The final bone height showed a moderate positive correlation (r = 0.43) with residual bone height, a statistically significant association (P = 0.0002). A moderate inverse correlation (r = -0.53) was established between residual bone height and augmented bone height, reaching statistical significance (p = 0.0002). Trans-crestally performed sinus augmentations produce uniformly good outcomes, with little disparity in results between experienced clinicians. In evaluating the pre-operative residual bone height, CBCT and panoramic radiographs produced equivalent findings.
Pre-operative CBCT measurements of mean residual ridge height yielded a value of 607138 mm, a figure mirroring the 608143 mm result from panoramic radiographs, with no statistically significant difference (p=0.535). A trouble-free postoperative healing period was observed in each and every case. The osseointegration of all thirty implants was successfully completed by the end of the six-month period. The mean final bone height across the group was 1287139 mm (1261121 mm for operator EM and 1339163 mm for operator EG), with a p-value of 0.019. Analogously, the average increase in postoperative bone height was 678157 mm. This translated to 668132 mm for operator EM and 699206 mm for operator EG, with a p-value of 0.066. Residual bone height and final bone height were found to be moderately positively correlated, as measured by a correlation coefficient of 0.43, with a highly significant p-value (p=0.0002). Statistically significant (p = 0.0002) moderate negative correlation was observed between the residual bone height and the augmented bone height, with a correlation coefficient of r = -0.53. Sinus augmentations performed trans-crestally produce results that are consistent, showing minimal inter-operator variability among experienced clinicians. Both CBCT and panoramic radiographs yielded a similar evaluation of pre-operative residual bone height.
Congenital tooth agenesis, a condition affecting children, whether or not part of a larger syndrome, can lead to oral difficulties with significant consequences for the child's physical and socio-psychological development. A 17-year-old girl, exhibiting severe nonsyndromic oligodontia, presented with the absence of 18 permanent teeth and a class III skeletal structure in this particular case. The difficulty of obtaining functional and aesthetically pleasing outcomes for temporary rehabilitation during growth and long-term rehabilitation in adulthood was substantial. The report on this case exemplifies the novel steps in oligodontia treatment, divided into two main sections for clarity. The osseous volume augmentation strategy, involving LeFort 1 osteotomy advancement and concurrent parietal and xenogenic bone grafting, is designed to increase bimaxillary bone volume for the facilitation of early implant placement while accommodating alveolar process growth. In prosthetic rehabilitation, utilizing screw-retained polymethyl-methacrylate immediate prostheses, while preserving natural teeth for proprioception, allows for the assessment of required vertical dimensional changes. This approach aims to improve the predictability of the functional and aesthetic results. This article on intellectual workflow difficulties pertaining to this case can be considered a valuable technical note for future reference.
A fracture of any implant component, although relatively infrequent, is a clinically important consideration when discussing dental implant complications. The mechanical construction of small-diameter implants makes them more vulnerable to such complications. This investigation, involving both laboratory and FEM methodologies, sought to differentiate the mechanical behavior of 29 mm and 33 mm diameter implants, equipped with conical connections, under controlled static and dynamic conditions, in accordance with the ISO 14801-2017 specifications. A study of stress distribution in tested implant systems under a 300 Newton, 30-degree inclined force was achieved by employing finite element analysis. Static tests were conducted employing a 2 kN load cell, applying the force to the experimental specimens at a 30-degree angle to the implant-abutment axis, with a 55 mm lever arm. Fatigue experiments, using a descending load sequence at a frequency of 2 Hertz, were performed until three samples endured 2 million cycles without sustaining any damage. WS6 supplier The finite element analysis identified the emergence profile of the abutment as the location of maximum stress; specifically, 5829 MPa for the 29 mm diameter implant and 5480 MPa for the 33 mm diameter implant complex. A 29 mm diameter implant displayed a mean maximum load of 360 N, whereas a 33 mm diameter implant showed a mean maximum load of 370 N. Antibiotic-siderophore complex Measurements of the fatigue limit yielded values of 220 N and 240 N, respectively. Despite the statistically superior performance of 33 mm implants, the distinctions among the implants tested are deemed clinically negligible in practice. Conical implant-abutment connections are believed to distribute stress effectively in the implant neck region, leading to enhanced fracture resistance.
