Dental Implants

Clinical Outcomes of Single Tooth Implant Placement in the Mandibular Region: A Case Report

The most frequent reasons why people lose their teeth are trauma, dental caries, developmental defects, and genetic abnormalities. Dental implants have become a popular alternative to traditional dentures and bridges due to their ability to restore function through osseointegration. This case report presents a 35-year-old male with a two-year history of a missing lower right molar due to caries. With no systemic health issues or harmful habits, the patient underwent dental implant placement after a thorough evaluation and cone-beam computed tomography (CBCT) analysis. A parallel-sided, threaded implant was placed in the 46 region. Postoperative care included antibiotics, analgesics, and follow-up visits. Second-stage surgery was done, which was followed by impression-making and healing abutment placement. The final crown was cemented with careful occlusion verification. The patient exhibited excellent healing and was scheduled for regular follow-ups to ensure successful implant integration and function restoration.

Tribocorrosion of 3D printed dental implants: An overview

With the advancements in dental science and the growing need for improved dental health, it has become imperative to develop new implant materials which possess better geometrical, mechanical, and physical properties. The oral environment is a corrosive environment and the relative motion between the teeth also makes the environment more hostile. Therefore, the combined corrosion and tribology commonly known as tribocorrosion of implants needs to be studied. The complex shapes of the dental implants and the high-performance requirements of these implants make manufacturing difficult by conventional manufacturing processes. With the advent of additive manufacturing or 3D-printing, the development of implants has become easy. However, the various requirements such as surface roughness, mechanical strength, and corrosion resistance further make the manufacturing of implants difficult. The current paper reviews the various studies related to3D-printed implants. Also, the paper tries to highlight the role of 3D-Printing can play in the area of dental implants. Further studies both experimental and numerical are needed to devise optimized conditions for 3D-printing implants to develop implants with improved mechanical, corrosion, and biological properties.

The potential bone regeneration effects of leptin- and osteolectin-coated 3D-printed PCL scaffolds: anin vivostudy

This study investigated the effectiveness of bone regeneration upon the application of leptin and osteolectin to a three-dimensional (3D) printed poly(ϵ-caprolactone) (PCL) scaffold. A fused deposition modeling 3D bioprinter was used to fabricate scaffolds with a diameter of 4.5 mm, a height of 0.5 mm, and a pore size of 420-520 nm using PCL (molecular weight: 43 000). After amination of the scaffold surface for leptin and osteolectin adhesion, the experimental groups were divided into the PCL scaffold (control), the aminated PCL (PCL/Amine) scaffold, the leptin-coated PCL (PCL/Leptin) scaffold, and the osteolectin-coated PCL (PCL/Osteo) scaffold. Next, the water-soluble tetrazolium salt-1 (WST-1) assay was used to assess cell viability. All groups exhibited cell viability rates of >100%. Female 7-week-old Sprague-Dawley rats were used forin vivoexperiments. Calvarial defects were introduced on the rats' skulls using a 5.5 mm trephine bur. The rats were divided into the PCL (control), PCL/Leptin, and PCL/Osteo scaffold groups. The scaffolds were then inserted into the calvarial defect areas, and the rats were sacrificed after 8-weeks to analyze the defect area. Micro-CT analysis indicated that the leptin- and osteolectin-coated scaffolds exhibited significantly higher bone regeneration. Histological analysis revealed new bone and blood vessels in the calvarial defect area. These findings indicate that the 3D-printed PCL scaffold allows for patient-customized fabrication as well as the easy application of proteins like leptin and osteolectin. Moreover, leptin and osteolectin did not show cytotoxicity and exhibited higher bone regeneration potential than the existing scaffold.

