Additive Manufacturing: A Comparative Analysis of Dimensional Accuracy and Skin Texture Reproduction of Auricular Prostheses Replicas.

PURPOSE: The use of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing in maxillofacial prosthetics has been widely acknowledged. Rapid prototyping can be considered for manufacturing of auricular prostheses. Therefore, so-called prostheses replicas can be fabricated by digital means. The objective of this study was to identify a superior additive manufacturing method to fabricate auricular prosthesis replicas (APRs) within a digital workflow. MATERIALS AND METHODS: Auricles of 23 healthy subjects (mean age of 37.8 years) were measured in vivo with respect to an anthropometrical protocol. Landmarks were volumized with fiducial balls for 3D scanning using a handheld structured light scanner. The 3D CAD dataset was postprocessed, and the same anthropometrical measurements were made in the CAD software with the digital lineal. Each CAD dataset was materialized using fused deposition modeling (FDM), selective laser sintering (SLS), and stereolithography (SL), constituting 53 APR samples. All distances between the landmarks were measured on the APRs. After the determination of the measurement error within the five data groups (in vivo, CAD, FDM, SLS, and SL), the mean values were compared using matched pairs method. To this, the in vivo and CAD dataset were set as references. Finally, the surface structure of the APRs was qualitatively evaluated with stereomicroscopy and profilometry to ascertain the level of skin detail reproduction. RESULTS: The anthropometrical approach showed drawbacks in measuring the protrusion of the ear's helix. The measurement error within all groups of measurements was calculated between 0.20 and 0.28 mm, implying a high reproducibility. The lowest mean differences of 53 produced APRs were found in FDM (0.43%) followed by SLS (0.54%) and SL (0.59%)--compared to in vivo, and again in FDM (0.20%) followed by SL (0.36%) and SLS (0.39%)--compared to CAD. None of these values exceed the threshold of clinical relevance (1.5%); however, the qualitative evaluation revealed slight shortcomings in skin reproduction for all methods: reproduction of skin details exceeding 0.192 mm in depth was feasible. CONCLUSION: FDM showed the superior dimensional accuracy and best skin surface reproduction. Moreover, digital acquisition and CAD postprocessing seem to play a more important role in the outcome than the additive manufacturing method used.

Restless legs syndrome in psoriasis: an unexpected comorbidity.

BACKGROUND: Restless legs syndrome (RLS) is characterized by unpleasant sensations in the legs and an uncontrollable urge to move them in order to gain relief. Higher frequencies of RLS have been reported in systemic lupus, multiple sclerosis, rheumatoid arthritis and atopic dermatitis. OBJECTIVES: Since the disease-related stress present in psoriasis is similar to the stress of those diseases, we aimed to study the frequency of RLS in a German cohort of patients with psoriasis. METHODS: 300 patients with psoriasis and 300 healthy controls were evaluated for RLS symptoms in this study. RESULTS: While 17% (n = 51) of patients with psoriasis reported symptoms of RLS, only 4% (n = 12) of individuals without psoriasis suffered from RLS symptoms (95% confidence interval: 0.08 - 0.18, p<0.01). In patients with psoriasis and RLS the average RLS score was 16.0 ± 9.2 whereas individuals with RLS in the control group had an average RLS score of 13.5 ± 7.1. CONCLUSIONS: Our findings indicate an increased frequency of RLS in patients with psoriasis, suggesting screening patients with psoriasis for the presence of RLS as a well-treatable co-morbidity.

Reporting of dental status from full-arch radiographs: Descriptive analysis and methodological aspects.

