Enhancing bone tissue engineering using iron nanoparticles and magnetic fields: A focus on cytomechanics and angiogenesis in the chicken egg chorioallantoic membrane model.

AIM: To evaluate the potential of iron nanoparticles (FeNPs) in conjunction with magnetic fields (MFs) to enhance osteoblast cytomechanics, promote cell homing, bone development activity, and antibacterial capabilities, and to assess their in vivo angiogenic viability using the chicken egg chorioallantoic membrane (CAM) model. SETTINGS AND DESIGN: Experimental study conducted in a laboratory setting to investigate the effects of FeNPs and MFs on osteoblast cells and angiogenesis using a custom titanium (Ti) substrate coated with FeNPs. MATERIALS AND METHODS: A custom titanium (Ti) was coated with FeNPs. Evaluations were conducted to analyze the antibacterial properties, cell adhesion, durability, physical characteristics, and nanoparticle absorption associated with FeNPs. Cell physical characteristics were assessed using protein markers, and microscopy, CAM model, was used to quantify blood vessel formation and morphology to assess the FeNP-coated Ti's angiogenic potential. This in vivo study provided critical insights into tissue response and regenerative properties for biomedical applications. STATISTICAL ANALYSIS: Statistical analysis was performed using appropriate tests to compare experimental groups and controls. Significance was determined at P < 0.05. RESULTS: FeNPs and MFs notably improved osteoblast cell mechanical properties facilitated the growth and formation of new blood vessels and bone tissue and promoted cell migration to targeted sites. In the group treated with FeNPs and exposed to MFs, there was a significant increase in vessel percentage area (76.03%) compared to control groups (58.11%), along with enhanced mineralization and robust antibacterial effects (P < 0.05). CONCLUSION: The study highlights the promising potential of FeNPs in fostering the growth of new blood vessels, promoting the formation of bone tissue, and facilitating targeted cell migration. These findings underscore the importance of further investigating the mechanical traits of FeNPs, as they could significantly advance the development of effective bone tissue engineering techniques, ultimately enhancing clinical outcomes in the field.

Clinical applications of the T-Scan quantitative digital occlusal analysis technology: a systematic review.

STATEMENT OF THE PROBLEM: Occlusion is associated with all disciplines of dentistry and plays a major role in the longevity of both implant- and tooth-borne restorations. Achieving occlusal harmony ensures balance is established between the dental and myofascial structures, which can be measurably established to high numerical tolerances with the T-Scan digital occlusal analysis system. PURPOSE: To describe and evaluate the known and proven applications of T-Scan digital occlusal analysis in various dental practice disciplines through a systematic review of the literature. MATERIALS AND METHODS: An electronic, English-language PubMed/MEDLINE and Cochrane Central Registry of Controlled Trials database search using the keywords "T-Scan," "TMD," "Occlusion," "Implant Protected Occlusion," and "Orthodontics" was conducted without any date restrictions. The related journal findings were hand searched to determine studies that met the eligibility criteria for inclusion in the present systematic review. RESULTS: The PubMed/MEDLINE search identified 423 articles. After removing duplicates, the titles and abstracts of the remaining 421 studies were screened. 274 ineligible articles were excluded, leaving 147 articles. Of those, 33 articles were not in English, 27 full-text articles were not available, 4 were comments and letters to editors, 1 was a review, and 2 described techniques. A total of 86 articles met the eligibility criteria for inclusion. CONCLUSION: Much scientific evidence supports the use of T-Scan, as it measures relative occlusal contact forces and the time sequence durations of occlusal contacts objectively, accurately, and repeatedly for improved treatment outcomes. The system's hardware, sensor, and software evolution from T-Scan I to today's T-Scan 10 Novus system has overcome early sensor and system drawbacks to improve the clinical performance of T-Scan in many disciplines of dental medicine.

Influence of chitosan and Cissus quandrangularis coating on osseointegration in titanium implants in rabbits: A preclinical in vivo study.

