Clinical evaluation of narrow platform RoxolidTM implants in patients with hypodontia at 1 year

Congenital absence of teeth, commonly known as hypodontia, has a reported prevalence of between 2 and 6%. It presents many clinical challenges, and it has a significant impact on psycho-social well being of patients. A typical presentation of mild hypodontia is shown in Figure 1. Rehabilitation of these patients with implants is complicated by small bone volume, and it requires multi-disciplinary input. Potential sites for implants in the anterior maxilla are compromised by low bone volume. A novel narrow implant made with TiZr alloy, RoxolidTM (Straumann AG), has been developed which offers the potential to place implants in these patients with minimal or no requirement for bone augmentation surgery

Effect of bioceramic powder abrasion on different implant surfaces

Purpose: Bioceramic coatings have been shown to promote bone repair, which aids in the early integration of implants. This study aimed to evaluate the influence of air abrasion with a bioceramic abrasive on the surface characteristics of different implant materials and surfaces. The dissolution of the applied treatment from the surfaces over 3 weeks was also assessed. Materials and Methods: Discs of three alloys used for dental implants were studied and compared: two types of commercially pure titanium (CpTi)/ (CpTi SLActive) and titanium-zirconia (TiZr). The tested surfaces were: CpTi control (CpC), sandblasted (SB), sandblasted and acid-etched (SBE), and CpTi SLActive®, (TiZr) Roxolid®. Three discs from each group underwent air abrasion with apatite bioceramic powders, 95% hydroxyapatite (HA)/5% calcium oxide (CaO), and 90% hydroxyapatite (HA)/10% calcium oxide (CaO). The treated discs were surface characterized by optical profilometry to obtain surface roughness, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS) to compare element weight percentages of titanium, calcium, and phosphate. Dissolution was assessed using inductively coupled plasma optic emission spectrometry (ICP-OES). Results: Bioceramic powders were deposited on all tested surfaces leading to changes in surface characteristics. The only statistically significant differences between the material groups for surface roughness were found with 95% HA/5% CaO powder in the Sp and Rp parameters (p = 0.03 and 0.04, respectively). There were no significant differences in the Ca and P wt% between all groups and powders 95% HA/5% CaO and 90% HA/10% CaO (p = 0.14, 0.18, and p = 0.15, 0.12, respectively). A non-uniform dispersion of the treatment on the surface layer was visible on all treated surfaces. The bioceramic powder continued to dissolute from the tested surfaces for 3 weeks. Conclusion: Bioceramic abrasion modifies implant surface characteristics, although the change in surface characteristics resulting from such treatment was not influenced by the implant material or surface treatment. Air abrasion with hydroxyapatite and calcium oxide bioceramics leaves powder deposits on the treated implant surfaces that could potentially influence the healing of implants affected by peri-implantitis

A review of implant provision for hypodontia patients within a Scottish referral centre

Background: Implant treatment to replace congenitally missing teeth often involves multidisciplinary input in a secondary care environment. High quality patient care requires an in-depth knowledge of treatment requirements. Aim: This service review aimed to determine treatment needs, efficiency of service and outcomes achieved in hypodontia patients. It also aimed to determine any specific difficulties encountered in service provision, and suggest methods to overcome these. Methods: Hypodontia patients in the Unit of Periodontics of the Scottish referral centre under consideration, who had implant placement and fixed restoration, or review completed over a 31 month period, were included. A standardised data collection form was developed and completed with reference to the patient's clinical record. Information was collected with regard to: the indication for implant treatment and its extent; the need for, complexity and duration of orthodontic treatment; the need for bone grafting and the techniques employed and indicators of implant success. Conclusion: Implant survival and success rates were high for those patients reviewed. Incidence of biological complications compared very favourably with the literature

Aragonite toothpaste for management of dental calculus: A double-blinded randomized controlled clinical trial