Evaluation of Effect of Different Insertion Speeds and Torques on Implant Placement Condition and Removal Torque in Polyurethane Dense D1 Bone Model

The aim of this study was to evaluate the effect of two different insertion speeds at eight different insertion torque values ranging from 25 to 60 during implantation in a dense polyurethane (PU) D1 bone model on the placement condition and removal torque of dental implants. In this study, 50 pcf single-layer PU plates were used. In the study, a total of 320 implant sockets were divided into two groups, Group 1 (30 rpm) and Group 2 (50 rpm), in terms of insertion speed. Group 1 and Group 2 were divided into eight subgroups with 25, 30, 35, 40, 45, 50, 55 and 60 torques. There were 20 implant sockets in each subgroup. During the implantations, the implant placement condition and removal torque values were assessed. There was a statistically significant difference between the 30 and 50 rpm groups in terms of overall implant placement condition (p < 0.01). It was found that the removal torque values at 50 rpm were statistically significantly higher than those at 30 rpm (p < 0.01). This study showed that in dense D1 bone, the minimum parameters at which all implants could be placed at the bone level were 50 torque at 30 rpm and 40 torque at 50 rpm.

PROPHYLACTIC ANTIBIOTICS DURING THE IMPLANT PROSTHETIC PHASE MAY NOT SUBSTANTIALLY DECREASE THE INCIDENCE OF INFECTIOUS COMPLICATIONS

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION

Does the Prosthetic Phase of Dental Implants Justify the Prescription of Preventive Antibiotics in Healthy Patients? A Systematic Review. Salgado-Peralvo AO, Uribarri A, Peña-Cardelles JF, Kewalramani N, Rodríguez JLG, Velasco-Ortega E. J Oral Implantol. 2023 Feb 1;49(1):93-101.

SOURCE OF FUNDING

The authors declared that no funding was received to support the study.

TYPE OF STUDY/DESIGN

Systematic review.

Comparative evaluation of implant stability with and without autologous platelet-rich fibrin prior to prosthetic loading - A split-mouth randomized clinical trial

Context:

Status of bone–implant interface or osseointegration can be assessed by using resonance frequency analysis (RFA), which measures implant stability. A modified implant surface can significantly enhance osseointegration and reduce healing period. Platelet-rich fibrin (PRF) consists of fibrin mesh with entrapped platelets and leukocytes that release a huge number of growth factors which contribute to wound healing and tissue regeneration.

Aims:

The present study aims to evaluate the effect of PRF on osseointegration in terms of implant stability.

Settings and Design:

This was a split-mouth randomized clinical trial.

Materials and Methods:

Sixty surgical sites were divided randomly into two groups. In Group 1 (thirty sites), PRF was placed in osteotomy sites before implant placement whereas no PRF was placed in Group 2 (thirty sites). Stability was measured using RFA in terms of implant stability quotient (ISQ) at baseline, 1 week, 1 month, and 3 months.

Statistical Analysis:

Intergroup comparison was done using Mann–Whitney U-test. Intragroup comparison was done using Friedman's test followed by pairwise comparison using Wilcoxon signed-rank test.

Results:

On intergroup comparison, Group 1 showed higher values for ISQ which were statistically significant (P < 0.05) at 1 week and 1 month. No significant difference (P > 0.05) was found at baseline and 3 months. Intragroup comparison and further pairwise comparison revealed a highly significant difference for values between all pairs of time intervals (P < 0.01) with higher values at 3 months.

Conclusions:

PRF has a significant effect on osseointegration of dental implants during the early healing period prior to loading.

Management of systemic risk factors ahead of dental implant therapy: A beard well lathered is half shaved

As the most successful therapy for missing teeth, dental implant has become increasingly prevalent around the world. A lot of papers have reported diverse local risk factors affecting the success and survival rate of dental implants, either for a short or a long period. However, there are also many types of systemic disorders or relatively administrated medicine that may jeopardize the security and success of dental implant treatment. Additionally, the coronavirus disease 2019 pandemic also poses a challenge to dental implant clinicians. Some of these risk factors are clinically common but to some extent unfamiliar to dentists, thus optimal measurements are often lacking when they occur in dental clinics. In this review, we analyze potential systemic risk factors that may affect the success rate of dental implants. Some of them may affect bone mineral density or enhance the likelihood of local infection, thus impeding osseointegration. Others may even systemically increase the risk of the surgery and threaten patients' life. In order to help novices receive high-risk patients who need to get dental implant treatment in a more reasonable way, we accordingly review recent research results and clinical experiments to discuss promising precautions, such as stopping drugs that impact bone mineral density or the operation, and addressing any perturbations on vital signs.

