Effect of Antimicrobial Agent Coating on Physicochemical and Biologic Properties of Implant Abutments: A Systematic Review.

PURPOSE: To analyze the effectiveness of coating of abutments with antimicrobial agents and their influence on the physicochemical and biologic properties of the coated materials. MATERIALS AND METHODS: This work was registered in Open Science Framework (osf.io/6tkcp) and followed the PRISMA protocols. A search of two independent reviewers of articles published up to October 29, 2021, was performed in the Embase, PubMed, Science Direct, and Scopus databases. RESULTS: The databases found a total of 1,474 references. After excluding the duplicates, 1,050 remained. After reading the titles and abstracts and applying the inclusion criteria, 13 articles remained and were read in full. A total of 8 articles were included in this systematic review. Different antimicrobial agents have been used to coat abutments, including graphene oxide, polydopamine, titanium and zirconium nitride, lactoferrin, tetracycline, silver, and doxycycline with varied release times. Titanium-coated silver showed a better antimicrobial agent release time of up to 28 days. Chemical analysis confirmed the presence of antimicrobials on the surface after coating. Different pathogenic microorganisms, such as Streptococcus sanguinis, Streptococcus oralis, and Staphylococcus aureus, were inhibited when in contact with the coated surface. CONCLUSIONS: This review showed that there is still no consensus on which is the better antimicrobial agent and which coated materials have the better performance. However, the association of surface coating of abutments with antimicrobials is feasible and can benefit many patients, which can support their clinical use to favor the healing process and prevent infections that can lead to treatment failure with dental implants.

Accuracy of Artificial Intelligence Models in Dental Implant Fixture Identification and Classification from Radiographs: A Systematic Review.

Background and Objectives: The availability of multiple dental implant systems makes it difficult for the treating dentist to identify and classify the implant in case of inaccessibility or loss of previous records. Artificial intelligence (AI) is reported to have a high success rate in medical image classification and is effectively used in this area. Studies have reported improved implant classification and identification accuracy when AI is used with trained dental professionals. This systematic review aims to analyze various studies discussing the accuracy of AI tools in implant identification and classification. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The focused PICO question for the current study was "What is the accuracy (outcome) of artificial intelligence tools (Intervention) in detecting and/or classifying the type of dental implant (Participant/population) using X-ray images?" Web of Science, Scopus, MEDLINE-PubMed, and Cochrane were searched systematically to collect the relevant published literature. The search strings were based on the formulated PICO question. The article search was conducted in January 2024 using the Boolean operators and truncation. The search was limited to articles published in English in the last 15 years (January 2008 to December 2023). The quality of all the selected articles was critically analyzed using the Quality Assessment and Diagnostic Accuracy Tool (QUADAS-2). Results: Twenty-one articles were selected for qualitative analysis based on predetermined selection criteria. Study characteristics were tabulated in a self-designed table. Out of the 21 studies evaluated, 14 were found to be at risk of bias, with high or unclear risk in one or more domains. The remaining seven studies, however, had a low risk of bias. The overall accuracy of AI models in implant detection and identification ranged from a low of 67% to as high as 98.5%. Most included studies reported mean accuracy levels above 90%. Conclusions: The articles in the present review provide considerable evidence to validate that AI tools have high accuracy in identifying and classifying dental implant systems using 2-dimensional X-ray images. These outcomes are vital for clinical diagnosis and treatment planning by trained dental professionals to enhance patient treatment outcomes.

Comparison of Zirconia Implant Surface Modifications for Optimal Osseointegration.

