How does the consecutive use of intraoral scanners affect musculoskeletal health? A preliminary clinical study.

BACKGROUND: Minimizing muscle strain and reducing the risk of musculoskeletal disorders associated with intraoral scanner (IOS) usage require ergonomic awareness, device selection, and workplace adjustments in dental practice. This preliminary clinical study aimed to simulate intraoral scanning tasks using wired and wireless IOSs and assess muscle activation and fatigue for both types. MATERIALS AND METHODS: Fourteen participants performed intraoral scanning tasks using wired and wireless IOSs (i700; MEDIT), with weights of 280 g and 328 g, respectively. The same computer system and software conditions were maintained for both groups (N = 14 per IOS group). Electrodes were placed on arm, neck, and shoulder muscles, and maximal voluntary contraction (MVC) was measured. Surface electromyography (EMG) was performed during the simulation, and EMG values were normalized using MVC. The root mean square EMG (%MVC) and muscle fatigue (%) values were calculated. Statistical comparisons were performed using the Mann-Whitney U and Friedman tests, with the Bonferroni adjustment for multiple comparisons (α = 0.05). RESULTS: Arm (flexor digitorum superficialis) and neck muscles (left sternocleidomastoid and left splenius capitis) showed significantly higher EMG values with wireless IOS (P < 0.05). The neck (left sternocleidomastoid and right levator scapulae) and shoulder muscles (right trapezius descendens) demonstrated significantly higher muscle fatigue with wireless IOS (P < 0.05). CONCLUSIONS: The consecutive use of heavier wireless IOS may increase the risk of muscle activation and fatigue in certain muscles, which may have clinical implications for dentists in terms of ergonomics and musculoskeletal health.

Prediction of learning curves of wired and wireless intraoral scanners.

This clinical study aimed to predict the learning curve of wireless and wired intraoral scanners (IOSs) and to compare the reduction patterns of working time. Overall, 14 participants were enrolled in the study. The intraoral scanning procedure was repeated four times, each using wireless and wired IOSs (i700; MEDIT). The work time from the first to the 600th iterations was predicted using the Wright model. Regarding statistical analysis, the Mann-Whitney U-test was performed for comparison between wireless and wired IOSs and between groups with and without an IOS usage experience, and the Friedman test was performed to evaluate the time reduction (α = 0.05). There was a significant difference between wireless and wired IOSs in the first (P = 0.008) and the third (P = 0.035) iterations. Moreover, the time for 600 iterations was statistically significantly different between wireless and wired IOSs (P < 0.05); however, there was no significant difference after the sixth iteration (e.g., seventh iteration: P = 0.062). In wireless IOS, no significant difference was found between participants with and without an IOS usage experience after the 34th iteration (P = 0.053). The difference in the learning effect between wireless and wired IOSs can be overcome by initial learning; however, an IOS usage experience can affect the learning time of wireless IOSs.

Does an ergonomic dentist stool design have a positive impact on musculoskeletal health during intraoral scans and tooth preparation?

PURPOSE: This study aimed to evaluate the effects of an ergonomic dentist stool design on muscle activity and fatigue in dentists. MATERIALS AND METHODS: Fourteen dentists were recruited, and electrodes were attached to the arm, neck, and shoulder muscles of these dentists according to the Surface ElectroMyoGraphy for the Non-Invasive Assessment of Muscles protocol. After measuring the maximal voluntary contraction, eight-channel surface electromyography was performed during simulations of two dental procedures (intraoral scanning and tooth preparation) while the dentists were using two types of dentist stools. Furthermore, muscle activity and fatigue were determined based on the eight-channel surface electromyography data, and ergonomic risk levels were evaluated according to the muscle activity. The Shapiro-Wilk test was used to confirm that all data were normally distributed, and the Mann-Whitney U test was used to compare the two types of dentist stools (α = 0.05). RESULTS: There was a significant difference between the conventional and ergonomically designed dentist stools in terms of the activity of trapezius descendens muscle (p < 0.05). Notably, the activity of the trapezius descendens muscle was lesser when the dentists used ergonomically designed dentist stools than when they used a conventional dentist stool. The activity of all muscles, except for the sternocleidomastoid, indicated moderate ergonomic risk. CONCLUSION: A dentist stool that enables dentists to maintain ergonomic posture should be used to prevent musculoskeletal disorders.

