Prospective evaluation of implants-supported, tooth-implant supported, and teeth-supported 3-unit posterior monolithic zirconia fixed restorations: Bite force and patient satisfaction

OBJECTIVES

This study aimed to evaluate the maximum bite force (MBF) and satisfaction of patients restored with implants, combined tooth-implants, and teeth-supported monolithic zirconia fixed dental prostheses (FDPs).

MATERIALS AND METHODS

Thirty partially edentulous patients in need of three units of FDPs in their mandibular posterior region were divided into three equal groups (n = 10) as follows: Group-1 patients received two implants for each at the second premolar and second molar regions, Group-2 patients received one implant for each at the second molar region, and Group-3 patients with missing lower first molar. All the restorations were constructed from monolithic zirconia. Patients were evaluated 1 week after placement of restorations (baseline) and then after 6, 12, and 24-month intervals for MBF using force transducer occlusal force meter and satisfaction (function, esthetic, and overall satisfaction) using a visual analog scale.

RESULTS

The mean MBF for Group 1 was higher than Group 2 (p = .044) but not that of Group 3 (p = .923). Additionally, Group 3 displayed a higher MBF than Group 2, although this difference was not statistically significant (p = .096). Concerning patient satisfaction, all study groups reported high levels of satisfaction across all satisfaction elements, and no significant differences were observed between the groups.

CONCLUSION

Within the limitations of this study, it can be concluded that Group 1 gives comparable anticipated treatment outcomes as Group 3 concerning biting force and patient satisfaction. However, Group 2 gives comparable satisfaction results with biting force value within the normal range; thus, it might be used as a treatment option in a specific situation.

Clinical Approaches to Nestorone Subdermal Implant Therapy in Women's Health

Segesterone acetate (SA) or Nestorone, a fourth-generation progestogen, is a synthetic compound with high progestational activity and no androgenic, glucocorticoid, or anabolic effects. However, due to its oral inactivity, SA must be used by other routes, such as subcutaneous. Thus, considering its peculiar properties, the SA subdermal implant is successfully used in female contraception and postmenopausal hormone replacement therapy (HRT). In recent years, its potential uses in endometriosis, polycystic ovaries syndrome (PCOS), and a new therapeutic possibility for neuroprotection have made this treatment extremely interesting. However, the absence of a standardized dose and the long-term safety of SA implant therapy in women is still controversial. Here, we present the possible indications, doses, limitations, and side effects of SA implant therapy.

Self-designed surgical guides for accurate socket shield preparation: An in vitro evaluation supported by a clinical report

PURPOSE

To achieve accurate socket shield preparation with newly proposed guides that are based on guiding rails and to investigate the effect of rail format (unilateral or bilateral) and rail height on the accuracy and efficiency of the guides.

MATERIALS AND METHODS

Two surgical guides based on grooved rails to guide the rotary instruments were produced. The first guide was used to cut the root into a labial shield with a pre-designed form and a lingual one, while the second guide was used to reduce the socket shield to the alveolar bone crest. The CBCT and intraoral scan data were first obtained and superimposed using the software. After isolating the root which would be used as a socket shield, grooved rails were designed on two separate guide templates according to the chosen rotary instruments to obtain a labial shield with a pre-designed form. An in vitro study was then conducted based on four cases in each group to determine the accuracy, efficiency, and optimal parameters of the guides, which was then verified with a clinical report. Comparisons between groups were performed with a one-way analysis of variance (ANOVA, for comparison between multiple groups) and the Student-Newman-Keuls test (for comparison between two groups).

RESULTS

With these two guides, the root can be divided into two pieces, including a palatal one and a labial one with a pre-designed form within a short time. Guide templates with bilateral rails more than 7 mm in height and those with unilateral rails 9 mm in height significantly increased the surgery accuracy, showing accurate shield preparation and decreased bone injury. Moreover, the guides with bilateral rails of more than 5 mm significantly decreased the surgery time for shield preparation. The presented case further verified the accuracy and efficiency of the guides.