Leveraging Advancements in Tissue Engineering for Bioprinting Dental Tissues

3D bioprinting allows biocompatible materials and cells to be deposited in precise locations in three-dimensional space, enabling researchers to surpass the limitations of traditional 2D cell culture and to create innovative therapies. 3D bioprinting is one of the newest tools developed in the field of tissue engineering, which has traditionally utilized a paradigm revolving around scaffolds, cells, and signals. In this review, we discuss how new developments in each of these three research areas relates to bioprinting dental tissues - specifically teeth, periodontal ligament, and alveolar bone. Important considerations include how scaffold materials and geometry affect regeneration of dental tissues, the importance of using dental cells in these applications, and the role of signaling molecules for creating a clinically relevant bioengineered dental implant. We conclude with potential new directions for research that would allow the burgeoning field of regenerative dentistry to achieve its lofty goals.

Postoperative Imaging Appearance of Iliac Crest Free Flaps Used for Palatomaxillary Reconstructions

The osteomyocutaneous iliac crest free flap is a reconstructive option for segmental mandibular or complex palatomaxillary defects. Familiarity with the radiographic appearance of free flaps such as the iliac crest is necessary for the postoperative evaluation of patients after mandibular, maxillary, or palatal reconstructions because it allows radiologists to properly monitor and interpret the appearance of the flap over time. This study presents a retrospective review of 5 patients who underwent palatomaxillary reconstruction with an iliac crest free flap at our institution. The imaging appearances of the 5 patients were analyzed to determine the key radiographic characteristics of a healthy and successful iliac crest free flap. Radiographic fluency with the imaging appearance of the iliac crest free flap, as well as the new anatomy of the region in the postoperative period, will allow for better interpretation of the flap appearance on imaging and will prevent false identification of tumor recurrence.

Effect of Implantation Ti-6Al-4V ELI in femoral bone defect regeneration of Sprague Dawley rat

Ti-6Al-4V ELI is one of the most commonly used dental implant restore function. The solution treatment temperature variation can significantly increase the strength, but it is not yet known the effect of these temperature variations on the alloy's biocompatibility properties. Twelve female Sprague Dawley rats were divided into six groups as follows: the treated group, the control group, and the defect group without implant material. In the treated group, the femur bone defect was implanted with as-cast Ti-6Al-4V ELI, 850°C, 950°C, and 1050°C heat-treated Ti-6Al-4V ELI implant material. The rats were euthanized after 30 days postimplantation and evaluated histologically. The results show that the histological scoring of the specimen for femur defect without implant material is 2 (fibrous union and fibrocartilaginous), score with implant as-cast is 2.5, the sample with 850°C heat treatment material is 2.5, 950°C is 2.5, and the temperature at 1050°C is 2.5. The score of 2.5 is between score 2 and score 3: hemorrhage, fibrous union, fibrocartilaginous microhemorrhage, and mineralized cartilage union. In conclusion, there is no effect of different heat treatment temperatures for Ti-6Al-4V ELI implant material in rat bone regeneration's maturation level.

Cell Type-Specific Adhesion and Migration on Laser-Structured Opaque Surfaces

Cytocompatibility is essential for implant approval. However, initial in vitro screenings mainly include the quantity of adherent immortalized cells and cytotoxicity. Other vital parameters, such as cell migration and an in-depth understanding of the interaction between native tissue cells and implant surfaces, are rarely considered. We investigated different laser-fabricated spike structures using primary and immortalized cell lines of fibroblasts and osteoblasts and included quantification of the cell area, aspect ratio, and focal adhesions. Furthermore, we examined the three-dimensional cell interactions with spike topographies and developed a tailored migration assay for long-term monitoring on opaque materials. While fibroblasts and osteoblasts on small spikes retained their normal morphology, cells on medium and large spikes sank into the structures, affecting the composition of the cytoskeleton and thereby changing cell shape. Up to 14 days, migration appeared stronger on small spikes, probably as a consequence of adequate focal adhesion formation and an intact cytoskeleton, whereas human primary cells revealed differences in comparison to immortalized cell lines. The use of primary cells, analysis of the cell-implant structure interaction as well as cell migration might strengthen the evaluation of cytocompatibility and thereby improve the validity regarding the putative in vivo performance of implant material.

