Influence of Immediate Implant Placement and Provisionalization with or without Soft Tissue Augmentation on Hard and Soft Tissues in the Esthetic Zone: A One-Year Retrospective Study.

The purpose of this clinical research was to evaluate peri-implant marginal changes around immediate implants placed either with the application of SCTG or XCM or without soft tissue grafting. A total of 48 patients requiring a single implant-supported restoration in the anterior jaw were selected for inclusion. Three surgical procedures were performed, as follows: type 1 implant with subepithelial connective tissue graft (SCTG), type 1 implant with xenogenic collagen matrix (XCM), and type 1 implant without soft tissue augmentation (NG) (control group). The marginal change of peri-implant soft tissue, facial soft tissue thickness (FSTT), peri-implant health status, esthetics, and patient satisfaction were assessed at one year after surgery. All of the placed implants showed a survival rate of 100%. No significant differences in FSTT were recorded between the SCTG group and the XCM group after treatment (P > 0.05), while the NG group presented a significant difference (P < 0.05). Patients in the NG group lost significantly more in the buccal marginal level than did patients in the SCTG group and those in the XCM group (P < 0.05). The favourable success rate recorded in all groups confirmed immediate tooth replacement as a choice of treatment for a missing anterior single tooth. The NG group presented significant changes of FSTT and buccal marginal level, while XCM constituted a viable alternative to SCTG.

Prosthetic treatment in the adult French population: Prevalence and relation with demographic, socioeconomic and medical characteristics.

BACKGROUND: The aim of this study was to estimate the prevalence of dental prosthetic treatment and to investigate the demographic, social, economic and medical factors associated with the use of fixed and removable dentures in a representative sample of adults living in France. METHODS: The data were obtained from the 2002-2003 Decennial Health Survey, a cross-sectional study of a representative sample of the population living in France, which included 29,679 adults. Information was collected by interview. The variables collected were fixed denture, removable denture, age, gender, number of children, area of residence, nationality, educational attainment, family social status, employment status, annual household income per capita, supplementary insurance, chronic disease, eyesight problems/glasses, hearing problems/hearing aids. Multinomial logistic regression models were used to study the relationship between prosthetic treatment and demographic, socioeconomic and medical characteristics unadjusted, adjusted for age and adjusted for all the characteristics. RESULTS: The prevalence of prosthetic treatment was 34.6% (95% confidence interval (CI): [34.1; 35.2]) for fixed prosthetic dentures and 13.8% (95% CI: [13.4; 14.2]) for removable prosthetic dentures. We showed a gradient between educational attainment and removable dentures; the odds ratio adjusted for all the variables (aOR) associated with no or primary education compared to post-secondary education was 2.56; 95% CI: [2.09; 3.13]. When annual household income per capita was low, subjects were less likely to report fixed dentures (aOR=0.68; 95% CI: [0.62; 0.75]) than those with high annual household income per capita. Individuals without insurance less often reported fixed dentures than those with private insurance. Those reporting chronic disease were less likely to report fixed dentures (aOR=0.87; 95% CI: [0.79; 0.95]) but more likely to report removable dentures (aOR=1.29; 95% CI: [1.17; 1.43]) than those without chronic disease. CONCLUSION: This study reveals social, economic and medical inequalities in fixed and removable prosthetic treatment among adults in France.

Dental Students' Exposure to Periodontal and Implant Placement Surgeries in U.S. Dental Schools.

The aim of this study was to assess nationwide trends in the exposure of dental students to periodontal and implant surgical procedures and to evaluate the potential factors that influence these clinical experiences. A 19-item questionnaire was sent to all 64 directors of predoctoral periodontics in U.S. dental schools. In addition to gathering information on the percentage of students who perform surgical periodontics or implant placement procedures in each program, data on student research groups, periodontics residency programs, and periodontics faculty practices were collected. A total of 33 responses were received, for a response rate of 51.5%. Among the responding institutions, 97% and 45.5% allowed dental students to perform periodontal and dental implant placement surgeries, respectively, although only 26.4% and 15.2% of the dental class ended up performing periodontal and dental implant placement surgeries, respectively. Crown lengthening was the most commonly reported (84.8%) periodontal surgical procedure performed by dental students. A negative correlation was found between the presence of a periodontics residency program and dental students' placing dental implants, while the size of the residency program positively correlated with dental students' placing dental implants. Overall, a wide variation in the exposure of dental students to periodontal and dental implant placement surgical experiences was found. Future surveys should assess clinical procedures performed in other special-ties to gain a broader picture of the experience students are gaining in these areas.