In Vitro Biofilm Formation on Zirconia Implant Surfaces Treated with Femtosecond and Nanosecond Lasers.

(1) Background: The purpose of this study was to evaluate how a zirconia implant surface treated with laser technology affects the degree of biofilm formation. (2) Methods: Experimental titanium (Ti) disks were produced that were sandblasted with large grit and acid-etched (T), and they were compared with zirconia (ZrO2) discs with a machined (M) surface topography; a hydrophilic surface topography with a femtosecond laser (HF); and a hydrophobic surface topography with a nanosecond laser (HN) (N = 12 per surface group). An in vitro three-species biofilm sample (Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi)) was applied to each disc type, and bacterial adhesion was assessed after 48 and 72 h of incubation using an anaerobic flow chamber model. Statistical significance was determined using the Kruskal-Wallis H test, with Bonferroni correction used for the post-hoc test (α = 0.05). (3) Results: Compared to the T group, the M group exhibited more than twice as many viable bacterial counts in the three-species biofilm samples (p < 0.05). In comparison to the T group, the HF group had significantly higher viable bacterial counts in certain biofilm samples at 48 h (Aa and Pi) and 72 h (Pi) (p < 0.05). The HN group had higher viable bacterial counts in Pi at 48 h (5400 CFU/mL, p < 0.05) than the T group (4500 CFU/mL), while showing significantly lower viable bacterial counts in Pg at both 48 (3010 CFU/mL) and 72 h (3190 CFU/mL) (p < 0.05). (4) Conclusions: The surface treatment method for zirconia discs greatly influences biofilm formation. Notably, hydrophobic surface treatment using a nanosecond laser was particularly effective at inhibiting Pg growth.

Feasibility of using an intraoral scanner for a complete arch digital scan, part 2: A comparison of scan strategies.

STATEMENT OF PROBLEM: Various strategies for intraoral scanners (IOSs) can be used to scan the oral cavity. However, research on the scan range that can be clinically is lacking. PURPOSE: The purpose of this in vitro study was to compare the 3-dimensional (3D) distortion of complete arch scans as part of the scan strategy and analyze the clinically recommended scan range. MATERIAL AND METHODS: A computer-aided design (CAD) reference model was obtained with an industrial scanner. A CAD test model was obtained by using 6 IOSs (TRIOS2, TRIOS3, CS3500, CS3600, i500, and Primescan) to apply 2 scan strategies and 2 dental laboratory scanners (DOF and E1) (N=15). All the teeth were segmented in the reference model by using 3D inspection software (Geomagic control X). The 3D analysis was performed by aligning the test model to the reference model and evaluating the root mean square values of all segmented teeth. The Mann-Whitney U-test was performed for a statistical comparison of the 2 scan strategies (α=.05), the Kruskal-Wallis test (α=.05) was used to compare the scanners, and the Mann-Whitney U-test and Bonferroni correction method were used as post hoc tests (α=.0017). RESULTS: The 8 scanners obtained significant differences in the root mean square values of all teeth (P<.001). The root mean square value of IOSs increased from the left maxillary second molar to the right maxillary second molar. The difference in the 2 scan strategies showed different patterns depending on the IOS. CONCLUSIONS: Scan strategy 2 improved the accuracy of the IOSs. TRIOS2 and CS3500 are for single crowns; TRIOS3, CS3600, and i500 are for short-span prostheses; and Primescan is for long-span prostheses.

Long-Term Survival Rate of Autogenous Tooth Transplantation: Up to 162 Months.

