Effect of the time interval of functional loading on the periapical healing of endodontically treated mandibular molar tooth with pulp necrosis and asymptomatic apical periodontitis: A split-mouth randomized clinical study.

INTRODUCTION: This prospective study evaluated the effect of immediate functional loading (IFL) of full coverage prosthesis on the clinical and radiographic outcome of nonsurgical endodontic therapy (NSET) performed on mandibular molar tooth with pulp necrosis and asymptomatic apical periodontitis. METHODS: In twenty subjects, standardized two visit NSET was performed in bilateral mandibular first molar teeth (split-mouth model) with a diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting a radiographic periapical index (PAI) score ≥3. In each subject, the non-vital bilateral mandibular first molar teeth were randomized to either of two groups that is IFL group (immediate functional loading) or NFL group (functional loading after a time interval of six months). Provisional full coverage prostheses were provided within seven days after completion of endodontic therapy. The cases were followed up clinically and radiographically at six and twelve months. Radiographs were assessed for periapical healing based on PAI scores which were dichotomized as healed (PAI score ≤2) or non-healed (PAI score ≥3). The data was compared using Chi-square and Fischer's exact tests. RESULTS: A recall rate of 100% was achieved at the end of twelve months. All teeth in IFL group and NFL group were clinically asymptomatic. On an inter-group comparison between the proportion of teeth healed and non-healed (radiographic), there was significant difference (p<0.05). CONCLUSION: Immediate functional loading of full coverage prosthesis in endodontically treated mandibular molar tooth with pulp necrosis and asymptomatic apical periodontitis delayed periapical healing.

New Radiological Corticalization Index as an Indicator of Implant Success Rate Depending on Prosthetic Restoration-5 Years of Follow-Up.

The new Radiological Corticalization Index (CI) is an indicator that describes bone remodeling near the dental implant's neck at the pixel level and is not visible to the naked eye. The aim of this research was to evaluate the correlation between the CI and bone remodeling using only radiographic (RTG) images. RTG samples were divided into groups depending on prosthetic restoration; the implant neck area around dental implants was examined, and texture features of the RTG images were analyzed. The study also investigated the type of prosthetic restoration and its influence as a factor on bone structure. The statistical analysis included evaluating feature distribution, comparing means (t-test) or medians (W-test), and performing a regression analysis and one-way analysis of variance or the Kruskal-Wallis test, as no normal distribution or between-group variance was indicated for the significant differences in the investigated groups. Differences or relationships were considered statistically significant at p < 0.05. The research revealed correlations between single crowns, overdenture restoration, bridge restoration, platform switching, prosthetic fracture, CI, and also marginal bone loss where p was lower than 0.05. However, the corticalization phenomenon itself has not yet been fully explored. The findings suggest that, depending on the type of prosthetic restoration, the corticalization index may correlate with marginal bone loss or not. Further research is necessary, as the index is suspected to not be homogeneous.

Immediate loading on two adjacent single dental implants with definitive nonsplinted restorations: A proof of concept in the posterior zone.

OBJECTIVES: To evaluate clinical, clinician- and patient-reported outcomes (PROs) of two adjacent single posterior implants immediately loaded with definitive single crowns up to 1 year. Ten patients in need of two adjacent posterior single implants were included. All implants were placed applying a fully digital workflow. Definitive screw-retained single zirconia crowns were delivered within 72 h after implant placement. Clinical parameters, patient- and clinician-reported outcomes were assessed up to 1 year of follow-up. CLINICAL CONSIDERATIONS: Clinical outcomes remained stable, with no implant failures or technical and biological complications throughout the observation period. Patient satisfaction was very high at baseline (crown delivery) and remained consistently high at 6 and 12 months of follow-up. Crown insertion 3 days after implant placement was rated as an easy procedure by clinicians. CONCLUSIONS: Two adjacent single implants with immediate definitive restorations (<72 h) in the posterior region appear to be a viable and easy treatment option to shorten the overall treatment time and potentially enhancing patient satisfaction. However, randomized controlled trials are needed to confirm the advantages of this treatment protocol over a delayed loading approach. CLINICAL SIGNIFICANCE: In selected cases, immediate implant loading with definitive restorations in the posterior region appears a valuable and straightforward option to shorten the overall treatment time.