"Burden of the Triumph:" Burden of peri-implantitis in Indian population - A mathematical model.

CONTEXT: India suffers from a heavy burden of oral diseases. Dental implants (DIs) are prescribed widely by the dental practitioners to replace lost natural teeth. There is no estimate, however, to determine the number of DIs or the number of people with peri-implantitis or the failure of implants after placement. In this modeling study, we attempted to estimate the prevalence of adult Indians who would choose DI in the near future and to calculate the peri-implantitis and failure of DI. MATERIALS AND METHODS: Using the Global Burden of Disease database (2016), the number of dental caries in permanent dentition, periodontal diseases, and edentulism was obtained. Empirical assumptions of patients with anodontia in urban and rural areas who opted for DI, percentage of implants placed, the affordability factors, and mathematical models for DI were formed and executed. Peri-implantitis and survival data from literary evidence were collated. RESULTS: Based on assumptions, 909,643 Indians, (830,231-858,703) would choose DI. Estimated number of peri-implantitis would be 145,543-254,700 and estimated number of failures should be 50,940-79,412 in the near future. CONCLUSIONS: In spite of the high economic challenge and the risks or complications of peri-implantitis, DIs are gaining prominence. It is the dentists' burden to face the renewed challenges due to emerge and provide remedial measures.

The role of hyperbaric oxygen therapy in the prevention and management of radiation-induced complications of the head and neck - a systematic review of literature.

Radiation therapy for the treatment of head and neck cancer can injure normal tissues and have devastating side effects. Hyperbaric oxygen (HBO) is known to reduce the severity of radiation-induced injury by promoting wound healing. While most of the research in literature has focused on its efficacy in osteonecrosis, HBO has other proven benefits as well. The aim of this review was to identify the various benefits of hyperbaric oxygen therapy in patients who have undergone radiation for head and neck cancer. An electronic database search was carried out to identify relevant articles and selected articles were reviewed in detail. The quality of evidence for each benefit, including preserving salivary gland function, preventing osteonecrosis, dental implant success, and overall quality of life, was evaluated. Evidence showed that HBO was effective in improving subjective symptoms of xerostomia, swallowing, speech and overall quality of life. There was no conclusive evidence to show that HBO improved implant survival, prevented osteonecrosis, or improved salivary gland function. The high costs and accessibility of HBO therapy must be weighed against the potential benefits to each patient.

Oral health-related quality of life and implant therapy: A prospective multicenter study of preoperative, intermediate, and posttreatment assessment.

PURPOSE: Loss of teeth is associated with a significant reduction in quality of life. The aim of this prospective multicenter study was to assess the impact of dental implants on oral health-related quality of life (OHRQoL). MATERIAL AND METHODS: Patients with various kinds of indications for dental implants ranging from single-tooth loss to edentulous jaws were included. Quality of life related to dental implants was assessed through the Oral Health Impact Profile (OHIP-G 21), which has a score from 0 to 20 in healthy patients. RESULTS: In total, 8689 patients from 17 centers from 2009 to 2014 were enrolled in the study. The sex distribution was almost even (53.3% men, 46.7% women). The most frequent indications for the insertion of dental implants were free-end gaps (30.6%) and posterior single-tooth gaps (27%). In all, 12.4% of patients had an edentulous jaw. For all indications, patients reported significant changes in mean OHIP scores after prosthetic reconstruction. The most significant improvements in the OHIP score occurred in the groups of patients with edentulous jaws (pretreatment score: 42.3) after prosthodontic reconstruction (score: 24.8) and in the patient group with an anterior single-tooth gap (pretreatment score: 36.4) after prosthodontic reconstruction (score: 24.8). CONCLUSION: The insertion of dental implants and prosthodontic rehabilitation led to an improved OHRQoL for patients with all indications for dental implants, with the most significant improvements in patients with edentulous jaws and anterior single-tooth gaps.