Zirconia ceramic implants are commercially available from a rapidly growing number of manufacturers. Macroscopic and microscopic surface design and characteristics are considered to be key determining factors in the success of the osseointegration process. It is, therefore, crucial to assess which surface modification promotes the most favorable biological response. The purpose of this study was to conduct a comparison of modern surface modifications that are featured in the most common commercially available zirconia ceramic implant systems. A review of the currently available literature on zirconia implant surface topography and the associated bio-physical factors was conducted, with a focus on the osseointegration of zirconia surfaces. After a review of the selected articles for this study, commercially available zirconia implant surfaces were all modified using subtractive protocols. Commercially available ceramic implant surfaces were modified or enhanced using sandblasting, acid etching, laser etching, or combinations of the aforementioned. From our literature review, laser-modified surfaces emerged as the ones with the highest surface roughness and bone-implant contact (BIC). It was also found that surface roughness could be controlled to achieve optimal roughness by modifying the laser output power during manufacturing. Furthermore, laser surface modification induced a very low amount of preload microcracks in the zirconia. Osteopontin (OPN), an early-late osteogenic differentiation marker, was significantly upregulated in laser-treated surfaces. Moreover, surface wettability was highest in laser-treated surfaces, indicating favorable hydrophilicity and thus promoting early bone forming, cell adhesion, and subsequent maturation. Sandblasting followed by laser modification and sandblasting followed by acid etching and post-milling heat treatment (SE-H) surfaces featured comparable results, with favorable biological responses around zirconia implants.

Advancing 3D Dental Implant Finite Element Analysis: Incorporating Biomimetic Trabecular Bone with Varied Pore Sizes in Voronoi Lattices.

The human mandible's cancellous bone, which is characterized by its unique porosity and directional sensitivity to external forces, is crucial for sustaining biting stress. Traditional computer- aided design (CAD) models fail to fully represent the bone's anisotropic structure and thus depend on simple isotropic assumptions. For our research, we use the latest versions of nTOP 4.17.3 and Creo Parametric 8.0 software to make biomimetic Voronoi lattice models that accurately reflect the complex geometry and mechanical properties of trabecular bone. The porosity of human cancellous bone is accurately modeled in this work using biomimetic Voronoi lattice models. The porosities range from 70% to 95%, which can be achieved by changing the pore sizes to 1.0 mm, 1.5 mm, 2.0 mm, and 2.5 mm. Finite element analysis (FEA) was used to examine the displacements, stresses, and strains acting on dental implants with a buttress thread, abutment, retaining screw, and biting load surface. The results show that the Voronoi model accurately depicts the complex anatomy of the trabecular bone in the human jaw, compared to standard solid block models. The ideal pore size for biomimetic Voronoi lattice trabecular bone models is 2 mm, taking in to account both the von Mises stress distribution over the dental implant, screw retention, cortical bone, cancellous bone, and micromotions. This pore size displayed balanced performance by successfully matching natural bone's mechanical characteristics. Advanced FEA improves the biomechanical understanding of how bones and implants interact by creating more accurate models of biological problems and dynamic loading situations. This makes biomechanical engineering better.

Dental Implant Abutment Screw Loss: Presentation of 10 Cases.

Re-tightening the loosened dental implant abutment screw is an accepted procedure, however the evidence that such screw will hold sufficiently is weak. The purpose of this study was material analysis of lost dental implant abutment screws made of the TiAlV alloy from various manufacturers, which became lost due to unscrewing or damaged when checking if unscrewed; undamaged screws could be safely re-tightened. Among 13 failed screws retrieved from 10 cases, 10 screws were removed due to untightening and 3 were broken but without mechanical damage at the threads. Advanced corrosion was found on nine screws after 2 years of working time on all surfaces, also not mechanically loaded. Sediments observed especially in the thread area did not affect the corrosion process because of no pit densification around sediments. Pitting corrosion visible in all long-used screws raises the question of whether the screws should be replaced after a certain period during service, even if they are well-tightened. This requires further research on the influence of the degree of corrosion on the loss of the load-bearing ability of the screw.

Biomechanical Effects of Ti-Base Abutment Height on the Dental Implant System: A Finite Element Analysis.

