Strategic treatment for a patient with missing lateral incisor and first molar accompanied by posterior scissor bite and an impacted premolar.

Managing orthodontic treatment for adults with missing permanent teeth can be intricate, especially when dealing with a posterior scissor bite and an impacted tooth. This case report presents successful treatment of a female patient with dental and skeletal Class II malocclusion, high mandibular plane angle, missing maxillary left lateral incisor and mandibular right first molar, as well as right posterior scissor bite, and a deeply impacted mandibular left second premolar. In the maxilla, the right second molar and right lateral incisor were strategically extracted to eliminate the scissor bite and enhance frontal esthetic balance. In the mandible, the edentulous space caused by early loss of the first molar was successfully closed and the impacted second premolar was guided into its proper position after surgical exposure. Finally, symmetric frontal esthetics, well-aligned dentition with ideal intercuspation and an improved profile were achieved, which remained stable in the 17 month follow-up.

Ultrasound-based jawbone surface quality evaluation after alveolar ridge preservation.

BACKGROUND: Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high-frequency ultrasound (US) can classify bone readiness in humans, using micro-CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans. METHODS: A total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co-registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B-mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro-CT as the gold standard. RESULTS: Hydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm3; >0.45 mm3/mm3), questionable (1500-2200 mg/cm3; 0.4-0.45 mm3/mm3), and unfavorable (<1500 mg/cm3; <0.4 mm3/mm3). The present US B-mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T-test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US-derived tiers and BVTV. CONCLUSION: Preliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US-based socket healing evaluation after ARP.

Retention of Mandibular Complete Overdentures using Mini Dental Implants (Ø < 3 mm) and Standard Diameter Implants (Ø > 3mm): A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

PURPOSE: The objective of the present systematic review and meta-analysis was to assess randomised controlled trials (RCTs) which assessed the efficacy of mini dental implants (MDIs) and standard-diameter implants (SDIs) in retaining mandibular overdentures (MO). MATERIALS AND METHODS: The focused question was "Is there a difference in the mechanical stability between MDIs and SDIs in retaining MO?" Indexed databases were searched up to and including November 2023 using different keywords. Boolean operators were used during the search. The literature was searched in accordance with the PRISMA guidelines. The PICO characteristics were: patients (P) = individuals with complete mandibular dentures requiring dental implants; Intervention (I) = placement of MDIs under mandibular dentures; Control (C) = placement of SDIs under mandibular dentures; Outcome (O) = comparison of stability between MDIs and SDIs in supporting mandibular dentures. Only RCTs were included. Risk of bias (RoB) was assessed using the Cochrane RoB tool. RESULTS: Five RCTs were included. The numbers of participants ranged between 45 and 120 edentulous individuals wearing complete mandibular dentures. The mean age of patients ranged between 59.5 ± 8.5 and 68.3 ± 8.5 years. The number of MDIs and SDIs ranged between 22 and 152 and 10 and 80 implants, respectively. The follow-up duration ranged between one week and 12 months. Three RCTs reported an improvement in the quality of life (QoL) of all patients after stabilisation of mandibular dentures using MDIs or SDIs. In one RCT, peri-implant soft tissue profiles were comparable between MDIs and SDIs at the 1-year follow-up. The implant survival rate was reported in two RCTs, which were from 89% to 98% and 99% to 100% for MDIs and SDIs, respectively. All RCTs had a low RoB. CONCLUSION: Mini dental implants represent a viable alternative to traditional standard-diameter implants when seeking optimal retention for mandibular overdentures.

The Effect of Different Intraoral Scanners on The Accuracy of Bite Registration in Edentulous Maxillary and Mandibular Arches.

