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The International Journal of Oral &... Jun 2024There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The...
PURPOSE
There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The purpose of the study was to explore the comparative efficacy of using two different drilling protocols using burs with different design for preparing implant sites, by evaluating radiographic and clinical outcomes.
MATERIALS AND METHODS
The present randomized controlled clinical trial with an allocation ratio of 1:1 was carried on in two private practice offices by two experienced surgeons and researchers. In the control group the surgeons followed the protocol with standard straight burs while in the test group they used step burs. In both groups the patients received the same type of implants and prosthesis. The primary outcome was the marginal bone resorption one year after the prosthetic placement.
RESULTS
In the study were included and treated a total of 60 subjects (86 implants). At the one-year follow-up were screened 54 subjects (74 implants), and 50 at the 2-year follow-up (69 implants). This study showed no evidence of a difference in bone resorption, which increased significantly over time, between the two groups.
CONCLUSIONS
Both clinical parameters and patientcentered outcomes revealed no difference between the two protocols of implant site preparation with two different drill shape.
PubMed: 38941163
DOI: 10.11607/jomi.11037 -
Clinical Oral Investigations Jun 2024The purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of...
OBJECTIVES
The purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of non-surgical mechanical treatment (NSMT), along with calprotectin (CLP) and MMP-8(matrix metalloproteinase-8) levels.
MATERIALS AND METHODS
77 implants from 39 patients were included. The implants were categorized Group-1(peri-implant mucositis), Group-2(peri-implantitis).Baseline (0. Month-PrT) clinical parameters (PD, GI, PI, BOP, CAL) and radiographic bone loss were documented, and peri-implant crevicular fluid (PICF) samples were collected. Various intruments and methodologies were employed to assess PPh components (mucosa thickness, supracrestal tissue height, keratinized mucosa) and peri-implant attached mucosa (AM). NSMT was applied to diseased implant sites. All clinical parameters were reassessed again by taking PICF samples at the 6th month-after treatment (PT). In PICF samples obtained from both groups, MMP-8 and CLP levels were evaluated using the ELISA test.
RESULTS
PrT-PD,PrT-GI,PrT-CAL and PrT-BOP percentage values in Group-2 were significantly higher than Group-1.PrT-PD,PrTPI scores are significantly higher in thin biotype implants. All components of the PPh and AM were significantly lower in thin biotype. Intra-group time-dependent changes of MMP-8 and CLP were significant in both groups (p < 0.05). When the relationship between thin and thick biotype and biochemical parameters was evaluated, the change in PrT-PT didn't show a significant difference (p > 0.05).
CONCLUSIONS
PPh plays a role in influencing the severity of peri-implant diseases. However, the impact of phenotype on NSMT outcomes was similar in both groups.
CLINICAL RELEVANCE
The PPh should be considered when planning implant surgery.
Topics: Humans; Matrix Metalloproteinase 8; Female; Prospective Studies; Peri-Implantitis; Male; Middle Aged; Phenotype; Gingival Crevicular Fluid; Leukocyte L1 Antigen Complex; Dental Implants; Enzyme-Linked Immunosorbent Assay; Biomarkers; Stomatitis; Periodontal Index; Adult; Aged
PubMed: 38940878
DOI: 10.1007/s00784-024-05798-w -
Clinical Implant Dentistry and Related... Jun 2024The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
AIM
The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
METHODS
This protocol involves the acquisition of three-dimensional (3D) patient data through intraoral scanning (IOS) and cone beam computed tomography (CBCT). These data are loaded into AI software which automatically segments and aligns the patient's 3D models. These 3D models are loaded into MR software and used for planning implant surgery through holography. The files are then exported and used to design surgical guides via open-source software, which are 3D printed and used to prepare the implant sites through static computer-assisted implant surgery (s-CAIS). The case is finalized prosthetically through a fully digital protocol. The accuracy of implant positioning is verified by comparing the planned position with the actual position of the implants after surgery.
RESULTS
As a proof of principle, the present protocol seems to be to be reliable and efficient when used for planning simple cases of s-CAIS in partially edentulous patients. The clinician can plan the implants in an authentic 3D environment without using any radiology-guided surgery software. The precision of implant placement seems clinically acceptable, with minor deviations.
CONCLUSIONS
The present study suggests that AI and MR technologies can be successfully used in s-CAIS for an authentic 3D planning. Further clinical studies are needed to validate this protocol.
PubMed: 38940681
DOI: 10.1111/cid.13357 -
Clinical Oral Implants Research Jun 2024The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single-piece zirconia versus titanium narrow-diameter implants....
OBJECTIVES
The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single-piece zirconia versus titanium narrow-diameter implants. Additionally, clinical, radiological and patient-reported outcome measures (PROMs) were analyzed.
MATERIALS AND METHODS
Thirty implants (tissue level implant) were placed in 30 patients in the maxillary esthetic sector. Depending on randomization, a zirconia (test) or titanium implant (control) was placed. Esthetic, clinical, and radiological parameters, including the implant crown esthetic index (ICAI), pink esthetic score (PES), probing pocket depth, bleeding on probing, plaque index, and marginal bone levels, were evaluated at 12, 36 and 60 months after loading.