This study aims to analyse, using a finite element analysis, the effects of Ti-base abutment height on the distribution and magnitude of transferred load and the resulting bone microstrain in the bone-implant system. A three-dimensional bone model of the mandibular premolar section was created with an implant placed in a juxta-osseous position. Three prosthetic models were designed: a 1 mm-high titanium-base (Ti-base) abutment with an 8 mm-high cemented monolithic zirconia crown was designed for model A, a 2 mm-high Ti-base abutment with a 7 mm-high crown for model B, and a 3 mm-high abutment with a 6 mm-high crown for model C. A static load of 150 N was applied to the central fossa at a six-degree angle with respect to the axial axis of the implant to evaluate the magnitude and distribution of load transfer and microstrain. The results showed a trend towards a direct linear association between the increase in the height of the Ti-base abutments and the increase in the transferred stress and the resulting microstrain to both the prosthetic elements and the bone/implant system. An increase in transferred stress and deformation of all elements of the system, within physiological ranges, was observed as the size of the Ti-base abutment increased.

Accuracy of template-based guided dental implant placement-An in vitro comparison of different manufacturing methods.

OBJECTIVES: This study investigates effects of surgical guide manufacturing process on 3D transfer accuracy of planned dental implant position, using three production methods: additive 3D-printed (3DF), subtractive milled (MF), and analog laboratory fabricated templates (LF). MATERIAL AND METHODS: Implant position for a single-tooth gap (#26) planned digitally. 3DF and MF templates were designed digitally, while LF templates were analogously created. For each manufacturing type, 10 surgical guides were fabricated. Each guide was used for template-guided implant placement in model replicas. For evaluation of implant placement, cone beam computed tomography scans of all implanted models were superimposed, and implant positions were determined. Deviations at implant shoulder/apex were measured, and median and inter-quartile range (IQR) were determined for mesio-distal, oro-facial, coronal apico, 3D spaces, and angles. RESULTS: At implant shoulder, vertical components dominated position deviations (up to 1.04 mm, IQR 0.28 mm for 3DF). Horizontal deviations were much lower (mesio-distally up to 0.38 mm, IQR 0.36 mm (LF)). Implant apex shows similar vertical deviations, while horizontal deviations clearly increased compared to shoulder, especially in mesio-distal direction. Median angular deviations were between 2.1° (IQR 2.0 mm, max. 4.2°) for 3DF and 3.3° (IQR 1.9 mm, max. 5.3°) for MF. No statistical differences were found between manufacturing types (Kruskal-Wallis test, p = .05). CONCLUSIONS: The study showed the method of implant guide fabrication did not affect the accuracy of implant placement within the limits of an in vitro environment. All methods resulted in implant placement which did not exceed the accepted safety deviation envelope (1.5-2.0 mm).

Magneto-dynamic tool for full arch immediate loading in post-traumatic restoration with narrow implants: A case report.

New surgical techniques using narrow, tilted implants positioned through a magneto-dynamic tool in guided surgery for a Toronto restoration. A 69-year-old woman wanted fixed rehabilitation to replace her removable complete dentures. A cone-beam computed tomography showed significant bone resorption in both the maxillary and mandibular regions. The plan was to load the entire upper arch with six implants immediately, while removable partial dentures were recommended for the lower jaw. The guided surgery project was aligned with the new dentures, and the laboratory created a printed cast with dental implant analogues in planned positions. A metal-reinforced denture was constructed, and surgery was performed to place six narrow implants using the magneto-dynamic instrument. The denture was directly screwed onto multi-unit abutments. Final rehabilitation was completed after 6 months. Narrow implants can be a good option for fixed, full-arch rehabilitations. Further research is needed to confirm these findings on a larger scale.

Clinical evaluation of bone quality of particulate cancellous bone and marrow, and implant prosthetic rehabilitation.

This study aimed to subjectively evaluate bone quality in the particulate cancellous bone and marrow (PCBM) graft area and to assess the survival rates of implants. A retrospective review was conducted based on patient age, sex, diagnosis, reconstructed site, number of implants, prosthetic type, and duration of follow-up. Images from computed tomography (CT) before implant insertion were obtained and used in this study. We selected a 4.0-mm diameter × 8.0-mm length region of interest in the implant placement area, and measured the CT attenuation value. No significant correlations were seen between CT attenuation values and implant survival rates in the maxilla and mandible. On the other hand, CT attenuation values and implant survival rates were significantly lower in patients with malignancy than in non-malignant cases. Placing implants in PCBM grafted bone requires a full understanding of bone quality before surgery and drilling to ensure primary stability, along with consideration of soft tissue management and maintenance programs.

