The influence of restorative materials on implant-prosthodontic therapy success

Modernu stomatologiju karakteriše ogroman napredak u tehnologiji izrade zubnih nadoknada, ali i pojava velikog broja novih gradivnih materijala. Upoređivanje dva različita materijala pod istim uslovima jedan je od načina za razumevanje različitosti između njih. Poli-etar-etar-keton je polimer koji ima mnogo potencijala u stomatologiji, kao i već uveliko poznata litijum-disilikatna staklo keramika. Ciljevi. Cilj ove doktorske disertacije je bio da se uporede stepen preživljavanja i stepen uspešnosti implantatno-protetske terapije izradom litijum-disilikatnih i poli-etar-etar-keton (PEEK) implantatno nošenih zavrtnjem retiniranih pojedinačnih kruna metodom podeljenih usta, procena estetskih svojstava i zadovoljstva zubnih nadoknada, analiza kvaliteta života subjektivnim tehnikama pacijenata pre i nakon implantatno-protetske terapije, analiza estetskih parametara mekog tkiva i estetskih parametara samih nadoknada od strane terapeuta, procena periimplantatno mekotkivnog zarastanja i periimplantatne koštane resorpcije u različitim opservacionim periodima, merenje vremena potrebnog za izradu i procena jednostavnosti izrade obe vrste nadoknada od strane zubnih tehničara. Materijal i metod. Ovo istraživanje je sprovedeno kao prospektivna randomizovana klinička studija, sa opservacionim periodom od godinu dana, tokom kojeg su u kontrolnim intervalima rezultati analizirani i međusobno poređeni. Celokupno istraživanje sprovedeno je na Klinici za stomatološku protetiku i na Klinici za oralnu hirurgiju Stomatološkog fakulteta Univerziteta u Beogradu. Na ugrađenim implantatima BlueSky®(Bredent, Senden, Nemačka), nakon perioda oseointegracije, izrađene su krunice od PEEK materijala fasetirane kompozitnim materijalima (BioHpp®) i krunice od presovane litijum-disilikatne keramike (Ips e.max press®) u cut-back body formi, fasetirane feldspatnom keramikom. Upoređivanje je izvedeno metodom podeljenih usta litijum-disilikatnih i poli-etar-etar-keton (PEEK) implantatno nošenih zavrtnjem retiniranih pojedinačnih kruna pomoću subjektivnih i objektivnih parametara. Analizirani su stepen preživljavanja i uspešnosti nadoknada, estetska procena i zadovoljstvo zubnom nadoknadom evaluirana od strane pacijenata pomoću vizuelno-analogne skale (VAS), kvalitet života analiziran OHIP testom, terapeutska analiza nadoknade pomoću CIS (Copenhagen Index Score), Mombelijev plak indeks (MPI) i indeks krvarenja (MBI), dubina periimplantatnog džepa (PPD), radiografska analiza periimplantatne koštane resorpcije, vreme potrebno za izradu obe vrsta nadoknada, kao i procena jednostavnosti izrade nadoknada vizuelnoanalognom skalama (VAS) od strane zubnih tehničara. Rezultati. Analiza kvaliteta života pre i nakon postavljanja nadoknada nošenih implantatima pokazuje statistički značajnu razliku. Rezultati VAS za estetska svojstva ne pokazuju razliku, dok rezultati zadovoljstva nadoknadom ukazuju na statistički značajnu razliku između poređenih grupa. Poređenjem dobijenih rezultata PEEK krunica i litijum-disilikatnih krunica, nije uočena statistički značajna razlika merena za MBI i MPI u nultom vremenu, kao ni nakon 6 i 12 meseci. Uočena je statistički značajna razlika za PPD nakon 12 meseci na oralnoj strani...Expansion of new production technologies characterizes modern dentistry, as well as many new materials on the market. Comparing two materials under the same conditions is the best way for defining differences between them. Polyetheretherketone (PEEK) is a polymer that has many potential uses in dentistry, the same as already well-known lithium disilicate ceramics. Aim. The aim of this doctoral thesis was to compare lithium disilicate and polyetheretherketone (PEEK) implant screw-retained solo crowns using the split-mouth design for analyzing the success and survival rate, the esthetic and restoration satisfaction evaluation by patient subjective techniques, quality of life evaluation, aesthetic soft tissue parameters and aesthetic restoration parameters evaluated by the therapist, evaluation of peri-implant soft tissue healing and peri-implant bone resorption in different observation periods, measuring the time required for the crown production and the simplicity evaluation for production phases between the two observed groups of crowns. Materials and Methods. This study was conducted as a prospective randomized clinical study, with an observation period of one year, during which the results were analyzed and compared with each other at control intervals. The entire research was conducted at the Clinic for Dental Prosthetics and the Clinic for Oral Surgery, School of Dentistry, University of Belgrade. After the implant osseointegration period (BlueSky® (Bredent, Senden, Germany)), crowns were made of PEEK material veneered with composite materials (BioHpp®) and pressed lithium-disilicate ceramics (E.max press®) in cut-back body form veneered with feldspathic ceramic. Comparison of lithium-disilicate and poly-ether-ether-ketone (PEEK) implant-supported screw-retained crowns using split-mouth design was evaluated with subjective and objective parameters. The analyses included patient’s aesthetic assessment and dental restoration satisfaction using visual-analogue scales (VAS), quality of life using OHIP test, therapist’s aesthetic crown analysis using CIS (Copenhagen Index Score), Mombelli Plaque Index (MPI) and Bleeding Index (MBI), periimplant pocket depth (PPD), radiographic analysis of peri-implant bone resorption and time measurement required for making both types of restorations, which were evaluated by dental technicians, as well as evaluting the simplicity for production both observed groups of crowns. Results. Comparing the results between PEEK crowns and already studied lithium disilicate crowns, showed that there were no statistical significances in values of MPI and MBI clinical parameters in baseline time, after 6 and 12 months. Clinical examination of PPD showed a statistically significant difference in values of these clinical parameters measured after 12 months on the oral side. Results for VAS for the esthetics showed no statistically significant difference between the groups, while VAS for restoration satisfaction showed a statistically significant difference

