A Literature Review on Implant Abutment Types, Materials, and Fabrication Processes

Comparative Evaluation of Accuracy of Adjacent Parallel Implant Placements Between Dynamic Navigation and Static Guide: A Prospective Study

Aim The study aims to compare the accuracy of dynamic navigation (DN) and static guides (SGs) for simultaneous adjacent parallel placement of implants, the time taken for the surgery, and the ease of handling the instruments. Materials and methods This prospective trial was carried out at the Department of Implantology of Saveetha Dental College from October 2022 to February 2023. A total of 20 patients who needed simultaneous adjacent dental implants were allocated randomly into two groups: Group 1 SG surgery and Group 2 DN surgery. Forty implants were placed, 20 under DN and 20 under SG. Bucco-lingual displacement, apico-coronal displacement, mesiodistal displacement, and mesiodistal angulation were compared between the two groups. The patients' data in both groups were evaluated by operating surgeons along with the surgical time taken and the ease of handling of instruments. Results The 20 patients who underwent implant placement in the DN and SG groups all had adjacent missing teeth in posterior sites, including lower posteriors (70%) and upper posteriors (30%). There was improved precision in relation to the mesiodistal displacement and angulation of the anterior implant of the adjacent parallel implants. The mesiodistal displacement in Group 1 (SG) was 5.61 + 3.1 mm, which was higher than Group 2 (DN), which was 0.55 + 0.56 mm. The mesiodistal angulation was 3.1 + 2.9 degrees in Group 2 and 0.42 + 0.5 degrees in Group 1. The second implant had a significant difference (p < 0.005) in mesiodistal displacement, mesiodistal angulation, and bucco-lingual displacement. The difference between the intergroup surgical time (mean + SD) in Group 1 was 30 + 4.5 mins and in Group 2 was 60.7 + 10.1 mins, with p < 0.05 statistically significant. The comfort of the operator was better in the SG group. Conclusion Any digitally aided implant placement technique can improve placement accuracy but each has its downfalls. Achieving the highest levels of precision and long-lasting prosthetic results hinges on both the suitability of the chosen case and the expertise of the surgeon performing the implant placement.

Dynamic Navigation Protocol for Direct Sinus Lift and Simultaneous Implant Placement: A Case Report

AIM

This study aims to evaluate the accuracy associated with the use of a dynamic navigation system for the lateral window opening for a direct sinus floor elevation (SFE) procedure with simultaneous implant placement.

MATERIALS AND METHODS

A female patient, aged 27 years, reported to the Department of Implantology seeking treatment for her lost tooth. On radiographic examination, the residual alveolar ridge height was 6 mm in the 26 (left upper first molar) region. For the implant placement, the case was planned to be carried out under dynamic navigation (Navident, Claronav, Canada). To make the lateral window accessible to the sinus floor, an implant trajectory resembling the required window dimensions and prosthetic implant position was planned. Post-surgery cone beam computed tomography (CBCT) was taken to assess the accuracy of the lateral window and implant trajectories using Evalunav (Navident, Claronav, Canada) analysis with dynamic navigation software.

RESULTS

There was improved accuracy of the lateral window opening, and the visualization of the lateral window was maintained in real-time throughout the procedure, which was advantageous to eliminate the tearing of the thin sinus membrane. The deviations found in the trajectory of the lateral window in comparison between the planning and post-procedure were: (a) entry was deviated by 2.83 mm; (b) the apex was deviated by 2.52 mm; (c) vertically, the apex was deviated by 0.29 mm; and (d) there was an 8.93° deviation in the angulation of the trajectory. The implant that was placed simultaneously with the SFE's accuracy was in comparison with the position that was planned: (a) entry was deviated by 0.03 mm, (b) the apex was deviated by 0.82 mm, (c) vertically, the apex was deviated by 0.82 mm, and (d) there was a 0° deviation in the angulation of the trajectory.

CONCLUSION

Dynamic navigation technology can help overcome complications associated with direct sinus lift procedures by providing highly accurate and precise planning and execution of the surgical procedure. This can lead to improved implant stability and a reduced risk of complications.

