Clinical Peri-Implant Parameters and Marginal Bone Loss for Early Mandibular Implant Overdentures: A Follow-Up of 60 Months.

Background and Objectives: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed to evaluate clinical peri-implant parameters and marginal bone loss around early placed and loaded mandibular implant overdentures with a 60-month follow-up. Materials and Methods: In this prospective cohort study, 43 patients were enrolled to receive 86 early loading sub-crestal dental implants through prosthetic guides. Implant overdentures were supported by two isolated implant locator attachments between two mental foramens. Clinical peri-implant parameters, including plaque index (PI), bleeding index (BI), peri-implant pocket depth (PIPD), and marginal bone loss (MBL) were evaluated using standardized techniques at 1, 12, 24, 36, 48, and 60 months follow-up. At 60 months, complications associated with implant overdentures (IOD's) were noted. The mean comparison of peri-implant clinical parameters was performed through ANOVA test. A p-value of ≤0.05 was taken as significant. Results: Out of the total 43 enrolled patients, 8 patients were lost during follow-up; as a result, 35 patients completed the 5 years follow-up. The mean values of PI, BI, and PIPD increased with no statistical difference (p > 0.05). For marginal bone loss, an increase in the mean values was noted at different time intervals with statistical differences (p < 0.001). The most common complications noted were loosening of the abutment, occlusal adjustment, retentive locator loosening and replacement, and relining of the denture. Conclusions: Early placement of IODs failed to prevent bone loss over time and was associated with complications, predominantly consisting of abutment loosening, occlusal adjustments, broken retentive locator components, relining, and rebasing.

The Surface Roughness of Contemporary Indirect CAD/CAM Restorative Materials That Are Glazed and Chair-Side-Finished/Polished.

The surface roughness (Ra) of indirect computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated dental restorations is crucial for their long-term durability. This study intended to evaluate the Ra of five different types of contemporary indirect CAD/CAM restorative materials with varying compositions that were glazed and finished/polished. A total of 75 specimens, disc-shaped (10 mm × 2 mm), were obtained from five materials (n = 15) (Tetric CAD, IPS e.max CAD, IPS e.max ZirCAD, CELTRA Duo, and Vita Enamic) and fabricated by CAD/CAM. One of the two surfaces for each specimen was subjected to glazing, while the other surface was subjected to finishing/polishing. The Ra of the two surfaces in micrometers (µm) was evaluated using a Profilometer, while the surface topography was examined using a scanning electron microscope. Using SPSS, the Kruskal-Wallis, post hoc Conover, and Mann-Whitney tests were used to statistically evaluate the data. A comparison of the Ra for the finished/polished surfaces of the five test materials showed significant differences (p < 0.0001). Among the finished/polished surfaces, the mean rank values of Vita Enamic were significantly higher than the other four test materials (p < 0.0001). A comparison of the Ra of glazed surfaces among the five study materials revealed significant differences (p < 0.0001). The Ra for the IPS e.max ZirCAD material was significantly higher than the rest of the four materials (p < 0.001). A comparison of the Ra for two types of surface conditioning within each of the five test materials showed a significant difference (p < 0.05). Only for IPS e.max ZirCAD was the Ra of the glazed surface significantly higher than the finished/polished surface (p < 0.0001). Significant variations in the surface roughness (Ra) were exhibited between the finished/polished and glazed surfaces of the five test materials. Hybrid ceramics showed the highest Ra values for the finished/polished surfaces, and zirconia exhibited the highest Ra values among the glazed surfaces among the tested materials. The Ra values of either finished/polished or glazed surfaces of the test materials were within the clinically acceptable range (0.2-0.5 µm), except for the glazed surface of the zirconia ceramics (0.84 µm).

A novel digital workflow for fabricating artificial periodontal ligament using three-dimensional printing flexible resin: A dental technique.