Procena simptoma i znakova oralnih mekotkivnih poremećaja kod hospitalizovanih bolesnika sa shizofrenijom

Introduction Patients with schizophrenia are likely to constitute a high-risk group of individuals with respect to prevalence of oral diseases and they require special attention. Factors like nature of psychiatric disorders, length of stay and oral-side effects of psychotropic medications have been noted as contributors to poor oral health among institutionalized chronic psychiatric patients. Methods This cross-sectional study comprised 190 inpatients with schizophrenia at the Dr Laza Lazarevic Clinic for Mental Disorders in Belgrade, and 190 mentally healthy patients at the Clinic for Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade. A questionnaire was designed for the purpose of this research with the aim of recording information on demographic data (age and sex), unhealthy habits (tobacco smoking, alcohol consumption and drug abuse), and data about the existence of any oral symptom and/or sings related to oral soft tissue pathology. All participants were subjected to targeted clinical examinations. Results All study group patients were receiving psychotropic medications (mean number 4.18 ± 1.14; from 1 to 7 medications). The study group patients had a total of 272 symptoms and 121 signs of oral disorders; which was almost four times higher for symptoms and even nine times higher for signs of oral disorders than in the control group. Conclusion Schizophrenia as a mental disorder does not directly affect the condition of oral health of this group of psychiatric patients, but indirectly - reducing their motivation and awareness of the importance of oral health, which is particularly emphasized in hospital conditions.Uvod Hospitalizovani bolesnici sa shizofrenijom mogu da predstavljaju visoko rizičnu grupu osoba sa aspekta prevalencije oralnih oboljenja, te zahtevaju posebnu pažnju. Faktori poput prirode psihijatrijske bolesti, dužine hospitalizacije i neželjenih efekata psihotropnih medikamenata utiču na loše oralno zdravlje hospitalizovanih hroničnih psihijatrijskih bolesnika. Metode Ova studija preseka obuhvatila je 190 bolesnika sa shizofrenijom hospitalizovanih u Klinici za psihijatrijske bolesti "Dr Laza Lazarević" u Beogradu i 190 mentalno zdravih bolesnika Klinike za paradontologiju i oralnu medicinu Stomatološkog fakulteta Univerziteta u Beogradu. U svrhu ovog istraživanja dizajniran je upitnik sa ciljem beleženja demografskih podataka (starost i pol), loših navika (pušenje duvana, konzumiranje alkohola i zloupotreba droga) i podataka o postojanju bilo kojeg oralnog simptoma i/ili znaka koji se odnosi na patologiju mekih tkiva usne duplje. Svi učesnici bili su podvrgnuti ciljanim kliničkim pregledima. Rezultati Svi bolesnici iz studijske grupe primali su psihotropne lekove (srednja vrednost 4,18 ± 1,14, od jednog do sedam lekova). Bolesnici studijske grupe imali su ukupno 272 oralna simptoma i 121 znak oralnih oboljenja, što je skoro četiri puta više za oralne simptome, a čak i devet puta više za znake oralnih poremećaja nego u kontrolnoj grupi. Zaključak Shizofrenija kao mentalni poremećaj ne utiče direktno na stanje oralnog zdravlja ove grupe psihijatrijskih bolesnika, već indirektno - smanjujući im motivaciju i svest o značaju oralnog zdravlja, posebno u bolničkim uslovima

