The Mineral Apposition Rate on Implants with Either a Sandblasted Acid-Etched Implant Surface (SLA) or a Nanostructured Calcium-Incorporated Surface (XPEED®): A Histological Split-Mouth, Randomized Case/Control Human Study.

This study aimed to histologically evaluate the effects of XPEED® and SLA surface on the mineral apposition rate (MAR) at 3 and 5 weeks in titanium dental implants placed in human bone. In total, 17 titanium dental implants with XPEED® surface (n = 9) used as test and SLA surface (n = 8) used as control were included in this study. Each patient received four doses of tetracycline 500 mg at 12 h intervals 2 weeks prior to biopsy retrieval. Implant retrieval was performed, and retrieved biopsies were carefully treated for histomorphometric evaluation under epifluorescence microscopy. At 3 and 5 weeks, newly formed bone appeared in direct contact with both types of tested surfaces. At 3 weeks, the MAR value was, respectively, 2.0 (±0.18) µm/day for XPEED® implants and 1.5 (±0.10) µm/day for SLA implants (p = 0.017). At 5 weeks, lower MAR values for both XPEED® and SLA implants were noted, with 1.2 (±0.10) µm/day and 1.1 (±0.10) µm/day, respectively (p = 0.046). The overall evaluation by linear regression analysis for both time and implant surfaces showed a decreased osteoblast activity at 5 weeks compared to 3 weeks (p < 0.005). The results of the present study show that the bone apposition rate occurs faster around implants with XPEED® surface at 3 weeks and 5 weeks of healing. MAR values may support the use of implants with XPEED® surfaces in early loading protocols.

Nano-Based Approaches in Surface Modifications of Dental Implants: A Literature Review.

Rehabilitation of fully or partially edentulous patients with dental implants represents one of the most frequently used surgical procedures. The work of Branemark, who observed that a piece of titanium embedded in rabbit bone became firmly attached and difficult to remove, introduced the concept of osseointegration and revolutionized modern dentistry. Since then, an ever-growing need for improved implant materials towards enhanced material-tissue integration has emerged. There is a strong belief that nanoscale materials will produce a superior generation of implants with high efficiency, low cost, and high volume. The aim of this review is to explore the contribution of nanomaterials in implantology. A variety of nanomaterials have been proposed as potential candidates for implant surface customization. They can have inherent antibacterial properties, provide enhanced conditions for osseointegration, or act as reservoirs for biomolecules and drugs. Titania nanotubes alone or in combination with biological agents or drugs are used for enhanced tissue integration in dental implants. Regarding immunomodulation and in order to avoid implant rejection, titania nanotubes, graphene, and biopolymers have successfully been utilized, sometimes loaded with anti-inflammatory agents and extracellular vesicles. Peri-implantitis prevention can be achieved through the inherent antibacterial properties of metal nanoparticles and chitosan or hybrid coatings bearing antibiotic substances. For improved corrosion resistance various materials have been explored. However, even though these modifications have shown promising results, future research is necessary to assess their clinical behavior in humans and proceed to widespread commercialization.

The effect of thermomechanical aging on the fracture resistance of additive and subtractive manufactured polyetheretherketone abutments.