OBJECTIVES: The objective of this study was to use in vitro models to examine the bite registration accuracy of four different intraoral scanners (IOS) for edentulous maxillary and mandibular arches. The objective was to assess the trueness and precision of the IOS and determine if there were significant differences between them. METHODS: An Asiga Max UV 3D printer was used to print maxillary and mandibular edentulous models based on the shape of Frasaco models (artificial dental arch models). Four dental implants were placed symmetrically in both models using Straumann BLT RC implants. Digital impressions were taken with Primescan, Trios 3, Trios 4, and Medit i500 intraoral scanners (n = 10 for each IOS). Digital bite registrations were made, and scanning data was exported in STL format. The accuracy of the interarch distance (the distance between the metrological spheres attached to the mandibular and maxillary models) was estimated for each IOS. RESULTS: The results showed significant differences in trueness and precision between different IOS (p <.05), except Medit i500 and Trios 3 (p >.05). Primescan provided the most accurate results, followed by Medit i500, Trios 3, and Trios 4, respectively. CONCLUSIONS: within the limitations of this study, the IOS type affects the accuracy of interocclusal bite registration in in vitro design. Only Primescan achieved clinically acceptable accuracy for the interocclusal recording of edentulous arches. CLINICAL RELEVANCE: The comparison of the accuracy of bite registration between different intraoral scanners will help increase the efficiency of the clinical application of digitalized interarch registration.

Marginal bone loss in ball versus locator attachments in implant-retained overdentures: systematic review and meta-analysis.

OBJECTIVES: This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients. METHOD AND MATERIALS: Following PRISMA guidelines, health science librarians completed literature searches from inception to March 17, 2023 in seven databases. There were 15,686 items exported to EndNote from Embase.com, CINAHL (EBSCO), Cochrane Library, Ovid MEDLINE-ALL, PubMed, Scopus, and Web of Science. Hand-searching added four more articles. After deduplication, 6756 items were screened for eligibility. Twenty-nine studies were assessed by full text, of which ten studies, involving 424 subjects, were included in the review. Risk of bias assessment was conducted using the Cochrane Risk of Bias tool and the Newcastle Ottawa Scale. A meta-analysis was performed to synthesize and analyze the collective data from the selected studies. RESULTS: The included studies used diverse methodologies, implant systems, and loading protocols. Most studies reported no significant difference in marginal bone loss between ball and locator attachments. The meta-analysis revealed high heterogeneity. CONCLUSION: The results of this systematic review suggest that ball and locator attachments exhibit similar performance in terms of marginal bone loss in implant-retained overdentures. However, the limited number, risk of bias, and heterogeneity of studies highlight the need for standardized research designs and larger sample sizes in future investigations to draw more definitive conclusions.

Evaluation of open-face maxillary complete denture for patients with prominent premaxilla: a crossover study.

BACKGROUND: The establishment of good facial esthetics is one of the main objectives of complete denture construction. Unfortunately, it may be the caused issue for patients having a prominent premaxilla due to excessive lip support by the labial flange of the maxillary denture. Open-face dentures (OFD) may suggest suitable prosthetic management for these patients. However, clinical evidence regarding the efficiency of OFD is scarce. METHODS: A total of 38 completely edentulous participants having prominent premaxilla and skeletal class I Angle's classification were enrolled in this study. Each participant received a mandibular complete denture and 2 opposing maxillary dentures; conventional (CD) and open-face (OFD). On the day of denture insertion, the participants were divided into 2 groups; CD-OFD and OFD-CD where CD-OFD group was instructed to use the mandibular denture and the maxillary CD for 3 months and then to use the maxillary OFD for another 3 months after a wash-out period of 2 weeks. While group OFD-CD was instructed to use the mandibular denture and the maxillary OFD for 3 months then to use the maxillary CD for another 3 months after a wash-out period of 2 weeks. The dislodging force of the maxillary dentures was evaluated using the universal testing machine and the patient perception of retention, esthetics, and comfort was evaluated using the Visual Analogue Scale (VAS). Evaluation was carried out 1 day, 1 month, and 3 months after denture insertion. The Student t-test was used to compare the 2 maxillary dentures and the intervals for each denture were compared by using the ANOVA test with repeated measures followed by a Post Hoc test (adjusted Bonferroni) for pairwise comparison. RESULTS: The significance of the obtained results was judged at the 5% level (P value). The dislodging force and patient perception of retention did not show significant differences between the 2 dentures, while the perception of esthetics showed significant differences throughout the follow-up period. Perception of comfort showed an insignificant difference only at the 3-month interval. CONCLUSIONS: Open-face maxillary dentures can be a suitable alternative for patients with prominent premaxilla to achieve satisfactory retention, aesthetics, and comfort.

