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Language Journal of Clinical and Experimental Dentistry. 2018. Vol. 10, no. 10
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- Four-year outcomes of full-arch fixed dental prostheses using CAD/CAM frameworks : a retrospective review of 15 cases(2018) Turkylmaz, Ilser; Hariri, Niki-HajThe aim of this report is to analyze the clinical performance of 20 full-arch implant-supported titanium frameworks using CAD/CAM (Computer-Aided Design and Computer-Aided Manufacturing) technology. One hundred and four implants were placed in 15 patients using a one-stage protocol. After planning the location of all implants via 3-dimensional software (NobleClinician), 4-8 implants were placed in each edentulous arch based on anatomical measurements. Twenty edentulous arches were treated with full arch implant-supported fixed dental prostheses utilizing CAD/CAM milled titanium frameworks . All patients were followed up for 48±4 months. Clinical performance of the implants and restorations were evaluated for implant/prosthesis survival, framework fit, marginal bone levels, and maintenance requirements. One implant was lost during the follow up period, giving an implant survival rate of 99.1%. The average distance from the implant platform to first bone-implant contact was 1.1±0.2 mm from the time of metal-framework try-in to the time of the last recall appointment. None of the prostheses needed a replacement, indicating the prosthesis success rate was 100%. Sixteen occlusal adjustments and 5 broken denture teeth were repaired chairside during the study period. The results of this retrospective clinical report suggest that CAD/CAM milled titanium frameworks using the software and scanner presented in this study fit accurately and can be a viable treatment option to restore edentulous arches.
- The effect of diode laser irradiation associated with photoabsorbing agents containing remineralizing materials on microhardness, morphology and chemical structure of early enamel caries(2018) Ahrari, Farzaneh; Mohamadipour, Hamideh; Hajimomenian, Ladan; Fallah-Rastegar, AmirThis study investigated the effects of laser irradiation associated with photo-absorbing agents containing sodium fluoride (NaF), MI paste Plus or Remin Pro® on microhardness and surface structure of white spot lesions (WSLs). Fifty-six premolars were divided into two halves, then immersed in a demineraling solution to induce WSLs. The samples were divided into 8 groups by treatment (n=12) : (1) control, (2) diode laser (810 nm, 500 mW, 90 s), (3) NaF, (4) MI Paste plus, (5) Remin Pro®, (6) NaF + Laser, (7) MI Paste Plus + Laser, (8) Remin Pro® + Laser. Microhardness was measured before and after remineralization treatments. Two samples from each group were selected for SEM analysis. Microhardness increased significantly after all treatments with the exception of control, Laser and Remin Pro® groups (p >0.05). ANOVA revealed no significant difference in initial microhardness (P=0.21), whereas a significant difference was noted after treatment (P=0.009). The application of sodium fluoride with or without laser irradiation produced the highest microhardness among the groups (p<0.05). SEM analysis revealed some cracks on lased enamel and non-homogenous coatings of minerals after the use of remineralizing products. The use of NaF either alone or combined with laser irradiation was the most effecttive strategy for increasing microhardness of WSLs. The application of diode laser through photoabsorbing agents containing sodium fluoride or MI Paste Plus did not produce any additional effects in enhancing remineralization of WSLs, whereas the combined application of diode laser with Remin Pro® was effective.
- Effectiveness of an erbium-doped:yttrium, aluminum and garnet laser for treatment of peri-implant disease : clinical, microbiological, and biochemical marker analyses(2018) Komatsu, Yasutaka; Kubota, Takehiko; Yasuda, Tadashi; Takahashi, Tsurayuki; Yamamoto, Atsuhiko; Kono, Tomoo; Tabata, Hajime; Nohno, Kaname; Shibutani, Toshiaki; Umeda, Makoto; Yoshie, HiromasaThe effectiveness of an erbium-doped: yttrium, aluminum and garnet (Er: YAG) laser (EYL) for the treatment of peri-implant disease (PID) remains unclear. The aim of this study was to compare non-surgical EYL therapy for PID with locally delivered minocycline hydrochloride (MC) ointment therapy by evaluating clinical, microbiological, and biochemical markers. Thirty-seven patients with PID were randomly assigned to either the EYL group (n = 18) or the MC group (n = 19). The clinical, microbiological, and biochemical markers at baseline and at 1 and 3 months after treatment were compared between the two groups. Subgingival plaque and peri-implant crevicular fluid (PICF) were collected from the diseased pockets. In the EYL group, probing pocket depth (PPD) was significantly decreased after treatment when compared with baseline. On the other hand, in the MC group, there was no significant decrease in PPD after treatment. Specific bacteria associated with PID were not determined. The counts of both Gram-positive and -negative species did not significantly decrease in the EYL group at 3 months after treatment. In the MC group, the counts of almost all bacterial species were significantly decreased after treatment. Biochemical marker analysis of PICF revealed significantly lower levels of metalloproteinase (MMP)-9 in the EYL group, as compared with the MC group at 3 months after treatment (p= 0.009). Non-surgical therapy with an EYL for PID was clinically effective, with decreased MMP-9 levels in PICF, which may lead to reduced peri-implant tissue destruction.
