-Guided Implant Treatment Software and Stereolithographic Models for a Patient with Eating Disorders
Journal of Prosthodontics 00 (2013) 1-6

This manuscript describes the reconstruction of a maxillary anterior segment using immediate implant placement and immediate implant loading techniques, aided by computer-guided implant treatment software and stereolithographic models and surgical templates, in a patient with a history of eating disorder. Her medical and dental histories did not make her a candidate for the use of conventional 2-stage implant surgery and restorative procedures along with an interim removable prosthesis.

2 authors: and
For more information about our Oral Surgery Practice or to schedule a consultation with Dr. Butura, call our office in Phoenix, AZ at Butura Oral & Dental Implant Surgery Phone Number 602-248-8745.