Actual Practical Attitude and Knowledge of Dental Implants among Senior Dental Students and General Dentists Graduated from Some Saudi and Non-Saudi Dental Schools

Objective: To assess the actual practical attitude and knowledge of dental implants among senior dental students and general dentists graduated from some Saudi and Non-Saudi dental schools. Methods: A total of 300 senior dental students and general dentists participated in the study. Hard copies of the self-designed, multiple-choice questionnaires were distributed to all participants. The questionnaire consisted of 31 questions in five parts. Data were collected and analyzed using Chi-square test and t-test, where p Results: There is a statistically significant relationship between the participants’ answers, and their dental schools. Participants’ general knowledge, training, and teaching of dental implants, as well as information about restorations retained for the dental implants, were higher among participants from Saudi dental schools than participants from non-Saudi dental schools, while the information about dental implants was higher among participants from non-Saudi dental schools than participants from Saudi dental schools. Conclusion: We conclude that the actual practical attitude and knowledge of dental implants among participants in the current study was insufficient. Therefore, dental implant education in the undergraduate curricula of dental schools surveyed should be updated to include teaching, laboratory training, and preclinical and clinical training.

Impact of osteoporosis in dental implants:A systematic review

AIM: To assess the failure and bone-to-implant contact rate of dental implants placed on osteoporotic subjects. METHODS: Extensive examination strategies were created to classify studies for this systematic review. MEDLINE(via Pub Med) and EMBASE database were examined for studies in English up to and including May 2014. The examination presented a combination of the MeS H words described as follow: "osteoporosis" or "osteopenia" or "estrogen deficiency" AND "implant" or "dental implant" or "osseointegration". Assessment of clinical and/or histological peri-implant conditions in osteoporosis subjects treated with titanium dental implants. The examination included a combination of the MeS H terms described as follow: "osteoporosis" or "osteopenia" or "estrogen deficiency" AND "implant" or "dental implant" or "osseointegration".RESULTS: Of 943 potentially eligible articles, 12 were included in the study. A total of 133 subjects with osteoporosis, 73 subjects diagnosed with osteopenia and 708 healthy subjects were assessed in this systematic review. In these subjects were installed 367, 205, 2981 dental implants in osteoporotic, osteopenic and healthy subjects, respectively. The failure rate of dental implant was 10.9% in osteoporotic subjects, 8.29% in osteopenic and 11.43% in healthy ones. Bone-to-implant contact obtained from retrieved implants ranged between 49.96% to 47.84%, for osteoporosis and non-osteoporotic subjects. CONCLUSION: Osteoporotic subjects presented higher rates of implant loss, however, there is a lower evidence to strengthen or refute the hypothesis that osteoporosis may have detrimental effects on bone healing. Consequently, final conclusions regarding the effect of osteoporosis in dental implant therapy cannot be made at this time. There are no randomized clinical trial accessible for evaluation and the retrospectivenature of the evaluated studies shall be taken in account when interpreting this study.

Improvement of Systemic Symptoms after Dental Implant Removal

Dental implants have spread worldwide in dentistry. The risks and complications reported are limited to local issues. However, in this case, a patient complained of systemic symptoms after dental implantation. This case report aims to demonstrate that systemic symptoms such as lumbago, shoulder stiffness, neck pain, hip joint pain, and facial pain improved after the removal of well-osseointegrated titanium implants. The results suggest that harmful electromagnetic waves received by implants affect body conditions;however, to date, the underlying mechanisms have not been identified. Therefore, further research is required.

