Benefits of Contemporary Rehabilitation of Edentulism: A Statement.

The purpose of this study was to review the impact of loss of teeth and the current state of treatment options available for oral rehabilitation of edentulism. Function with complete dental prostheses varies based on a patient's ability to adapt to removable prostheses and their psychologic acceptance of the treatment. There is varying dissatisfaction with removable prostheses, particularly in Western economies. This is driven in part by the availability of oral implants, which have transformed the treatment options for oral rehabilitation in general and for edentulous rehabilitation in particular. Quality-of-life studies have confirmed the advantages of implants for the retention and support of dental prostheses, as they improve function and esthetic measures to nearly those of the dentate state. Osseoperception, the concept of feedback to the sensorimotor system from tissues surrounding osseointegrated implants, contributes to enhanced function with implant treatment. It is recognized that tooth loss resulting in the loss of periodontal mechanoreceptors has a detrimental effect on jaw motor control even after implant treatment. However, despite this limitation, oral rehabilitation with or without implants, which improves function and esthetics, helps maintain psychosocial and cognitive health.

Rehabilitation of a patient diagnosed with Ectodermal Dysplasia presenting hypodontia: a case report

Purpose: The study showed a patient with Ectodermal Dysplasia (ED) who was treated with implants and fixed dental prosthesis by a multidisciplinary team. Case Report: Acrylic resin dental prostheses were designed as long-term provisionals, which allowed modifications when required. After imaging and treatment planning, four implants were placed in the inter-foramenal area of the mandible and 2 years later the definitive prosthesis was fitted. In a second phase, the patient received a combination of autogenous and allogeneic bone grafts in the maxilla. The autogenous graft was removed from the retro-molar region in the mandible. He also received a fixed dental prosthesis supported by 4 implants on the position of the upper canines and second pre-molars. Conclusion: Patient reports successful outcomes and despite the long treatment, patient states is confident with his appearance and speaking improvement. Follow-up was done every six months, for 10 years, and showed encouraging post-treatment outcomes.

Adipose Tissue Dysfunction: Impact on Bone and Osseointegration.

Bone metabolism may be adversely affected in metabolic diseases such as obesity and metabolic syndrome, which are characterised by weight gain, due to the expansion of adipose tissue deposits. As an important regulator of energy metabolism, adipose tissues synthesise and secrete several key regulatory adipokines that influence a range of metabolic functions. This narrative review outlines the evidence for the mechanisms by which adipose tissue dysfunction may alter bone metabolism prior to the development of frank hyperglycaemia and presents the emerging evidence for the impact of diet-induced expansion of adipose tissue on implant osseointegration. Successful osseointegration requires normal bone cell function, and the expansion of adipose tissue deposits results in dysregulated adipokine production favouring an increase in pro-inflammatory adipokines, contributing to the development of a chronic inflammatory state and insulin resistance. The increase in inflammatory cytokines promotes the growth and differentiation of osteoclasts indirectly through the modulation of osteoblastic RANKL production and directly by reducing osteoclast apoptosis and increased osteoclastic expression of RANK. Conversely, the suppression of osteoblastic regulatory genes results in reduced osteoblast numbers and function contributing to compromised bone turnover. Compromised osseointegration has been established in hyperglycaemia; however, as discussed in this review, it may not be the only driver of altered bone metabolism. The incidence of metabolic disease in the community is rising, patients may present for implant treatment with undiagnosed, underlying changes to bone cell metabolism due to adipose tissue dysmetabolism.

Functional properties of single motor units in the human medial pterygoid muscle: Thresholds.

