Effects of Candidalysin Derived from Candida albicans on the Expression of Pro-Inflammatory Mediators in Human Gingival Fibroblasts.

Candida albicans (Ca) is frequently detected in the peri-implant sulcus with peri-implantitis, a major postoperative complication after oral implant therapy. However, the involvement of Ca in the pathogenesis of peri-implantitis remains unclear. In this study, we aimed to clarify Ca prevalence in the peri-implant sulcus and investigated the effects of candidalysin (Clys), a toxin produced by Ca, on human gingival fibroblasts (HGFs). Peri-implant crevicular fluid (PICF) was cultured using CHROMagar and Ca colonization rate and colony numbers were calculated. The levels of interleukin (IL)-1ß and soluble IL-6 receptor (sIL-6R) in PICF were quantified by enzyme-linked immunosorbent assay (ELISA). Pro-inflammatory mediator production and intracellular signaling pathway (MAPK) activation in HGFs were measured by ELISA and Western blotting, respectively. The Ca colonization rate and the average number of colonies in the peri-implantitis group tended to be higher than those in the healthy group. IL-1ß and sIL-6R levels in the PICF were significantly higher in the peri-implantitis group than in the healthy group. Clys significantly induced IL-6 and pro-matrix metalloproteinase (MMP)-1 productions in HGFs, and co-stimulation with Clys and sIL-6R increased IL-6, pro-MMP-1, and IL-8 production levels in HGFs compared with Clys stimulation alone. These findings suggest that Clys from Ca plays a role in the pathogenesis of peri-implantitis by inducing pro-inflammatory mediators.

Diagnosis of inflammatory peri-implant diseases using an immunochromatographic assay for calprotectin in peri-implant crevicular fluid.

BACKGROUND: The incidence rate of peri-implant diseases is increasing with implant placement. Early detection of peri-implant diseases is important to prevent and treat these diseases, and a simple and objective diagnostic method is expected. Immunochromatographic (IC) assays are used for rapid diagnostic methods for some diseases. The aim of this clinical study was to determine the amount of calprotectin, an inflammatory marker, in peri-implant crevicular fluid (PICF) using an IC chip, and estimate the possibility of this diagnostic system. METHODS: Forty-six individuals with dental implants participated in a pilot study. PICF samples were collected from the peri-implant sites with or without inflammation after clinical examinations including probing depth (PD), bleeding on probing (BOP) and gingival index (GI). Calprotectin in PICF was determined by an IC chip and enzyme-linked immunosorbent assay (ELISA) for calprotectin. The density of calprotectin line on the IC chip was measured using an IC reader (IC reader value). The relationship between IC reader value and ELISA value or clinical parameters was investigated. A receiver operating characteristic (ROC) curve analysis of IC reader value of calprotectin was performed to predict inflammation in peri-implant diseases. RESULTS: IC reader value of calprotectin was significantly correlated with its ELISA value and PD. IC reader values of calprotectin in PICF samples from periodontal sites with GI-1 and GI-2, and with BOP-positive sites were significantly higher than those of PICF samples from GI-0 sites, and BOP-negative sites, respectively. The IC reader value for calprotectin in PICF samples from inflammatory diseased sites was significantly higher than that of non-diseased sites. ROC analysis suggested that the IC reader value of PICF calprotectin was useful for predicting inflammatory peri-implant diseases. CONCLUSION: IC assay for PICF calprotectin may be a possible system for diagnosing the inflammatory peri-implant diseases.

Does Periodontal Tactile Input Uniquely Increase Cerebral Blood Flow in the Prefrontal Cortex?