Optics‑guided Robotic System for Dental Implant Surgery

At present,dental implant surgery mainly relies on the clinical experience of the doctor and the assistance of preoperative medical imaging.However,there are some problems in dental implant surgery,such as narrow space,sight obstruction,inaccurate positioning,and high requirements of doctors’proficiency.Therefore,a dental implant robot system(DIRS)guided by optical navigation is developed in this study,with an x-shaped tool and an irregular pentagonal tracer are designed for spatial registration and needle tip positioning strategy respectively.The coordinate system of each unit in DIRS is unified through system calibration,spatial registration,and needle tip positioning strategy.Then the surgical path is planned on the computed tomography(CT)images in the navigation software before operation.The automatic positioning method and the auxiliary positioning method can be used in the operation to achieve accurate positioning and assist doctors to complete the operation.The errors of spatial registration,needle tip positioning strategy,and the overall accuracy of the system were evaluated respectively,and the results showed that they all met the needs of clinical surgery.This study preliminarily verified the feasibility of the precise positioning method for dental surgery robots and provided certain ideas for subsequent related research.

Posterior partially edentulous jaws, planning a rehabilitation with dental implants

AIM: To discuss important characteristics of the useof dental implants in posterior quadrants and the rehabilitation planning. METHODS: An electronic search of English articles was conducted on MEDLINE(PubM ed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. RESULTS: One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations(bone quantity and density), radiographic techniques, implant selection(number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. CONCLUSION: The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

Surface treatment of titanium dental implant with H2O2 solution

The surface treatment is important for titanium and its alloys as promising candidates for dental implantation due to their bioinert surface.Titanium surface samples were modified using H2O2 solution at different times up to 72 h to boost their bioactivity.According to the results of the field emission scanning electron microscopy test,some nanostructures are formed on the surface of treated titanium samples and increased in size by increasing the time of treatment up to 24 h.After 24 h of application,the sharpness of nanostructures decreased and the micro-cracks and discontinuity in the coating surface increased.The results of the X-ray diffraction study and Raman spectroscopy revealed that anatase(TiO2)was formed on the surface of treated titanium samples.The peak intensity of Raman spectroscopy increased with an improvement in treatment time of up to 24 h and then decreased due to the discontinuity of the coating.Full wettability and ability to form apatite were reached at 6 h of treatment.It is clear that the treatment time has a significant effect on the surface treatment of titanium using the H2O2 solution.

Oblique Cutting Based Mechanical Model for Insertion Torque of Dental Implant

The insertion torque of a dental implant is an important indicator for the primary stability of dental implants.Thus,the preoperative prediction for the insertion torque is crucial to improve the success rate of implantation surgery.In this present research,an alternative method for prediction of implant torque was proposed.First,the mechanical model for the insertion torque was established based on an oblique cutting process.In the proposed mechanical model,three factors,including bone quality,implant geometry and surgical methods were considered in terms of bone-quality coefficients,chip load and insertion speeds,respectively.Then,the defined bone-quality coefficients for cancellous bone with the computed tomography(CT)value of 235–245,345–355 and 415–425 Hu were obtained by a series of insertion experiments of IS and ITI implants.Finally,the insertion experiments of DIO implants were carried out to verify the accuracy of developed model.The predicted insertion torques calculated by the mechanical model were compared with those acquired by insertion experiments,with good agreement,the relative error being less than 15%.This method allows the insertion torque for different implant types to be quickly established and enhances prediction accuracy by considering the effects of implants’geometries and surgical methods.

Mechanical Experiment for 3D Printing of Titanium Bone Bionic Dental Implants

[Objectives] To explore the flexural strength of 3D printed titanium bone bionic dental implants and provide a scientific basis for the clinical application of 3D printed porous bionic bone dental implants. [Methods] The cone-beam CT( CBCT) image information of 20 premolars extracted by orthodontic requirement was collected,and a new porous bone bionic dental implant was produced using modeling software and 3D printer. The premolars were divided into two groups( A and B). The universal testing machine was used to test the flexural strength of the two groups and the difference in flexural strength between the two groups was compared through statistics. [Results]Twenty 3D printed porous titanium bone bionic implants were accurately produced; the morphology of group A and group B were extremely similar to each other; the average flexural strength of group A was 2 767. 92 N,while the average flexural strength of group B was 778. 77 N,showing that the average flexural strength of group A was significantly higher than that of group B,and the difference was statistically significant( P < 0. 05).[Conclusions]The personalized porous structure root implants produced by 3D printing technology are very similar to the target tooth morphology,and show high accuracy and small error of production. Besides,the flexural strength of 3D printed personalized porous structure root implants can fully meet the requirements of the maximum occlusal force for dental implant restoration. It is expected to provide a scientific basis for clinical application of 3 D printed porous bionic bone tooth implants.