Background and Objectives: The purpose of this study is to observe the usefulness of autogenous tooth transplantation by examining the cumulative survival rate according to the period of auto-transplanted teeth as pre-implant treatment. Materials and Methods: This study was conducted on 111 patients who visited Kyungpook National University Dental Hospital and underwent autogenous tooth transplantation between November 2008 and January 2021 (about 13 years). The cumulative survival rate of autogenous tooth transplantation according to the causes of extraction of the recipient tooth (caries, periapical lesion, crack, crown fracture, periodontitis) and condition of opposing teeth (natural teeth vs. fixed prosthesis). The cumulative survival rate of autogenous tooth transplantation according to the age (under 30 vs. over 30) was also investigated and it was examined whether there were any differences in each factor. Results: The average follow-up period was 12 months, followed by a maximum of 162 months. The 24-month cumulative survival rate of all auto-transplanted teeth was 91.7%, 83.1% at 60 months and the 162-month cumulative survival rate was 30.1%. There were no statistical differences between the causes of extraction of the recipient's teeth, differences in the condition of the opposing teeth, and differences under and over the age of 30. Conclusions: The survival rate of autogenous tooth transplantation appears to be influenced by the conditions of the donor tooth rather than the conditions of the recipient tooth. Although autogenous tooth transplantation cannot completely replace implant treatment, it is meaningful in that it can slightly delay or at least earn the time until implant placement is possible.

How Does the Use of an Intraoral Scanner Affect Muscle Fatigue? A Preliminary In Vivo Study.

The purpose of this study was to evaluate muscle activation and fatigue in the operator during tooth preparation and intraoral scanning by simulating these tasks in two types of dental unit chair systems (UCS). Six participants were recruited, and the above tasks were simulated. Electrodes were placed on the skin over five types of muscles (arm, neck, and shoulder muscles), and the maximal voluntary contraction (MVC) was measured. Electromyography (EMG) was assessed during the simulation, and EMG values were normalized using MVC. The root mean square (RMS) EMG (%MVC) and muscle fatigue (%) were calculated. Owing to a lack of normal distribution of the data, Mann−Whitney U test and Kruskal−Wallis H test were performed for statistical comparison, and Bonferroni adjustment was performed for multiple comparisons (α = 0.05). There was no significant difference in RMS EMG between the two types of dental UCS (intraoral scanning, p = 0.237; tooth preparation, p = 0.543). Moreover, the RMS EMG and muscle fatigue were not significantly different between the two tasks (p > 0.05). There was significant muscle fatigue after the intraoral scanner use was simulated thrice (p < 0.001). It is necessary to refrain from performing continuous intraoral scanning and tooth preparation and to take appropriate rest to reduce the incidence of musculoskeletal disorders in dentists in clinical settings.

Satisfaction Factors with a Dental Unit Chair System in South Korea: A Dentist's Perspective.

This study aimed to survey users' satisfaction with a dental unit chair in order to highlight the elements affecting the dentist's satisfaction. The questionnaire items were drawn up with seven components that constitute a dental unit chair, including the light, patient seat, foot controller, water fountain and cuspidor, monitor, bracket table and controller, and dentist chair. With these questionnaire elements, a pilot experiment was conducted to test the reliability, and reliability analysis was conducted. The scale reliability was checked using Cronbach's alpha coefficient. Bartlett's test of sphericity, the Kaiser-Meyer-Olkin (KMO) measure, and factor analysis were performed to test whether the items would constitute appropriate questionnaire items for the survey. The survey was conducted with 26 dentists with more than three years of clinical experience. A correlation analysis was conducted using Pearson's correlation coefficient (PCC) (α = 0.05) to analyze the impact of the factors on the overall satisfaction with the dental unit chair. The items that were strongly correlated with the overall satisfaction score of the dental unit chair were the design and appearance quality of the dental unit chair (PCC = 0.781), its maintenance (PCC = 0.784), and the overall satisfaction with the water fountain and cuspidor (PCC = 0.703) (p < 0.05). Most of the questionnaire items could affect the overall satisfaction with the dental unit chair. Additionally, because the design and appearance quality, maintenance, and overall satisfaction with the water fountain and cuspidor may have the greatest impact on the overall satisfaction with the dental unit chair, the improvement of these elements may bring about the enhancement of the overall satisfaction.

In vivo and in vitro assessment of the bleaching effectiveness of a brush-off patch containing 3.0% hydrogen peroxide.

