Clinical outcomes of 3-5 years follow-up of immediate implant placement in posterior teeth: a prospective study.

BACKGROUND: Immediate implant placement in posterior teeth has become popular in recent years. However, only a few studies focused on evaluating the long-term success of immediate implant placement. PURPOSE: To analyze the clinical outcomes of immediate implant placement in the posterior region with conventional loading with 3-5 years follow-up following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. METHOD: The study was done in 25 bone-level implants (Straumann® SLActive® bone level tapered implant, Straumann®, Basel, Switzerland) in 19 patients who underwent immediate implant placement in a posterior tooth with conventional loading with 3-5 years follow-up. The overall success and survival of these placements were evaluated following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference using chart records, clinical examination, radiographic evaluation, and outcomes measurement. Patient satisfaction was evaluated by using a numeric rating scale. The biological and technical status, modified Pink Esthetic Score (mPES), complications, and marginal bone change were also evaluated. The analysis was done using SPSS version 21 (SPSS Inc., Chicago, IL, USA). The data were analyzed using a paired samples t-test. RESULTS: It was found that 24 out of the 25 (96%) dental implants survived for an average of 57 ± 8.07 months. All of the 24 surviving dental implants were considered an operational success. The average mPES was 9.75 ± 0.44. The major prosthetic complications seen were: (1) proximal contact loss (41.67%), (2) loosening of the screw (8.33%), and (3) cement debonding (4.17%). CONCLUSIONS: Immediate implant placement in a posterior tooth with conventional loading yields a predictable result with some complications. The most prominent complications were proximal contact loss, followed by loosening of the screw and cement debonding. The implant survival rate was 96% at a mean time follow-up of 4 years and 9 months.

Soft tissue dimensional change using customized titanium healing abutment in immediate implant placement in posterior teeth.

BACKGROUND: The morphologic and dimensional alveolar bone is significant for resorption in the first 3 months after tooth removal because they restrict treatment outcomes with respect to function and esthetic. Following teeth extraction, the width and height of the alveolar ridge contour are reduced in both the horizontal and vertical dimensions. Following implant placement, the gingival morphology should be changed minimally compared to pre-extraction. Surrounding natural-like tissue is also an ultimate goal of the dental implant treatment, which is correlated with the cervical third contour on the anatomical tooth, for comfortable cleansing, food impaction avoidance, and esthetics. PURPOSE: To evaluate the peri-implant soft tissue changes after immediate implant placement (IIP) with the use of a customized titanium healing abutment in the posterior teeth. METHOD: Digital impressions using the intraoral scanner (MEDIT i500) were taken from 30 patients. Customized titanium healing abutments were designed and milled before extraction. Flapless extractions were done using surgical guides, 32 immediate implants placement were done in posterior areas, and healing abutments were placed. Soft tissues were scanned during pre-operation, and post-surgery during the 1st, 3rd, and 6th months. A 3D analysis program (Final Surface) evaluated the gingival margin distance, height, contour width, and volume in each period. SPSS was used to analyze the data with a p-value = 0.05. The between-time interval comparisons were done and the analysis was done using a Multivariate test. RESULTS: Customized titanium healing abutments used in immediate implantation maintained optimal peri-implant mucosa. In intermittent periods, there was no significant reduction in all aspects of the margin distances and heights. During the entire period, the margin height reduction on the buccal, lingual, mesial, and distal was 0.63 mm, 0.93 mm, 0.08 mm, and 0.24 mm, respectively, and contour width reduction on the buccal, lingual, and buccolingual was 0.59 mm, 0.43 mm, and 1.03 mm, respectively. There was a significant reduction in the total buccolingual contour width in the 1st month and total volume in the 3rd to 6th months. CONCLUSIONS: Immediate implant placement with customized titanium healing abutment can achieve the optimal peri-implant mucosa and this protocol is an alternative for soft tissue management.

Efficacy of Biofilm Removal on the Dental Implant Surface by Sodium Bicarbonate and Erythritol Powder Airflow System.