- Odontogenic deep neck space infection in a patient with hyper-IgE syndrome : a case report(2018) Sugiura, Tsutomu; Yamamoto, Kazuhiko; Murakami, Kazuhiro; Kirita, TadaakiHyperimmunoglobulin E syndrome is a primary immunodeficiency state that is characterized by eczema, recurrent skin and lung infections, and markedly increased levels of IgE. Odontogenic infection can spread to vital and deep structures in such immunocompromised patients. We report a case of a 19-year-old man with hyperimmunoglobulin E syndrome presenting deep neck space infection that had spread from periapical periodontitis of the lower molars. A computed tomography scan showed an area of bony destruction in the left mandible and abscess formation in the submandibular and submental spaces. The patient was successfully treated by cervical drainage, extraction of the causative teeth, and antibiotic therapy. The present case highlights the importance of adequate treatment of dental infections in immunocompromised patients.
- Detection of human papillomavirus DNA in formalin-fixed, paraffin-embedded squamous papillomas of the oral cavity(2018) Daigrepont, Jack; Cameron, Jennifer E.; Wright, Kelly L.; Cordell, Kitrina G.; Rosebush, Molly S.Squamous papillomas are exophytic proliferations of surface oral epithelium. Human papillomavirus (HPV) infection is widely accepted as the etiology of squamous papillomas however the virus cannot be detected in a significant percentage of lesions. Using polymerase chain reaction (PCR), we tested 35 formalin-fixed paraffin-embedded (FFPE) squamous papillomas for the presence of HPV DNA. Six papillomas (17%) tested positive for HPV DNA; four contained HPV-6 and two contained HPV-11. Given that ??globin DNA was only identified in half of the samples, DNA degradation appears to have significantly impacted the results. The results likely represent an underestimation of the true number of HPV-positive specimens in our study. Potential explanations for HPV-negative squamous papillomas include transient HPV infection, failure of the experiment to detect HPV if present, or the possibility that some lesions may not result from HPV infection.
- Comparison of pharyngeal airway volume in different skeletal facial patterns using cone beam computed tomography(2018) Shokri, Abbas; Miresmaeili, Amirfarhang; Ahmadi, Ali; Amini, Payam; Falah-kooshki, SepidehThis study aimed to compare the pharyngeal airway volume in class I,II and III skeletal malocclusion patients using cone beam computed tomography (CBCT). This retrospective, cross sectional study was conducted on lateral cephalograms of 71 patients derived from their CBCT scans. Using the ANB angle, the patients were divided into class I,II and III malocclusion. Two observers used Dolphin 3D software to calculate the pharyngeal airway volume, airway area, minimum axial area, minimum area location, airway length and morphology. Data were analyzed using one-way ANOVA, Kruskal-Wallis test, Tukey?s test, Spearman?s correlation coefficient and multiple regression analysis. The three skeletal classes were significantly different in airway volume, minimum axial area, mean airway area and airway morphology (P<0.05). Significant differences were found in airway volume and mean airway area between class II and III patients (P<0.05). The minimum axial area and airway morphology in class III patients were greater than those in class I and II patients (P<0.05). Every one unit increase in the ANB angle decreased the airway volume by 0.261 units. The effect of ANB angle on airway volume was statistically significant and it was shown that one unit increase in the angle decreased the airway volume by 453.509 units. A significant correlation exists between the skeletal facial pattern and upper airway dimensions. In our study, the total airway volume and the mean airway area of class III patients were larger than those in class II patients.
