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Journal of Indian Prosthodontic Society Jan 2024The primary objective of this research was to assess and compare the impact of customized zirconia (Zr) and titanium (Ti) abutments, placed on early loaded dental...
AIM
The primary objective of this research was to assess and compare the impact of customized zirconia (Zr) and titanium (Ti) abutments, placed on early loaded dental implants, on both hard tissue (as measured crestal bone level) and soft tissue (as assessed by sulcular bleeding index [SBI], probing depth [PD], and Pink Esthetic Score [PES]), through clinical and radiographic evaluation.
SETTINGS AND DESIGN
This research involved a sample of 15 patients who had partially dentulous mandibular arch. Within this group, a total of 30 implants were surgically placed. Specifically, each patient received two implants in the posterior region of the mandible, and the bone density in this area was classified as D2 type. In each patient, one implant was loaded with Zr abutment and the other was loaded with Ti abutment. The bone quality in the area of implant placement was Type D2. Two groups were created for this research. Each group consisted of 15 early loaded dental implants with customized Zr abutments and customized Ti abutments respectively.
MATERIALS AND METHODS
Hard- and soft-tissue changes were evaluated in both the groups. Evaluation of crestal bone loss (CBL) with cone beam computed tomography and SBI, PD and PESs were evaluated by various indices at 2, 4, and 6 months postloading.
STATISTICAL ANALYSIS USED
After obtaining the readings, data were subjected to statistical analysis and comparison of quantitative data was done, paired t-test was used.
RESULTS
The mean CBL in the Ti abutment is higher; the difference between the two groups was not statistically significant. SBI and PD for Zr were higher, but there was no statistically significant difference between the two groups. Zr had a higher PES than Ti abutment and the difference between the two groups was statistically significant. In the literature till date, the PES of Zr abutments were proven better for provisional restorations in implant prosthesis, but very few literatures support the same for the final implant restorations.
CONCLUSION
The study did not reveal a clear advantage of either Ti or Zr abutments over the other. Nevertheless, Zr abutments tended to produce a more favorable color response in the peri-implant mucosa and led to superior esthetic outcomes as measured by the PES.
Topics: Humans; Titanium; Dental Implants; Esthetics, Dental; Foot; Bone Diseases, Metabolic; Zirconium
PubMed: 38263560
DOI: 10.4103/jips.jips_201_23 -
Journal of Cancer Research and... Jan 2024Squamous cell carcinoma is one of the most prevalent cancers affecting the oral cavity. Rehabilitation following surgical treatment requires a multidisciplinary approach...
Squamous cell carcinoma is one of the most prevalent cancers affecting the oral cavity. Rehabilitation following surgical treatment requires a multidisciplinary approach and care. Multiple disabilities such as dysarthria, dysphagia, unesthetic appearance, and psychosocial disorders following the surgery for carcinoma can greatly impact the quality of life of such patients, thereby necessitating multidisciplinary intervention. The clinician has to wait for the healing of the lesion and the effects of radiotherapy to be dwindled in case a secondary osseous grafting is planned. During this time lag until a more definitive prosthesis is planned, an interim prosthesis is must to correct the mandibular deviation due to the unilateral muscular pull. This case presentation describes the utilization of guiding flange prosthesis (GFP) as an interim modality for the establishment of a stable and functional maxillomandibular relationship following combined ipsilateral partial mandibulectomy and maxillectomy.
PubMed: 38261439
DOI: 10.4103/jcrt.jcrt_170_23 -
Heliyon Jan 2024To investigate the effect of different designs of movable parts and prosthetic materials on the stress distribution of supporting tissues in mandibular free end...
OBJECTIVES
To investigate the effect of different designs of movable parts and prosthetic materials on the stress distribution of supporting tissues in mandibular free end dentition defects using three-dimensional finite element analysis of digital Roach attachments.
MATERIAL AND METHODS
A 3D model of a patient with Kennedy class I mandibular edentulous conditions was generated, and twelve prosthesis models were applied, combining two designs of removable parts and six types of CAD/CAM restorative materials with different elastic modulus (conventional zirconia, ultra-translucent zirconia, Polyetheretherketone (PEEK), Lithium disilicate, Nanoceramic resin, and resin composite (Paradigm MZ100, 3 M ESPE)). The stress distribution of abutment periodontal ligament, edentulousmucosa, and junction of attachment were analyzed using finite element analysis.
