A review on guided bone regeneration using titanium mesh.

The gold standard for bone regeneration in atrophic ridge patients is guided bone regeneration (GBR). This makes it possible to get enough bone volume for an appropriate implant-prosthetic rehabilitation. The barrier membranes must meet the primary GBR design requirements, which include adequate integration with the surrounding tissue, spaciousness and clinical manageability. Titanium mesh's superior mechanical qualities and biocompatibility have broadened the indications of GBR technology, enabling it to be used to restore alveolar ridges with more significant bone defects. GBR with titanium mesh is being used in many clinical settings and for a range of clinical procedures. Furthermore, several advancements in digitalization and material modification have resulted from the study of GBR using titanium mesh. Hence, we report a review on the various characteristics of titanium mesh and its current use in clinical settings for bone augmentation.

Glucose monitoring from gingival crevicular fluid blood among chronic periodontitis patients at Ar Rass, Saudi Arabia.

Gingival crevicular fluid blood (GCFB), during periodontal probing is useful to assess blood sugar levels using a glucometer. Hence, blood glucose levels in chronic periodontitis with and without diabetes were measured using gingival crevicular fluid and compared to finger stick blood glucose levels (FSBG). A total of 48 patients (24 diabetics and 24 non-diabetics) with chronic periodontitis who matched the inclusion criteria were divided into two groups, Group I and Group II, respectively. The entire patient's plaque and Russel's periodontal indices were recorded and a glucometer was used to measure random blood glucose from the gingival crevicular fluid and finger pricks. A positive association between the blood glucose level measured by a fingerstick and the gingival crevicular fluid is observed. Thus, GCFB can be used as a reliable chairside diagnostic technique for diagnosis diabetes in a dental setting.

Evaluating the impact of scan body angulation and geometric attachments on the accuracy of complete-arch digital implant impressions: A comparison of two intraoral scanners.

PURPOSE: To investigate the effects of scan body (SB) angulation and geometric attachments (GAs) on the deviations of complete-arch digital implant impressions obtained using intraoral scanners (IOSs), in relation to the gold-standard desktop scanner. MATERIAL AND METHODS: Two IOSs (iTero and Omnicam), two SB angulations (0 degrees and 30 degrees), and GAs for the SBs were investigated. SBs were attached to an edentulous maxillary cast with the following implant analogs: parallel 0-degree at positions #13, #23, and #26, and 30-degree posteriorly tilted at position #16. The cast was digitized using a reference desktop scanner, followed by ten consecutive digital scans using each IOS (five scans with GAs and five without GAs, n = 20). Meshes obtained from the IOS scans were superimposed on the master reference mesh. Linear distance and 3D surface deviations from the reference mesh were calculated. A three-way multivariate analysis of variance (MANOVA) was employed to assess the effects of angulation, IOS type, and GAs on the combined dependent variables (α = 0.05). RESULTS: No significant three-way interaction was observed between IOS type, SB angulation, and GAs for combined deviations from the reference scan (p = 0.56). Simple main effect analysis revealed that iTero exhibited significantly lower mean 3D surface and linear deviations than Omnicam (p < 0.05). Additionally, the use of GAs significantly reduced deviations (p < 0.001), with mean deviation reductions for both scanners ranging from 26-33 micrometers (µm) for 3D deviations and 15-21 µm for linear distance deviations. No differences were found between angled and parallel SBs regarding 3D surface and linear distance deviations (p ≥ 0.05). CONCLUSIONS: ITero demonstrated significantly smaller deviations, and the use of GAs led to significantly reduced distance and 3D surface deviations. SB angulations did not impact scan deviations.

Disinfection of implant abutment connection using antimicrobial photodynamic therapy and 0.2% chlorhexidine gel applications immediately before prosthesis delivery: Clinical and radiographic status at 1-year of follow-up.

OBJECTIVE: The aim of this 1-year follow-up randomized control trial was to compare the clinicoradiographic status of implants that were disinfected with antimicrobial photodynamic therapy (aPDT) and 0.2% chlorhexidine gel immediately before prosthesis delivery. METHODS: Forty-five partially edentulous patients with implants placed in the region of missing mandibular first molars and a history of periodontal diseases were included. Immediately before prosthesis delivery, patients were divided into three groups. In groups 1 and 2, implant abutment disinfection (IAD) was performed using aPDT and 0.2% chlorhexidine immediately before prosthesis delivery. In Group-3, IAD was performed using a steaming protocol. Peri-implant modified plaque index (mPI), modified gingival index (mGI), probing depth (PD) and crestal bone loss (CBL) were assessed at 1 year of follow-up. Power analysis was done and group comparisons were done. Logistic regression analysis was done to corelate clinical parameters with demographic variables. P<0.01 was considered statistically significant. RESULTS: In total, 15, 15, and 15 implants were present among patients in groups 1, 2 and 3, respectively. There was no statistically significant difference in peri-implant mPI, mBoP, PD and CBL in all groups (Table 2). None of the patients had periodontal disease and there was no statistically significant correlation between peri-implant clinicoradiographic parameters with age, toothbrushing and flossing habits, and duration of implants in function. Eighty percent, 86.7% and 100% individuals in groups 1, 2 and 3, respectively reported that they were brushing teeth twice daily. Flossing of interproximal spaces once daily was reported by 66.7%, 73.3% and 66.7% individuals in groups 1, 2 and 3, respectively. CONCLUSION: As long as oral hygiene is stringently maintained after implant prosthesis delivery, IAD can be performed using aPDT, 0.2% CHX gel or steam-disinfection.

