Evaluating the Effect of Attached Gingiva Height on Pre-implant Tissue

Background: Many patients refer to their load implants while there is no attached gingiva in the area of prosthetic implants – unlike the attached gingivae found with natural teeth. The important role played by gingiva in comforting the patient and preventing gingival inflammation has not been fully appreciated yet. This study aimed to evaluate the association between the attached gingival height with gingival inflammation and patients’ comfort. Methods: This retrospective cohort study was conducted to examine 80 implants (Dio uf) placed in 63 patients. At least two months had passed since the patients had had implant crown. The patients were divided into three groups: attached gingiva, gingival up to 2 mm, and at least 2 mm of attached gingiva. Indices such as bleeding on probing (BOP), the amount of plaque, gingival index and patient comfort during brushing and chewing were evaluated. Statistical data were analyzed using the Kolmogorov– Smirnov test, Levene’s test and independent t-test. Results: By increasing the height of attached gingiva, decreases were observed in probing depth (P value=0.004), BOP (P value=0.001), the degree of plaque index (P value=0.006), and gingival index (P value=0.003); and this association was statistically quite significant. By increasing the attached gingiva height, furthermore, the patients felt less discomfort when brushing and chewing; however, the findings were not statistically significant in terms of patients’ comfort during chewing (P value=0.364). Conclusions: Increasing the height of attached gingiva reduced the symptoms of gingival inflammation, but increased patients’ comfort when chewing and brushing.

A pilot study on immediate loading dental implants

Evolution in the field of dental implantology made the replacement of missing tooth easy and quick. During initial phase of evolution, there was a need of 3 to 6 months of healing period to get teeth on implants but with advancement of technology and research, immediate replacement of missing teeth without waiting period could become a possibility. To access the efficacy of immediate loading in dental implantology using Hexacone® (IHDE DENTAL - Switzerland) dental implant. The objectives were to evaluate pain, infection, recession, loosening of abutment, fracture of implant/crown, de-cementation, peri-implant radiolucency, and marginal bone loss. Five patients (3 male and 2 female) who needed teeth replacement were included in the study. Among 5 patients, 3 patients needed single tooth replacement and the remaining 2 needed segmental replacement. Out of 7 implants 6 implants were placed in the healed bone and 1 was placed in the extraction socket. In case of healed bone, permanent prosthesis were given on 3 day. In case of extraction site, temporary acrylic crown was given on 2 day, which was replaced by permanent prosthesis after 3 month. These patients were evaluated at 7 day, 1 month, 3 months, 6 months and 12 months clinically and radiographically. Infection, prosthetic problems, peri-apical radiolucency, and implant mobility were not observed and marginal bone loss was observed during follow-up periods. On 6 months follow up, 0.5mm and 0.45mm marginal mean bone loss was observed on mesial and distal aspect respectively whereas the same was 1.24mm and 1.14 mm on 12 months follow-up respectively.The immediate loading for dental implants is a successful procedure that decreases the time for the patients to obtain a final restoration satisfying both esthetical and functional problems. Immediately loaded implants survive equally well in extraction socket. No significant difference was seen in survival when implants were placed in healed bone and extraction socket.

Titanium Functionalized with Polylysine Homopolymers: In Vitro Enhancement of Cells Growth

In oral implantology, the success and persistence of dental implants over time are guaranteed by the bone formation around the implant fixture and by the integrity of the peri-implant mucosa seal, which adheres to the abutment and becomes a barrier that hinders bacterial penetration and colonization close to the outer parts of the implant. Research is constantly engaged in looking for substances to coat the titanium surface that guarantees the formation and persistence of the peri-implant bone, as well as the integrity of the mucous perimeter surrounding the implant crown. The present study aimed to evaluate in vitro the effects of a titanium surface coated with polylysine homopolymers on the cell growth of dental pulp stem cells and keratinocytes to establish the potential clinical application. The results reported an increase in cell growth for both cellular types cultured with polylysine-coated titanium compared to cultures without titanium and those without coating. These preliminary data suggest the usefulness of polylysine coating not only for enhancing osteoinduction but also to speed the post-surgery mucosal healings, guarantee appropriate peri-implant epithelial seals, and protect the fixture against bacterial penetration, which is responsible for compromising the implant survival.

Challenges in Managing a Fractured Cement-retained Crown Located at the Aesthetic Zone: A Case Report

Implant prosthesis is a popular treatment modality but it is not complication free. This article discussed the management of a cemented, all-ceramic implant crown in the maxillary anterior region that had veneering ceramic fracture after three years in function. A screw-retained prosthesis was prescribed to avoid the show of the screw access channel on the incisal edge of the crown. This was achieved by changing the location of the screw hole using the angle screw channel that overcame the angulation issue.