I Do Biotech Dental Implants: Prospective Multicentric Study after 5 Years of Functional Loading

Introduction: I Do Biotech’s implants were developed starting in 2014. Since then, they obtained GMP and KFDA licenses for distribution in 2015. The main objective of this paper is to determine the survival rate of I Do Biotech implants five years after the first surgery. Material and Methods: 1000 implants were used on 480 prostheses across 10 clinics on 320 healthy, non-smoker and non-diabetic patients, chosen at random, of which 160 are male and 160 female, all in the age range of 30 to 50 years old. The failure rate was studied related to the patient’s gender, the length and diameter of the implant, anatomical location, the percentage of peri-implantitis, prosthodontic failures and the patient’s quality of life. Discussion: The results obtained are similar to those of Van Steenberghe D. Dieter-Busenlechner, E. Serrano Catauria and far superior to those of Sáenz Guzmán. Failure rates vary greatly from study to study due to the heterogeneity of the samples in the other research papers. Conclusion: The overall implant failure rate at 5 years is 1.7%. The factors affecting significantly the survival rate are: the implant diameter, its length and the anatomic area. Failure ratios increase significantly when the diameter or the length of the implant decreases, and when they are placed in the posterior maxilla (up to 4.3%). The rate of peri-implantitis is 5.1%. The prosthodontic failure rate is 2.91%. The improvement in quality of life and satisfaction increases with the years.

Ultrastructural Characterization of the Titanium Surface Degree IV in Dental Implant Aluminum Free (Acid Attack)

Following the worldwide trend of developing heavy metal free materials, dental implants aren’t out of this tendency. Over the years, a number of techniques to condition the surface of dental implants have been designed and used such as oxide blasting, however the scientific medical community has been concerned about the use of these heavy metals which leads us to investigate and develop new conditioning techniques. The aim of the study was the analysis of the Systhex® implant surface in automatic system for the treatment of the surface with acid, where we can identify the surfaces purity level, pore size, deepness and especially the roughness proportionated by the technology of acid conditioning on the titanium surfaces of degree IV dental implants. We conclude that the automatic conditioning of acid attack promoted cleanliness, homogeneity and ideal roughness for the osseointegration process.

Reactivity of Titanium Dental Implants in Salivary Environment in the Presence of Foods Consumed in the Republic of the Congo

In this work, samples of titanium dental implants in salivary environment in the presence of certain foods were studied. 24 samples were prepared and subjected to the reactivity of certain foods for 6, 5, 6 and 7 weeks. The ICP-MS technique was used to analyze the prepared samples. The results obtained showed no corrosion of the titanium alone in an artificial salivary medium. Significant corrosion was observed in the presence of food, which is manifested by the presence of traces of titanium in the samples.

Dental Implant Patients Grouped by the Brinkman Index: Their Attitude toward Smoking, Nicotine Dependence, and Knowledge of Peri-Implantitis

Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.