RESULTS
The stress value of the buccal neck of the periodontal ligament and the maximum compressive stress of the distal periodontal ligament of the design with clasp arms were higher than those without clasp arms, while the stress on the junction of attachment and the displacement of the mucosa in the edentulous area were smaller. Restorative materials with high elastic modulus, such as conventional zirconia and ultra-translucent zirconia, are recommended to be used as the fixed part of Roach attachment.
CONCLUSION
CAD/CAM Roach attachments with clasp arms are recommended for the protection of mucosal soft tissue. Restorative materials with high elastic modulus, such as conventional zirconia and ultra-translucent zirconia, are recommended as the fixed part of Roach attachment for patients with free end defect of mandibular dentition.
CLINICAL SIGNIFICANCE
This study provides references for the design with clasp arms and the selection of clinical fixed-movable prosthetic materials. Clinicians should consider the design of attachments and selection of appropriate manufacturing materials carefully to avoid negative impacts on patients' periodontal support tissues.
PubMed: 38205291
DOI: 10.1016/j.heliyon.2023.e23283 -
Journal of the Korean Association of... Dec 2023This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of...
This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.
PubMed: 38155088
DOI: 10.5125/jkaoms.2023.49.6.347 -
Journal of Dentistry (Shiraz, Iran) Dec 2023The common causes of obstructive sleep apnea (OSA) are identified as anatomic and/or functional abnormality in the oral cavity, oropharynx, velopharynx, and hypopharynx...
STATEMENT OF THE PROBLEM
The common causes of obstructive sleep apnea (OSA) are identified as anatomic and/or functional abnormality in the oral cavity, oropharynx, velopharynx, and hypopharynx leading to compromised airway space and increased collapsibility.
PURPOSE
This study was conducted to evaluate the effect of implant-supported mandibular complete denture in improving the airway space among completely edentulous patients with OSA and compare it with conventional complete denture.
MATERIALS AND METHOD
In this observational study, completely edentulous individuals were screened with snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and gender (STOP-Bang) questionnaire to evaluate the incidence of OSA. Ten mild-moderate patients were included as study participants. Lateral cephalograms (L1) made at the edentulous state was considered baseline. They were rehabilitated with complete denture prosthesis. One week after denture insertion, two implants were placed in the edentulous mandibular arch. Delayed loading protocol was followed. Lateral cephalogram (L2) was made 6 months after complete denture insertion and 6 months after implant-supported prosthesis (L3). Cephalometric tracings were used to evaluate change in upper airway space (UAS), middle airway space (MAS), and lower airway space (LAS). Repeated measures ANOVA was used to evaluate statistical significance in the airway measurements made at the three intervals. Post hoc Tukey HSD and Bonferroni test were used to assess if the differences obtained were truly significant.
RESULTS
Statistical analysis revealed significant differences in UAS, MAS and LAS between L1, L2 and L3 (< 0.05). Post hoc Tukey HSD indicated that UAS increased significantly at all three intervals followed by LAS and MAS respectively (α=.05). Post hoc Bon-ferroni test indicated that implant-supported mandibular complete dentures had a significant improvement in airway space when compared to conventional complete dentures (α=.05).
CONCLUSION
Implant-supported mandibular complete denture could be effective in edentulous patients with mild-moderate OSA.
PubMed: 38149232
DOI: 10.30476/dentjods.2022.95716.1886 -
Medical Science Monitor : International... Dec 2023This systematic review aimed to identify and analyze in vitro studies on the marginal adaptation values of computer-aided-design/computer-aided-manufacturing (CAD/CAM)...
A Comparative Analysis of Marginal Adaptation Values between Lithium Disilicate Glass Ceramics and Zirconia-Reinforced Lithium Silicate Endocrowns: A Systematic Review of In Vitro Studies.