BACKGROUND: Titanium (Ti) implants has been criticized for the tiring wait for osseointegration, often making the patient reconsider implant treatment. Surface treated Ti implants are emerging as a promising solution with superior osseointegration, early loading protocols and shortened period of edentulousness. The aim of this study is to assess the osseointegration of Ti surface coated with novel Cissus quandrangularis Chitosan Hydrogel (CqChH) compared to Commercially pure (Cp) implants. METHODS: 24 Cp Ti implants were divided into 2 subgroups (n = 12). The test group consisted of Ti implants surface treated with the novel hydrogel and control group consisted of Cp Ti implants. 3 % CqChH was prepared and was coated on the Ti implants prior to placement in the femur and tibial heads of rabbits. Implant Stability Quotient (ISQ) was recorded at the 6th and 12th week. Animals were sacrificed and subjected to Removal Torque Quotient (RTQ). The samples were retrieved en bloc and stained for histopathologic analysis. The collected data was subjected to statistical analysis using Unpaired student t-Test. RESULTS: At the end of 6th week CqChH coated implants did not show any statistically significant difference in both ISQ and RTQ values compared to Cp ones. However, at the end of the 12th week CqChH coated implants demonstrated significantly higher ISQ (73.91 ± 4.39) and RTQ (75.96 ± 14.10) compared to Cp ones. CONCLUSIONS: This study demonstrated that the novel hydrogel coating applied to the implant's surface exhibited not only enhanced bone regeneration but also elicited a new bone formation.

Complete-arch implant-supported fixed dental prostheses fabricated with PEEK and PEKK framework: a systematic review.

PURPOSE: To evaluate the performance of complete-arch implant-supported fixed dental prostheses (FDPs) fabricated with polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) framework in clinical cases. MATERIALS AND METHODS: This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered in the International Prospective Register of Systematic Reviews with the number CRD42023399494. The electronic database PubMed, Cochrane Library and EBSCOhost were assessed for clinical research and reports on complete-arch implant-supported FDPs fabricated with PEEK and PEKK framework. Human studies with a minimum follow-up of 1 year and published in an English language were the only ones included. RESULTS: The initial database and hand search provided 564 articles. Finally, 12 articles published between 2018 and 2022 were included in this systematic review. The mean follow-up ranged from 1 year to 6 years. The included studies reported 119 (114 PEEK, 5 PEKK) complete-arch implant-supported FDPs during 1 year follow-up. The cumulative survival rate of prostheses with PEEK as a framework was 97.3%. Prostheses fractures and complications were found with both PEEK and PEKK frameworks. No implant failure reported with both PEEK and PEKK prostheses. CONCLUSION: In short-term follow-up, the complete-arch implant-supported FDPs with PEEK as a framework showed a good survival rate and acceptable health of the supporting tissues. The PEEK framework had shown adhesion issues as the most common prosthetic complication. Limited data were available on PEKK as framework material, so further long-term clinical trials are required.

Do antihypertensive medications have an effect on dental implants? A systematic review.

PURPOSE: The purpose of this systematic review was to compare the clinical outcomes of dental implants in users of antihypertensive medication with those of nonusers. METHODS: This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered in the International Prospective Register of Systematic Reviews under the number CRD42022319336. The electronic databases Medline (PubMed) and Central Cochrane were searched for relevant scientific literature published in English through May 2022. The focused question was, "Do patients taking antihypertensive medications have a similar impact on the clinical outcome and survival of dental implants compared with nonusers?". RESULTS: A total of 49 articles were found, of which 3 articles were finally selected for a qualitative synthesis. The three studies included 959 patients. In all three studies, the commonly used medication was renin-angiotensin system (RAS) inhibitors. Two studies mentioned implant survival rate, which was 99.4% in antihypertensive medication users and 96.1% in the nonusers. One study found a higher implant stability quotient (ISQ) in patients taking antihypertensive medication (75.7 ± 5.9) compared with patients not taking antihypertensive medication (73.7 ± 8.1). CONCLUSIONS: The limited available evidence showed that patient taking antihypertensive medications had comparable success rate and implant stability to patients not taking medications. The studies included patients taking different antihypertensive medications, so a drug-specific conclusion regarding the clinical outcome of dental implants is not possible. Further studies are needed, including patients taking certain antihypertensive medications, to determine their effects on dental implants.

Marginal Gap and Internal Fit of Fixed Dental Prostheses Fabricated Using Intraoral vs Extraoral Scanning: A Systematic Review and Meta-analysis.