AIM: To identify standards, how entities of dental status are assessed and reported from full-arch radiographs of adults. METHODS: A PubMed (Medline) search was performed in November 2011. Literature had to report at least one out of four defined entities using radiographs: number of teeth or implants; caries, fillings or restorations; root-canal fillings and apical health; alveolar bone level. Cohorts included to the study had to be of adult age. Methods of radiographic assessment were noted and checked for the later mode of report in text, tables or diagrams. For comparability, the encountered mode of report was operationalized to a logical expression. RESULTS: Thirty-seven out of 199 articles were evaluated via full-text review. Only one article reported all four entities. Eight articles reported at the maximum 3 comparable entities. However, comparability is impeded because of the usage of absolute or relative frequency, mean or median values as well as grouping. Furthermore the methods of assessment were different or not described sufficiently. Consequently, established sum scores turned out to be highly questionable, too. The amount of missing data within all studies remained unclear. It is even so remissed to mention supernumerary and aplased teeth as well as the count of third molars. CONCLUSION: Data about dental findings from radiographs is, if at all possible, only comparable with serious limitations. A standardization of both, assessing and reporting entities of dental status from radiographs is missing and has to be established within a report guideline.

The peri-implant health in patients attending an annual recall program. A clinical and microbiological study in 74 patients from the Tübingen Implant Registry.

OBJECTIVES: To describe the peri-implant condition of unselected implant recall patients, to relate it to relevant features from the patient medical history, and to look at associations across these findings. PATIENTS AND METHODS: Prior to their most recent recall appointment, 74 individuals underwent a clinical and microbiological (PCR) investigation. RESULTS: Signs of a serious peri-implantitis condition were not encountered in this patient cohort. However, a high prevalence of moderate plaque and bleeding on probing (60% and 78%, respectively) and PCR proof of periodonto-pathogenic bacteria (43% positive for one or more target species) was apparent. The mean pocket probing depth was 2.9 mm. The by far most prominent co-morbidity belonged to the group of patients with cardiovascular diseases (CVD; 27%). CVD were statistically significantly associated with the prevalence and concentration of Prevotella intermedia in the peri-implant sulcus (P = 0.022). Age was positively associated with plaque load (P < 0.001). The Tanerella forsythensis score and prevalence was higher in implants supporting fixed than removable restorations (P = 0.025). Four of the five bacteria species assessed showed a high association with each other (exception: Aggregatibacter actinomycetemcomitans), but not to other hygiene findings. CONCLUSIONS: A considerable number of individuals exhibited peri-implant findings that would require anti-infective treatment. Prevalence and concentrations of periodonto-pathogenic bacteria seemed to be associated with a variety of other variables from the patients' history, but not to clinical findings in this patient group.

Lip and tongue movements during phonetic sequences: analysis and definition of normal values.

Precise knowledge of lip and tongue movements is limited. Conventional investigative methods do not allow for their precise representation and analysis. In the present study, electromagnetic articulography (EMA) was used to define normal values for lip movements based on consonant-vowel-consonant (CVC) sequences and for tongue movements based on vowel-consonant-vowel (VCV) sequences. The study population included 25 volunteers (11 males and 14 females) with a median age of 26 (23 to 29) years. An EMA unit was used to conduct the measurements. For this purpose, the volunteers repeated a number of VCV and CVC text sequences 10 times each during two different body positions (upright and relaxed). Statistical analysis (including Bland and Altman's measurement error, non-parametric Wilcoxon rank score testing, and analysis of variance) of distance and time variables resulted in a small measurement error. There was no effect of different body positions on measurement error. Gender was found to have a significant effect on the values measured (67 versus 17 per cent of variables related to distances in CVC versus VCV sequences and 38 versus 75 per cent of variables related to intervals in CVC versus VCV sequences). This finding did not, however, hold true for any of the other parameters investigated as potential influencing factors. EMA is capable of providing valuable information about lip and tongue movements and any pathological dysfunctions involved.

Day-to-day reliability of two different models to quantify knee kinematics in subjects with knee osteoarthritis and healthy controls.

