Maxillary sinus augmentation by the crestal approach: radiographic changes in graft height. A 1-year retrospective study

The purpose of this study is to evaluate, radiographically, the change in intra-sinus graft height after implant placement using inorganic mineral bovine bone and the osteotome technique. Thirty-one implants were placed in twenty-five patients with simultaneous sinus lift using the crestal approach and deproteinized bovine bone ((Bio-Oss®). Periapical radiographs were taken immediately after implant placement, after six months (healing period), and after a minimum of six months of loading. Changes of the graft height were evaluated using image analysis software (Image Tool for Windows, version 3, UTHSCA). The distance between the implant apex and the graft summit was measured along the longitudinal axis of the implant (distance D). This distance was consecutively measured on radiographs taken immediately after surgery (D0), at second stage surgery (D6), and at follow-up visits (D12). Only 25 out of 31 implants were included to analyze the variation in the distance D in time (D6 and D12). Statistical analysis showed a significant difference between D0 and D6 (p\u3c0.0001), between D6 and D12 (p\u3c0.002), and between D0 and D12 (p\u3c0.001). The graft lost 27.4% of its apical height after twelve months. Within the limitations of the present study it was found that the use of deproteinized bovine bone, which has a very slow resorption rate, could not prevent changes in the initially gained intrasinus graft height. However, the reported results showed that its use was beneficial in limiting the loss of the augmented height to a minimum

Comparing clinical and radiographic periodontal parameters to software generated CBCT measurements

The aim of this study was to compare direct surgical measurements to data extracted from periapical radiographs and CBCT by means of software (coPeriodontix™ and Blue Sky Plan®) in order to assess the accuracy delivered by these 2 software. Ten patients were included in the study, and the number of teeth selected for measurements ranged from one to 10 per patient. All CBCT scans and X-rays were acquired within a maximum period of 1 month prior to surgery. Clinical linear measurements were performed at 6 sites for each tooth. Furcation defects were recorded according to the Hamp classification.Differences between data acquired from these 3 modalities were analyzed. Linear measurements showed statistically significant difference, where CBCT showed the least bone loss, periapical radiographs showed more bone loss, while direct surgical measurements showed the most bone loss. The Blue Sky Plan® that measured the furcation involvement accurately depicted the true furcation defect

L’échec implantaire : revue de la littérature

Since the 1960s, the introduction of osseointegration principles and improved surgical protocols has resulted in an increasing use of oral implants in clinical practice. Despite their high long-term success rates in the rehabilitation of fully or partially edentulous patients, dental implants failures might occur. The implant failure can be classified as early failure (the osseointegration is not yet established) and late failure (involving a breakdown of the established osseointegration). The aim of this article was to present a literature review regarding mechanism, etiologies and risk factors associated with implant failures

L’échec implantaire : étude rétrospective

The rehabilitation of patients with failing or missing dentition using titanium implants has dramatically changed in the last decades. Despite the predictability of implant therapy, failures that mandate implant removal do occur. The aim of our study was to determine the failure rates of implants placed during the last nine years at the dental clinic of the Faculty of Dental Medicine at Saint-Joseph University, Beirut. 640 individuals received dental implants; failures were clustered in 75 (11.7%) patients (27 men and 48 women, mean age 49.66 ±13.4 years). The total failure rate was 5.68%. Most failures were early (66.3%) and a statistically significant decrease in failure rate was observed during the last years (p=0.003)

Marginal bone stability around bone level versus tissue level implants in non-compliant patients with healthy or reduced periodontium: A 10-year retrospective study

The aim of this retrospective study was to investigate the effects of bone level implants (BL) in non-compliant patients on marginal bone alterations compared with the tissue level implants group (TL) at a mean follow-up period of at least 10 years.This study reports on 44 non-compliant patients selected from 3 private practices located in Beirut. Patients selected underwent implant surgery between 2005 and 2009 and had BL (Branemark and 3I Biomet) or TL (Straumann) implants. Periapical radiographs were taken directly after loading and at least at 10 years later. Crestal bone loss (CBL) for a total of 140 implants, including 97 BL and 43 TL implants was measured on radiographic images using the image tool software. Image calibration was done according to implant length. Hygiene level, smoking status and implant surface were also registered.After a mean period of 10 years, implants in the TL group had a mean CBL of 1.18± 0.89 (0.85 on the mesial side and 1.5 on the distal side). The BL group showed a mean CBL of 0.97 ± 0.64 (0.65 on the mesial side and 1.29 on the distal side). No significant difference (p \u3e0.05) was found between the 2 groups. Hygiene level was significantly associated with mesial and average bone loss. TiUnite surface showed a lower distal bone loss compared to SLA and acid etched surfaces. Furthermore, the average bone loss was significantly elevated in multiple-implant compared to single-tooth fixed implant restorations. No significant difference in bone loss was found between the maxilla and the mandible or between non-smokers and smokers.Analysis of the obtained results did not reveal a lower bone loss between bone level and tissue level implants in patients who didn’t commit to a strict maintenance program. However, bone loss was strongly correlated to hygiene level, confirming the importance of SPT and compliance

The pertinence of oral health indicators in nutritional studies in the elderly.