PURPOSE: To compare the marginal gap and internal fit of fixed dental prostheses (FDPs) fabricated using intraoral vs extraoral scanning methods. MATERIALS AND METHODS: MEDLINE/PubMed and the Cochrane database were searched. The focused PICO question was: For the fabrication of FDPs, does an intraoral scanning technique result in a different marginal gap than an extraoral scanning technique? The secondary outcome assessed was internal fit. Studies were selected based on the inclusion criteria, and a meta-analysis was performed. RESULTS: A total of 14 studies (10 in vitro and 4 in vivo) were included in the meta-analysis. Marginal gap in single crowns was evaluated in 5 studies, copings for single crowns in 5 studies, three-unit FDPs in 3 studies, and both single-crown and three-unit FDPs in 1 study. Significantly lower marginal gap was found with intraoral scanning compared to impression scanning (P < .001) and cast scanning (P < .001), and for impression scanning compared to cast scanning (P = .037). Internal fit was superior with intraoral scanning compared to impression scanning, and this difference was significant (P < .001). No significant differences were found in internal fit with cast scanning compared to intraoral or impression scanning. The mean marginal gap/internal fit was 188.3 µm/146.2 µm with intraoral scanning, 116.29 µm/168.2 µm with impression scanning, and 195.1 µm/229.1 µm with cast scanning. CONCLUSION: Marginal gap was lower with intraoral scanning than with impression scanning and cast scanning. Impression scanning showed less marginal gap than cast scanning. Internal fit with intraoral scanning was superior to impression scanning, but when compared to cast scanning, no difference was found.

Patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdenture: A randomized controlled clinical study.

PURPOSE: The present study was done to assess patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdentures (SIMOs). METHODS: The participants included in Group 1 (n=12) received one-piece SIMOs; the participants in Group 2 (n=12) received two-piece SIMOs.Scheduled follow-ups were done at 1 month and 1 year after implant placement. Patient satisfaction and crestal bone changes were evaluated. The data obtained were analyzed statistically with independent Student t-test. RESULTS: Visual analogue scale (VAS) score for patient satisfaction with one-piece and two-piece SIMOs were statistically significant at 1-year of follow-up. The patient satisfaction level on the VAS score increased (38.1 to 51.1) with group one-piece SIMOs and two-piece SIMOs (36.6 to 46.8) at baseline to 1 month (P=0.13). The patient satisfaction level increased (38.1 to 56.6) with group one-piece SIMOs and two-piece SIMOs (36.6 to 52.2) at baseline to 1 year (P=0.03). At the 1 year follow-ups, group 1 had mean crestal bone loss of 0.80 ± 0.49 mm and group 2 had 1.24 ± 0.90 mm (P=0.16). Crestal bone loss was greater in the two-piece SIMOs group at 1 month and 1 year follow-ups, but statistically it was insignificant. CONCLUSIONS: One-piece SIMOs seemed to be a viable treatment option with increased patient satisfaction on a VAS. Crestal bone loss was greater in the patients with two-piece SIMOs during follow-up. One-piece SIMOs was comparatively simple with less invasive procedures and needed fewer components,so considerable number of patients requiring implant retained dentures could be benefited.

The effect of external magnetic field on osteogenic and antimicrobial behaviour of surface-functionalized custom titanium chamber with iron nanoparticles. A preliminary research.

PURPOSE: The controlled responsive characteristics of iron nanoparticles (FeNp) in magnetic fields make them an attractive prospect in this field. In the presence of a magnetic field, FeNp can significantly impact cell behaviour, leading to breakthroughs in nanotechnology. AIM/HYPOTHESIS: The aim is to determine the possible applications of iron nano particles (FeNp), and induced magnetic exposure role in osteoconduction and antibacterial activity. MATERIALS AND METHODS: The custom-grade IV titanium (Ti)hollow chamber is fabricated, surface treated with FeNp. Each titanium chamber contained neodymium, iron, and boron magnet disc, and the effect of FeNp on osteoblast-like cells (MG63) was evaluated in terms of cell attachment and survivability, morphological characteristics, particle absorption, and antibacterial properties. The effects of cellular uptake of FeNp and their responses to subcellular thrust were studied using fluorescent microscopy. MTT was used to determine cell viability, and von Kossa histochemical staining was used to determine matrix mineralization. RESULTS: In the magnetized Ti chambers group, osteogenic activity and mineralization were considerably greater than in the control groups (p 0.05). With a p value of 0.027, the S. aureus and E. coli were resistant to the antibacterial properties of the FeNp modified titanium custom Ti chamber (MIC: 0.03135 mg/mL and 0.02915 mg/mL, respectively). CONCLUSION: The one-of-a-kind, in vitro, conveniently modelled, limited sample study sheds light on the effect of surface-functionalized titanium custom Ti chamber with FeNp on MG63. The use of magnetized FeNp-surfaced implants for long-term strategic bone tissue engineering and bacteriostatic implants.