- A randomized controlled trial comparing nerve block and mandibular infiltration techniques in posterior mandible implant surgeries(2018) Garcia Blanco, M.; Gualtieri, Ariel-Felix; Puia, Sebastian-ArielTo compare global surgical pain under nerve block and mandibular infiltration anesthesia techniques, and to evaluate pain during drilling and the distance to the mandibular canal in posterior mandible implant surgeries. A prospective, randomized, controlled, double-blind, clinical trial was conducted to compare nerve block (Group A) to mandibular infiltration (Group B) techniques for dental implant placement. Global surgical pain (VAS = visual analogue scale), pain during drilling or implant placement (MPQ = McGill pain questionnaire) and distance to the mandibular canal (Image J) were statically analyzed. Age, gender, anxiety levels, tooth to be replaced, implant size, adjacent teeth and duration of surgery were also analyzed. 172 patients were included and 283 dental implants were analyzed. VAS values were significantly higher in Group B (p<0.05). In Group A, 99% of the surgeries were performed painlessly during drilling and implant placement, but in Group B, 11.6% of implant placements (17 implants) felt pain during these surgical steps. Mean distance to mandibular canal (3.8 mm, range: 0.0 to 7.0) in those 17 implants placed under mandibular infiltration was clinically and statistically similar to the mean distance (3.0 mm, range: 0.0 to 9.0) of 130 implants placed painless (p=0.10). Pain during drilling under mandibular infiltration was significantly associated with the duration of surgery (p<0.05) and to both adjacent teeth being present (p<0.05). Although both techniques are safe and effective for placing implants in the posterior mandible, nerve block provides a more profound analgesia than mandibular infiltration. When placing implants under mandibular infiltration, as getting closer to the canal does not increase the feeling of pain, it is not recommended to use the presence of pain as a preventive resource to avoid inferior alveolar nerve injuries.
- Comparison of dental treatment performed under general anesthesia between healthy children and children with special health care needs in a hospital setting, Saudi Arabia(2018) Al-Ogayyel, Shahed; Al-Haj Ali, SanaaThe aim of this retrospective study was to assess and compare the dental treatments performed under general anesthesia (GA) between healthy children and children with special health care needs (SHCN) according to age group and gender at king Fahd hospital, Dhahran, Saudi Arabia. Data was retrieved from the records of 304 healthy and SHCN children 1 18 years of age who received dental rehabilitation under GA in the period 2015-2018. The dental treatment modalities were compared in the two groups and differences according to age group and gender were reported. Compared to healthy children, children with SHCN received significantly less pulp therapy treated teeth, and restored primary teeth. While, they received significantly more extracted teeth, and restored permanent teeth (P<0.05). In both groups, younger children (? 6 years) received significantly more crowns, pulp therapy treated teeth, and restored primary teeth than older children (> 6 years) (P<0.05). While, they received significantly less fissure sealed teeth, extracted primary teeth, and restored permanent teeth (P<0.05). No gender difference was found among children with SHCN; however, healthy boys ? 6 years received significantly more extracted primary teeth than girls of same age group, while healthy boys > 6 years received significantly more pulp therapy treated teeth than girls of same age group (P<0.05). Healthy children had different approaches for treatment under GA than children with SHCN. The use of radical treatment approaches like extraction in children with SHCN and the lessened preference toward pulp therapy coupled with greater need for permanent teeth restorations when compared to healthy children were observed. Greater emphasis on oral health education and preventive strategies for children with SHCN is required. It is important to educate their parents/caregivers on the importance of establishing early dental home.
- One-stage laser-microtextured implants immediately placed in the inter-radicular septum of molar fresh extraction sockets associated with GBR technique. A case series study(2018) Guarnieri, Renzo; Di Nardo, Dario; Gaimari, Gianfranco; Miccoli, Gabriele; Testarelli, LucaThe outcome of one-stage trans-mucosal immediate implants with simultaneous guided bone regeneration (GBR) technique has become highly predictable. Furthermore, when this approach is performed to place one-stage implants into the inter-radicular septum of fresh extraction sockets in the molar region, the risk of incorrect emergence profile and off-angle loading is reduced. The aim of the present study was to clinically evaluate the horizontal hard and soft tissue changes, and radiographically the vertical socket walls remodeling, and the early peri-implant marginal bone loss (EMBL) following the placement of immediate one-stage implants in the inter-radicular septum of molar fresh extraction sockets, associated with a collagen membrane. Twenty patients were selected to receive a one-stage implant with laser-microtextured collar surface into the inter-radicular septum of a fresh molar extraction sockets, associated with a simultaneous placement of a collagen membrane. Intraoral radiographs and model casts were used for the evaluation. Correlation between the amount of the keratinized tissue thickness (KTT) with EMBL was also analyzed. After 4 months, the vertical radiographic mesial and distal EMBL around implants was of 0.06 ±0.01 mm and 0.04±0.02 mm, respectively, with no statistically significant difference between T0 and T1 (P >0.05). No statistical differences were found also for each radiographic measure used for the examination of implant sites vertical bone changes (p >0.05). Clinically, horizontal changes of the bucco-lingual central width were found statistically significant (p<0.05), whereas no statistical differences were found for bucco-lingual mesial and distal width changes (p >0.05). In addition, no statistically significant correlation between EMBL and the amount of KTT was found (P >0.05). Results suggest that the immediate placement of one-stage laser-microtextured implants could provide advantages in preserving the extraction socket?s hard and soft tissue remodeling, and the peri-implant marginal bone level before the prosthetic loading.