Eficácia de um agente cimentante e antisséptico no controle bacteriano nas conexões dos implantes / Efficacy of a cementing and antiseptic agent in preventing contamination and bacterial flow at the dental implant connection

Objetivo: avaliar a eficácia de um antisséptico de longa duração no controle microbiano dos espaços entre o implante e o parafuso de cobertura (PC), pela contagem das unidades formadoras de colônias (UFCs) no ato da reabertura. Material e métodos: foram selecionados 70 sítios em 17 pacientes, para instalação de implantes dentais, e divididos aleatoriamente em dois grupos. No grupo experimental (n=35), o antisséptico foi aplicado na rosca do PC, imediatamente antes de sua instalação. No grupo-controle, a instalação do PC foi feita sem o antisséptico. A reabertura foi realizada após seis meses e os PCs foram removidos e armazenados em frascos assépticos contendo solução salina. Cada amostra foi centrifugada, diluída seriadamente até 10-10, semeada e encubada em microaerofi lia para a cultura de UFCs. Após a contagem, as análises estatísticas comparativas foram feitas pelo teste de Kruskal-Wallis (p < 0,05). Resultados: o grupo-controle apresentou média de 7,18 x 107 UFC/ml, enquanto no experimental a média foi de 2,12 x 105 UFC/ml. O crescimento bacteriano foi significativamente menor no grupo experimental (p=0,0003). Conclusão: o antisséptico reduziu signifi cativamente o crescimento bacteriano entre implante e parafuso de cobertura, tendo sido eficaz no controle microbiano destes espaços.

Objective: to evaluate the effi cacy of a long-term antiseptic in bacterial control of the spaces between the implant and the cover screw (PC), by counting colony-forming units (UFC) at the time of the re-entry surgery. Material and methods: seventy sites for implant placement were selected in 17 patients referred for dental implants, and divided randomly into two groups. In the experimental group (n=35), the antiseptic was applied on the thread of the PC immediately before installation. In the control group, the PC was installed with no antiseptic. The re-entry was performed after six months, the PCs removed and stored in asseptic recipients containing saline solution. Each sample was centrifuged, diluted serially up to 10-10, seeded and incubated in microaerophilic conditions for CFU culture. After counting, statistical comparative analyzes were performed by Kruskal-Wallis test (p < 0.05). Results: the control group had a mean of 7.18 x 107 CFU/mL, while the experimental average was 2.12 x 105 CFU/mL. Bacterial growth was significantly lower in the experimental group (p=0.0003). Conclusion: the antiseptic reduced, significantly, the bacterial contamination in the spaces between the implant and the cover screw, being effective in the microbial control of those spaces.

O uso de gengiva artificial para melhorar a estética de dentes naturais e implantes / The use of artificial gum to improve aesthetic of natural teeth and implants

Apesar dos grandes esforços feitos para alcançar o resultado estético das restaurações implantossuportadas, complicações podem ocorrer. Para o tratamento destas complicações, correções podem ser necessárias, sendo elas cirúrgicas (reconstrução óssea e do tecido mole) ou protéticas. Quando muito extensas e diante da recusa dos pacientes pelos procedimentos cirúrgicos, a alternativa para estas situações clínicas é a prótese gengival. Esta pode ser fixa ou removível e feita a partir de acrílico, resinas e materiais à base de porcelana. Pode ser utilizada para reconstruir proteticamente regiões onde houve perda de estrutura óssea e/ou de tecido mole, para minimizar defeitos estéticos de exposição da cinta metálica em componentes angulados, e em casos de doença periodontal com migração apical da margem gengival, provocando sensibilidade, dificuldades fonéticas por escape do ar e espaços negros na região de dentes anteriores. Compreender os métodos usados para incorporar próteses gengivais em tratamento protético é vital para assegurar que aos pacientes sejam oferecidas todas as possíveis opções no início do planejamento do tratamento. É procedimento de baixo custo e confecção, ao alcance de qualquer laboratório e facilmente aceito pelos pacientes pela facilidade de manutenção (AU)