Results from instrumented gait analysis vary between test situations. Subject characteristics and the biomechanical model can influence the total amount of variability. The purpose of this study was to quantify reliability of gait data in general, and with respect to the applied model, and investigated population group. Reliability was compared between a functional and a predictive gait model in subjects with knee osteoarthritis and healthy controls. Day-to-day consistency for sagittal plane variables was comparable between models and population groups. Transversal plane variables relative to joint excursion showed larger inconsistency for repeated measures, even for a more sophisticated biomechanical approach. In conclusion, the presented reliability data of sagittal plane kinematics should be used for a reasonable interpretation of results derived in clinical gait analysis. Variables of the transversal plane should not be used as long as sources of error are not sufficiently minimized.

Effect of simulated diving trips on pulmonary artery pressure in healthy men.

BACKGROUND: Environmental stresses, such as immersion, cold, and venous gas microbubbles, have been shown to contribute to an increase in pulmonary artery pressure (PAP) after single SCUBA dives. This study was carried out to investigate PAP changes following a dry chamber dive. METHODS: 17 male divers [mean age 32 years, standard deviation (SD) 7 years, mean body mass index 26 kg m(-2) (SD 3 kg m(-2))] participated in the study. Heart disease was ruled out by ECG, stress-ECG and transthoracic echocardiography in all subjects. Echocardiographic assessment of PAP (peak gradient at pulmonary and tricuspid valve), acceleration time (AT), ejection time (ET) and the ratio AT/ET as an estimate of PAP was performed directly prior to, directly, and 20 and 80 min after a simulated dive (maximal pressure 600 kPa, duration 60 min). RESULTS: AT/ET decreased from 0.40 (SD 0.03) to 0.34 (SD 0.03) directly after the dive (p = <0.0001), which was statistically significant, whereas 80 min after decompression, AT/ET tended to return to baseline levels (0.36, SD 0.03; p = 0.001). Other echocardiographic indices, e.g. ET, systolic PAP, and heart rate, did not change significantly after the dive. No gas microbubbles were detected during or after decompression. CONCLUSIONS: A transient decrease of both AT and AT/ET following a simulated hyperbaric dry chamber dive indicated an increase in mean PAP in healthy men. We speculate that factors other than immersion, cold, or gas microbubbles may contribute to an elevation of PAP after a single hyperbaric exposure.

Effect of simulated dives on diastolic function in healthy men.

Scuba diving may elicit acute changes to human cardiovascular function. Environmental stresses such as immersion, cold, and venous gas microbubbles all have been shown to contribute to right ventricular overload and impaired left ventricular filling after single dives. We investigated cardiac function after simulated dry chamber dives. Twenty male divers [mean age 31 years, standard deviation (SD) 8 years, mean body mass index 26 kgm(-2) (SD 3 kgm(-2))] participated in the study. All subjects had normal ECG, stress-ECG, and transthoracic echocardiography at rest. Echocardiographic assessment of diastolic function [E/A-ratio, deceleration time (DT), isovolumic relaxation time (IVRT), E/e'-ratio] was performed directly prior to and 20 and 80 min after two simulated dry hyperbaric chamber dives (maximal pressure 600 kPa, duration 60 min) that were conducted within 1 week. DT statistically significantly decreased from 163 ms (SD 14 ms) to 125 ms (SD 15 ms) 20 min after the dive (p < 0.0001), whereas 80 min after decompression these changes tended to return to baseline [146 ms (SD 14 ms); p = 0.06]. There was no statistically significant change in heart rate, E/A-ratio or E/e'-ratio after 20 or 80 min compared to baseline. These changes could be reproduced after the second dry chamber dive. No gas microbubbles were detectable during or after decompression from either dive. Simulated hyperbaric dry chamber dives were associated with a transient decrease in deceleration time in healthy men. Factors other than immersion, cold, or nitrogen microbubbles may contribute to acute changes in cardiac function after single scuba dives.

Application times for the single-step/double-mix technique for impression materials in clinical practice.