Clinical Outcome of Immediate Loading UV-Photofunctionalized Implants in Patients with Completely Edentulous Mandible, Placed with Guided Surgery.

Objectives: The purpose of this study was to evaluate clinical results of immediate loading UV-photofunctionalized dental implants placed using guided surgery in patients with completely edentulous mandible. Material and Methods: In this study, 58 fully edentulous patients were treated with immediate loading implant-supported mandibular prostheses. All patients underwent a thorough clinical examination according to the generally accepted scheme; qualitative and quantitative parameters of the jaw bones patients were diagnosed with cone beam computerized tomography (CBCT). Surgical templates modeled in the 3 Shape software were made from biocompatible polymeric materials and provided with depth-calibrated drill sleeves for preparing osteotomies using a 3D printer (Stratasys). Before short implant placement, ultraviolet functionalization of implant surfaces was performed by UV Activator YWJ-QSY001 (Foshan, Wenjian Medikal Enstriman) in the device for 20 s. After flapless surgery, implant sockets were prepared with guided surgery and implants were placed through the sleeves of the surgical template tightening torque of 35-45 Ncm. An implant-supported temporary prosthesis made of acrylic resin was installed 6 h after implantation. Final dental prosthetics was performed 2 months after implant placement.The patients had 128 short (length 5-6 mm, diameters 4,5-5 mm) and 256 implants with length greater than 10 mm in bone segments with sufficient bone parameters. The following parameters were assessed: implant success, prosthetics survival and changes in peri-implant marginal bone loss (MBL). Results: During a clinical examination, no serious biological or prosthetic complications have been reported. The esthetic result evaluated from patients was excellent. The mean ISQ of short implants was 69.2 ± 8 for primary stability at implant placement and 73.6 ± 4 ISQ after 3 months. The mean of implants with length greater than 10 mm was 71,2ISQ at implant placement, respectively, and 75,6 ISQ after 3 months. After 3 months of prosthetic loading for short implants marginal bone loss (MBL) 0.74 mm, after 1 year of MBL 11.21 mm, after 5 years of MBL 1,37 mm, for implants with length greater than 10 mm after 3 months of MBL 0.72 mm, after 1 year of MBL 1.19 mm and after 5 years of MBL 1.35. There was no statistically significant difference in clinical indices between short and standard implants. After 5 years of follow-up, stable levels of bone tissue around the implants and healthy tissues around the implants were recorded, and postoperative occlusal function was favorable. The success rates of the short implants in maxilla were 95.5%, and the success rates of the short implants in mandible were 98.7%. The success rates of the implants with length greater than 10 mm in maxilla were 97.8%, and the success rates of the implants with length greater than 10 mm in mandible were 98.8%. Conclusion: Computer-guided implant surgery and immediate loading of UV-photofunctionalized implants in patients with completely edentulous mandible are a predictable and effective method with a minimum rehabilitation period.

Precisely controlling the surface roughness of silica nanoparticles for enhanced functionalities and applications.

HYPOTHESIS: Colloids with rough topography demonstrate more complex interactions and tremendous potential in industrial applications. However, relevant studies suffer from a range of challenges, including cumbersome synthesis, complex characterization, and very limited functionalities. A comprehensive study of rough nanoparticles can not only broaden our understanding of rough colloids, but also help to avoid some of their detrimental impacts in real life (e.g., clogging and pumping failures in slurry processing). EXPERIMENTS: A facile route to precisely control the surface roughness of silica nanoparticles and a highly efficient method to characterize the surface roughness were developed respectively. The fabricated particles can be applied for the immobilization of metal nanostructures; their cytotoxic effects and the capability to be used as a drug-delivery vehicle were also evaluated. FINDINGS: Modifying the addition time of precursors (i.e., TEOS and MPTMS) can precisely control the surface roughness of silica nanoparticles. The developed characterization method based on TEM observations allows statistical analyses on a large number of particles, and therefore features very reasonable accuracy. These rough particles behave like microporous materials, where the loading strategy is closely related to their surface roughness. Medium rough particles are promising carriers of metal nanostructures, while the roughest ones are excellent candidate for doxorubicin delivery to cancer cells.

