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International Journal of Implant... Oct 2020The objective of the study was to evaluate the relation between occlusal loading and peri-implant crevicular fluid cytokine expression in patients with implant-supported...
OBJECTIVE
The objective of the study was to evaluate the relation between occlusal loading and peri-implant crevicular fluid cytokine expression in patients with implant-supported complete fixed prostheses in both arches.
MATERIAL AND METHODS
A prospective longitudinal clinical study was performed at a university clinic. Fifteen patients were selected and 11 were included. All patients had bimaxillary implant-supported complete fixed ceramo-metallic prostheses loaded at least 12 months before the beginning of the study. Allocation was established for each patient using a computerized occlusal analysis system. The test implant was the maxillary implant closest to the point of highest occlusal loading. The maxillary implant with least loading was the control implant. Occlusal adjustment was performed using a round diamond burr. This occlusal distribution was verified with the occlusal analysis system. Expression of cytokines from peri-implant crevicular fluid (TNF-α, IL-10, IL-6, IL-1β, IL-8) were recorded and analyzed in both test and control implants before (baseline: T0) and 2 (T1) and 12 months (T2) after occlusal adjustment. The Brunner-Langer non-parametric test was performed.
RESULTS
At T0, the expression of IL-10 was significantly higher in the test group implants (p = 0.018). Between T0 and T1, the expression of all the cytokines decreased in the implants of both groups with statistically significant differences, except for TNF (p = 0.271). When comparing both groups at T1, there was no statistically significant difference in any of the analyzed cytokines. At T2, TNF-α suffered when compared with baseline, a statistical decrease in both study and control implants (p < 0,001). At T2, there were no statistically significant differences between groups in any of the cytokines analyzed.
CONCLUSIONS
Implants with higher occlusal load presented higher expression of IL-10 in peri-implant crevicular fluid. Occlusal adjustment produced a decrease in the expression of all the analyzed cytokines, both in test and control implants.
PubMed: 33111201
DOI: 10.1186/s40729-020-00262-2 -
International Journal of Environmental... Sep 2022This study assessed the clinical variables influencing the success of three-unit implant-supported fixed dental prostheses (ISFDPs) fabricated using either fully digital...
This study assessed the clinical variables influencing the success of three-unit implant-supported fixed dental prostheses (ISFDPs) fabricated using either fully digital or conventional workflows. The clinical trial evaluated 10 patients requiring three-unit ISFDPs in the posterior mandible. Maxillomandibular relation records, and digital and conventional impressions were obtained from each patient using an intraoral scanner (IoS) and polyvinylsiloxane (PVS), and the frameworks were fabricated using zirconia and cobalt-chromium, respectively. A 2 µm accuracy scanner scanned the conventional master casts and standard reference models. The stereolithography (STL) files of the digital and conventional impressions were superimposed on the standard model file, and the accuracy was calculated with the best-fit algorithm. The framework adaptation and passivity were assessed using the one-screw and screw resistance tests. The time required for occlusal adjustment of both types of reconstructions, including the duration of the whole treatment, was recorded. The aesthetic appearance of ISFDPs was rated by each patient and clinician using a self-administered visual analogue scale questionnaire and the FDI World Dental Federation aesthetic parameters, respectively. The sample size was based on the power calculation, and alpha was set at 0.05 for the statistical analyses. The impression accuracy, framework adaptation and passivity, and reconstructions aesthetics did not significantly differ between the digital and conventional approaches. The total fabrication time was significantly shorter using the digital workflow. Within the limitations of this clinical study, the fully digital workflow can be used for the fabrication of ISFDPs with a clinical outcome comparable to that of the conventional workflow.
Topics: Chromium; Cobalt; Computer-Aided Design; Cross-Over Studies; Humans; Prospective Studies; Workflow
PubMed: 36141729
DOI: 10.3390/ijerph191811456 -
Cranio : the Journal of... Sep 2022To assess the effectiveness of the stabilization splint (SS) combined with the T-Scan™ III system in the treatment of temporomandibular joint disorder (TMD) with...
