Clinical and radiographic changes following transcrestal sinus augmentation: A scoping review of the last 25 years.

INTRODUCTION: Maxillary sinus floor elevation is a surgical procedure intended to increase the volume of the bone vertically to accommodate dental implant placement. This intervention is frequently required for implant installation in the posterior maxilla, where the bone may be insufficient for securing implants of necessary length and stability. Sinus floor elevation can be completed either through a direct approach with a "window" through the lateral wall of the alveolar ridge or an indirect "transcrestal/transalveolar" sinus floor elevation (TSFE), which accesses the sinus floor through the crest of the edentulous ridge. Our study aims to provide a comprehensive scoping review of research conducted over the past 25 years on TSFE, specifically. METHODS: A literature search aimed at identifying pertinent literature for the purpose of this PRISMA-ScR-compliant scoping review was conducted. Only randomized controlled trials, non-randomized controlled trials, prospective cohort studies, and case series that met the eligibility criteria were selected. Relevant data from these studies were extracted. Primary outcome measures included radiographic bone levels and implant failure >5 years. Secondary outcome measures included implant stability at time of placement and complications. Interventions reported in the selected studies were grouped based on treatment modality, which were then compared with the control therapy (traditional osteotome technique) after a minimum of 12 months healing period. RESULTS: Our search yielded 633 records, and after deduplication, 574 of these were screened. Application of the eligibility criteria led to the inclusion of 37 articles in the final selection. Case selection for included studies enrolling subjects: Four different transcrestal sinus elevation treatment modalities were identified: (a) osteotome, (b) piezoelectric surgery, (c) osseodensification, and (d) hydraulic techniques. Due to the heterogeneity of the studies, no superior approach for TSFE could be identified. Overall, all techniques demonstrated high implant survival rates. CONCLUSION: Comprehensive understanding of the patient's medical history, available armamentarium, and post-operative complications/management strategies are all essential to the completion of a successful TSFE approach for implant placement in the posterior maxilla, regardless of the treatment modality used.

Osseodensification technique in crestal maxillary sinus elevation-A narrative review.

Osseodensification is a novel approach that has significantly advanced the field of implant dentistry, particularly in the context of transcrestal maxillary sinus floor elevation. This technique involves the use of specially designed burs that compact and densify bone along the osteotomy walls, thereby enhancing implant primary stability and facilitating osseointegration in low-density bone. This article reviews the historical evolution of implant site preparation, and the biomechanical, histological, and clinical evidence of osseodensification with a special focus on its application in sinus floor augmentation. The integration of this technique into contemporary practice represents a paradigm shift, offering a minimally invasive and efficient solution for addressing the challenges of posterior maxilla, with improved patient-reported outcomes and low complication rate. Three different protocols for sinus lift and implant placement using osseodensification burs are proposed based on available literature, and risk factors for Schneiderian membrane perforation based on residual bone height are discussed, along with implant-related outcomes and patient-reported outcome measures. The potential for osseodensification to become a standard practice in sinus floor augmentation is emphasized, highlighting key aspects such as surgical protocol and patient selection.

Immediate implant placement in damaged extraction sockets: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: The aim of this study was to observe whether immediate implant placement (IIP) into damaged extraction sockets is a successful modality for treating hopeless teeth that require extraction. DATA SOURCE: An electronic search was carried out through four databases (PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect) to identify randomized controlled trials (2013-2023) to understand whether IIP in damaged sockets is a successful treatment. The focus question was, 'In a patient with a hopeless tooth that needs extraction with the indication for dental implant treatment, is IIP in damaged extraction sockets, compared to undamaged sockets or healed sites, an effective method for the replacement of hopeless teeth and achieving a favorable clinical result?' The risk of bias was appraised and a meta-analysis using random effect was applied. Five studies with 135 patients and 138 implants were included. The implant survival rate was 100% for all studies and period evaluated; the pink esthetic score (PES) scores had no statistically significant result for all articles that evaluated this parameter; the soft tissue changes was reported by two studies: one found no significant differences and the other showed that the test group experienced reduced soft tissue loss at the 1-year evaluation (measured with digital intraoral scanners); other two studies assessed the marginal bone loss, presenting no differences between groups. The meta-analysis showed homogeneity between the studies. There was an equilibrium among the groups in the various studies included, and age tended to be lower in the test group. The buccal bone tissue and pink esthetic score showed favoritism for the test group but without statistical significance. CONCLUSION: This study suggests that IIP in the presence of buccal bone defects can achieve comparable clinical and radiological outcomes to traditional methods in the short term of the limited studies available. The buccal aspect is not possible to be evaluated through radiographs. Bone regeneration was essential to reach optimal results. It is important to emphasize that IIP requires adherence to rigorous criteria to ensure functionally acceptable results.

