Clinical Peri-Implant Parameters and Marginal Bone Loss for Early Mandibular Implant Overdentures: A Follow-Up of 60 Months.

Background and Objectives: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed to evaluate clinical peri-implant parameters and marginal bone loss around early placed and loaded mandibular implant overdentures with a 60-month follow-up. Materials and Methods: In this prospective cohort study, 43 patients were enrolled to receive 86 early loading sub-crestal dental implants through prosthetic guides. Implant overdentures were supported by two isolated implant locator attachments between two mental foramens. Clinical peri-implant parameters, including plaque index (PI), bleeding index (BI), peri-implant pocket depth (PIPD), and marginal bone loss (MBL) were evaluated using standardized techniques at 1, 12, 24, 36, 48, and 60 months follow-up. At 60 months, complications associated with implant overdentures (IOD's) were noted. The mean comparison of peri-implant clinical parameters was performed through ANOVA test. A p-value of ≤0.05 was taken as significant. Results: Out of the total 43 enrolled patients, 8 patients were lost during follow-up; as a result, 35 patients completed the 5 years follow-up. The mean values of PI, BI, and PIPD increased with no statistical difference (p > 0.05). For marginal bone loss, an increase in the mean values was noted at different time intervals with statistical differences (p < 0.001). The most common complications noted were loosening of the abutment, occlusal adjustment, retentive locator loosening and replacement, and relining of the denture. Conclusions: Early placement of IODs failed to prevent bone loss over time and was associated with complications, predominantly consisting of abutment loosening, occlusal adjustments, broken retentive locator components, relining, and rebasing.

Evaluation of Peri-Implant Parameters and Functional Outcome of Immediately Placed and Loaded Mandibular Overdentures: A 5-year Follow-up Study.

PURPOSE: To evaluate the peri-implant parameters of immediately placed and loaded mandibular overdentures over a 5-year follow-up period. MATERIALS AND METHODS: All subjects who had been advised and planned for two-implant mandibular overdenture treatment were included in this study. The peri-implant parameters -including plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) as well as marginal bone loss (MBL) - were assessed. In addition, prosthodontic parameters including abutment-, implant- and denture-related complications were assessed. Patients were evaluated at follow-up visits, scheduled at 1, 12, 24, 36, 48, and 60 months. The data distribution was analysed with the Shapiro-Wilk test. Data within follow-up categories were compared using ANOVA and the Tukey-Kramer test. A p-value < 0.05 was considered statistically significant. RESULTS: Among the 32 participants, 19 were males and 13 were females, with a mean age of 60.5 ± 7.33. The mean plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) varied over time. However, no statistically significant difference was observed in the plaque index, bleeding index and peri-implant pocket depth over time (p > 0.05). The mean value at baseline was found to be -0.9 ± 0.3. The values increased over time, with the highest value observed at 60 months 2.6 ± 0.7, which was statistically significant (p < 0.001). CONCLUSION: Immediately placed and loaded mandibular implant overdentures using two un-splinted implants with locator attachments showed acceptable PI, BI and PIPD at the 5-year follow-up. Statistically significantly greater marginal bone loss was observed from baseline to follow-up, but it was within acceptable limits. A moderate number of restorative and abutment complications were observed during the follow-up of IODs.

Salivary Antibody Responses to Two COVID-19 Vaccines following Different Vaccination Regimens.

Background: To date, little is known about the salivary mucosal immune response following different COVID-19 vaccine types or after a booster (3rd) dose of the BNT162b2 (BNT) vaccine. Methods: A total of 301 saliva samples were collected from vaccinated individuals and arranged into two cohorts: cohort 1 (n = 145), samples from individuals who had received two doses against SARS-CoV-2; cohort 2 (n = 156), samples from individuals who had received a booster of BNT vaccine. Cohorts 1 and 2 were sub-stratified into three groups based on the types of first and second doses (homologous BNT/BNT, homologous ChAdOx1/ChAdOx1, or heterologous BNT/ChAdOx1vaccinations). Salivary immunoglobulin G (IgG) response to SARS-CoV-2 spike glycoprotein was measured by ELISA, and clinical demographic data were collected from hospital records or questionnaires. Results: Salivary IgG antibody responses against different vaccines, whether homologous or heterogeneous vaccination regimens, showed similar levels in cohorts 1 and 2. Compiling all groups in cohort 1 and 2 showed significant, albeit weak, negative correlations between salivary IgG levels and time (r = -0.2, p = 0.03; r = -0.27, p = 0.003, respectively). In cohort 2, the durability of salivary IgG after a booster dose of BNT162b2 significantly dropped after 3 months compared to the <1 month and 1-3 months groups. Conclusions: Different COVID-19 vaccine types and regimens elicit similar salivary anti-SARS-CoV-2 IgG with modest waning over time. Boosting with BNT162b2 vaccine did not produce an evident increase in mucosal IgG response whereby COVID-19 recovered subjects show higher salivary IgG than naive, post-vaccination subjects. The ChAdOx1/ChAdOx1 regimen showed better correlation between salivary IgG levels and durability. These findings highlight the importance of developing oral or intra-nasal vaccines to induce stronger mucosal immunity.

Comparative Evaluation of Surface Roughness and Hardness of 3D Printed Resins.