- Current understanding of genetic polymorphisms as biomarkers for risk of biological complications in implantology(2018) Eguía Del Valle, Asier; López Vicente, José; Martínez-Conde Llamosas, Rafael; Aguirre Zorzano, Luis AntonioIn the last decade, multiple studies have been published that analyze the relationship between the risk of experiencing biological complications with implants and the presence of certain types of genetic polymorphisms. In the present report, we analyze the controversies that have arisen from this important area of investigation and synthesize the most prominent aspects of knowledge related to this possible etiopathogenic relationship. For this review, the biomedical databases PubMed-Medline, SciELO, and DOAJ were used. Different search strategies were employed, from which 298 articles initially emerged. After refinement of the search, 55 articles published between 2002 and 2018 were finally selected based on relevance. In certain population groups, there is evidence to support that about a dozen polymorphisms could in some way be related to biological complications in implantology. Indeed, the results may vary according to the ethnic origin of the population studied. Most of the published investigations are initial studies reporting small sample sizes and utilizing different study group homogenization methods. We are still at a preliminary stage of our understanding and development with regard to these types of biomarkers. The interesting results identified indicate that new investigations will be necessary to eliminate the biases observed in some studies and to homogenize the research groups. In order to clarify the controversies surrounding the current knowledge in this field, we believe that it will be necessary to employ larger study groups and search for possible synergistic effects between different polymorphisms.
- Marginal bone loss around cement and screw-retained fixed implant prosthesis(2018) Hameed, Muhammad-Hasan; Khan, Farhan-Raza; Ghafoor, Robia; Azam, Syed-IqbalImplant-supported fixed restorations are considered as the standard treatment for replacement of missing teeth. These can be either screw or cement retained. The success or failure of implant restorations depend upon amount of marginal bone loss (MBL). The present study is to determine the MBL around cement and screw-retained implant prosthesis and to determine various predictors of the MBL. A retrospective charts review was conducted at the dental clinics, Aga Khan University Hospital, Karachi from February 2017 to June 2017 in which 104 implants restorations were assessed using periapical radiographs. MBL was calculated at baseline and at 12 months and the difference was recorded on a proforma. SPSS version 21.0 was used for statistical analysis. Descriptive statistics was computed. Generalized estimation equation analysis (GEE) was applied to determine the predictors of MBL. Level of significance was kept at ? 0.05. There were 104 implant restorations belonging to 41 patients. Screw retained prosthesis showed significantly greater MBL than cement retained prosthesis (p-value =0 .018) (irrespective of crowns or fixed partial dentures). Other factors that turned out to be significant predictors of MBL were male gender (p-value= <0.01), age >65 yrs. (p-value=0.028) and sites where bone grafting was performed (p-value=0.003). Male patients of age >65 yrs. with sites needing bone grafts who were provided with screw retained prosthesis (irrespective of crown or fixed partial dentures) had significantly greater marginal bone loss around implants.