Hydrophilicity of unset impression materials underlies changes occurring during working time. Hence, the clinical application time when impression materials contact oral tissues after mixing may play a critical role in successful impressions. The aim of this study was to analyze the clinical time course of impression taking applying the single-step/double-mix technique. Application times of 86 impressions, comprising 265 prepared teeth and 46 implants, taken by 14 different clinicians at a university dental clinic were analyzed. The mean time from loading the impression tray until its final position in the patient's mouth (total application time) was 51.2 seconds; confidence intervals were 46.9 (lower limit) and 55.5 (upper limit). The number of registered teeth and implants did not influence the duration of impression taking. Related to wettability data, several polyvinyl siloxane impression materials show decreased hydrophilicity with respect to estimated application times. The authors suggest considering clinically relevant application times for impression taking in future in vitro studies on physicochemical characteristics of impression materials.

Influence of implant geometry on primary insertion stability and simulated peri-implant bone loss: an in vitro study using resonance frequency analysis and damping capacity assessment.

PURPOSE: To investigate the influence of implant geometry on primary stability and on peri-implant bone loss in an in vitro model using the Periotest and Osstell devices. MATERIALS AND METHODS: Screw-type implants of various diameters and lengths were inserted into bovine bone blocks of different densities, and the primary insertion stability was recorded. To study the influence of implant geometry on implant stability with different levels of peri-implant bone loss, implants were inserted into acrylic resin blocks to mimic osseointegration, and different amounts of the peri-implant acrylic resin were removed. Measurements with both devices at each millimeter step yielded the threshold for the least detectable attachment loss. RESULTS: The predominant factors influencing implant stability were bone quality and attachment loss. Implant type and length exerted some influence on implant stability values, while variations in implant diameter produced only minor alterations in the measurements. In simulations of peri-implant attachment loss, implant stability decreased more dramatically for the shorter and narrower implants. The inclusion of more variables in the analyses resulted in less focused measurements. CONCLUSIONS: The results of this study clearly show that the outcome of implant stability assessment depends on environmental factors such as bone quality and implant geometry. While the authors do not recommend the use of the Periotest or Osstell devices for a comparison of the stability of two individual implants, both should be useful to monitor the state of an individual implant over time.

Effects of a sensory-motor exercise program for older adults with osteoarthritis or prosthesis of the hip using measurements made by the Posturomed oscillatory platform.

OBJECTIVES: To assess changes in balance capacities after a 12-week sensory-motor training program for older adults with osteoarthritis or prosthesis of the hip. BACKGROUND: Sensory-motor training is recommended to help aging adults with osteoarthritis maintain activity, avoid injurious falls, and improve functioning. Up to now, however, there has been no standard training protocol for sensory-motor training. METHODS AND MEASURES: Thirty-five participants in a hip exercise group who had a mean age of 58 years (SD 12) were quasi-randomized into a training group (TG) and a control group (CG) by the month they applied for the Hip School program. The TG performed balance exercises using balance pads and received Hip School training once a week. The CG did not receive any training intervention. Balance was measured by recording center-of-pressure excursion while participants were in 1-legged stance on the oscillatory Posturomed platform. Outcome measures were the total path of center of pressure on the platform during balance recovery and the percentage of failed attempts. RESULTS: The TG had a lower percentage of failed attempts (TG 5%, CG 18%, P = .001) and required fewer balance recovery movements to maintain balance (TG: mean [SD] measurement is 59 [36] mm; CG: 96 [68] mm, P = .036] after completing the 12-week training program. After the training period, participants in the TG compensated better for perturbations in the nondisplaced medial-lateral (ML) direction (pretest [SD] measurement was 48 [18] mm; posttest, 36 [14] mm; P= .001]. CONCLUSIONS: Participants could successfully cope with more disturbances and improved their reactions to sudden displacements after training intervention. This exercise setting improves balance abilities and should be included in Hip School programs for patients with osteoarthritis.