Three Dimensional Digitally Designed Surgical Guides in Esthetic Crown Lengthening: A Clinical Case Report with 12 Months Follow Up.

INTRODUCTION: The digital workflow has improved the quality of dental care. The integration of computer-aided design/computer-aided-manufacturing (CAD/CAM), cone-beam-computer-tomography (CBCT) and three-dimensional (3D) printing offers significant advantages for treatment planning and allows the dentist to visualize the treatment outcomes before they are initiated. Digital dental technology has become reliable and affordable with many applications for surgical and restorative solutions. CASE DESCRIPTION: The aim of the presented case is to demonstrate the advantages of 3D digitally-designed surgical guides in periodontal surgery. The patient needed esthetic crown lengthening to correct the altered passive eruption. Digital impressions, digital smile design (DSD) and CBCT were used for treatment planning and fabricating of 3D printed surgical guides using a 3D printer. These surgical guides were then used clinically. The clinical outcomes of 12 months follow up were precise and the surgeries were straight-forward, with relatively short procedure time. This is consistent with published literature comparing digitally generated guides to free-hand procedures. CONCLUSION: The digitally generated 3D printed guides are reliable tools to perform surgeries precisely. Digital planning software is an efficient communication tool with referring dentists.

Comparison of Peri-Implant Clinicoradiographic Parameters among Non-Smokers and Individuals Using Electronic Nicotine Delivery Systems at 8 Years of Follow-up.

PURPOSE: It is hypothesised the peri-implant soft-tissue inflammatory parameters (plaque index [PI], gingival index [GI], and probing depth [PD]) are poorer and crestal bone loss (CBL) higher around dental implants placed in electronic nicotine delivery systems (ENDS)-users than controls (individuals that had never consumed any form of tobacco). The aim of this study was to assess the peri-implant clinicoradiographic parameters among non-smokers and individuals using ENDS at 8 years of follow-up. MATERIALS AND METHODS: Self-reported non-smokers and individuals habitually using ENDS were included. A questionnaire was used to gather information about age in years, sex (female or male), daily frequency and duration of use of ENDS, family history of smoking and/or vaping, daily toothbrushing and flossing and most recent visit to a dentist or dental hygienist. These patients were evaluated for peri-implant CBL, PD, PI, BOP. The mesial and distal CBL was measured on digital bitewing radiographs that were taken using the long-cone paralleling technique. Group comparisons were statistically assessed and the level of significance was set at p < 0.05. RESULTS: One hundred twenty-seven individuals (92 males and 35 females) were included. Sixty-three individuals (46 males and 17 females) had used ENDS for 9.2 ± 0.8 years (group 1) and 64 (46 males and 18 females) did not use any nicotinic products (group 2). The mean ages of individuals in groups 1 and 2 were 34.2 ± 1.3 and 35.1 ± 0.5 years, respectively. In all patients, platform-switched dental implants with moderately rough surfaces were placed at bone level using an insertion torque of 30--35 Ncm. In both groups, implants had a diameter of 4.1 mm and the lengths ranged between 11 and 14 mm. In groups 1 and 2, implants were in function for 8.8 ± 0.4 and 8.5 ± 0.2 years, respectively. There was no statistically significant difference in mPI, mBoP, PD, and mesial and distal CBL around implants in groups 1 and 2 at 8 years of follow-up. CONCLUSION: Dental implants can demonstrate stable clinicoradiographic status and can remain functionally stable in non-smokers and ENDS users, provided that strict home oral hygiene measures are adopted.

Ten-year Survival Rate of Cement- and Screw-retained Restorations on Bone-level Dental Implants in Grafted and Non-grafted Sites: A Retrospective Study.

PURPOSE: The aim of the present 10-year follow-up study was to assess the survival rate of cement- and screw-retained restorations on dental implants placed in grafted sites. MATERIALS AND METHODS: Patients with cement- (group 1) and screw-retained (group 2) restorations on implants placed in grafted sites and patients with cement- (group 3) and screw-retained (group 4) restorations on implants placed in non-grafted sites were included. Demographic data was recorded using a questionnaire, and information regarding implant dimensions, surface characteristics, insertion torque, type of bone graft used, jaw location and duration of implants in function was retrieved from patients' records. These patients were evaluated for peri-implant crestal bone loss (CBL), probing depth (PD), modified plaque index (mPI), and modified bleeding on probing (mBOP). p < 0.05 was considered statistically significant. RESULTS: Eighty-eight partially edentulous individuals (n = 22 in each group) were included. The mean ages of individuals in all groups were comparable in all groups. In each patient, 1 bone-level platform-switched dental implant with moderately rough surfaces was placed using an insertion torque of 30-35 Ncm. In all groups, the length and diameter of implants ranged between 11-14 mm and 4.1-5 mm, respectively. There was no statistically significant difference in mPI, mBoP, PD, and mesial and distal CBR around implants in any of the groups. CONCLUSION: Bone-level implants restored with cement and screw-retained restorations can possess a stable clinicoradiographic status and remain functional in grafted and non-grafted sites, provided strict domestic oral hygiene measures are adopted and routine dental prophylaxis is carried out by oral healthcare providers.