Multifactorial analysis of the maxillary premolar area for immediate implant placement using cone beam computed tomography: A study of 333 maxillary images.

STATEMENT OF PROBLEM: Immediate implant placement in the maxillary premolar area is challenged by anatomic variations imposing risks such as perforation of the buccal bone and the maxillary sinus. Previous studies have addressed the potentially relevant factors individually; a study assessing all relevant variables comprehensively and with a large sample size is lacking. PURPOSE: The purpose of this observational study was to analyze multiple anatomic considerations, including sagittal root position, alveolar bone concavity angle, buccal bone perforation, maxillary sinus floor root proximity, and maxillary sinus perforation in the maxillary premolar area, using cone beam computed tomography (CBCT) to inform, perceive, and simplify the placement of immediate implants. MATERIAL AND METHODS: The analysis involved 333 CBCT images (189 of men, 144 of women). A total of 1332 first and second maxillary premolars were assessed for sagittal root position, alveolar bone concavity angle, buccal bone perforation, maxillary sinus floor root proximity, and maxillary sinus perforation. Chi-squared and kappa tests were used to analyze the distributions and agreement, respectively, while dependent and independent t tests were used to assess sex and tooth-specific differences. The Spearman correlation test was used to explore the potential correlations (α=.05) RESULTS: The majority of sagittal root position distribution was on the buccal side, ranging from 79.3% to 88.3%, while maxillary sinus floor root proximity showed a predominance of the T0 category (roots separated from the maxillary sinus floor), with noticeable sex disparities in the second right premolar (73% in men versus 50.7% in women; P<.001). The "perforation" category of buccal bone perforation was highest in the right first premolar (54.1%), being higher in women across all teeth. The "perforation" category of maxillary sinus perforation was highest in the left second premolar (21.9%). Associations were found between buccal bone perforation and sagittal root position in the second premolars. The Spearman correlation between root proximity and sinus perforation was high, ranging from 0.68 to 0.78. CONCLUSIONS: The alveolar bone concavity angle in first premolars, compared with second premolars, poses a higher risk of buccal bone perforation, especially in women. The buccal position is the most common sagittal root position. The risk of sinus perforation is higher in maxillary second premolars, with proximity to or protrusion into the maxillary sinus floor categories strongly correlating with this complication. These findings highlight the importance of thorough assessment and strategic planning to ensure successful immediate implant placement and minimize potential complications.

Prevalence of periodontitis in Saudi Arabia: A systematic review and meta-analysis.

Objective: The aim of this systematic review was to assess the prevalence of periodontal disease among Saudi Arabian adults based on studies conducted from 1992 to 2023. Methods: The study protocol was registered in PROSPERO. Three databases (MEDLINE, EMBASE and Cochrane library) and the Saudi Dental Journal were searched for published literature up to June 2023 using prespecified search strategy. Quality of included studies was checked using the risk of bias in population-based prevalence studies tool. Results: The systematic review included 15 studies that assessed the prevalence of periodontal disease in Saudi Arabia. Most of the studies used non-confident case definitions. The pooled estimate of periodontal disease prevalence in Saudi Arabia based on the data of 14 which included 6,596 individuals is 51% (95% CI: 35.99, 73.05). Conclusion: Periodontal disease is a significant public health issue in Saudi Arabia, with a substantial prevalence among the included participants. Nevertheless, the existing studies exhibit methodological disparities and regional limitations. Therefore, while the results shed light on the pressing nature of periodontal disease in Saudi Arabia, further comprehensive research is imperative. A more accurate estimate, coupled with effective strategies, can be achieved through broader, multidisciplinary collaborations and the prioritization of a national oral health survey in Saudi Arabia.

Practical applications of robots in prosthodontics for tooth preparation and denture tooth arrangement: A scoping review.

