Bhumija Gupta

In Vitro Assessment of Primary Stability of Straumann® Implant Designs

BACKGROUND Primary implant stability (PS) is one of the main factors influencing implant survival rate. Several methods to determine the PS have been used, such as Periotest values (PVs) and resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. PURPOSE The aim of this study was to compare different implant designs in regard to PS assessed by Periotest and RFA in vitro. MATERIALS AND METHODS A total of 90 implants were placed in freshly slaughtered cow ribs. The implants (Straumann®, Institute Straumann AG, Basel, Switzerland; length 10 mm, ø3.3 mm) had the following three designs: Bone Level (BL, 30 implants), Standard Plus (SP, 30 implants), and Tapered Effect (TE, 30 implants). Before implant placement, the investigator was calibrated for every design according to the manufacturers instructions. An independent observer, blinded to the study, assessed the accuracy of placement. RFA based on the Osstell device and PVs were performed after abutment connection. One-way analysis of variance and Tukeys post hoc test were used for statistical evaluation. RESULTS All implants were mechanically stable. The mean PV for BL was -4.67(± 1.18), for SP, -6.07(± 0.94), and for TE, -6.57(± 0.57). The mean ISQ values were 75.02(± 3.65), 75.98(± 3.00), and 79.83(± 1.85), respectively. The one-way ANOVA showed significant difference among three implant designs in PV (p < .0001) and for the ISQ between BL/TE or SP/TE implants (p < .0001). In addition, the Tukeys (pair-wise comparison) test showed significant differences in PV and RFA between the BL/T (p < .0001). CONCLUSION Within the limitations of this study, higher implant stability was found for tapered designed implants.

Oral manifestations in patients with neurofibromatosis type-1: a comprehensive literature review.

UNLABELLED Oral health status is jeopardized in patients with neurofibromatosis (NF) type-1 (NF-1). The aim of the present study was to comprehensively review the oral manifestations in NF-1 patients. PubMed/Medline and Google-Scholar databases were explored using different keywords. Reviews, commentaries, letters to Editor and articles published in languages other than English were excluded. RESULTS Neurofibromas of oral and perioral soft tissues with subsequent periodontitis, impacted and supernumerary teeth, enlarged alveolar process with dental spacing, morphological changes in teeth and class III molar relationship have been reported in NF-1 patients. Plexiform neurofibromas were reported both in oral soft tissue, maxilla and mandible with evidence of malignant transformation in some cases. Facial skeletal abnormalities, including enlargement of mandibular foramen, increased dimensions of the coronoid and sigmoid notches and notching of the posterior border of the mandible have also been reported. Association between dental caries and NF-1 remains unclear.

Lasers use in dental implantology.

Objective: The purpose of this literature review was to evaluate the present use of different laser systems in implant dentistry. Materials and Methods: A literature search of MEDLINE-PubMed for articles published, describing the use of lasers in implant dentistry, was performed and articles were critically reviewed by the investigators to determine the strength of evidence. Results: The literature review reveals a limited number of randomized clinical trials with regard to laser use in dentistry. Although many case studies indicate extensive use of lasers and promising results in dental implantology, lasers may be used for uncovering submerged implants atraumatically to prevent crestal bone loss, recontouring periimplant soft tissues and sculpting emergence profile for prosthetic components, raising surgical flaps, osseous recontouring, and creating parabolic tissue architecture. Additionally, bone harvesting of block grafts, window preparation in sinus lift procedures, ridge splitting, and debridement of extraction sockets for immediate implant placement were described. Conclusions: Aside from the many benefits associated with the use of lasers in implant-related procedures, there are also risks to consider from the laser irradiation on the implant surface and the periimplant tissues. Therefore, an appropriate training on laser use is mandatory to increase the clinical outcome and to control the potential of complications.

Distal cantilever in full-arch prostheses and immediate loading: a retrospective clinical study.

PURPOSE The purpose of this study was to analyze and evaluate the clinical success of distal cantilevers of fixed full-arch prostheses for the rehabilitation of edentulous arches in conjunction with immediate loading. MATERIALS AND METHODS Twenty-seven patients (15 men and 12 women) with a mean age of 59 years received 203 implants (Ankylos, Dentsply), either in edentulous jaws or after extraction and immediate implant placement. All implants were splinted together with provisional restorations and loaded immediately after surgery. After an average of 60 days, the definitive prostheses were fabricated and cemented provisionally. Thirty-one prostheses were delivered. A total of 92 units on distal cantilevers were incorporated into the prostheses. Implant stability was recorded (via percussion testing) after prostheses were removed and crestal bone levels were measured with radiographs. RESULTS Average crestal bone loss was 0.33 mm. After a follow-up of 5 years, only one prosthesis broke (at the connection between the main part of the denture and the distal extension). A total of five implants were lost because of overloading or peri-implantitis (during early healing). The success rate of implants was 94.5%, the survival rate was 97.5%, and the survival rate of the prostheses was 96.7% after a loading period of 79.30 ± 35.31 months. CONCLUSIONS Based on the long-term clinical data, distal cantilevers on a full-arch prosthesis can be a successful treatment modality and can be employed in patient treatment planning when posterior support is indicated.

Primary Stability of Implants Placed at Different Angulations in Artificial Bone

Introduction:The aim of this study was to evaluate the primary stability (PS) of titanium implants with a progressive thread design and more thread stability in the apical threads placed in artificial bone materials. Materials and Methods:A total of 120 implants were placed in commercially available polyurethane composite bone blocks. The angulations that were chosen to place the implants in bone types II and IV were 0, 10, and 20 degrees, respectively. The implant dimensions were 11 mm in length and 3.5 mm in diameter. Two clinicians placed all implants, and an independent examiner evaluated the PS using the Osstell (ISQ) and Periotest devices. The &khgr;2 test was used to evaluate the statistical differences between the PS at different angulations. Results:This study showed that there was a statistically significant difference (P = 0.02) of the PS values, when measured using the Periotest values, among all 3 angulations in both bone qualities. Tilted implants with 10 degrees, angulation had a better stability than conventionally placed implants. Conclusions:The PS of dental implants is higher for implants placed in type II when compared with type IV artificial bone. A higher stability was found for implants placed with 10-degree angulations.

Selective serotonin reuptake inhibitors and dental implant failure—A significant concern in elders?

OBJECTIVE Depression is a significantly prevalent health concern in geriatric populations. Selective serotonin reuptake inhibitor drugs (SSRI) are the most commonly prescribed antidepressant agents, with increasing rates of prescription. The present report aimed to present a concise review of the current understanding regarding SSRI effects on bone and dental implant outcomes. MATERIALS AND METHODS A broad-based review and summary of literature pertaining to the effects of SSRI on bone metabolism and on dental implant survival was performed. RESULTS The available literature indicates that serotonin plays a significant role in bone metabolism and experimental reports demonstrate adverse impacts of SSRI on multiple pathways of bone metabolism. Early clinical reports suggest detrimental effects of SSRI on dental implant survival. The type of SSRI drug, dosage and host-related genetic and metabolic factors could be potential modulating factors. There is a paucity of data regarding SSRI usage and dental implant survival specific to geriatric cohorts. CONCLUSION As older individuals comprise a high-risk group for both high oral rehabilitation and SSRI use, clinicians should be aware the potential association between SSRI and dental implant failures. Well-designed investigations specific to geriatric cohorts are essential to understand the implications of SSRI use on dental implant prognosis.