Immediate versus early implant placement for single tooth replacement in the aesthetic area: A systematic review and meta-analysis.

OBJECTIVES: To compare immediate implant placement (IIP) with early implant placement (EIP) for single tooth replacement in the aesthetic area in terms of aesthetic, clinical, and patient-reported outcomes. MATERIALS AND METHODS: Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to February 2023. Randomized Controlled Trials (RCTs) comparing IIP with EIP were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue change. Secondary outcomes were horizontal midfacial soft tissue change, vertical papillary change, pink esthetic score (PES), implant survival, buccal bone thickness, marginal bone level change, patient discomfort, chair time, and patient satisfaction. RESULTS: Out of 1185 records, 6 RCTs were selected, reporting on 222 patients who received 222 single implants (IIP: 112 implants in 112 patients; EIP: 110 implants in 110 patients) in the anterior maxilla or mandible. Patients had a mean age ranging from 35.6 to 52.6 years and were followed between 8 and 24 months. Two RCTs showed some concerns, and four showed a high risk of bias. Four studies could be included in a meta-analysis on the primary outcome and three only considered cases with an intact buccal bone wall. Meta-analysis failed to demonstrate a significant difference in terms of vertical midfacial soft tissue change between IIP and EIP (mean difference: 0.31 mm, 95% CI [-0.23; 0.86], p = .260; I2 = 83%, p < .001). No significant differences were found for PES (standardized mean difference: 0.92, 95% CI [-0.23; 2.07], p = .120; I2 = 89%, p < .001), implant survival (RR: 0.98, 95% CI [0.93, 1.03], p = .480; I2 = 0%, p = .980), and marginal bone level change (mean difference: 0.03 mm, 95% CI [-0.12, 0.17], p = .700; I2 = 0%, p = .470). Insufficient data were available for meta-analyses of other secondary outcomes. CONCLUSION: In low-risk patients with an intact buccal bone wall, there seems to be no difference between IIP and EIP in terms of aesthetic and clinical outcomes. The strength of this conclusion is rated as low since studies showed an unclear or high risk of bias. In addition, state-of-the-art therapy was only delivered in a minority of studies. Future RCTs should also provide data on patient-reported outcomes since these have been underreported.

Do Implant Coatings Affect Healing of Placed Implants? An Umbrella Review.

PURPOSE: To analyze the available evidence and assess the effect of different implant coatings on healing outcomes. MATERIALS AND METHODS: Using the PICOS strategy, a structured question was formed. A protocol was agreed upon and registered with PROSPERO (no. CRD42022321926). The MEDLINE, Embase, Cochrane Database of Systematic Reviews, Scopus, Web of Science, Pubmed, and ScienceDirect databases were searched using a structured strategy. Study selection was independently carried out in duplicate, first by title and abstract, then by full-text assessment. Quality and risk of bias were independently assessed in duplicate using AMSTAR 2 and ROBIS. Data extraction was independently undertaken in duplicate using a predefined extraction form. RESULTS: The search yielded 11 systematic reviews for inclusion. The most commonly assessed coatings were based on calcium phosphate-including hydroxyapatite (HA), brushite, and bioabsorbable nano-HA-followed by bisphosphonate, then bioactive glass coatings. Included reviews most frequently assessed marginal bone loss (MBL), bone-to-implant contact (BIC), and survival/success rates. There was considerable heterogeneity and small sample sizes. The quality assessment suggested low confidence in the reviews and high risk of bias. CONCLUSIONS: The included reviews provide weak evidence that implant coatings improve osseointegration and reduce MBL following implant placement. There was weak evidence for progressive complications for calcium phosphate coatings. Further research and long-term multicenter controlled clinical trials with improved standardization and control of bias are required to better understand the effects of coating implants.

A 3D printed ultra-short dental implant based on lattice structures and ZIRCONIA/Ca2SiO4 combination.