Evaluation of different surface treated implants after provisionalization: A 6-month prospective study.

Background: Replacing missing teeth with dental implants has become the best treatment option; therefore, clinicians need to understand the predictability of the treatment. Surface treatment of implants is one of the methods to improve osseointegration, thus improving the quality of treatment. Increasing esthetic awareness among patients has led to the popularity of immediate provisionalization of dental implants. This study investigated the effect of surface treatment on implant stability when loaded with immediate non-functional temporary prostheses and compared the superiority of one surface treatment over the other in terms of osseointegration by evaluating implant stability quotient (ISQ). Methods: Twenty implants with different surface treatments were placed, i.e., resorbable blast media (RBM) surface and alumina blasted/acid-etched (AB/AE) surfaces. All the implants were non-functionally loaded, and ISQ was measured immediately after implant placement and 6 and 12 weeks after non-functional loading. Crestal bone levels, mPI, mSBI, and peri-implant probing depths were compared for both groups at 1, 3, and 6 months. Results: At 12 weeks, all the implants showed desirable ISQ, indicating successful osseointegration. The increase in ISQ at 12 weeks was significantly higher for RBM implants compared to baseline, indicating a more predictable course of osseointegration. Crestal bone levels recorded at 1, 3, and 6 months did not significantly differ between the groups. All other parameters showed comparable values for both groups at all intervals. Conclusion: Replacing missing teeth with dental implants with immediate non-functional restorations is a predictable treatment option.

Exploring the Importance of Corticalization Occurring in Alveolar Bone Surrounding a Dental Implant.

Several measures describing the transformation of trabecular bone to cortical bone on the basis of analysis of intraoral radiographs are known (including bone index or corticalization index, CI). At the same time, it has been noted that after functional loading of dental implants such transformations occur in the bone directly adjacent to the fixture. Intuitively, it seems that this is a process conducive to the long-term maintenance of dental implants and certainly necessary when immediate loading is applied. The authors examined the relationship of implant design features to marginal bone loss (MBL) and the intensity of corticalization over a 10-year period of functional loading. This study is a general description of the phenomenon of peri-implant bone corticalization and an attempt to interpret this phenomenon to achieve success of implant treatment in the long term. Corticalization significantly increased over the first 5-year functional loading (CI from 200 ± 146 initially to 282 ± 182, p < 0.001) and maintained a high level (CI = 261 ± 168) in the 10-year study relative to the reference bone (149 ± 178). MBL significantly increased throughout the follow-up period­5 years: 0.83 ± 1.26 mm (p < 0.001), 10 years: 1.48 ± 2.01 mm (p < 0.001). MBL and radiographic bone structure (CI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. In the scope of the study, it can be concluded that the phenomenon of peri-implant jawbone corticalization seems an unfavorable condition for the future fate of bone-anchored implants, but it requires further research to fully explain the significance of this phenomenon.

Versatility of Basal Cortical Screw Implants with Immediate Functional Loading.

Background: The purpose of this study is to evaluate the survival rate of the basal cortical screw (BCS) implant system inserted in healed edentulous ridges (E) or extraction sockets (ES) with immediate loading functional protocol in varying clinical situations. Methods: A total of 125 BCS implants were placed in 14 patients, immediately loaded and observed for 20.07(± 4.23) months. Ninety-four were placed in E sites and 31 were placed in ES sites. They were evaluated for bone loss, soft tissue shrinkage around the prosthesis, improvement in quality of life (QOL), and their survival after 1 year. Results: Total of 121/125(96.8%) implants survived while 4/125(3.2%) failed at the end of follow-up. Average bone loss after 1 year was 0.33 mm (E) and - 1.57 mm (ES), average soft tissue shrinkage was 0.50 mm (E) and 1.42 mm (ES) and average Patient's Global Impression of Change (PGIC) scale score was 6.36(± 0.63) at 1 year. The complications observed were mobility {3(2.4%)}, pain/discomfort {1(0.8%)} and fracture of abutment at the neck {1(0.8%)}, prosthesis loosening {2(9%)} and requirement of relining {3(13%)}. No periimplantitis was observed. Conclusion: This is the only study to report the marginal bone loss and soft tissue changes around BCS implants and an index-based improvement in QOL of such patients. The BCS implant system with immediate functional loading protocol is a versatile modality to rehabilitate a single tooth, a segment or a full arch with healed ridges as well as extraction sites; it gives high success rate and minimal complications.