Role of Hippo-YAP Signaling in Osseointegration by Regulating Osteogenesis, Angiogenesis, and Osteoimmunology

The social demand for dental implantation is growing at a rapid rate, while dentists are faced with the dilemma of implantation failures associated with unfavorable osseointegration. Clinical-friendly osteogenesis, angiogenesis and osteoimmunology around dental implants play a pivotal role in a desirable osseointegration and it's increasingly appreciated that Hippo-YAP signaling pathway is implicated in those biological processes both in vitro and in vivo in a variety of study. In this article we review the multiple effects of Hippo-YAP signaling in osseointegration of dental implants by regulating osteogenesis, angiogenesis and osteoimmunology in peri-implant tissue, as well as highlight prospective future directions of relevant investigation.

Dental Emergencies: A Practical Guide

Dental disease is a frequent finding on head and neck images, especially in the context of emergencies, and can be a challenge for radiologists who are inexperienced with findings of dental trauma or disease. Dental abnormalities can be subtle and therefore must be included in the systematic approach to these images. Although dedicated dental images are not acquired in most emergency cases, the teeth are included on many different images of the head and neck, and their initial evaluation seldom requires a specific protocol. The high prevalence of craniofacial trauma, sinus infection, and maxillomandibular procedures, among other conditions, frequently requires interpretation of dental images in daily emergency practice. The imaging findings can be categorized into infection, trauma, and complications of procedures, although sometimes these categories can overlap. Such categories can help the radiologist decide which imaging protocol and dynamic maneuvers should be used and are also useful when reading images and proposing differential diagnoses. Familiarity with the imaging findings of dental emergencies improves the radiologist's diagnostic confidence and role in guiding patient care, avoiding progression to life-threatening conditions, and reducing aesthetic problems, dental loss, and related conditions. Information about the imaging protocols is provided, the relevant anatomy of the teeth and related structures is reviewed, and the key imaging findings of dental emergencies are presented.^©RSNA, 2019.

Long-Term Influence of Platelet-Rich Plasma (PRP) on Dental Implants after Maxillary Augmentation: Implant Survival and Success Rates

The atrophic maxilla often requires bone augmentation before implant placement to ensure long-term implant success. A previous prospective clinical trial examined the use of platelet-rich plasma (PRP) during maxillary augmentation. The short-term results showed no positive effect of PRP. The aim of this study was to evaluate the same patient collective of the previous study regarding the PRP long-term impact on the survival and success of dental implants. Fifty-three patients from the previous study diagnosed with maxillary atrophy and augmented with autologous bone grafts from the iliac crest and dental implants, were included in this study. Treatment was carried out on both sides in 34 patients with a split-mouth-design in which one randomly chosen side was treated additionally with PRP, the other side was the control-side. Nineteen patients were treated only on one side and were assigned to the PRP-or the control group randomly. Implant follow-up of the patients from the previous study was performed after an average time of 13 years. Implant success was evaluated using two different success criteria. Thitry-seven patients (25 women and 12 men) were investigated in this study. Seventeen patients (12 female, 5 male) were included in the PRP group, while 20 patients (13 female, 7 male) participated in the control group. A total of 210 implants were inserted. Of these, 102 implants (48.57%) were placed in the PRP group and 108 implants (51.42%) in the control group. Out of 102 investigated implants in the PRP group, 6 were removed (survival rate 94.1%). While two of the 108 implants in the control group were loss (survival rate 98.1%). In the PRP group, the cumulative probability of survival after 15.1 years was 94.1% and in the control group, was 98.1%, with no significant difference between the two groups. Higher significant difference for the control group was found in the cumulative success probability using Albrektson criteria (p = 0.05). Positive impact of PRP on long-term implant survival and success could not be found.

Radiomorphometric analysis of edentulous posterior mandibular ridges in the first molar region: a cone-beam computed tomography study

Purpose

The aim of our study was to determine the prevalence and degree of lingual concavities in the first molar region of the mandible to reduce the risk of perforating the lingual cortical bone during dental implant insertion.

Methods

A total of 163 suitable cross-sectional cone-beam computed tomography images of edentulous mandibular first molar regions were evaluated. The mandibular morphology was classified as a U-configuration (undercut), a P-configuration (parallel), or a C-configuration (convex), depending on the shape of the alveolar ridge. The characteristics of lingual concavities, including their depth, angle, vertical location, and additional parameters, were measured.