OBJECTIVES: To evaluate the efficacy of a brush-off patch containing 3.0% hydrogen peroxide, which is a new over-the-counter (OTC) product for tooth whitening, and determine the optimal protocol for use. MATERIALS AND METHODS: We performed an in vitro study using hydroxyapatite specimens and a clinical trial involving 140 volunteers. The brush-off patch was applied to the specimens (in vitro) or the maxillary anterior teeth (in vivo; 14 days) for 10 min twice daily (case 10 group) or 30 min once daily (case 30 group). We also included control groups in both experiments. Lightness (L*), redness (a*), and yellowness (b*) values were measured using a colorimeter. In the in vivo study, color changes were measured at baseline and 7 and 14 days after the start of patch application. The overall color change (ΔE) was statistically analyzed. RESULTS: In the in vitro study, the color change (ΔE*) after the experiment was significantly different between the two case groups and the control group (p < 0.001). In the in vivo study, the case groups showed color changes at both 7 and 14 days after patch application. In particular, the change in the case 30 group was significantly more prominent on day 14 than on day 7 (p < 0.05). CONCLUSION: Our findings suggest that brush-off patches containing 3.0% hydrogen peroxide are effective OTC products for tooth whitening. CLINICAL RELEVANCE: For best results, brush-off patches containing 3.0% hydrogen peroxide can be applied once daily for 30 min.

Comparative Evaluation of Recombinant Human Bone Morphogenetic Protein-2/Hydroxyapatite and Bovine Bone for New Bone Formation in Alveolar Ridge Preservation.

PURPOSE: Hydroxyapatite treated with recombinant human bone morphogenetic protein-2/Hydroxyapatite (rhBMP-2/HA) or bovine bone was applied on extraction sockets for alveolar ridge preservation, and the results were compared with respect to clinical and histological bone formation. MATERIALS AND METHODS: This was a prospective, randomized controlled clinical trial performed on 20 implant placement sites (10 in the experimental and 10 in the control group). rhBMP-2/HA was applied on extraction sockets in the experimental group and bovine bone on those of the control group. The bone at the corresponding sites was biopsied 3 months later, and clinical, histological, and histomorphometric analyses were performed. RESULTS: The alveolar bone height was well preserved in both groups with relatively less change in width in the experimental group compared with the control group. The percentage of new bone was 25.37% ± 17.23% in the experimental group and 6.13% ± 4.32% in the control group; the difference was statistically significant. CONCLUSIONS: The alveolar ridge was preserved clinically and histologically in both groups. rhBMP-2/HA resulted in greater new bone formation than bovine bone 3 months after the surgery.

Root Canal Shaping Effect of Instruments with Offset Mass of Rotation in the Mandibular First Molar: A Micro-computed Tomographic Study.

INTRODUCTION: The aim of this study was to evaluate the root canal shaping effect of 2 nickel-titanium rotary instruments with offset mass of rotation compared with an instrument with a conventional centered mass of rotation. METHODS: Thirty-six extracted human mandibular first molars with 2 independent mesial canals and 1 oval distal canal were selected and divided equally into 3 groups for instrumentation with ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), Revo-S (RS; Micro-Mega, Besançon, France), and ProTaper Universal (PTU, Dentsply Maillefer) systems (n = 12). For apical preparation, PTN X2 (#25/0.06), RS SU (#25/0.06), and PTU F2 (#25/0.08) were used in the mesial canals and PTN X3 (#30/0.07), RS AS30 (#30/0.06), and PTU F3 (#30/0.09) were used in the distal canals. Specimens were scanned before and after instrumentation using a SkyScan 1272 scanner (Bruker micro-CT, Kontich, Belgium) at 10-µm isotropic resolution. Changes in the canal area, volume, structure model index (SMI), and untouched canal area were evaluated. Canal transportation and centering ratio were measured at 1, 3, 5, and 7 mm from the apical foramen. Data were statistically analyzed using 1-way analysis of variance with the Tukey post hoc test. RESULTS: The PTN and RS systems showed significantly less transportation and better centering ability compared with the PTU system at 1 mm from the apical foramen (P < .05). All instrumentation increased the canal area, volume, and SMI values without significant differences among the 3 groups (P > .05). CONCLUSIONS: Regardless of the differences in the cross-sectional design, alloy type, and taper variation, instruments with offset mass of rotation showed better root canal shaping ability compared with an instrument with a centered mass of rotation.