CONCLUSIONS

The newly proposed guides can help to accurately prepare the socket shield, resulting in long-term stability of peri-implant tissues. Moreover, bilateral guiding rails with a height of 7-9 mm are recommended in such a guided socket shield surgery.

APDDM mixed with i-PRF as a graft material for bone regeneration - A case report

Demineralized dentine matrix (DDM) has both osteoconductive and osteoinductive properties, and has porous structure which helps in cell and blood vessel penetration and the release of various growth factors from the dentinal tubules. The first human dentine autograft case was done in 2002 in Japan for maxillary sinus lifting. In this clinical report, we use a hand-operated order made stainless steel apparatus to crush the tooth and prepare the DDM chair side. Chemical treatment of DDM particulate was done for demineralization and sterilisation purpose, and used immediately as a graft material for socket preservation. Dentascan after 4 month showed remarkable bone at the site of grafting and implant was placed. The patient was restored successfully with their own DDM and implant-supported prosthesis.

Minimum 25-Year Results of a Tapered Titanium Porous Plasma Spray Coated Femoral Component

BACKGROUND

Previous studies have reported excellent results with tapered, titanium, porous plasma-sprayed components in patients undergoing uncemented primary total hip arthroplasty (THA). The purpose of this study was to examine survival and clinical results at a minimum 25-year follow-up.

METHODS

We reviewed all patients who underwent primary THA at our center through 1995 with a specific femoral component that was essentially unchanged since its 1984 introduction, except porous coating was continued circumferentially in 1987, a hydroxyapatite-coated option was offered in 1988, and an offset option was added in 1999. There were 332 patients (396 THA) who had a minimum 25-year follow-up (range, 25 to 37). Mean age at surgery was 48 years (range, 21 to 70 years). Mean follow-up in nonfailed patients was 29 years (range, 25 to 37 years).

RESULTS

There were 31 femoral revisions (7.8%): 9 infections, 3 failures of ingrowth, 5 aseptic loosening, 8 osteolysis well-fixed, 2 periprosthetic fractures, 2 polyethylene wear with trochanteric avulsion, 1 component breakage, and 1 malalignment well-fixed. Kaplan-Meier survival with the endpoint of all-cause stem revision was 94.8% (95% confidence interval: ±0.9%) at 37 years, and with the endpoint of aseptic loosening/failure of ingrowth was 98.7% (95% confidence interval: ±0.5) at 37 years. Harris hip scores improved significantly from 43 preoperatively to 76 most recently.

CONCLUSION

This tapered, titanium, porous plasma spray-coated femoral component continues to demonstrate high long-term survival with a low rate of femoral component revision for any reason or aseptic loosening/failure of ingrowth.

Electrodeposited Zinc Coatings for Biomedical Application: Morphology, Corrosion and Biological Behaviour

The improvement of biodegradable metals is currently an active and promising research area for their capabilities in implant manufacturing. However, controlling their degradation rate once their surface is in contact with the physiological media is a challenge. Surface treatments are in the way of addressing the improvement of this control. Zinc is a biocompatible metal present in the human body as well as a metal widely used in coatings to prevent corrosion, due to its well-known metal protective action. These two outstanding characteristics make zinc coating worthy of consideration to improve the degradation behaviour of implants. Electrodeposition is one of the most practical and common technologies to create protective zinc coatings on metals. This article aims to review the effect of the different parameters involved in the electrochemical process on the topography and corrosion characteristics of the zinc coating. However, certainly, it also provides an actual and comprehensive description of the state-of-the-art of the use of electrodeposited zinc for biomedical applications, focusing on their capacity to protect against bacterial colonization and to allow cell adhesion and proliferation.