3D printing vs traditional workflow for the fabrication of mandibular implant overdentures: study protocol for a mixed-methods cross-over RCT.

BACKGROUND: Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods. METHODS/DESIGN: We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs. DISCUSSION: This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic. CLINICALTRIALS: gov/ct2/show/NCT06155630.

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.

Challenges and Solutions in Clinical Workflow for the Rehabilitation of Completely Edentulous Patients Through CAD/CAM Dentures: A Case Study.

In the field of removable prosthodontics, computer-aided design and computer-aided manufacturing (CAD/CAM) have become widely recognized. The traditional method, which uses heat-polymerized resins for injection or compression molding, necessitates up to five patient visits and laborious laboratory processes. A digital workflow combined with a CAD/CAM methodology can provide prompt prosthesis delivery for patients with time constraints. This article's goal is to outline the steps and the limitations in the fabrication of digital dentures as well as the challenges, limitations, and solutions developed while developing a clinical workflow for the rehabilitation of completely edentulous patients with the CAD/CAM System.

Influence of new complete dentures on the touch perception threshold and quality of life of edentulous patients.

OBJECTIVE: To evaluate the touch perception threshold of the alveolar mucosa and quality of life of edentulous patients before (T0) and 30 days after (T1) the insertion of new complete dentures. BACKGROUND: Touch perception is important so that edentulous patients can detect the position of complete dentures in their mouth. MATERIALS AND METHODS: This study included 32 complete denture wearers with good oral and systemic health and no temporomandibular disorders for at least 5 years. At each time point (T0 and T1), two tests were performed (touch perception threshold and quality-of-life scale). The touch perception threshold (Von Frey or Semmes-Weinstein test) was assessed using nylon monofilaments on the regions of the alveolar mucosa of the maxilla and mandible. The Oral Health Impact Profile for edentulous individuals (OHIP-EDENT) was administered to evaluate oral health-related quality of life. RESULTS: In the maxilla and mandible, the touch perception thresholds for all regions of the alveolar mucosa were significantly lower at T1 than at T0. The OHIP-EDENT mean scores showed that the overall quality of life was significantly better at T1 (3.6) than at T0 (4.7), and a significant improvement in quality of life was observed in all domains of the OHIP-EDENT at T1. For touch perception threshold, effect sizes ranged from 0.4 to 0.8; and for quality of life, effect sizes ranged from 0.4 to 1.0. CONCLUSIONS: New complete dentures reduced the touch perception threshold of the alveolar mucosa of both edentulous arches and improved individuals' quality of life.

Complete denture palatal rugae design impact on satisfaction and quality of life.

OBJECTIVES: To compare the impact of three complete denture palatal rugae designs on participants' satisfaction and oral-health-related quality of life. BACKGROUND: Complete dentures palatal rugea are usually polished to a smooth finish, which can affect the patient's adaptation. Roughening or keeping an opening in the rugae area to replicate the natural sensation of the palatal rugae has been suggested but lacks clinical evidence. METHODS: This randomised crossover trial included participants with complete dentures randomly allocated to six sequences. Each sequence alternated between polished, roughened, and open rugae designs. Participants evaluated general and domain-specific satisfaction (eating, taste, speaking, phonetics, and ease of cleaning) on a 100-mm visual analogue scale. They also completed the Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT) and indicated their preferred design at the end. Repeated-measure ANOVA compared satisfaction, and one-way ANOVA with Tukey's test compared OHIP-EDENT scores. RESULTS: Forty-two participants were randomised. Seven dropped out. General satisfaction ratings were comparable for the polished (Mean = 80.2, SD = 19.7) and roughened designs (Mean = 79.5, SD = 20.2). However, the open design had a significantly lower satisfaction rating (Mean = 41.1, SD = 32.2). OHIP-EDENT scores for the open design (Mean = 44.9, SD = 17.5) were significantly worse than those for the polished (Mean = 36.1, SD = 12.7) and roughened designs (Mean = 36.2, SD = 13.3). Two-thirds of the participants chose the polished design. One-third chose the roughened design; of those, 83% were first-time denture wearers. CONCLUSIONS: Complete dentures with polished and roughened rugae designs were perceived similarly. Both designs could be recommended based on the patient's preference. However, the open design should be avoided due to negative perception.