Additive Manufacturing (AM) enables the generation of complex geometries and controlled internal cavities that are so interesting for the biomedical industry due to the benefits they provide in terms of osseointegration and bone growth. These technologies enable the manufacturing of the so-called lattice structures that are cells with different geometries and internal pores joint together for the formation of scaffold-type structures. In this context, the present paper analyses the feasibility of using diamond-type lattice structures and topology optimisation for the re-design of a dental implant. Concretely, a new ultra-short implant design is proposed in this work. For the manufacturing of the implant, digital light processing additive manufacturing technique technology is considered. The implant was made out of Nano-zirconia and Nano-Calcium Silicate as an alternative material to the more common Ti6Al4V. This material combination was selected due to the properties of the calcium-silicate that enhance bone ingrowth. The influence of different material combination ratios and lattice pore sizes were analysed by means of FEM simulation. For those simulations, a bio-material bone-nanozirconia model was considered that represents the final status after the bone is integrated in the implant. Results shows that the mechanical properties of the biocompatible composite employed were suitable for dental implant applications in dentistry. Based on the obtained results it was seen that those designs with 400 µm and 500 µm pore sizes showed best performance and led to the required factor of safety.

Dental Implant Failure in Post-Menopausal Women on Oral Bisphosphonates: A Systematic Review and Meta-Analysis.

A systematic review was designed to investigate the effect of treatment with oral bisphosphonate (BP) on osseointegration of dental implants and the incidence of BP-related osteonecrosis of the jaw (BRONJ) in post-menopausal women. Multiple electronic databases, including MEDLINE (PubMed), EMBASE, and SCOPUS, were searched to find all eligible articles published since 1990. All titles and abstracts retrieved by searching information sources were evaluated independently by two authors against the eligibility criteria. The number of cases ranged from 11 to 235, and the number of controls ranged from 14 to 343. Alendronate was used in all other studies. Risedronate was used in six studies, while ibandronate was used in four studies. The number of implants in cases ranged from 25 to 1267, while in controls, the number of implants ranged from 28 to 1450. The time between the placement of implant and the follow-up visit ranged from 4-6 months to 8 years. The results show that out of 2582 placed implants, 50 (1.94%) failed in BP-treated patients. This is while out of 4050 placed implants, 188 (4.6%) failed in the non-BP group. The results from the meta-analysis demonstrated that BP therapy is significantly associated with increased implant failure rates (RR (95% CI)=1.73 (1.03-2.83), p=0.04). Overall, the qualitative assessment of this review suggests that oral treatment with BPs in post-menopausal women does not increase the rate of dental implant failure. Thus, further studies with larger sample sizes should compare BP and non-BP groups in regard to dental implants.

Investigation of peri-implant diseases prevalence and related risk indicators in patients with treated severe periodontitis over 4 years after restoration.

Background/purpose: History of periodontitis is a well-documented risk indicator of peri-implantitis. However, the influence of severity of periodontitis is still unclear, especially for severe periodontitis. This study was aimed to investigate the prevalence of peri-implant disease and analyze the risk indicators in patients with treated severe periodontitis. Materials and methods: A total of 182 implants from 88 patients (44 males and 44 females) with severe periodontitis with a mean fellow-up period of 76.5 months were enrolled in this study. Patient and implant information, and periodontal and peri-implant conditions were collected to evaluate the prevalence of peri-implant disease and risk indicators. Results: The prevalence of peri-implantitis was 9.1% and 6.6% at the patient-level and implant-level. The prevalence of peri-implant mucositis was 76.1% and 51.1% at the patient-level and implant-level. Risk indicators of peri-implantitis included older age (OR: 1.132), poor proximal cleaning habits (OR: 14.218), implants in anterior area (OR: 10.36), poor periodontal disease control (OR: 12.76), high peri-implant plaque index (OR: 4.27), and keratinized tissue width (KTW)＜2 mm (OR: 19.203). Conclusion: Implants in patients with severe periodontitis after periodontal treatment and maintenance show a low prevalence (9.1%) of peri-implantitis and a relatively high prevalence (76.2%) of peri-implant mucositis. Patient age, peri-implant proximal cleaning habits, implant position, periodontal disease control, peri-implant plaque index, and KTW are associated with prevalence of peri-implantitis.