Results

Lingual undercuts had a prevalence of 32.5% in the first molar region. The mean concavity angle was 63.34°±8.26°, and the mean linear concavity depth (LCD) was 3.03±0.99 mm. The mean vertical distances of point P from the alveolar crest (Vc) and from the inferior mandibular border were 9.39±3.39 and 16.25±2.44, respectively. Men displayed a larger vertical height from the alveolar crest to 2 mm coronal to the inferior alveolar nerve (Vcb) and a wider LCD than women (P<0.05). Negative correlations were found between age and buccolingual width at 2 mm apical to the alveolar crest, between age and Vcb, between age and Vc, and between age and LCD (P<0.05).

Conclusions

The prevalence of lingual concavities was 32.5% in this study. Age and gender had statistically significant effects on the lingual morphology. The risk of lingual perforation was higher in young men than in the other groups analyzed.

Effect of Combined Application of Growth Factors and Diode Laser Bio-Stimulation on the Osseo Integration of Dental Implants

BACKGROUND:

The success of implants is associated first with their osseointegration, and later on with their survival rate. In recent years, many efforts have been exerted to develop implant design, geometry, materials and techniques to enhance the osseointegration process and also to increase the success rate of implant procedures. New techniques, like leukocyte and platelet-rich fibrin (L-PRF) and low-level laser treatment (LLLT), have been developed to enhance the osseointegration around dental implants.

AIM:

This study aims at accelerating bone osseointegration process around dental implant using new techniques to increase the success rate, to allow immediate or early loading of a dental implant, and to make a comparison between the various new techniques in dental implant procedures to figure out which technique will achieve the best results.

METHODS:

The study was conducted on a random sample of 40 male patients. Dental implants were placed in the posterior areas of the lower jaw. Patients were divided randomly into 4 groups; control group, LLLT group, L-PRF group and L-PRF plus LLLT group. They were assessed using cone-beam computed tomography (CBCT).

RESULTS:

The results showed significant differences between all groups over different measured times. All the groups showed improvement in comparison with Normal group, where L-PRF group showed the best result followed by (L-PRF+LLLT) group, while the LLLT group showed the least improvement in comparison with bothL-PRF group and (L-PRF+LLLT) group.

CONCLUSION:

The study demonstrates that L-PRF gives a better performance in the osseointegration around dental implants than LLLT.

Recent advances in dental implants

Dental implants are a common treatment for the loss of teeth. This paper summarizes current knowledge on implant surfaces, immediate loading versus conventional loading, short implants, sinus lifting, and custom implants using three-dimensional printing. Most of the implant surface modifications showed good osseointegration results. Regarding biomolecular coatings, which have been recently developed and studied, good results were observed in animal experiments. Immediate loading had similar clinical outcomes compared to conventional loading and can be used as a successful treatment because it has the advantage of reducing treatment times and providing early function and aesthetics. Short implants showed similar clinical outcomes compared to standard implants. A variety of sinus augmentation techniques, grafting materials, and alternative techniques, such as tilted implants, zygomatic implants, and short implants, can be used. With the development of new technologies in three-dimension and computer-aided design/computer-aided manufacturing (CAD/CAM) customized implants can be used as an alternative to conventional implant designs. However, there are limitations due to the lack of long-term studies or clinical studies. A long-term clinical trial and a more predictive study are needed.

Dental Implant Complications

Dental implants have increased in the last few decades thus increasing the number of complications. Since many of these complications are easily diagnosed on postsurgical images, it is important for radiologists to be familiar with them and to be able to recognize and diagnose them. Radiologists should also have a basic understanding of their treatment. In a pictorial fashion, this article will present the basic complications of dental implants which we have divided into three general categories: biomechanical overload, infection or inflammation, and other causes. Examples of implant fracture, loosening, infection, inflammation from subgingival cement, failure of bone and soft tissue preservation, injury to surround structures, and other complications will be discussed as well as their common imaging appearances and treatment. Lastly, we will review pertinent dental anatomy and important structures that are vital for radiologists to evaluate in postoperative oral cavity imaging.