Immediate Functional Loading with Full-Arch Fixed Implant-Retained Rehabilitation in Periodontal Patients: Clinical Study.

(1) Background. The immediate functional loading of implants is a clinical procedure used for treating periodontal edentulous patients. This clinical study aimed to evaluate the clinical outcomes of the immediate functional loading of implants with fully fixed rehabilitations in compromised periodontal patients. (2) Methods. Three hundred and five implants IPX screw implants were placed in 27 periodontal patients using an immediate functional loading protocol with fixed rehabilitations. All patients had a previous history of periodontitis, four patients (14.8%) were smokers and seven patients (25.9%) suffered from chronic medical conditions. (3) Results. Implant and prosthetic clinical findings were evaluated during a mean period of 41.3 ± 19.6 months. No implants were lost during the clinical follow-up. The cumulative survival rate for all implants was 100%. Regarding the prostheses designed, a total of 54 fixed prostheses were placed in the 27 patients immediately after the surgery. Forty-four hybrid fixed prostheses (81.5%) and 10 fixed rehabilitations (18.5%) were placed in the patients. The mean marginal bone loss was 1.51 ± 1.16 mm, ranging from 0 to 3.5 mm during the follow-up evaluation. Thirty-one implants (10.2%) in 10 patients (37%) were associated with peri-implantitis. Five patients (18.5%) showed some kind of technical complications (loss/fracture of the prosthetic screw, acrylic resin fracture, ceramic chipping). (4) Conclusions. The clinical outcomes of this study demonstrate that fixed rehabilitation by immediate functional loading of implants is considered a predictable procedure.

Measures of Corticalization.

After the insertion of dental implants into living bone, the condition of the peri-implant bone changes with time. Implant-loading phenomena can induce bone remodeling in the form of the corticalization of the trabecular bone. The aim of this study was to see how bone index (BI) values behave in areas of bone loss (radiographically translucent non-trabecular areas) and to propose other indices specifically dedicated to detecting corticalization in living bone. Eight measures of corticalization in clinical standardized intraoral radiographs were studied: mean optical density, entropy, differential entropy, long-run emphasis moment, BI, corticalization index ver. 1 and ver. 2 (CI v.1, CI v.2) and corticalization factor (CF). The analysis was conducted on 40 cortical bone image samples, 40 cancellous bone samples and 40 soft tissue samples. It was found that each measure distinguishes corticalization significantly (p < 0.001), but only CI v.1 and CI v.2 do so selectively. CF or the inverse of BI can serve as a measure of peri-implant bone corticalization. However, better measures are CIs as they are dedicated to detecting this phenomenon and allowing clear clinical deduction.

Marginal Bone Level Evaluation of Fixed Partial Dental Prostheses Using Preformed Stock versus CAD/CAM Customized Abutments.