This systematic review aimed to identify and analyze in vitro studies on the marginal adaptation values of computer-aided-design/computer-aided-manufacturing (CAD/CAM) and heat-pressed lithium disilicate glass ceramics and zirconia-reinforced lithium silicates and endocrown restorations. A full literature search was conducted in Web of Science, PubMed/Medline, EMBASE, Scopus, Cochrane Library, Google Scholar, and ProQuest electronic databases. The following keywords: endocrown [(marginal adaption) or (marginal fit) or internal fitting)], endocrown [(molar(s)) or (premolar(s) or (posterior teeth) or (maxillary arch) or (mandibular arch)] and ceramic materials as [(lithium disilicate glass ceramic CAD/CAM) or (zirconia) or (heat-press)] were used. Articles were manually searched utilizing their reference lists. Study selection was restricted or limited to the time of publication but not to the type of tested teeth or ceramic material, endocrown design, system of endocrown construction, abutment scanning, and system of the marginal adaption measurement. A total of 17 in vitro studies published between 2016 and 2023 were included in this systemic review. Less than half of the studies were published during 2023. Most studies used lithium disilicate glass ceramic and zirconia-reinforced lithium silicate all-ceramic materials by CAD/CAM or heat-press systems. Marginal adaptation, or marginal gap, was almost equal in the 2 materials, while it was slightly or marginally higher in the heat-press than in the CAD/CAM system. All-ceramic lithium disilicate glass ceramic and/or zirconia endocrowns fabricated for posterior teeth in both arches using CAD/CAM or heat-press had recorded marginal adaptation values within an acceptable range.
Topics: Lithium; Materials Testing; Ceramics; Dental Porcelain; Silicates; Dental Prosthesis Design
PubMed: 38148601
DOI: 10.12659/MSM.942649 -
Journal of Clinical Medicine Dec 2023Hemifacial hyperplasia (HFH) is a rare congenital disorder characterized by marked unilateral overgrowth of the facial tissues. A subtype of HFH is congenital...
Hemifacial hyperplasia (HFH) is a rare congenital disorder characterized by marked unilateral overgrowth of the facial tissues. A subtype of HFH is congenital infiltrating lipomatosis of the face (CIL-F). This disease is characterized by unilateral diffuse infiltration of mature adipose cells in the facial soft tissue and is associated with skeletal hypertrophy. This work aims to report a case of a CIL-F patient with right facial asymmetry and progressive growth at adolescent age, causing mandibular asymmetry due to signs of concomitant unilateral condylar hyperplasia. At the age of seventeen, a condylectomy was performed to stop the progression of asymmetric mandibular growth. Five years later, the patient developed CIL-F-associated temporomandibular joint ankylosis, manifesting as progressive restricted mouth opening along with temporal facial pain. In this CIL-F patient, a TMJ reconstruction with an alloplastic total joint prosthesis was successfully performed with optimal maximal mouth opening, complete alleviation of temporal facial pain, and stable dental occlusion one year postoperatively. A TMJ reconstruction with a complete alloplastic total joint prosthesis proved to be a predictable, stable, and safe treatment option in a patient with CIL-F-associated TMJ ankylosis who was previously treated with condylectomy due to progressive mandibular asymmetry.
PubMed: 38137792
DOI: 10.3390/jcm12247723 -
Cureus Nov 2023The goal of modern dentistry is to restore optimum oral health, function, and comfort for a patient. For an implant-supported fixed prosthesis, these goals cannot be met...
The goal of modern dentistry is to restore optimum oral health, function, and comfort for a patient. For an implant-supported fixed prosthesis, these goals cannot be met if the biomechanical factors governing the success of the prosthesis are overlooked. Mandibular flexure is one such factor that needs to be considered, especially when implants are being placed posterior to the interforaminal region. If not, it can lead to problems like increased stress, bone resorption, poor fit of the prosthesis, screw loosening, and patient discomfort. The use of a split-framework prosthesis is one of the measures that could be taken to decrease the stress, ensure a passive fit of the framework, and long-term maintenance of patient comfort and function. This case report describes the oral rehabilitation of a patient using a maxillary cast partial denture and mandibular split framework fixed prosthesis to compensate for mandibular flexure.