Despite the great efforts to achieve good aesthetic results of dental implants restorations, complications can occur. For the treatment of these complications, corrections may be necessary. This corrections can be surgical (bone and soft tissue reconstruction) or prosthetic. When major reconstructions are required and the patient refuses to submit to surgical procedures, the prosthetic gingival reconstruction is an alternative. This prosthesis can be fixed or removable and made of acrylic, resin materials and porcelain. It can be used to reconstruct prosthetic regions with bone and/or soft tissue loss, to minimize metal exposure of angulated abutments in aesthetic regions, and in cases of periodontal disease and apical migration of gingival margin, causing sensitivity, phonetic problems due to air escape, and black spaces in the region of anterior teeth. Understanding the methods used to incorporate gingival prostheses in prosthetic treatments is vital to ensure that patients all possible options are presented to the patient at the beginning of treatment planning. It is a low cost procedure that can be manufactured by any laboratory and easily accepted by patients due to its simple maintenance (AU)

Implantes de diâmetros reduzidos extrafinos em áreas estéticas: relato de caso / Superfine narrow diameter implants in aesthetic zones: case report

As regiões que devam ser reabilitadas com implantes, quando pobres em volume ósseo, podem inviabilizar a utilização de implantes de diâmetro padrão. Quando, por alguma razão, as técnicas de regeneração óssea coadjuvantes não são as escolhas desejáveis, os implantes de diâmetro reduzido extrafinos podem ser uma alternativa satisfatória, inclusive em áreas estéticas. O objetivo do presente artigo foi descrever o emprego dessa solução mediante o relato de um caso clínico, no qual foram empregados dois implantes de diâmetro reduzido extrafinos, para a reabilitação estética imediata das áreas de incisivos laterais superiores com espessura óssea reduzida, em uma paciente cuja condição (Síndrome de Down) não permitiria o emprego de técnicas regenerativas sem anestesia geral (AU).

The regions to be rehabilitated with implants, when having poor bone volume, may hinder the use of standard diameter implants. When for some reason, the supporting bone regeneration techniques are not desirable choices, narrow superfine implants can be a satisfactory alternative, including aesthetic zones. The goal of this article was to describe the use of this solution through a clinical case report in which two superfine narrow diameter implants were used for the immediate aesthetic rehabilitation of upper lateral incisors with reduced bone thickness in a patient whose condition (Down Syndrome) would not allow the use of regenerative techniques without general anesthesia (AU).

The importance of implantology in the undergraduate program and the experience of an institution / La importancia de la implantología en el programa de pregrado y la experiencia de una institución

The aim of this study was to identify the teaching discipline of Implantology in all the dental schools in Brazil and report the 9 years of experience after the induction of this material in a teaching institution. The universal sample consisted of dental schools accredited by the Federal Council of Dentistry (n= 198). The results were analyzed with the SPSS Statistics IBM program. It was observed that the discipline of Implantology is offered by 26.9% of the institutions in the fourth year of the undergraduate course. The format of the lessons is 83.3% theory and laboratory. It is also important to note that 2.5% of the institutions do not offer Implantology as a discipline, and in 33.3% of the cases, it appears as a mandatory subject. In order to report the experience, it was observed that the patients' quality of life increased after implantation, and 69.8% classified mastication as excellent after placement of the implant element. Thus, the format offered in the discipline of Implantology proved quite variable according to each institution. The high levels of satisfaction with dental implants and the increased demand for this procedure allowed a suggestion for a possible standardization of the discipline.

El objetivo fue identificar la enseñanza de la disciplina de Implantología en todas las escuelas de odontología en Brasil y reportar los 9 años de experiencia después del inicio de esta disciplina en una institución. La muestra consistió en escuelas de odontologia acreditadas por el Consejo Federal de Odontología (n= 198). Los resultados fueron analizados con el paquete estadístico SPSS IBM. La disciplina de Implantología es ofrecida por el 26,9% de las instituciones en el cuarto año del pregrado en Odontología. El formato de clases fue teórico y práctico (83,3%). En 2,5% de las instituciones no se ofrece Implantología como disciplina, y en 33,3% de los casos, aparece como una disciplina obligatoria. Con el fin de informar la experiencia de una institución, se observó que la calidad de vida de los pacientes aumentó después de la colocación de implantes y 69,8% clasificaron su masticación como excelente después de la colocación de implantes. El formato que se ofrece en la disciplina de Implantología se mostró muy variable en cada institución. Los altos niveles de satisfacción con los implantes dentales y el aumento de la demanda de este procedimiento permite una sugerir una posible normalización de la disciplina.

