Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review

The Effect of Patient-associated Factors on Long-term Survival of Dental Implants

Dental implant therapy has developed over the past half century to have documented successful outcomes in most patients who receive treatment. The long-term survival of dental implants depends upon a variety of factors including patient, surgeon, restorative dentist, and materials-related factors. The impact of patient-associated factors may impact significantly on the success of dental implants including diabetes mellitus, medications, smoking, parafunctional habits, oral hygiene, head and neck radiation, and the use of bisphosphonates, antiangiogenic, and antiresorptive medications.

Mechanical Behavior of Five Different Morse Taper Implants and Abutments with Different Conical Internal Connections and Angles: An In Vitro Experimental Study

The present study evaluated the mechanical behavior of five designs of Morse taper (MT) connections with and without the application of loads. For this, the detorque of the fixing screw and the traction force required to disconnect the abutment from the implant were assessed. A total of 100 sets of implants/abutments (IAs) with MT-type connections were used, comprising five groups (n = 20/group): (1) Group Imp 11.5: IA sets with a cone angulation of 11.5°; (2) Group SIN 11.5: with a cone angulation of 11.5°; (3) Group SIN 16: with a cone angulation of 16°; (4) Group Neo 16: with a cone angulation of 16°; and (5) Group Str 15: with a cone angulation of 15°. All sets received the torque recommended by the manufacturer. After applying the torque, the counter torque of the fixing screws was measured in ten IA sets of each group without the application of cyclic loads (frequencies ≤ 2 Hz, 360,000 cycles, and force at 150 Ncm). The other ten sets of each group were subjected to cyclic loads, after which the detorque was measured. Afterwards, the force for disconnection between the implant and the abutment was measured by traction on all the samples. The untwisting of the abutment fixation screws showed a decrease in relation to the initial torque applied in all groups. In the unloaded samples, it was found to be -25.7% in Group 1, -30.4% in Group 2, -36.8% in Group 3, -29.6% in Group 4, and -25.7% in Group 5. After the applied loads, it was found to be -44% in Group 1, -43.5% in Group 2, -48.5% in Group 3, -47.2% in Group 4, and -49.8% in Group 5. The values for the IA sets were zero for SIN 16 (Group 3) and Neo16 (Group 4), both without and with loads. In the other three groups, without loads, the disconnection value was 56.3 ± 2.21 N (Group 1), 30.7 ± 2.00 N (Group 2), and 26.0 ± 2.52 N (Group 5). After applying loads, the values were 63.5 ± 3.06 N for Group 1, 34.2 ± 2.45 N in Group 2, and 23.1 ± 1.29 N in Group 5. It was concluded that in terms of the mechanical behavior of the five designs of MT IA sets, with and without the application of loads, the Imp 11.5, SIN 11.5, and Srt 15 groups showed better results compared to the SIN 16 and Neo 16 groups, showing that lower values of cone angulation increase the friction between the parts (IA), thus avoiding the need to maintain the torque of the fixing screw to maintain the union of the sets.

Effect of vertical implant position on marginal bone loss: a randomized clinical trial

OBJECTIVES

One of the most important factors that has influence on dental implants success rate is marginal bone loss. The purpose of this study is to investigate the effect of the implant's vertical position and the soft tissue's thickness on the rate of marginal bone loss of the dental implant.

MATERIALS AND METHODS

In this single-blind randomized clinical trial study, 56 implants placed in the posterior region of mandible of 33 patients (19 women, 14 men) were divided into two groups. The group of crestal (28 implants) and subcrestal (28 implants) implants, each group was divided into two sub-groups with soft tissue thickness of 2 mm and less than 2 mm (14 implants) and more than 2 mm (14 implants). The amount of marginal bone loss was measured by Scanora 5.2 program with radiographs Digital parallelism based on the effect of the vertical position of the implant, soft tissue thickness, three months after placement, and three months after loading implants (six months after implant placement).

RESULTS

The results showed that marginal bone loss in subcrestal implants is significantly more than crestal implants (p-value = 0.001), and also marginal bone loss in the soft tissue thickness group of 2 mm and less is significantly more than the group of soft tissue thickness more than 2 mm (p-value < 0.001). The amount of marginal bone loss three months after implant loading was significantly higher than three months after implant placement (p-value < 0.001).