Evaluation of Maxillary Sinus Septa Using Cone Beam Computed Tomography (CBCT): A Retrospective Study.

BACKGROUND: Maxillary sinus septa, which are bony structures dividing the sinus cavity, can pose challenges during sinus lift or implant surgeries by potentially causing perforation of the Schneiderian membrane. This study aimed to estimate the prevalence, height, location, orientation, and risk of perforation of the maxillary sinus septa using cone beam computed tomography (CBCT). MATERIALS AND METHODS: This retrospective, cross-sectional study utilized CBCT (NewTom CBCT machine, of which the scan parameters were 90 KvP, 8 mAs, and 14 s exposure with a field of view (FOV) of 8×8 cm and a 0.2 mm3 voxel size) images of 300 maxillary sinuses from patients aged >18 years, obtained from Swami Devi Dyal Hospital and Dental College in Panchkula, India. Scans were analyzed for the presence, height, location, orientation, and risk of septal perforation. The data were categorized based on age, sex, and dentition status. Statistical analyses were performed to assess the prevalence, configuration, and risk factors. RESULTS: The prevalence of maxillary sinus septa was 21.33%, with the majority showing a single septum (90.63%). Septa were predominantly found in the middle region (48.44%), with bucco-palatal orientation (93.75%) being more common than anteroposterior. The mean septa height was 6.16 mm. The perforation was classified as moderate (48.4%), low (46.8%), or high (4.6%). Class III septa were associated with the highest risk of perforation. CONCLUSION: This study highlights a significant prevalence of maxillary sinus septa with variations in height, orientation, and location. The risk of perforation varies with the septa configuration and orientation. CBCT is essential for identifying these anatomical features to minimize surgical complications and to guide preoperative planning.

Repairing Dehiscence Defects at Implant Sites using ß-Tricalcium Phosphate/Calcium Sulfate versus Xenograft Combined With Membrane: A Randomized Clinical Trial.

Guided bone regeneration (GBR) typically involves bone grafts and a membrane to enhance bone formation. Beta-tricalcium phosphate calcium sulfate (ß-TCP/CS) is a novel material with self-hardening and tissue growth inhibition properties and can potentially replace the need for a membrane. This study compares ß-TricalciumPhosphate/CalciumSulfate with deproteinized bovine bone mineral and a collagen membrane (DBBM/CM) to repair bone defects at implant sites over six months. Sixteen implant defects were divided into ß-TCP/CS (n = 8) and DBBM/CM (n = 8). The results showed no significant differences in vertical and horizontal defect fill in millimeters between ß-TCP/CS (2.87±1.25 and 2.37±1.06 mm., respectively) and DBBM/CM (3.5±0.92 and 2.87±1.12 mm. , respectively). Buccal bone thickness (BT) alterations at the implant platform levels (BT0) were similar for both materials. However, ß-TCP/CS exhibited greater bone alteration at the 2-mm level (BT2: -1.85 mm vs. -0.47 mm) and 4-mm level (BT4: -1.79 mm vs. 0.12 mm) apical to the implant platform compared to DBBM/CM. When assessing volume alteration, ß-TCP/CS showed a significantly greater reduction at the platform to the 2 mm level (-61.98% vs. -23.76%) than DBBM/CM. In conclusion, ß-TCP/CS demonstrated promise for treating buccal bone defects around implants but exhibited higher graft reduction. This suggests that while ß-TricalciumPhosphate/CalciumSulfate may offer clinical benefits, its potential for greater graft reduction should be considered. Further research and evaluation are warranted to fully understand the long-term implications of using ß-TCP/CS in guided bone regeneration procedures.

