Evaluation of Predictability of Suitable Implant Lengths as related to Accurate Treatment Planning using Recent Roentgenographic Measures: A Key to Success.

BACKGROUND AND AIM: Selection of suitable length of dental implants is very subjective and largely depends on clinical evidences and operator's expertise. The present study was aimed to assess the role of cone beam computed tomography (CBCT) and cephalograms as far as the selection of right implant length is concerned. MATERIALS AND METHODS: The study includes 220 patients for whom radiographic and follow-up records were obtained. There were 105 males and 115 females in the age range of 22 to 58 years. A total of 98 implant sites in different edentulous areas were studied. Length of implant was predicted at treatment planning and compared with finally placed implant at surgical stages. It also includes the in-depth exploration of (1) number of implants placed per patient, (2) implant per edentulous areas, (3) implant location, and (4) implant region. For prediction of implant lengths, CBCT results were obtained and compared with cephalometric findings. Accuracies of implant lengths as planned by CBCT and cephalometric images were also studied at treatment planning and surgical stages. Statistical analysis and results: Upon statistical comparisons, we found that larger implant lengths chosen at treatment planning stage did not change in 65.5% of patients. In addition, the smaller length implants were just about the same as that with larger dimensions. The CBCT results were satisfactory (up to 98.5%). Cephalometry was performed well in this prediction, especially in posterior mandible (87.9%). However, its performance in anterior maxillary region was not satisfactory (69.6%). Intergroup comparisons of CBCT and cephalometric results at different regions were significant (p < 0.001). CONCLUSION: Our study results show insignificant changes in the length of implants that was exactly planned using CBCT scans. Therefore, accurate prediction of implant lengths can be done using CBCT scans as they have superior and advanced tools that facilitate presurgical decision-making. Lateral cephalometric evaluation has been shown as an imperative radiographic tool for determining implant lengths as it confirmed the significance bone resorption on the selection of implant length at different sites. CLINICAL SIGNIFICANCE: The CBCT and lateral cephalogram offer excellent anatomical details that can be judiciously applied for treatment planning and other clinical decision-making, including selection of correct implant length. Our study advocates thorough cephalometric evaluations of mandible wherein implants are to be placed for implant-supported overdentures.

Intricate Assessment and Evaluation of Dental Implants in Patients on Bisphosphonate Therapy: A Retrospective Analysis.

BACKGROUND: Osteonecrosis is one of the prevalent side effects of bisphosphonate (BP) therapy in oral cancer patients. In case of patients with various oncologic lesions, standard guidelines contraindicate the use of dental implants if the patients are on BP therapy. Literature also quotes studies that emphasize on the safety of dental implants in patients on BP therapy. Hence, this study aimed to retrospectively evaluate the clinical outcome of dental implants in patients on BP therapy. MATERIALS AND METHODS: In this retrospective analysis, a total of 140 dental implants in 112 patients were included. Inclusion criteria included only those patients who were on or had history of BP therapy. Calculation of implant failure and survival rate was done. RESULTS: Ten cases of implant failure occurred, giving a success rate of above 92%, which was comparable to the results found in previous studies in patients who were not on BP therapy. CONCLUSION: No significant risk of implant failure is seen in patients on BP therapy compared with other patients.

Prevalence based epidemiological cancer statistics: a brief assessment from different populations in India.

Modern civilization, urbanization, industrialization, changes in daily life, population growth and ageing all have contributed to epidemiological changes in many diseases, including cancer, in India and other countries. Tobacco has been identified as the most important cause of cancer followed by alcohol consumption, dietary practices, inadequate physical activity, infections due to viruses and sexual behavior. The total number of new cancer cases is increasing rapidly, due to growth in size of the population, and an increase in the proportion of elderly persons, as a result of improved life expectancy, following control of communicable diseases. Such changes in the age structure automatically alter the disease pattern associated with ageing and increase the burden of problems such as cancer, cardiovascular and other non-communicable diseases in the society. Knowledge based on epidemiological patterns and trends would be of great help in identifying persons at high risk for the development of a particular cancer. Public education on 'tobacco and its health hazards', recommended dietary guidelines, safe sexual practices, and lifestyle modifications form the scientific basis for planning and organizing prevention, diagnosis and treatment of cancer in a community. Moreover, incorporating screening for cervical, breast and oral cancers into the peripheral health infrastructure can have a significant effect on reducing mortality from these diseases. This paper highlights the incidence and prevalence based epidemiological cancer statistics, its early detection and prevention measures in India.

Recurrence of keratocyst in nevoid basal cell carcinoma syndrome: A major diagnostic dilemma for clinicians.

The odontogenic keratocysts (OKC) usually represent a particular entity that has been of interest primarily due to biological aggressiveness and to its frequent recurrence. Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome is a hereditary condition characterized by a wide-range of developmental abnormalities and a predisposition to neoplasms. There are several possible reasons why OKC recur so frequently and require meticulous surgical planning and execution. This article has attempted to show that there is a lack of published evidence regarding the cause of frequent recurrent of OKC that presented in NBCCS. However, the findings of the study revealed differences in opinion regarding the treatment modalities, which necessitates further long term clinical studies that could precisely document certain reliable guidelines in this point of view.

Comparative assessment of marginal accuracy of grade II titanium and Ni-Cr alloy before and after ceramic firing: An in vitro study.

OBJECTIVE: The aims of the study are to assess the marginal accuracy of base metal and titanium alloy casting and to evaluate the effect of repeated ceramic firing on the marginal accuracy of base metal and titanium alloy castings. MATERIALS AND METHODS: Twenty metal copings were fabricated with each casting material. Specimens were divided into 4 groups of 10 each representing base metal alloys castings without (Group A) and with metal shoulder margin (Group B), titanium castings without (Group C) and with metal shoulder margin (Group D). The measurement of fit of the metal copings was carried out before the ceramic firing at four different points and the same was followed after porcelain build-up. RESULTS: Significant difference was found when Ni-Cr alloy samples were compared with Grade II titanium samples both before and after ceramic firings. The titanium castings with metal shoulder margin showed highest microgap among all the materials tested. CONCLUSIONS: Based on the results that were found and within the limitations of the study design, it can be concluded that there is marginal discrepancy in the copings made from Ni-Cr and Grade II titanium. This marginal discrepancy increased after ceramic firing cycles for both Ni-Cr and Grade II titanium. The comparative statistical analysis for copings with metal-collar showed maximum discrepancy for Group D. The comparative statistical analysis for copings without metal-collar showed maximum discrepancy for Group C.