Effect of xylitol/chlorhexidine versus xylitol or chlorhexidine as single rinses on initial biofilm formation of cariogenic streptococci.

OBJECTIVES: Oral bacteria implying a natural resistance may deteriorate the antibacterial efficacy of chlorhexidine on cariogenic microorganisms. Xylitol, mostly applied via chewing gum, is known to possess favorable plaque-reducing properties. The aim of this study was to investigate the effect of a xylitol rinse formulated as pure solution or combined with chlorhexidine on the viability of Streptococcus sanguis (early colonizer of human teeth) and Streptococcus mutans (the most causal strain for caries) during initial steps of biofilm formation. METHOD AND MATERIALS: After exposure to the test solutions, the bacteria suspended in human sterile saliva were allowed to attach to human enamel slides for 60 minutes in a preclinical flow chamber system. The bacterial vitality of suspended and attached cells was monitored using 2 fluorescent DNA stains by epifluorescence microscopy. Further parameters measured were the total bacterial cell counts on enamel slides and growth of suspended streptococci. RESULTS: The sensitivity of S mutans to pure chlorhexidine or in combination with xylitol is contrary to the natural resistance of S sanguis to chlorhexidine. The combination of xylitol/chlorhexidine showed a statistically significant antivital effect on S sanguis cells compared to the pure agents xylitol and chlorhexidine. The bacterial cell density on enamel and bacterial reproduction on agar plates were similarly affected by the combination of xylitol/chlorhexidine or the single substances. CONCLUSION: The newly discovered synergistic antivital effect of xylitol combined with chlorhexidine may contribute to the favorable potential of xylitol use for the improvement of new formulations of caries-preventive mouthrinses.

Effect of relative humidity on the hydrophilicity of unset elastomeric impression materials.

This study aimed to analyze the effect of relative humidity (RH) on the initial hydrophilicity of unset elastomeric dental impression materials. Initial water contact angles were studied on thin unset films of 1 polyether and 4 polyvinyl siloxane (PVS) impression materials at 20%, 50%, and 80% RH by high-resolution drop shape analysis. One of 4 PVS materials reached the polyether's initial hydrophilicity. This PVS showed increased hydrophilicity with increasing RH. The initial hydrophilicity of impression materials can be influenced by the RH level. Accounting for RH will enhance the clinical relevance of hydrophilicity studies.

Reproducibility of plantar pressure distribution data in barefoot running.

The aim of this study was to provide detailed information on rationales, calculations, and results of common methods used to quantify reproducibility in plantar pressure variables. Recreational runners (N=95) performed multiple barefoot running trials in a laboratory setup, and pressure variables were analyzed in nine distinct subareas of the foot. Reproducibility was assessed by calculating intraclass correlation coefficients (ICC) and the root mean square error (RMSE). Intraclass correlation coefficients ranged from 0.58 to 0.99, depending on the respective variable and type of ICC. Root mean square errors ranged between 2.3 and 3.1% for relative force-time integrals, between 0.07 and 0.23 for maximum force (Fmax), and between 107 and 278 kPa for maximum pressure (Pmax), depending on the subarea of the foot. Force-time integral variables demonstrated the best within-subject reproducibility. Rear-foot data suffered from slightly increased measurement error and reduced reproducibility compared with the forefoot.

The influence of matching populations on kinematic and kinetic variables in runners with iliotibial band syndrome.

The purpose of this study was to assess how participant matching influences biomechanical variables when comparing healthy runners and runners with iliotibial band syndrome (ITBS). We examined 52 healthy runners (CO) and 18 with ITBS, using three-dimensional kinematics and pressure distribution. The study population was matched in three ways and compared with the biomechanical findings: ITBS versus CO I (unmatched), ITBS versus CO II (matched to gender) and ITBS versus CO III (matched to gender height, and weight). The final number of participants in each group was n = 18. The kinematic variables showed a dependency on the matching process. The largest statistically significant differences (after Bonferroni adjustment) in the frontal and transverse planes were between ITBS and CO III (p = .008). Pressure measurements were also dependent on the matching process, with decreasing and nonsignificant differences (p = .006) between ITBS and CO after refining the process (ITBS vs. CO III). The results of this study and the necessity of matching seem to be plausible (lever arms, different running styles). Data matching is important for understanding overuse injuries in running.