The success of an outcome is measured by factors including satisfactory function, attractive aesthetics, clear phonetics, long-term stability, and minimal complications. This case report describes a mandibular subperiosteal implant that has achieved a successful follow-up spanning 56 years. A variety of factors were responsible for the long-term successful results; these factors included judicious patient selection, steadfast adherence to fundamental anatomical and physiological principles, the thoughtful design of the implant and superstructure, the meticulous execution of the surgical procedure, the application of appropriate restorative principles, conscientious oral hygiene, and a comprehensive re-care strategy. The case highlights the profound collaboration and synchronized efforts of the surgeon, restorative dentist, laboratory technicians, alongside the patient's sustained commitment. This patient's journey from dental cripple to restored oral function was facilitated by the mandibular subperiosteal implant procedure. The case's distinguishing characteristic is the exceptional length of its successful implant treatment, exceeding all documented instances in history.
In implant-supported bar-retained overdentures featuring cantilever bars, higher posterior loads result in elevated bending moments on the implants nearest the cantilever, and concomitant increased stress on the overdenture's constituent parts. Employing a new abutment-bar structural connection, this study investigated how to minimize bending moments and the associated stresses by facilitating enhanced rotational mobility of the bar on the abutment points. Modifications to the bar structure's copings involved the addition of two spherical surfaces, their centers aligned with the coping screw head's top surface centroid. A four-implant-supported mandibular overdenture, having its design enhanced through a novel connection, was adapted into a modified overdenture. For both classical and modified models, finite element analysis was performed to determine deformation and stress distribution. These models included bar structures with cantilever extensions in the first and second molar regions. The same methodology was used for analysis of the overdenture models, which lacked these cantilever bar extensions. Real-scale models of both designs, augmented with cantilever extensions, were built, assembled onto implants nestled within polyurethane blocks, and subjected to rigorous fatigue testing. To evaluate the strength of the implants, pull-out testing was performed on both models' devices. The innovative connection design resulted in enhanced rotational freedom for the bar structure, mitigating bending moments and lessening stress within the peri-implant bone and overdenture components, regardless of their cantilever status. Our research conclusively confirms the effects of bar rotational mobility on abutments, thereby validating the critical role of the abutment-bar connection geometry in structural design.
The objective of this study is to develop a comprehensive strategy for the combined medical and surgical management of neuropathic pain related to dental implants. Based on the good practice guidelines set forth by the French National Authority for Health, the methodology was developed, with data sourced from the Medline database. From a compilation of qualitative summaries, a working group has developed a first draft of professional recommendations. By the hands of an interdisciplinary reading committee's members, the consecutive drafts were revised. Scrutinizing a total of ninety-one publications, twenty-six were selected to form the basis of the recommendations. This selection included one randomized clinical trial, three controlled cohort studies, thirteen case series, and nine individual case reports. For the prevention of post-implant neuropathic pain, a thorough radiological examination, at least using a panoramic radiograph (orthopantomogram) or preferably a cone-beam computed tomography scan, is required to precisely determine the implant tip's distance, ensuring it is placed more than 4 mm from the mental nerve's anterior loop for anterior implants and 2 mm from the inferior alveolar nerve for posterior implants. Administering a high dose of steroids early, potentially in conjunction with a partial or full implant removal, ideally within 36 to 48 hours of placement, is recommended. The incorporation of anticonvulsants and antidepressants within a cohesive pharmacological regimen may serve to decrease the risk of chronic pain development. To address nerve lesions occurring during or after dental implant surgery, a course of action including potentially removing the implant (fully or partially), along with early pharmacological therapy, should begin within 36 to 48 hours.
Preclinically, polycaprolactone's performance as a biomaterial for bone regeneration is notable for its speed. Hepatic decompensation Two clinical cases in the posterior maxilla form the basis of this report, which details the inaugural clinical use of a custom-made 3D-printed polycaprolactone mesh for alveolar ridge augmentation. The selection process for dental implant therapy focused on two patients who needed extensive ridge augmentation.