3-Year prospective multicenter study on one-stage implant surgery and early loading in the edentulous mandible

Background: The long-term success rates achieved in dental implantology suggest that flexibility might well exist within the various implant systems to a degree that an altered protocol (ie, one-stage surgery and immediate or early loading) can be performed under controlled conditions. However, before variations of the protocol can be considered for general use, they must be subjected to critical analysis, particularly with respect to the predictability of osseointegration, alteration of soft tissue barrier, and relative change in bone height around the implants. Purpose: The aim of this prospective multicenter study was to evaluate implant survival and periimplant conditions around endosseous implants placed in a one-stage surgical procedure and early loading. Materials and Methods: A total of 170 implants were placed in 40 patients with mandibular edentulism and were functionally loaded within 6 weeks with overdentures (n = 30) or fixed prostheses (n = 10). All patients and prosthetic constructions were evaluated according to a standardized protocol during 3 years of follow-up. Cumulative implant survival rates were calculated, and implant loss in relation to implant size and bone quality and quantity were evaluated. Furthermore, the protocol included assessment of clinical (plaque and bleeding scores, prosthesis stability) and radiographic parameters. Results: Over a period of 3 years, the implant survival rate was 93% for both implants and prostheses (fixed or removable). No implants were lost after the first year of loading. The periimplant tissues were in a healthy condition. Mean marginal bone resorption from the time of loading to the 3-year follow-up was 0.41 mm (SD 0.52). Conclusions: From this study it may be concluded that early loading results in good implant survival and proper periimplant health in edentulous mandibles.</p

Relevance of Variations in the Opposing Dentition for the Functionality of Fixed and Removable Partial Dentures: A Systematic Review

The aim of this systematic review was to evaluate the functionality of fixed and removable partial dentures as test interventions in relation to variations in the opposing dentition and their prosthetic restoration. The abstracts identified in the respective databases were screened independently by two investigators. RCTs and uncontrolled studies were considered, provided the patients were included consecutively and the confounding variables were adequately monitored. Seventeen papers were included. The study and publication quality was assessed using a “biometric quality” tool showing an overall poor quality. The reported outcomes, such as survival rates, were in each case obtained from a single study. Two possible trends could be deduced for the endpoint longevity: (a) the first trend in favor of removable partial dentures, compared to fixed partial dentures, with a fully edentulous opposing arch fitted with a removable prosthesis; (b) the second trend in favor of implant-supported partial dentures, compared to conventionally fixed partial dentures, with natural opposing dentition or with a removable partial denture in the opposing arch. No evidence could be generated as to whether, and if so how, variations in the opposing dentition have a bearing on the decision to fit a partially edentulous arch with a fixed or removable partial denture

Hydrogen and Metal Line Absorption Around Low-Redshift Galaxies in Cosmological Hydrodynamic Simulations

We study the physical conditions of the circum-galactic medium (CGM) around z=0.25 galaxies as traced by HI and metal line absorption, using cosmological hydrodynamic simulations that include galactic outflows. Using lines of sight targeted at impact parameters from 10 kpc to 1 Mpc around galaxies with halo masses from 10^11-10^13 M_solar, we study the physical conditions and their variation with impact parameter b and line-of-sight velocity delta v in the CGM as traced by HI, MgII, SiIV, CIV, OVI, and NeVIII absorbers. All ions show a strong excess of absorption near galaxies compared to random lines of sight. The excess continues beyond 1 Mpc, reflecting the correlation of metal absorption with large-scale structure. Absorption is particularly enhanced within about v<300 km/sec and roughly 300 kpc of galaxies (with distances somewhat larger for the highest ion), approximately delineating the CGM; this range contains the majority of global metal absorption. Low ions like MgII and SiIV predominantly arise in denser gas closer to galaxies and drop more rapidly with b, while high ions OVI and NeVIII trace more diffusely distributed gas with a comparatively flat radial profile; CIV is intermediate. All ions predominantly trace T~10^4-4.5 K photo-ionised gas at all b, but when hot CGM gas is present (mostly in larger halos), we see strong collisionally-ionised OVI and NeVIII at b <= 100 kpc. Larger halo masses generally produce more absorption, though overall the trends are not as strong as that with impact parameter. These findings arise using our favoured outflow scalings as expected for momentum-driven winds; with no winds, the CGM gas remains mostly unenriched, while our outflow model with a constant velocity and mass loading factor produce hotter, more widely dispersed metals.Comment: 26 pages, 15 figures, published in MNRAS. Updates to citations from previous versio