Strontium-containing mineralized phospholipid coatings improve osseointegration in osteoporotic rats.

Surface treatments play an important role in enhancing the osseointegration of Titanium (Ti) and its alloys. This study introduces a method employing biomimetic hydroxyapatite (Hap) deposition guided by molecularly organized phospholipids, affixed to the metal implant surface. Using the Langmuir-Blodgett technique, phospholipids were deposited onto Ti-screws by using CaCl2 or CaCl2/SrCl2 aqueous solution in the subphase of a Langmuir trough in the target proportion (i.e. 10 and 90 mol% of Sr2+ in relation of Ca2+) followed by immersion in phosphate buffer and in supersaturated simulated body fluid. Coating composition and morphology were evaluated using infrared spectroscopy and scanning electron microscopy, respectively, while contact angle measurements assessed coating wettability and surface energy. Randomized screws were then implanted into the tibias of healthy and osteoporotic female rats (G1: Control-Machined, G2: Hap, G3: HapSr10, G4: HapSr90). Osseointegration, assessed 60 days post-implantation, included reverse torque, fluorochrome area, bone tissue-screw contact area, and linear extent of bone-screw contact. Results, grouped by surface treatment (Machined, Hap, HapSr10, HapSr90), revealed that the deposition of Hap, HapSr10, and HapSr90 resulted in thin and rough coatings composed of hydroxyapatite (Hap) on the screw surface with nanoscale pores. The coatings resulted in increased wettability and surface energy of Ti surfaces. The minerals are chemically similar to natural bone apatite as revealed by FTIR analysis. In vivo analyses indicated higher torque values for strontium-containing surfaces in the osteoporotic group (p = 0.02) and, in the control group superior torque for screw removal on the Hap surface (p = 0.023). Hydroxyapatite-treated surfaces enhance morphology, composition, and reactivity, promoting screw osseointegration in healthy and osteoporotic female rats. The incorporation of strontium into the mineral phase has been proposed to not only stimulate osteoblast activity but also reduce osteoclastic resorption, which may explain the improved outcomes observed here in experimental osteoporotic conditions.

A Comprehensive Review on Manufacturing and Characterization of Polyetheretherketone Polymers for Dental Implant Applications.

Aging, tooth trauma, and pathological infections cause partial or total tooth loss, leading to the usage of dental implants for restoration treatments. As such, mechanical and tribological properties play an important role in the osseointegration and durability of these implants. Metallic and ceramic implants are shown to have mechanical properties much higher than the natural teeth structure, leading to stress shielding-related failure of an implant. Stress shielding occurs due to the difference in the elastic modulus between the implant material and the surrounding teeth structure, leading to bone loss and implant failure. The implant's properties (i.e., mechanical) should be as close as human teeth components. To achieve this, various materials and coatings are being developed and investigated. This review is a comprehensive survey of materials, manufacturing, coating techniques, and mechanical and tribological characterizations of dental implants, with a particular focus on polyetheretherketone (PEEK) as a potential alternative dental implant material. PEEK has mechanical properties similar to natural teeth, which make it a promising material for dental implants. The findings of this review suggest that PEEK offers superior biocompatibility, osseointegration, and wear resistance for implant applications. With the help of bioactive coatings, bone growth on the implant surface can be promoted. In addition, PEEK dental implants made using three-dimensional (3D) printing technology can significantly reduce the cost of implants, making them more affordable and increasing access to dental care, which can improve oral health significantly. In summary, this review highlights the potential of PEEK as a promising alternative dental implant material, and provides an overview of various techniques, testing, and future directions for PEEK dental implants.

Physician-dentist dual referral model concept for coordinated bone anabolic therapy.

