Complications associated with the ball, bar and locator attachments for implant-supported overdentures

Background: The purpose of this clinical study was to evaluate the complications associated with the different attachments used in implant-supported overdentures, including prosthetic problems and implant failures. A comparison of ball, bar and Locator (Zest Anchors, Inc, homepage, Escondido, CA, USA) attachments, in completely edentulous patients with two, three or four implants, was conducted. Material and methods: A total of 36 edentulous patients (20 female, 16 male) with a mean age of 66.3 years, were enrolled in the study. The patients were treated with 95 implants, for the prosthetic restoration of the maxilla or the mandible. The mean follow-up time was 41.17 months. Prosthetic complications including, fractured overdentures, replacements of O-ring attachment and retention clips, implant failures, hygiene problems, mucosal enlargements, attachment fractures, retention loss and dislodgement of the attachments were recorded and evaluated. The recall visits at 3, 6, 12 months and, annually thereafter. Results: Fourteen complications in the ball attachment group and 7 complications in the bar group were observed. No complications were observed in the locator group. The difference was found to be as statistically significant (p=0,009). Six of the 95 implants had failed. Totally 39 implant overdentures were applied. Three prostheses were renewed because of fractures. Conclusion: Within the limits of the present study, it was concluded that the locator system showed superior clinical results than the ball and the bar attachments, with regard to the rate of prosthodontic complications and the maintenance of the oral function. © Medicina Oral S. L

Platelet-Rich Plasma in Trauma Patients

Platelet-rich plasma (PRP) was mixed with thrombin and excess calcium resulting in activated platelets trapped within the fibrin network; within the matrix, platelets secrete bioactive substances that diffuse into the surroundings tissues. PRP is prepared from the patient’s own blood, a variety of manufacturing techniques in vastly different cell counts, and growth factor concentrations. The clinical use of PRP is treatment of soft tissue diseases and injuries, treatment of burns, hard-to-heal wounds, tissue engineering, and implantology in dentistry. An essential criterion for PRP is for it to be autologous, for the donor of the blood, and the recipient of the PRP to the same person. Most of the literatures suggest that PRP does not appreciably impact bone healing or induce bone formation. PRP might augment recruitment of osteoblast progenitors to injection sites or in sites expected to experience delayed healing. In this capacity, PRP might be utilized to initiate repair of an otherwise poorly healing bony lesion. PRP stimulates bone repair in fractures. Early through late healing process is compromised with fractures, including reduced cell proliferation, delayed chondrogenesis, and decreased biomechanical properties. In this chapter, the importance of the PRP in oral and maxillofacial surgery in trauma patients is studie

Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm) Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months), the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur

Biomaterial Used in Trauma Patients

The development of bone tissue engineering and bone regeneration is always of interest to improve methods to reduce costs of trauma patient. Ability to use autogenous bone forming cells attached to bone morphogenetic proteins would be ideal. There are many clinical reasons to develop bone tissue engineering alternatives, for use in the reconstruction of large defects and implants. The traditional methods of bone defect management include autografting and allografting cancellous bone, vascularized grafts, and other bone transport techniques. However, these are the standard treatments. Since bone grafts are avascular and dependent on the size of the defect, the viability can limit their application. In large defects, the grafts can be resorbed by the body before osteogenesis is complete; tissue loss develops in the living organism due to infection, trauma, congenital, and physiological reasons. Placing tissue defects in the dentist and maxillofacial surgery and accelerating wound healing are an important issue. From an old Egypt, material used in treatment of different doctors with various causes. Oral surgery, periodontology, and implantology, which are surgical branches of the dentistry, need to increase bone formation in the treatment of bone defects, congenital defects, and defects around the implant. Many years of work have been done to obtain ideal biomaterials, and many materials have been used. We have prepared detailed information on biomaterials used in dentistry, oral, and maxillofacial surgeries in this book to help dentists and dental students

Factors associated with dental caries among institutionalized residents with schizophrenia in Taiwan: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Little research has been done on the relationship between dental caries and the personal characteristics of institutionalized residents diagnosed with schizophrenia. This study investigates the individual and treatment factors associated with the dental caries among institutionalized residents with schizophrenia in Taiwan.</p> <p>Methods</p> <p>An oral health survey of institutionalized residents with schizophrenia in the largest public psychiatric hospital was conducted in Taiwan in 2006. Based on this data, multiple logistic analyses were used to determine the relationship between some explanatory variables and the outcome variables of dental caries among subjects with schizophrenia.</p> <p>Results</p> <p>Among the 1,108 subjects with schizophrenia, age was the only variable independently associated with DMFT > 8 (OR = 7.74, 95% CI = 3.86-15.55, p < 0.001 in comparison to residents aged 65 + years vs. 20-44 years; OR = 3.06, 95% CI = 2.03-4.61, p < 0.001 in comparison to residents aged 55-64 years vs. 20-44 years) after making adjustments for other explanatory variables. In addition, those with an education of only elementary school (OR = 1.67, 95% CI = 1.08-2.56, p = 0.021), low income (OR = 1.58, 95% CI = 1.02-2.44, p = 0.039), and length of stay (LOS) of > 10 years (OR = 2.09, 95% CI = 1.30-3.37, p = 0.002) were associated with a care index < 54.7%. Older age, lower educational level, and longer hospital stays were associated with number of remaining teeth being < 24.</p> <p>Conclusions</p> <p>Aging was the most important factor related to a high level of dental caries. Low educational level, low income, and LOS were also associated with the indicators of dental caries among institutionalized subjects with schizophrenia. It is necessary to address the treatment factors such as prolonged stay in institutions when decision-makers are planning for preventive strategies of oral health for institutionalized residents with schizophrenia.</p

Reaction of rat connective tissue to mineral trioxide aggregate and diaket

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to compare the reaction of rat connective tissue to two root-end filling materials: white Mineral Trioxide Aggregate (WMTA) and Diaket.</p> <p>Methods</p> <p>Each of the materials was placed in dentine tubes and implanted subcutaneously in the dorsal connective tissue of 21 Wistar albino rats. Tissue biopsies were collected 7, 30, and 60 days after the implantation procedure. The specimens were processed and stained with hematoxylin and eosin and examined microscopically. After determining inflammatory cell numbers in sections from each specimen, inflammatory reaction scores were defined as follows: 0; no or few inflammatory cells (no reaction), 1; less than 25 cells (mild reaction), 2; 25 to 125 cells, (moderate reaction), and 3; 125 or more cells (severe reaction). Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney tests.</p> <p>Results</p> <p>There were statistically significant differences in the median inflammatory cell numbers throughout the three test periods, with the most severe degree of inflammation observed at the one-week period. Few cases of necrosis were observed with WMTA. Diaket exhibited the most severe degree of inflammation and necrosis. After 30 days, both materials provoked moderate inflammatory reaction. The eight-week period showed the least severe degree of inflammation in all groups.</p> <p>Conclusions</p> <p>It was concluded that WMTA exhibits a more favourable tissue response compared with Diaket which induced more severe inflammatory reaction than WMTA and the control.</p