The effect of printing parameters on the surface characteristics of three-dimensional (3D)-printed denture base resins (DBRs) is neglected. Therefore, this study investigated the effect of printing orientation and post-curing time on the surface roughness and hardness. One conventional heat-polymerized (HP) resin and two 3D-printing resins (NextDent (ND) and ASIGA (AS)) were used to fabricate a total of 250-disc (10 × 2.5 mm) specimens. ND and AS specimens were printed with different orientations (0-, 45-, and 90-degree) and each orientation group was subjected to four post-curing times (30, 60, 90, 120 min). Printed specimens were thermo-cycled (10,000 cycles) followed by the measuring of surface roughness (Profilometer (Ra)) and hardness (a Vickers hardness (VH)). ANOVA and post hoc tests were used for data analysis (α = 0.05) at significant levels. AS and ND showed no significant changes in Ra when compared with HP (p ˃ 0.05), except the 45-degree orientation (AS/90 min and AS/120 min) significantly increased surface roughness (p ˂ 0.001). There was no significant difference in Ra with different orientations and post-curing time for both materials AS and ND (p ˃ 0.05). Compared with HP, 3D-printed DBRs showed low VH values (p ˂ 0.001). For AS, 90-degree orientation showed a significant decrease in VH at 60, 90, and 120 min when compared with 0- and 45-degree orientation (p ˂ 0.001), while ND showed no significant difference in VH with different printing orientations (p ˃ 0.05). The VH of AS and ND improved when increasing post-curing time to 120 min (p ˂ 0.001), and the printing orientations and post-curing time did not affect the Ra of 3D-printed DBRs.

Procedure Time and Students' Perception Comparing Full Arch Digital Scans with Conventional Impressions: A Cross-Over Randomized Experimental Trial.

Methods: Ninety-six dental students each prepared tooth #36 for an all-ceramic crown on typodont models and were then randomly assigned into either group A: performed digital scan first, or Group B: performed conventional impression first. Procedure time was recorded for both. Immediately following each procedure, students indicated their perceived procedure difficulty. After exposure to both techniques, they selected their preferred one. Results: There was a statistically significant difference between the mean procedure time of both techniques (P < 0.0001), where students spent 663.76 ± 442.50 seconds to complete the conventional impression and 293.32 ± 181.49 seconds to complete the digital scan. Females were significantly faster in completing the conventional impression compared to males. On the contrary, male students were faster in digital scanning than female students. There were no carryover effects in the duration and the initially performed procedure. 76% (73 of 96) of participants preferred digital scanning with no statistical significance shown between the preferred and initially performed procedure. Participants perceived conventional impressions to be more difficult than digital scans. There was a weak positive correlation between the VAS score and the procedure time for the digital technique (R = 0.25) and a moderate positive correlation for the conventional technique (R = 0.45). Conclusions: The digital technique was preferred and perceived as easier than the conventional among undergraduate dental students with no impression-making experience, suggesting their readiness for new technology uptake. However, no significant correlation was found between the initially performed procedure and preference.

Socioeconomic inequalities in pediatric obstructive sleep apnea.

STUDY OBJECTIVES: To examine the association between multiple measures of socioeconomic status (SES) and objectively measured obstructive sleep apnea (OSA) in a Canadian pediatric population. METHODS: This was a cross-sectional study of 188 children (4-17 years, mean age 9.3 ± 3.5 years) prospectively recruited from two hospital sleep clinics in Canada, using multivariable-adjusted linear and logistic regression of five measures of SES including parental education, income, social class, geographic location, and perceived SES based on the MacArthur Scale of Subjective Social Status, assessed in relation to four polysomnographic OSA variables including apnea-hypopnea index, apnea index, mean oxygen saturation level, and oxygen desaturation index. RESULTS: Overall, low household-level SES appeared to be associated with both frequency (apnea index ≥ 1 events/h) and severity (apnea-hypopnea index ≥ 5 events/h) of OSA in children, with maternal education showing the most consistent and significant associations. Specifically, children with mothers reporting less than high school education had nearly three times the odds of having OSA after controlling factors including body mass index (odds ratio 2.96 [95% confidence interval, 1.05-8.37]), compared to university-educated participants. Consistent associations were also observed for geographic location with less frequency and severity of OSA among nonurban children. Perceived SES was minimally inversely associated with our outcomes. CONCLUSIONS: This cross-sectional, multicenter study demonstrated that SES factors are linked to the occurrence and severity of OSA in children. Results indicated the need to incorporate the screening of SES in the diagnostic process of pediatric OSA to provide more targeted intervention and patient-centered care. CITATION: Park JW, Hamoda MM, Almeida FR, et al. Socioeconomic inequalities in pediatric obstructive sleep apnea. J Clin Sleep Med. 2022;18(2):637-645.

Prosthetic rehabilitation of meth mouth with implant-supported fixed dental prostheses: A clinical report.

This clinical report describes the prosthetic restoration of a failing dentition subsequent to methamphetamine abuse. The treatment involved the use of endosteal dental implants and milled cobalt-chromium, screw-retained, implant-supported fixed dental prostheses. At the 1-year follow-up, the prosthetic rehabilitation had markedly improved the patients' health, esthetics, and function.