OBJECTIVES: To evaluate the fracture resistance (FR) of polyetheretherketone (PEEK) abutments produced by additive and subtractive methods compared to milled zirconia abutments. METHODS: Custom abutments were designed on Ti-base abutments and produced from three different materials, namely additively manufactured PEEK (PEEK-AM), subtractively manufactured PEEK (PEEK-SM), and zirconia (N=60). PEEK-AM abutments were printed using PEEK filaments (VESTAKEEP®i4 3DF-T, Evonik Industries AG) on a M150 Medical 3D Printer (ORION AM) by fused filament fabrication (FFF). All surface treatments were carried out according to the manufacturer's instructions. All abutments were cemented on Ti-bases with hybrid abutment cement and then restored with milled zirconia crowns. Each subgroup was divided into non-aged and aged subgroups (n=10). The aged groups were subjected to thermomechanical aging (49 N, 5-55°C, 1.2 million cycles). FR tests were performed by using a universal testing machine. Data were statistically analyzed with one-way and two-way ANOVA and t-test. RESULTS: The survival rate of the specimens after aging was determined as 100%. It was found that both the material and aging had a significant effect on the FR (p<.001). There was a statistical difference among the fracture values of the groups (p<0.001). In both the aged and non-aged groups, PEEK-AM showed the statistically lowest FR, while the highest FR was seen in the zirconia group, which was significantly higher than the PEEK-SM (p<0.001). CONCLUSION: Hybrid abutments were successfully manufactured, and extrusion-based processed PEEK seems to be a good alternative to subtractive processed PEEK. However, since subtractive manufacturing still appears to be superior, further developments in additive manufacturing are needed to further improve the quality of 3D-printed PEEK parts, especially in terms of accuracy and bonding between adjacent layers. CLINICAL SIGNIFICANCE: Additively manufactured PEEK abutments have the potential to be an alternative for implant-supported restorations in the posterior region.

Comparison of fatigue lifetime of new generation CAD/CAM crown materials on zirconia and titanium abutments in implant-supported crowns: a 3D finite element analysis.

OBJECTIVES: Due to the dynamic character of the stomatognathic system, fatigue life experiments simulating the cyclic loading experienced by implant-supported restorations are critical consideration. The aim of this study was to examine the effect of different crown and abutment materials on fatigue failure of single implant-supported crowns. METHODS: Models were created for 10 different designs of implant-supported single crowns including two zirconia-reinforced lithium silicates (crystallized and precrystallized), monolithic lithium disilicate, polymer-infiltrated ceramic networks, and polyetheretherketone supported by zirconia and titanium abutments. A cyclic load of 179 N with a frequency of 1 Hz was applied on palatal cusp of a maxillary first premolar at a 30° angle in a buccolingual direction. RESULTS: In the models with titanium abutments, the polymer-infiltrated ceramic network model had a lower number of cycles to fatigue failure values in the implant (5.07), abutment (2.30), and screw (1.07) compared to others. In the models with zirconia abutments, the crystallized zirconia-reinforced lithium silicate model had a higher number of cycles to fatigue failure values in the abutment (8.52) compared to others. Depending on the fatigue criteria, polyetheretherketone implant crown could fail in less than five year while the other implant crowns exhibits an infinite life on all models. CONCLUSIONS: The type of abutment material had an effect on the number of cycles to fatigue failure values for implants, abutments, and screws, but had no effect on crown materials. The zirconia abutment proved longer fatigue lifetime, and should thus be considered for implant-supported single crowns.

"Accuracy of 3D printed implant surgical guides with the manufacturer workflow of four different printers. A comparative in vitro study."

OBJECTIVES: The aim of this study was to assess the accuracy of surgical guides printed using four different manufacturer workflows. METHODS: Forty-eight surgical guides (BlueSky Plan, BlueSky Bio) were produced using four different printers, with strict adherence to each manufacturer's instructions. The printers used were three DLP printers (SolFlex170 (VC), Nextdent5100 (ND), D30+Rapidshape (RS)) and one SLA printer (Formlabs3B+ (FL)). The study evaluated the trueness and precision of the overall surface, the region of interest (RoI) (occlusal and guide zone), the repeatability in several batches, and the guide hole's diameter and xyz axes. The printed guides were digitized and compared with the CAD design control specimen (Control X, Geomagic). Descriptive statistics and Kruskal-Wallis tests with post-hoc Mann-Whitney tests were performed (α=0.05). RESULTS: Statistical analysis revealed differences in trueness and precision were found between groups in the overall zone and RoI (p=0.00). The ND group demonstrated the highest repeatability. Only the RS group exhibited a comparable guide hole diameter to the master specimen (5.27±2.12 mm; p=0.104). No statistical differences were observed between groups in the x and z axes. However, in the y-axis, the VC group displayed statistically significant differences (p=0.01). CONCLUSIONS: The results showed that the DLP groups had better overall accuracy, while the SLA group had the best results in the RoI. The manufacturer's workflows demonstrated a high reproducibility between batches in the RoI. The RS group had values most similar values to the guide hole diameter of the master specimen, with minimal deviations in guide hole orientation. CLINICAL SIGNIFICANCE: Implant position is a crucial factor in the long-term success, and it can be affected by the accuracy of the 3D printed surgical guide. Therefore, it is critical to analyze the final dimensions and the direction of the guide hole using available printing technologies.