An Assessment of the Risk of Bias in Randomized Controlled Trial Reports Published in Prosthodontic and Implant Dentistry Journals.

PURPOSE: The objective of this study was to assess the risk of bias of randomized controlled trials (RCTs) published in prosthodontic and implant dentistry journals. MATERIALS AND METHODS: The last 30 issues of 9 journals in the field of prosthodontic and implant dentistry (Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, Implant Dentistry, International Journal of Oral & Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics, Journal of Dentistry, Journal of Oral Rehabilitation, and Journal of Prosthetic Dentistry) were hand-searched for RCTs. Risk of bias was assessed using the Cochrane Collaboration's risk of bias tool and analyzed descriptively. RESULTS: From the 3,667 articles screened, a total of 147 RCTs were identified and included. The number of published RCTs increased with time. The overall distribution of a high risk of bias assessment varied across the domains of the Cochrane risk of bias tool: 8% for random sequence generation, 18% for allocation concealment, 41% for masking, 47% for blinding of outcome assessment, 7% for incomplete outcome data, 12% for selective reporting, and 41% for other biases. CONCLUSION: The distribution of high risk of bias for RCTs published in the selected prosthodontic and implant dentistry journals varied among journals and ranged from 8% to 47%, which can be considered as substantial.

Publication of statistically significant research findings in prosthodontics & implant dentistry in the context of other dental specialties.

OBJECTIVES: To assess the hypothesis that there is excessive reporting of statistically significant studies published in prosthodontic and implantology journals, which could indicate selective publication. METHODS: The last 30 issues of 9 journals in prosthodontics and implant dentistry were hand-searched for articles with statistical analyses. The percentages of significant and non-significant results were tabulated by parameter of interest. Univariable/multivariable logistic regression analyses were applied to identify possible predictors of reporting statistically significance findings. The results of this study were compared with similar studies in dentistry with random-effects meta-analyses. RESULTS: From the 2323 included studies 71% of them reported statistically significant results, with the significant results ranging from 47% to 86%. Multivariable modeling identified that geographical area and involvement of statistician were predictors of statistically significant results. Compared to interventional studies, the odds that in vitro and observational studies would report statistically significant results was increased by 1.20 times (OR: 2.20, 95% CI: 1.66-2.92) and 0.35 times (OR: 1.35, 95% CI: 1.05-1.73), respectively. The probability of statistically significant results from randomized controlled trials was significantly lower compared to various study designs (difference: 30%, 95% CI: 11-49%). Likewise the probability of statistically significant results in prosthodontics and implant dentistry was lower compared to other dental specialties, but this result did not reach statistical significant (P>0.05). CONCLUSIONS: The majority of studies identified in the fields of prosthodontics and implant dentistry presented statistically significant results. The same trend existed in publications of other specialties in dentistry.

Osteoporosis and bisphosphonate-related osteonecrosis in a dental school implant patient population.

PURPOSE: Studies have demonstrated an inconsistent association between implant failure and bone mineral density. The prevalence of osteoporosis in US adults has been reported to range from 5% to 10% in women and from 2% to 4% in men. The prevalence of bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) has been reported to range from 0% to 4.3% of patients taking oral BPs. The purpose of this study was to calculate the risk of dental implant loss and the incidence of BRONJ in patients with osteoporosis at the University of Kentucky College of Dentistry (UKCD). MATERIALS AND METHODS: This study analyzed data collected from patients who had implants placed between 2000 and 2004 at UKCD. Data were gathered from patient interviews regarding implant survival and patient-satisfaction parameters, and interviews were conducted either chairside at a scheduled maintenance appointment or by telephone interview. RESULTS: Among 203 patients who received 515 implants, the prevalence of osteoporosis was 23.3% for women and 1.2% for men. None of the 20 patients who reported a history of oral BP use exhibited BRONJ, and there were no implant failures in patients with a history of osteoporosis. CONCLUSIONS: In this study, osteoporosis conferred no risk of implant failure, and oral BP therapy was not associated with BRONJ.

Periimplant bacteria associated with different transmucosal designs or smoking habits.