OBJECTIVE
To assess the effectiveness of the stabilization splint (SS) combined with the T-Scan™ III system in the treatment of temporomandibular joint disorder (TMD) with myofascial pain.
METHODS
Forty-eight enrolled patients were randomly assigned to the SS group or T-Scan™-guided SS group. Mandibular Function Impairment Questionnaire (MFIQ), Maximum Comfortable Opening (MCO), Visual Analog Scale (VAS), and Patient Health Questionnaire-9 (PHQ-9) were used as the outcome variables.
RESULTS
The occlusal contacts of patients in the SS plus T-Scan™ group showed lower Occlusal Time (OT), Disocclusion Time (DT), and Asymmetry Index of Occlusal Force (AOF) after occlusal adjustment under the guidance of the T-Scan™. Importantly, the TMD symptoms were alleviated more obviously in SS plus T-Scan™ group, with better scores for MCO and MFIQ.
CONCLUSION
T-Scan™-guided occlusal adjustment of SS can obtain better OT, DT, and AOF, which furthers improvement of the therapeutic effects on TMD with myofascial pain.
PubMed: 36094222
DOI: 10.1080/08869634.2022.2113272 -
Journal of Esthetic and Restorative... Mar 2021To meet esthetic requirements, monolithic zirconia can be stained by color-infiltration. However, adjustments of occlusal surfaces are often necessary, leading to...
OBJECTIVE
To meet esthetic requirements, monolithic zirconia can be stained by color-infiltration. However, adjustments of occlusal surfaces are often necessary, leading to demasking effects if too much of the color-infiltrated layer is removed. The effect of subsequent material removal on color stability of individually stained zirconia is analyzed here.
MATERIALS AND METHODS
Thirty-six white zirconia disks were divided into three groups. Standardized staining strategies for tooth colors VITA A2, A3.5, and A4 were developed and applied to the disks. Samples were grinded in nine successive steps from 20 to 500 μm. A spectroradiometer was used to measure the color differences after each step. Regression analyses were performed for color differences from baseline as a function of depth of material removal. Depth of material removal resulting in color changes surpassing the acceptability threshold of ΔE = 1.8 was estimated using inverse prediction.
RESULTS
Up to 500 μm material removal, color difference ΔE changes linearly with the depth of material removal (P < 0.05). Regression analyses showed coefficients of determination (R ) of 0.97 (VITA A2), 0.87 (VITA A3.5), and 0.96 (VITA A4). Acceptability threshold was surpassed at 62, 87, and 92 μm, respectively.
CONCLUSIONS
Discolorations occur within clinically relevant occlusal adjustments of <100 μm. The effect is more severe with lighter, less saturated tooth colors.
CLINICAL SIGNIFICANCE
Staining that is resistant to occlusal adjustments and abrasion is only possible if the staining solution infiltrates sufficiently deep into the ceramic structure. This study provides for the first time in the literature numerical values that describe the thresholds of acceptability of color differences in zirconia ceramics. These values are essential because they determine the extent of possible occlusal adjustments, and thus the color stability. Further research is necessary to improve the infiltration depth of staining solutions.
Topics: Ceramics; Color; Dental Porcelain; Materials Testing; Occlusal Adjustment; Surface Properties; Zirconium
PubMed: 32609416
DOI: 10.1111/jerd.12620 -
Case Reports in Dentistry 2022In this study, we have introduced a case in which the effective blood oxygenation level-dependent signal on functional magnetic resonance imaging (fMRI) was altered by...
