Altug Cilingir

Evaluation of possible prognostic factors for the success, survival, and failure of dental implants.

Purpose:To analyze the prognostic factors that are associated with the success, survival, and failure rates of dental implants. Material and Methods:Data including implant sizes, insertion time, implant location, and prosthetic treatment of 1656 implants have been collected, and the association of these factors with success, survival, and failure of implants was analyzed. Results:The success rate was lower for short and maxillary implants. The failure rate of maxillary implants exceeded that of mandibular implants, and the failure rate of implants that were placed in the maxillary anterior region was significantly higher than other regions. The failure rates of implants that were placed 5 years ago or more were higher than those that were placed later. Conclusions:Anterior maxilla is more critical for implant loss than other sites. Implants in the anterior mandible show better success compared with other locations, and longer implants show better success rates. The learning curve of the clinician influences survival and success rates of dental implants.

A comparative in vitro evaluation of two different magnetic devices detecting the stability of osseo-integrated implants.

BACKGROUND AND OBJECTIVE It is unknown whether the resonance frequency analysis (RFA) measurements made by two different magnetic resonance frequency analysers are comparable. This in vitro study was designed to compare the RFA measurements made by the two magnetic resonance frequency analysers and to evaluate the intra- and interobserver reliability of the magnetic devices. MATERIAL AND METHODS Thirty-two implants were placed in four cow ribs. The RFA value of each implant was measured by five different examiners. The measurements were repeated five times, in both the buccal and mesial directions, for each implant at 2 h intervals, and the averages of registered implant stability quotient (ISQ) units were recorded as the buccal ISQ value and the mesial ISQ value for every implant. RESULTS No statistically significant differences (p>0.05) were observed between the RFA measurements made by the two magnetic devices. The intra-observer reliability of both devices was excellent, whereas the interobserver reliability of the devices was poor. CONCLUSION The results of the RFA measurements of both tested devices overlap. Although both devices show excellent intra-observer reliability, there are variations between the measurements of different examiners.

The influence of implant number and attachment type on maximum bite force of mandibular overdentures: a retrospective study

AIM Assessment of the influence of such factors as attachment type, number of implants, gender and age of patients on maximum bite force (MBF). MATERIAL AND METHODS Sixty-two edentulous patients (32 females, 30 males; aged 64.03 ± 10.07 years, range 42-90 years) with mandibular implant overdentures with various attachment types were included in the study and their MBFs were recorded. The results were evaluated statistically at a significance level of p < 0.05. RESULTS The MBF in male patients was found to be statistically significantly (p < 0.05) higher than in female patients. No statistically significant differences (p > 0.05) were found with respect to age groups, attachment types and number of implants supporting the mandibular overdentures. CONCLUSION Within the limitations of this study, it is concluded that independent of the number applied, dental implants increase MBF in edentulous patients. While males show higher bite force, patient age and attachment type seem not to play an important role.

The influence of momentary retention forces on patient satisfaction and quality of life of two-implant-retained mandibular overdenture wearers.

PURPOSE The purpose of this study was to assess the influence of momentary retention forces on patient satisfaction and quality of life of two-implant-retained mandibular overdenture wearers. MATERIALS AND METHODS Edentulous patients who had been rehabilitated with two-implant-supported mandibular overdentures with single attachments and maxillary complete dentures at a university clinic were included in this study. The overdenture attachments were either ball or locator attachments. All the patients completed the Turkish version of the Oral Health Impact Profile-14 (OHIP-14) and the visual analog scale (VAS) satisfaction questionnaires. Momentary retention forces of the overdentures were measured using a custom-made dynamic testing machine. RESULTS Fifty-five patients were included in this study. No statistically significant association was detected between momentary retention forces and VAS scores (P > .05), but higher retention forces presented significantly better quality of life scores in the social disability and handicap domains of OHIP-14 (P < .05). CONCLUSION Within the limitations of this clinical study, it may be presumed that although higher instant retention force of an implant-retained overdenture provides better quality of life, it does not affect patient satisfaction.

The impact of frenulum height on strains in maxillary denture bases

PURPOSE The midline fracture of maxillary complete dentures is a frequently encountered complication. The purpose of this study was to assess the effect of frenulum height on midline strains of maxillary complete dentures. MATERIALS AND METHODS A removable maxillary complete denture was fabricated and duplicated seven times. Four different labial frenulum heights were tested for stresses occurring on the palatal cameo surface. The strains were measured with strain gauges placed on 5 different locations and the stresses were calculated. To mimic occlusal forces bilaterally 100 N of load was applied from the premolar and molar region. RESULTS A statistically significant association between the height of the labial frenulum and the calculated stresses and strains was shown (P<.05) predominantly on the midline and especially on the incisive papilla. The results showed that stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. CONCLUSION Within the limitations of this in vitro study, it can be concluded that the stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. Surgical or mechanical precautions should be taken to prevent short-term failure of maxillary complete dentures due to stress concentration and low cycle fatigue tendency at the labial frenulum region.

Two-body wear of occlusal splint materials.