The fabrication of periodontal ligament (PDL) models for in vitro dental studies has seen a wide range of techniques and materials being utilized. This paper introduces a novel dental technique that employs a digital workflow for the fabrication of artificial PDL using three-dimensional printing of flexible resin. This innovative approach offers several advantages, including enhanced accuracy and realism in simulating PDL. The digital workflow facilitates a streamlined fabrication process, ensuring efficiency and precision. By presenting this novel technique, this digital approach contributes to the advancement of in vitro dental research, providing researchers with a reliable and realistic model for studying various dental phenomena.

Evaluation of Peri-Implant Parameters and Functional Outcome of Immediately Placed and Loaded Mandibular Overdentures: A 5-year Follow-up Study.

PURPOSE: To evaluate the peri-implant parameters of immediately placed and loaded mandibular overdentures over a 5-year follow-up period. MATERIALS AND METHODS: All subjects who had been advised and planned for two-implant mandibular overdenture treatment were included in this study. The peri-implant parameters -including plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) as well as marginal bone loss (MBL) - were assessed. In addition, prosthodontic parameters including abutment-, implant- and denture-related complications were assessed. Patients were evaluated at follow-up visits, scheduled at 1, 12, 24, 36, 48, and 60 months. The data distribution was analysed with the Shapiro-Wilk test. Data within follow-up categories were compared using ANOVA and the Tukey-Kramer test. A p-value < 0.05 was considered statistically significant. RESULTS: Among the 32 participants, 19 were males and 13 were females, with a mean age of 60.5 ± 7.33. The mean plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) varied over time. However, no statistically significant difference was observed in the plaque index, bleeding index and peri-implant pocket depth over time (p > 0.05). The mean value at baseline was found to be -0.9 ± 0.3. The values increased over time, with the highest value observed at 60 months 2.6 ± 0.7, which was statistically significant (p < 0.001). CONCLUSION: Immediately placed and loaded mandibular implant overdentures using two un-splinted implants with locator attachments showed acceptable PI, BI and PIPD at the 5-year follow-up. Statistically significantly greater marginal bone loss was observed from baseline to follow-up, but it was within acceptable limits. A moderate number of restorative and abutment complications were observed during the follow-up of IODs.

Biomechanical behavior of all-ceramic endocrowns fabricated using CAD/CAM: A systematic review.

PURPOSE: This study performed a systematic review to assess the biomechanical behavior of all-ceramic endowcrowns fabricated using computer-aided design and computer-aided manufacturing (CAD/CAM) for the restoration of endodontically treated teeth. STUDY SELECTION: Three electronic databases (PubMed, Web of Science, and Scopus) were searched by operators specializing in health sciences databases searches to answer the following focused question based on the Population, Intervention, Comparison, Outcome (PICO) format: "Whether all-ceramic CAD/CAM endocrowns (Intervention) used to restore human endodontically treated teeth (Population) exhibit superior fracture resistance (Outcome) compared to non-CAD/CAM all-ceramic or non-ceramic endocrowns (Comparison)." The methodological quality assessment was performed using previously conducted systematic reviews of in vitro studies. The outcomes were expressed as the mean ± the standard deviation (SD). RESULTS: Seventeen in vitro studies were included. The materials used in these studies were lithium disilicate glass-ceramic, polymer-infiltrated ceramic, zirconia-reinforced lithium silicate glass-ceramic, resin/hybrid nanoceramics, zirconia-reinforced lithium silicate ceramics, and feldspathic ceramic. The fracture resistance of endocrowns using different ceramics varied as follows: (i) IPS e.max CAD (2863.62 ± 51.47 N), (ii) Vita Enamic (1952 ± 378 N), (iii) Vita Suprinity (1859 ± 588 N), (iv) Cerasmart (1981 ± 169.5 N), (v) LAVA Ultimate (2484 ± 464 N), (vi) Celtra Duo (1618.30 ± 585.00 N), and (vii) Cerec Blocs (236.29 ± 32.12 N). CONCLUSIONS: CAD/CAM all-ceramic endocrowns can withstand occlusal forces in the posterior region. All-ceramic endocrowns improve the fracture strength of endodontically treated teeth. Lithium disilicate crowns were commonly and successfully used in the included studies. More in vitro investigations that implement uniformity in material and measurement approaches are required to strengthen the evidence currently available in the literature regarding the durability of all-ceramic endocrowns.