PURPOSE: This study is to compare periimplant microbiota associated with implant transmucosal designs or smoking habits. METHODS: Submucosal samples from healthy 52 implants were collected for analysis of bacteria associated with bone-level (n = 37) or tissue-level (n = 15) implants or smoking habits, using quantitative polymerase chain reaction. Profiles of periimplant bacteria of smokers (n = 5) were investigated using PhyloChip Array version G3 and compared with nonsmokers (n = 5). RESULTS: The number of bone-level implants positive for at least 1 pathogen was higher than that of tissue level; however, differences in each bacterium were insignificant. The prevalence and abundance of Treponema denticola in smokers were significantly higher than that in nonsmokers (P < 0.05). Smokers and nonsmokers exhibited similar periimplant microbiota based on the PhyloChip Array, but they could be distinguished by limiting observations to only 18 operational taxonomic units. Streptococcus macedonicus within Firmicutes and Prevotella within Bacteroidetes were more abundant in smokers compared with nonsmokers. CONCLUSION: Prevalence of putative pathogens with bone-level implants was higher than tissue-level implants in nonsmokers. Firmicutes and Bacteroidetes were significantly higher in smokers. Smoking therefore strongly influenced peri-implant bacterial composition of bone-level implant.

Retrospective clinical outcome of nanopolymorphic crystalline hydroxyapatite-coated and anodic oxidized titanium implants for 10 years.

PURPOSE: Nanopolymorphic crystalline Hydroxyapatite (HA)-coated implants were different in surface property from conventional HA-coated implants subjected to previous clinical studies. The purposes of the present study were to retrospectively evaluate 10-years clinical outcome of the HA-coated implants (HA implants) with a comparison to the same system implants with anodic oxidized titanium surface (Ti implants). METHODS: Cumulative survival rate (CSR) of HA or Ti implants placed in 183 patients (55±12.4 years old) over two decades was calculated with life table analysis. Differences in CSR at each interval year, sex, age, frequency of number of implant placement according to implant location and diameter were compared between both types of implants. RESULTS: Total 455 HA implants and 255 Ti implants were included. CSR at upper molar site was consistently higher in HA implants than Ti implants until 8 years after placement. The values after 10 years was 89.9% or 77.7% in HA or Ti implants, respectively. There were no significant differences in overall CSR at any interval year. HA implants were more distributed at upper molar site but less at lower molar site than Ti implants. Diameter of HA implants tended to be wider than Ti implants. CONCLUSIONS: Under limitation of this retrospective study, the nanopolymorphic crystalline HA-coated implants were more survived at upper molar site than anodic oxidized implants until 8 years after placement. This clinical outcome might attribute to differences in topographical and physicochemical characteristics between both types of implants.

Implant therapy in a surgical specialty clinic: an analysis of patients, indications, surgical procedures, risk factors, and early failures.

PURPOSE: The aim of this study was to analyze the patient pool referred to a specialty clinic for implant surgery over a 3-year period. MATERIALS AND METHODS: All patients receiving dental implants between 2008 and 2010 at the Department of Oral Surgery and Stomatology were included in the study. As primary outcome parameters, the patients were analyzed according to the following criteria: age, sex, systemic diseases, and indication for therapy. For the inserted implants, the type of surgical procedure, the types of implants placed, postsurgical complications, and early failures were recorded. A logistic regression analysis was performed to identify possible local and systemic risk factors for complications. As a secondary outcome, data regarding demographics and surgical procedures were compared with the findings of a historic study group (2002 to 2004). RESULTS: A total of 1,568 patients (792 women and 776 men; mean age, 52.6 years) received 2,279 implants. The most frequent indication was a single-tooth gap (52.8%). Augmentative procedures were performed in 60% of the cases. Tissue-level implants (72.1%) were more frequently used than bone-level implants (27.9%). Regarding dimensions of the implants, a diameter of 4.1 mm (59.7%) and a length of 10 mm (55.0%) were most often utilized. An early failure rate of 0.6% was recorded (13 implants). Patients were older and received more implants in the maxilla, and the complexity of surgical interventions had increased when compared to the patient pool of 2002 to 2004. CONCLUSION: Implant therapy performed in a surgical specialty clinic utilizing strict patient selection and evidence-based surgical protocols showed a very low early failure rate of 0.6%.

Implant angulation: 2-year retrospective analysis on the influence of dental implant angle insertion on marginal bone resorption in maxillary and mandibular osseous onlay grafts.