We previously studied the effect of peripheral sensory information from sensory periodontal ligament receptors on prefrontal cortex (PFC) activity. In the dental field, an alternative dental implant without periodontal sensation can be applied for missing teeth. In this study, we examine whether periodontal tactile input could increase cerebral blood flow (CBF) in the PFC against elderly patients with dental implants lacking periodontal tactile (implant group), elderly individuals with natural teeth (elderly group), and young individuals with natural teeth (young group). The experimental task of maintaining occlusal force as closed-loop stimulation was performed. Compared with the young group, the elderly group showed significantly lower CBF. Contrastingly, compared with the young group, the implant group showed significantly lower CBF. There were no significant differences between the elderly and implant groups. Regarding the mean occlusal force value, compared with the young group and the elderly group, the implant group had a numerically, but not significantly, larger occlusal force exceeding the directed range. In conclusion, the periodontal tactile input does not uniquely increase PFC activity. However, increased CBF in the PFC due to the periodontal tactile input in the posterior region requires existing attention behavior function in the PFC.

Calprotectin and cross-linked N-telopeptides of type I collagen levels in crevicular fluid from implant sites with peri-implant diseases: a pilot study.

BACKGROUND: Peri-implant crevicular fluid (PICF) contains calprotectin and NTx, which are markers for inflammation and bone resorption, respectively. The aims of this pilot study were to compare calprotectin and NTx levels in PICF from implant sites with or without peri-implant diseases and to evaluate the usefulness of calprotectin and NTx as diagnostic markers for peri-implant diseases. METHODS: Thirty-five patients with dental implants participated in this pilot study. PICF samples were collected from peri-implant disease sites (n = 40) and non-diseased (healthy) sites (n = 34) after clinical indicators including probing depth (PD), bleeding on probing (BOP), gingival index (GI), and bone loss (BL) rate were investigated. Calprotectin and NTx amounts in PICF were measured using their respective ELISA kits and then compared between diseased and healthy samples. The relationship between PICF calprotectin or NTx levels and clinical indicator levels was investigated. A receiver operating characteristic (ROC) curve analysis of calprotectin and NTx was performed to predict peri-implant diseases. RESULTS: Calprotectin and NTx levels in PICF were significantly higher from peri-implant disease sites than from healthy sites. PICF calprotectin amounts correlated with PD, and its levels were significantly higher in the GI-1 and GI-2 groups than in the GI-0 group. PICF NTx amounts correlated with PD and the BL rate. ROC curves indicated that PICF calprotectin and NTx are useful biomarkers for peri-implant diseases. CONCLUSIONS: Calprotectin and NTx in PICF have potential as biomarkers for the diagnosis of peri-implant diseases.

Antifungal and Mechanical Properties of Tissue Conditioner Containing Plant-Derived Component: An In Vitro Study.

PURPOSE: To evaluate the antifungal activity and mechanical properties of a novel antifungal tissue conditioner containing Juncus powder. MATERIALS AND METHODS: Juncus powder was mixed with GC tissue conditioner at concentrations of 2.5%, 5.0%, and 10.0% by mass. The cylindrical specimens of Juncus-mixed tissue conditioner (dimensions: 10 mm in diameter and 2 and 6 mm in height for antimicrobial and mechanical tests, respectively) were prepared. The specimens placed on the bottom of the 24-well tissue culture plate were cultured with Candida albicans CAD1 for 2 and 4 days. The proliferation of the C. albicans in the wells was determined by measuring the optical density of fungal culture, and the surface of the specimens were also observed by scanning electron microscopy (SEM). To assess the mechanical properties of the specimens, the fluidity and hardness of Juncus-mixed tissue conditioner were measured using the methods certified according to ISO 10139-1. RESULTS: Juncus-mixed tissue conditioner significantly exhibited growth inhibitory effect in a Juncus concentration-dependent manner after both 2- and 4- day cultures. SEM observation showed that the amount of C. albicans on Juncus-mixed specimens drastically decreased, and biofilm formation was markedly inhibited. Moreover, both mechanical properties were found to be within the ranges regulated and specified by ISO. CONCLUSION: These findings demonstrated that the tissue conditioner including Juncus powder has a significant growth inhibitory effect against C. albicans, and it is suggested that the application of Juncus-mixed tissue conditioner may prevent denture stomatitis and oral candidiasis in denture wearers.

Application of porous titanium in prosthesis production using a moldless process: Evaluation of physical and mechanical properties with various particle sizes, shapes, and mixing ratios.