Comparative Evaluation of Implant-Protected Occlusion in Partially Edentulous Fixed Restoration Using Qualitative and Quantitative Assessment - A Prospective Clinical Trial.

OBJECTIVES: To compare and evaluate the occlusal variability/discrepancy recorded using qualitative (articulating paper) and quantitative (T-scan) techniques in partially edentulous implant-supported restorations. MATERIALS AND METHODS: A total of 20 patients in the age group of 25-61 yrs participated in this study. All the patients had more than one tooth replaced with implant-supported prosthesis. After three months of restoration, occlusion reevaluated was carried out using qualitative (articulating paper) and quantitative (T-scan). T-scan data were used to measure implant occlusion time, occlusion time, and the relative occlusal force (ROFs) on implant prosthesis. And the data were statistically evaluated. RESULTS: The T-scan values showed high points on the implants in most of the patients, which could not be evaluated by that of articulating paper outcomes. CONCLUSION: The occlusal harmony achieved from using qualitative analysis of articulating paper was not supported by the finding of the quantitative analysis (T-scan). Also the T-scan provided the time interval of occlusion of the implant-supported restorations, which would help in better defining the implant-protected occlusal. CLINICAL RELEVANCE: The T-scan occlusal analysis system provides ROF and time intervals of occlusal contact. This allows accurate occlusal equilibration of implant-supported restoration according to implant protected occlusal concept.

Evaluation of customized cobalt-chromium abutments fabricated with different manufacturing process versus titanium stock abutments on the marginal misfit -An in vitro study.

Aim: Accurate fit of the abutment to the implant is required for the uniform load distribution throughout the assembly. The study aims to compare the marginal misfit of titanium stock abutments with the cobalt-chromium (CoCr) customized abutments fabricated with the different manufacturing processes in internal hex implant-abutment connection using an appropriate scanning technique. Setting and Design: In vitro comparative study. Materials and Methods: A total of 40 abutments were included in the study. Ten titanium stock abutments were used as control (Group CN) and 30 CoCr abutments were fabricated and taken as the test group. Stock abutments were scanned and from obtained images test group abutments were fabricated as follows: Ten cast abutments (Group CA), 10 sintered abutments (Group SA), and 10 milled abutments (Group MA). Endosseous implanst having internal hex connections were matched with 10 stock abutments and 30 customized CoCr abutments. Implants were mounted in a clear epoxy resin block and the abutments were then fitted onto the implants with a torque of 30Ncm. The marginal discrepancy at implant-abutment connections was measured with confocal laser scanning microscope. Statistical Analysis Used: One-way ANOVA and Tukey's post hoc test was done for statistical analysis. Results: One-way ANOVA revealed a significant difference in marginal misfit of abutments. The mean marginal misfit was lowest for stock abutments (0.35 ± 0.009 µm). Among the customized abutments, the mean marginal misfit was highest for cast abutments (2.44 ± 0.445 µm) followed by sintered abutments (1.67 ± 0.232 µm) and least for milled abutments (0.65 ± 0.041 µm). A significant difference was found in marginal misfit with cast abutments and sintered abutments when compared to stock abutments (P < 0.001). The difference in marginal misfit was insignificant between stock abutments and milled abutments (P = 0.052). Conclusion: Difference in marginal misfit exists between the titanium stock abutments and customized CoCr abutments. Among the customized abutments, milled CoCr abutments have the least marginal discrepancy and cast CoCr abutments have a maximum marginal discrepancy. Milled CoCr abutments can be used as an alternative to titanium stock abutments.