BACKGROUND: Bone anabolic drugs used for the pharmacologic treatment of osteoporosis have the potential to enhance alveolar bone regeneration to improve implant success. There are no US Food and Drug Administration-approved drugs indicated to improve oral bone density around teeth or implants. METHODS: The authors summarized expert opinions on a novel coordinated treatment approach leveraging the effects of systemic bone anabolic drugs to enhance dental implant therapy in patients with osteoporosis and a dual referral model for physicians and dentists to address the clinical needs of patients with osteoporosis from a comprehensive perspective of oral-systemic health. Interviews of key opinion leaders were conducted with a bone health specialist group consisting of specialists in orthopedic surgery, internal medicine, geriatrics, endocrinology, and clinical densitometry and a surgical dental specialist group consisting of periodontists and oral surgeons. RESULTS: Overall, both groups shared positive feedback on the idea of strategically timing administration of anabolic osteoporosis drugs with dental treatment. Both groups expressed interest in the dual referral model. CONCLUSIONS: The feedback of key opinion leaders supported the coordinated bone anabolic therapy concept and identified a need for improved interdisciplinary collaboration, education, and communication to realize the synergies of physician-dentist clinical cooperation. PRACTICAL IMPLICATIONS: Strategic timing of osteoporosis therapy could improve skeletal bone health and reduce fracture risk while offering adjunctive dental benefits.

Novel use of dynamic navigation for guiding a piezoelectric device during window osteotomy for maxillary sinus floor elevation in complex clinical scenarios.

In patients with severe atrophy of the posterior maxilla requiring lateral maxillary sinus floor elevation (MSFE), the window location and size are commonly designed according to the future implants and anatomical conditions. A window osteotomy becomes challenging when there is an extended edentulous space in the maxilla with no reference from the natural dentition, or when the surgical site involves anatomical variations, for example in the course of a large vessel or a sinus septum. Through preoperative planning and real-time visualization, the application of dynamic navigation allows an accurate location, optimal dimension, and customized shape during lateral window osteotomy. This article introduces a digital protocol for ensuring an accurate and safe window osteotomy for MSFE in complex clinical scenarios, by integrating dynamic navigation and a piezoelectric device.

Simple-Challenging-Difficult (SCD) Difficulty Classification for Vertical Bone Augmentation.

OBJECTIVE: To propose a new difficulty classification for vertical bone augmentation (VBA) based on different defect morphologies. OVERVIEW: VBA procedures for dental implant placement present significant biological and technical challenges. Among the various techniques, guided bone regeneration (GBR) provides an optimal balance between the anticipated bone gain and the likelihood of postoperative complications. Understanding the specific configuration of defects and adjacent bone peaks is essential for tailoring treatment strategies and improving outcomes. The proposed Simple-Challenging-Difficult (SCD) difficulty classification was based on defect morphology (V-shaped, U-shaped, VV-shaped), including defect size (Height: < 5 mm, 5-8 mm, and > 8 mm), proximity of neighboring bony walls (Width: < 10 mm, 10-20 mm, and > 20 mm), as well as predictability of treatment outcomes. CONCLUSIONS: The proposed difficulty classification for VBA serves as a guide for selecting the most appropriate GBR treatment modality and sequence for safe and predictable management of VBA in implant therapy. In addition, when determining the preferred treatment, it is again essential to consider site-specific and patient-related factors alongside the clinician's surgical experience and skill. CLINICAL SIGNIFICANCE: Identifying defect patterns and bone peak structures is crucial, and the proposed classification assists in decision-making in VBA treatment.

The Effect of Implant-Associated Factors on the Long-Term Outcomes of Dental Implants.

The long-term outcomes of dental implants are influenced by a variety of factors, all of which play critical roles in their stability, functionality, and esthetic appeal. This review focuses on several key characteristics of dental implants that impact their success overtime: dimensional, morphologic, material, osseointegrative, and connective/prosthetic characteristics. This article synthesizes current literature to analyze how these factors influence the long-term success of dental implants, emphasizing the need for a comprehensive approach in implant selection and placement.

Bioactive surface modifications on dental implants: a systematic review and meta-analysis of osseointegration and longevity.

