A 5- to 6-year radiological evaluation of titanium plasma sprayed/sandblasted and acid-etched implants: results from private practice.

OBJECTIVES: This study aimed to determine bone level changes after 5-6 years of follow-up for a large group of one-stage dental implants consecutively placed in private practice. Potential confounding factors influencing crestal bone loss (CBL) were also assessed. MATERIALS AND METHODS: A total of 378 transmucosal Straumann implants in 174 patients were examined radiographically. Half of the study population (189 implants) had a titanium plasma sprayed (TPS) surface, and the other half (189 implants) were sandblasted and acid-etched (SLA). Mean CBL was measured from 5 to 6 years post-operative radiographs on the basis of known implant landmarks. Correlations of increased CBL with various independent variables were also investigated. Statistical analyses were performed using generalized estimating equations. RESULTS: Radiographic measurements showed a CBL ≤ 1.5 mm for 65% of studied implants. A CBL > 1.5 mm was found for 28% of implants, while 7% of implants had a CBL ≥ 3 mm. Three factors significantly influenced CBL (P < 0.05): implant surface texture (TPS > SLA), smoking status (smokers > non-smokers), and implant location (anterior > posterior). CONCLUSIONS: CBL was ≤1.5 mm after 5-6 years for the majority of followed implants. For implants with a CBL > 1.5 mm, statistically significant correlations were found for TPS surface type, anterior jaw locations, and smoking. Implant length did not influence CBL.

An in vitro comparison of the shear bond strengths of two different gingiva-colored materials bonded to commercially pure titanium and acrylic artificial teeth.

PURPOSE: The purpose of this study was to compare shear bond strengths between two different gingiva-colored materials bonded to titanium alloy discs and acrylic resin artificial teeth. MATERIALS AND METHODS: For the first part of this study, 30 titanium alloy disc specimens were embedded in autopolymerizing resin. These discs were then divided randomly into two groups: Heat Cure (HT(1) ) and Pink Composite (CT(1) ). The discs were sandblasted with 100 µm aluminum oxide particles. For the HT(1) group using silicone molds, a wax-up was performed. After the wax removal step, heat-cured acrylic resin was applied and processed according to the manufacturer's recommendations. For the CT(1) group using silicone molds, metal primer II and gum opaque were applied and light cured; pink composite was then applied and light cured. For the second part of the study, 30 artificial resin first molar teeth were completely embedded in autopolymerizing resin. Teeth were then divided randomly into two groups: Heat Cure (HT(2) ) and Pink Composite (CT(2) ). For the HT(2) group using silicone molds, wax-up was performed. Specimens were then transferred to be processed in the heat-cured acrylic resin according to the manufacturer's recommendations. For the CT(2) group using silicone molds, composite primer followed by pink composite were applied and light cured. Shear bond tests were performed using an Instron 3345 universal testing machine. The shear load at the point of failure was recorded in Newtons. The force was calculated in MPa by calculating the failure load divided by the surface area. Two independent-samples t-tests were performed. A significance level of p < 0.05 was used for comparison. RESULTS: This study revealed that the difference in the shear bond strengths of two different gingiva-colored materials bonded to titanium discs was statistically significant (p = 0.012). The difference in the shear bond strengths of two different gingival-colored materials bonded to acrylic teeth was statistically significant (p < 0.001). CONCLUSION: In this in vitro study, heat-cured acrylic resins exhibited higher bonding strengths when bonded to titanium discs or acrylic artificial teeth in comparison to pink composite resins.

An alternative technique for the accurate transfer of periimplant soft tissue contour.

This article presents a technique for an accurate transfer of periimplant soft tissue contour during implant impression by combining the use of a conventional implant level impression and a silicone impression. This is an accurate and time-effective chairside procedure which produces minimal discomfort for the patient.

Comprehensive Oral Rehabilitation of a Patient With Dentinogenesis Imperfecta.

INTRODUCTION: The treatment of dentinogenesis imperfecta is complex and requires a team approach. The aim of this case report is to describe the steps taken in the long-term rehabilitation of a middle-aged female with dentinogenesis imperfecta with severe attrition. This treatment included an initial temporary treatment to restore esthetic appearance and function followed by a complete prosthetic rehabilitation with implants in the second stage. In advanced stages of dentinogenesis imperfecta, patients can benefit from full-mouth rehabilitation where the deteriorated - yet still present - teeth can be used as abutments for a fixed, temporary restoration throughout the stages of treatment. Detailed pretreatment planning of how much bone and soft tissue are to be removed and an accurate determination of where the implants should be placed must be considered very thoroughly. CASE PRESENTATION: All teeth were ultimately extracted and replaced with fixed implant-supported prostheses in a staged approach using remaining teeth for interim support and/or retention of provisional prostheses. CONCLUSIONS: Early and accurate diagnosis of dentinogenesis imperfecta is essential to enable preventive interventions. In many patients, this has not occurred and severe loss of tooth structure, esthetics, and function results. If restorability and prognosis of these teeth are questionable or poor, their replacement with implant-supported fixed or removable prostheses should be the treatment of choice in modern dentistry. Given the appropriate indication and availability of financial means, a fixed solution appears preferable for reasons documented in this case presentation.