RESULTS
Sixty months after crown placement, no significant differences were found between groups. The ICAI values were 5.25 ± 4.21 and 4.50 ± 2.98 for the test and control groups, respectively. The corresponding PES values were 7.44 ± 1.93 and 7.43 ± 1.74 for the test and control groups, respectively. There were no significant intergroup differences for the rest of the parameters evaluated.
CONCLUSION
It can be suggested that monotype zirconia implants may serve as a potential alternative to titanium implants in selected clinical scenarios. While the results demonstrated comparable esthetic, clinical, and radiological aspects for zirconia implants as compared to titanium implants after a 5-year follow-up period, further research with larger sample sizes and longer-term follow-up is recommended.
PubMed: 38940623
DOI: 10.1111/clr.14319 -
Clinical Implant Dentistry and Related... Jun 2024The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume...
INTRODUCTION
The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect.
MATERIALS AND METHODS
Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery.
RESULTS
A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm) in VCMX and (186.38 ± 57.52) (mm) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups.
CONCLUSION
The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.
PubMed: 38938060
DOI: 10.1111/cid.13353 -
Journal of Periodontology Jun 2024Diabetes is one of the major inflammatory comorbidities of periodontitis via 2-way interactions. Cystathionine γ-lyase (CTH) is a pivotal endogenous enzyme synthesizing...
BACKGROUND
Diabetes is one of the major inflammatory comorbidities of periodontitis via 2-way interactions. Cystathionine γ-lyase (CTH) is a pivotal endogenous enzyme synthesizing hydrogen sulfide (HS), and CTH/HS is crucially implicated in modulating inflammation in various diseases. This study aimed to explore the potential role of CTH in experimental periodontitis under a hyperglycemic condition.
METHODS
CTH-silenced and normal human periodontal ligament cells (hPDLCs) were cultured in a high glucose and Porphyromonas gingivalis lipopolysaccharide (P.g-LPS) condition. The effects of CTH on hPDLCs were assessed by Cell Counting Kit 8 (CCK8), real-time quantitative polymerase chain reaction (RT-qPCR), and enzyme-linked immunosorbent assay (ELISA). The model of experimental periodontitis under hyperglycemia was established on both Cth and wild-type (WT) mice, and the extent of periodontal destruction was assessed by micro-CT, histology, RNA-Seq, Western blot, tartrate-resistant acid phosphatase (TRAP) staining and immunostaining.
RESULTS
CTH mRNA expression increased in hPDLCs in response to increasing concentration of P.g-LPS stimulation in a high glucose medium. With reference to WT mice, Cth mice with experimental periodontitis under hyperglycemia exhibited reduced bone loss, decreased leukocyte infiltration and hindered osteoclast formation, along with reduced expression of proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in periodontal tissue. RNA-seq-enriched altered NF-κB pathway signaling in healthy murine gingiva with experimental periodontitis mice under hyperglycemia. Accordingly, phosphorylation of p65 (P-p65) was alleviated in CTH-silenced hPDLCs, leading to decreased expression of IL6 and TNF. CTH knockdown inhibited activation of nuclear factor kappa-B (NF-κB) pathway and decreased production of proinflammatory cytokines under high glucose and P.g-LPS treatment.
CONCLUSION
The present findings suggest the potential of CTH as a therapeutic target for tackling periodontitis in diabetic patients.
PubMed: 38937859
DOI: 10.1002/JPER.23-0811 -
Clinical Oral Investigations Jun 2024The aim of this study was to evaluate whether thermal implant removal of osseointegrated implants is possible using a diode laser with an specific temperature-time...
OBJECTIVES
The aim of this study was to evaluate whether thermal implant removal of osseointegrated implants is possible using a diode laser with an specific temperature-time interval.
MATERIALS AND METHODS
First, tooth extraction of the first three premolars was performed in the maxilla and mandible on both sides of 10 pig. After 3 months, implants were inserted into the upper and lower jaws of 10 pigs. After 3 more months, osseointegrated implants were heated with a laser device to a temperature of 50 °C for 1 min. After 14 days, the implant stability quotient (ISQ), torque-out values, and bone-to-implant contact (BIC) ratio were assessed using resonance frequency analysis.
RESULTS
ISQ values showed no significant differences within each group or between the control and test groups. Furthermore, torque-out and BIC value measurements presented no significant differences between the groups.
CONCLUSIONS
At 50°C, changes in the BIC values were noticeably smaller; however, these differences were not significant. Future studies should evaluate the same procedures at either a higher temperature or longer intervals.
CLINICAL RELEVANCE
With only 50 °C for 1 min, a dental implant will not de-integrate predictably.
Topics: Animals; Swine; Dental Implants; Device Removal; Proof of Concept Study; Hot Temperature; Resonance Frequency Analysis; Dental Implantation, Endosseous; Torque; Osseointegration
PubMed: 38937381
DOI: 10.1007/s00784-024-05619-0 -
International Journal of Implant... Jun 2024This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with...