Survival of dental implants in patients with bone dysplasia:A systematic review

Objective:This study used published studies to assess the survival rate of dental implants placed in patients with bone dysplasia of the maxillofacial region.Material and methods:An electronic search without a specified date range was performed using the MEDLINE,PubMed,EMBASE,Web of Science,and Cochrane databases.No gender or age restrictions were applied.Results:Eighteen publications were found that met the study’s criteria,reporting data on 18 patients with bone dysplasia including cleidocranial dysplasia(CDD),fibrous dysplasia(FD),florid cemento-osseous dysplasia(FCOD),and odonto-maxillary segmental dysplasia(SOMD),who received a total of 130 implants,an average of 7.2 implants/patient(range 1 to 16).The mean age of the patients was 36.7 years(range 15 to 70 years).For implants placed in bone dysplasia,the survival rates were 100% for patients with CDD(n=8),FD(n=5),SOMD(n=2),FCOD with implants inserted far from the lesions(n=2)and 0% for dental implants inserted within FCOD(n=1).The mean follow-up was 38.2 months(min 6,max 60).Conclusions:Dental implants placed in patients with dysplastic bone lesions show high survival rates,similar to those in the general population for CDD,FD,and SOMD.For FCOD,the failure rate was 100%.

Maxillo-mandibular rehabilitations with very early osteointegrated dental implants for severe hypodontia and anodontia related to ectodermal dysplasia

The ectodermal dysplasias are rare diseases with hypodontia, hypotrichosis and hypohidrosis. The subject's life is considerably constrained and this from an early age, with major difficulties for the integration and acceptance of conventional prosthetic occlusal rehabilitation. The use of implants is an integral part of early treatment, in the regions of stable growth, that is to say symphysis. In two childs of 5 and 6 years we have made implant-borne prosthetic rehabilitation in the maxilla and the mandible. Aesthetic and social evaluation were positive. We have restored the normal oro-facial functions for the correct development of skeletal bases. They acted as an external fixator intraoral, stimulating the growth by the function. Our question was: can we leave a child throughout his childhood and adolescence with a not suitable removable prosthesis, under the pretext of growth unfinished?

A Comparative Analysis on the Curative Effects of Different Treatment for Infections Around Dental Implants

Objective:To analyze and evaluate the clinical efficacy of different treatment options for patients with peri-implant infection.Methods:The study period was from June 2019 to June 2020.Seventy-six patients with peri-implant infection that were treated in Stomatological Hospital of Hefei were selected as study samples.The patients were divided into a research group and a control group by random number table method in which the sample size of each group was n=38.Patients in the control group were treated with drugs combined with ultrasonic cleaning while patients in the research group were treated with guided bone regeneration combined with flap curettage.The indicators of the two groups were compared and analyzed.Results:The plaque index(PLI),probing depth(PD),and sulcus bleeding index(SBI)of the two groups after treatment were lower than those before treatment(P<0.05).There was no significant difference between the groups(P>0.05).However,the height of the implant marginal bone of the study group after treatment was higher than that of the control group(P<0.05)..Conclusion:The use of guided bone regeneration combined with flap curettage for patients with infection around dental implants promotes the fusion of bone and implants.The clinical effect was significant and this should be comprehensively promoted in medical institutions at all levels.

Micromotions and combined damages at the dental implant/bone interface

Micromotion and fretting damages at the dental implant/bone interface are neglected for the limitation of check methods, but it is particularly important for the initial success of osseointegration and the life time of dental implant. This review article describes the scientific documentation of micromotion and fretting damages on the dental implant/bone interface. The fretting amplitude is less than 30 mm in vitro and the damage in the interface is acceptable. While in vivo, the micromotion's effect is the combination of damage in tissue level and the real biological reaction.

Dental implant treatment for renal failure patients on dialysis:a clinical guideline

Chronic kidney disease(CKD) is a worldwide public health problem that is growing in prevalence and is associated with severe complications. During the progression of the disease, a majority of CKD patients suffer oral complications. Dental implants are currently the most reliable and successful treatment for missing teeth. However, due to complications of CKD such as infections,bone lesions, bleeding risks, and altered drug metabolism, dental implant treatment for renal failure patients on dialysis is more challenging. In this review, we have summarized the characteristics of CKD and previous publications regarding dental treatments for renal failure patients. In addition, we discuss our recent research results and clinical experience in order to provide dental implant practitioners with a clinical guideline for dental implant treatment for renal failure patients undergoing hemodialysis.