CONCLUSION

The implant's vertical position and the soft tissue's thickness around the implant are effective factors in the amount of marginal bone loss. Marginal bone loss is more in subcrestal implants and in cases with less soft tissue thickness. The time factor significantly affects the amount of marginal bone loss.

TRIAL REGISTRATION

this clinical trial was registered at Iranian Registry of Clinical Trials, registration number IRCT20120215009014N415, registration date 20,220,110, (https//en.irct.ir/trial/60,991).

Advancements in tooth autotransplantation

BACKGROUND

Tooth autotransplantation (AT) involves the surgical relocation of a tooth from 1 site in the mouth to another site within the same patient. This approach is a good option in a growing patient when dental implant placements or fixed bridges are not suitable and when preserving natural teeth is a priority. Tooth AT is a complex procedure that requires specialized skills from a multidisciplinary team with careful patient and tooth selection and treatment planning.

TYPES OF STUDIES REVIEWED

The authors provided a review of the state of knowledge and research on tooth AT and presented a case scenario and barriers to adoption, with a focus on the United States.

RESULTS

Success rates for tooth AT can vary depending on several factors, including the patient's overall health, specific tooth involved, skill of the dental surgeon, and postoperative care provided. Long-term outcomes of autotransplanted teeth have been cited in the literature with impressive longitudinal follow-up spanning up to 26 years. Results of several systematic reviews showed survival rates from 75% through 98%.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Adoption of tooth AT has grown over the years, owing to advancements in dental techniques, improved patient outcomes, and increased awareness among both dentists and patients. Increasing awareness and availability of tooth AT to replace missing teeth can provide a natural and functional alternative to traditional prosthetic options. Tooth AT helps preserve the alveolar bone in growing patients and can offer excellent esthetic and functional outcomes.

Er:YAG Laser and Hemolasertherapy: Bone and Gingiva Gain-Case Report

Background: Modern dentistry has increasingly valued conservative and biologically less invasive clinical practices, seeking to preserve the patients' tissues and natural dental elements. Most extractions in the dental clinic are preceded by periodontal disease that presents bone and gingival tissue loss, compromising the aesthetics as well as the support of dental elements. Objectives: The clinical approach in these cases often involves bone exertion followed by the successful installation of osseointegrated implants. Material and Methods: In this study, a case of extensive periodontal involvement and mobility of dental elements was carried out in a minimally invasive way, using the Er:YAG laser for periodontal decontamination and the hemolasertherapy technique to regenerate adjacent tissues, totaling nine weeks of treatment. Results: Clinical and radiographical improvement of tissue health and complete preservation of dental elements were observed. Conclusion: The patient underwent a follow-up appointment 2 years after the start of treatment when it was still possible to verify the stability of the clinical condition and the tissue gains obtained.

Treatment planning algorithm for patients with a terminal dentition

This article discusses the variables that affect the diagnostic process in patients with a compromised dentition and addresses the clinical decision of whether to extract or maintain teeth. A decision tree algorithm is proposed to guide clinicians in planning complete arch rehabilitations.

Fitting of Different Intraradicular Composite Posts to Oval Tooth Root Canals: A Preliminary Assessment

The purpose of the present study was to perform a preliminary analysis of the fitting of different fiber-reinforced composite (GFRC) posts to tooth root canals and determine the resin cement layer thickness. The following GFRC posts were assessed: bundle posts (Rebilda GTTM, VOCO, Germany), sleeve system (SAPTM, Angelus Ind, Brazil), and accessory posts (ReforpinTM, Angelus, Brazil). Twenty-four freshly extracted mandibular single-rooted pre-molars were endodontically treated and divided into six groups, according to the type of GFRC post and resin cement (self-adhesive or conventional dual-cured). Then, specimens were cross-sectioned and inspected by optical microscopy regarding the cement layer thickness and presence of defects such as pores, voids, or fissures were assessed. Bundle and accessory posts revealed a regular distribution of resin cement with a lower number of voids than found with sleeve systems. The sleeve system posts showed poor fitting at the apical portion of the root canals. The type of resin cement did not affect the thickness of the interface, although both bundle and accessory posts allow a better distribution of resin cement and fibers. The present preliminary study reveals interesting insights on the fitting of bundle and accessory posts to root dentin and resin cement layer thickness in oval-shape root canals. The sleeve system posts showed adequate fitting only at the coronal portion of the canals.