The prosthetic applications of titanium have been challenging because titanium does not possess suitable properties for the conventional casting method using the lost wax technique. We have developed a production method for biomedical application of porous titanium using a moldless process. This study aimed to evaluate the physical and mechanical properties of porous titanium using various particle sizes, shapes, and mixing ratio of titanium powder to wax binder for use in prosthesis production. CP Ti powders with different particle sizes, shapes, and mixing ratios were divided into five groups. A 90:10wt% mixture of titanium powder and wax binder was prepared manually at 70°C. After debinding at 380°C, the specimen was sintered in Ar at 1100°C without a mold for 1h. The linear shrinkage ratio of sintered specimens ranged from 2.5% to 14.2%. The linear shrinkage ratio increased with decreasing particle size. While the linear shrinkage ratio of Groups 3, 4, and 5 were approximately 2%, Group 1 showed the highest shrinkage of all. The bending strength ranged from 106 to 428MPa under the influence of porosity. Groups 1 and 2 presented low porosity followed by higher strength. The shear bond strength ranged from 32 to 100MPa. The shear bond strength was also particle-size dependent. The decrease in the porosity increased the linear shrinkage ratio and bending strength. Shrinkage and mechanical strength required for prostheses were dependent on the particle size and shape of titanium powders. These findings suggested that this production method can be applied to the prosthetic framework by selecting the material design.

Bone ingrowth of various porous titanium scaffolds produced by a moldless and space holder technique: an in vivo study in rabbits.

Porous titanium has long been desired as a bone substitute material because of its ability to reduce the stress shielding in supporting bone. In order to achieve the various pore structures, we have evolved a moldless process combined with a space holder technique to fabricate porous titanium. This study aims to evaluate which pore size is most suitable for bone regeneration using our process. The mixture comprising Ti powder, wax binder and PMMA spacer was prepared manually at 70 °C which depended on the mixing ratio of each group. Group 1 had an average pore size of 60 µm, group 2 had a maximum pore size of 100 µm, group 3 had a maximum pore size of 200 µm and group 4 had a maximum pore size of 600 µm. These specimens were implanted into rabbit calvaria for three and 20 weeks. Thereafter, histomorphometrical evaluation was performed. In the histomorphometrical evaluation after three weeks, the group with a 600 µm pore size showed a tendency to greater bone ingrowth. However, after 20 weeks the group with a pore size of 100 µm showed significantly greater bone ingrowth than the other groups. This study suggested that bone regeneration into porous titanium scaffolds is pore size-dependent, while bone ingrowth was most prominent for the group with 100 µm-sized pores after 20 weeks in vivo.

Digital assessment of preliminary impression accuracy for edentulous jaws: Comparisons of 3-dimensional surfaces between study and working casts.

PURPOSE: The aim of this study was to compare 3-dimensional surfaces of study and working casts for edentulous jaws and to evaluate the accuracy of preliminary impressions with a view to the future application of digital dentistry for edentulous jaws. METHODS: Forty edentulous volunteers were serially recruited. Nine dentists took preliminary and final impressions in a routine clinical work-up. The study and working casts were digitized using a dental 3-dimensional scanner. The two surface images were superimposed through a least-square algorithm using imaging software and compared qualitatively. Furthermore, the surface of each jaw was divided into 6 sections, and the difference between the 2 images was quantitatively evaluated. RESULTS: Overall inspection showed that the difference around residual ridges was small and that around borders were large. The mean differences in the upper and lower jaws were 0.26mm and 0.45mm, respectively. The maximum values of the differences showed that the upward change mainly occurred in the anterior residual ridge, and the downward change mainly in the posterior border seal, and the labial and buccal vestibules, whereas every border of final impression was shortened in the lower jaw. The accuracy in all areas except the border, which forms the foundation, was estimated to be less than 0.25mm. CONCLUSION: Using digital technology, we here showed the overall and sectional accuracy of the preliminary impression for edentulous jaws. In our clinic, preliminary impressions have been made using an alginate material while ensuring that the requisite impression area was covered.

MiR-494-3p induced by compressive force inhibits cell proliferation in MC3T3-E1 cells.