Evaluation of photodynamic therapy efficacy vs. conventional antifungal therapy in patients with poor-fitting dentures suffering from denture stomatitis. A prospective clinical study

Background: The long-term use of antifungal therapy in denture stomatitis (DS) treatment could be accompanied by antifungal-resistant strain onset, leading to compromised therapeutic procedure and disease reappearance. Photodynamic therapy (PDT) has shown the ability to eradicate oral infections and resistance strains. This prospective clinical study aimed to assess the PDT’s effectiveness compared to the conventional treatment on clinical and microbiological parameters in patients with DS without denture wear during the treatment and follow-ups. Methods: Forty-two patients diagnosed with DS were randomly assigned to one-session single PDT application (test group) or conventional antifungal therapy (control group). Clinical and microbiological parameters were assessed and analyzed before and at 3rd, 15th, and 30th day following the treatments. Microbiological samples were analyzed by a Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The data was statistically analyzed. Results: Prior to the treatment, Candida species, including C. albicans (100%), C. glabrata (33%), C. tropicalis (31%), C. krusei (31%) were isolated in all patients. Both treatment procedures demonstrated a statistically significant reduction in C. albicans at all follow-up time intervals (p < 0.05). However, PDT displayed a statistically significant reduction in C. krusei compared to the conventional treatment at all follow-up periods (p < 0.05). Clinical parameters improved considerably in the test group compared to the control group at the 3rd and 15th day of follow-up. Conclusion: One-session single PDT application demonstrated significant improvement in both clinical and microbiological outcomes in a short-term period, resulting in complete Candida spp. eradication compared to conventional antifungal therapy