Hybrid tracer - A modified novel extra oral tracer.

Introduction: Gothic arch Tracing has been a common modality in the recording of centric jaw relation. There has been two ways of recording the gothic tracing. They are extra oral and intra oral tracing. Among the extra oral tracers hight tracers are the most used tracers. Aim: Intra-oral and extra-oral tracers have a number of individual advantages and limitations. With the idea to overcome the short comings of both the tracers, hybrid tracers were made. Hybrid tracers could be a good alternative to the Hight-tracer in recording centric relation and can provide better clinical and teaching experience to the students. Methodology: The hybrid tracer is a two-component assembly, upper and lower component. The upper component has a central bearing plate and stylus in continuation with the central bearing plate. The lower component has central bearing device with three central bearing points one anteriorly and two posteriorly, and it has a tracing platform (15 × 35 mm) in continuation with the central bearing device. The length of these upper and lower components ismade to confine within the incisal rod of semi adjustable articulator. Result: hybrid tracers showed more accuracy while recording the centric jaw relation. There was more stability and equalization of pressure during the movement due to a tripod effect of three screws. Hence it provided more precise recording and being less technique sensitive. It was also more comfortable and acceptable by the patient. Conclusion: hybrid tracers hence will provide more accuracy and precision in recording of horizontal jaw relation. This will in turn help in fabricating a successful prosthesis and enhance the well-being of the patient. This tracer will also be significant in institutions for educational purpose. Clinical implication: Hybrid tracers are simple, non-technique sensitive, provide balance, equalization of pressure, stabilize the occlusal rims well, are close to the centre of rotation providing precise record and provide easy access and visibility to the operator which will help the operator in guiding the patient well for a correct jaw relation.

Effect of Cissus quadrangularis Hydrogel on Enhancing Osseointegration of Titanium Implant to Bone: An In Vivo Study.

AIM: The aim of the study was to evaluate the osteogenic potential of Cissus quadrangularis (CQ) hydrogel in enhancing the osseointegration of titanium to the bone in an experimental rabbit model. MATERIALS AND METHODS: Six adult male New Zealand white rabbits were used in this study. A total of 24 implants (12 coated test implants and 12 uncoated control implants) were placed in these 6 rabbits. A polyethylene glycol (PEG) hydrogel was prepared with the C. quadrangularis hydrogel in which the test implants were coated. Each rabbit was operated on both hind legs and one implant, each, was placed in the femur and tibia. Hence, one rabbit received four implants [two test implants (HG coated) and two control implants (uncoated)]. The animals were sacrificed after 4 weeks, and the specimens were histomorphometrically analyzed. The bone-to-implant contact (BIC) and the bone area fraction occupancy (BAFO) were calculated using Image J analysis. RESULTS: The statistically analyzed values which were obtained by paired t-test, revealed that the average mean values were higher in the test implants (coated) than the control implants (uncoated). The BIC values of the test implants were not significantly different from the control implants in the case of both femur and tibia (p >0.05). The test implants showed significantly increased BAFO values in femur (p <0.05). However, the BAFO values of test implants in tibia did not vary significantly from the control implants. CONCLUSION: Based on the findings of the study, the authors conclude that the coating of C. quadrangularis hydrogel enhances the osseointegration of titanium implants to bone. The further studies need to be designed to check the osseointegrative potential of C. quadrangularis. CLINICAL SIGNIFICANCE: The findings of this study suggest that the C. quadrangularis hydrogel is a potent osteogenic material that can reduce the osseointegration period and thus enhance the patient compliance toward implant treatment.

Resonance Frequency Analysis to Evaluate the Effect of Different Drilling Techniques on Implant Stability at Different Time Intervals: A Randomized Clinical Trial.

