Recent advancements in surface modifications of dental implants: systematic review

Implantology is one of the most investigated topic in modern dentistry, This review is aimed to systematically summarize all the industrial, mass production and experimental trends in dental implant manufacture relative primarily to their surface modification over the last year. Research was conducted in Army Medical college, NUMS, Rawalpindi, Armed forces institute of dentistry, CMH, Rawalpindi, Foundation University college of Dentistry, FFH, DHA, Islamabad and the HEC Library, HEC, Islamabad. Literature was searched on PubMed, SCOPUS, MEDLINE, Cochrane and Science direct. The key words employed were “dental Implants”, “surface modification”, “surface morphology”, “surface treatment” and “surface augmentation”. A total of 38 articles were short listed and reviewed in detail. There is abundant evidence suggesting the importance of these surface modification on improving the implant success. Several strategies have been suggested to modify the implant surface topography as well as surface chemistry in order to achieve a micro-porous structure with nano scale architecture, with increased bio activity; hydrophilicity and anti-bacterial properties. There is commendable success with many of these strategies in the lab. However, following the lab success in ex vivo studies, very few of these surface modalities have found their way to clinical set-ups. Key Words: Dental Implants, surface modification, surface morphology, Continuous...

Legal and Ethical Knowledge Applied to Implantodontics

Knowing the large demand for treatments with implants and prostheses over implants and the lawsuits that involve these procedures, the aim of this study was to verify the knowledge of dental surgeons who perform dental implants about professional responsibility. The sample comprised 62 dental surgeons who perform dental implants in their practice and agreed to attend this research. All participants signed a Consent Form, were interviewed and answered a questionnaire applied individually. The validated questionnaire was divided into five sections: professional profile, professional conduct and procedural issue, structure of the workplace, ethical and legal issues, dental documentation. About 76% of professionals interviewed were male, 93,5% cited the Brazilian Dentistry Code of Ethics, 82,3% reported that offer more than one treatment option, 79% of the professionals were not responding or had not responded to a civil / criminal / ethical lawsuit or had a complaint in Consumer Protection and Defense Program (PROCON), 64.5% performed the surgical guide for certain cases, 58% had medical records and informed consent for all patients, 80.6% had appropriate practices and structures for patient care. Most of the study professionals act according to the ethical and legal aspects of professional responsibility, but there is a lack of knowledge of current legislation and need to be aware of the documentation of medical records, terms and contracts. Key words: Dental Implants. Legal Dentistry. Professional Responsibility.Resumo Sabendo da grande demanda por tratamentos com implantes e próteses sobre implantes e ainda, as ações na justiça que envolvem esses procedimentos, o objetivo deste estudo foi verificar o conhecimento dos profissionais que atuam com implantes na região Noroeste do Paraná, sobre o tema responsabilidade profissional. A amostra foi constituída por 62 profissionais que realizam implantes e aceitaram participar da pesquisa. Os participantes assinaram um termo de consentimento livre e esclarecido e responderam a um questionário validado aplicado individualmente em forma de entrevista. O questionário continha questões divididas em cinco variáveis: perfil profissional; conduta profissional e experiência processual; estrutura do local de trabalho; aspectos éticos e legais; e documentação odontológica. Estas foram divididas por categorias. O perfil profissional evidenciou que 76% dos entrevistados eram do sexo masculino, 93,5% citou o Código de Ética Odontológico na legislação aplicada, 82,3% relataram propor mais de uma opção de tratamento ao paciente, 79% dos profissionais não estavam respondendo ou não havia respondido algum processo cível/criminal/ético ou tiveram reclamação no Programa de Proteção e Defesa do Consumidor (PROCON), 64,5% realizavam o guia cirúrgico para determinados casos, 58% possuíam prontuário e termo de consentimento para todos os pacientes, 80,6% apresentavam consultórios e estruturas adequadas para o atendimento ao paciente. A maioria dos profissionais do estudo atua de acordo com os aspectos éticos e legais de responsabilidade profissional, porém existe desconhecimento da legislação vigente e precisam atentar-se quanto à documentação de prontuários, termos e contratos. Palavras-chave: Implantes Dentários. Odontologia Legal. Responsabilidade Profissional.

Is Dental Implantation Indicated in Patients with Oral Mucosal Diseases

Summary Background/Aim: Dental implants are a reliable treatment choice for rehabilitation of healthy patients as well as subjects with several systemic conditions. Patients with oral mucosal diseases often exhibit oral mucosal fragility and dryness, erosions, blisters, ulcers or microstomia that complicate the use of removable dentures and emphasize the need for dental implants. The aim of the current study is to review the pertinent literature regarding the dental implantation prospects for patients with oral mucosal diseases. Material and Method: The English literature was searched through PubMed and Google Scholar electronic databases with key words: dental implants, oral mucosal diseases, oral lichen planus (OLP), epidermolysis bullosa (EB), Sjögren’s syndrome (SS), cicatricial pemphigoid, bullous pemphigoid, pemphigus vulgaris, scleroderma/systemic sclerosis, lupus erythematosus, leukoplakia, oral potentially malignant disorders, oral premalignant lesions, oral cancer and oral squamous cell carcinoma (SCC). Results: Literature review revealed dental implantation in patients with OLP (14 articles), EB (11 articles), pemphigus vulgaris (1 article), SS (14 articles), systemic sclerosis (11 articles), systemic lupus erythematosus (3 articles) and oral SCC development associated with leukoplakia (5 articles). No articles regarding dental implants in patients with pemphigoid or leukoplakia without SCC development were identified. Most articles were case-reports, while only a few retrospective, prospective or observational studies were identified. Conclusions: Dental implants represent an acceptable treatment option with a high success rate in patients with chronic mucocutaneous and autoimmune diseases with oral manifestations, such as OLP, SS, EB and systemic sclerosis. Patients with oral possibly malignant disorders should be closely monitored to rule out the development of periimplant malignancy. Further studies with long follow-up, clinical and radiographic dental data are required to predict with accuracy the outcome of dental implants in patients with oral mucosal diseases.