Effects of various prosthetic methods for patients with Kennedy Class I partial edentulism on oral hypofunction, subjective symptoms, and oral health-related quality of life.
PURPOSE
This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with Kennedy Class I partial edentulism (KCIPE) on oral hypofunction, subjective frailty symptoms, and oral health-related quality of life (QOL).
METHODS
Patients (n = 348) were classified into the following three groups for analysis: NT, patients with natural dentition providing intermaxillary contact in four occlusal supporting zones; RPD, patients with KCIPE who received removable partial dentures; and ISFP, patients with KCIPE who received implant-supported fixed prostheses. Participants' basic characteristics were recorded, and oral function tests were conducted. Subjective symptoms of physical and oral frailty were investigated via questionnaire. Oral health-related QOL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16). Propensity score matching was performed to adjust for patient background factors that could influence oral hypofunction in each group.
RESULTS
Compared with the ISFP group, the RPD group had significantly higher rates of poor oral hygiene, reduced occlusal force, decreased masticatory function, and declines in swallowing function and oral hypofunction; the odds ratio for oral hypofunction was 4.67. Compared with the ISFP group, the RPD group had significantly greater subjective symptoms of physical frailty and oral frailty, as well as higher OHIP scores.
CONCLUSIONS
Prosthetic treatment of KCIPE affected oral hypofunction, subjective frailty symptoms, and oral health-related QOL in dental clinic outpatients.
Topics: Humans; Quality of Life; Cross-Sectional Studies; Male; Female; Middle Aged; Oral Health; Jaw, Edentulous, Partially; Denture, Partial, Removable; Aged; Surveys and Questionnaires; Propensity Score; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Adult
PubMed: 38935335
DOI: 10.1186/s40729-024-00555-w -
Indian Journal of Dental Research :... Jan 2024This case report outlines a novel prosthodontic approach for managing a broken screw inside an implant screw channel, emphasising the importance of innovative solutions...
RATIONALE
This case report outlines a novel prosthodontic approach for managing a broken screw inside an implant screw channel, emphasising the importance of innovative solutions in implant dentistry.
PATIENT CONCERNS
A 57-year-old male patient sought restoration for implant-supported crowns (#46 and #47). A broken screw inside the implant screw channel posed a significant concern for both the patient and the dental team.
TREATMENT
Utilising an impression pickup technique of the inner surface of the implant body, a custom titanium abutment was fabricated in the laboratory and restoration was successfully replaced. A follow-up of 6 months was performed, ensuring optimal function and patient satisfaction.
OUTCOME
The custom titanium abutment with a zirconia crown was placed, leading to a successful restoration. The patient reported no discomfort, demonstrating improved function and aesthetics.
TAKEAWAY LESSON
This case highlights the effectiveness of tailored prosthodontic interventions in addressing complex implant-related complications.
Topics: Humans; Male; Middle Aged; Crowns; Dental Prosthesis, Implant-Supported; Dental Implants; Dental Implant-Abutment Design; Dental Restoration Failure; Zirconium; Titanium; Dental Abutments
PubMed: 38934762
DOI: 10.4103/ijdr.ijdr_953_23 -
Indian Journal of Dental Research :... Jan 2024To comparatively evaluate the effect of normal saline gel and ozonated saline-ozonated gel (ozone therapy) on pain, inflammation, soft tissue, and crestal bone loss in... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
AIMS
To comparatively evaluate the effect of normal saline gel and ozonated saline-ozonated gel (ozone therapy) on pain, inflammation, soft tissue, and crestal bone loss in dental implant surgery.
METHODS AND MATERIAL
Forty adult patients scheduled to undergo implant were randomized into two groups: Twenty patients (n = 20) received ozone therapy and controls (n = 20) received normal saline and gel during implant placement. Inflammation and pain were noted at days 1 and 7 and 3 month intervals by estimating C-reactive protein (CRP) levels and assessing visual analogue scale (VAS) scores. At 3 months, soft tissue outcomes were noted in terms of plaque index, gingival index, and pocket depth, while crestal bone loss was noted via a radiograph.
RESULTS
Mean CRP levels were significantly higher in the control group as compared to that in the case group on day 1 and day 7 follow-ups (P < 0.05). Mean VAS scores for pain were also lower in the case group as compared to the control group at all follow-ups, but the difference was significant statistically only at day 1 (P = 0.061). The plaque index was significantly lower in the case group as compared to the control group (P = 0.011) at final follow-up. No significant difference between two groups was observed for crestal bone loss.
CONCLUSIONS
Ozone therapy during implant placement was effective in reduction of pain, systemic inflammation, and plaque deposition in dental implant patients.
Topics: Humans; Ozone; Gels; Male; Female; Adult; Middle Aged; C-Reactive Protein; Saline Solution; Dental Implants; Dental Plaque Index; Alveolar Bone Loss; Periodontal Index; Pain Measurement; Dental Implantation; Inflammation
PubMed: 38934740
DOI: 10.4103/ijdr.ijdr_591_23