Impact of dental implant diameter on the efficiency of fatigue: A systematic review analysis.

OBJECTIVE: To explain the success and failure of dental implant diameter on the efficiency of fatigue. METHODS: The systematic review was conducted using PubMed and Cochrane databases for Original Articles published in the English language from 1999 to 2019. Outcomes were evaluated to determine perceptions regarding the role of dental implant diameter in influencing the implant's fatigue performance. Data was analysed using SPSS 22. RESULTS: Of the 263 abstracts retrieved, 53(20%) were reviewed. Of them, 14(26.4%) were included; 9(64.3%) systematic reviews, and 5(35.7%) studies. The implant diameter could be categorised into wide diameter (5-6mm), regular diameter (3.75-4mm), and small/narrow diameter (3-3.4mm). The narrow diameter implants are indicated through thin alveolar ridges and mesiodistal spaces (<7mm). The implants with narrow diameter would offer greater risk of fatigue failure for clinical situations with significant functional loading (p<0.05). No significant differences were found either in success or failure of dental implant diameter on fatigue efficiency at 1-year and 3-year follow-ups (p>0.05). CONCLUSIONS: The technical complication of dental implant included abutment screw loosening or fracture, abutment and superstructure fracture, and implant body fracture. The review mainly focussed on the impact of dental implant diameter on the efficiency of fatigue and reviewed a significant impact of dental implant diameter on the fatigue efficiency.

Novel CAD-CAM zirconia coping design to enhance the aesthetics and strength for anterior PLZ crowns.

BACKGROUND: The aesthetics and strength of anterior porcelain layered zirconia (PLZ) crowns are mainly affected by the zirconia (Zr) coping design. There is a need for a modified design to enhance aesthetics with strength. OBJECTIVES: The purpose of this study was to compare the fracture resistance of anterior PLZ crowns having modified CAD-CAM Zr coping designs (in terms of thickness and marginal collar designs) with standard Zr copings. METHODS: Fifty PLZ crowns were fabricated and divided into two groups: Gr 1: Standard Zr Coping (SZC) (control gr) with 0.5 mm thickness (Facial-F, Mesial-M, Distal-D, incisal-I, and Palatal-P) without a collar; Gr 2: Collar Zr Coping (CZC) (test gr) with 2.5 mm collar height on M, D, P and 0.2 mm F and variable facial wall thickness. Subgroups: Gr 2a: (CZC-0.5 mm) facial wall thickness 0.5 mm; Gr 2b: (CZC-0.4 mm) facial wall thickness 0.4 mm; Gr 2c: (CZC-0.3 mm) facial wall thickness 0.3 mm; Gr 2d: (CZC-0.2 mm) facial wall thickness 0.2 mm. The fracture load was determined and analysed using One-way ANOVA and Dunnet test. RESULTS: The minimum fracture load was 927.36 ± 127.80 N observed for Gr 2c (CZC at 0.3 mm) while the maximum fracture load was 1373.61 ± 146.54 N observed for Gr 2a (CZC at 0.5 mm). A highly significant difference in mean fracture load among various Zr coping groups (p< 0.001) was determined. CONCLUSIONS: Novel Zr coping design for anterior PLZ crowns can provide better aesthetics with strength. Reducing the thickness of Zr coping in the aesthetic zone to 0.2 mm and providing a modified collar design (2.5 mm collar height on M, D, P, and 0.2 mm F) would provide strength without jeopardizing aesthetics.

Knowledge and attitude toward replacing missing teeth with dental implants among the Saudi population.

OBJECTIVES: To assess the knowledge level and attitude of the Saudi population about the use of a dental implant as a treatment option for replacing the missing teeth. MATERIALS AND METHODS: This cross-sectional study adopted a quantitative approach and used an online questionnaire to collect data. Nine hundred and five participants were recruited as per the inclusion criteria (above 18 years of age, know how to read and write, and technology literate). The collected data were analyzed statistically using IBM Statistical Package for Social Sciences (SPSS) software. RESULTS: A low level of knowledge about teeth replacement methods (56%) was recorded among the participant, while 44.4% of them had heard about implant, bridges, and dentures. The oral hygiene of the participants was considered good (59.3%). The main source of information, reported by the participants, was the dentist (53.4%). The knowledge about dental implants was found to be significantly the highest (P = 0.02) among the highly educated participant who had completed postgraduate studies. CONCLUSION: There is a need for introducing comprehensive orientation programs, conducted by dentists, to communicate knowledge about dental implants. The social campaigns and official information programs should be instigated for improving the knowledge of the patients. Structured programs should be also introduced at an academic level, for enhancing the knowledge related to replacing missing teeth and dental implants.

Restoring the Esthetics for a Cleft Palate Patient by Using Modified Preparation and Pink Porcelain.

AIM: This report describes the challenges experienced in a unique case involving dental esthetics, and the treatment provided to achieve satisfactory conservative treatment. BACKGROUND: Even minor aspects of dental esthetics can significantly affect a patient's quality of life. Moreover, the patient's level of satisfaction with rehabilitative dentition and prosthetics affects oral health, daily living, and dental perceptions. It is not unusual for clinicians to encounter cases with complex esthetics that have affected the patient's life. Such cases need careful treatment planning to meet the patient's expectations. Conservative treatment should be the clinician's goal, because complex treatment may result in negative outcomes. CASE DESCRIPTION: Here, the patient exhibited severe bone loss due to cleft palate, as well as improper positioning of the teeth. He could not be treated with implants because of poor bone quality and quantity. Orthodontic treatment was performed, but did not improve the outcome. A wax-up was made for each of the three possible options, and then transferred to the patient's mouth by making a mock-up. This allowed the patient to clearly understand the results of each option. After selecting an option, we performed the procedure on the cast before it was undertaken in the patient's mouth. This helped us to precisely determine the preparation needed for all teeth. Teeth were saved where possible to preserve the remaining bone. The lost bone was replaced with pink porcelain. Treatment was conservative and the results were optimal for the patient and our clinical team. CONCLUSION: In some cases, clinicians may have few options available to achieve satisfactory results. However, the use of appropriate diagnostic tools, data collection, and conservative treatment procedures can help achieve these goals. CLINICAL SIGNIFICANCE: Fabrication of wax-ups and mock-ups can help the clinician and patient predict the results of dental treatment and ensure a conservative procedure.

Clinical Concerns Regarding Dentition and Connections to Osseointegrated Implants: A Systematic Review of Implant Restoration Trends and Treatment of Partial Edentulism.

Issues associated with missing teeth can be found in almost all age groups. For edentulous patients, osseointegration is a highly efficient treatment. However, certain biochemical challenges are presented when osseointegrated implants are taken into consideration due to the periodontal ligament. Therefore, the current study focuses on clinical concerns that can occur with the use of dental implants and examines different trends of implant restoration and treatment of partial edentulous patients. Data were collected from ten research articles and analyzed by means of a qualitative secondary approach. The findings of the current study indicate that restoration and preservation of natural teeth are significant in the development of dental practices. Moreover, the determinant of endodontic treatment is considered to be a key factor in the retention and reconstruction of tooth functioning that is influenced by necrosis of dental pulp. We conclude that the osseointegration method is significant and highly effective for treating edentulous patients.