BACKGROUND: Little is known regarding the functional properties of single motor units (SMUs) in the medial pterygoid muscle (MPt) during jaw movements. OBJECTIVES: The aims are (a) to report the thresholds of onset of MPt SMUs during 4 goal-directed jaw movement tasks, and (b) to determine whether the threshold of onset of SMU activation varies with the velocity of jaw movement and the location within the muscle. METHODS: Intra-muscular electrodes were inserted in the right MPt of 18 participants performing ipsilateral (right), contralateral, protrusive and opening-closing jaw movements recorded at 2 velocities. Task phases were as follows: BEFORE, OUT, HOLDING, RETURN and AFTER. SMU onset thresholds were determined from the displacement (mm) of the lower mid-incisor point. Electrode location within 4 arbitrary muscle divisions was determined with computer tomography. Statistical tests: Spearman's correlations, Kruskal-Wallis tests; significance accepted at P < .05. RESULTS: A significant inverse relation occurred between velocity and threshold for the RETURN of the ipsilateral movement (n = 62 SMU thresholds), while a significant positive relation occurred for the OUT of the contralateral movement (n = 208); there were no significant associations for the protrusive (n = 131) and opening-closing (n = 58) tasks. Significant threshold differences occurred across the 4 muscle divisions only during the OUT of the contralateral and protrusive movements. Some evidence was provided for gender differences in MPt SMU properties. CONCLUSIONS: The absence of a significant inverse relation between velocity and SMU threshold for most recorded movements suggests the MPt acts as a stabilizer of the jaw in horizontal and opening-closing jaw movements.

The role of progressive oral implant rehabilitation in mastication, cognition and oral health-related quality of life outcomes-A pilot to define the protocol.

BACKGROUND: The implications of oral rehabilitation after tooth loss require further investigation. OBJECTIVES: To conduct a pilot study to investigate: (a) changes in masticatory performance with progressive oral implant rehabilitation (POR); (b) association between POR and neurocognitive function using functional magnetic resonance imaging (fMRI); and (c) oral health-related quality of life (OHQoL) outcomes. METHODS: Four completely edentulous patients (mean age: 73 ± 1.4 years) participated. Each received new complete removable dental prostheses (RDPs) transitioned to mandibular two implant-retained RDPs (IR-RDP). Assessments were performed at 4 time points for neurocognitive skills, fMRI with functional tasks (jaw clenching, working memory and sustained attention, inhibition), masticatory performance with colour-changing gum and OHQoL. Assessments were performed with new complete RDPs (T0 as baseline data) and IR-RDPs at 1 week (T1), 6 weeks (T2) and 12 months (T3) post-insertion. Data analyses were based on intra-patient and inter-patient results. RESULTS: Masticatory performance and QoL improved with an IR-RDP at each time point. FMRI jaw clenching sensory and motor cortical activity decreased at T1, with motor cortical activity increasing to T0 levels at T2. For cognitive fMRI activation tasks, cortical activity decreased from T0 to T1 across all regions of interests (ROI) and increased at T2 throughout the cognitive brain regions. Neurocognitive skills declined at T1, followed by improvement to or beyond T0 levels at T2. CONCLUSION: Improvements in masticatory performance and OHQoL occurred from complete RDPs to IR-RDP. Prosthetic adaptation was associated with neurocognitive changes to pre-insertion activity levels or greater after 6 weeks. These pilot data suggest both behavioural and neural associations between POR and cognition; however, larger study numbers are required.

A diet high in fat and fructose adversely affects osseointegration of titanium implants in rats.