Objectives: Aragonite from animal origin such as cuttlefish bone powder is an abrasive with hardness properties ideal for calculus removal. The purpose of this randomized controlled trial was to test the efficacy of a cuttlebone-derived aragonite toothpaste in removing dental calculus. Materials and Methods: Eighty-one patients who fulfilled the inclusion criteria were blindly and randomly assigned into two study groups. The intervention treatment group (n = 40) received cuttlebone toothpaste (Dr. D-Tart) and the control group (n = 41) received an off-the-shelf commercial toothpaste (Crest). Evaluations were performed before and after scaling and polishing procedures done at 3 months in order to evaluate the toothpaste's ability to remove calculus and to prevent calculus formation. Calculus, stains, plaque, and gingival indices scores, and patient satisfaction surveys were compared at baseline (first visit), 3, and 9 months, using generalized linear models and Wald's χ2 test. Results: At the end of the 3-month period, the intervention group showed a 30% reduction in total calculus compared to the baseline score (p =.0006) and 45% less total calculus compared to the control group (p =.0001). Six months after scaling, the mean calculus score for Crest users was 42% higher than that for Dr. D-Tart users (p =.0692). There was a significant improvement in the gingival health of cuttlebone toothpaste users at the observed intervals, and both kinds of toothpaste achieved comparable results in terms of plaque and stains removal. Conclusions: Aragonite toothpaste can remove calculus, prevent calculus formation, and improve gingival health. Patients are generally satisfied with the performance of the aragonite toothpaste. Clinical significance: Animal-derived aragonite toothpaste (Dr. D-Tart) shows promising efficacy in removing calculus, preventing calculus formation, and for the improvement of gingival health. Clinical trial ID: A08-M35-16B.The authors acknowledge Hassan Sbayte for his help in organizing the data. We also thank the following funding agencies for supporting this research:study: MEDTEQ, MITACS, and Visionaturolab Inc

Development of professional identity among dental students - A qualitative study

The study explored dental students' perception of their professional identity (PI) development at a newly established dental college with a problem-based learning (PBL) curriculum. Qualitative methods based on focus groups were used for data collection. The conceptual framework of the study was informed by a subject-centered sociocultural approach to PI development. Purposive sampling was used to collect data from five focus groups of undergraduate dental students to gain a deeper understanding of their PI development in a PBL environment. Out of a total of 38 dental students in years 2 and 3, 34 students (89.47%) participated in the focus groups. A theory-driven thematic analysis was used to dissect the views and experiences of the participants to explore factors contributing to PI development in the early years of the program. At an individual level, PBL was seen to be appropriate for PI development. However, some participants placed more emphasis on practical training in operative dental skills. Relational sources especially role modeling by the PBL facilitators and faculty staff were identified as a key factor to nurture PI development. Mixed views were observed on the value of PBL to enhance team-working skills. The participants also identified challenges of PBL and provided recommendations on further improvements to enhance the learning experiences of the students. This study provided useful insights into a PBL curriculum at a newly established dental institution. The findings underscore the value of PBL in developing PI and also highlight the challenges of implementing PBL in a socio-cultural context and pedagogical implications for further program improvement.The authors would like to thank all the student participants for their contribution to this research. Open access funding was provided by the Qatar National Library

Impact of Virtual Reality Simulation in Endodontics on the Learning Experiences of Undergraduate Dental Students

Abstract: We aimed to evaluate the impact of Virtual Reality Dental Simulators (VRDS) on preclinical training in endodontics for undergraduate dental students. Purposive sampling technique was used to target undergraduate dental students at two dental schools: in Qatar and Turkey. After training on endodontic access cavity preparation on upper anterior teeth using acrylic teeth on dental mannequins and virtual reality haptic dental simulator, a questionnaire based on a combination of open- and closed-ended items was distributed to the participants. The sample included 60 dental undergraduate students. The participants reported positive experiences with VRDS and 76% considered it to be helpful in improving their fine motor skills. Endodontic access cavity preparation on VRDS was perceived to be similar to natural and acrylic teeth by 73.34% and 53% of participants, respectively. Overall, 85% of participants supported the use of VRDS training to supplement conventional training on dental mannequins but also recommended the need for improvements in VRDS training in endodontics. The findings of this study underscore the benefits of VRDS in endodontics. Future research involving larger samples from multiple institutions may help to optimize VRDS in undergraduate dental education