Push-Out Bond Strength of Endodontic Posts Cemented to Extracted Teeth: An In-Vitro Evaluation.

(1) Background: An ideal bond strength between endodontic posts and root canal dentin is essential for optimal retention and good prognosis. This study aimed to evaluate the push-out bond strength (PBS) of prefabricated fiber and metal posts, luted with resin cement to natural dentin. (2) Methods: Extracted premolars with similar root dimensions were assigned into two groups of 30 each for the metal and fiber posts. Teeth were mounted in acrylic blocks exposing 2 mm of the coronal root. Teeth were subjected to endodontic treatment and post-space preparations. Two groups were further subdivided into three sub-groups (n = 10) according to the size of the posts (# 4, 5 and 6). Posts were cemented with resin cement. Specimens were sectioned into 4 mm slices and subjected to the PBS test. (3) Results: The mean PBS was similar for the metal and fiber posts bonded with resin cement, showing a statistically significant result. An increase in post size increased the bond strength initially, but a further increase in size did not show any marked difference. A total of 71.66% of tested specimens failed with the adhesive failure mode. (4) Conclusions: Metal posts showed slightly higher retention compared to the fiber posts, although the p-value was similar for both types. An increase in the size of posts showed increased retention. The most common mode of failure was adhesive failure between cement and dentin.

Disinfection efficacy and fracture strength of PMMA denture-based polymer with chlorhexidine, PDT utilizing Rose Bengal and hematoporphyrin, and Er, Cr: YSGG laser.

OBJECTIVE: The study aimed to assess and compare disinfection efficacy and fracture strength of PMMA based DBPs using chlorhexidine (CHX), PDT utilizing Rose Bengal (RB) and hematoporphyrin HPD, and Er,Cr:YSGG laser (ECL) induced antimicrobial action against in-vitro biofilms colonized with C.albicans, S.aureus, S. mutans, and E. coli. MATERIAL AND METHODS: American Type Culture Collection (ATCC) of C.albicans, S.aureus, S. mutans and E. coli were cultured. Forty-eight PMMA-based denture base plates (DBPs) were prepared by heat-cure acrylic resin and contaminated by in-vitro biofilm under-stimulated in-vitro conditions. DBPs were treated with group1; ECL group 2; RB 5µm, group 3; HPD 500 mg/L and group 4; 0.12% CHX (controls) respectively, for the disinfection of biofilms. All photosensitizers (PS) were activated by LED at a different wavelength. Each contaminated DBP was sprayed on all its surfaces with the aforementioned photosensitizers and CHX. One-way analysis of variance (ANOVA) was used to test the efficacy of disinfection and fracture load testing. Tukey multiple comparison tests were performed to compare means of CFU/mL (log10) for exposed E. coli, C. albicans, S aureus, and S. mutans. RESULTS: Specimens in group 1 disinfected with erbium laser, group 3 disinfected with HPD, and group 4 sterilized with chemical disinfection were effective in decreasing bacterial load CFU/mL (log10) against C.albicans, S. aureus, S.mutans, and E. Coli (p>0.05). Intergroup comparison demonstrated ECL, CHX and HPD demonstrated a comparable reduction against C.albicans and S.aureus (p>0.05). Similarly, S.mutans and E.coli were sensitive against all experimental groups (p>0.05). no significant difference in fractural load analysis among the different investigated groups was noted (p>0.05). CONCLUSION: ECL and HPD photosensitizer revealed a significant reduction in CFU/ml of exposed viable colonies of C.albicans, S.aureus, S. mutans, and E. coli comparable to 0.12% CHX mediated disinfection of PMMA-based DBPs. Irrespective of the type of disinfection no influence of disinfection was noted on the fracture load of PMMA DBPs.