OBJECTIVES: Diet-induced metabolic dysfunction such as type 2 diabetes mellitus increases the risk of implant failure in both dental and orthopaedic settings. We hypothesised that a diet high in fat and fructose would adversely affect peri-implant bone structure and function including osseointegration. MATERIALS AND METHODS: Thirty female Sprague-Dawley rats were divided into three groups (n = 10), control group (normal chow) and two intervention groups on a high-fat (60%), high-fructose (20%; HFHF) diet. Titanium implants were placed in the proximal tibial metaphysis in all groups either before commencing the diet (dHFHF group) or 6 weeks after commencing the diet (HFHF group) and observed for an 8-week healing period. Fasting blood glucose levels (fBGLs) were measured weekly. Structural and functional features of the peri-implant bone, including bone-to-implant contact (BIC), were analysed post euthanasia using microcomputed tomography, pull-out tests, and dynamic histomorphometry. RESULTS: The fBGLs were unchanged across all groups. Peri-implant trabecular bone volume was reduced in the HFHF group compared with controls (p = .02). Percentage BIC was reduced in both HFHF group (25.42 ± 3.61) and dHFHF group (28.56 ± 4.07) compared with the control group (43.26 ± 3.58, p < .05) and reflected the lower pull-out loads required in those groups. Osteoblast activity was reduced in both intervention groups compared with the control group (p < .05). CONCLUSION: The HFHF diet compromised osseointegration regardless of whether the implant was placed before or after the onset of the diet and, despite the absence of elevated fBGLs, confirming that changes in bone cell function affected both the initiation and maintenance of osseointegration independent of blood glucose levels.

A Within-Subject Comparison of Patient Satisfaction and Quality of Life Between a Two-Implant Overdenture and a Three-Implant-Supported Fixed Dental Prosthesis in the Mandible.

PURPOSE: This within-subject comparison tested the null hypothesis that there is no difference in patient satisfaction and oral health-related quality of life when an individual with an edentulous mandible is rehabilitated with a two-implant overdenture or a three-implant-supported fixed dental prosthesis. MATERIALS AND METHODS: Twelve subjects with an edentulous mandible or failing dentition were rehabilitated with the use of endosseous dental implants. Three implants were placed, and were immediately loaded with a provisional fixed prosthesis with minimal cantilever. After healing for 4 months, two Locator attachments were inserted and an overdenture was trialed; then, after a further 4 months, a fixed prosthesis was placed on the three implants. The fixed prosthesis was fabricated using computer-assisted design, and a titanium framework was manufactured with a resin base and teeth. Patient satisfaction and oral health-related quality of life was assessed before treatment, after wearing the provisional, and after each treatment option using a seven-item visual analog scale and a modified version of the 49-item oral health impact profile. RESULTS: Of the 12 subjects, 11 chose the fixed over the removable prosthesis. A statistically significant (P < .05) and positive effect on the overall score of both assessment tools was reported for both treatment modalities (when compared with pretreatment scores). Although no significant difference (P > .05) was found between the two options in overall scores of both surveys or in any of the seven domains of the modified oral health impact profile, the fixed prosthesis had a statistically higher score for stability, retention, and ease of chewing on a visual analog scale. CONCLUSION: Both treatment modalities provided a significant and similar improvement in patient satisfaction and oral health-related quality of life compared with a conventional complete mandibular removable dental prosthesis; however, a statistically significant higher score was reported for stability, retention, and ease of chewing for the fixed dental prostheses. Based on the 12 participants in this study, greater stability and ease of chewing with the fixed prosthesis likely influenced patient preference in most but not all subjects.

Rehabilitation of ectodermal dysplasia patients presenting with hypodontia: outcomes of implant rehabilitation part 1.

PURPOSE: This study has evaluated the pre and post perceptions of patients with ectodermal dysplasia (ED) who have been referred to Westmead Centre for Oral Health for treatment with dental implants. METHODS: Six patients with ED and hypodontia were treated with new maxillary complete dental prostheses or fixed implant prostheses, and a mandibular fixed dental prosthesis with implants. Patient perceptions were recorded with a 10cm visual analogue scale (VAS). All patients were asked to draw a line on the VAS which best described their feelings regarding aesthetics, chewing, diet and speech. RESULTS: Improvement in aesthetics was reported for all patients with change scores ranging from +9 to +4 points. Similarly, all patients reported an improvement in chewing ability with +6 point changes in 2 patients, and +8, +3, +7 and +1 in the other 4 patients. Five out of 6 patients reported less dietary restriction with 3 patients each indicating a change of +6 points, +4 points, +3 points, and 2 patients reporting +1 point change. Speech improved by +1 point for 3 patients, whilst 1 patient improved by +6 points, a further 2 patients scored no change. CONCLUSIONS: Patients with ED treated with dental implants reported encouraging outcomes post treatment after prostheses were fitted. Follow-up from 1.6 to 6.8 years has confirmed these improvements.