BACKGROUND: Bioactive surface modifications have been proposed to enhance osseointegration and longevity of dental implants. This study aimed to systematically review and perform a meta-analysis on the effectiveness of various bioactive coatings in promoting bone integration and improving implant longevity. METHODS: A systematic review was conducted, including studies that investigated bioactive surface modifications on titanium dental implants. Outcomes of interest were bone-to-implant contact (BIC) and implant longevity over a 30-day period. Data were extracted and analyzed using RevMan 5 (version 5.4.1), with forest plots generated to represent the mean difference (MD) and 95% confidence intervals (CI) under a random effects model. RESULTS: The meta-analysis showed a significant improvement in BIC for surface-modified implants, with an overall MD of 7.29 (95% CI [2.94, 11.65]). Heterogeneity analysis indicated moderate heterogeneity (Tau² = 18.57, Chi² = 16.08, df = 8, P = 0.04, I² = 50%). The test for overall effect yielded Z = 3.28 (P = 0.001). For implant longevity, the overall MD was 7.52 (95% CI [3.18, 11.85]), with moderate heterogeneity (Tau² = 17.28, Chi² = 14.95, df = 8, P = 0.06, I² = 47%). The test for overall effect yielded Z = 3.40 (P = 0.0007). CONCLUSION: Bioactive surface changes significantly improved osseointegration and lifespan of dental implants. Collagen-based coatings consistently encouraged early bone integration, while BMP-2 combinations were effective for osseointegration. Optimizing bioactive agent doses and combinations was critical for achieving desired outcomes.

Bibliometric Analysis of 100 Most Cited Articles in Middle East and North Africa (MENA) Region on Implant Prosthodontics.

Aim: This study aims to conduct a comprehensive analysis and scientometric evaluation of the top 100 most cited publications in the field of implant prosthodontics, authored by individuals affiliated with nations of the Middle East and North Africa (MENA) region. Materials and Methods: In October 2023, the 100 most cited articles were gathered from the Web of Science database using the bibliometric research technique. The analysis was conducted on bibliometric indicators, including the distribution of articles over time, authorship, design of study, field of study, nature of research, contribution from various countries in MENA, international research collaboration, and most frequently used keywords by authors. Chi-square and one-way analysis of variance were used for statistical analysis. VOSviewer software was used to analyze the bibliometric network for co-occurrence among countries, coauthors, and common keywords. Results: The results revealed that the top 100 most cited articles from MENA countries on the topic of implant prosthodontics, published between 1995 and 2020, had received an average of 73.31 citations each. About one-third of the papers were published in the top 4 journals. The journal with the most published articles was Clinical Oral Implant Research, followed by the International Journal of Oral & Maxillofacial Implants, the International Journal of Prosthodontics, and the Journal of Oral and Maxillofacial Surgery. Saudi Arabia had the distinction of producing the greatest number of highly cited papers. The co-occurrence network analysis using VOSviewer software identified 10-15 related clusters. Research studies with multiple authors received significantly more citations (P < 0.05). Significant relationships were observed between the number of citations and journal type (open access vs. non-open access; P < 0.05), and also articles published in dental journals received the most citations and were statistically significant (P = 0.001). Conclusion: Over the last decade, there has been a significant surge in research related to implant prosthodontics. Among the countries in the MENA region, Saudi Arabia has distinguished itself by leading in terms of overall research output. This resource would benefit academicians, clinicians, and researchers in prosthodontics, oral surgery, and periodontic specialties of dentistry.

Clinical and in vitro application of robotic computer-assisted implant surgery: a scoping review.

In recent years, the emergence and application of robotic computer-assisted implant surgery (r-CAIS) has resulted in a revolutionary shift in conventional implant diagnosis and treatment. This scoping review was performed to verify the null hypothesis that r-CAIS has a relatively high accuracy of within 1 mm, with relatively few complications and a short operative time. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). From the 3355 publications identified in the PubMed, Scopus, Web of Science, and Google Scholar databases, 28 were finally included after a comprehensive review and analysis. The null hypothesis is partly accepted, as r-CAIS has a relatively high accuracy (coronal and apical deviation within 1 mm), and no significant adverse events or complications have been reported to date, although additional confirmatory studies are needed. However, there is insufficient evidence for a shorter surgical time, and further clinical research on this topic is required.