PURPOSE: To evaluate the effect of different drilling techniques on implant stability at different time intervals. MATERIALS AND METHODS: Patients were randomly allotted into three groups based on drilling technique for osteotomy: conventional drilling technique; simplified drilling technique; or modified conventional drilling technique. In 30 patients (n = 10 each group), a total of 44 implants were placed. In the conventional drilling technique, drills with increasing diameters were used. In the simplified drilling technique, only pilot and final-diameter drills were used. In the modified conventional drilling technique, all the drills were used in sequential order in the clockwise direction except the last drill, which was used in the counterclockwise direction. Implant stability quotient was recorded immediately after placing implants and at 1 and 3 months. Statistical analysis was performed with two-way analysis of variance (ANOVA) and Student t test. RESULTS: Two-way ANOVA showed that drilling technique (P < .001) and time (P = .002) did have a statistically significant effect on implant stability quotient. The modified conventional drilling technique showed a drop in secondary implant stability at 1 month that was negligible compared to the other techniques. After 1 month, there was a significant increase in implant stability quotient with the modified conventional drilling technique compared to the conventional drilling technique (P = .001). The least crestal bone loss during 3 months of follow-up was with the modified conventional drilling technique (0.37 ± 0.06). CONCLUSION: Secondary stability increased with the modified conventional drilling technique in 3 months and showed a negligible drop at 1 month. This novel drilling technique had an early shift from a decrease to an increase in stability pattern, along with the least crestal bone loss at 3 months.

The effects of reinforcement with nanoparticles of polyetheretherketone, zirconium oxide and its mixture on flexural strength of PMMA resin.

Purpose: Polymethylmethacrylate denture bases are prone to fracture, so reinforcement of dentures with nanoparticles is required to overcome these challenges. This invitro study was done to assess the effect of reinforcement with nanoparticles of polyetheretherketone (PEEK), zirconium oxide (ZrO2) and its mixture on flexural strength of polymethylmeythacrylate resin. Materials and methods: A total of 60 acrylic resin specimens measuring 65 mm × 10 mm × 2.5 mm were fabricated. The specimens were divided in to fifteen specimens in each group [control group (C), 3wt% PEEK group (P), 3wt% zirconia group (Z), and hybrid reinforcement of 1.5wt% PEEK and 1.5wt% ZrO2 group (P-Z)]. The flexural strength of the specimens was evaluated using a three-point bending test on a universal testing machine. The statistical analysis was done using one-way analysis of variance (ANOVA), and the intergroup comparison was done using Tukey's post hoc analysis. Results: The mean flexural strength was maximum in group P-Z (98.73MPa) followed by group P (86.22 MPa) and group Z (84.48 MPa). The mean flexural strength was least in the control group (74.86MPa). One-way ANOVA revealed a highly significant (P<0.01) difference among the groups. Pairwise comparison among groups showed a significant difference (P<0.05) among all the groups except in between groups P and Z where no significant difference was found (P=0.406). Conclusion: Hybrid reinforced PEEK and zirconia could be used as an effective reinforcement material for denture base resin. The hybrid PEEK and zirconia reinforced resin can be an alternative treatment option in patients with heavy occlusal forces and for patients who have previous experience of multiple denture fractures.

Platform-Switching Concept in Dental Implants: A Systematic Review and Meta-analysis of Randomized Controlled Trials with a Minimum Follow-up of 3 Years.

PURPOSE: To evaluate studies with a minimum follow-up of 3 years to find the peri-implant marginal bone loss (MBL) and rate of implant failure with platform-switching (PS) and platform-matching (PM) implant-abutment connections. MATERIALS AND METHODS: A systematic review and meta-analysis was done based on the preferred reporting items for systematic reviews and meta-analyses guidelines, with a focused question on population, intervention, comparison, and outcome. The Cochrane Collaboration's Risk of Bias tool was used to assess bias. Randomized controlled trials (RCTs) comparing peri-implant MBL and implant failure in patients receiving PS implants and PM implants only were included. The risk ratio (RR) of the implant-abutment connection and implant failure was calculated, and peri-implant MBL was expressed in mean differences (MD) at 95% confidence intervals (CIs). RESULTS: Three hundred eighty-one articles were obtained after an initial literature search. Finally, nine articles were included in the study that fulfilled the inclusion criteria. Four hundred twenty-six PS and 411 PM implants were placed with 16 implant failures (8 PS and 8 PM). The implant survival rate was 98.12% for the PS group, and 98.05% for the PM group, with no statistically significant difference (P = .97). The mean peri-implant MBL with the PS implant was lower (0.33 ± 0.41 mm) compared with the PM implant (0.66 ± 0.42 mm). A significant effect of PS implants was found in reducing peri-implant MBL (MD: -0.70, 95% CI: -1.25,-0.15; P = .01) compared with PM implants. The MD of peri-implant MBL between the PS and PM implants decreases with increased follow-up: MD of 0.69 (P = .15) with follow-up of ≥ 3 years but < 5 years, and MD of 0.62 (P = .04) with follow-up of ≥ 5 years. CONCLUSION: Reduced peri-implant MBL was found with the PS concept. The peri-implant MBL decreases with an increased mismatch between the abutment and implant platform. The difference in peri-implant MBL in PS and PM implants in the maxilla was greater and favored the PS concept. Bone-level implants with single crowns or splinted prostheses better preserved the peri-implant marginal bone with the PS concept.

