Assessment of demographic and clinical data related to dental implants in a group of Turkish patients treated at a university clinic

Association of Age, Gender, and Site of Implant Placement: An Institution-Based Retrospective Study

Tooth loss is an undesirable condition that leads to functional, esthetic and social damage, having an impact on an individual's quality of life. Dental implants are man-made tooth root replacements that are increasingly used to replace a missing tooth. It is important to gather demographic data in order to take precautions before the possible failures. Hence the objective of this study was to retrospectively determine the association between age, gender, and site of implant placement in patients reporting to a private dental institution. This study was carried out from the data obtained from the case records of 1281 patients who had undergone implant therapy. Chi-square test was applied to see associations of gender, age and implant site. The results show that a maximum number of 348 implants (27.7%) were placed in patients aged between 41-50 years. The patient pool consisted of 705 (55%) females and 576 (45%) males. A maximum of 228 implants (17.80%) were placed in region 46 and 224 implants (17.49%) in region 36. Only 2 implants (0.2%) were placed in region 41. There was a positive association between age, gender and site of implant. In those aged 20-30 years, 20.53% of implants were placed, 26.23% in 31-40 years, 27.1% in 41-50 years, 17.95% in 51-60 years and 8.11% in 61-70 years of age. In male, a maximum of 124 implants (54.4%) were placed in region 46 and only 1 implant (50%) in region 41. In females, region 36 had a maximum of 110 implants (49.1%), and the least number of implants were placed in regions 31 and 41. In this study, it can be concluded that general factors such as age and gender had a significant effect on the site of implant placement.

Comparing Original and Universal Screwdrivers and How They Affect Friction in the Screw

The present study focused on investigating whether universal screwdriver kits cause less friction between the screwdriver and the abutment screw than original screwdrivers. For this purpose, 2 original screwdrivers (Straumann and BEGO) and a universal screwdriver kit (bredent) were investigated. On 1 implant per screwdriver, 26 abutments were properly attached one after the other with the corresponding abutment screws. After tightening the abutment screw, the force required to pull the screwdriver off the screw head was determined with a spring balance. For both manufacturers, greater pull-off forces were measured when using the original screwdrivers than when using the universal screwdriver. The pull-off force (mean ± SD) required for the Straumann original screwdriver was 3.7 ± 1.4 N, while that required for the universal screwdriver was 0.1 ± 0.1 N (P < .001). The pull-off force was 1.5 ± 1.5 N for the BEGO original screwdriver and 0.7 ± 0.9 N for the universal screwdriver (P = .19). Using original manufacturer-supplied screwdrivers could thus minimize the risk of the screwdriver slipping out of the screw head during dental treatment and being swallowed or aspirated by the patient.

Global Interest in Oral and Maxillofacial Surgery: Analysis of Google Trends Data

PURPOSE

Oral and maxillofacial surgery (OMS) has an expansive scope, with myriad diagnoses treated by practicing surgeons. Patients and referring providers are increasingly turning to Web-based sources to find information about clinical conditions before consultations or in conjunction with ongoing care. The purpose of this study was to examine the current trends of public interest of OMS procedures as assessed by online search trends.

MATERIALS AND METHODS

A cross-sectional study of Internet search data obtained via Google Trends (GT; Alphabet, Mountain View, CA) was conducted. Data were collected using GT for OMS-related search terms between January 2004 and May 2019. The search terms used in the analysis were "wisdom teeth," "TMJ," "dental implants," "jaw surgery," "jaw fracture," "facial trauma," and "facial cosmetic surgery," defined to be the core surgical aspects of OMS based on public awareness campaigns sponsored by the American Association of Oral and Maxillofacial Surgeons. Relative search volumes, trends over time, geographic trends, and seasonal trends were analyzed. For all analyses, P ≤ .05 was considered significant.

RESULTS

Overall search volume trends for OMS procedures showed an increase over time, with seasonal and geographic trends. "Wisdom teeth" was the most searched term and had the greatest increase in search volume over time. "Facial trauma" was the least searched term, with no appreciable trend over time. Geographic search volume was greatest in the United States. Seasonal changes were most apparent with searches for "wisdom teeth" and "jaw surgery."

CONCLUSIONS

Analysis of GT data shows substantial interest in core OMS procedures, with seasonal variations noted for certain areas of practice (third molars and jaw surgery) and consistent interest in other areas (facial cosmetic surgery, dental implant reconstruction, and temporomandibular disorders). The use of GT data may be a powerful tool for predicting demand for OMS services and for public education campaigns.