OBJECTIVE: Peri-implantitis is a common complication in implant therapy and it is one of the main contributing factors to implant failure. This can be prevented by regular maintenance with mechanical debridement. One of the recent mechanical debridement methods is air abrasion therapy using different abrasive powders. This study aimed to evaluate the two common abrasive powders of different sizes (sodium bicarbonate and erythritol) for their biofilm cleaning efficacy on dental implant surfaces. MATERIALS AND METHODS: In an in vitro setting, a total of 33 implants were divided into three groups: Group 1 (n =11) = no treatment; group 2 (n = 11) = air abrasion therapy treated group using a sodium bicarbonate powder (AIRFLOW Powder Classic Comfort, EMS Electro Medical Systems, Nyon, Switzerland); and group 3 (n = 11) = air abrasion therapy treated group using an erythritol powder (AIRFLOW Powder Plus, EMS Electro Medical Systems, Nyon, Switzerland). The implants in each group were subjected to biofilm formation, and group 2 and group 3 were treated with air abrasion therapy of two different powders having different sizes with the same settings. The particle sizes were sodium bicarbonate (40 µm) and erythritol (14µm). The surface characteristics of the dental implants in three groups were studied from a digital camera and under the scanning electron microscope at different magnifications. The comparison of biofilm-removal efficacy between the three groups was performed by using a one-way analysis of variance with post-hoc Dunnett's T3 test. A p-value less than 0.05 was chosen to indicate statistical significance. RESULTS: There were no statistical differences (p > 0.05) between the two powder-treated groups for the biofilm cleaning efficacy. However, both groups showed significantly better biofilm-cleaning efficacy than the control group (p < 0.05). CONCLUSION: This suggests that both powders are effective in removing biofilm from the implant surface under ideal conditions. However, there was no clear distinction between the cleaning potential of the two powders, as both performed in a similar manner.

Experimental Study of Surface Roughness of Dental Ceramics After Polishing with Three Types of Polishing Systems.

Aims and Objectives: This study evaluated the surface roughness of three dental ceramics after polishing with three types of extraoral ceramic polishing sets. Materials and Methods: One hundred and twenty specimens were fabricated from feldspathic porcelain, lithium disilicate, and zirconia ceramics. The specimens were randomly allocated into four subgroups (n = 10). Group one was glazed (control) and the other three groups were ground using fine diamond burs and then sequentially polished by two rubber wheels from three polishing sets: feldspathic porcelain, lithium disilicate, and zirconia sets. The surface roughness measurement was performed with a profilometer and the surfaces were analyzed using scanning electron microscopy. Elemental compositions of three polishing sets were examined using x-ray powder diffraction. The surface roughness values of three polishing systems were compared by one-way analysis of variance with Dunnett's T3 post hoc test. The significance level was set at p < 0.05. Results: There was no significant difference in surface roughness when polishing ceramics with the lithium disilicate and zirconia polishing sets. In addition, those two sets provided lower roughness compared with the feldspathic porcelain polishing set and glazing. The main component of all polishing wheels was carbon, and only zirconia polishing wheel had more additional trace elements, which were titanium and silica. Conclusion: Lithium disilicate and zirconia extraoral polishing sets achieved superior results compared to feldspathic polishing set and glazing.

Effects of photocuring strategy on bonding of dual-cure one-step self-etch adhesive to root canal dentin.

This study evaluated the effects of light power density and light exposure time on regional bond strength of Clearfil DC Bond to root canal dentin. Post spaces were prepared in extracted premolars. Root canal dentin was treated with a dual-cure bonding system, Clearfil DC Bond, and light-cured for 10, 20, or 30 seconds using two halogen light curing units: Optilux 501 (830 mW/cm2) and Hyperlightel (1350 mW/cm2). Following which, all post spaces were filled with a dual-cure resin composite. After 24-hour storage, microtensile bond strengths (microTBS) at the coronal and apical regions were measured. At the coronal region, microTBS values were similar among all the experimental groups. At the apical region, bond strength improved when the curing time was extended to 30 seconds with Optilux 501, and likewise with Hyperlightel when curing time was extended to 20 or 30 seconds. In addition, significant differences in microTBS between the coronal and apical regions disappeared with prolonged curing times.

Regional bond strengths and failure analysis of fiber posts bonded to root canal dentin.

This study evaluated the regional bond strengths of fiber posts to root canal dentin luted with dual-cure resin composite. Twelve extracted human premolars were decoronated and post spaces prepared to a depth of 8 mm. The root canal dentin was treated with Clearfil SE Bond and light-cured for 20 seconds. Three posts from each of the following four types of fiber posts-Snowlight, FibreKor, DT Light-Post and GC Fiber Post-were surface-treated with a mixture of Porcelain Bond Activator and Photobond, then luted into the post spaces with Clearfil DC Core Automix and light-cured for 60 seconds. After 24-hour water storage, each specimen was serially sliced into eight 0.6 x 0.6 mm-thick beams for the microtensile bond strength (microTBS) test. Failure modes were observed using SEM. The microTBS data were divided into coronal and apical regions and statistically analyzed. The highest bond strengths were obtained from FibreKor posts. Regional factors had no effect on bond strength. FibreKor and DT Light-Post specimens primarily failed at the post-resin composite interface, whereas Snowlight and GC Post cohesively failed within the post.