Anatomical profile of the mesial root of the Burmese mandibular first molar with Vertucci's type IV canal configuration.

This study evaluated the anatomical profile of the mesial root canals of the Burmese mandibular first molar with Vertucci's type IV canal configuration (VT4) using microcomputed tomography analysis. Seventy-five mesial roots of extracted mandibular first molars were scanned and evaluated. Fourteen middle mesial canals (MMCs) were observed in the specimens; each specimen had an average of 1.63 lateral canals and 3.77 apical foramina. The lateral canals arising from the mesiobuccal canal, mesiolingual canal, MMC, and isthmus terminated at an average distance of 0.92, 0.73, 2.11, and 1.89 mm, respectively, from the apex. The mean distance between the centers of the mesiobuccal and mesiolingual canals at 1.5 mm coronal to the furcation was 2.60 mm. A higher incidence of isthmus was observed in the apical 2-6-mm region compared with the apical 0-2-mm region (P < 0.05). The incidence of lateral canals in the isthmus was similar to that of the mesiobuccal and mesiolingual canals (P > 0.05). This study shows that the mesial root of the Burmese mandibular first molar with VT4 has complex anatomical profiles comprising MMCs and isthmus and their lateral canals.

Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study.

OBJECTIVES: The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. RESULTS: The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). CONCLUSIONS: For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.

Esthetic enhancement of a traumatized anterior tooth with a combination of forced eruption and tooth alignment: a case report.

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.

Effect of dual treatment with SDF-1 and BMP-2 on ectopic and orthotopic bone formation.

PURPOSES: The potent stem cell homing factor stromal cell-derived factor-1 (SDF-1) actively recruits mesenchymal stem cells from circulation and from local bone marrow. It is well established that bone morphogenetic protein-2 (BMP-2) induces ectopic and orthotopic bone formation. However, the exact synergistic effects of BMP-2 and SDF-1 in ectopic and orthotopic bone regeneration models have not been fully investigated. The purpose of this study was to evaluate the potential effects of simultaneous SDF-1 and BMP-2 treatment on bone formation. MATERIALS AND METHODS: Various doses of SDF-1 were loaded onto collagen sponges with or without BMP-2.These sponges were implanted into subcutaneous pockets and critical-size calvarial defects in C57BL/6 mice. The specimens were harvested 4 weeks post-surgery and the degree of bone formation in specimens was evaluated by histomorphometric and radiographic density analyses. Osteogenic potential and migration capacity of mesenchymal cells and capillary tube formation of endothelial cells following dual treatment with SDF-1 and BMP-2 were evaluated with in vitro assays. RESULTS: SDF-1-only-treated implants did not yield significant in vivo bone formation and SDF-1 treatment did not enhance BMP-2-induced ectopic and orthotopic bone regeneration. In vitro experiments showed that concomitant use of BMP-2 and SDF-1 had no additive effect on osteoblastic differentiation, cell migration or angiogenesis compared to BMP-2 or SDF-1 treatment alone. CONCLUSIONS: These findings imply that sequence-controlled application of SDF-1 and BMP-2 must be further investigated for the enhancement of robust osteogenesis in bone defects.

Burnout and its related factors in Korean dentists.