OBJECTIVE
In this study, we have introduced a case in which the effective blood oxygenation level-dependent signal on functional magnetic resonance imaging (fMRI) was altered by the improvement of periodontal tissue and occlusal function in a patient with periodontitis Stage II Grade B. . A 61-year-old female patient requiring periodontal treatment was diagnosed as having periodontitis Stage II Grade B via clinical and radiographic examinations. Her past medical history included type 2 diabetes, hypertension, and hyperlipidemia. Following the patient's informed written consent, the periodontal initial treatment provided to the patient included tooth brushing instruction and scaling and root planing; however, occlusal adjustment was not performed at this stage. Occlusal force and fMRI results were also evaluated at the initial and reevaluation examinations.
RESULTS
After the periodontal initial treatment had been performed, it was noted that the patient's periodontal tissue and occlusal force had improved. It was also evident from fMRI that cerebral blood flow had been activated in the insula, primary motor cortex, and premotor cortex.
CONCLUSION
This result suggested that the periodontal ligament had recovered and the periodontal ligament neuron had been further subjected to clenching in the insula so that the muscle spindle sensation impacted the motor cortex.
PubMed: 35527723
DOI: 10.1155/2022/5383893 -
Journal of Stomatology, Oral and... Dec 2023Jaw cysts often deeply involve adjacent tooth roots, making it difficult to preserve them. The purpose of this retrospective study was to investigate the effectiveness...
BACKGROUND
Jaw cysts often deeply involve adjacent tooth roots, making it difficult to preserve them. The purpose of this retrospective study was to investigate the effectiveness of an intentional replantation (IR) strategy combined with cyst enucleation in preserving cyst-involved teeth during jaw cyst removal.
MATERIALS AND METHODS
Fifteen patients with jaw cysts and deeply involved teeth were treated with IR and cyst enucleation. All patients received root canal therapy prior to surgery, except for one patient who received it during surgery. The involved teeth were extracted, and the root surface was carefully cleaned before IR and cyst enucleation. Patients were followed up for 12-14 months, with indicators including clinical complaints, replanted tooth stability, and root resorption.
RESULTS
No cyst recurrence was observed, and all replanted teeth survived with good local gingival condition and no marked swelling or recession. Radiographic findings showed clear periodontal space surrounding the replanted teeth. One replanted tooth exhibited slight root resorption due to occlusal trauma, but the resorption ceased after occlusal adjustment.
CONCLUSIONS
IR combined with cyst enucleation is an effective strategy for thoroughly cleaning jaw cysts and preserving teeth involved in the cyst.
PubMed: 38097014
DOI: 10.1016/j.jormas.2023.101731 -
Cranio : the Journal of... Jul 2021: Assessment of clinical symptoms and condylar position of TMD patients using CBCT imaging with deprogramming splint therapy and occlusal equilibration. The hypothesis...
: Assessment of clinical symptoms and condylar position of TMD patients using CBCT imaging with deprogramming splint therapy and occlusal equilibration. The hypothesis tested was the alleviation of symptoms of TMD with possible changes in condylar position occurs with this treatment.: The condylar position of 12 TMD patients was observed from CBCT images, and clinically, symptom severity score, mouth opening, and range of motion were compared pre- and post-treatment.: All patients reported a statistically significant decrease in the symptom severity score and increase in mouth opening and range of motion ( < .05). A significant decrease was only achieved in the left anterior joint space ( < .05).: Deprogramming splint therapy and occlusal equilibration benefitted patients with a reduction in clinical symptoms, and minor changes in condylar position were observed.
Topics: Humans; Occlusal Adjustment; Occlusal Splints; Spiral Cone-Beam Computed Tomography; Splints; Temporomandibular Joint Disorders
PubMed: 31451061
DOI: 10.1080/08869634.2019.1650216 -
BMC Oral Health Jun 2023This study is to investigate the referral pattern and treatment modality of dentists in the management of peri-implant diseases between periodontists and...
OBJECTIVES
This study is to investigate the referral pattern and treatment modality of dentists in the management of peri-implant diseases between periodontists and non-periodontist dentists (NPDs).
