Accuracy of CBCT and 3D Stereolithographic Model in Identifying the Anterior Loop of the Mental Nerve: A Study on Cadavers.

J Oral Implantol. 2012 Mar 12;

Authors: Santana RR, Lozada J, Kleinman A, Al-Ardah A, Herford A, Chen JW

Abstract
Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of cone beam computed tomography(CBCT) and 3D stereolithographic(STL) model in identifying and measuring the anterior loop length(ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus. STL models of the two acquired CBCT images were made. ANLL were measured using CBCT, STL and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. Paired sample t-test was used. P values less than .05 was considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04mm and not statistically significant (p= .332) while the mean difference between STL and anatomic measurement was 0.4mm and statistically significant (p=.042). There was also a statistical significant difference between CBCT and STL (p=.048) with the mean difference of 0.35mm. Therefore, CBCT is an accurate and reliable method in determining and measuring the ANLL while the STL over or underestimated the ANLL by as much as 1.51mm and 1.83mm respectively.

PMID: 22409704 [PubMed - as supplied by publisher]

Biological Adaptation to Misfits of Immediately Loaded Fixed Prostheses Following Computer-Guided Surgery.

J Prosthodont. 2012 Feb 19;

Authors: Puterman I, Kan JY, Rungcharassaeng K, Oyama K, Morimoto T, Lozada J

Abstract
In this clinical report, following computer-guided (3D Procera Software Planning Program, Nobel Biocare, Yorba Linda, CA) placement and immediate provisionalization of 12 dental implants (NobelSpeedy™ Replace, Nobel Biocare), misfits of the prefabricated screw-retained interim prostheses were noted at several implant-abutment junctions. Nevertheless, adaptation of the misfits was observed 10 days later, after the loosened screws were tightened. While a high mean marginal bone loss of 2.1 mm (range: 1.4 to 3.5 mm) was noted, all implants remained osseointegrated at 3-year follow-up.

PMID: 22339733 [PubMed - as supplied by publisher]

Are sectioning and soldering of short-span implant-supported prostheses necessary procedures?

Acta Odontol Latinoam. 2011;24(1):21-8

Authors: Bianchini MA, Souza JG, Souza DC, Magini RS, Benfatti CA, Cardoso AC

Abstract
The aim of this study was to evaluate the fit between dental abutments and the metal framework of a 3-unit fixed prosthesis screwed to two implants to determine whether sectioning and soldering of the framework are in fact necessary procedures. The study was based on a model of a metal framework of a 3-unit prosthesis screwed to two implants. A total of 18 metal frameworks were constructed and divided into 3 groups: (1) NS group - each framework was cast in one piece and not sectioned; (2) CS group - the components of each sectioned framework were joined by conventional soldering; and (3) LW group - the components of each sectioned framework were joined by laser welding. The control group consisted of six silver-palladium alloy copings that were not cast together. Two analyses were mperformed: in the first analysis, the framework was screwed only to the first abutment, and in the second analysis, the framework was screwed to both abutments. The prosthetic fit was assessed at a single point using a measuring microscope (Measurescope, Nikon, Japan) and the marginal gap was measured in micrometers. Statistical analysis was performed using analysis of variance (ANOVA), Scheffe's test, Student's t-test, and Mann-Whitney U test. The NS group had larger marginal gaps than the other groups (p<0.01), while the CS and LW groups had a similar degree of misfit with no significant difference between them. The results revealed that, in the case of short-span 3-unit fixed prostheses, the framework should be sectioned and soldered or welded to prevent or reduce marginal gaps between the metal framework and dental abutments.

PMID: 22010402 [PubMed - indexed for MEDLINE]

Surgical experience influences 2-stage implant osseointegration.

J Oral Maxillofac Surg. 2011 Nov;69(11):2771-6

Authors: Zoghbi SA, de Lima LA, Saraiva L, Romito GA

Abstract
PURPOSE: With the increasing number of surgical procedures for osseointegrated implant placement, there has also been an increase in the number of professionals performing this procedure. Surgeons undergo different types of training, and this may influence their surgical experience. The objective of this study was to evaluate the effect of surgical experience on the osseointegration of dental implants.
MATERIALS AND METHODS: A retrospective study was conducted using clinical charts from 2002 through 2008, during which time 265 implants were performed in 110 patients by 2 professionals who completed a postgraduate program in implant dentistry in 2002. Cases were selected for degree of difficulty, avoiding those involving areas that required bone grafts for the placement of implants, with a regular platform (3.75) and a height ranging from 10 to 13 mm. The criteria for evaluating implant osseointegration included clinical and radiographic evidence observed for a minimum period of 1 year, in accordance with the success criteria proposed by Albrektsson et al:(1)1) individual, unattached implant is immobile when tested clinically; 2) radiograph does not demonstrate evidence of peri-implant radiolucency; 3) vertical bone loss is less than 0.2 mm annually after the first year postimplantation; and 4) individual implant performance is characterized by an absence of signs and symptoms such as pain, infections, neuropathies, paresthesia, or violation of the mandibular canal. Implantation was performed in 2 stages. To relate the osseointegration rate with professional experience, cases were arranged by increasing order of placement date and were then evaluated per year and region. They were then separated into 2 groups: first 50 implants performed and implants performed after the first 50.
RESULTS: The osseointegration rate of implants performed was 92.5%, with rates of 87.6% for those placed in the maxilla and 95.6% for those in the mandible. For the first 50 implants, the osseointegration rate was 84.0%, whereas in the implants performed thereafter, the rate was 94.4%.
CONCLUSION: Surgical experience acquired during and after a postgraduate program in implant dentistry appears to influence osseointegration of dental implants, with a higher osseointegration rate found in implants performed by more experienced professionals.