Evaluation of Different Procedures for Titanium Dental Implant Surface Decontamination-In Vitro Study

Polymicrobial biofilm removal and decontamination of the implant surface is the most important goal in the treatment of periimplantitis. The aim of this study is to evaluate the efficacy of four different decontamination methods for removing Acinetobacter baumannii and Staphylococcus aureus biofilms in vitro. Seventy-five dental implants were contaminated with a bacterial suspension and randomly divided into five groups (n = 15): the negative control group, which received no treatment; the positive control group, treated with 0.2% chlorhexidine; group 1, treated with a chitosan brush (Labrida BioCleanTM, Labrida AS, Oslo, Norway); group 2, treated with a chitosan brush and 0.2% chlorhexidine; and group 3, treated with a device based on the electrolytic cleaning method (GalvoSurge, GalvoSurge Dental AG, Widnau, Switzerland). The colony-forming unit (CFU) count was used to assess the number of viable bacteria in each sample, and statistical analyses were performed. When compared to the negative control group, all the decontamination methods reduced the CFU count. The electrolytic cleaning method decontaminated the implant surface more effectively than the other three procedures, while the chitosan brush was the least effective. Further research in more realistic settings is required to assess the efficacy of the decontamination procedures described in this study.

Patients' Perceptions Regarding Acceptance of Dental Implants as an Option for the Replacement of Missing Teeth: An Observational Study

INTRODUCTION

Dental implants enhance the self-assurance and overall well-being of individuals by providing oral comfort during mastication and a notable degree of contentment. The objectives of the present study were to assess patients' perception of opting or non-opting for dental implants as a replacement for missing teeth and to determine the correlation between various factors and perceived demand for dental implant treatment.

MATERIALS AND METHODS

 A cross-sectional observational study was conducted on 214 partially edentulous individuals aged between 21 and 50 years. These patients sought treatment to replace their missing teeth. The participants were provided with detailed information regarding various options for replacing their missing teeth, including removable prostheses, fixed partial dentures, and dental implants. The researchers recorded and evaluated the reasons behind the patients' decision to opt for or decline dental implant treatment using the chi-squared test. Categorical variables were summarized as percentages (n %). The association between variables and binary data was examined using point biserial correlation, whereas, for continuous data, the Pearson correlation coefficient was employed.

RESULTS

About 65 (30.4%) patients opted for dental implant treatment and 149 (69.6%) patients did not opt for dental implant treatment. Missing teeth were found in 120 women (56.08%) and 94 men (43.92%). The main reason for seeking dental implant treatment was the need for improvement in functions such as chewing in 65 (100%) patients, followed by the need for improvement in oral health in 57 (88%), aesthetics in 54 (83%), need for bone and adjacent teeth preservation in 52 (80%), and durability of dental implants in 46 (71%) patients. The main reasons for not seeking dental implant treatment and opting for fixed prostheses other than dental implants or removable prostheses cost 149 (100%), fear of surgery 132 (91%), underlying health issues 121 (81%), lack of knowledge about dental implants 120 (80.5%), and time management issues 92 (62%). Gender, age, and number of missing teeth showed a negative correlation, whereas level of education, social status, and oral health awareness showed a positive correlation with the perceived need for dental implant treatment.

CONCLUSION

Dental implant treatment was preferred by 30.4% of patients, which was influenced by gender, sex, level of education, social status, awareness of oral health, and number of missing teeth. Cost, fear of surgery, underlying medical conditions, lack of knowledge, and time management are some reasons for not opting for dental implant treatment.

Current advancements in therapeutic approaches in orthopedic surgery: a review of recent trends

Recent advancements in orthopedic surgery have greatly improved the management of musculoskeletal disorders and injuries. This review discusses the latest therapeutic approaches that have emerged in orthopedics. We examine the use of regenerative medicine, including stem cell therapy and platelet-rich plasma (PRP) injections, to accelerate healing and promote tissue regeneration. Additionally, we explore the application of robotic-assisted surgery, which provides greater precision and accuracy during surgical procedures. We also delve into the emergence of personalized medicine, which tailors treatments to individual patients based on their unique genetic and environmental factors. Furthermore, we discuss telemedicine and remote patient monitoring as methods for improving patient outcomes and reducing healthcare costs. Finally, we examine the growing interest in using artificial intelligence and machine learning in orthopedics, particularly in diagnosis and treatment planning. Overall, these advancements in therapeutic approaches have significantly improved patient outcomes, reduced recovery times, and enhanced the overall quality of care in orthopedic surgery.