Influence of scanning protocol on the accuracy of complete-arch digital implant scans: An in vitro study.

OBJECTIVE: This in-vitro study assessed the influence of two intraoral scanning (IOS) protocols on the accuracy (trueness and precision) of digital scans performed in edentulous arches. METHODS: Twenty-two abutment-level master casts of edentulous arches with at least four implants were scanned repeatedly five times, each with two different scanning protocols. Protocol A (IOS-A) consisted of scanning the edentulous arch before inserting the implant scan bodies, followed by their insertion and its subsequent digital acquisition. Protocol B (IOS-B) consisted of scanning the edentulous arch with the scan bodies inserted from the outset. A reference scan from each edentulous cast was obtained using a laboratory scanner. Trueness and precision were calculated using the spatial fit analysis, cross-arch distance, and virtual Sheffield test. Statistical analysis was performed using generalized estimating equations (GEEs). Statistical significance was set at α = .05. RESULTS: In the spatial fit test, the precision of average 3D distances was 45 µm (±23 µm) with protocol IOS-A and 25 µm (±10 µm) for IOS-B (p < .001), and the trueness of average 3D distances was 44 µm (±24 µm) with protocol IOS-A and 24 µm (±7 µm) for IOS-B (p < .001). Cross-arch distance precision was 59 µm (±53 µm) for IOS-A and 41 µm (±43 µm) for IOS-B (p = .0035), and trueness was 64 µm (±47 µm) for IOS-A and 50 µm (±40 µm) for IOS-B (p = .0021). Virtual Sheffield precision was 286 µm (±198 µm) for IOS-A and 146 µm (±92 µm) for IOS-B (p < .001), and trueness was 228 µm (±171 µm) for IOS-A and 139 µm (±92 µm) for IOS-B (p < .001). CONCLUSIONS: The IOS-B protocol demonstrated significantly superior accuracy. Placement of scan bodies before scanning the edentulous arch is recommended to improve the accuracy of complete-arch intraoral scanning.

A Finite Element Analysis Study of Edentulous Model with Complete Denture to Simulate Masticatory Movement.

The purposes of this study are to establish and validate a finite element (FE) model using finite element analysis methods and to identify optimal loading conditions to simulate masticatory movement. A three-dimensional FE model of the maxillary and mandibular cortical bone, cancellous bone, and gingiva was constructed based on edentulous cone-beam-computed tomography data. Dental computer-aided design software was used to design the denture base and artificial teeth to produce a complete denture. Mesh convergence was performed to derive the optimal mesh size, and validation was conducted through comparison with mechanical test results. The mandible was rotated step-by-step to induce movements similar to actual mastication. Results showed that there was less than a 6% difference between the mechanical test and the alveolar bone-complete denture. It opened 10° as set in the first stage, confirming that the mouth closed 7° in the second stage. Occlusal contact occurred between the upper and lower artificial teeth as the mouth closed the remaining angle of 3° in the third stage while activating the masseter muscle. These results indicate that the FE model and masticatory loading conditions developed in this study can be applied to analyze biomechanical effects according to the wearing of dentures with various design elements applied.

Changes in masticatory performance and bite force after treatment with mandibular overdentures retained by four titanium-zirconium mini implants: One-year randomised clinical trial.