PMID: 21798649 [PubMed - indexed for MEDLINE]

The ongoing ICOI educational experience.

Implant Dent. 2011 Aug;20(4):255

Authors: Perel ML

PMID: 21778883 [PubMed - indexed for MEDLINE]

Immediate single tooth replacement with subepithelial connective tissue graft using platform switching implants: a case series.

J Oral Implantol. 2011 Oct;37(5):559-69

Authors: Chung S, Rungcharassaeng K, Kan JY, Roe P, Lozada JL

Abstract
This case series evaluated the facial gingival stability following single immediate tooth replacement in conjunction with subepithelial connective tissue graft (SCTG). Implant success rate and peri-implant tissue response were also reported. Ten patients (6 male, 4 female), with a mean age of 52.1 (range = 22.7 to 67.1) years, underwent immediate implant placement and provisionalization with SCTG and were evaluated clinically and radiographically at presurgery (T0), at the time of immediate tooth replacement and SCTG (T1), and 3 months (T2), 6 months (T3), and 12 months (T4) after surgery. Data were analyzed using the Friedman and Wilcoxon signed-ranks tests at the significance level of α = .05. At 1 year, 9 of 10 implants remained osseointegrated with the overall mean marginal bone change of -0.31 mm and a mean facial gingival level change of -0.05 mm. The modified plaque index scores showed that patients were able to maintain a good level of hygiene throughout the study. The papilla index score indicated that at T4, more than 50% of the papilla fill was observed in 89% of all sites. When proper 3-dimensional implant position is achieved and bone graft is placed into the implant-socket gap, favorable success rate and peri-implant tissue response of platform switching implants can be achieved following immediate tooth replacement in conjunction with subepithelial connective tissue graft.

PMID: 20883114 [PubMed - indexed for MEDLINE]

Implant dentistry curriculum in undergraduate education: part 2-program at the albert-ludwigs university, freiburg, Germany.

Int J Prosthodont. 2011 Nov-Dec;24(6):544-56

Authors: Kroeplin BS, Strub JR

Abstract
Purpose: The aim of this study was to describe the didactic and clinical undergraduate implant dentistry program of the Albert-Ludwigs University, Freiburg, Germany, with emphasis on the clinical implant experience. Materials and Methods: A detailed description of the implant curriculum at Albert-Ludwigs University is given with documented exemplary cases and additional flow charts. Results: All students participate in 28 hours of lectures and approximately 64 hours of seminars with hands-on courses and gain clinical experience. All undergraduate students are eligible to place and restore oral implants. Emphasis is placed on prosthetic-driven planning of implant positions, three-dimensional imaging, and computer-guided implant placement. Implant restorations performed by undergraduate students comprise single crowns and small multiunit fixed dental prostheses in partially edentulous posterior maxillae and anterior or posterior mandibles, implant-retained overdentures (snap attachment) in edentulous patients, and telescopic fixed-removable dental prostheses on remaining teeth and strategically placed additional implants. Over the past 2.5 years, 51 patients were treated with 97 dental implants placed by students in the undergraduate program. Seventy-one restorations were inserted: 60.6% single crowns, 7% fixed dental protheses, 21.1% overdentures, and 11.3% telescopic fixed-removable dental prostheses. The implant survival rate was 98.9%. Conclusions: Because survival rates for dental implants placed and restored by students are comparable to those of experienced dentists, oral implant dentistry should be implemented as part of the undergraduate dental curriculum. Int J Prosthodont 2011;24:544-556.

PMID: 22146254 [PubMed - in process]

Periodontal Inflammation in Relation to Cognitive Function in an Older Adult Danish Population.

J Alzheimers Dis. 2011 Nov 1;

Authors: Kamer AR, Morse DE, Holm-Pedersen P, Mortensen EL, Avlund K

Abstract
Inflammation plays a significant role in Alzheimer's disease (AD) pathogenesis. Studies have shown that systemic, peripheral infections affect AD patients. Cognitive dysfunction is a consistent finding in AD and periodontal disease is a chronic, peripheral infection often resulting in tooth loss. We hypothesized that older adults with periodontal inflammation (PI) or many missing teeth would show impaired cognition compared to subjects without PI or with few missing teeth, and among subjects with PI, those with many missing teeth would show impaired cognition compared to those with few missing teeth. The effect of PI/tooth loss on cognitive function [measured by Digit Symbol (DST) and Block Design (BDT) tests] was assessed in 70-year old Danish subjects. We found: 1) subjects with PI obtained lower mean DST scores compared to subjects without PI (p < 0.05); 2) subjects with many missing teeth had lower mean DST and BDT scores compared to subjects with few missing teeth (p < 0.05); 3) the association of PI with DST and BDT scores was dependant on the number of missing teeth (interaction: p = 0.03 and p = 0.06); and 4) education and previous cognitive scores (age 50) were important covariates. Subjects with PI had significantly lower adjusted mean DST scores compared to subjects without PI. However for adjusted BDT, the significance held only for subjects with few missing teeth. No difference in the adjusted DST and BDT scores was seen between subjects with many missing teeth compared to those with few missing teeth. These results support the hypothesis that PI may affect cognition.

PMID: 22045483 [PubMed - as supplied by publisher]