On Implant Prosthodontics: One Narrative, Twelve Voices - 5.

No abstract available.

The effect of hyperglycaemia on osseointegration: a review of animal models of diabetes mellitus and titanium implant placement.

UNLABELLED: Patients with type 2 diabetes mellitus have a higher risk of dental and/or orthopaedic implant failure. However, the mechanism behind this phenomenon is unclear, and animal studies may prove useful in shedding light on the processes involved. This review considers the available literature on rat models of diabetes and titanium implantation. INTRODUCTION: The process of osseointegration whereby direct contact is achieved between bone and an implant surface depends on healthy bone metabolism. Collective evidence suggests that hyperglycaemia adversely affects bone turnover and the quality of the organic matrix resulting in an overall deterioration in the quality, resilience and structure of the bone tissue. This in turn results in compromised osseointegration in patients receiving dental and orthopaedic implants. The incidence of diabetes mellitus (DM), which is a chronic metabolic disorder resulting in hyperglycaemia, is rising. Of particular significance is the rising incidence of adult onset type 2 diabetes mellitus (T2DM) in an ageing population. Understanding the effects of hyperglycaemia on osseointegration will enable clinicians to manage health outcomes for patients receiving implants. Much of our understanding of how hyperglycaemia affects osseointegration comes from animal studies. METHODS: In this review, we critically analyse the current animal studies. RESULTS: Our review has found that most studies used a type 1 diabetes mellitus (T1DM) rodent model and looked at a young male population of rodents. The pathophysiology of T1DM is however very different to that of T2DM and is not representative of T2DM, the incidence of which is rising in the ageing adult population. Genetically modified rats have been used to model T2DM, but none of these studies have included female rats and the metabolic changes in bone for some of these models used are not adequately characterized. CONCLUSIONS: Therefore, the review suggests that the study population needs to be broadened to include both T1DM and T2DM models, older rats as well as young rats, and importantly animals from both sexes to reflect more accurately clinical practice.

Assisted Wound Healing and Vertical Bone Regeneration with Simultaneous Implant Placement: A Histologic Pilot Study.

PURPOSE: To evaluate the effectiveness of platelet-rich fibrin (PRF) and freeze-dried bone allograft (FDBA) in vertical bone augmentation with immediate implant placement using histologic analysis. MATERIALS AND METHODS: Six Merino sheep received a total of 36 Brånemark MKIII implants; three implants were placed supracrestally in each tibia with vertical exposure of four threads. Each implant received one of the three grafting options (MinerOss + PRF or MinerOss or PRF). The grafting materials were covered with a resorbable collagen membrane (Mem-Lok 30 × 40 mm, BioHorizons). Animals were sacrificed at 4 and 8 weeks, respectively, and specimens were prepared and collected for histologic analysis. Ground sections and decalcified sections were prepared. RESULTS: The various stages of graft integration into native bone and the implant were observed at different time points, and comparison between the three grafting options was possible. Osteogenic potential with vertical generation of bone was observed in the three groups. At week 4, woven bone formation at the bone graft interface was observed; new bone did not appear to be organized at week 4. At week 8, the graft appeared to be fully replaced by vital mature and well-organized bone arranged in lamellae with osteocytes encapsulated within the bone. The vertical bone gain at 8 weeks was higher for the PRF + MinerOss group with viable bone extending above the first thread. Both the MinerOss and PRF groups had vertical bone gain extended to the second thread. CONCLUSION: MinerOss appeared to be effective in vertical bone augmentation with simultaneous implant placement. PRF enhanced vertical bone augmentation when combined with MinerOss.

Clinical and laboratory surface finishing procedures for zirconia on opposing human enamel wear: A laboratory study.