OBJECTIVE: This prospective study is part of a randomised clinical trial and reports the changes in masticatory performance (MP) and bite force, and explores their influential factors, 1 year after the provision of mandibular overdentures retained by four titanium-zirconium mini implants. METHODS: Edentulous patients received conventional complete dentures, followed by placement of four mini implants (Straumann® Mini Implant System) in the anterior mandible and converting the conventional prosthesis into a mandibular overdenture. Treatment protocols were randomised using a 2×2 factorial design combining different surgical (flapped vs. flapless) and loading (immediate vs. delayed) protocols. MP was assessed using a two-colour mixing ability test and a colorimetric analysis to measure the level of colour mixing (Variance of Hue-VoH). Maximum voluntary bite force (MBF) was measured by a digital gnathodynamometer in the posterior and anterior regions. Sex, age, surgical and loading protocols and ridge morphology were tested as independent variables. MP and MBF tests were performed at baseline (pre-treatment) and the 3-, 6- and 12-month after implant loading. Descriptive statistics, independent t-test, and linear mixed-effect model (LMM) regression were used for data analysis. RESULTS: Seventy-four participants were assessed and 73 completed the 1-year follow-up. Statistically significant improvements in functional parameters were observed in all follow-up periods compared to baseline (p < .001). The flapless protocol was associated with higher improvement in MP at the 3-month follow-up (p = .004), while less resorbed ridges were associated with better MP (p = .038) and higher MBF (p < .001). CONCLUSION: The mandibular overdenture protocol using four titanium-zirconium mini implants was effective in improving MP and MBF of edentulous patients, compared to pre-treatment values. The findings also suggest that improvements in chewing function and bite force are impacted by clinical factors since better outcomes were observed for flapless surgeries and less resorbed edentulous ridges. CLINICAL TRIAL REGISTRATION: ClinicalTrials.Gov ID NCT04760457.

Clinical Peri-Implant Parameters and Marginal Bone Loss for Early Mandibular Implant Overdentures: A Follow-Up of 60 Months.

Background and Objectives: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed to evaluate clinical peri-implant parameters and marginal bone loss around early placed and loaded mandibular implant overdentures with a 60-month follow-up. Materials and Methods: In this prospective cohort study, 43 patients were enrolled to receive 86 early loading sub-crestal dental implants through prosthetic guides. Implant overdentures were supported by two isolated implant locator attachments between two mental foramens. Clinical peri-implant parameters, including plaque index (PI), bleeding index (BI), peri-implant pocket depth (PIPD), and marginal bone loss (MBL) were evaluated using standardized techniques at 1, 12, 24, 36, 48, and 60 months follow-up. At 60 months, complications associated with implant overdentures (IOD's) were noted. The mean comparison of peri-implant clinical parameters was performed through ANOVA test. A p-value of ≤0.05 was taken as significant. Results: Out of the total 43 enrolled patients, 8 patients were lost during follow-up; as a result, 35 patients completed the 5 years follow-up. The mean values of PI, BI, and PIPD increased with no statistical difference (p > 0.05). For marginal bone loss, an increase in the mean values was noted at different time intervals with statistical differences (p < 0.001). The most common complications noted were loosening of the abutment, occlusal adjustment, retentive locator loosening and replacement, and relining of the denture. Conclusions: Early placement of IODs failed to prevent bone loss over time and was associated with complications, predominantly consisting of abutment loosening, occlusal adjustments, broken retentive locator components, relining, and rebasing.

Dental Implants Acting as External Fixation for the Fracture of Severe Atrophic Mandible: A Case Report.

Treatment of edentulous and atrophic mandibular fractures is extremely difficult. Generally, mandibular fractures are repaired and fixed as internal fixation using a reconstruction plate or miniplates with intra- or extraoral approach. Few cases in which external fixation including a transmucosal fixation was performed have also been reported. We report a case of atrophic and edentulous mandibular fracture which was healed by the fixation using dental implants and implant-supported bridge.

Accuracy of flapless surgery using an autonomous robotic system in full-arch immediate implant restoration: A case series.