Background: The maintenance of marginal bone levels around dental implants is an important criterion for evaluating the success of implants. Although computer-aided design/computer-aided manufacturing (CAD/CAM) customized abutments (CAs) provide more flexible solutions, compared with the original preformed stock abutments (PAs), there are dimensional tolerances and underlying drawbacks in the production of CAD/CAM CAs, which may change the tightness and seamless connection between fixtures and abutments set by the manufacturer and then affect the long-term stability of the abutments. This study aimed to examine the change in both mesial and distal bone levels using digital periapical radiographs to evaluate the difference between CAD/CAM CAs and original PAs.Material and methods: Radiographs were taken before delivery; after functional loading for 1 month; and after 3, 6, and 12 months; and the vertical marginal bone levels (vMBLs) of both the mesial and distal surrounding implant bones were measured. All data are presented as means ± standard errors and were analyzed using Student's t-test. A p-value < 0.05 was judged to represent a significant difference. Results: A total of 57 implants in 50 patients were divided into 22 CAD/CAM CAs and 35 original stock abutments. The PAs appeared to have a more stable bone level. By contrast, the amount of bone level change in the CAs was higher than that in the PAs. The change in the vMBL of the CAs was significantly more than that of the PAs after functional loading for 1 month (p = 0.006), 3 months (p = 0.013), 6 months (p = 0.014), and 12 months (p = 0.002). In contrast, the distal marginal bone level was lower than the mesial marginal bone level in any period. Nevertheless, the bone levels of the CAs and PAs in any period were comparable with no significant difference. Conclusions: Significant differences were found between the mesial and distal bone levels in the PAs. The CAD/CAM CAs showed a significantly greater bone level change than the original stock abutments after functional loading.

What Does Bone Corticalization around Dental Implants Mean in Light of Ten Years of Follow-Up?

The phenomenon of peri-implant bone corticalization after functional loading does not yet have a definite clinical significance and impact on prognosis. An attempt was made to assess the clinical significance of this phenomenon. This prospective study included 554 patients. Standardized intraoral radiographs documenting the jawbone environment of 1556 implants were collected. The follow-up period was 10 years of functional loading. Marginal alveolar bone loss (MBL) and radiographic bone structure (bone index, BI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. After five years, bone structure abnormalities expressed by a reduction of BI to 0.47 ± 0.21 and MBL = 0.88 ± 1.27 mm were observed. Both values had an inverse relationship with each other (p < 0.0001). Reference cancellous bone showed BI = 0.85 ± 0.18. The same relationship was observed after ten years of functional loading: BI = 0.48 ± 0.21, MBL = 1.49 ± 1.94 mm, and again an inverse relationship (p < 0.0001). Increasing corticalization (lower BI) is strongly associated with increasing marginal bone loss and increasing corticalization precedes future marginal bone loss. Marginal bone loss will increase as corticalization progresses.

An evaluation of peri-implant marginal bone loss according to implant type, surgical technique and prosthetic rehabilitation: a retrospective multicentre and cross-sectional cohort study.

To evaluate implant loss (IL) and marginal bone loss (MBL); follow-up period of up to 10 years after prosthetic loading. Retrospective multi-centre cross-sectional cohort study. Double analysis: (1) all the implants (n = 456) were analysed; (2) to allow for possible cluster error, one implant per patient (n = 143) was selected randomly. Statistical analysis: Spearman's correlation coefficient; Kruskal-Wallis (post-hoc U-Mann-Whitney); Chi-square (post-hoc Haberman). (1) Analysing all the implants (456): IL was observed in patients with past periodontitis (6 vs. 2.2%, p < 0.05), short implants (12 vs. 2.8%, p < 0.001) and when using regenerative surgery (11.3 vs. 2.9%, p < 0.001); greater MBL was observed among smokers (0.39 ± 0.52 vs. 0.2 ± 0.29, p < 0.01), maxillary implants (0.28 ± 0.37 vs. 0.1 ± 0.17, p < 0.0001), anterior region implants (0.32 ± 0.36 vs. 0.21 ± 0.33, p < 0.001), external connection implants (0.2 ± 0.29 vs. 0.63 ± 0.59, p < 0.0001), and 2-3 years after loading (p < 0.0001). (2) analysing the cluster (143): IL was observed in smokers (18.8 vs. 3.5%, p < 0.05), splinted fixed crowns (12.9%, p < 0.01), short implants (22.2 vs. 4.0%, p < 0.01) and when using regenerative surgery (19.2 vs. 3.4%, p < 0.01); greater MBL was observed in maxillary implants (0.25 ± 0.35 vs. 0.11 ± 0.18, p < 0.05), in the anterior region (p < 0.05), in the first 3 years (p < 0.01), in external connection implants (0.72 ± 0.71 vs. 0.19 ± 0.26, p < 0.01) and in short implants (0.38 ± 0.31 vs. 0.2 ± 0.32, p < 0.05). There is greater risk in smokers, patients with past periodontal disease, external connection implants, the use of short implants and when regenerative techniques are used. To prevent MBL and IL, implantologists should be very meticulous in indicating implants in patients affected by these host factors.