A 3D-printed patient-specific modular implants for pelvic reconstruction of bone tumors involving the sacroiliac joint

Background: Current reconstruction methods of the pelvic ring after extensive resection of tumors involving the sacroiliac joint have a high incidence of failure. We aimed to study the effect of 3D-printed patient-specific implant reconstruction to show that this method is stable and has a low risk of failure. Methods: Between February 2017 and November 2021, six patients with bone tumors involving the sacroiliac joint (Enneking I + IV) who received 3D-printed patient-specific implants for pelvic reconstructive surgery were retrospectively analyzed. Two female and four male patients with a mean age of 41.83 years (range 25-65 years) were included. Two were osteosarcomas, two chondrosarcomas, one malignant fibrous histiocytoma, and one giant cell tumor of bone. For each patient, preoperative osteotomy guides were designed to ensure accurate tumor resection and individualized prostheses were designed to ensure a perfect fit of the bone defect. General, oncologic, and functional outcomes, implant status, and complications were retrospectively analyzed. The Visual Analog Scale (VAS) was used to assess pain and the Musculoskeletal Tumor Society (MSTS) score was used to assess hip function. Osseointegration was assessed by CT. Results: According to the preoperative design, complete resection of the entire tumor and reconstruction with a custom 3D-printed sacroiliac joint implant was completed without perioperative severe complications or deaths. Relatively satisfactory surgical margins were achieved. The mean operative time and intraoperative blood loss were 495 min (420-600 min) and 2533.33 mL (range, 1,200-3,500 mL), respectively. The mean follow-up was 49.83 months (range, 18-75 months). At the last follow-up, all four patients were disease-free, and the two patients who developed lung metastases were alive with tumors. All patients could walk unassisted. The mean VAS was 1.33 (range, 0-2). The mean MSTS score was 25.33 (range, 24-27). CT showed complete osseointegration of the implant to the ilium and sacrum. Conclusion: The 3D-printed custom prosthesis can effectively reconstruct pelvic stability after total sacroiliac joint resection with satisfactory clinical results.

Foreign Body Reaction (Immune Response) for Artificial Implants Can Be Avoided: An Example of Polyurethane in Mice for 1 Week

Despite great success with artificial implants for the human body, modern implants cannot solve major health problems. The reason is an immune reaction of organisms to artificial implants, known as the foreign body reaction. We have found a way to avoid or decrease the foreign body reaction. The surface of an artificial implant is modified with condensed aromatic structures containing free radicals, which provide a covalent attachment of host proteins in a native conformation. The total protein coverage prevents the direct contact of immune cells with the implant surface, and the immune cells are not activated. As a result, the immune response of the organism is not generated, and the artificial implant is not isolated from the tissue; there is no collagen capsule, low activity of macrophages, low cell proliferation, and low inflammatory activity.

Dopamine-Mediated Biopolymer Multilayer Coatings for Modulating Cell Behavior, Lubrication, and Drug Release

Biopolymer coatings on implants mediate the interactions between the synthetic material and its biological environment. Owing to its ease of preparation and the possibility to incorporate other bioactive molecules, layer-by-layer deposition is a method commonly used in the construction of biopolymer multilayers. However, this method typically requires at least two types of oppositely charged biopolymers, thus limiting the range of macromolecular options by excluding uncharged biopolymers. Here, we present a layer-by-layer approach that employs mussel-inspired polydopamine as the adhesive intermediate layer to build biopolymer multilayer coatings without requiring any additional chemical modifications. We select three biopolymers with different charge states─anionic alginate, neutral dextran, and cationic polylysine─and successfully assemble them into mono-, double-, or triple-layers. Our results demonstrate that both the layer number and the polymer type modulate the coating properties. Overall, increasing the number of layers in the coatings leads to reduced cell attachment, lower friction, and higher drug loading capacity but does not alter the surface potential. Moreover, varying the biopolymer type affects the surface potential, macrophage differentiation, lubrication performance, and drug release behavior. This proof-of-concept study offers a straightforward and universal coating method, which may broaden the use of multilayer coatings in biomedical applications.