Combination of metal artifact reduction and sharpening filter application for horizontal root fracture diagnosis in teeth adjacent to a zirconia implant.

Purpose: This study examined the influence of metal artifact reduction (MAR), the application of sharpening filters, and their combination on the diagnosis of horizontal root fracture (HRF) in teeth adjacent to a zirconia implant on cone-beam computed tomography (CBCT) examinations. Materials and Methods: Nineteen single-rooted teeth (9 with HRF and 10 without) were individually positioned in the right central incisor socket of a dry human maxilla. A zirconia implant was placed adjacent to each tooth. Imaging was performed using an OP300 Maxio CBCT (Instrumentarium, Tuusula, Finland) unit with the following settings: a current of 8 mA, both MAR modes (enabled and disabled), a 5×5 cm field of view, a voxel size of 0.085 mm, and a peak kilovoltage of 90 kVp. Four oral and maxillofacial radiologists independently evaluated the CBCT scans under both MAR conditions and across 3 levels of sharpening filter application (none, Sharpen 1×, and Sharpen 2×). Diagnostic metrics were calculated and compared using 2-way analysis of variance (α=5%). The weighted kappa test was used to assess intra- and inter-examiner reliability in the diagnosis of HRF. Results: MAR tool activation, sharpening filter use, and their combination did not significantly impact the area under the receiver operating characteristic curve, sensitivity, or specificity of HRF diagnosis (P>0.05). Intra- and inter-examiner agreement ranged from fair to substantial. Conclusion: The diagnosis of HRF in a tooth adjacent to a zirconia implant is not affected by the activation of MAR, the application of a sharpening filter, or the combination of these tools.

Dental Implant Surface Topography and Stability With Resonance Frequency Analysis: An Overview and Case Report.

Dental implants are fixtures that replace a natural tooth that has been missing. The outcome depends on the safety and longevity of the bone-implant relationship. The process of direct and strong anchoring of an implant due to the surrounding bone tissue growing around it is called osseointegration. The establishment of an osseointegrated contact depends on a variety of systemic and local variables and diagnostic methods. Resonance frequency analysis is one of the methods used to analyze implant stability. The surface topography, mainly surface texture and roughness, also helps in promoting a favorable interaction between the implant and biological tissues. This case report aimed to indicate the importance of implant surfaces showing primary and secondary stability and implant stability quotient (ISQ) values that can be analyzed by resonance frequency analysis (RFA) using the Osstell implant device, which can be a useful tool used to determine the risk of failure.

Survival Rate, Biomechanical Complications, and Patient Satisfaction of Implant-Supported FRC Full-Arch Prostheses: A Retrospective Study with Follow up of 5 Years.

Statement of the Problem: The satisfaction of patients with dentures on implants has different points of view that become fundamental aspects for the development of research on the quality of life of these patients, the eventual biomechanical complications to which these prostheses and implants can be subjected, and design considerations for cantilever extensions. Purpose: The objective of research was to assess the implants and prosthesis survival rates, biomechanical complications relative to the length of the distal extensions (cantilevers), and the satisfaction of the patients with a fixed implant-supported full-arch fiber-reinforced composites prosthesis. Materials and Method: A retrospective clinical and radiographic cohort study was developed. Clinical records of a selected cohort were analyzed according to inclusion and exclusion criteria. Data on a patient who underwent to fixed implant-supported full-arch fiber-reinforced composites prosthesis at least of five years of function were collected. Data analysis was performed using Kaplan-Meier curves and Fisher's Exact Test. P values less than 0.05 were considered statistically significant. Results: After insertion, 1 of 29 prostheses failed, the overall prosthetic survival rate observed at 5 years was 96.5%. Of the 120 implants placed in 28 patients, only 4 patients experienced loss of an implant during the 5 years of observation; the implant survival rate throughout the observation period was 86.2%. Distal extension seems to negatively affect the prognosis of implant-supported rehabilitation. Regarding the level of satisfaction of the patient with the prosthesis, none reported being uncomfortable or dissatisfied neither with their appearance nor with the taste of food throughout the studied period. Conclusion: No relevant associations were found between the variables involved. The study found the improvement in quality of life following the installation of fixed rehabilitation on the patients. Once the potential benefits of patients are obtained, controlled clinical trials are encouraged.