STATEMENT OF PROBLEM: With the increasing interest in using robots in dentistry and the widespread dissemination of information on this topic and its applications, a comprehensive review of robot applications in prosthodontics is needed. PURPOSE: The purpose of this scoping review was to assess the current status of prosthodontic robotic applications, their achievements to date, and the barriers hindering their broader adoption and further advancement. MATERIAL AND METHODS: The checklist for Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was used to conduct this review. A comprehensive search methodology was developed to identify relevant studies on the use of robots in prosthodontic procedures in the PubMed, Scopus, Web of Science, and Google Scholar databases. The inclusion criteria were studies that specifically outlined the application of robots in the field of prosthodontics. RESULTS: Eighteen relevant studies were found. Of these, 10 studies focused on assessing the effectiveness of robotic systems through in vitro testing using phantom models for tooth preparation. These studies specifically explored the processes involved in creating complete crowns and veneers. The remaining 8 studies investigated the use of robotics in tooth alignment, with a specific focus on complete dentures. CONCLUSIONS: Robots have the potential to improve precision and accuracy in prosthetic dentistry. However, clinical studies are needed to confirm the widespread use of robots in prosthodontics, as their clinical application is still in its early stages.

Comprehensive analysis of the maxillary esthetic zone for immediate implant placement using cone beam computed tomography: A study of 352 maxillary images.

STATEMENT OF PROBLEM: Previous studies have examined the maxillary esthetic zone for immediate implant placement, but these studies had small sample sizes and did not investigate multiple parameters. PURPOSE: The purpose of this cross-sectional study was to use cone beam computed tomography (CBCT) to evaluate the sagittal root position (SRP), alveolar bone concavity, labial bone perforation (LBP), and tooth-ridge angle in the maxillary anterior teeth region. MATERIAL AND METHODS: A total of 352 CBCT images of patients (180 men and 172 women) who visited the dental hospital between 2018 and 2023 were analyzed. The sample included 2112 anterior maxillary teeth. SRP, alveolar bone concavity, tooth ridge angle, and LBP were assessed using virtual implant simulation. The data were analyzed by using chi-squared and kappa tests to analyze distributions and agreement, respectively, dependent and independent t-tests to assess sex and tooth-specific differences, and the Spearman correlation test to explore potential correlations (α<.05). RESULTS: The CBCT images revealed that the majority of SRP were in Class I (85.4%), with smaller percentages in Class II (12.5%) and Class IV (2.3%); Class III was the least common (1%). The canine exhibited the most significant alveolar bone concavity angle average (149.14 ±6.35 degrees), followed by the lateral incisor (142.32 ±8.7 degrees). The canines had the highest occurrence of LBP (63.1%) (P<.01). Women had a higher frequency of labial bone perforation and deeper alveolar bone concavities than men (P<.01). CONCLUSIONS: The findings of this study indicate that careful assessment and planning are necessary for immediate implant placement in the maxillary anterior region. The significant occurrence of LBP highlights the importance of thorough planning and evaluation to avoid surgical mishaps and complications which may necessitate bone grafting and result in added costs and time. Special attention should be given to women and the canine area.

Applications of robots in implant dentistry: A scoping review.

STATEMENT OF PROBLEM: With the increasing interest in the applications of robots in implant dentistry and an acceleration in disseminating information about this field and its applications, a comprehensive review of robots in implant dentistry has become necessary. PURPOSE: The purpose of this scoping review was to identify the present status and development of robotic applications in implant dentistry and provide insights into future implementation and advancement, limitations, and strategies for enhanced clinical adoption and technical advancement. MATERIAL AND METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was followed. A search strategy was developed to identify relevant studies in the PubMed, Scopus, Web of Science, Embase, and Google Scholar databases. Studies were included if they described using robots in implant dentistry. RESULTS: The literature search identified 34 relevant studies, with the majority published after 2020. Most research used robotic arms to place alveolar implants and test placement accuracy. Twenty-one of the included studies described the in vitro testing of robotic systems using phantom models or specimens, while 10 studies evaluated these systems clinically and 3 tested both in vitro and clinical applications. CONCLUSIONS: Robots are becoming increasingly common in implant dentistry, offering efficiency, time-saving benefits, and improved accuracy. However, more research and development are needed to optimize and streamline robotic software programs for practical application.