The past forty-three years of dental implantology literature. A global mapping and scientometric analysis.

PURPOSE: The aim of this research is to make a scientometric analysis of the dental implantology literature and to present the results in a more understandable way to the reader by visualizing them with maps. METHODS: The dental implantology literature was accessed through the Web of Science database. Scientometric data was obtained with Citespace 6.1 software, co-citation, clustering analysis, citation burst, and mapping analyzes were performed. Scimago Graphica software was used for additional visualizations. RESULTS: A total of 35,704 articles were included in the analysis. There were 88,616 authors, 72,333 institutes, 142 countries/regions, and 3,265 journals contributing to the dental implantology literature. The United States was first with 7,334 publications and 225,868 citations. The literature between 1980 and 2023 was divided into 19 different clusters, and the literature between 2000 and 2023 was divided into 16 different clusters. CONCLUSIONS: Key themes in the field include the use of autogenous bone, advancements in implant surface technology, and the use of platform switching and intraoral scanners. Emerging topics of interest include esthetic considerations in the treatment of the anterior region, stress distribution, the use of zirconia, and the impact of implant treatment on oral health-related quality of life. With similar scientometric analysis studies to be done in the future, the progress of the literature can be followed on the basis of evidence.

Modified Palatal Roll Flap: A Novel Technique for Horizontal Ridge Augmentation.

The Abrams' palatal roll technique has undergone significant changes over time and is routinely utilized to widen peri-implant soft tissues in the maxillary aesthetic zone. The described technique involves the use of a de-epithelized pedicled connective tissue flap from the palate and rolling it under the labial oral mucosa to increase the soft tissue bulk. It is an easy and efficient technique that improves gingival thickness and contour in the aesthetic region and is a great substitute for areas lacking gingival soft tissue. Furthermore, this technique eliminates the need for a second surgical site to harvest the connective tissue graft for soft tissue augmentation. This study reports a clinical case where the modified roll technique was used for horizontal ridge augmentation.

Immediate implant placement in a dialysis patient. A case report.

Implant-supported rehabilitation in high-risk patients poses significant challenges for the dental team. The presence of comorbidities and increased infection risk can, for example, lead to a higher risk of implant loss. For the therapy to be completed with as few complications as possible, special anamnesis, detailed diagnostics, and a risk analysis based on those findings are indispensable. The aim of all considerations is to keep the risk of infection for the patient with a disease history to a minimum and to strive for an appropriate functional and esthetic therapeutic success. Particularly in the esthetic zone, in addition to the general health risks of the surgical procedure, esthetic aspects are increasingly taken into account in planning. The present article describes the implant-prosthetic replacement of a single anterior tooth in a dialysis patient. Several aspects (regular dialysis, missing buccal lamella, high smile line, functional risk) increased the risk of complications in this case.

Utilizing partially demineralized dentin plate for horizontal ridge augmentation: A case report.