Comparative analysis of stress distribution around CFR­PEEK implants and titanium implants with different prosthetic crowns: A finite element analysis.

BACKGROUND: Polyetheretherketone (PEEK) is a new material that was introduced for the fabrication of implants and their superstructure along with other available materials. It is not yet known whether the carbon fiber-reinforced polyetheretherketone (CFR­PEEK) material can be used as an implant and its superstructure in place of titanium (Ti). OBJECTIVES: The study evaluated stress distribution around CFR­PEEK implants and Ti implants with 5 different prosthetic crowns. MATERIAL AND METHODS: A three-dimensional (3D) model of a bone block was created to represent the right maxillary premolar area with a bone-level implant system with 100% osseointegration, using the Ansys Workbench software, v. 15.0. In total, 10 3D finite element analysis (FEA) models were created. The models were divided into 2 groups according to the type of implant: the CFR­PEEK group (n = 5); and the Ti group (n = 5). Each group was subdivided to imitate 5 different restorative crown materials (PEEK, zirconia, porcelain fused to metal (PFM), metal, and acrylic resin). Each implant model was loaded vertically (200 N) and obliquely (100 N). Stress distribution in the implants, the abutments, the cement layers, and the crowns was evaluated using the von Mises stress analysis. Maximum and minimum principal stress analyses were used to determine the stress generated in the bone. RESULTS: The CFR­PEEK implants bore more stress in vertical and oblique loading as compared to the Ti implants. The stress generated in the bone with the CFR­PEEK implants was similar to that generated with the Ti implants under vertical loading. Under oblique loading, less stress was transferred to the bone with the CFR­PEEK implants as compared to the Ti implants, showing better adaptation of the CFR­PEEK implants to lateral stress. CONCLUSIONS: In this FEA study, the amount of stress generated within the bone in the case of the CFR­PEEK implants with different restorative crowns was smaller in comparison with the Ti implants in oblique loading. This could help reduce lateral stress on implants as well as crestal bone loss.

Rehabilitation of Severe Atrophic Ridges with Zygomatic Implant and/or All-on-4 Treatment Concepts-A Case Series.

Rehabilitation of completely edentulous patients with implant-supported prosthesis (ISP) is the need of the day, but in many patients, the routine ISP is not possible due to the severe atrophic residual ridges. The present case series describes three cases with atrophic ridges rehabilitated using zygomatic implants and/or All-on-4 treatment concepts. In case 1 and case 3, in maxillary arch, there was not enough bone in Zone 3 to rehabilitate the patient with routine protocol followed for the All-on-4 treatment concept, so in these two cases, zygomatic implants were placed. Case 1 and case 2 were rehabilitated with Malo Bridge and case 3 with acrylic teeth-hybrid prosthesis using a computerized milling procedure to obtain improved fit, function, esthetics, and ease of retrievability whenever required.

Stress distribution around different abutments on titanium and CFR-PEEK implant with different prosthetic crowns under parafunctional loading: A 3D FEA study.

