Immunohistochemical assessment of the peri-implant soft tissue around different abutment materials: A human study.

BACKGROUND: Soft tissue reaction to dental implant abutments influences the sustainability of restoration. Several abutment materials, such as titanium and gold alloy, have been introduced for strength and esthetic solutions. Zirconia and titanium-base abutments have also become popular in recent years due to high esthetic demands. PURPOSE: To investigate the immune cell infiltration into the soft tissue in response to different abutment materials. MATERIALS AND METHODS: Twenty dental implants were placed in the posterior regions of 17 patients. Titanium, zirconia, gold alloy, and titanium-base were randomly selected for each patient on the day of surgery. After 8 weeks of healing, the abutments were removed along with 1 mm of peri-implant soft tissue. Immunohistochemical assessment was performed using labeled streptavidin-biotin to identify T cells, B cells, macrophages, plasma cells, and microvascular infiltration. RESULTS: Gold alloy demonstrated an overall higher inflammatory cell infiltration and highest number of CD3+ , CD20+ , and CD 68+ cells (P value <.05). The number of plasma cell and new microvascular infiltrations among abutment materials was not significantly different. CONCLUSION: Titanium, titanium-base, and zirconia abutments showed comparable infiltration profiles; gold alloy abutments showed the highest B-cell, T cell, and macrophage infiltration. None of the abutment materials caused clinical inflammation; hence, they can be effectively used.

Patient-based outcomes following surgical implant placements.

OBJECTIVES: To assess the postoperative oral health-related quality of life (OHRQoL), pain and swelling after surgical implant placement and to investigate their association with socio-demographic and clinical variables. MATERIALS AND METHODS: A total of 85 partial edentulous patients requiring implant-supported fixed prostheses were enrolled. Standard surgical practice for implant placement was employed. Interviews were conducted to assess the OHRQoL based on the oral impact on daily performances (OIDP) index preoperatively as well as 2 weeks and 1 month postoperatively in addition to the degree of pain and swelling at 2 weeks postoperatively. The socio-demographic and clinical variables of interest were also assessed. RESULTS: Patient's OHRQoL was reduced at 2 weeks followed by a return to baseline levels 1 month postoperatively. The median OIDP scores were 5.0, 12.0 and 3.5 preoperatively, 2 weeks and 1 month postoperatively, respectively. Eating and teeth cleaning were affected after surgery. Overall, 50.6% of the patients perceived no to mild pain, whereas 36.5%, 49.4% and 14.1% reported no, localized or extensive facial swelling, respectively. No association was found between pain and any variable, but anterior implantation and bone augmentation were more commonly associated with facial swelling. Oral health-related quality of life worsened in patients with more pain or facial swelling as well as in cases involving multiple implant placement or bone augmentation procedures. CONCLUSIONS: Oral health-related quality of life deteriorated shortly after surgery based on eating and teeth cleaning difficulties. A high degree of pain, extensive swelling, multiple implant placement and bone augmentation procedures were all associated with oral impacts.

New casemix classification as an alternative method for budget allocation in thai oral healthcare service: a pilot study.

This study aimed to develop a new casemix classification system as an alternative method for the budget allocation of oral healthcare service (OHCS). Initially, the International Statistical of Diseases and Related Health Problem, 10th revision, Thai Modification (ICD-10-TM) related to OHCS was used for developing the software "Grouper". This model was designed to allow the translation of dental procedures into eight-digit codes. Multiple regression analysis was used to analyze the relationship between the factors used for developing the model and the resource consumption. Furthermore, the coefficient of variance, reduction in variance, and relative weight (RW) were applied to test the validity. The results demonstrated that 1,624 OHCS classifications, according to the diagnoses and the procedures performed, showed high homogeneity within groups and heterogeneity between groups. Moreover, the RW of the OHCS could be used to predict and control the production costs. In conclusion, this new OHCS casemix classification has a potential use in a global decision making.