Esthetic Indication for Dental Implant Treatment and Immediate Loading (3). Case Report and Considerations Regarding the Aspect of the Patient's Right to Self-Determination in Medical Decision-Making.

The technology of the Strategic Implant® has expanded the indications for tooth and bone removal. This case report shows what kind of results are possible and how much the appearance of a patient can be changed within a few days if both teeth and bone are removed. The treatment option explained here could be considered by patients with a gummy smile. This treatment conflicts with the traditional thinking of dentists, who are educated to keep and maintain teeth. This can be compared to other fields of esthetic surgery where the patient's right to self-determination in medical decision-making has been established for a considerable period of time and is more frequent than in dentistry.

Consensus Regarding 16 Recognized and Clinically Proven Methods and Sub-Methods for Placing Corticobasal® Oral Implants.

This Consensus-Document is issued by the International Implant Foundation (Munich/Germany). It describes distinct methods of placement of cortico-basal oral implants in different areas of the jaw bone and the maxillo-facial skeleton. The implants utilize the method of "osseofixation" instead of "osseointegration" for achieving primary, functional stability, hence they work according to the (AO-) principles of fracture treatment. The concept of the technology allows for immediate functional loading, just as it allows for various types of loading following orthopaedic surgery. The 16 methods and sub-methods as described and displayed here have been undergoing extensive observation and testing and they have been approved by the Board of the International Implant Foundation. All Consensus Documents of the International Implant Foundation are revised every three years. This is the 3rd version of the Consensus Document on placement of corticobasal oral implants Level of Evidence: S3 (evidence based, systematically developed consensus guideline).

Immediate Functional Loading: Results for the Concept of the Strategic Implant®.

BACKGROUND: Immediate functional loading of one-piece dental implants has become an accepted treatment modality for fixed restorations in fully edentulous mandibles and maxillae. Nevertheless, studies regarding immediate loading procedures in extraction sites in both the jaws, as well as in segment reconstructions and single-tooth replacements, are limited. PURPOSE: The purpose of this study was to evaluate the presently used protocol for immediate functional loading (within maximum 3 days) of one-piece implants which are placed according to the following methods as published by the IF. MATERIALS AND METHODS: This prospective cohort study included totally 87 consecutively treated patients who receive 1169 immediately loaded one-piece Strategic Implant®, supporting fixed complete-arch maxillary or mandibular metal-ceramic bridges or segment reconstructions in both the jaws. All implants were placed by one treatment provider, who delivered also the prosthetics and controlled all cases himself over the years. Data were extracted by an experienced dentist from the patient records and from panoramic X-rays. A number of patients were interviewed at the end of the observation period. Although a total of 5100 implants were placed and observed for 12 - 57 months totally (with 105 implants out of these, having failed), this article reports the detailed results only for 1169 implants which have been followed for at least 48 months. RESULTS: Immediate functional loading of using multiple, cortically anchored basal screw implants as a support for fixed full-arch and segment prosthesis in the upper and lower jaw demonstrated a high cumulative implant survival rate after an observation period of up to 57 months. Neither hypertension nor diabetes and neither smoking nor bending of the implant's neck had an influence on the success of the implants observed in this study. Within the limits of this study (5100 Strategic Implants were observed over a period of up to 57 months), "peri-implantitis" was not observed at all. CONCLUSION: The treatment concept developed for the technology of the Strategic Implant® is safe and effective and it avoids bone augmentations and "peri-implantitis".