Mechanical stimuli regulate fundamental cell processes such as proliferation, differentiation, and morphogenesis. We attempted to identify microRNA (miRNA) whose expression is changed during compressive treatment in MC3T3-E1, a pre-osteoblastic cell line. Microarray analysis followed by reverse transcription-quantitative polymerase chain reaction revealed that compressive force at 294 Pa for 24 h in MC3T3-E1 cells increased levels of miR-494-3p, miR-146a-5p, miR-210-3p, and miR-1247-3p. Among these miRNAs, miR-494-3p was found to inhibit cell proliferation in MC3T3-E1 cells. Furthermore, cells subjected to compressive force showed slower cell growth compared with control cells. Levels of mRNA for fibroblast growth factor receptor 2 (FGFR2) and Rho-associated coiled-coil kinase 1 (ROCK1), which were predicted to be targets of miR-494-3p, were decreased by compressive force or overexpression of miR-494-3p mimics in MC3T3-E1 cells. Furthermore, binding sites of miR-494-3p within 3'-untranslated regions of Fgfr2 and Rock1 were determined using luciferase reporter assay. In conclusion, compressive force affected expressions of several miRNAs including miR-494-3p in MC3T3-E1 cells. Compressive force might inhibit cell proliferation in osteoblasts by up-regulating miR-494-3p followed by FGFR2 and ROCK1 gene repressions.

Influence of matrix attachment installation load on movement and resultant forces in implant overdentures.

PURPOSE: This in vitro study investigated the effect of attachment installation conditions on the load transfer and denture movements of implant overdentures, and aims to clarify the differences among the three types of attachments, namely ball, Locator, and magnet attachments. MATERIALS AND METHODS: Three types of attachments, namely ball, Locator, and magnetic attachments were used. An acrylic resin mandibular edentulous model with two implants placed in the bilateral canine regions and removable overdenture were prepared. The two implants and bilateral molar ridges were connected to three-axis load-cell transducers, and a universal testing machine was used to apply a 50 N vertical force to each site of the occlusal table in the first molar region. The denture movement was measured using a G(2) motion sensor. Three installation conditions, namely, the application of 0, 50, and 100 N loads were used to install each attachment on the denture base. The load transfer and denture movement were then evaluated. RESULTS: The resultant force decreased with increasing installation load for all attachments. In particular, the resultant force on implants on the loading side of the Locator attachment significantly decreased when the installation load was increased from 0 to 50 N, and that for magnetic attachment significantly decreased when the installation load was increased from 50 to 100 N. For the residual ridges on the loading side, the direction of the forces for all attachments changed to downward with increasing installation load. Furthermore, the yaw Euler angle increased with increasing installation load for the magnetic attachment. CONCLUSIONS: Subject to the limitations of this study, the use of any installation load greater than 0 N is recommended for the installation of ball and Locator attachments on a denture base. Regarding magnetic attachments, our results also recommend installation on a denture base using any installation load greater than 0 N, and suggest that the resultant force acting on the implant can be decreased by increasing the installation load; however, a large installation load of 100 N should be avoided when installing the attachment on the denture base to avoid increasing the denture movement.

Do sensation differences exist between dental implants and natural teeth?: a meta-analysis.

OBJECTIVE: The purpose of this systematic review was to survey evidence pertaining to the sensation differences between natural teeth and osseointegrated dental implants. MATERIAL AND METHODS: Using the MEDLINE (online PubMed) database, Cochrane Library, and Scientific Citation index, we performed a systematic search of articles. We used the following search terms: "perception or sensation and dental implant." The systematic review of the extracted articles was performed to see the sensation differences between natural teeth and dental implants. RESULTS: A total of six studies on oral sensation, "tactile sensibility," and "thickness discrimination" were included in the meta-analysis. As to the "tactile sensibility", all studies indicated the threshold levels of the implants were about 4-20 times higher than that of natural teeth. The tactile sensibility of an implant was significantly higher than that of a natural tooth, with an standardized mean difference (SMD) of 8.3619 (95% CI, 6.3920-10.3317) and a P < 0.0001. As to the "thickness discrimination", all studies indicated the threshold levels of implants were about 1.2-2.3 times higher than that of natural teeth. The thickness discrimination was significantly higher than that of natural teeth with an SMD of 1.2368 (95% CI, 0.8699-1.6038) and a P < 0.0001. CONCLUSION: This meta-analysis suggested that both tactile sensibility and thickness discrimination thresholds of implants were significantly higher than those of natural teeth. This meta-analysis reconfirms that sensation differences between dental implants and natural teeth exist.