Palladium(II) Metal Complex Fabricated Titanium Implant Mitigates Dual-Species Biofilms in Artificial Synovial Fluid

Metallodrugs have a potent application in various medical fields. In the current study, we used a novel Palladium(II) thiazolinyl picolinamide complex that was directly fabricated over the titanium implant to examine its potency in inhibiting dual-species biofilms and exopolysaccharides. Additionally, inhibition of mono- and dual-species biofilms by coated titanium plates in an in vitro joint microcosm was performed. The study was carried out for 7 days by cultivating mono- and dual-species biofilms on titanium plates placed in both growth media and artificial synovial fluid (ASF). By qPCR analysis, the interaction of co-cultured biofilms in ASF and the alteration in gene expression of co-cultured biofilms were studied. Remarkable alleviation of biofilm accumulation and EPS secretion was observed on the coated titanium plates. The effective impairment of biofilms and EPS matrix of biofilms on Pd(II)-E-coated titanium plates were visualized by Scanning Electron Microscopy. Moreover, coated titanium plates improved the adhesion of osteoblast cells, which is crucial for a bone biomaterial. The potential bioactivity of coated plates was also confirmed at the molecular level using qPCR analysis. The stability of coated plates in ASF for 7 days was examined with FESEM-EDAX analysis. Collectively, the present study provided an excellent anti-infective effect on Pd(II)-E-coated titanium plates without affecting their biocompatibility with bone cells.

3D-to-4D Structures: an Exploration in Biomedical Applications

3D printing is a cutting-edge technique for manufacturing pharmaceutical drugs (Spritam), polypills (guaifenesin), nanosuspension (folic acid), and hydrogels (ibuprofen) with limitations like the choice of materials, restricted size of manufacturing, and design errors at lower and higher dimensions. In contrast, 4D printing represents an advancement on 3D printing, incorporating active materials like shape memory polymers and liquid crystal elastomers enabling printed objects to change shape in response to stimuli. 4D printing offers numerous benefits, including greater printing capacity, higher manufacturing efficiency, improved quality, lower production costs, reduced carbon footprint, and the ability to produce a wider range of products with greater potential. Recent examples of 4D printing advancements in the clinical setting include the development of artificial intravesicular implants for bladder disorders, 4D-printed hearts for transplant, splints for tracheobronchomalacia, microneedles for tissue wound healing, hydrogel capsules for ulcers, and theragrippers for anticancer drug delivery. This review highlights the advantages of 4D printing over 3D printing, recent applications in manufacturing smart pharmaceutical drug delivery systems with localized action, lower incidence of drug administration, and better patient compliance. It is recommended to conduct substantial research to further investigate the development and applicability of 4D printing in the future.

Hybrid Implants Based on Calcium-Magnesium Silicate Ceramic Diopside as a Carrier of Recombinant BMP-2 and Demineralized Bone Matrix as a Scaffold: Ectopic Osteogenesis in Intramuscular Implantation in Mice

High efficiency of hybrid implants based on calcium-magnesium silicate ceramic, diopside, as a carrier of recombinant BMP-2 and xenogenic demineralized bone matrix (DBM) as a scaffold for bone tissue regeneration was demonstrated previously using the model of critical size cranial defects in mice. In order to investigate the possibility of using these implants for growing autologous bone tissue using in vivo bioreactor principle in the patient's own body, effectiveness of ectopic osteogenesis induced by them in intramuscular implantation in mice was studied. At the dose of 7 μg of BMP-2 per implant, dense agglomeration of cells, probably skeletal muscle satellite precursor cells, was observed one week after implantation with areas of intense chondrogenesis, initial stage of indirect osteogenesis, around the implants. After 12 weeks, a dense bone capsule of trabecular structure was formed covered with periosteum and mature bone marrow located in the spaces between the trabeculae. The capsule volume was about 8-10 times the volume of the original implant. There were practically no signs of inflammation and foreign body reaction. Microcomputed tomography data showed significant increase of the relative bone volume, number of trabeculae, and bone tissue density in the group of mice with BMP-2-containing implant in comparison with the group without BMP-2. Considering that DBM can be obtained in practically unlimited quantities with required size and shape, and that BMP-2 is obtained by synthesis in E. coli cells and is relatively inexpensive, further development of the in vivo bioreactor model based on the hybrid implants constructed from BMP-2, diopside, and xenogenic DBM seems promising.

