Group 4 ITI Consensus Report: Patient benefits following implant treatment in partially and fully edentulous patients.

OBJECTIVES: The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient-reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant-retained/supported dental prostheses were addressed. MATERIALS AND METHODS: Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal. RESULTS: Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant-supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness. CONCLUSIONS: Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.

The Impact of the ITI International Team for Implantology on Implant Dentistry: A Retrospective and Descriptive Analysis of 30 Years of Research Support.

PURPOSE: The purpose of this study was to analyze the projects submitted to the ITI International Team for Implantology for funding and the scientific publications ensuing from these projects, over a period of 30 years. MATERIALS AND METHODS: This analysis was performed based on information available in the database of the ITI. For each project, data related to institution, country of origin, and grant status (financed or rejected) were extracted. For the financed projects, the grant amount and number of publications were recorded. Publications were searched independently by two investigators. For all publications, the study topic, study design, and citation number were recorded. RESULTS: From a total of 1,372 submitted projects from 51 different countries and 308 different institutions, 514 (37.46%) were financed by the ITI. This amounts to more than CHF 52 million invested in favor of implant dentistry and related fields. A total of 552 publications (including original research and reviews) were identified related to these projects, with the majority being in vitro studies (n = 198), and the most common topic researched was implant surface modification (n = 134). The United States was the country and the University of Bern was the institution with the largest number of financed projects and published papers. CONCLUSION: This analysis revealed that the ITI has been actively supporting research in the field of implant dentistry and related areas globally. Several concepts in present-day implantology are based on literature from ITI-funded projects.

Influence of implant macrodesign and insertion connection technology on the accuracy of static computer-assisted implant surgery.

OBJECTIVE: The aim of this study was to evaluate the effect of three different macrodesigns and two different insertion devices on the accuracy of static computer-assisted implant surgery (sCAIS). MATERIALS AND METHODS: Ninety implant replicas with three different macrodesigns: Soft tissue level (TL), bone level (BL), and bone level tapered (BLT) were placed in 30 dental models with two implant insertion devices: Guided adapter and guided screwed-in mount. Preoperative and postoperative positions of implants were compared and the mean angular deviation, crestal, and apical three-dimensional (3D) deviation were calculated for each implant macrodesign and each insertion device. Data were analyzed using analysis of variance, post hoc t-tests and Bonferroni-Holm's adjustment method. P values less than .05 were considered statistically significant. RESULTS: BLT implants had lower mean 3D deviation values at the crest and the apex when compared with 3D deviations with BL and TL implants (P < .05). Also, BLT implants had lower angular deviations, when compared with BL and TL Implants, however, angular deviations were not statistically significant (P > .05). Considering the insertion device method, no significant differences were noted between insertion devices irrespective of the deviation analyzed. CONCLUSION: The macrodesign of dental implants may have an influence on the accuracy of sCAIS, with tapered designs offering slightly better positional accuracy than parallel-walled macrodesigns independent on the method of insertion used.

Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial.

OBJECTIVES: The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. METHODS AND DESIGNS: This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants. Success rates of the implants were evaluated at 3 months, 6 months and 12 months following implant loading using marginal bone level changes as well as peri-implant indices (Buser et al., 1990). RESULTS: 52 patients were randomized into two treatment groups (26 each), out of which 18 patients (36 implants) of Group-I and 17 patients (68 implants) of Group-II were evaluated. One implant in Group-I was lost due to infective complications and one patient in the same group had superior barrel necrosis. There was a statistically significant increase at both time points (p = 0.03, p = 0.04 at 6 months, 12 months) in the amount of marginal bone loss in Group-I (0.4 mm, 0.5 mm at 6 months, 12 months) as compared to Group-II (0.1 mm, 0.2 mm at 6 months, 12 months). There were no clinically significant changes peri-implant parameters between both groups. Peri-implant soft tissue hyperplasia was seen in both groups, 32% of implants at 3-months, 26% at 6-months and 3% at 12-months follow-up. CONCLUSION: The results of this study show that patients with 2-implant-supported-overdentures had higher marginal bone loss as compared to patients with 4-implant-supported-overdentures. There were no clinically significant differences in peri-implant soft tissue factors in patients with 2- or 4-implant-supported-overdentures. Hyperplastic peri-implant tissues are common in the early implant-loading phase and tend to decrease over time under appropriate management.

Implant supported dental rehabilitation following segmental mandibular reconstruction- quality of life outcomes of a prospective randomized trial.

PURPOSE: The primary objective of this study was to assess the difference in quality of life (QoL) in patients with dental rehabilitation using two or four implant-supported overdentures following segmental mandibulectomy defect reconstruction with fibula free flap. MATERIAL AND METHODS: This prospective, parallel designed, randomized clinical study was conducted with a 1:1 ratio. At baseline, all participants already had fibula flap reconstruction for segmental defects of the mandible and rehabilitation with conventional (non-implant supported) removable partial dentures. The participants were then randomized into two groups. Group I received implant supported overdentures on two implants, and Group II received four implants. QoL outcomes were evaluated using standardized questionnaires (EORTC_QLQ c30, H&N35, OHIP, DSI). Outcomes of treatment were evaluated at 6 months (T1) and 1 year (T2) following rehabilitation. RESULTS: A total of 52 patients were randomized into two treatment groups (26 each). After accounting for the loss to lack of follow-up, 22 patients in Group I and 24 patients in Group II were evaluated for QoL at the end of the study. There was a significant improvement in QoL with implant-assisted dental rehabilitation. However there were no significant differences in QoL between the two-implant and four-implant groups. CONCLUSION: Implant-supported removable overdentures improve QoL outcomes in patients with reconstructed mandibles. This study showed no significant difference in QoL outcomes in patients with two- or four-implant supported removable prostheses.