An osteopenic/osteoporotic phenotype delays alveolar bone repair

Aging is associated with a function decline in tissue homeostasis and tissue repair. Aging is also associated with an increased incidence in osteopenia and osteoporosis, but whether these low bone mass diseases are a risk factor for delayed bone healing still remains controversial. Addressing this question is of direct clinical relevance for dental patients, since most implants are performed in older patients who are at risk of developing low bone mass conditions. The objective of this study was to assess how an osteopenic/osteoporotic phenotype affected the rate of new alveolar bone formation. Using an ovariectomized (OVX) rat model, the rates of tooth extraction socket and osteotomy healing were compared with age-matched controls. Imaging, along with molecular, cellular, and histologic analyses, demonstrated that OVX produced an overt osteoporotic phenotype in long bones, but only a subtle phenotype in alveolar bone. Nonetheless, the OVX group demonstrated significantly slower alveolar bone healing in both the extraction socket, and in the osteotomy produced in a healed extraction site. Most notably, osteotomy site preparation created a dramatically wider zone of dying and dead osteocytes in the OVX group, which was coupled with more extensive bone remodeling and a delay in the differentiation of osteoblasts. Collectively, these analyses demonstrate that the emergence of an osteoporotic phenotype delays new alveolar bone formation.

A Comparative Assessment of Implant Site Viability in Humans and Rats

Our long-term objective is to devise methods to improve osteotomy site preparation and, in doing so, facilitate implant osseointegration. As a first step in this process, we developed a standardized oral osteotomy model in ovariectomized rats. There were 2 unique features to this model: first, the rats exhibited an osteopenic phenotype, reminiscent of the bone health that has been reported for the average dental implant patient population. Second, osteotomies were produced in healed tooth extraction sites and therefore represented the placement of most implants in patients. Commercially available drills were then used to produce osteotomies in a patient cohort and in the rat model. Molecular, cellular, and histologic analyses demonstrated a close alignment between the responses of human and rodent alveolar bone to osteotomy site preparation. Most notably in both patients and rats, all drilling tools created a zone of dead and dying osteocytes around the osteotomy. In rat tissues, which could be collected at multiple time points after osteotomy, the fate of the dead alveolar bone was followed. Over the course of a week, osteoclast activity was responsible for resorbing the necrotic bone, which in turn stimulated the deposition of a new bone matrix by osteoblasts. Collectively, these analyses support the use of an ovariectomy surgery rat model to gain insights into the response of human bone to osteotomy site preparation. The data also suggest that reducing the zone of osteocyte death will improve osteotomy site viability, leading to faster new bone formation around implants.

Significance of mandibular molar replacement with a dental implant: a theoretical study with nonlinear finite element analysis

Background

Dental implants are frequently applied to unilateral defects in the mandible. However, implant placement in the molar region of the mandible can be difficult due to anatomical structure. The aim of this study was to evaluate the distribution of occlusal force in a mandibular shortened dental arch (SDA) with implants.

Methods

Three-dimensional finite element (FE) models of the mandible with varying numbers of teeth and implants were constructed. Models Im6 and Im67 contained one and two implants in the defect of the left molar region, respectively. Models Im456 and Im4567 contained three and four implants in the defect of the left premolar and molar regions, respectively. Model MT67 contained a defect in the molar region with no implant placed. Model MT7 represented natural dentition without a left second molar, as a control. Modification of the condition of occlusal contacts assuming the intercuspal position was performed before analysis under load 400 N; therefore, the load condition as total force on the occlusal surface was 400 N. FE analyses were subsequently performed under load conditions of loads 100, 200, and 800 N. The distribution of reaction forces on the occlusal surface and the mandibular condyle was investigated.

Results

Force distribution in models Im67 and Im4567 appeared to be symmetrical under all load conditions. Occlusal force distribution in models Im6 and Im456 was similar to that in model MT7. However, the occlusal force at the second premolars on the defect side in those models was larger under loads 100 and 200 N. Conversely, the occlusal force on the first molars was much larger than that in model MT7 under load 800 N.

Conclusions

Within the limitations of this theoretical study, we demonstrated that restoration with the same number of implants as missing teeth will show almost symmetric occlusal force distribution, and it will produce less biomechanically stress for a unilateral defect of the mandible. However, if restoration of a missing second molar with an implant is impossible or difficult, then an SDA with implants may also be acceptable except for individuals with severe bruxism.