Trends and Challenges in the Development of 3D-Printed Heart Valves and Other Cardiac Implants: A Review of Current Advances

This article provides a comprehensive review of the current trends and challenges in the development of 3D-printed heart valves and other cardiac implants. By providing personalized solutions and pushing the limits of regenerative medicine, 3D printing technology has revolutionized the field of cardiac healthcare. The use of several organic and synthetic polymers in 3D printing heart valves is explored in this article, with emphasis on both their benefits and drawbacks. In cardiac tissue engineering, stem cells are essential, and their potential to lessen immunological rejection and thrombogenic consequences is highlighted. In the clinical applications section, the article emphasizes the importance of 3D printing in preoperative planning. Surgery results are enhanced when surgeons can visualize and assess the size and placement of implants using patient-specific anatomical models. Customized implants that are designed to match the anatomy of a particular patient reduce the likelihood of complications and enhance postoperative results. The development of physiologically active cardiac implants, made possible by 3D bioprinting, shows promise by eliminating the need for artificial valves. In conclusion, this paper highlights cutting-edge research and the promise of 3D-printed cardiac implants to improve patient outcomes and revolutionize cardiac treatment.

Novel Digital Mouth Preparation Technique for Fabricating Implant-Retained Removable Partial Dentures with Distal Extension: a Case Report

Implant-retained removable partial dentures (RPDs) are commonly used to resolve the complications associated with traditional distal extension RPDs; however, this technology does not consider the necessity and importance of parallelism between the path of RPD insertion and the long axis of the implant. This clinical report presents a novel digital preparation technique that involves the preparation of parallel guiding planes on abutment teeth and implant insertion in the distal extension area using a computer-aided design and manufacturing template. This clinical case of implant-retained RPDs illustrates the fabrication and application of the digital template. Using this technique, the path of RPD insertion is parallel to the long axis of the implant. As a result, the components of the implant-retained RPD, including the abutment teeth, implants and attachments, can demonstrate greater longevity.

Engineering 3D-Printed Advanced Healthcare Materials for Periprosthetic Joint Infections

The use of additive manufacturing or 3D printing in biomedicine has experienced fast growth in the last few years, becoming a promising tool in pharmaceutical development and manufacturing, especially in parenteral formulations and implantable drug delivery systems (IDDSs). Periprosthetic joint infections (PJIs) are a common complication in arthroplasties, with a prevalence of over 4%. There is still no treatment that fully covers the need for preventing and treating biofilm formation. However, 3D printing plays a major role in the development of novel therapies for PJIs. This review will provide a deep understanding of the different approaches based on 3D-printing techniques for the current management and prophylaxis of PJIs. The two main strategies are focused on IDDSs that are loaded or coated with antimicrobials, commonly in combination with bone regeneration agents and 3D-printed orthopedic implants with modified surfaces and antimicrobial properties. The wide variety of printing methods and materials have allowed for the manufacture of IDDSs that are perfectly adjusted to patients' physiognomy, with different drug release profiles, geometries, and inner and outer architectures, and are fully individualized, targeting specific pathogens. Although these novel treatments are demonstrating promising results, in vivo studies and clinical trials are required for their translation from the bench to the market.