AIM: To investigate the effect of laboratory and clinical finishing procedures for zirconia on antagonistic enamel wear. MATERIALS AND METHODS: Forty-eight yttria-tetragonal partially stabilised zirconia (Y-TZP) specimens were prepared and divided into four groups according to their surface preparation: laboratory polished (LP); laboratory polished and glazed (G); clinically adjusted (CA); and clinically adjusted and repolished (CAR). Enamel opposing enamel was used as a control. Pre-testing surface roughness for each group was determined using contact profilometry. Two-body wear resistance tests were conducted using a masticatory simulator. Enamel specimens were subjected to 120,000 cycles in distilled water (frequency 1.6 Hz, loading force of 49 N). Volumetric and vertical enamel losses were measured by superimposition of pre- and post-testing images using a three-dimensional laser scanner and software analysis. Scanning electron microscopy was used for qualitative surface analysis of pre- and post-testing zirconia and enamel surfaces. One-way ANOVA and multiple comparisons with Bonferroni corrections were used for statistical analysis at a significance level of α=0.05. RESULTS: There was no statistical difference in volumetric and vertical enamel loss between CAR, G and LP. CAR produced statistically significantly less volumetric enamel loss compared with CA and control, and statistically significantly less vertical enamel loss compared with CA. Volumetric and vertical enamel loss were highly correlated in all groups. CONCLUSIONS: Enamel wear by clinically ground zirconia is comparable to that of opposing enamel surfaces and greater than clinically repolished zirconia. Repolishing of zirconia restorations following clinical adjustment with diamond burs is effective in reducing antagonistic enamel wear.

Surface roughness of restoration margin preparations: a comparative analysis of finishing techniques.

This study compared the margin profile and surface roughness created by the tips of four different finishing instruments: fine diamond, dura white stone, tungsten carbide, and ultrasonic diamond-coated tips (UDTs). The aim was to determine which of these instruments produced the smoothest finish and created the most evenly contoured margin characteristics. It was hypothesized that UDTs would produce a rougher dentin surface than a fine diamond bur, that a tungsten carbide bur would provide a smoother finish than a fine diamond, and that the dura white stone would produce an intermediate finish. Forty extracted premolars were divided into two groups. For the first group, a 1.5 x 3.0-mm dentin slot was prepared in 30 teeth using a control 50-µm diamond bur, followed by one of the four finishing instruments. The surface roughness (Ra) was then measured using a surface profilometer and a one-way analysis of variance followed by a post hoc Bonferroni test to assess whether any statistical difference existed among the Ra values. For the second group, shoulder margins were prepared in 10 teeth. They were then refined with one of the four finishing instruments and examined with scanning electron microscopy (SEM). The fine diamond bur created a significantly smoother surface than the control diamond (P < .001), UDTs (P < .007), and tungsten carbide bur (P < .010). The fine diamond was not found to be significantly smoother than the dura white stone. SEM images of the fine diamond showed divoting on the margin floor. The dura stone showed a well-defined, undamaged margin. The tungsten carbide bur created frequent chipping in enamel margins. The UDT specimens showed an inconsistent finish and discrete patches of open dentinal tubules. The fine diamond created the lowest Ra values; however, the dura stone offered efficient finishing and less damage to the margin profile.

Rehabilitation of children with ectodermal dysplasia. Part 1: an international Delphi study.