Oral Hygiene and Dietary Habits in Adolescents with Fixed Orthodontic Appliances: A Cross-sectional Study.

OBJECTIVES: Fixed orthodontic appliances (FOAs) may cause a temporary deterioration of oral hygiene with corresponding gingival inflammatory changes. Optimal oral hygiene and dietary changes are essential in order to avoid periodontal inflammation. The present study investigates to what extent the recommendations made by the orthodontist are followed by young patients. MATERIALS AND METHODS: A total of 67 adolescent patients with FOA were examined and interviewed. The control group consisted of 70 patients of the same age who had not undergone any orthodontic treatment. A specific questionnaire (assessing dietary habits, oral hygiene measures) was used and comprehensive oral findings along with oral hygiene status were evaluated. RESULTS: The analysis of the data showed that despite intensive oral hygiene and dietary advice in the patients with FOA, there was no change in diet or oral hygiene habits. There were significantly higher signs of gingival inflammation and amount of dental plaque in FOA patients. Nutritional recommendations and oral hygiene measures for young people with FOA were not adequately enforced. CONCLUSION: The findings indicate that frequent recalls should be scheduled with repeated reinforcement of oral hygiene and dietary modifications in FOA patients.

Awareness of the association between periodontal disease and adverse pregnancy outcome among the general female population.

BACKGROUND: Preterm low birth weight (PTLBW) is a public health issue which needs to be dealt with by educating the general female population. One of the major contributing factors is periodontal disease and treatment of the same could reduce the occurrence of PTLBW babies. Therefore, awareness of this among the female population is highly essential. Hence, this survey was planned with the aim to explore the awareness of the general female population regarding the association of periodontal disease and PTLBW. MATERIAL AND METHODS: This survey consisted of nine close-ended questions answered by 1284 females. RESULTS: Younger individuals had higher knowledge scores as compared to the older individuals (r = -0.161) and the more educated group had a higher knowledge score as compared to the less educated groups (r = 0.322). Furthermore, married women seemed to be more aware of the relation of PTLBW to periodontal disease as compared to unmarried women. CONCLUSION: Younger and educated females had better awareness of the association between periodontal diseases and PTLBW. Hence, efforts to educate the general female population on this association could contribute toward the reduction of the risk of PTLBW.

Long standing intra oral Acid burn.

Oral burn due to ingestion of corrosive substances can bring about debilitating consequences. It often brings mortality, and the survivors can have severe impairment of functions, especially in relation to the stomatognathic and gastrointestinal systems. This article presents a long-standing case (21 years) of an oral burn caused by a corrosive substance, its manifestation on growth and development of the face and its treatment. The patient was accidentally given acid orally when he was 4 months of age. He was treated at 21 years of age: the time he reported to us. This seems to be the first case report that describes the effects of long standing oral contracture secondary to burns on the growth and development of the maxillofacial structures and its treatment with a novel approach.

Comparative evaluation of thickness of jaw-closing muscles in patients with long-standing bilateral temporomandibular joint ankylosis: a retrospective case-controlled study.

OBJECTIVES: The aim of the study was to compare the thickness and cross-sectional area (CSA) of masseter and medial pterygoid muscles in young patients with long-standing bilateral temporomandibular joint ankylosis (bTMJA) in relation to controls. METHODS: Axial sections of computed tomography scans of patients with bTMJA from two tertiary care university hospitals were reviewed from 1995 to 2010 and compared to age- and sex-matched controls. The outlines of masseter and medial pterygoid muscles corresponding to a predefined reference plane were traced onto acetate paper. The thickness and CSA of the muscles were calculated using an image-analyzing software and calibrated according to the scale provided in the CT scan slides. RESULTS: Out of a total of 167 cases of temporomandibular joint ankylosis (TMJA), 15 fulfilled the inclusion criteria. The mean thickness and CSA of masseter and medial pterygoid muscles in cases of bTMJA were 19.4 mm (SD 2.3), 734.9 mm(2) (SD 156.7), 11.53 mm (SD 1.35), and 267.4 mm(2) (SD 65.35), respectively. For the control group, respective values were 10.5 mm (SD 1.8), 430.1 mm(2) (SD 66.8), 9.2 mm (SD 1.2), and 254.6 mm(2) (SD 45.7). There was a statistically significant increased thickness and CSA of the muscles in cases of bTMJA as compared to control as evaluated by Mann-Whitney U test. CONCLUSIONS: The results show that thickness and CSA of masseter and medial pterygoid muscles in patients with bTMJA were larger as compared to controls. This may suggest that, muscular hyperactivity, may be a cofactor in the pathogenesis of TMJA. CLINICAL SIGNIFICANCE: Although temporomandibular joint ankylosis is one of the most restrictive musculoskeletal disorder in the maxillofacial region, there is little information on the form and function of jaw muscles in this condition. This study evaluates thickness and cross-sectional areas of jaw elevator muscles and indicates that muscle hyperactivity might be associated with ankylosis, thereby providing a probable hypothesis on the etiopathogenesis of this condition.

Clinicopathologic conference: multiquadrant expansile fibro-osseous lesion in a juvenile.

This paper intends to present clinical, radiologic, and histopathologic features of a case of gigantiform cementoma manifesting in a 14-year-old boy, without any familial involvement. He has been followed for 3 years. Further cases from the literature have been reviewed that confirm a similar clinicopathologic picture. This is the first case report that describes "non-familial gigantiform cementoma" after the World Health Organisation's classification of 2005.