This study investigates the wear resistance of four different types of occlusal splint materials based on two-body wear simulations under wet and dry conditions. Twenty specimens of each splint material (Dentalon Plus, Orthoplast, Biocryl C, and Eclipse), each with a diameter of 16 mm and a thickness of 3 mm, were tested, half under wet and half under dry conditions. Each wear test was performed using a device called chewing simulator CS-4 (n=10; test load: 50 N; number of cycles: 10000, 20000, and 30000; continuous rinsing with 30°C water for wet conditions); the antagonists were simulated using steel balls. Wear was determined using a 3D laser scanner and a surface analysis program. To detect significant statistical differences, wear data after 10000; 20000; and 30000 cycles were compared using the Kruskal-Wallis test and the Mann-Whitney U-test. The level of significance was set at 5%. Significant differences were found between the groups of different materials tested under wet conditions (P<0.05), whereas no differences between them were found under dry conditions (P>0.05). No significant difference was found between the wet and dry conditions for all materials and cycles (P>0.05). For groups of different materials tested under wet conditions, the degree of volume loss generated in the Chewing Simulator CS-4 was found to differ significantly for different numbers of cycles. The presence of water had no effect on the volume loss in the different material groups that were tested.

Comparative Ex Vivo Evaluation of Two Electronic Percussive Testing Devices Measuring the Stability of Dental Implants

BACKGROUND A comparative ex vivo study was performed to determine electronic percussive test values (PTVs) measured by cabled and wireless electronic percussive testing (EPT) devices and to evaluate the intra- and interobserver reliability of the wireless EPT device. METHODS Forty implants were inserted into the vertebrae and forty into the pelvis of a steer, a safe distance apart. The implants were all 4.3 mm wide and 13 mm long, from the same manufacturer. PTV of each implant was measured by four different examiners, using both EPT devices, and compared. Additionally, the intra- and interobserver reliability of the wireless EPT device was evaluated. RESULTS Statistically significant differences (P <0.05) were observed between PTVs made by the two EPT devices. PTVs measured by the wireless EPT device were significantly higher than the cabled EPT device (P <0.05), indicating lower implant stability. The intraobserver reliability of the wireless EPT device was evaluated as excellent for the measurements in type II bone and good-to-excellent in type IV bone; interobserver reliability was evaluated as fair-to-good in both bone types. CONCLUSION The wireless EPT device gives PTVs higher than the cabled EPT device, indicating lower implant stability, and its inter- and intraobserver reliability is good and acceptable.

Assessment of demographic and clinical data related to dental implants in a group of Turkish patients treated at a university clinic.

PURPOSE This retrospective study analyzed the distribution of the dental implants with regards to age and gender of the patients and type of indication for the implant therapy, as well as the location, dimension and type of the implants. MATERIALS AND METHODS The data of demographics (age and gender), type of indication for implant therapy, anatomical location, dimensions (length and diameter) and type (bone and tissue level) of 1616 implants were recorded from patient charts between January 2000 and January 2010. Descriptive statistics were analyzed using a chi-squared test for demographic parameters, type of indication, tooth position, anatomical location, implant dimensions and type (α=.05). RESULTS The patient pool comprised of 350 women and 266 men, with a mean age of 52.12 ± 13.79 years. The difference in n% of the implants of the age groups was statistically significant between the types of indications. The difference in the position of the implants was statistically significant between the n% of the implants of all age groups. Gender did not significantly vary, except that the diameter of the implants was significantly higher for the standard diameter implants in males. The difference between the implant positions was statistically significant when considered according to indication. The relationship between implant length and anatomical location was statistically significant. CONCLUSION The indication for dental implant use is age dependent and the type and size of the implant seems to be strongly related to the location of the implant.

Comparison of the Primary Stability of Two Implant Designs in Two Different Bone Types: An In Vitro Study.

PURPOSE Achievement of primary stability upon surgical placement of dental implants is a key factor for successful osseointegration and depends mainly on implant-related factors. The aim of this study was to compare and assess the primary stability of implants with active and regular threads in type 2 as well as type 4 bone. MATERIALS AND METHODS Fresh cow vertebrae and a pelvis were used as models of type 4 bone and type 2 bone, respectively. Implants with two different designs-regular-threaded and active-threaded-both 4.3 mm wide and 13 mm long, were placed in both types of bone (n = 80). Stability measurements were completed by four prosthodontists using two different Periotest devices and resonance frequency analysis. Statistical analyses were performed with the Mann-Whitney U test. RESULTS No statistically significant differences were found between the implant types in either type of bone in the stability measured with different methods. For both implant types, the mean resonance frequency values in type 2 bone were statistically significantly higher than in type 4 bone, whereas the mean Periotest values in type 2 bone were statistically significantly lower than in type 4 bone. CONCLUSION Within the limitations of this in vitro study in bone types 2 and 4, the active-threaded implant, which was invented to increase primary stability, did not show higher primary stability compared to a regular-threaded implant.

Edentulous Maxillary Arch Fixed Implant Rehabilitation Using a Hybrid Prosthesis Made of Micro-Ceramic-Composite: Case Report

The prosthetic treatment of patients with an edentulous maxilla opposing mandibular natural teeth is one of the most challenging endeavors that face clinicians. Occlusal forces from the opposing natural teeth may cause fractures in the maxillary prosthesis and also result in advanced bone loss of the edentulous maxilla. With the presence of extreme gagging reflex, the treatment may become more complicated. This article describes and illustrates the 2-stage surgical and prosthetic treatment of a patient with an edentulous maxilla opposing natural teeth. In the beginning, the patient was treated with 4 implants and a maxillary implant-supported overdenture. The extreme gagging reflex and the occlusal forces from the mandibular natural teeth obligated the team a second stage surgical and prosthetic treatment, which included increasing the number of implants after bilateral sinus lifting in the posterior maxilla and fabricating a maxillary fixed hybrid prosthesis made of micro-ceramic composite that yielded a satisfactory result.