PURPOSE: An international Delphi study was undertaken to determine by consensus an agreed approach to the management of children with dental manifestations of ectodermal dysplasia, including the use of dental implants. This was done using a questionnaire developed by an interdisciplinary team. MATERIALS AND METHODS: The Delphi study questionnaire was built around 19 areas of clinical relevance and included 90 items. Topic areas included dental disability; initial diagnosis; global disability; oral health aspects of dental treatment (orthodontics, hypodontia, anodontia, implants); and case studies of selected treatment options. Eleven teams from six countries contributed to three iterations of the questionnaire. An algorithm was designed to standardize analysis of the questionnaire answers, all of which were blinded to ensure anonymity. The second and third rounds of the questionnaire excluded previously agreed-upon items but included the responses to the questions from the earlier rounds. The nonconsensus items inquired about the use of radiographs at initial diagnosis; sedation of an uncooperative child; use of a pretreatment questionnaire; the age range for specific treatments (eg, dentures, orthodontics, implants); specific uses of implants (eg, partial prostheses, overdentures, cantilevered prostheses); and case study 2. The residual nonconsensus questions were subsequently discussed at a 2-day meeting. RESULTS: Among the 90 questions and partial questions, there was progressive consensus, with agreements in rounds 1, 2, and 3 of 61%, 21%, and 8%, respectively. At the conclusion of round 3, there was 90% agreement and it was considered that the nonconsensus items required in-depth face-to-face discussion at a consensus meeting, which is described in part 2 of the study. CONCLUSION: The Delphi study provided an opportunity to engage specialist teams in recognized centers to integrate their clinical knowledge and draw on published data to develop a consensus of evidence-based responses.

Rehabilitation of children with ectodermal dysplasia. Part 2: an international consensus meeting.

A consensus meeting was arranged to provide an opportunity to discuss the residual nonconsensus questions following three rounds of a Delphi study. It was hoped that the nonagreements could be resolved to define a comprehensive protocol for the management of ectodermal dysplasia, particularly with respect to the use of dental implants in growing patients. An international panel of expert clinicians in pediatric dentistry, prosthodontics, and orthodontics was invited to be part of the Delphi study to develop agreement on clinical questions through a consensus of ideas. Each expert had been invited to form a study group or team within his or her home institution. As required by the Delphi protocol, a 90-part questionnaire was considered by the collaborating teams and progressed through three iterations with increasing agreement. This process is discussed in part 1 of the study. The residual nonconsensus questions, which represented 10% of the questionnaire, required collaborative interaction for resolution. The consensus meeting was held in London, England, over a 2-day period with support from Nobel Biocare and the British Dental Association.

Neuroplasticity in the adaptation to prosthodontic treatment.

AIMS: To investigate cerebral cortical changes by using functional magnetic resonance imaging (fMRI) after denture renewal and to test how these relate to prosthodontic treatment adaptability as measured by chewing efficiency and maximum bite force. METHODS: Ten complete denture wearers (five women and five men, mean age ± standard deviation: 70.3 ± 9.1 years) participated in the study. Each had their complete dentures renewed and underwent an fMRI examination with three functional tasks (lip pursing; jaw tapping; jaw clenching) as well as a color-mixing test for chewing efficiency and unilateral maximum bite force measurements. Recordings were performed with the old dentures (T0) and with the new dentures on insertion (T1) and at 1 week (T2) and 3 months postinsertion (T3). At T1, denture stability and retention (S/T) were assessed by two independent operators. Wilcoxon signed rank tests and Spearman's rho correlation were carried out for data analysis. RESULTS: The right and the left precentral gyrus (PRCG) and postcentral gyrus (POCG) were identified with significant activation across all three functional tasks. A statistically significant increase in the level of activity between T0 and T2 (POCG: P = .022; PRCG: P = .017) was found during jaw clenching tasks. Both regions of interest (PRCG, POCG) appeared to correlate with S/T of the new dentures while the subject performed a lip-pursing task (PRCG: r = 0.689, P = .027; POCG: r = 0.665, P = .036). The chewing efficiency and maximum bite force increased significantly during the adaptation to replacement dentures (chewing efficiency: T1-T2 P = .032, T2-T3 P = .012; maximum bite force right side: T2-T3 P = .047). CONCLUSION: Changes in brain activity occurred in the adaptation to replacement dentures and appeared to regain preinsertion activity levels during motor tasks involving the dental occlusion after 3 months postinsertion.

Influence of implant abutment angulations and two types of fibers on the fracture resistance of ceramage single crowns.

