Importance of Osseoperception and Tactile Sensibility during Masticatory Function in Different Prosthetic Rehabilitations: A Review

Background and Objectives: Tactile sensibility is an important characteristic for evaluating the masticatory efficiency in different occlusal situations. When a tooth is extracted, relevant proprioceptors from the periodontal ligament get lost; and after the rehabilitation of this abscess by means of oral prosthesis, this sensibility decreases influencing masticatory function. Osseoperception is a sensitive phenomenon associated with dental implants that allows an increased tactile sensibility to those wearing implant prostheses. The purpose of this study was to determine the difference in tactile sensibility values between implant prosthesis, complete dentures, and natural teeth through a review of the available literature. Materials and Methods. In order to dissect the information, 24 articles from 2004 to 2021 were analyzed from MEDLINE, PubMed Central, and Web of Science databases. These articles were directly related to measuring tactile sensibility in different situations and demonstrating the influence of osseoperception in an improved masticatory function. Results: Tactile sensibility in implant prosthesis is slightly reduced compared with natural dentition but presents improved values with regard to complete dentures. Conclusions: Implant prosthesis are more effective during masticatory function than complete dentures, as they present an increased tactile sensibility, very similar to that present in natural dentition. This enhanced sensibility in implants is due to the osseoperception phenomenon.

Management of endo perio lesion with class iii furcation defect –A case report

The primary aim of periodontal and endodontic therapy is to restore the lost periodontium and maintain the natural dentition. An ideal endodontic treatment involves removal of any infected pulp completely, preventing or minimizing any chances of reinfection, with proper irrigation and drying of canals, care to be taken not to break any file during cleaning and shaping of canals, proper obturation and not over or under filling of canals, proper sealing, proper restoration and an ideal crown placement. An ideal periodontal treatment involves scaling and root planing, proper reflection of flap to visualize the furcation areas, removal of diseased soft tissue surrounding the lesion and furcation areas and giving adequate oral hygiene instructions. Based on grade of furcation defects, suitable treatment modalities should be chosen. This case report aims at managing an endo-perio lesion involving class III furcation defect using tunneling technique.

Utilisation of Dental Services of Older People in Australia: An Economic Explanatory Model Based on Cost and Geographic Location

The increased percentage of older people retaining their natural dentition was associated with a burden of poor oral health and increased service demands. This study analyses the dental service utilisation of the ageing population in Australia and develops a modelled cost design that estimates the dental expenditure required to cover dental services for the aged population. Using the Australian Census of Population and Housing, ageing population and socioeconomic data were mapped to geographic boundaries and integrated with dental service provision data to estimate a model for the utilisation of dental services. The estimated financial cost of dental services was calculated based on the mean fees as per the Australian Dental Association’s Dental Fees Survey. The utilisation of the services varied considerably across the states and also by type of service, with limited numbers using periodontic services. However, there was an increase in cost for replacement and restorative services (5020 million AUD), most evident in the socioeconomic deprivation areas. In addition, the average dental services utilisation cost increased noticeably in the lower socioeconomic deciles of all regions outside major cities. The geographic maldistribution of older people significantly affects the utilisation of dental services, especially among disadvantaged communities. A predicted cost model of 6385 million AUD would cover the oral health needs of older Australians.

Influence of blenching agents on the mechanical properties and colour of dental restorative nanocomposite

Purpose: Bleaching agents are commonly used to make the natural dentition look more attractive. Currently, in addition to products from reputable manufacturers, products of not fully known origin are available for purchase. The aim of the study was to investigate whether products of this type have a destructive influence on the mechanical and aesthetic properties of the dental restorative nanocomposite. Design/methodology/approach: Four bleaching agents were used, two recognized brands, and two products were purchased from Chinese websites (their manufacturer is unknown). Two gels and two types of whitening strips were used. One composite nanomaterial was used. Microhardness, diametral tensile strength,, compressive strength and colour measurements were tested. Findings: For some bleaching agents, studies have shown a relatively small effect on mechanical properties and an acceptable effect on colour changes. Regardless of the observed changes, the use of bleaching agents qualified for the experiment should be considered safe for composites. Research limitations/implications: The number of blenching agents used as well as dental composites in this study was limited. In future studies, increasing the number of cycles in the bleaching process should be considered. Practical implications: A popular method of improving the aesthetic properties of teeth is the use of a wide range of blenching agents. Most patients who use teeth whitening procedures are also users of composite fillings. The use of bleaching agents may have a different effect on the mechanical and aesthetic restorative composites. For economic reasons, many people decide to import cheap bleaching agents of unknown or dubious origin via Internet services to perform the bleaching process on their own. In this study, it was investigated whether products of this type have an influence on the mechanical and aesthetic properties of the dental restorative nanocomposite. Originality/value: Until now, no comparison of the safety of the use of bleaching agents of recognized manufacturers and of unknown origin in terms of the effect on composite materials has been presented, despite their high social importance.