Assessment of a novel electrochemically deposited smart bioactive trabecular coating (SBTC®): a randomized controlled clinical trial.

OBJECTIVES: A randomized controlled clinical trial of dental implants was conducted to compare the clinical properties of a novel electrochemically deposited calcium phosphate coating to those of a common marketed surface treatment. MATERIAL AND METHODS: Forty implants of the same brand and type were placed in 20 fully edentulous participants requiring mandibular implantation. The two study groups were defined by the surface treatment of the implants. 20 implants in the control group were coated via a commercial electrochemical surface treatment that forms a mixture of brushite and hydroxyapatite, while the remaining 20 in the test group were coated with a novel electrochemical Smart Bioactive Trabecular Coating (SBTC®). A split-mouth design was employed, with each participants receiving one control implant in one mandibular side and a test implant in the other. To mitigate potential operator-handedness bias, control and test implants were randomly assigned to mandibular sides. All cases underwent digital planning, implant placement with a static surgical guide, and participants received locator-anchored full-arch dentures. The primary outcome was implant stability (measured using Osstell ISQ) assessed at insertion, loading, and then 3 months, 9 months, and 2 years post-insertion. The secondary outcome was bone level change (in millimeters) over the 2-year observation period. Oral health-related quality of life (OHRQL) was monitored using the OHIP-14 questionnaire. Complications and adverse events were recorded. RESULTS: Successful osseointegration and implant stability were achieved in all cases, allowing loading. ISQ values steadily increased throughout the observation period. While no significant differences were observed between the SBTC® and control coatings, the test group exhibited a higher ISQ gain. Bone resorption was somewhat lower in the SBTC® but not significantly so. Patients' OHRQL significantly improved after denture delivery and remained stable throughout the follow-up. No complications or adverse events were observed. CONCLUSIONS: Based on the study results, we conclude that the new surface treatment is a safe alternative to the widely used control surface, demonstrating similar osseointegrative properties and time-dependent bone level changes. Further research may explore the broader implications of these findings. TRIAL REGISTRATION: The study is registered on clinicaltrials.gov under the identifier ID: NCT06034171.

Adjacent Implant Influence on Tooth Restoration in a Gastro-Esophageal Reflux Disease (GERD) Patient Using Monoblock Post-Fused Crown: A Case Report.

This case report explores how the presence of an adjacent implant influenced the restoration of a tooth with pulpitis in a gastro-esophageal reflux disease (GERD) patient. A patient with GERD requires a tooth-colored crown not only for aesthetics but also to address potential galvanic concerns arising from an adjacent implant. GERD, a condition causing non-cavity erosion, weakens tooth structure over time, presenting significant challenges in treatment. It resulted in bite relapse and insufficient occlusal clarity over time. A comprehensive treatment approach was needed to restore both function and appearance. This involved managing galvanism using non-metallic materials to ensure optimal occlusal clarity, as well as meticulously reinforcing and restoring tooth structure. Monoblock post-fused crowns were chosen for their superior durability, stability, and comfort. The ceramic layering not only effectively prevented galvanic issues by insulating the tooth structure but also significantly improved the natural appearance of teeth, thereby promoting long-term oral health and successfully managing complex dental concerns. The dental team successfully restored the damaged tooth by considering specific factors that influenced the treatment plan, including achieving optimal aesthetic outcomes.

Estimation of Loss of Crestal Bone Around Dental Implants in Various Tissue Biotypes Using CBCT.