BACKGROUND: This article intends to showcase a case of guided bone regeneration (GBR) utilizing a partially demineralized dentin plate processed from an extracted second molar for horizontal augmentation of the posterior ridge for implant placement. METHODS AND RESULTS: A 60-year-old patient presented with horizontal ridge deficiency at site #30 and an endodontically treated tooth #31 with recurrent decay. A treatment plan was proposed to extract tooth #31 and utilize a dentin graft from the tooth for ridge augmentation at site #30. Following the atraumatic extraction of tooth #31, it was sectioned into a 1 mm thick dentin plate, sterilized, and processed to obtain a demineralized dentin graft. Following a mid-crestal incision and full-thickness flap elevation, the dentin plate was adapted on the buccal defect of site #30 with 10 mm fixation screws, and the gap between the plate and the buccal bone was filled with 0.5 cc of 50/50 cortico-cancellous bone allograft hydrated with saline, covered with collagen membrane followed by primary closure. At 6 months, a postoperative cone-beam computed tomography (CBCT) was obtained to evaluate the ridge width revealing sufficient ridge width for optimal implant placement. The radio-opaque dentin plate was visible on the CBCT depicting integration with the alveolar ridge. Following surgical implant preparation protocol, a 4 mm diameter and 8.5 mm length implant was placed in a restoratively driven position. CONCLUSION: This case reports favorable outcomes for GBR using a partially demineralized dentin plate as an alternative to an autogenous bone block graft for horizontal ridge augmentation for future implant placement. KEY POINTS: This case introduces a novel method utilizing partially demineralized dentin plates derived from extracted teeth for guided bone regeneration, showcasing its potential efficacy in addressing ridge deficiencies. Success, in this case, relies on meticulous sectioning of the tooth and processing of the dentin graft, precise adaptation and fixation of the graft to the residual ridge, and achieving primary closure for undisturbed healing. Limitations to success include the availability of teeth for extraction coinciding with the need for ridge augmentation and unstable graft fixation.

Bone-to-Implant Contact in Implants with Plasma-Treated Nanostructured Calcium-Incorporated Surface (XPEEDActive) Compared to Non-Plasma-Treated Implants (XPEED): A Human Histologic Study at 4 Weeks.

Titanium implants undergo an aging process through surface hydrocarbon deposition, resulting in decreased wettability and bioactivity. Plasma treatment was shown to significantly reduce surface hydrocarbons, thus improving implant hydrophilicity and enhancing the osseointegration process. This study investigates the effect of plasma surface treatment on bone-to-implant contact (BIC) of implants presenting a nanostructured calcium-incorporated surface (XPEED®). Following a Randomized Controlled Trial (RCT) design, patients undergoing implant surgery in the posterior maxilla received additional plasma-treated (n = 7) or -untreated (n = 5) 3.5 × 8 mm implants that were retrieved after a 4-week healing period for histological examination. Histomorphometric analysis showed that plasma-treated implants exhibited a 38.7% BIC rate compared to 22.4% of untreated implants (p = 0.002), indicating enhanced osseointegration potential. Histological images also revealed increased bone formation and active osteoblastic activity around plasma-treated implants when compared to untreated specimens. The findings suggest that plasma treatment improves surface hydrophilicity and biological response, facilitating early bone formation around titanium implants. This study underscores the importance of surface modifications in optimizing implant integration and supports the use of plasma treatment to enhance osseointegration, thereby improving clinical outcomes in implant dentistry and offering benefits for immediate and early loading protocols, particularly in soft bone conditions.

Evaluation of the Stability of Open-Tray Impression Coping Using Two Different Impression Materials at Three Different Subgingival Implant Placement Depths.