Elderly and Patients with Large Breast Volume Have an Increased Risk of Seroma Formation after Mastectomy-Results of the SerMa Pilot Study

The collective of the SerMa pilot study included 100 cases of primary breast cancer or Carcinoma in situ who had undergone a mastectomy procedure with or without reconstruction of the breast using an implant or expander at Augsburg University Hospital between 12/2019 and 12/2022. The study aimed to investigate possible causes of seroma formation; reported here are the clinicopathological correlations between seroma formation and tumor biology and surgical procedures. Seroma occurred significantly more often in patients with older age (median patient age in cases with seroma was 73 years vs. 52 years without seroma; p < 0.001). In addition, patients with larger mastectomy specimen were significantly more likely to develop seroma (median ablation weight in cases with seroma 580 g vs. 330 g without seroma; p < 0.001). Other significant parameters for seroma formation were BMI (p = 0.005), grading (p = 0.015) and tumor size (p = 0.036). In addition, with insertion of implant or expander, a seroma occurred significantly less frequently (p < 0.001). In a binary logistic regression, age in particular was confirmed as a significant risk factor. In contrast, tumor biological characteristics, number of lymph nodes removed or affected showed no significant effect on seroma formation. The present study shows the need for patient education about the development of seroma in particular in older patients and patients with large breast volumes within the preoperative surgical clarification. These clinicopathological data support the previously published results hypothesizing that seroma formation is related to autoimmune/inflammatory processes and will be tested on a larger collective in the planned international multicenter SerMa study.

Implant surface physicochemistry affects keratinocyte hemidesmosome formation

Previous studies have shown hydrophilic/hydrophobic implant surfaces stimulate/hinder osseointegration. An analogous concept was applied here using common biological functional groups on a model surface to promote oral keratinocytes (OKs) proliferation and hemidesmosomes (HD) to extend implant lifespans through increased soft tissue attachment. However, it is unclear what physicochemistry stimulates HDs. Thus, common biological functional groups (NH2 , OH, and CH3 ) were functionalized on glass using silanization. Non-functionalized plasma-cleaned glass and H silanization were controls. Surface modifications were confirmed with X-ray photoelectron spectroscopy and water contact angle. The amount of bovine serum albumin (BSA) and fibrinogen, and BSA thickness, were assessed to understand how adsorbed protein properties were influenced by physicochemistry and may influence HDs. OKs proliferation was measured, and HDs were quantified with immunofluorescence for collagen XVII and integrin β4. Plasma-cleaned surfaces were the most hydrophilic group overall, while CH3 was the most hydrophobic and OH was the most hydrophilic among functionalized groups. Modification with the OH chemical group showed the highest OKs proliferation and HD expression. The OKs response on OH surfaces appeared to not correlate to the amount or thickness of adsorbed model proteins. These results reveal relevant surface physicochemical features to favor HDs and improve implant soft tissue attachment.

A Finite Element Analysis of Stress Allocation around Three Types of Abutment-Implant Interfaces

Objectives

This study examined the effects of stress distribution at three abutment-implant interfaces on various implant systems.

Materials and Methods

Group I: tri-channel internal connection (Nobel Biocare), Group II: 1.5-mm deep internal hex (BioHorizons Co. Birmingham, USA), and Group III: ADIN Touareg, to create computerized models of implants and mandibular modeling software, close fit WP, ANSYS Version 14.0 for finite element analysis (FEA), Hypermesh 12 for meshing and CATIA were used. A top-notch scanner was used to scan the implant. CATIA software created computerized models using all the aforementioned data. By applying bonded state on the abutment-implant borders and four various load conditions within the implant system, finite element method modeling was carried out. The computerized model was imported into the ANSYS program. To compare the groups, a statistical analysis was conducted.

Result

Through the use of three-dimensional FEA, the samples were assessed. Stress was found to be utmost in Group I, followed by Group III and Group II, at 80 N, 80 N with a 15° tilt, 250 N, and 250 N with a 15° tilt, and the divergence was statistically inconsequential.

Conclusion

The tri-channel internal connection displayed the highest stresses compared to the internal hex within the constraints of the current study.