The influence of restorative materials on implant-prosthodontic therapy success

Modernu stomatologiju karakteriše ogroman napredak u tehnologiji izrade zubnih nadoknada, ali i pojava velikog broja novih gradivnih materijala. Upoređivanje dva različita materijala pod istim uslovima jedan je od načina za razumevanje različitosti između njih. Poli-etar-etar-keton je polimer koji ima mnogo potencijala u stomatologiji, kao i već uveliko poznata litijum-disilikatna staklo keramika. Ciljevi. Cilj ove doktorske disertacije je bio da se uporede stepen preživljavanja i stepen uspešnosti implantatno-protetske terapije izradom litijum-disilikatnih i poli-etar-etar-keton (PEEK) implantatno nošenih zavrtnjem retiniranih pojedinačnih kruna metodom podeljenih usta, procena estetskih svojstava i zadovoljstva zubnih nadoknada, analiza kvaliteta života subjektivnim tehnikama pacijenata pre i nakon implantatno-protetske terapije, analiza estetskih parametara mekog tkiva i estetskih parametara samih nadoknada od strane terapeuta, procena periimplantatno mekotkivnog zarastanja i periimplantatne koštane resorpcije u različitim opservacionim periodima, merenje vremena potrebnog za izradu i procena jednostavnosti izrade obe vrste nadoknada od strane zubnih tehničara. Materijal i metod. Ovo istraživanje je sprovedeno kao prospektivna randomizovana klinička studija, sa opservacionim periodom od godinu dana, tokom kojeg su u kontrolnim intervalima rezultati analizirani i međusobno poređeni. Celokupno istraživanje sprovedeno je na Klinici za stomatološku protetiku i na Klinici za oralnu hirurgiju Stomatološkog fakulteta Univerziteta u Beogradu. Na ugrađenim implantatima BlueSky®(Bredent, Senden, Nemačka), nakon perioda oseointegracije, izrađene su krunice od PEEK materijala fasetirane kompozitnim materijalima (BioHpp®) i krunice od presovane litijum-disilikatne keramike (Ips e.max press®) u cut-back body formi, fasetirane feldspatnom keramikom. Upoređivanje je izvedeno metodom podeljenih usta litijum-disilikatnih i poli-etar-etar-keton (PEEK) implantatno nošenih zavrtnjem retiniranih pojedinačnih kruna pomoću subjektivnih i objektivnih parametara. Analizirani su stepen preživljavanja i uspešnosti nadoknada, estetska procena i zadovoljstvo zubnom nadoknadom evaluirana od strane pacijenata pomoću vizuelno-analogne skale (VAS), kvalitet života analiziran OHIP testom, terapeutska analiza nadoknade pomoću CIS (Copenhagen Index Score), Mombelijev plak indeks (MPI) i indeks krvarenja (MBI), dubina periimplantatnog džepa (PPD), radiografska analiza periimplantatne koštane resorpcije, vreme potrebno za izradu obe vrsta nadoknada, kao i procena jednostavnosti izrade nadoknada vizuelnoanalognom skalama (VAS) od strane zubnih tehničara. Rezultati. Analiza kvaliteta života pre i nakon postavljanja nadoknada nošenih implantatima pokazuje statistički značajnu razliku. Rezultati VAS za estetska svojstva ne pokazuju razliku, dok rezultati zadovoljstva nadoknadom ukazuju na statistički značajnu razliku između poređenih grupa. Poređenjem dobijenih rezultata PEEK krunica i litijum-disilikatnih krunica, nije uočena statistički značajna razlika merena za MBI i MPI u nultom vremenu, kao ni nakon 6 i 12 meseci. Uočena je statistički značajna razlika za PPD nakon 12 meseci na oralnoj strani...Expansion of new production technologies characterizes modern dentistry, as well as many new materials on the market. Comparing two materials under the same conditions is the best way for defining differences between them. Polyetheretherketone (PEEK) is a polymer that has many potential uses in dentistry, the same as already well-known lithium disilicate ceramics. Aim. The aim of this doctoral thesis was to compare lithium disilicate and polyetheretherketone (PEEK) implant screw-retained solo crowns using the split-mouth design for analyzing the success and survival rate, the esthetic and restoration satisfaction evaluation by patient subjective techniques, quality of life evaluation, aesthetic soft tissue parameters and aesthetic restoration parameters evaluated by the therapist, evaluation of peri-implant soft tissue healing and peri-implant bone resorption in different observation periods, measuring the time required for the crown production and the simplicity evaluation for production phases between the two observed groups of crowns. Materials and Methods. This study was conducted as a prospective randomized clinical study, with an observation period of one year, during which the results were analyzed and compared with each other at control intervals. The entire research was conducted at the Clinic for Dental Prosthetics and the Clinic for Oral Surgery, School of Dentistry, University of Belgrade. After the implant osseointegration period (BlueSky® (Bredent, Senden, Germany)), crowns were made of PEEK material veneered with composite materials (BioHpp®) and pressed lithium-disilicate ceramics (E.max press®) in cut-back body form veneered with feldspathic ceramic. Comparison of lithium-disilicate and poly-ether-ether-ketone (PEEK) implant-supported screw-retained crowns using split-mouth design was evaluated with subjective and objective parameters. The analyses included patient’s aesthetic assessment and dental restoration satisfaction using visual-analogue scales (VAS), quality of life using OHIP test, therapist’s aesthetic crown analysis using CIS (Copenhagen Index Score), Mombelli Plaque Index (MPI) and Bleeding Index (MBI), periimplant pocket depth (PPD), radiographic analysis of peri-implant bone resorption and time measurement required for making both types of restorations, which were evaluated by dental technicians, as well as evaluting the simplicity for production both observed groups of crowns. Results. Comparing the results between PEEK crowns and already studied lithium disilicate crowns, showed that there were no statistical significances in values of MPI and MBI clinical parameters in baseline time, after 6 and 12 months. Clinical examination of PPD showed a statistically significant difference in values of these clinical parameters measured after 12 months on the oral side. Results for VAS for the esthetics showed no statistically significant difference between the groups, while VAS for restoration satisfaction showed a statistically significant difference