Objective To evaluate and compare the stability of the open tray impression coping within the set impression while attaching the lab analog when polyether (PE) heavy body and polyvinyl siloxane (PVS) putty impression materials were used and the implant platform was placed sub-gingivally at three different depths. Methods Two impression materials, PE and PVS, and custom-made plexiglass models with embedded single implants to simulate implant positioning depths of 0 mm, 2 mm, and 4 mm, sub-gingivally, were used in the study. Open tray impressions were made after attaching impression coping to the implant embedded in the model. Implant lab analog was attached to the impression coping in the set impression, and its stability was measured using a universal testing machine. Forty-two open tray impressions were made in six groups, with seven impressions in each group. Descriptive statistics such as mean and standard deviation were calculated. A comparison of the mean stability between the two impression materials at each depth was done using an independent t-test. Comparison of the mean stability between the three different subgingival implant depths in each material was done by one-way ANOVA with the Scheffe multiple comparison test (post-hoc analysis). The level of significance was set at p<0.05. Results The stability of the impression coping was measured as the force in Newtons required for the displacement of the analog attached to the impression coping embedded in the set impression. PE with the embedded impression coping at a depth of 0 mm gave the highest mean stability value (4.37+/-0.41), and the least mean stability was offered by PVS with the embedded impression coping at 4 mm depth (1.88+/-0.37). When an independent t-test was done to compare the mean stability values of PE and PVS, there was a statistically significant difference at 0 mm, 2 mm, and 4 mm. On doing one-way ANOVA to compare the mean stability between the different depth groups, there was a statistically significant difference between the three depth groups in PE and PVS. Scheffe multiple comparison tests (post-hoc analysis) revealed a statistically significant difference between 0 mm, 2 mm, and 4 mm subgingival depths of the impression coping placement in both PE and PVS. Conclusion The accuracy of the master cast is an important determinant for the precise fit and long life of the final prosthesis. In the case of maxillary anterior implant placements where deep subgingival placement of the implant platform is needed for aesthetic and functional reasons, the impression material should be selected carefully to ensure the stability of the impression coping. Among the materials included in the present study, the PE impression material offered the maximum stability for impression coping compared to PVS.

Evaluation of Osteogenic Potential of a Polysaccharide-Based Hydrogel Coating on Titanium.

INTRODUCTION: Reducing the healing period after surgical placement of dental implants can facilitate the loading of dental prostheses. AIM: The aim is to compare the osteogenic potential of unmodified titanium disks with titanium disks that were surface-modified or hydrogel-coated. MATERIALS AND METHODOLOGY: One hundred eight titanium disks (Ø6 × 2-mm) were divided into three groups: (1) unmodified titanium as control (Ti-C); (2) sandblasted and acid-etched (Ti-SLA), and (3) coated with tamarind kernel polysaccharide hydrogel grafted with acrylic acid (Ti-TKP-AA). The osteogenic potential and cytotoxic effect of various groups of titanium were compared using human osteoblasts Saos-2. The surface topography of the titanium disks and morphology of osteoblasts grown on disks were investigated by scanning electron microscopy (n = 3). Cell attachment to the disks and actin expression intensity were investigated by confocal imaging (n = 3). Cytotoxicity was quantified by cell viability assay (n = 9). Osteoblast maturation was determined by alkaline phosphatase assay (n = 9). Cell mineralization was quantified by Alizarin red staining (n = 9). One-way analysis of variance followed by Tukey's multiple comparisons test was used for intergroup comparisons (α= 0.05). RESULTS: The surface modifications on Ti-SLA and Ti-TKP-AA support better morphology and proliferation of osteoblasts than Ti-C (P< 0.001) and significantly higher levels of actin cytoskeleton accumulation (P< 0.0001). Ti-TKP-AA showed a significantly higher maturation rate than Ti-C (P< 0.001). Ti-TKP-AA showed > twofold increased mineralization than Ti-C and Ti-SLA (P< 0.001). CONCLUSIONS: TKP-AA hydrogel-coated titanium promotes faster osteoblast proliferation, maturation, and mineralization than SLA-treated or untreated titanium. These advantages can be explored for achieving early osseointegration and prosthetic loading of titanium dental implants.

The application of virtual reality and augmented reality in dentistry - a literature review.