OBJECTIVES: The purpose of this study was to determine the existence of correlations between marginal peri-implant linear bone loss and the angulation of implants in maxillary and mandibular augmented areas over the course of a 2-year survey. MATERIALS AND METHODS: Dependent variables described the sample of the present retrospective chart review. By using three-dimensional radiographs, input variables, describing the implant angulation (buccal-lingual angle [φ] and mesial-distal angle [θ]) were measured; outcome variables described survival rate and marginal bone resorption (MBR) around dental implants in autogenous grafts (10 maxillae and 14 mandibles). Pairwise comparisons and linear correlation coefficient were computed. RESULTS: The peri-implant MBR in maxillary buccal and palatal areas appeared less intensive in the presence of an increased angulation of an implant towards the palatal side. Minor MBR was recorded around mandibular dental implants positioned at a right angle and slightly angulated towards the mesial. CONCLUSIONS: Resorption in buccal areas may be less intensive as the angulation of placed implants increases towards the palatal area in the maxilla, whereas for the mandible, a greater inclination towards the lingual area could be negative. In the mandibular group, when the implant was slightly angulated in the direction of the distal area, bone resorption seemed to be more marked in the buccal area. CLINICAL RELEVANCE: In the planning of dental implant placement in reconstructed alveolar bone with autograft, the extremely unfavourable resorption at the buccal aspect should be considered; this marginal bone loss seemed to be very sensitive to the angulation of the dental implant.

A national survey of restorative consultants' treatment provision for head and neck oncology patients.

AIM: To investigate current UK practices in the treatment of head and neck oncology patients by consultants in restorative dentistry. METHOD: A postal questionnaire requesting details of surgical and restorative head and neck oncology care from diagnosis to oral rehabilitation was circulated to all 315 consultants in restorative dentistry in the UK. If a reply was not received within 12 weeks a follow up was sent. RESULTS: One hundred and thirty-two (43%) completed questionnaires were returned. On average 46% of respondents treated head and neck oncology patients, this varied with geographical location. Sixty percent of consultants' weekly workload was less than 25% oncology related, while 13% indicated more than 75%. Of the cohort providing oncology care only 12% thought there was always time for dental screening pre-radiotherapy, furthermore 67% had difficulty liaising with primary care. Within the UK great variety existed between attendance at multidisciplinary team meetings, dental care professional support, and provision of dental implant reconstruction including timing, manufacturer, operator, and funding. CONCLUSION: Significant variation in dental input into head and neck oncology patients' pathways exists, most notably with pre-radiotherapy screening. This study highlights a change in trend for patient rehabilitation with dental implants, and an increase to 52% of restorative dentistry consultants' attendance during a multidisciplinary team meeting.

Reporting of statistical results in prosthodontic and implantology journals: p values or confidence intervals?

PURPOSE: Confidence intervals (CIs) are integral to the interpretation of the precision and clinical relevance of research findings. The aim of this study was to ascertain the frequency of reporting of CIs in leading prosthodontic and dental implantology journals and to explore possible factors associated with improved reporting. MATERIALS AND METHODS: Thirty issues of nine journals in prosthodontics and implant dentistry were accessed, covering the years 2005 to 2012: The Journal of Prosthetic Dentistry, Journal of Oral Rehabilitation, The International Journal of Prosthodontics, The International Journal of Periodontics & Restorative Dentistry, Clinical Oral Implants Research, Clinical Implant Dentistry and Related Research, The International Journal of Oral & Maxillofacial Implants, Implant Dentistry, and Journal of Dentistry. Articles were screened and the reporting of CIs and P values recorded. Other information including study design, region of authorship, involvement of methodologists, and ethical approval was also obtained. Univariable and multivariable logistic regression was used to identify characteristics associated with reporting of CIs. RESULTS: Interrater agreement for the data extraction performed was excellent (kappa = 0.88; 95% CI: 0.87 to 0.89). CI reporting was limited, with mean reporting across journals of 14%. CI reporting was associated with journal type, study design, and involvement of a methodologist or statistician. CONCLUSIONS: Reporting of CI in implant dentistry and prosthodontic journals requires improvement. Improved reporting will aid appraisal of the clinical relevance of research findings by providing a range of values within which the effect size lies, thus giving the end user the opportunity to interpret the results in relation to clinical practice.