Ganho ósseo apical a longo prazo após Instalação do implante combinado com elevação do seio maxilar sem enxerto.

Background: Assess changes in apical bone height / bone gain for up to 8 years after implant placement combined with simultaneous elevation of the internal sinus from the sinus floor (ISFE) without the use of a graft. Methods: 217 implants were placed in combination with ISFE without graft and successfully integrated into the posterior maxilla of 138 patients. Radiographs after surgery over an evaluation period of up to 8 years were analyzed. Changes in the apical and marginal bone height related to the implants were measured. Differences in bone height over the study period were assessed using the Wilcoxon test. To identify possible factors influencing apical bone gain and marginal bone loss, regressive linear regression selections and mixed linear regression models were performed. Results: In the apical aspects of the implants, significant mean vertical bone gain of 2.4 mm (mesial) and 2.6 mm (distal) was observed after 6 months (p <0.05). Radiographic analysis produced an additional bone gain of up to approximately 3.5 mm during the study period. The small initial bone height was crossed with a more pronounced apical bone gain (p <0.05). Conclusions: If the implants are placed in combination with the ISFE without a graft, a significant vertical bone gain can be expected, especially in the first postoperative year. Lower initial bone height is associated with a greater probability of greater bone gain.Fundo: Avaliar as alterações na altura óssea apical / ganho ósseo por até 8 anos após a colocação do implante combinada com elevação simultânea do seio interno do assoalho do seio (ISFE) sem o uso de enxerto. Métodos: 217 implantes foram colocados em combinação com ISFE sem enxerto e integrados com sucesso na maxila posterior de 138 pacientes. As radiografias após a cirurgia ao longo de um período de avaliação de até 8 anos foram analisadas. Alterações na altura óssea apical e marginal relacionadas aos implantes foram medidas. As diferenças na altura óssea ao longo do período do estudo foram avaliadas pelo teste de Wilcoxon. Para identificar possíveis fatores de influência no ganho ósseo apical e perda óssea marginal, foram realizadas seleções de regressão linear regressiva e modelos de regressão linear mista. Resultados: Nos aspectos apicais dos implantes, observou-se ganho ósseo vertical médio significativo de 2,4 mm (mesial) e 2,6 mm (distal) após 6 meses ( p  < 0,05). A análise radiográfica produziu ganho ósseo adicional de até aproximadamente 3,5 mm durante o período do estudo. A altura óssea inicial pequena foi cruzada com ganho ósseo apical mais pronunciado ( p  < 0,05). Conclusões: Se os implantes forem colocados combinados com o ISFE sem enxerto, pode-se esperar um ganho ósseo vertical significativo, especialmente no primeiro ano pós-operatório. Menor altura óssea inicial está associada a uma maior probabilidade de maior ganho ósseo

Disposable plastic trays and their effect on polyether and vinyl polysiloxane impression accuracy—an in vitro study

Objectives!#!To evaluate the dimensional accuracy of impressions taken by use of disposable stock plastic trays and to compare performance with that of metal trays.!##!Materials and methods!#!From a metallic model incorporating three precision balls and three abutment teeth, one-step dual-phase polyether (PE) and vinyl polysiloxane (VPS) impressions were taken using either metal or disposable plastic trays (n = 10 for each of the resulting four test groups). Respective plaster cast scans were aligned with the reference dataset to evaluate global (distance and angle deviations) and local (trueness and precision) accuracy. Analyses of variance (ANOVA) were conducted to determine group differences.!##!Results!#!For all impression tray and material combinations, global accuracy was good (mean distance changes < 100 μm) with greatest deviations being observed for distances exceeding one quadrant of the dental arch. In general, distances measured in the plaster casts were too short. Only VPS impressions with plastic trays showed a different behavior with a large percentage of cross-arch distances exceeding the reference value. Mean local accuracy ranged between 6 and 14 μm (trueness), and 6 and 16 μm (precision). On abutment tooth level, metal trays were associated with a significantly better precision (p = 0.015).!##!Conclusions!#!The observed distortions of the studied impression trays and materials are small and should enable satisfying clinical impression-taking.!##!Clinical relevance!#!Cleaning and processing of metal trays before re-use are time-consuming. Especially for patients' management with single crowns and small fixed dental prostheses, disposable plastic trays can be a viable and cost-effective alternative