In recent times, dentistry has seen significant technological advancements that have transformed various specialized areas within the field. Developed into applications for mobile devices, augmented reality (AR) seamlessly merges digital components with the physical world, enhancing both realms while maintaining their individual separateness. On the other hand, virtual reality (VR) relies on advanced, tailored software to visualize a digital 3D environment stimulating the operator's senses through computer generated sensations and feedback. The current advances use the application of VR, haptic simulators, the use of an AI algorithm and many more that provides new opportunities for smart learning and enhance the teaching environment. As this technology continues to evolve, it is poised to become even more remarkable, enabling specialists to potentially visualize both soft and hard tissues within the patient's body for effective treatment planning. This literature aims to present the newest advancements and ongoing development of AR and VR in dentistry and medicine. It highlights their diverse applications while identifying areas needing further research for effective integration into clinical practice.

Peri-implant soft tissue volume changes after microsurgical envelope technique with a connective tissue graft. A 5-year retrospective case series.

AIM: The aim of the present retrospective case series was to longitudinally assess soft tissue volume changes on the vestibular aspect of implants in relation to keratinized mucosa thickness (KMT) and width (KMW) after the application of the microsurgical envelope technique combined with a connective tissue graft (CTG). MATERIALS AND METHODS: A total of 12 healthy patients received 12 dental implants placed either in the posterior maxilla or mandible. The study involved the harvesting of 12 CTGs with a minimally invasive single-incision technique, grafted to the vestibular peri-implant soft tissue utilizing the envelope technique, followed by the insertion of 12 screw-retained IPS e.max crowns. RESULTS: The healing process was uneventful across all areas, and all patients were followed up for a period of 5 years. The evaluation of KMT showed the highest decrease in the first 6 weeks after surgery (5.5 ± 0.79 to 4.59 ± 0.62 mm), then dropped slightly to 4 ± 0.85 mm, after which it maintained at 4 ± 0.36 mm until the 2-year time point. Between the second and third years after surgery, a further decrease of 3.59 ± 0.42 mm was recorded for KMT, which then remained constant until the end of the 5-year research period. The observations regarding KMW were slightly different, with the measurements demonstrating the greatest decrease in first 6 weeks (from 2.5 ± 0.42 to 1.5 ± 0.42 mm), which was maintained until the 1-year time point. Between the first and second years after surgery, the KMW increased to 2 ± 0.60 mm and remained level for the next 3 years, at 2 ± 0.85 mm. CONCLUSIONS: The current research demonstrated the advantages of using a combination of a minimally invasively harvested CTG and the microsurgical envelope technique for a duration of 5 years.

Evaluation of Survival Rates of Dental Implants and the Risk Factors: A Retrospective Follow-Up Study.

Introduction The current research sets out to assess implant early survival rates and identify relevant parameters. Methods The research spanned the years 2021 and 2022 and included all individuals who had dental implants. Various criteria, such as age, sex, maxilla/mandible, implant location, immediate implant, implant diameter, implant length, and others, were used to determine the implant survival rate in the research. A multiple logistic regression model was used to show the risk variables for early survival rates of implants, and components with p < 0.05 were further included after the Chi-square test was employed to filter them. Results The current research included 128 patients who had a single implant procedure, including 70 males and 58 females. The early survival rate was 91.40%, and 117 implants were retained after implantation. Risk variables that were shown to be associated with early survival rates were patients aged 30-60 years (OR: 2.542), immediate implant placement (OR: 3.742), and implant length less than 10 mm (OR: 3.972). Conclusions Age, tooth location, implant length, and immediate implantation were risk variables that contributed to our subjects' above 91% early survival rate of implants.

Evaluating the Role of Nanoparticles in Enhancing Bone Regeneration in Dental Implantology.

Background: Dental implantology has witnessed substantial progress in recent years, driven by a growing emphasis on optimizing bone regeneration around dental implants. Nanoparticles have emerged as a potential tool for enhancing osseointegration and bone tissue regeneration. Materials and Methods: This human clinical trial enrolled 60 adult participants requiring dental implants. Patients were randomly assigned to one of two groups: a control group receiving conventional dental implants, and an experimental group receiving dental implants with nanoparticle-coated surfaces. Radiographic imaging, histological analysis of bone biopsies, and implant stability assessments were conducted at three and six months post-implantation. Results: Histological examination of bone biopsies revealed a statistically significant increase in new bone formation in the experimental group compared to the control group at both three and six months (P < 0.05). Radiographic assessment demonstrated a 25% higher bone density around nanoparticle-coated implants (P < 0.01) at the six-month mark. Implant stability quotient (ISQ) measurements indicated a 20% greater stability in the experimental group (P < 0.05) at the same time point. Conclusion: This human clinical trial provides strong evidence that the incorporation of nanoparticles on dental implant surfaces enhances bone regeneration and osseointegration in a human population.