International audienceBACKGROUND AND AIM: Studies concerning the more appropriate criteria for evaluating oral health in relation to nutrition in the elderly vary greatly. There is a need to identify the most relevant criteria for classifying dental indicators of mastication in nutritional studies, so these indicators may be considered for epidemiological and clinical purposes. The aim of this study was to explore the associations between nutritional deficit and measures of oral health in a group of elderly. METHODS: A convenience sample of independent elderly aged 65 years or more attending two primary care clinics in Beirut, Lebanon was selected. Data were collected from a questionnaire including the Mini-Nutritional Assessment (MNA), Geriatric Oral Health Assessment Index (GOHAI) and questions about perception of xerostomia and chewing problems. The oral examinations recorded decayed, missing and filled teeth (DMFT), the prosthetic status and the number of functional units (FU). RESULTS: The sample was composed of 121 women (mean age: 71.59 ± 5.97 years) and 80 men (mean age: 72.74 ± 6.98 years). They were allocated to two groups: 85 participants suffering from malnutrition (MNA score < 17, n = 17) or at risk of malnutrition (17 < MNA score < 24, n = 68) and 116 participants with a normal nutritional status (MNA score ≥ 24). Parameters that explain MNA variations were perception of xerostomia (OR = 3.49, 95% CI [1.66-7.34]), number of FU (OR = 2.79, 95% CI [1.49; 5.22]), and GOHAI score (OR = 2.905, 95% CI [1.40; 6.00]). CONCLUSION: Further studies exploring factors affecting nutrition in the elderly should take into consideration perception of xerostomia, number of FUs and GOHAI score

Assessment of changes in the oral tactile function of the soft tissues by implant placement in the anterior maxilla: a prospective study

The aim of the present study was to assess the somatosensory function in the peri-implant soft tissues in the anterior jaw bone by means of two psychophysical tests. Light-touch sensation (LTS) and two-point discrimination (2PD) were performed before, and at planned intervals until 18 months after the placement of one or two implants in the anterior maxilla. The same tests were used on the contralateral control sites. The psychophysical threshold was determined by performing the staircase method. The mean values and standard deviation of LTS and 2PD, pooled over the four sessions at each test area, were calculated. Despite a large intersubject variation in both the LTS and 2PD, significantly high intra-individual correlations were found (P 0.05) on both implant and control sites. The 2PD increased significantly after surgery and maintained the higher discriminatory sense for 1 year (P-value 0.005). The control sites remained stable over time. However, no correlation was revealed between LTS and 2PD perception (Pearson correlation test). In this prospective study, no major differences between the different sites and testing sessions were reported; except for the 2PD thresholds which were lowered after implant surgery. These findings suggest that the regenerated nerves may be responsible for the increased 2PD sensitivity in the peri-implant soft tissue. The unchanged LTS thresholds did not allow confirming this hypothesis

Vieillissement de la population libanaise : démographie, évaluation sanitaire et impact en santé bucco-dentaire

This research was performed with national organizations to gather socio-demographic and sanitary information regarding aging population in Lebanon. It was also accomplished through investigators concerned in health care in Lebanon. Demographic trends, life expectancy, variations in population aging within the country were illustrated. We also appraised general and dental status, health service and policy, in addition to social security anticipated for elderly

Oral and general health indicators for lebanese elderly in oral surveys: review article

Various factors are taken into account in assessing objectively the dental status and the quality of life related to oral health, particularly in elderly. Basic socio-demographic characteristics and oral hygiene habits must be identified and screened, respectively. The dental health can be evaluated using indicators such as the ASA score or by determining the person’s level of autonomy. Cognitive ability of older people must be checked prior to use oral health questionnaires. This competence can be assessed by the Mini Mental State score (MMS). The use of Mini Nutritional Assessment (MNA) evaluates the nutritional status of patients. The aim of the article is to identify the most relevant indicators that can be used in epidemiological studies to assess the oral health of Lebanese elderly

Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon

Abstract Background The respective abilities of the GOHAI and OHIP-14 to discriminate between aged patients with different levels of oral diseases have rarely been studied in developing countries. The aim of this study was to compare the discriminative abilities of the OHIP-14 and the GOHAI in an elderly Lebanese population, and particularly to identify persons with different masticatory function. Methods A sample of elderly, aged 65 years or more, living independently was recruited in two primary care offices in Beirut, Lebanon. Data were collected by means of personal interview and clinical examination. The Arabic OHIP-14 and GOHAI questionnaires were used after cultural adaptation for use in Lebanon. The internal consistency, reproducibility and concurrent validity were verified. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile respectively and logistic regressions were conducted using socio-demographic, clinical and subjective explanatory variables. Results Two hundred and six participants were included; mean age was 72 years and 60% were women. Good psychometric properties were observed for both questionnaires for internal consistency (Cronbach’s alpha>0.88), reproducibility (ICC>0.86) and concurrent validity. Strong correlations were found between GOHAI and OHIP-14 scores but a high prevalence of subjects with no impact was observed using the OHIP-14. Both questionnaires were able to discriminate between participants according to age, perception of temporomandibular joint (TMJ) pain or functional status as represented by the number of dental Functional Units (FU). GOHAI was more discriminant since it identified participants with high dental care needs: high numbers of decayed teeth, low numbers of teeth and socially deprived status. Conclusions Lebanese elderly with high dental care needs and impaired oral health were identified more easily with the GOHAI. These results may guide the choice of dental indicators to use in a national geriatric survey.</p