Comparative Evaluation of Two Implant Designs Based on Bone Loss and Stability with Early Loading Method

The study evaluated the implant bone loss and stability of implant changes with diverse designs with early placement at eight weeks and eight months' time. The subjects for the current study had partial tooth loss in the posterior mandibular arch. A total of 30 samples were split into two groups of 15, one with a flared crest module and a buttress thread design, the other with a parallel crest module and a V-shaped thread design. Ostell assessed each subject's implant stability four times, at baseline, eight weeks, four months, and eight months. At intervals of eight weeks, four months, and eight months, intraoral periapical radiographs were examined using ImageJ software to measure crestal bone loss. When Group I and Group II's implant stability quotient (ISQ) values at baseline, eight weeks, four months, and eight months were compared; Group I's ISQ values at each of the four measured time periods were statistically significant. At eight weeks in Group I, the ISQ value was very considerable. At eight weeks, four months, and eight months, there was a statistically significant bone loss in Group II in comparison to Group I. At eight months, Group II's bone loss value was very considerable. In contrast to Group II implant designs, it was found that Group I implants demonstrated enhanced implant-less bone loss and stability.

An Evaluation of the Effectiveness of Various Luting Cements on the Retention of Implant-Supported Metal Crowns

Background and objective Cement-retained prostheses have replaced screw-retained prostheses as the preferred restoration in recent years in order to overcome the latter's limitations. In this study, four different luting cements were compared to evaluate their efficacy on the retention of cement-based metal crowns to implant abutments. Materials and methods In the right and left first molar regions, four implant analogs (Internal Hex, Adin Dental Implant Systems Ltd., Tel-Aviv, Israel) were screwed into epoxy resin casts (Araldite CY 230-1 IN, India) that were positioned perpendicular to the cast's plane. Four metal copings were created and cemented. Group A: polycarboxylate cement (DUR) (DurelonTM, 3M Espe, St. Paul, MN); Group B: PANAVIA™ F 2.0 dual-cure resin cement (Kuraray America, Inc., New York, NY); Group C: resin-modified glass ionomer (3M™ RelyX™ Luting, 3M Espe); and Group D: non-eugenol temporary resin cement (Kerr-Temp, KaVo Kerr, Brea, CA) were used to cement crowns. To check the retention capacity, samples were put through a pull-out test on an Instron universal testing machine (TSI‑Tecsol, Bengaluru, India) with a crosshead speed of 0.5 mm/min. Each coping's de-cementing load was noted, and average values for every sample were computed and statistically analyzed. Results The findings demonstrated that non-eugenol temporary resin implant cement has the lowest retention value at 138.256 N, followed by resin-modified glass ionomer cement at 342.063 N, polycarboxylate luting cement at 531.362 N, and resin cement at 674.065 N. The average difference in retentive strength across all four groups was statistically very significant (p=0.001). Conclusion Based on our findings, non-eugenol temporary resin implant cement enables simple retrievability of the prosthesis in the event of a future failure and is appropriate for implant restorations with cement retention. Also, cements made of polycarboxylate and resin have the highest retention values.

Survival and Complications of Single Dental Implants in the Edentulous Mandible following Immediate or Delayed Loading: A Randomized Controlled Clinical Trial

Introduction

The lifespan of an edentulous mandible with one median implant to hold a full denture for 24 months was evaluated to see if the early loading had any impact on it. Single-implant denture retention for the mandibular region was proposed by "Cordioli et al. in the 1990s.

Objectives

Whether rapid loading and placement of a "single median implant" may result in the implant survival rate comparable to rehabilitation with a single implant and second-stage surgery.

Methods

It was found that 81 of the 158 implant recipients had quick loading, whereas the rest had delayed loading (77 patients). Patients in the context of "delayed loading group" had follow-up appointments at 1 month, 4 months, 12 months, and 24 months. In addition, the nine implants failed in the 3 months after loading in a quick loading group, while just one implant failed before loading. Median implant survival at 2 years was the study's main goal. Direct loading had a 7% fatality rate advantage over traditional loading because of the alleged advantages of immediate loading, including the avoidance of second-stage surgery. Prosthetic problems were evaluated using Fisher's exact test.