Crack growth pattern analysis of monolithic glass ceramic on a titanium abutment for single crown implant restorations using smooth particle hydrodynamics algorithm

Background. Glass ceramic materials have multiple applications in various prosthetic fields. Despite the many advantages of these materials, they still have limitations such as fragility and surface machining and ease of repairing. Crack propagation has been a typical concern in fullceramic crowns, for which many successful numerical simulations have been carried out using the extended finite element method (XFEM). However, XFEM cannot correctly predict a primary crack growth direction under dynamic loading on the implant crown. Methods. In this work, the dental implant crown and abutment were modeled in CATIA V5R19 software using a CT-scan technique based on the human first molar. The crown was approximated with 39514 spherical particles to reach a reasonable convergence in the results. In the present work, glass ceramic was considered the crown material on a titanium abutment. The simulation was performed for an impactor with an initial velocity of 25 m/s in the implant-abutment axis direction. We took advantage of smooth particle hydrodynamics (SPH) such that the burden of defining a primary crack growth direction was suppressed. Results. The simulation results demonstrated that the micro-crack onset due to the impact wave in the ceramic crown first began from the crown incisal edge and then extended to the margin due to increased stress concentration near the contact region. At 23.36 µs, the crack growth was observed in two different directions based on the crown geometry, and at the end of the simulation, some micro-cracks were also initiated from the crown margin. Moreover, the results showed that the SPH algorithm could be considered an alternative robust tool to predict crack propagation in brittle materials, particularly for the implant crown under dynamic loading. Conclusion. The main achievement of the present study was that the SPH algorithm is a helpful tool to predict the crack growth pattern in brittle materials, especially for ceramic crowns under dynamic loading. The predicted crack direction showed that the initial crack was divided into two branches after its impact, leading to the crown fracture. The micro-crack initiated from the crown incisal edge and then extended to the crown margin due to the stress concentration near the contact area.

Clinical Performance of Implant Crown Retained Removable Partial Dentures for Mandibular Edentulism—A Retrospective Study

The studies on implant-crown-retained removable partial dentures (IC-RPDs) for edentulism are scarce. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of IC-RPDs compared to implant overdentures (IODs) in mandibular edentulism. Variables that influenced survival and marginal bone loss (MBL) of implants in both treatment modalities were analyzed and the functional/esthetic satisfaction of patients as well as prosthetic complications were also observed. Eighteen IC-RPDs with a total of 60 implant-supported survey crowns and 24 IODs with a total 94 implants retained with magnet attachments were observed. After a median observation period of 46.6 months (up to 149 months), we observed 98.3% implant survival rates for IC-RPDs and 92.5% for IODs. Kaplan–Meier survival curves based on the treatment modality showed that, at 96 months, cumulative survival rates were 98.3% in IC-RPD and 83.1% in IOD. For implant survival rates, no statistical differences were observed according to age, sex, opposing dentition, or implant positions (p = 0.515, 0.666, 0.201, 0.749, respectively). The implant MBL measurements for IC-RPD and IOD groups at the final recall check were 0.93 ± 1.22 mm and 2.12 ± 2.09 mm, respectively. Additionally, there were no significant differences between groups (p = 0.554). The implants with peri-implantitis at year 1 showed significantly higher MBL at final check-up (p < 0.001). The MBL of implants showed significant differences based on age (p = 0.008) and opposing dentition (p = 0.003). No significant differences of implant MBL were observed for the position of placed implants (p = 0.621) or sex (p = 0.666). Patient-reported outcome measures (PROMs) on functional and esthetic satisfaction were significantly improved after IC-RPD or IOD treatment (p < 0.001). The most frequent prosthetic complication of IC-RPD was clasp loosening, while for IOD group, it was attachment dislodgement. Within the limitations of this retrospective study, we concluded that IC-RPDs could be considered as a viable treatment option for edentulous patients who need few fixed abutments for satisfaction.

New Rehabilitation Concept for Maxillary Edentulism: A Clinical Retrospective Study of Implant Crown Retained Removable Partial Dentures

There have been no studies of implant-crown-retained removable partial dentures (IC-RPD) for the treatment of maxillary edentulism. The purpose of this study was to perform clinical and radiographic evaluations of implants in IC-RPD compared to implant overdentures (IOD) in maxillary edentulous patients. Twenty IC-RPDs with 74 splinted implant crowns and 18 IODs with 71 implants retained with magnet attachments were observed in 38 patients. We statistically analyzed survival rates and marginal bone loss (MBL) of implants based on multiple variables including first year pathologic condition, location of placed implant, age, and sex in both treatments. Patient reported oral measurements (PROMs) regarding functional/esthetic improvement after IC-RPD or IOD treatments and prosthetic complications were also statistically analyzed. After a median observation period of 47.1 months (up to 147 months), we observed 97.3% implant survival rates for IC-RPD and 70.4% for IOD (p < 0.001). Among variables, first year pathologic condition (p < 0.001) and sex (p = 0.027) influenced implant survival rates. The MBL of implants for IC-RPD and IOD groups at the final check-up were 1.12 ± 1.19 mm and 3.31 ± 1.71 mm, respectively (p < 0.001). In both groups, patients with peri-implantitis (p < 0.001) and patients older than 65 years (p = 0.029) showed significantly higher implant MBL regardless of treatment modality. Functional and esthetic satisfaction were significantly improved (p < 0.001) after both treatments. The IOD group showed more frequent prosthetic complications compared to the IC-RPD group. Within the limitations of a retrospective study, we concluded that RPD with few splinted implant crowns is a feasible alternative treatment modality for maxillary edentulous patients with anatomical limitations.

Rehabilitation single tooth loss with screw retained implant crown: Case report

Tooth loss is a common problem in adults. the negative effects of tooth loss are decreased chewing and speech function, reduced aesthetics, and migration of adjacent teeth. Many types of dental prosthetics can be used to prevent these negative effects, such as removable partial dentures, adhesive resin dentures, fixed partial dentures, and dental implants each prosthesis had its advantages and disadvantages. In this case report the clinician will discuss about single tooth implants. The aim of this case report is to provide information about the procedure for placement single tooth implants to the posterior mandibular teeth using the screw retained implant technique.