PubMed: 38130512
DOI: 10.7759/cureus.49071 -
World Journal of Plastic Surgery 2023Pericoronitis is a common pathological condition related to mandibular third molar teeth (wisdom teeth). It is an inflammation of the soft tissue surrounding the crown...
BACKGROUND
Pericoronitis is a common pathological condition related to mandibular third molar teeth (wisdom teeth). It is an inflammation of the soft tissue surrounding the crown of an erupted or partially erupted tooth that causes pain and discomfort. We aimed to investigate the relation between third molar impaction types and pericoronitis.
METHODS
This cross-sectional study assessed 60 patients referred to the Oral and Maxillofacial Surgery Department of Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran in 2022 for totally and partially impacted mandibular third molar tooth surgery with pericoronitis. Their demographic data, including age and gender, was recorded. The impacted tooth's side and the symptoms of pericoronitis were identified using clinical examination and panoramic radiography imaging, based on the Pell & Gregory criteria and Peterson's classification. Third-molar tooth surgery was performed according to standard protocol. Patients' data were recorded and were analyzed using Excel 2019 and SPSS ver 21.
RESULTS
The prevalence of pericoronitis symptoms in women was higher than in men (< 0.001). The Class B type of third molar teeth impaction had a relation with the majority of pericoronitis cases (< 0.001). Pericoronitis and systemic symptoms were more likely to occur in Class II than in Class I type of third molar teeth impaction (< 0.001). The most frequent kind of impaction linked to pericoronitis and systemic symptoms such as malaise was mesio-angular (< 0.001). The symptoms of pericoronitis were substantially correlated with smoking (< 0.001).
CONCLUSION
Class B, Class II, and mesio-angular types of third molar impaction are linked with a higher risk of pericoronitis. This information might help in the early diagnosis and management of pericoronitis in patients with impacted third molar teeth.
PubMed: 38130387
DOI: 10.52547/wjps.12.2.57 -
BMC Oral Health Dec 2023The aim of this study was to compare the microstrain transmitted to peri-implant tissues of implant-assisted mandibular overdentures using two different low-profile...
A comparative study to evaluate microstrain of low-profile attachment associated with and without bar connection in implant assisted mandibular overdenture (in vitro study).
BACKGROUND
The aim of this study was to compare the microstrain transmitted to peri-implant tissues of implant-assisted mandibular overdentures using two different low-profile attachment designs; OT- Equator attachment with and without bar attachment.
MATERIALS AND METHODS
A completely edentulous epoxy resin mandibular model was used, in which two parallel dental implants were inserted at the canine region bilaterally and one in the middle. Sixteen identical complete edentulous mandibular overdentures were fabricated following conventional, standardized techniques and were divided equally between two groups according to the design and placement of the OT-Equator. Group A implants were kept solitary with an OT-Equator attachment, while group B implants were kept splinted with a bar associated with two mini-OT-Equator attachments in between. Sixteen identical mandibular complete overdentures were constructed, to which attachments were picked up. The difference in stress distribution was measured using strain gauges and compared between the two studied groups. A vertical load of 100 N using the universal testing machine was applied unilaterally on the left mesial fossae of the mandibular first molar and bilaterally on the bar attached to the mandibular premolar molar region of the overdentures. Statistical analysis was conducted using IBM SPSS version 28. Normality was checked by using the Shapiro-Wilk test and normality plots. The Mann-Whitney U test was then used to analogize the groups.
RESULTS
There was a statistically significant difference between groups A and B upon application of vertical unilateral and bilateral loadings of 100 N, with mean microstrain values of P 0.05. Group A (OT-Equator attachment) showed lower strain values than Group B (OT-Equator bar attachment) upon application of vertical, unilateral, and bilateral loadings of 100 N.
CONCLUSIONS
Implant-assisted mandibular overdenture with a solitary attachment is associated with lower microstrain values around the implants after application of unilateral and bilateral vertical loadings of 100 N.
Topics: Humans; Dental Implants; Denture, Overlay; Dental Prosthesis, Implant-Supported; Mandible; Mouth, Edentulous; Denture Retention; Dental Stress Analysis
PubMed: 38066586
DOI: 10.1186/s12903-023-03702-8