A longitudinal comparison of appendicular bone growth and markers of strength through adolescence in a South African cohort using radiogrammetry and pQCT.

To compare growth patterns and strength of weight- and non-weight-bearing bones longitudinally. Irrespective of sex and ethnicity, metacarpal growth was similar to that of the non-weight-bearing radius but differed from that of the weight-bearing tibia. Weight- and non-weight-bearing bones have different growth and strength patterns. INTRODUCTION: Functional loading modulates bone size and strength. METHODS: To compare growth patterns and strength of weight- and non-weight-bearing bones longitudinally, we performed manual radiogrammetry of the second metacarpal on hand-wrist radiographs and measured peripheral quantitative computed tomography images of the radius (65%) and tibia (38% and 65%), annually on 372 black and 152 white South African participants (ages 12-20 years). We aligned participants by age from peak metacarpal length velocity. We assessed bone width (BW, mm); cortical thickness (CT, mm); medullary width (MW, mm); stress-strain index (SSI, mm3); and muscle cross-sectional area (MCSA, mm2). RESULTS: From 12 to 20 years, the associations between metacarpal measures (BW, CT and SSI) and MCSA at the radius (males R2 = 0.33-0.45; females R2 = 0.12-0.20) were stronger than the tibia (males R2 = 0.01-0.11; females R2 = 0.007-0.04). In all groups, radial BW, CT and MW accrual rates were similar to those of the metacarpal, except in white females who had lower radial CT (0.04 mm/year) and greater radial MW (0.06 mm/year) accrual. In all groups, except for CT in white males, tibial BW and CT accrual rates were greater than at the metacarpal. Tibial MW (0.29-0.35 mm/year) increased significantly relative to metacarpal MW (- 0.07 to 0.06 mm/year) in males only. In all groups, except white females, SSI increased in each bone. CONCLUSION: Irrespective of sex and ethnicity, metacarpal growth was similar to that of the non-weight-bearing radius but differed from that of the weight-bearing tibia. The local and systemic factors influencing site-specific differences require further investigation. Graphical abstract.

Indications and Treatment Modalities with Corticobasal Jaw Implants.

This consensus document describes treatment modalities with corticobasal implants in the field of oral and maxillofacial implantology.

Dental Implant Treatment and Immediate Functional Loading (1). Case Report and Considerations: Extended Treatment Options Using the Strategic Implant® and Indications and Objectives for Comprehensive Dental Implant Treatment.

While materials for the restoration of teeth and new (digital) technologies develop fast, the choices of the treatment provider and the patients get wider. Choosing an adequate and long-lasting treatment is a question of "doing the right thing," and only after that, the dentist has to think about the question how to do the work properly. This case report explains and illustrates a case, where an adequate treatment by means of conventional dentistry would not have been possible on one hand, and where treatment with the technology of the Strategic Implant® provided a perfect result within only a few days. Thanks to this technology, patients can be treated with fixed prostheses regardless of the amount of residual bone. Recently, published long-term observations on large amounts of implants have shown that the results are sustainable.

Functional and Esthetic Indication for Dental Implant Treatment and Immediate Loading (2) Case Report and Considerations: Typical Attitudes of Dentists (and their Unions) toward Tooth Extractions and the Prevention of Early, Effective, and Helpful Dental Implant Treatment in the European Union.

The technology of the Strategic Implant® facilitates dental implant treatment almost regardless of the available bone. This explains its increasing use to resolve problems with the dentition of the middle-aged patient in a radical manner, simply by extracting the residual dentition and placing implants. While a radical change in the implant treatment paradigm has taken place in some countries, in other countries, dentists try hard to keep their work area free of implants or to deliver them only as a last resort. Liberating patients from the burdens of their own teeth are not advocated by dental universities, as their main field of teaching deals with the repair of teeth and conventional ways of replacing them. This case report shows a standard treatment with Strategic Implants®, discussing the topic from the point of view of practitioners, universities, and other parties involved in decision-making. The authors conclude that the interests of the patients are not respected in many cases because the parties involved have vested interests in other treatment modalities.