OBJECTIVES: Dentistry has been identified as one of the most stressful work environments. Knowledge of modifiable work-environment factors related to job stress could lead to a strategy and policy to provide a better work environment for dentists. The aims of this study were to examine the degree and distribution of burnout and to determine the factors associated with burnout subscale of Korean dentists. METHODS: A cross-sectional survey of Korean dentists was conducted using a custom-designed and validated questionnaire that incorporated the Maslach Burnout Inventory Human Services Survey (MBI-HSS) as well as questions regarding sociodemographic and job-related characteristics. A random sample of 1,000 dentists was selected from 13,207 registered dentists in the Korean Dental Association. The MBI-HSS scores were summarised in the three dimensions of emotional exhaustion, depersonalisation, and personal sense of accomplishment. Bivariate and multivariate analyses were conducted to assess the prevalence of burnout and its related factors. RESULTS: The adjusted response rate was 45.9% (444/967). In the subscales of burnout, 41.2%, 55.9%, and 41.4% of respondents scored highly in emotional exhaustion and depersonalisation and poorly for personal sense of accomplishment, respectively. High burnout seems to be more likely to occur in association with some of the sociodemographic and job-related characteristics, especially younger age, male gender, without occupational calling, and unwilling to reselect a dentistry as a job. CONCLUSIONS: This study suggests that burnout is a common problem in Korean dentists and that occupational calling and willing to reselect a dentistry as a job are important factors for managing burnout.

Expression of vesicular glutamate transporters VGLUT1 and VGLUT2 in the rat dental pulp and trigeminal ganglion following inflammation.

BACKGROUND: There is increasing evidence that peripheral glutamate signaling mechanism is involved in the nociceptive transmission during pathological conditions. However, little is known about the glutamate signaling mechanism and related specific type of vesicular glutamate transporter (VGLUT) in the dental pulp following inflammation. To address this issue, we investigated expression and protein levels of VGLUT1 and VGLUT2 in the dental pulp and trigeminal ganglion (TG) following complete Freund's adjuvant (CFA) application to the rat dental pulp by light microscopic immunohistochemistry and Western blot analysis. RESULTS: The density of VGLUT2- immunopositive (+) axons in the dental pulp and the number of VGLUT2+ soma in the TG increased significantly in the CFA-treated group, compared to control group. The protein levels of VGLUT2 in the dental pulp and TG were also significantly higher in the CFA-treated group than control group by Western blot analysis. The density of VGLUT1+ axons in the dental pulp and soma in the TG remained unchanged in the CFA-treated group. CONCLUSIONS: These findings suggest that glutamate signaling that is mediated by VGLUT2 in the pulpal axons may be enhanced in the inflamed dental pulp, which may contribute to pulpal axon sensitization leading to hyperalgesia following inflammation.

Endodontic treatment of maxillary lateral incisors with anatomical variations.

Maxillary lateral incisors usually exhibit a single root with a single canal. However, maxillary lateral incisor teeth with unusual morphology of root canal system are frequently reported. These cases of variable root canal anatomy can be treated well by nonsurgical endodontic methods. A detailed description of root canal morphology is fundamental for successful endodontic treatment. Treatment using an operating microscope, radiographs from different angles, and cone-beam computerized tomography (CBCT) can produce more predictable endodontic outcomes.

Relationship of tooth mortality and implant treatment in Type 2 diabetes mellitus patients in Korean adults.

PURPOSE: The purpose of this study was to to analyze the effect of Type 2 diabetes on tooth mortality, implant treatment and prosthetic status. MATERIALS AND METHODS: 275 Type 2 diabetics and 300 non-diabetics, aged 40-80 years were selected for analysis. The assessment of number of teeth, missing teeth, fixed prostheses (bridge pontics), implants using panoramic radiographs and dental records were carried out. RESULTS: Diabetes mellitus (DM) patients had a higher number of missing teeth (P<.05) and placed implants (P=.074), age (P<.05), male gender percentage (P=.042), smoker percentage (P<.05) than non-DM patients. In univariate analysis, the patients in older group showed significantly higher number of tooth loss rate at the first dental examination than the patients in younger group. Tooth loss rate of smokers did not show higher value than that of non-smokers. When multiple variables including DM, age, smoking, gender were considered together, diabetics and older group patients showed significantly higher tooth loss rate at the first dental examination than non-diabetics and younger group patients, respectively. Smokers and male group did not show a significant difference than non-smokers and female group, respectively. CONCLUSION: Tooth mortality and implant treatment rate were significantly higher in the DM group as indicated by univariate and multivariate logistic regression analysis. Old age groups showed significantly higher odds ratios and tooth loss rate. As diabetics showed the higher tooth loss rate than non-diabetics, diabetics also had more implant restorations than non-diabetics.