Anti-bacterial Efficacy of Probiotics used in Provisional Polymethyl Methacrylate Crowns against Porphyromonos gingivalis – an In vitro Study

Aim: To evaluate the effect of Probiotic used in PMMA Temporary restorations on gingival inflammatory response by its action on the marginal gingival epithelial cells. Materials and Methods: This is an in vitro Interventional pilot study using discs of PMMA ( Group A ) and PMMA incorporated with Probiotics (Group B . The effect of probiotics incorporated PMMA on strains of Porphyromonos gingivalis grown on culture plates will be assessed using zone of inhibition test and minimum inhibitory concentration was assessed . Data was recorded, tabulated and statistically evaluated using SPSS software. Results: The zone of Inhibition in the Group B was (Mean = 16.30mm) is comparatively higher than that of Group A with mean value 12.92mm. Results states that among the various concentration of Probiotic Lozenges (2.5, 5, 10, 15 and 20 µg/ml) used to determine the antibacterial activity , Highest mean zone of inhibition was observed with 20 µg/ml with 16 mm, followed by 15 µg/ml with 14mm , 10 µg/ml with 9mm, 5 µg/ml with 11 mm & with the lowest inhibition observed in 2.5 µg/ml with 8mm. There is significant correlation between concentration of probiotics and its antibacterial efficacy. The increase in concentration of probiotics in the PMMA discs is directly proportional to its antibacterial efficacy against P. gingivalis. Conclusion: Thus the study proved a significant correlation between Probiotic used in PMMA Temporary crowns and reduction in gingival Inflammation at the margins of the restoration which will be beneficial when used in crowns used in patients undergoing Orthodontic treatment or Immediate Implant Loading with acrylic crowns.

Accuracy of Free Hand Dental Implant Placement in a Private Dental College Setup - A Radiographic Analysis

BACKGROUND The factors that influence the implant accuracy are the anatomy of the patient, the experience of the practitioner and the surgical approach. However, the relative importance of each factor is poorly understood. Favourable function, occlusion, aesthetics and implant loading patterns can be obtained by optimal positioning. The experience of the surgeon is of utmost importance for the skill of placing a dental implant with proper angulation. The purpose of this retrospective study was to determine the increased accuracy obtained in performing freehand surgical placement of implants. METHODS This study was conducted in the Department of Implantology. A total of 1216 postoperative periapical radiographs from which single implant placement with adjacent straight root morphology was collected from the department in the period of June 2019 to June 2020 and checked for angulation, practitioner’s experience and the site of placement. Mesio-distal angulation was calculated. Statistical analysis was performed using the SPSS method. RESULTS The results showed accuracy in angulation and positioning of implants increased with an increase in experience of the dental surgeon (oral surgeons, prosthodontists, periodontists). Within the limitations of the study, it showed that the freehand dental implant placement angulation was less than a degree for experienced surgeons. The postgraduates had a better understanding and orientation of the angulation than the undergraduates. Moreover, the difficult site was the second and third quadrant to assess the angulation properly. CONCLUSIONS With proper assessment of the anatomy and with experience freehand dental implant placement shows significant results with less angulation which can be prosthetically accepted. KEY WORDS Free Hand Surgery, Guided Surgery, Angulation Of Implants.

Survey of Dental Implant and Restoration Selection by Prosthodontists in Dubai

Background. With various surgical and prosthetic component designs being introduced in dental implants, decisions have to be made when choosing a system and a certain prosthodontic protocol. A survey of implant prosthodontic specialists has not been previously performed in the Middle East. Aim. This study aimed to determine selection criteria and choice of dental implants and restorations by prosthodontic specialists in the Emirate of Dubai, United Arab Emirates. Materials and Methods. A validated 16-item questionnaire was used in the survey which included demographic information, implant training and experience, implant treatment planning, implant restoration, and implant system preference. The research protocol was approved by the Research and Ethics Committees of Hamdan Bin Mohammed College of Dental Medicine and Dubai Health Authority. Prosthodontists were identified from regulatory authority websites and contacted by e-mail with the questionnaire attached. Results. A total of 84.6% (77) of the registered prosthodontists in Dubai completed the questionnaire with 66.2% reported practicing implant dentistry. Out of which, 54.9% reported surgically placing dental implants and 45.1% restore them only prosthetically. Prefabricated metal abutments were the most commonly selected abutments for single crowns (76.0%) and for fixed dental prostheses (66.7%). Screw retention is preferred mostly for single crowns (68.0%) and fixed dental prostheses (74.0%). Locators were the most commonly selected type of attachment for implant-retained/supported overdentures (49.0%). Conventional loading was the most selected type of loading in all oral conditions. Conclusion. Within the limitations of this study, it can be concluded that most prosthodontists in Dubai practice implant dentistry and more than half surgically place dental implants. Prefabricated metal abutments are the most selected type of abutments. Most prosthodontists use screw-retained implant restorations and prefer locator attachments for implant-retained/supported overdentures. Conventional loading is the most preferred implant loading method in all oral conditions. Implant company/system selections are various and there is no major preference for a certain system. The majority of prosthodontists select implant systems based on implant features, literature review, and simplicity of restorative kit.

Compliance with Postoperative Recommendations by Patients with Different Psychological Types after Early Implant Loading Treatment

The objective of the research was to explore the relationship between different psychological types of patients with an edentulous mandible and their attitudes toward postoperative recommendations and prescriptions after early implant loading treatment. Materials and Methods. The study was conducted at the Dentistry Center (University Clinic, Ivano-Frankivsk National Medical University), November 2019 - March 2020. Study group consisted of 28 individuals with an edentulous mandible. Patients were divided into subgroups (philosophical, exacting-mind, indifferent, and hysterical) based on their mental characteristics. Surveys about complaints, compliance with postoperative recommendations and prescriptions were performed on the 2nd, 4th, 8-10th and 12-14th days after surgical treatment. Results. Clinical evaluation data, patients’ complaints, and compliance with the postoperative treatment protocol after early implant loading treatment were analyzed. The degree of compliance to prescribed recommendations in patients with different psychological types were evaluated and discussed. Conclusions. According to the results within the limitations of this study, it can be concluded that compliance with postoperative recommendations and prescriptions is highly dependent on the patient’ psychological type.

Clinical outcomes of single implant supported crowns versus 3-unit implant-supported fixed dental prostheses in Dubai Health Authority: a retrospective study

Background This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs). Methods This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant-supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations. Results A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient’s age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001). Conclusions Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.

Comparative Evaluation of Primary Stability between Different Diameters Multi-Scale Roughness Dental Implant by Solid Rigid Polyurethane Simulation

Background: Implant primary stability is determined by screw characteristics and surgical procedure. The aim of the present study was to evaluate, on a polyurethane model, the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) of multi-scale roughness dental implants of different diameters. Methods: Two implant sizes were tested on two polyurethane blocks (20 pounds per cubic foot (PCF) and 30 PCF): 3.0 diameter and 13 mm length and 5.0 diameter and 13 mm length. The IT, RT, and RFA were assessed. Results: A significant difference of IT and RT was present in favor of wider implants at both polyurethane densities. No statistical difference was present between the 5.0 diameter and 3.0 diameter implants at both polyurethane densities. A statistically increased RFA was reported for 5.0 implant 30 PCF polyurethane blocks. Conclusions: Multi-scale roughness dental implants of both diameters showed high insertion torque and primary stability on polyurethane blocks, which is valuable for implant loading protocols.