Variability of sleep bruxism—findings from consecutive nights of monitoring

Objectives!#!To determine sleep bruxism (SB) behavior during five consecutive nights and to identify correlations between SB episodes per hour (SB index) and sleep-time masseter-muscle activity (sMMA).!##!Material and methods!#!Thirty-one participants were included in the study. Of these, 10 were classified as sleep bruxers (group SB-1) and nine as non-sleep bruxers (group non-SB). The bruxism status of these 19 patients was identified by means of questionnaires, an assessment of clinical symptoms, and electromyographic/electrocardiographic data (Bruxoff® device). The remaining 12 participants were also identified as bruxers, but based exclusively on data from the Bruxoff device (group SB-2). Data analysis included descriptive statistics and Spearman's correlation to assess the relationship between the SB index and sMMA.!##!Results!#!Participants in group SB-1 showed an overall mean SB index of 3.1 ± 1.6 and a mean total sMMA per night of 62.9 ± 38.3. Participants in group SB-2 had an overall mean SB index of 2.7 ± 1.5 and a mean total sMMA of 56.0 ± 29.3. In the non-SB group, participants showed an overall mean SB index of 0.8 ± 0.5 and a mean total sMMA of 56.8 ± 30.3. Spearman's correlation yielded values of - 0.27 to 0.71 for the correlation between sMMA and SB index.!##!Conclusions!#!The data revealed variable SB activity and the absence of a reliable correlation between sMMA and the SB index.!##!Clinical relevance!#!The high variation in SB activity and lack of correlation between sMMA and the SB index should be considered when diagnosing SB.!##!Trial registration!#!Clinical Trials [NIH], clinical trial no. NCT03039985

Which factors influence the oral health of nursing-home residents with cognitive and motor impairments?

Background!#!There is limited information available about the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments.!##!Aims!#!The purpose of this study was to identify factors influencing the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments.!##!Methods!#!The study was performed in nine nursing-homes in Germany. Sociodemographic and general data were collected for all participants (n = 150). The Clinical Dementia Rating (CDR) was used to identify the presence of dementia, and the Apraxia Screening Test (AST) was used to identify motor impairment. A comprehensive dental examination was also performed. This included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMFT). In addition, dental and denture hygiene were assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI). Univariate and multivariate regression models were used to analyse possible factors affecting the dependent target variables.!##!Results!#!In multivariate regression analysis, the factors that most strongly influenced greater PI were a lower number of medications taken (p = 0.018), poorer general health (p = 0.013) and the presence of dementia (p < 0.010). A more advanced age (p = 0.036) and longer nursing-home stay (p = 0.048) had a negative effect on the DHI. Furthermore, gender (p = 0.037, in favour of women), poorer general health (p = 0.003), presence of dementia (p = 0.003), and the absence of natural teeth (p = 0.028) influenced poorer oral health. The factors most strongly influenced greater number of missing teeth were a more advanced age (p = 0.021) and longer nursing-home stay (p = 0.015). In terms of fewer filled teeth, a shorter nursing-home stay (p = 0.002) was the factor most strongly influenced this.!##!Conclusions!#!Poorer general health and the presence of apraxia and cognitive impairment are the main determinants for poorer oral hygiene and oral health among nursing-home residents. A longer nursing-home stay also seems to be relevant for oral health and denture hygiene

Correlations between sleep bruxism and temporomandibular disorders

The aim of this study was to identify correlations between sleep bruxism (SB) and temporomandibular disorders (TMD) as diagnosed by means of the research diagnostic criteria for temporomandibular disorders (RDC/TMD). Sleep bruxism was diagnosed on the basis of I) validated questionnaires, II) clinical symptoms, and III) electromyographic/electrocardiographic data. A total of 110 subjects were included in the study. Fifty-eight patients were identified as bruxers and 52 as nonbruxers. A psychosocial assessment was also performed. An RDC/TMD group-I diagnosis (myofascial pain) was made for 10 out of 58 bruxers, whereas none of the nonbruxers received a diagnosis of this type. No significant differences were found between bruxers and nonbruxers with regard to RDC/TMD group-II (disc displacement) and group-III (arthralgia, arthritis, arthrosis) diagnoses. Somatization was significantly more common among bruxers than nonbruxers. Multivariate logistic regression analysis revealed that somatization was the only factor significantly correlated with the diagnosis of myofascial pain. The results of this study indicate a correlation between myofascial pain, as diagnosed using the RDC/TMD, and somatization. It seems that somatization is a stronger predictor of an RDC/TMD diagnosis of myofascial pain than sleep bruxism is

Ceramic Crowns and Sleep Bruxism: First Results from a Randomized Trial

Background: This randomized clinical trial was conducted to assess whether sleep bruxism (SB) is associated with an increased rate of technical complications (ceramic defects) in lithium disilicate (LiDi) or zirconia (Z) molar single crowns (SCs). Methods: Adult patients were classified as affected or unaffected by SB based on structured questionnaires, clinical signs, and overnight portable electromyography (BruxOff) and block randomized into four groups according to SB status and crown material (LiDi or Z): LiDi-SB (n = 29), LiDi-no SB (n = 24), Z-SB (n = 23), and Z-no SB (n = 27). Differences in technical complications (main outcome) and survival and success rates (secondary outcomes) one year after crown cementation were assessed using Fisher’s exact test with significance level α = 0.05. Results: No technical complications occurred. Restoration survival rates were 100% in the LiDi-SB and LiDi-no SB groups, 95.7% in the Z-SB group, and 96.3% in the Z-no SB group (p > 0.999). Success rates were 96.6% in the LiDi-SB group, 95.8% in the LiDi-no SB group (p > 0.999), 91.3% in the Z-SB group, and 96.3% in the Z-no SB group (p ≥ 0.588). Conclusions: With a limited observation time and sample size, no effect of SB on technical complication, survival, and success rates of molar LiDi and Z SCs was detected