PURPOSE: To assess the effect of three implant abutment angulations and two types of fibers on the fracture resistance of overlaying Ceramage single crowns. MATERIALS AND METHODS: Three groups, coded A to C, with different implant abutment angulations (group A/0°, group B/15°, and group C/30° angulation) were restored with 45 overlay composite restorations; 15 Ceramage crowns for each angulation. Groups A, B, and C were further subdivided into three subgroups (n = 5) coded: 1, crowns without fiber reinforcement; 2, crowns with Connect polyethylene reinforcement; and 3, crowns with Interlig glass reinforcement. All crowns were constructed by one technician using the Ceramage System. The definitive restorations (before cementation) were stored in distilled water at mouth temperature (37°C) for 24 hours prior to testing. Before testing, the crowns were cemented using Temp Bond. The compressive load required to break each crown and the mode of failure were recorded. The speed of testing was 1 mm/min. The results were statistically analyzed by two-way ANOVA (p < 0.05). The tested crowns were examined using a stereomicroscope at 40×, and selected crowns (five randomly selected from each group) were further examined by scanning electron microscopy (SEM) to reveal the composite-fiber interface. RESULTS: Fracture resistance of single crowns was not affected (p > 0.05) by the different abutment angulations chosen (0°, 15°, 30°) or fiber reinforcement (Connect and Interlig fibers). Crowns in group A exhibited average loads to fracture (N) of A1 = 843.57 ± 168.20, A2 = 1389.20 ± 193.40, and A3 = 968.00 ± 387.53, which were not significantly different (p > 0.05) from those of groups B (B1 = 993.20 ± 327.19, B2 = 1471.00 ± 311.68, B3 = 1408.40 ± 295.07), or group C (C1 = 1326.80 ± 785.30, C2 = 1322.20 ± 285.33, C3 = 1348.40 ± 527.21). SEM images of the fractured crowns showed that the origin of the fracture appeared to be located at the occlusal surfaces of the crowns, and the crack propagation tended to extend from the occlusal surface towards the gingival margin. CONCLUSIONS: Implant abutment angulations of 0°, 15°, and 30° did not significantly (p > 0.05) influence the fracture resistance of overlaying Ceramage single crowns constructed with or without reinforcing fibers. The two types of fibers used for reinforcement (Connect and Interlig) had no effect (p > 0.05) on the fracture resistance of overlaying Ceramage single crowns.

Bone microarchitecture at oral implant sites in ectodermal dysplasia (ED): a comparison between males and females.

OBJECTIVE: The aim of this study was to analyse the microarchitecture of bone in association with implant placement in young ectodermal dysplasia (ED) patients. The general hypothesis was that the structural and morphological features of bone microarchitecture are different between males and females, which may influence clinical outcomes. MATERIALS AND METHODS: The bone harvesting is not additionally invasive, as the procedure was made at the time and site of implant placement. Twenty one samples (8 female, 13 male) were harvested from nine ED participants whose age ranged between 14 and 21 years and specified by the site of harvesting. Micro-CT analysis at 5 µm resolution was conducted on each sample. Specialized CT analysis of the three-dimensional (3-D) bone microstructure was made to compare structural parameters. In addition, two bone samples (one male, one female) were sent to the University of Michigan and analysed at 9 µm resolution. RESULTS: No significant difference was found between male and female samples. Bone analysis of particular sites revealed that bone-specific surface (BS/BV) was found to be significantly higher in male than in female samples, whilst the mean values of 10 parameters, the grey scale value histograms and 3-D visualization showed that female samples had higher compact density than male samples. CONCLUSION: Microstructural analyses indicated that female ED bone was more compact and with greater trabecular connectedness than male bone. These features may enhance resistance to external force transfer of mastication compared with male bone. Further bone samples from other jaw bone areas will provide information on whether there are regional differences in jawbone quality and quantity, which may influence implant treatment outcomes, as well as follow-up analyses of treatment outcomes.