AIM & OBJECTIVES: Clinical trials had concluded a significant relationship between implant failure and bruxism. A three-dimensional (3D) finite element analysis (FEA) was done to evaluate the stress distribution in straight and angled abutments around titanium and carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implant with 2 different prosthetic crowns under parafunctional loading. MATERIALS AND METHOD: Twelve 3D models of bone block were created representing the maxillary right premolar area with osseointegrated implants. The models were divided in two group; CFR-PEEK implant (n â€‹= â€‹6) and group titanium implant (n â€‹= â€‹6).Each group was subdivided based on implants with three different abutments (straight, 15°, 25° angled abutments) and having two different prosthetic crowns: porcelain fused to metal (PFM) and polyetheretherketone (PEEK). A vertical load of 1000 â€‹N was applied to the central fossa and an oblique load of 500 â€‹N (30°) was applied to the buccal incline of the palatal cusp. The von Mises stresses and principal stresses were analyzed using ANSYS software. RESULTS: CFR-PEEK and titanium implants produced similar stress in bone under vertical and oblique loading. Straight abutment showed better results than 15° and 25° angled abutments in all the groups. PEEK crown produced lesser stress than PFM crown under vertical and oblique loading. CONCLUSION: The study concluded that straight abutment along with PEEK crown could be given in patients with bruxism to reduce the stress concentration in bone, thus preventing possible implant failure. Titanium and CFR-PEEK implants with straight abutments if given, then it should be provided with an occlusal splint.

Use of Facebow device in prosthodontics: A systematic review on randomized control trials.

Aim: Recording the maxillomandibular relationship is important in various prosthodontic treatments. Evidence of face-bow transfer resulting in improved outcome is conflicting. Hence the objective of this study is to determine the use of face-bow transfer in prosthodontics. Settings and Design: : Systematic review based on PRISMA guidelines.">. Materials and Methods: A protocol was developed prior, which covered all aspects of the review. The databases explored were MEDLINE database, ScienceDirect, and Cochrane collaboration library. The PICO model included participants who received a complete denture/partial denture prosthesis. Intervention was the use of the face-bow device. Comparator was prosthesis made with a simple procedure of not using a face-bow device for prosthodontic rehabilitation. Outcomes were patient satisfaction with dentures, the stability of the dentures, esthetics, and time taken for clinical and laboratory procedures. Only randomized clinical trials were included in this study. The methodological quality of the studies was assessed according to the Cochrane risk of bias tool. Statistical Analysis Used: Qualitative analysis. Results: A total of 144 articles were identified. On excluding 4 duplicates and screening the title and abstracts of the rest of the records based on exclusion criteria only 15 studies were selected for review. Conclusions: The use of the face-bow did not yield superior results for the quality of the prosthesis. Therefore, there is no evidence for the utility of face-bow transfer in complete denture treatment. However, no inference could be drawn for its utility in partial denture prosthodontics as there was no study to draw an inference.

Comparative Evaluation of Occlusal Bite Force in Relation to the Muscle Activity in the Mixed Dentition Children of Age Group 9-12 Years: A T-scan Analysis.

AIM AND OBJECTIVE: Compare and evaluate the muscle activity and the occlusal force between the mixed dentition boys and girls of 9-12 years. MATERIALS AND METHODS: The study included 15 boys and 15 girls. The occlusal force and activity of the masseter and temporalis muscle were measured with a T-scan device using a sensor, a module to transmit the signals to a computer and the complete data of the bite force and muscle activity with the EMG recordings and data were collected and evaluated. RESULTS: Relative occlusal force in the primary and permanent molars between the boys and girls showed no significant difference on the left side compared to the right. The electromyography values of masseter and temporalis in boys and girls showed a significant difference in which (TAR and MMR), (TAR and MML), (TAL and MMR), and (TAL and MML) are significant. The overall paired sample statistics showed higher muscle activity in masseter. CONCLUSION: T-scan analysis has proved to be a dependable method for the evaluation of occlusal bite force with the muscle activity interpretation using EMG. This study concluded that there is a difference in the occlusal pattern and muscle activity in the mixed dentition that showed the maximum force was on the permanent molars and the symmetry of EMGs activity in children was on the right masseter comparatively with higher bite values in boys compared to girls. CLINICAL SIGNIFICANCE: T-scan is a computerized analysis system that helps in the proper assessment of the patient's occlusion and assists in the proper treatment planning and diagnosis accurately without much effort. HOW TO CITE THIS ARTICLE: Prabahar T, Gupta N, Chowdhary NR, et al. Comparative Evaluation of Occlusal Bite Force in Relation to the Muscle Activity in the Mixed Dentition Children of Age Group 9-12 Years: A T-scan Analysis. Int J Clin Pediatr Dent 2021;14(S-1):S29-S34.