Comparative evaluation of open tray impression technique: investigating the precision of four splinting materials in multiple implants

BACKGROUND

This study aimed to determine the relative positioning accuracy of multiple implants utilizing four distinct types of splinting materials.

METHODS

The purpose of this in-vitro study was to compare the precision of four splinting materials in an open tray impression technique in multiple implant situations. Based on the material used for splinting, four groups were made (n = 40)- Group A: Conventional Method, Group B: Prefabricated Pattern Resin Framework, Group C: Prefabricated Metal Framework, Group D: Light Cured Pattern Resin, these groups were compared with the master model. A heat-cured clear acrylic resin and a master model were constructed. A pilot milling machine drill was used to drill four parallel holes in the anterior and premolar regions, which were later labeled as A, B, C, and D positions from right to left. Then, sequential drilling was carried out, and four 3.75‑mm diameter and 13-mm long ADIN implant analogs with internal hex were placed in the acrylic model using a surveyor for proper orientation. The impression posts were then manually screwed to the implant analogs using an open tray, and they were secured to the implants using 10 mm flat head guide pins with a 15 N.cm torque. 10 Open tray polyether impressions were made, and casts were poured. Each splinting method's distortion values were measured using a coordinate measuring machine capable of recordings in the X-, Y-, and Z-axes. Comparison of mean distances for X1, X2, and X3 was made using the Kruskal-Wallis test, and Pairwise comparison was done using Post Hoc Tukey's Test.

RESULTS

The differences between the groups were significant when assessing the distances X1, X2, and X3 (p < 0.05). The comparison of deviations between the groups revealed a statistically significant difference (p < 0.05) for the deviation distance X3 but not for the deviation distances X1 and X2. For distance Y1, the difference between the groups was statistically significant (p0.05), but it was not significant for distances Y2 and Y3. A statistically significant difference was seen in the comparison between the groups (p < 0.05) for the deviation distances Y1, Y2, and Y3. The results were statistically significant for the distance Z1 comparisons, namely, control vs. Group A (p = 0.012), control vs. Group B (p = 0.049), control vs. Group C (p = 0.048), and control vs. Group D (p = 0.021), and for distance Z3 comparison for control vs. Group A (p = 0.033). The results were statistically insignificant for the distance Z2 comparisons (p > 0.05).

CONCLUSIONS

All splinting materials produced master casts with measurements in close proximity to the reference model. However, prefabricated pattern resin bars splinting showed the highest accuracy among the studied techniques. The most recent splinting techniques using prefabricated metal framework and light-cure pattern resin showed similar accuracy.

Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols-An In Vitro Analysis

(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25-50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant's superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.

Factors Affecting the Choice of Implant Specialists Among the Saudi Population: A Cross-Sectional Study

Background Patients are frequently exposed to misleading information about dental implants on social media or from dental marketing businesses. Patients' selection of an implant specialist for placing dental implants may vary due to several factors, including cost, social media, dentist qualification, and previous patient experience. Objective This study aims to assess and evaluate the factors that influence the choice of implant specialist in the Saudi population. Materials and methods The data were collected from 625 participants in Riyadh, Saudi Arabia, from January 2023 to April 2023. The study targeted males and females over 20 years old living in Riyadh, Saudi Arabia, and excluded those under 20 years old or not living in Riyadh, Saudi Arabia. Results The dentist's qualification (80.2%), dental implant cost (77.3%), and clinic or hospital (68.2%) were the most frequently agreed-upon factors for selecting an implant specialist. The study found that 13.7% of respondents disagreed or strongly disagreed that social media could influence the choice of an implant specialist. Among females, those with higher educational levels, middle-income groups, and those who had ever replaced a missing tooth, the importance of a dentist's specialty to perform a dental implant increased significantly. Conclusion Different factors contributed to the selection of an implant specialist among the population, with dentist qualification followed by dental implant cost being the most commonly discussed factors in the study.