MATERIALS AND METHODS
A total of 167 validated questionnaires were obtained from periodontists and NPDs, who had experience of placing implants for at least one year. Question I to IV asked how the dentist would respond if a patient came for treatment of their peri-implant diseases with four different scenarios according to resource of patient and disease severity. For each Scenario, dentists also replied which treatment procedures they would use if they decide to treat the patient.
RESULTS
Periodontal training, resource of patient, and disease severity were shown to significantly influence the referral pattern and treatment modality in the management of peri-implant disease (p < 0.05). Periodontists were more likely to use variable treatment procedures, including occlusal adjustment (OR = 2.283, p < 0.01), oral hygiene instruction (OR = 3.751, p < 0.001), topical antiseptic agent (OR = 2.491, p < 0.005), non-surgical mechanical therapy (OR = 2.689, p < 0.001), surgical therapy (OR = 2.009, p < 0.01), and remove implant (OR = 3.486, p < 0.001) to treat peri-implant diseases, compared to NPDs.
CONCLUSION
The periodontal specialty training, resource of patient, and disease severity significantly influenced the referral pattern and treatment modality of dentist treating an implant diagnosed with peri-implant disease. This study also highlighted the importance of educating basic periodontal and peri-implant disease-related knowledge to all dentists regularly performing dental implant treatments.
CLINICAL RELEVANCE
Peri-implant diseases are highly prevalent among patients with dental implants. Periodontal specialty training could enhance using variable treatment procedures to treat peri-implant diseases for dentists.
Topics: Humans; Peri-Implantitis; General Practice, Dental; Dental Implants; Dentists; Referral and Consultation
PubMed: 37370067
DOI: 10.1186/s12903-023-03135-3 -
The Journal of Prosthetic Dentistry Sep 2023This technique report presents a novel method of digitally replicating a treatment denture and converting it into a definitive denture. The procedure accurately...
This technique report presents a novel method of digitally replicating a treatment denture and converting it into a definitive denture. The procedure accurately duplicates the appearance of the mucosal surface and border of the treatment dentures, mounts the jaw relation on a virtual articulator to arrange artificial teeth, and optimizes the occlusion based on recorded mandibular motion tracks. This technique uses personalized jaw relation transfer and dynamic occlusal adjustment to establish balanced occlusion, which accomplishes the digital duplication of the treatment denture with high accuracy and minimal effort.
Topics: Denture, Complete; Occlusal Adjustment; Workflow; Denture Design; Dental Occlusion; Dental Articulators; Jaw Relation Record
PubMed: 34887077
DOI: 10.1016/j.prosdent.2021.09.014 -
The Saudi Dental Journal Nov 2021Occlusal appliances can distribute aggressive loads which are generated by bruxism and can reduce their frequency. The facebow record, when used in the construction of...
BACKGROUND
Occlusal appliances can distribute aggressive loads which are generated by bruxism and can reduce their frequency. The facebow record, when used in the construction of occlusal appliances, helps in minimizing occlusal discrepancies. This study aimed to compare the effect of CAD/CAM stabilization occlusal splint made with and without facebow for management of bruxer patients.
METHOD
24 Patients who were diagnosed as bruxers were randomly assigned into two equal groups and obtained maxillary CAD/CAM occlusal stabilizing splint recorded with centric relation either with or without using a facebow. The patient satisfaction using the visual analog scale (VAS) was recorded at baseline, one month and three months' follow-up periods. The adjustment time of both splints, from the start of splint delivery until becoming well-fitted and occlusally adjusted, was calculated using a stopwatch.
RESULTS
The CAD/CAM occlusal splints with or without the use of facebow improved the patient's satisfaction with no statistically significant difference between both groups at baseline, one month and three months with p values of 0.73, 0.24 and 0.45 respectively. The comparison between the two modalities regarding the adjustment time showed no statistically significant difference between both groups (P = 0.06).
CONCLUSION
According to the results of this study; no difference was detected in patient satisfaction and the time required for adjustment of CAD/CAM occlus.
PubMed: 34803311
DOI: 10.1016/j.sdentj.2020.07.002