Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design-retrospective analysis after a mean follow-up of 5 years.

BACKGROUND: As a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI. RESULTS: Clinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = - 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs. CONCLUSIONS: Treatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.

Primary tooth autotransplantation: update and retrospective clinical study.

OBJECTIVE: A new technique of primary tooth autotransplantation has recently been published demonstrating reliable replacement of missing permanent incisors in young children due to trauma or agenesis. This retrospective clinical study reports on the longterm success of this new technique in a larger patient group regarding its potential to support bone and soft tissue growth. STUDY DESIGN: 40 children (age range: 2.7-17.6 years) received 53 primary tooth autotransplants (49 canines and 4 incisors) due to traumatic tooth loss (73%), agenesis (19%) or dysplasia/displacement (8%). Clinical and radiological follow-up examinations were performed to check up on root resorption, bone and soft tissue growth, survival and success. RESULTS: 22 transplants still present in the oral cavity of 18 patients yielded a success rate of 77%. The Kaplan-Meier estimator measured a median survival time of 86 months (7.2 years) for all 53 grafts. In all cases, increasing soft tissue and bone development enabled a successful prosthetic rehabilitation regarding aesthetics and function. CONCLUSIONS: Primary tooth autotransplantation reliably restores edentulous anterior space in children experiencing traumatic tooth loss or agenesis and acts as an immediate therapy before other therapies such as premolar transplantation or orthodontic space closure can be carried out at a later time. It guarantees the co-development of soft tissue and bone in the teenage jaw which is associated with high patient satisfaction and acceptance of this method.

Synergistic effects of H2O2 with components of dental restorative materials on gluconeogenesis in rat kidney tubules.

No data are available about (toxic) effects of dental materials administered in combination with H(2)O(2) from dental bleaching compounds. The effect of dental composite components triethyleneglycoldimethacrylate (TEGDMA) and hydroxyethylmethacrylate (HEMA) as well as mercuric chloride (HgCl(2)) and methylmercury chloride (MeHgCl), each in combination with H(2)O(2), was investigated on gluconeogenesis in kidney cells. From rats kidney tubules were prepared. Every 10 min up to 60 min 1-ml samples were drawn from the cell suspension for quantitating the glucose content. Glucose formation in controls was 3.5+/-0.3 nmol/mg.per min (mean+/-SEM, n=21). Relative rates of glucose formation were obtained by expressing individual rates as percentage of the corresponding control. X-Y concentration curves (effective concentration, EC) of the substances were calculated by fitting a four-parametric sigmoid function to the relative rates of the glucose formation at various test concentrations. At the end of the incubation period cell viability was assessed by trypan blue exclusion. Cell viability decreased within the 60 min interval from 90% to approx. 80% (controls), <25 (HEMA), <20 (TEGDMA), <20 (H(2)O(2)) <10 (MeHgCl), and <10 (HgCl(2)). Values of 50% effective concentration (EC(50)) were calculated from fitted curves. EC(50) values were (mmol/l; mean+/-SEM; n=4): HEMA, 17.2+/-2.8; TEGDMA, 1.9+/-0.2; H(2)O(2) 0.22+/-0.03, MeHgCl, 0.016+/-0.0005; and HgCl(2), 0.0017+/-0.0005. No significant decrease of the EC(50) values was found when kidney cells were exposed to HEMA, HgCl(2), or MeHgCl in addition with H(2)O(2) (1-100 microM), compared to those EC(50) values of each compound without H(2)O(2) addition. A significant decrease of the TEGDMA EC(50) values to about 0.25 or 0.04 (mmol/l) was found when cells were exposed to TEGDMA in combination with H(2)O(2) (75 or 100 microM), compared to that TEGDMA EC(50) value without H(2)O(2) addition. The addition of H(2)O(2) (75 and 100 microM) resulted in a synergistic toxic effect of TEGDMA.