Efficacy of photodynamic therapy on candida colonization and clinical symptoms in denture stomatitis: a systematic review and meta-analysis

Background: Photodynamic therapy (PDT) has been recently proposed as a promising alternative therapy for Denture Stomatitis (DS). The present systematic review and meta-analysis investigated the current available evidence regarding the efficacy of PDT in the management of DS. Materials and methods: PubMed, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 7, 2023. All relevant clinical trials were included. RevMan software was used for the statistical analyses. Results: Elven randomized clinical trials (460 DS patients) were included. Eight studies assessed the efficacy of PDT vs. topical antifungal therapy, while three studies assessed the adjunctive use of PDT (PDT + antifungal therapy) vs. topical antifungal therapy alone. The results revealed comparable efficacy of PDT and conventional antifungal therapy on candida colonization at 15 days (MD: 0.95, 95% CI: -0.28, 2.19, p = 0.13) and at the end of follow-up (MD: -0.17, 95% CI: -1.33, 0.98, p = 0.77). The pooled two studies revealed relatively better efficacy of adjunctive use of PDT with antifungal therapy on candida colonization compared to antifungal therapy alone at 15 days (MD: -6.67, 95% CI: -15.15, 1.82, p = 0.12), and at the end of follow-up (MD: -7.14, 95% CI: -19.78, 5.50, p = 0.27). Additionally, the results revealed comparable efficacy of PDT and topical antifungal therapy on the clinical outcomes. Conclusions: PDT might be considered a viable option for DS either as an adjunct or as an alternative to the topical antifungal medications. Further studies with adequate sample sizes and standardized PDT parameters are warranted

Does replacement of missing dental units with resin-retained bridges improve oral health-related quality of life?: A systematic review

Objectives To assess the current literature in regard to two research questions: • Does placement of a 2-unit cantilever RRB to replace a missing dental unit improve oral health-related quality of life (OHRQoL) in patients over 18 years old? • Are there any differences in OHRQoL between different methods of replacing missing teeth? Methods Systematic review following the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) statement. Data/sources MEDLINE via Ovid, Scopus, PsycINFO via Ovid, Cochrane Library, Web of Science and clinicaltrials.gov were searched (Jan 1980 to Nov 2018) using high-level MeSH terms for studies published in English, investigating OHRQoL, using valid indices. Risk of bias (RoB) Determined using Cochrane RoB tool and ROBINS-I. Evidence certainty Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group tool. Results Study Selection: 280 articles were identified; 270 were excluded after abstract review, 7 after examining full text, leaving 3 articles (3 studies, 188 participants, 172 analysed) included in this review; one RCT and two observational studies. Synthesis of results: There was significant heterogeneity and no meta-analysis was possible. Description of effect: One pre-post study design found provision of 2-unit RRBs significantly reduced the total OHIP-49 score (effect size 0.67), compared with an untreated control. One case-control study found no differences in total OHIP-49 between individuals treated with RRB or implant-supported crown. Major complications related to a worse OHRQoL. Discussion Quality of evidence: The overall RoB assessments were one study “some concerns” and two studies “serious”. The GRADE assessment was “moderate” for one comparison and “low” for two comparisons. Clinical significance: A 2-unit cantilever RRB to replace one missing tooth probably results in a large improvement in oral health-related quality of life. Clinicians should ensure that the correct investigations and design of prosthesis are prescribed to help reduce any failures that may impact on OHRQoL