Immediate Implant Placement and Provisionalization in the Esthetic Zone: A 6.5-Year Follow-Up and Literature Review

The success of dental implant therapy in the esthetic zone requires not only functional osseointegration but also a satisfactory esthetic outcome. To establish harmony, balance, and continuity of gingival architecture between an implant restoration and the adjacent natural dentition is challenging. Immediate implant placement and provisionalization following tooth extraction have been documented as a predictable treatment modality, with fewer surgical interventions needed, to replace a missing tooth in the esthetic zone. This case report illustrates immediate implant placement and provisionalization to replace a failing maxillary right central incisor while maintaining optimal gingival esthetics. The maxillary right central incisor was extracted without flap elevation to minimize soft and hard tissue trauma. Immediately afterwards, the implant was installed using a surgical stent and restored with a provisional crown that had no occlusal contacts. During healing, no significant adverse effects were observed clinically or radiographically. This proposed treatment modality provided the patient with immediate esthetics, function, and comfort without any complications during a follow-up period of 6.5 years.

General health, healthcare costs and dental care use of elderly with a natural dentition, implant-retained overdenture or conventional denture: an 8-year cohort of Dutch elderly (aged 75 and over)

Background Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design. Methods This prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures. Results At baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures. Conclusions It was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants).

Active Tactile Sensibility of Brånemark Protocol Prostheses: A Case–Control Clinical Study

Few studies have assessed active tactile sensibility in patients rehabilitated with implants. Improved knowledge about functional tactile sensibility will contribute to several clinical applications, such as protocols for immediate loading, prosthesis design, occlusal improvement in implantology, and physiological integration of implant-supported prostheses. The present study evaluated active tactile sensibility in patients rehabilitated with Brånemark-type mandibular prostheses that impede the total mucosa-supported maxillary prosthesis. Thirty-five subjects participated in this study. The experimental group (n = 18) inclusion criteria were as follows: Brånemark-type prosthesis and a total mucosa-supported maxillary prosthesis. The control group (n = 17) was composed of participants with complete healthy dentition. Carbon foils with different thicknesses (12 μm, 24 μm, 40 μm, 80 μm, and 200 μm) were placed in the premolar region to evaluate the brink of active oral tactile sensibility. The researchers assessed the participants 120 times. After evaluation, we observed a statistical difference (p < 0.05) between the groups. Additionally, the degree of sensibility was found for all thicknesses, except for 12 μm, on both sides. There was a more significant increase in perception in the control group as the carbon thickness increased. The tactile sensibility threshold was 2.5 times greater for participants with prostheses. Thus, the tactile sensibility for mandibular implant-supported and maxillary mucosa-supported prostheses is significantly lower than that of dentate patients, which was detected above the thickness of 80 μm; in patients with natural dentition, different thicknesses were seen starting from 24 μm.

Effect of Grinding and Subsequent Various Surface Treatments on the Surface Roughness of Full Contour Monolithic Zirconia

BACKGROUND A smooth zirconia surface is necessary to protect the opposing natural dentition, to prevent plaque accumulation and to increase the survival rate of restoration by reducing the chances of failure by crack propagation. Surface roughness can be incorporated by routine dental procedures done in labs and clinics to adjust the restoration. It is unclear which surface treatment is most appropriate to achieve clinically acceptable zirconia surface. The purpose of this study was to evaluate the effect of grinding and subsequent various surface treatments on the surface roughness of full contour monolithic zirconia. METHODS In this invitro study 10 zirconia bars of final dimensions 20 x 4 x 2 mm & 40 zirconia bars of final dimensions 20 x 4 x 2.2 mm were milled and sintered. The zirconia bars with final dimensions 20 x 4 x 2mm were glazed and selected as samples for control group (Group C) (n = 10). Forty zirconia bars with dimensions of 20 x 4 x 2.2 mm were grounded using a standard straight cylindrical diamond point (105 – 125 µm) by placing them in a customized grinding apparatus till the dimensions became similar to that of control group i.e. 20 x 4 x 2 mm. After grinding and confirming the dimensions of each full contour monolithic zirconia bar using digital vernier caliper, zirconia bars were randomly allocated into 4 groups with 10 samples in each group (n = 10), namely (Group G: Grinding only, Group G+R: Grinding & Reheating, Group G+G: Grinding & Glazing, Group G+P: Grinding & Polishing) respectively. Surface roughness values were measured using a profilometer. Differences between groups were examined using one-way analysis of variance (ANOVA) (P ≤ 0.05) and Post hoc Tukey HSD test was done for multiple comparisons of surface roughness in between the groups using Statistical Package for Social Sciences (SPSS) software. RESULTS Group C showed the least surface roughness values. The maximum surface roughness values were seen in Group G. Surface roughness of Group G, Group G + H and Group G + G were statistically significant from Group C and Group G + P. There was no statistically significant difference in surface roughness values between Group C and Group G + P. CONCLUSIONS It can be concluded that polishing after grinding significantly reduced the surface roughness and re-established the surface smoothness of full-contour monolithic zirconia bars. KEY WORDS Surface Roughness, Zirconia, Monolithic, Full Contour, Profilometer