Reliability of findings around healthy implants in association with oral hygiene measures: a clinical, microbiological, and immunological follow-up in edentulous patients.

OBJECTIVES: To assess the performance of clinical, microbiological, and immunological diagnosis of peri-implant health and the influence of professional hygiene measures on them. MATERIAL AND METHODS: Twenty-one edentulous patients with oral implants supporting a lower overdenture were followed up over 3 months beginning 1 week before their annual recall visit. Hygiene scores, probing depth, bleeding on probing (BOP), implant stability, gingival crevicular fluid (GCF) volume, sulcular interleukin-1beta (IL-1beta) and prostaglandin E2 (PGE2) concentrations, and relative concentrations of five bacterial species (polymerase chain reaction) were investigated. Measurement variation was assessed as a function of (a) intra- and (b) inter-examiner reliability, (c) inter-implant variation in each patient, (d) time, and (e) effect of hygiene measures by accuracy, repeatability, reproducibility, and visualization with the Bland and Altman Plot. RESULTS: Measurement means and accuracy (in parentheses) were as follows: GCF volume 1.5 microl (1.5), Interleukin-1beta 8 ng/ml (26), PGE2 63 ng/ml (185), bacteria sum score 0.2 (0.7), plaque score 1 (1), BOP score 0 (1), Periotest value -4 (3), resonance frequency analysis ISQ 66 (11), and pocket probing depth 2.3 mm (0.7). No finding exhibited any statistically significant measurement variation as explained by accuracy, repeatability, or reproducibility. Bland and Altman Plots revealed insufficient agreement for replicated BOP assessments. A short post-treatment reduction in plaque and BOP scores was visually apparent. Still, professional oral hygiene measures exerted no sustained influence on the clinical and biochemical appearance of the peri-implant tissues. CONCLUSION: All findings except BOP showed statistically acceptable repeatability and moderate vulnerability to influences present 'chairside' in clinical practice.

Associations between peri-implant crevicular fluid volume, concentrations of crevicular inflammatory mediators, and composite IL-1A -889 and IL-1B +3954 genotype. A cross-sectional study on implant recall patients with and without clinical signs of peri-implantitis.

OBJECTIVES: To assess possible relationships between peri-implant crevicular fluid (PICF) volumes, biochemical markers of the peri-implant immune response, and periodontitis-associated genotype. MATERIAL AND METHODS: PICF samples from 29 implant maintenance patients, 24 wearing overdentures, five having single crowns and bridgework (11 patients with peri-implantitis and 18 individuals with healthy peri-implant conditions), were analyzed for per site and per crevicular-fluid-volume concentrations of interleukin-1beta, plasminogen activator inhibitor type 2, and prostaglandin E2 by ELISA. Associations between the three substance concentrations and to crevicular fluid flow rate were analyzed by linear regression analysis. The possible differentiating influence of the composite interleukin-1A and -1B genotype on the patients' peri-implant health and biochemical inflammatory status was checked formally with t-test statistics and the Wilcoxon' test. One implant per patient was chosen for analysis. RESULTS: In patients with healthy peri-implant conditions, genotype-positive individuals showed elevated crevicular fluid flow rates and at the same time reduced mediator concentrations. In patients with an implant affected from peri-implantitis, no statistically significant influence of the periodontitis-associated genotype around the fixture can be stated. There was no statistical difference between per site and per crevicular-fluid-volume concentration analyses. All three mediator concentrations were positively related to each other, while there was a strong negative correlation between crevicular fluid volume and plasminogen activator inhibitor 2 or prostaglandin E2. CONCLUSIONS: The Interleukin-1 polymorphism investigated exerted only little influence on the peri-implant crevicular immune response, and this influence appeared to be of limited impact in sites with established peri-implantitis lesions.

