Immediate versus early loading of immediately placed bone-level tapered dental implants with hydrophilic surface in full arch maxillary rehabilitation: A pilot randomized clinical trial with 2-year follow-up.

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone-level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health-related quality of life (OHRQoL), and patient satisfaction at a 2-year follow-up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone-level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant-supported screw-retained complete porcelain-fused-to-metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2-year follow-up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone-level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition.

Analysis of load distribution in tooth-implant supported fixed partial dentures by the use of resilient abutment.

INTRODUCTION: Differences between the tooth and implant response to load can lead to many biological and technical implications in the conditions of occlusal forces. OBJECTIVE: The objective of this study was to analyze load distribution in tooth/implant-supported fixed partial dentures with the use of resilient TSA (Titan Shock Absorber, BoneCare GmbH, Augsburg, Germany) abutment and conventional non-resilient abutment using finite element method. METHODS: This study presents two basic 3D models. For one model a standard non-resilient abutment is used, and on the implant of the second model a resilient TSA abutment is applied. The virtual model contains drawn contours of tooth, mucous membranes, implant, cortical bones and spongiosa, abutment and suprastructure. The experiment used 500 N of vertical force, applied in three different cases of axial load. Calculations of von Mises equivalent stresses of the tooth root and periodontium, implants and peri-implant tissue were made. RESULTS: For the model to which a non-resilient abutment is applied, maximum stress values in all three cases are observed in the cortical part of the bone (maximum stress value of 49.7 MPa). Measurements of stress and deformation in the bone tissue in the model with application of the resilientTSA abutment demonstrated similar distribution; however, these values are many times lower than in the model with non-resilient TSA abutment (maximum stress value of 28.9 MPa). CONCLUSION: Application of the resilient TSA abutment results in more equal distribution of stress and deformations in the bone tissue under vertical forces. These values are many times lower than in the model with the non-resilient abutment.

Prosthetic treatment after teeth extractions in patients with type 2 diabetes mellitus.

Introduction: Good and well balanced diet provided by adequate mastication is part of therapy in patients with type 2 diabetes mellitus (DM). The critical period presents the time immediately after teeth extractions; hence, immediate denture is a rational therapeutical choice for diabetic patients. The presence of immediate denture and its compression might compromise wound healing process, affect chewing ability, food intake and consequently blood glucose level in type 2 DM patients. Objective: The objective of this study was to compare socket opening diameters (SOD), chewing ability, changes in blood glucose level and food intake in type 2 DM patients with and without maxillary immediate complete denture (MICD) during a three-week wound healing period. Methods: The study comprised 78 type 2 DM partially removable denture wearers (42 candidates for teeth extractions and 36 candidates for teeth extractions and insertion of MICDs). During the three-week period participants were followed for SOD, chewing ability and changes in blood glucose level and food intake. Results: Patients with MICD showed significantly lower reduction of SOD (seventh, 14th, 21st day) and higher chewing ability (seventh, 14th, 21st day) in comparison to patients without an MICD. Significantly lower number of patients with an MICD had changes in blood glucose level and food intake. Conclusion: Maxillary immediate complete denture presents a good therapeutic choice for type 2 DM patients, as it provides possibility of adequate mastication after teeth extractions and maintenance of nutritional status and blood glucose level.

Effect of surgical drill guide and irrigans temperature on thermal bone changes during drilling implant sites - thermographic analysis on bovine ribs.

Background/Aim: During drilling implant sites, mechanical energy is converted into thermal one resulting in transient rise in temperature of surrounding bone. The temperature of 47°C exeeding one minute impairs osseointegration, compromises mechanical properties of the local bone and could cause early implant failure. This in vitro study aimed to assess the effect of surgical drill guide and temperature of irrigans on thermal changes of the local bone during drilling implant sites, and to test the influence of irrigans temperature on the temperature of surgical drill guide. Methods: A total of 48 specimens obtained from bovine ribs were randomly allocated to four experimental conditions according to the 2 x 2 factorial design: drill guide (with or without) and saline (at 25°C or 5°C). Real-time infrared thermography was used as a method for temperature measurement. The primary outcome was bone temperature change during drilling implant sites measured at 3 osteotomy depths, whereas the second one was change in the temperature of the drill guide. Data were analyzed by Brunner and Langer nonparametric analysis and Wilcoxon test. Results: The effect of drill guide on the changes of bone temperature was significant at the entrance of osteotomy, whereas the effect of saline temperature was significant at all osteotomy levels (p < 0.001). No significant interaction was found (p > 0.05). Guided surgery and irrigation with saline at 25°C were associated with the highest bone temperature increase. Increase in drill guide temperature was significantly higher when saline at 25°C was used (p < 0.001). Conclusion: Guided implant site preparation generates higher temperature of the local bone than conventional drilling, not exceeding the threshold for thermal bone necrosis. Although saline at room temperature provides sufficient heat control during drilling, cooled saline is more effective regardless the use of surgical drill guide.