Objectives: To evaluate the loss of crestal bone height around dental implants placed in various tissue biotypes. Materials and Methods: 20 patients with single edentulous sites were allocated randomly, with 10 samples in each into Group I (implants were placed in thick tissue biotype) and Group II (implants were placed in thin tissue biotype). Baseline cone-beam computed tomography (CBCT) was performed after implant placement in both groups, and follow-up CBCT was taken at the time of cementation prior to occlusal loading to assess the crestal bone loss around the mesial and distal side of implants in both groups. Result: A significant loss of crestal bone at both the distal and mesial sides of the implants at the time of cementation was observed in both groups but Group II showed more crestal bone loss as compared to Group I. Conclusion: Mean crestal bone loss was more in Group II (thin tissue biotype) in comparison to Group I (thick tissue biotype). The thick biotype causes less crestal bone changes than the thin biotype, which evokes more loss of crestal bone during the period of peri-implant healing.

Finite Element Analysis of the Influence of Implant Tilting and the Direction of Loading on the Displacement and Micromotion of Immediately Loaded Implants.

Objectives: To investigate the outcome of the loading direction and implant tilting on the micromotion and displacement of immediately placed implants with finite element analysis (FEA). Materials and Method: Eight blocks of synthetic bone were created. Eight screw-type implants were inserted, four axially and four slanted, each measuring 11 mm in length and 4.5 mm in diameter. The axial implants and the tilted implants were distally inclined by 30°. The top of the abutment was subjected to 180 N vertical and mesiodistal oblique (45° angle) loads, and the displacement of the abutment was measured. The abutment displacement and micromotion were estimated, and nonlinear finite element models simulating the in vitro experiment were built. In vitro studies and FEA data on abutment displacement were compared, and the reliability of the finite element model was assessed. Result: Under oblique stress, abutment displacement was larger than under axial loading, and it was also greater for tilted implants than for axial implants. The consistency of the in vitro and FEA data was satisfactory. Under vertical stress, the highest micromotion values in the axial and tilted implants were extremely near. Conclusion: Under mesiodistal oblique stress, tilted implants may have a smaller maximum amount of micromotion than axial implants. The loading direction had a significant impact on the highest micromotion values. The abutment displacement values were not reflected in the maximum micromotion measurements.

Radiographic Diagnostic Choices of Palestinian Dentists for Implant Therapy.

Aim: To report the radiographic preferences during dental implant therapy in Palestine. Materials and Methods: Fourteen multiple-choice questions were delivered in electronic and hardcopy formats questionnaires during the Sixth International Implantology Conference (Palestine). The questions investigated the radiographic techniques that are mostly used based on various clinical scenarios and treatment phases. Results: One hundred and thirty-seven responses were captured. The majority of the participants were general dentists with implant experience (79.6%). Less than a third of the participants (27.2%) were members of the Palestinian Association of Dental Implantology. The majority (85.9%) of them have their practice in a city zone. Panoramic radiograph (PAN) combined with cone beam computed tomography (CBCT) was the most preferred radiographic technique during the planning stage. Conclusion: PAN and CBCT was the preferred choice during the planning stages. A PAN was preferred postoperatively and if no complications were associated. In the case of symptomatic patients, CBCT was the radiograph of choice.

Evaluation of the Effectiveness of Telemedicine in Postoperative Follow-Up Care After Dental Implant Surgery. A Pilot Study.

Aim: Telemedicine has emerged as a potential solution to enhance postoperative follow-up care after dental implant surgery, offering the convenience of remote monitoring and reduced need for in-person visits. Materials and Methods: Participants were randomly assigned to either the telemedicine group (n = 15) or the in-person group (n = 15). In the telemedicine group, patients received remote follow-up care through virtual consultations, during which they could communicate their concerns and share images of the surgical site. The in-person group received standard in-person follow-up visits. Patient satisfaction was measured using a standardized survey, with responses collected on a Likert scale. Results: Telemedicine group exhibited comparable levels of patient satisfaction (mean satisfaction score ± standard deviation: 4.6 ± 0.3) to the in-person group (4.7 ± 0.2). Moreover, clinical outcomes, including wound healing assessment, were similar between the two groups. No significant differences were observed in the incidence of postoperative complications or the need for additional interventions. Conclusion: In conclusion, this pilot study demonstrates that telemedicine is an effective alternative to traditional in-person follow-up care for postoperative dental implant surgery patients. It offers comparable patient satisfaction and clinical outcomes while proving to be more cost-effective.