A comparison of implant-supported, bar- or ball-retained mandibular overdentures: a retrospective clinical, microbiologic, and immunologic study of 10 edentulous patients attending a recall visit.

PURPOSE: Clinical, microbiologic, and immunologic comparisons of the peri-implant health in edentulous volunteers wearing long-standing implant-supported ball- or Dolder bar-retained mandibular overdentures were performed. MATERIALS AND METHODS: Ten age- and gender-matched individuals (mean age, 71 years) with either ball- or bar-retained complete mandibular overdentures, scheduled for an annual implant recall examination, were investigated an average of 7 years after implant placement. Plaque and gingival crevicular fluid samples were obtained from the peri-implant sulcus. The groups were compared with regard to peri-implant probing depth; plaque and bleeding on probing scores; sulcular fluid flow rates; implant stability measurements (Periotest device); relative concentrations of Actinobacillus actinomycetemcomitans, Prevotella intermedia, Fusobacterium nucleatum, Porphyromonas gingivalis, Tannerella forsythensis, and Treponema denticola assessed by polymerase chain reaction analysis; and sulcular concentrations of interleukin-1beta and prostaglandin E2, assessed by enzyme-linked immunosorbent assay. RESULTS: No statistically significant differences were found for any of the examined parameters between both study groups. CONCLUSION: Within the limitations of this study, both ball attachments and Dolder bars can be recommended for overdenture retention, with either one showing satisfying clinical, microbiologic, and immunologic findings in the peri-implant tissues after several years of service in healthy recall patients with good oral hygiene habits.

Resonance frequency analysis and damping capacity assessment. Part I: an in vitro study on measurement reliability and a method of comparison in the determination of primary dental implant stability.

OBJECTIVES: The aims of this in vitro study were to evaluate reliability of the Osstell and Periotest devices in the assessment of implant stability and to perform a method comparison. MATERIAL AND METHODS: Commercial dental implants were inserted into bovine rib segments of different anatomical origins and densities. Repeated measurements were performed, varying (a) the torque-in force of the devices' attachment screw (the Osstell transducer and the ball attachment, insert for the Periotest device), (b) the insertion site bone quality, and (c) the thread exposure in simulated peri-implant bone defects. RESULTS: Both methods were comparably reliable and showed a strong association to each other in the classification of implant stability. As opposed to torque-forced screw attachment, the variations in bone composition, differences in inter-implant stability of adjacent implants, and peri-implant bone reduction were statistically significant for both methods. CONCLUSIONS: Both non-invasive diagnostic devices seem to be useful in the long-term follow-up of implant integration.

Resonance frequency analysis and damping capacity assessment. Part 2: peri-implant bone loss follow-up. An in vitro study with the Periotest and Osstell instruments.

OBJECTIVE: We compared the performance of damping capacity assessment (Periotest device) to resonance frequency analysis (Osstell device) in the assessment of peri-implant bone loss in an in vitro experiment. MATERIAL AND METHODS: Screw-type oral implants were polymerized into acrylic blocks. Peri-implant bone loss was simulated by successively removing defined portions of material surrounding the implants in millimeter increments. Measurement values of both devices were compared by assessing the associated measurement errors, by calculating correlation analyses and drawing scatterplots, and by means of regression analysis referring to increasing bone loss. RESULTS: Both devices produced comparable results suggesting agreement of the measured implant stability values to the actual loss of peri-implant resin. There was a noticeable correlation of the Periotest and Osstell implant stability values. CONCLUSION: The results of this experiment suggest agreement in predicting the actual implant stability with both the instruments with the Osstell instrument being the more precise device.