[Prevention, diagnosis and management of osteoradionecrosis: Where do we stand?] / Prévention, diagnostic et prise en charge de l'ostéoradionécrose : où en est-on ?

Osteoradionecrosis (ORN) is a late secondary iatrogenic complication of external radiotherapy for cancers of the upper aero-digestive tract. Despite the systematization of intensity-modulated radiotherapy and its potential for preserving salivary secretion and limiting the dose delivered to the supporting bone, ORN remains a feared and frequent complication. The objective of this literature review was to provide an overview of the management of ORN and to determine the key points that would make it possible to improve patient care. The diagnosis of ORN requires to eliminate tumor recurrence then is based on clinical arguments and imaging by CT or Cone Beam evolving in a chronic mode (more than 3-6 months). The harmonization of its classifications aims to offer comprehensive and multidisciplinary care as early as possible. Primary prevention is based on pre-therapeutic oral and dental preparation, then associated with fluoroprophylaxis if salivary recovery is insufficient and requires supervision of invasive dental care and prosthetic rehabilitation. Semi-automatic contouring tools make it possible to identify doses delivered to dental sectors and guide dental care with personalized dosimetric mapping. Conservative medical treatment is offered at an early stage where innovative medical treatments, highlighted by early studies, could be of interest in the future. In the event of advanced ORN, a non-conservative treatment is then proposed and frequently consists of interruptive mandibulectomy associated with reconstruction by bony free flap, the conditions of implantation remaining to be defined with the support of prospective clinical trials.

Comparative Analysis of Surface Modification Techniques for Assessing Oral Implant Osseointegration: An Animal Study.

BACKGROUND: Effective implant placement depends critically on the implant's level of osseointegration with the alveolar bone. To increase osseointegration during implant placement, research has concentrated on the surface modification of implants, and morphological analyses have looked at the thread pattern in close interaction with the bone's surface. AIM: This study aimed to assess and compare the extent of oral implant osseointegration in different surface modification techniques. MATERIALS AND METHODS: In this study, 12 healthy adult dogs aged 18-24 months were used. Tooth extractions were performed on both sides of the mandible, and wounds were closed with sutures. Two months later, the right mandible of each dog underwent local anesthesia and general anesthesia. Four different implant types were placed based on their surface treatments: resorbable blast media (RBM)-treated implants, hydroxyapatite (HA) implants with an ultra-thin HA film, hydrothermal-treated HA implants coated with HA, and sandblasting combined acid etching (SLA) implants treated with plasma spray and acid etching. A total of 48 implants were divided into two- and four-week groups, with identical dimensions. Each dog received two implants from each group, for a total of eight implants per dog. The implants were securely placed into the superior alveolar bone with a torque greater than 35-N up to a depth of 1 mm. Periotest M (Medizintechnik Gulden e.K., Modautal, Germany) was used to calculate the periotest value (PTV) as a typical value on the buccal side of each implant immediately following placement and sacrifice to test the main fixation and stability of the implants. Resonance frequency analysis (RFA) was utilised by Osstell Mentor (Osstell AB, Gothenburg, Sweden) to simultaneously assess the implant stability quotient (ISQ) on the medial, distal, buccal, and lingual sides of the implant. The rotational torque in one of the sacrificed dogs was calculated using the MGT 50 (ELECTROMATIC Equipment Co., Inc., New York, USA) torque analyzer. The histomorphometric evaluation was performed using an optical microscope (Olympus Corporation, Tokyo, Japan). The upper half's bone-implant contact (BIC), which was found to be more important for implant stability, was studied together with the ratio of the new bone formation area (NBFA) to the complete implant. RESULTS: The maximum stability was observed in HA-treated implants in the fourth week. The minimum stability was observed in hydrothermal-treated HA implants in the fourth week. The stability in each group was greater in the four-week evaluation as compared to the two-week evaluation. The stability was satisfactory in almost all implants at two- and three-week evaluations. The maximum value of the percentage area of newly formed bone at the two- and four-week evaluations was observed in HA-treated implants. The minimum value of the percentage of the area of newly formed bone at two- and four-week evaluations was observed in SLA and RBM-treated implants respectively. The difference was significant statistically (p ≤ 0.05). CONCLUSION: All implant surface modifications, in general, produced satisfactory osseointegration. Excellent osseointegration was seen in the upper portion of the implant with hydrothermally treated HA.