OBJECTIVES: This observational study aimed to evaluate the accuracy of robotic computer-assisted implant surgery (r-CAIS) for full-arch immediate restoration and to analyse possible factors contributing to deviations. METHODS: Three edentulous patients (five arches) underwent r-CAIS. Osteotomies were performed using an autonomous robot under the surgeon's supervision, and implant placement was performed in a freehand or robotic manner. Prefabricated provisional prostheses were delivered immediately after surgery. Postoperative cone beam computed tomography scans were performed to assess the deviations between the planned and placed implants. Statistics were compared with deviations of s-CAIS outlined in a meta-analysis. RESULTS: A sum of 28 implants were used. The mean global coronal and apical deviations measured 0.91 ± 0.43 mm and 1.01 ± 0.45 mm, respectively, and the mean angular deviation measured 1.21 ± 1.24 º. The r-CAIS showed significantly better precision than the s-CAIS in full-arch cases (P < 0.001). The implants inserted using the robotic arm exhibited fewer deviations than those placed in the freehand manner. Eighty percent of prefabricated provisional prostheses were successfully delivered. CONCLUSIONS: Within the limitations of the present study, our data suggest that autonomous r-CAIS is a feasible approach for simultaneous immediate restoration in edentulous patients, showing better accuracy than s-CAIS. Further large-scale studies are necessary to verify the advantages and disadvantages of this novel technique and to explore possible factors that influence its accuracy. CLINICAL SIGNIFICANCE: Autonomous r-CAIS can provide clinically acceptable implant placement accuracy in edentulous patients, significantly surpassing s-CAIS. This level of accuracy may represent a viable therapeutic approach for simultaneous immediate full-arch restoration.

Biomechanical behavior of all-on-4 concept and alternative designs under different occlusal load configurations for completely edentulous mandible: a 3-D finite element analysis.

The aim of this study was to evaluate the effect of the All-on-4 design and 4 alternative implant-supported fixed prosthesis designs on stress distribution in implants, peri-implant bone, and prosthetic framework in the edentulous mandible under different loading conditions using three-dimensional finite element analysis (3D-FEA).Five different experimental finite element models (Model A (unsplinted 6), Model B (splinted 6), Model C (All-on-4), Model D (axial; 2 anterior, 2 posterior), and Model E (4 interforaminal)) were created. Three different loading conditions were applied (canine loading, unilateral I-loading, and unilateral II-loading). The highest minimum (Pmin) and the maximum (Pmax) principal stress values were acquired for cortical and trabecular bones; the highest von Mises (mvM) stress values were obtained for implants and metal frameworks. Model B and Model D showed the most favorable stress distribution. The All-on-4 design (Model C) also showed acceptable stress values close to those of Model B and Model D in the cortical and trabecular bones. In accordance with the stress values in the bone structure, the lowest stress values were measured in the implants and Co-Cr framework in Model B and Model D. The highest stress values in all structures were measured for unilateral loading- II, while the lowest values were found for canine loading. It was concluded that Model B and Model D experimental models showed better biomechanical performance in all structures. Furthermore, the use of a splinted framework, avoiding cantilevers, results in lower stress transmission. On the other hand, canine loading and unilateral loading-I exhibited the best loading conditions.

Patterns and predictors of tooth loss among partially dentate individuals in Jordan: A cross-sectional study.

Aim: This study aimed to examine the patterns of partial edentulism and the associated risk factors in Jordan. Methods: A cross-sectional, epidemiological study was carried out across Jordan, and data was collected from adult partially dentate patients in various healthcare facilities. The data collected included sociodemographic data, dental and social history, and clinical examination findings for the jaw and teeth. Multivariate regression models were used to determine the predictors for the number of missing teeth. Results: The sample consisted of 467 partially dentate participants. The leading cause of tooth loss was dental caries (85.4 %), followed by periodontal disease (13.7 %), and trauma (7.5 %). The mean number of missing teeth was significantly higher in the upper jaw (2.5 ± 3.1) compared to the lower jaw (2.2 ± 2.6, p = 0.02). In both jaws, the most prevalent Kennedy classification was Class 3, followed by Class 3/Modification 1 and Class 2/Modification 1. Increased age, smoking, lack of daily tooth brushing, and low education level were significantly associated with high tooth loss. Conclusions: This study contributes to the understanding of partial edentulism in Jordan, reflecting broader oral health concerns and the factors influencing tooth loss. The findings, vital for future research and interventions, offer insights applicable to global oral health challenges, particularly for at-risk groups.

Comparison of Implant-Retained Overdenture and Conventional Complete Denture: A Survey Study to Measure Patients' Satisfaction and Quality of Life in Dental School Clinics.

Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CD) or Implant Retained-Overdentures (IOD), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CD and IOD are the two leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the [redacted for peer review] from 2014 to 2016 with at least one year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IOD had lower physical pain, limitations, and concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IOD and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.