- Endodontic management of type II dens invaginatus with open apex and large periradicular lesion using the XP-endo Finisher : a case report(2018) Rodrigues, Evaldo-Almeida; Belladonna, Felipe-Gonçalves; De-Deus, Gustavo; Silva, Emmanuel João Nogueira Leal daDens invaginatus (DI) represents an endodontic challenge because of its complex root canal morphology. This case report presents the clinical management of a 22-year-old woman with type II DI in right maxillary lateral incisor with a painful swelling. Pulp testing revealed no response with the tooth. Type II DI with open apex and large periradicular lesion was seen on radiograph. The treatment was planned by using cone-beam computed tomography (CBCT) imaging. Canal treatment was completed in two appointments with the aid of a dental operating microscope. In the first appointment, the internal anatomy was modified using an ultrasonic tip, and chemo-mechanical preparation was performed using the XP-endo Finisher instrument and NaOCl; calcium hydroxide intracanal dressing was used for one month. In the second appointment, an apical plug of mineral trioxide aggregate (MTA) Repair HP was performed and the remaining pulp space was then filled with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. At the fourteen-month reevaluation, the patient was asymptomatic, the tooth had remained functional, and radiographic and CBCT assessment showed significant osseous healing of the lesion. Successful non-surgical management of the present type II DI was achieved in the present case. The association of CBCT, dental operating microscope, XP-endo Finisher, NaOCl and MTA Repair HP were important for ensuring a predictable outcome.
- Sinus floor elevation with platelet-rich fibrin alone : a clinical retrospective study of 1-7 years(2018) Aoki, Naofumi; Maeda, Michinori; Kurata, Masashi; Hirose, Marina; Ojima, Yasutaka; Wada, Keinoshin; Shibuya, YasuyukiSeveral sinus floor elevation procedures for implant placement have been introduced. The present study aimed to evaluate the implants placed with Platelet-rich fibrin (PRF) alone in atrophic posterior maxillae and survival rates and the potential factors associated with implant loss. This retrospective study evaluated 71 implants in 34 patients after 1-7 years? follow-up time. Statistical models were used to determine the implant survival and the potential factors associated with loss. Overall, 7 implants were lost, and the cumulative survival rate at 7 years by implant-based and patient-bases analyses were 85.5% and 85.7%, respectively. The mean residual bone height (RBH) was 4.26 mm. The implant survival rate was significantly lower at RBH < 4 mm than RBH ? 4 mm. This retrospective study showed that sinus floor elevation with PRF alone could be applied in cases of lower RBH. However, it should be carefully performed in cases of RBH < 4 mm before surgery.
- Relevance of functional imaging in dental implantology(2018) Benouaich, Vincent; Hitzel, Anne; Armand, SergeDespite it is widely used in many medicine fields, the use of functional imaging to examine dental implants has not been reported in the literature. This work aimed to evaluate the relevance of functional medical imaging in oral implantology. This single-center observational study was conducted for 6 months at the Toulouse University Hospital, France. All patients who underwent positron emission tomography with 18-fluorodeoxyglucose integrated with X-ray computed tomography (FDG PET/CT) and had dental implants were included. Metabolic activity of the peri-implant tissues was assessed qualitatively and quantitatively jointly by a nuclear physician and a dental surgeon. In 31 patients (121 implants), peri-implant metabolic activity was normal. In 3 patients (4 implants), localized peri-implant hypermetabolism was observed. In all the patients presenting abnormal peri-implant activity, the implants with normal activity were clinicaly and radiogicaly normal, whereas those with hypermetabolism presented peri-implantitis. This study assess of the relevance of FDG PET/CT in oral implantology. It shows a link between peri-implant hypermetabolism and peri-implantitis. Therefore, FDG PET/CT could become a new tool for the assessment of peri-implant diseases.
- Coronectomy - An alternative approach to remove impacted teeth in oncological patients(2018) Alves, Fabio A.; Serpa, Marianna-Sampaio; Delagado Azañero, Wilson; Almeida, Oslei Paes deCoronectomy involves the section of the tooth crown leaving the roots in the socket. Possibility of inferior alveolar nerve injury and mandibular fracture are the main indications for this approach. Herein, we describe a case series of coronectomy to highlight its indication in normal and oncological patients. A total of 9 patients were submitted to coronectomy, 6 of them were oncological. Three patients were evaluated before head and neck radiotherapy (HNRT), 2 after HNRT and 1 before bone marrow transplantation. Mean age of the patients was 49 years, most of them male (n=7). Lower third molars were the main teeth that received this procedure, and all cases presented intimate anatomic relationship between the roots and the mandibular canal. Moreover, three cases also presented evident mandibular fracture risk in removing the tooth. During the follow-up period, none complications were observed related to coronectomy and oncological treatment. Coronectomy is a safe approach including for cancer patients and it should be considered in high-risk impacted teeth extractions.