A Systematic Review on Maxillofacial Prosthesis with Respect to Their Color Stability

The aim of this systematic review was to identify and analyze the findings of various studies that analyzed the changes in the color stability of maxillofacial prosthetic materials after the addition of various colorants and nanoparticles and assess the change in color after being subjected to either natural or artificial accelerated aging as well as outdoor aging. This systematic review was conducted in accordance with the guidelines of transparent reporting of systematic reviews and meta-analysis (PRISMA Statement). The primary objective of this systematic review was to evaluate the color stability of maxillofacial prosthesis. The secondary objective was to assess the effect of various colorants; pigments; opacifiers; UV absorbers-such as inorganic colorants (dry earth pigments); metal oxides; and organic colorants. The time period of the included studies extended from 2013 to 2023. Electronic database search identified a total of 217 studies. Ten studies were included to meet the research question. All 10 included studies analyzed the effect of various colorants and their exposure to various aging and weathering conditions. It was found that various pigments and nanoparticles had an effect on the color stability. Also weathering and aging conditions had a direct effect on the color stability as well. In terms of disinfection, although there was not much color difference observed, highest change in color stability was observed when rubbing or brushing of the prosthesis was carried out. In conclusion, the color stability of maxillofacial prosthetics is a critical factor that influences both patient satisfaction and the overall cosmetic look. The potential of pigments and nanoparticles to enhance the color stability of silicone-based maxillofacial prosthesis has received much research. By avoiding color fading and discoloration brought on by environmental variables including UV radiation, aging, and chemical exposure, the inclusion of various pigments and nanoparticles has been demonstrated to improve the color stability of silicone maxillofacial prostheses.

Chitosan-Reinforced Gelatin Microspheres-Modified Glass Ionomer Cement (GIC): A Novel Bone Alloplast Graft Material Synthesis and an In Vivo Analysis

Aim and objective The study aimed to assess and evaluate the efficacy of glass ionomer modified with chitosan-reinforced gelatin microspheres on bone formation. Materials and methods  The study involved three groups: Group I comprised plain glass ionomer cement; Group II comprised glass ionomer cement/gelatin (70:30 wt%); in Group III, glass ionomer cement/gelatin/chitosan (70:30%) scaffold were made into discs; the gelatin microspheres were synthesized by oil emulsion method. The synthesized scaffold was subjected to the following in vitro testing, Instron Universal Testing Machine (UTM), U3000, (Instron Corporation, Norwood, Massachusetts, United States) to assess compressive strength, scanning electron microscope (SEM) examination, and biocompatibility testing using hemocompatibility assay. The material was then tested in vivo; male Wistar albino rats, a total of nine animals, were utilized for this purpose. Three animals were used in each group; a femoral defect model was the model of choice for the experiment and the animals were observed for a period of four weeks, following which the animals were sacrificed and sent for histopathological analysis. Results The compression testing was carried out using UTM; test group I was 33 MPa, test group II was 2.3 MPa, and test group III was 25.75 MPa. SEM (JSM-IT800 Schottky Field Emission NANO SEM (JEOL, Tokyo, Japan)) analysis was done to observe the porosity of the fabricated scaffold with the average measurement of 0.12 ± 0.2 μm in test group II and 0.29 ± 0.4 μm in test group III. Hemocompatibility reports noted 0.4-0.8% lysis for the synthesized scaffolds. Histopathology staining of the femur defects showed that group III favoured bone formation. One-way analysis of variance (ANOVA) and post hoc Bonferroni test was done on the data. The optical density values of the alizarin red stained slide showed statistical significance for group III. Conclusion In conclusion, the synthesized scaffolds are biocompatible, distribution of porosity and pore characteristics in the glass ionomer cement/gelatin/chitosan group is better than that of the glass ionomer cement/gelatin group. The glass ionomer cement/gelatin/chitosan group had better compressive strength and induced more bone formation compared to the other test group and the control. Thus, the novel glass ionomer modified with chitosan-reinforced gelatin microspheres has optimal properties to be used as a bone graft material.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.

Hybrid Navigation Technique for Improved Precision in Implantology

The hybrid navigation technique involves the merging of the Dynamic navigation (DN) system (Navident, Claronav, Canada) and static navigation technique (3Shape, Copenhagen, Denmark). Combining the advantages of both techniques, devising a protocol of hybrid navigation will be advantageous to eliminate the difficulties faced by operators in using either methods separately. Three patients requiring dental implants were included in this study. This requires the cone beam computed tomography (CBCT) (Digital Imaging and Communications in Medicine (DICOM) data) and intra-oral scan (Standard Tessellation Language (STL) format) data for the accurate planning of the implant positions in both the static and dynamic approaches. The steps carried out were repeated for each of the patients, the accuracy of the implant placement was verified postoperatively by merging the CBCT data pre and post through the Evalunav software (NaviDent, Claronav). The accuracy of the implants placed were assessed based on the mesio-distal, bucco-lingual, apical deviations in distance and in angulation. The semi-robotic DN and static guide combination as a hybrid technique is an interesting method to improve the accuracy of flapless implant surgeries and can be used in cases where the anatomical landmarks are determinant factors for the implant placement.