Osteoblast integration of dental implant materials after challenge by sub-gingival pathogens: a co-culture study in vitro

Sub-gingival anaerobic pathogens can colonize an implant surface to compromise osseointegration of dental implants once the soft tissue seal around the neck of an implant is broken. In vitro evaluations of implant materials are usually done in monoculture studies involving either tissue integration or bacterial colonization. Co-culture models, in which tissue cells and bacteria battle simultaneously for estate on an implant surface, have been demonstrated to provide a better in vitro mimic of the clinical situation. Here we aim to compare the surface coverage by U2 OS osteoblasts cells prior to and after challenge by two anaerobic sub-gingival pathogens in a co-culture model on differently modified titanium(Ti), titanium-zirconium(Ti Zr) alloys and zirconia surfaces. Monoculture studies with either U2 OS osteoblasts or bacteria were also carried out and indicated significant differences in biofilm formation between the implant materials, but interactions with U2 OS osteoblasts were favourable on all materials. Adhering U2 OS osteoblasts cells, however,were significantly more displaced from differently modified Ti surfaces by challenging sub-gingival pathogens than from Ti Zr alloys and zirconia variants. Combined with previous work employing a co-culture model consisting of human gingival fibroblasts and supra-gingival oral bacteria, results point to a different material selection to stimulate the formation of a soft tissue seal as compared to preservation of osseointegration under the unsterile conditions of the oral cavity.

Effect of High Positive Acceleration(+Gz) Environment on Dental Implant Osseointegration:A Preliminary Animal Study

Objective To observe the effect of high positive acceleration(+Gz) environment on dental implant osseointegration in a rabbit model and to investigate its mechanism.Methods Forty-eight New Zealand white rabbits were randomly divided into 6 groups. The rabbit’s mandibular incisors were extracted and 1 implant was placed in each socket immediately. After 1 week of rest, the rabbits were exposed to a high +Gz environment, 3 times a week. The rabbits were sacrificed at 3 weeks(2 weeks +Gz exposure), 5 weeks(4 weeks +Gz exposure), and 12 weeks(4 weeks +Gz exposure and 7 weeks normal environment) after surgery, respectively. Specimens were harvested for micro-CT scanning, histological analysis, and real-time polymerase chain reaction examination.Results Compared with those in the control group, the mRNA expression levels of bone morphogenetic protein-2(BMP-2), osteopontin(OPN), and transforming growth factor-β1(TGF-β1)were significantly lower(P < 0.05), while the mRNA expression level of receptor activator of nuclear factor κB ligand(RANKL) and the RANKL/osteoprotegerin(OPG) ratio were significantly higher(P < 0.05)at 3 weeks;values of bone volume fraction, trabecular number, bone-implant contact(BIC), and TGF-β1 and OPG mRNA expression levels were significantly lower(P < 0.05), and the value of trabecular separation, RANKL mRNA expression level and RANKL/OPG ratio were significantly higher(P < 0.05) at 5 weeks;and the value of BIC was still significantly lower(P < 0.05) at 12 weeks in the experimental group.Conclusion Early exposure to the high +Gz environment after implant surgery might have an adverse effect on osseointegration, and its mechanism could be related to the inhibition of osteoblast activity and promotion of osteoclast activity.

Investigation of a new design for zirconia dental implants

Objective:To assess the biomechanical properties of a new design configuration for zirconia dental implants. Methods: The new design has a cylindrical shape that is partially hollow and porous in the bottom, which permits the implants to be locked into the alveolar bone over time. It also utilizes bioactive glass coatings to increase adhesion to surrounding bone structure. Samples of the new design were fabricated in the laboratory and their material strength, hardness, and fracture toughness were evaluated. In addition, biocompatibility of the new design was evaluated through testing in dogs. Results: Results of mechanical tests indicate that structural properties of the new design exceed the usual requirements for implants. Moreover, animal tests suggest that there is appreciable improvement in lock-in strength and osteointegration. Conclusion: The new design configuration is biomechanically feasible and further research is warranted to improve the design for human use.