Single-tooth replacement: factors affecting different prosthetic treatment modalities

<p>Abstract</p> <p>Background</p> <p>The choice between several treatment options for replacing a single missing tooth is influenced by clinical, dentist- and patient-immanent factors. This study aimed to determine the patient factors that would affect the treatment decision to replace a single missing tooth and to assess the satisfaction with several options.</p> <p>Method</p> <p>200 volunteers involved (121 females and 79 males) divided into four groups, Group A: consisted of patients with conventional fixed partial dentures or patients with resin bonded fixed partial dentures. Group B: consisted of patients who received removable partial dentures while Group C: consisted of patients who received a single implant supported crown, and a control group D: consisted of patients who received no treatment. Data were collected using a questionnaire.</p> <p>Results</p> <p>The highest percentage of males within groups (58%) was within the removable prostheses category. The majority of the subjects in the study reported that the main reason for replacing a missing tooth was for esthetic and function. Most important factor affecting the choice between treatment modalities was damaging the neighboring teeth. Pain, post operative sensitivity and dental phobia were important factors in choosing the prosthesis type and affected the control group patients not to have any treatment. The highest satisfaction percentage among groups studied was recorded for dental implants then FPD groups, while the least percentage were in both the control and RPD groups, for all aspects of function, esthetic and speech efficiency.</p> <p>Conclusions</p> <p>The final choice between FPD, RPD and implant depended on several factors which affected the decision making; among these is cost and patients' awareness of the different treatment options.</p

Auricular acupuncture effectively reduces state anxiety before dental treatment—a randomised controlled trial,”

Abstract Objectives The objective of this study was to analyse whether auricular acupuncture, acupuncture at the outer ear, could reduce state anxiety before dental treatment. Methods This prospective, randomised patient-blinded study with 182 patients compared anxiety before dental treatment following auricular acupuncture at the relaxation-, tranquillizer-and master cerebral points (auricular acupuncture group) versus acupuncture at sham points (finger-, shoulderand tonsil points; sham group) and a non-intervention control group. Anxiety was assessed using the Spielberger State Trait Anxiety Inventory (German version) before auricular acupuncture and 20 min thereafter, immediately before dental treatment

A 5-year prospective multicenter study on 1-stage smooth-surface Branemark System implants with early loading in edentulous mandibles

Purpose: The purpose of the current prospective multicenter Study was to evaluate the 5-year implant success and peri-implant conditions of smooth-surface Branemark System implants when using a novel technique including a 1-stage surgical procedure with early loading in edentulous mandibles. Materials and Methods: The study protocol included 1-stage surgery as well as placement of the definitive prosthesis within 6 weeks after implant insertion (ie, early loading). Clinical evaluation, as well as evaluation of function and esthetics, was performed at each follow-up visit. Radiographs were obtained at connection of the prostheses and at the 1-, 3-, and 5-year check-ups. Results: A total of 40 patients with a mean age of 56 years (range, 30 to 70) were included in the study. In all, 170 implants were placed in between the mental foramina, of which 120 implants in 30 patients were associated with overdenture treatment and 50 implants in 10 patients with fixed complete dentures. Twelve implants failed in 6 patients. The cumulative implant survival rate was 92.9% after both 1 and 5 years of follow-up. Another 3 implants were recorded as mobile but still in function when individually checked at the 5-year visit, which resulted in a cumulative success rate of 91.0%. Mean bone remodeling over the study period was less than 0.1 mm/y after the first year of loading, resulting in a mean marginal bone level of 0.66 mm (SD 0.73, n = 138) apical to the? implant collar reference point after 5 years. Conclusions. One-stage, early loaded smooth-surface Branemark System implants functioned well for the majority of patients with edentulous mandibles. Stable peri-implant conditions were observed. Bone remodeling resulted in a mean bone level above the first implant thread after 5 years. The somewhat lower success rate of 91.0% compared to a 2-stage procedure may be related to generous inclusion criteria and to a learning curve involving a novel treatment procedure