A Cross-Sectional Study of Peri-Implant Diseases in a Random Norwegian Population: Prevalence, Risk Indicators, and Clinical Validation of Patient-Reported Outcomes.

OBJECTIVES: The primary aim of this study was to investigate the prevalence of peri-implant diseases in a randomly selected Norwegian population. The secondary aims were to explore risk indicators for peri-implant diseases and to validate self-reported outcome measures from a survey with clinical parameters. MATERIAL AND METHODS: Patients (n = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire and invited to a clinical examination. A randomly selected subset of responders underwent a clinical examination (n = 242). Full mouth clinical and radiographic examinations were conducted. Multiple logistic regression was used to assess patient-related risk indicators for peri-implantitis. Self-reported data were compared with data from the clinical examination using Spearman correlation and binary logistic regression. RESULTS: The prevalence of peri-implantitis was 17.0% at patient level and 8.6% at implant level, according to the 2018 classification. Risk indicators for peri-implantitis included smoking and periodontitis in the adjusted model. The correlation was strong (r = 0.91, p < 0.001) between number of self-reported implants and clinical counts, whereas self-reported peri-implant inflammation was associated with peri-implantitis (OR 6.4 [95% CI 3.0, 13.7]). CONCLUSIONS: Smoking and periodontitis were identified as key risk indicators for peri-implantitis. Questionnaire data rendered clinically valid estimates of implant number, and self-reported peri-implant inflammation was associated with clinical peri-implantitis.

The Applications of 3D-Printing Technology in Prosthodontics: A Review of the Current Literature.

Prosthodontics has become increasingly popular because of its cosmetic attractiveness. 3D printing has revolutionized prosthodontics, enabling the creation of high-quality dental prostheses. It creates detailed restorations, such as crowns, bridges, implant-supported frameworks, surgical templates, dentures, and orthodontic models. In addition, it saves production time but faces challenges such as elevated expenses and the requirement for innovative materials and technologies. This review gives insights into the uses of 3D printing in prosthodontics, presenting how it has significantly changed clinical practices. This article discusses different materials and techniques. Additionally, it showcases the capacity of 3D printing to improve prosthodontic practice and proposes prospects for future investigation.

Evaluation of Postoperative Effects of Using Ozonated Water as an Irrigant on Soft and Hard Tissues Surrounding Dental Implants: A Randomized Controlled Clinical Trial.

Aim To evaluate the short-term and long-term postoperative effects of ozonated water when used as an irrigant in terms of postoperative pain, healing, and implant stability when compared to normal saline irrigation during implant surgery, both carried out using conventional drilling protocol. Methods A total of 34 implants were placed in 17 patients, two implants in each patient, one implant using normal saline as an irrigant and another one using ozonated water as an irrigant during the surgical procedure of implant site osteotomy. Postoperative pain was assessed after 48 hours of the surgical procedure using the visual analog scale (VAS). Soft tissue healing was assessed after eight days using the tissue healing index. Osseointegration was checked by measuring the primary stability at the moment of implant placement and comparing it to the secondary stability measured three months after the implant placement. These stability values (ISQ) were obtained using resonance frequency analysis (RFA). Results The VAS scores for the control group (Group A) after 48 hours were 71.76±5.57 and for the experimental group (Group B) after 48 hours were 47.64±5.33 so mean values in the experimental group were significantly lower as compared to that in the control group (p<0.001). The mean healing index score for the control group (Group A) was 3.35±0.49 and the mean healing index score for the experimental group (Group B) was 4.64±0.49 so the mean values of tissue healing index in the experimental group were significantly higher as compared to that in the control group (p<0.001). The increase in stability value over the period of three months is 5.83 ISQ in the control group while the increase in stability value over the period of three months is 7.06 ISQ in the experimental group. The difference although not statistically significant shows a slight increase in stability in the experimental group as compared to that of the control group. Conclusion Ozone water irrigation at implant site osteotomy reduced postoperative pain and accelerated the tissue wound healing but the significant effect on osseointegration could not be determined.