Evaluation of the Success of Autogenous Block Grafting in Atrophic Maxillary and Mandibular Ridges Prior to and After Implant Placement.

BACKGROUND: Dental implantology's success relies on adequate bone volume and quality, necessitating bone augmentation for implant placement. Primary lateral bone augmentation, utilizing autogenous block grafts, addresses horizontal bone loss. OBJECTIVE: This study aims to evaluate the efficacy of autogenous block grafting, specifically ramus and fibula blocks, in addressing severe atrophic ridges before and after implant placement. METHODS: Twenty-one patients underwent block grafting, predominantly using the ramus technique (80/20 ratio). CBCT measurements assessed horizontal grafting outcomes. Implant success and bone volume changes were analyzed. RESULTS: Post-grafting, bone width increased from 1.8-3.1 mm to 4.5-6 mm, exceeding critical thresholds. Implant success reached 95%, indicating the grafting techniques' effectiveness. CONCLUSION: Autogenous block grafting, especially with ramus and fibula blocks, transforms severe atrophic ridges, enabling successful implant integration. Long-term follow-up is essential for a comprehensive evaluation. CLINICAL RELEVANCE: This study provides crucial insights into autogenous block grafting's transformative impact on challenging cases, guiding future applications in reconstructive dentistry.

Peri-implantitis: Knowledge and attitudes of implantology clinicians regarding the disease management: Peri-implantitis knowledge.

OBJECTIVES: Since peri-implantitis is an increasing and prevalent concern in clinical practice and there is no consensus regarding the best therapeutic protocol, this study evaluated the knowledge and behaviours of dentists working in Implantology regarding implant-related infections modulating factors and therapeutic protocols used in the management of peri-implantitis. METHODS: Cross-sectional study was conducted with 86 Brazilian Implantology clinicians. Data were collected using a structured and online questionnaire evaluating socioeconomic characteristics, education, work/clinical practice, knowledge and attitudes regarding the risk factors and management of peri-implantitis. The reliability of the questionnaire was evaluated by test-retest technique. The questionnaire was developed based on the last consensus on peri-implant diseases (2018) and the current evidence related to implant-related infections. Descriptive, bivariate and logistic regression analyses were conducted adopting a significance level of 5%. RESULTS: In this study, 89.5% of included dentists reported that already treated patients with peri-implantitis. Approximately 80% of dentists use antibiotics and mouth rinses during the treatment, and surgical procedures seem the main choice to treat peri-implantitis (91.8%) by dentists. As a preventive approach, 94.2% of dentists reported that routinely assessed biofilm accumulation in the follow-up visits after implant placement. Logistic regression showed that the self-reported ability to treat peri-implantitis was statistically (p < 0.05) higher among dentists who reported abilities to diagnose the disease and use laser for peri-implantitis treatment. CONCLUSION: Dentists working in Implantology have a good level of knowledge and behaviors in the management of peri-implantitis. However, the lack of consensus regarding the best treatment protocols may reflect dentist's behaviours because different treatment protocols have been used by evaluated clinicians.