Results

A higher rate of implant survival was not seen when implants were loaded more quickly (P = 0.81). A statistically significant difference (P = 0.019) was seen in implant survival between the therapy groups.

Conclusion

Single implant loading in an edentulous mandible has a worse survival rate than delayed loading, according to all available research.

Assessment of Biograft-HT with I-PRF Graft in Immediate Dental Implant Placement

Objectives

This research was done to assess the efficacy of I-PRF and bone graft in immediate dental implant placement.

Materials and Method

Twenty patients were selected randomly into 2 groups with 10 samples in each as Group I- using I-PRF and Group II with synthetic bone replacement alloplast (biograft-HT) after immediate implant placement. Postoperative clinical assessment after graft placement was done based on visual analog scale for pain, modified gingival index and modified plaque index at 2nd, 4th, and 6th months. A radiographic assessment of bone density was performed two and six months after the placement of the implant.

Result

There was a statistically considerable variation between the change in modified plaque index and modified gingival index. There was a statistically insignificant divergence in the mean visual analog scale between the two groups at 1, 3, and 6 days. Group I demonstrated a higher change in bone density than group II, with a statistically significant difference (P = .002).

Conclusion

An innovative, safe, and efficient method for controlling the healing process around immediate dental implants is provided by the use of I-PRF in conjunction with immediate dental implant placement.

Clinical and CBCT Assessment of Crestal Bone Changes in Immediate and Delayed Placement of Implant

Objectives

The present research was done to assess the crestal bone changes in immediate and delayed dental implant placement.

Materials and Method

Twenty four implant sites in participants within the age group of 25-60 years in both genders were done with immediate (Group I) and delayed implant (Group II) placement method. Clinical parameters such as pain, mobility, and radiographic assessment for crestal bone alterations were recorded at baseline, 3 months, and 6 months.

Results and Conclusion

On intergroup assessment, the mean variation of the pain, mobility, and crestal bone loss was insignificant.

A Comparative Evaluation of Vertical Marginal Gap for Vented and Precemented Cad-Cam Zirconium Copings on Angulated Abutments: An In vitro Study

Objective

To evaluate vertical marginal gap after cementation of Zr (zirconium) copings with palatal vent, open vent, and precementation technique on angulated abutments resulting from cement entrapment between intaglio surface of copings and angulated abutments.

Materials and Methods

Twenty-four angled abutments and 24 CAD-CAM Zr copings were assigned to three groups depending on the type of cementation technique, comprising eight copings with palatal vent, open vent, and no vent, respectively. Vertical marginal gaps between abutment shoulder and coping margin were evaluated at four points: buccal, palatal, mesial, and distal. The readings were statistically analyzed.

Results

The average mean value of vertical marginal gap at all sites for Group A with palatal vent was 158.45, for Group B with open vent was 151.84, and for Group C using precementation technique was 163.58. A statistically non-significant difference was seen for values between all sites (P > 0.05) for all groups.

Conclusion

The average vertical marginal gap for Group B was comparatively lower compared to Groups A and C.

Flap versus Flapless Immediate Implants with Bone Augmentation: A Novel Study

Background

This study aimed to equate implants placed using a traditional flap elevation technique with implants placed using a flapless process regarding bone healing and success in clinical conditions.

Materials and Methods

Sixty subjects were included in this research work. The participants were randomly divided into two groups. Patients in group A underwent implant placement with the flap elevation technique. Similarly, group B patients underwent implant placement without flap reflection. Parameters such as plaque index, wound healing index, crestal bone loss, and radiograph were considered to estimate the effectiveness of the two techniques.

Results

Plaque indexes were improved in both groups. The modified gingival index also improved in all the phases of healing. The flapless method showed a better crestal bone.

Conclusion

It can be concluded that this study showed that with the right augmentation techniques, implants could be successfully performed immediate extraction sockets, both with and without elevation of the mucoperiosteal flap.