Blue-violet laser modification of titania treated titanium: antibacterial and osteo-inductive effects.

BACKGROUND: Many studies on surface modifications of titanium have been performed in an attempt to accelerate osseointegration. Recently, anatase titanium dioxide has been found to act as a photocatalyst that expresses antibiotic properties and exhibits hydrophilicity after ultraviolet exposure. A blue-violet semiconductor laser (BV-LD) has been developed as near-ultraviolet light. The purpose of this study was to investigate the effects of exposure to this BV-LD on surface modifications of titanium with the goal of enhancing osteoconductive and antibacterial properties. METHODS: The surfaces of pure commercial titanium were polished with #800 waterproof polishing papers and were treated with anatase titania solution. Specimens were exposed using BV-LD (λ = 405 nm) or an ultraviolet light-emitting diode (UV-LED, λ = 365 nm) at 6 mW/cm(2) for 3 h. The surface modification was evaluated physically and biologically using the following parameters or tests: surface roughness, surface temperature during exposure, X-ray diffraction (XRD) analysis, contact angle, methylene blue degradation tests, adherence of Porphyromonas gingivalis, osteoblast and fibroblast proliferation, and histological examination after implantation in rats. RESULTS: No significant changes were found in the surface roughness or XRD profiles after exposure. BV-LD exposure did not raise the surface temperature of titanium. The contact angle was significantly decreased, and methylene blue was significantly degraded. The number of attached P. gingivalis organisms was significantly reduced after BV-LD exposure compared to that in the no exposure group. New bone was observed around exposed specimens in the histological evaluation, and both the bone-to-specimen contact ratio and the new bone area increased significantly in exposed groups. CONCLUSIONS: This study suggested that exposure of titanium to BV-LD can enhance the osteoconductivity of the titanium surface and induce antibacterial properties, similar to the properties observed following exposure to UV-LED.

Oral factors affecting titanium elution and corrosion: an in vitro study using simulated body fluid.

OBJECTIVES: Ti, which is biocompatible and resistant to corrosion, is widely used for dental implants, particularly in patients allergic to other materials. However, numerous studies have reported on Ti allergy and the in vitro corrosion of Ti. This study investigated the conditions that promote the elution of Ti ions from Ti implants. METHODS: Specimens of commercially pure Ti, pure nickel, a magnetic alloy, and a gold alloy were tested. Each specimen was immersed in a simulated body fluid (SBF) whose pH value was controlled (2.0, 3.0, 5.0, 7.4, and 9.0) using either hydrochloric or lactic acid. The parameters investigated were the following: duration of immersion, pH of the SBF, contact with a dissimilar metal, and mechanical stimulus. The amounts of Ti ions eluted were measured using a polarized Zeeman atomic absorption spectrophotometer. RESULTS: Eluted Ti ions were detected after 24 h (pH of 2.0 and 3.0) and after 48 h (pH of 9.0). However, even after 4 weeks, eluted Ti ions were not detected in SBF solutions with pH values of 5.0 and 7.4. Ti elution was affected by immersion time, pH, acid type, mechanical stimulus, and contact with a dissimilar metal. Elution of Ti ions in a Candida albicans culture medium was observed after 72 h. SIGNIFICANCE: Elution of Ti ions in the SBF was influenced by its pH and by crevice corrosion. The results of this study elucidate the conditions that lead to the elution of Ti ions in humans, which results in implant corrosion and Ti allergy.

Formability and mechanical properties of porous titanium produced by a moldless process.

Tailor-made porous titanium implants show great promise in both orthopedic and dental applications. However, traditional powder metallurgical processes require a high-cost mold, making them economically unviable for producing unique devices. In this study, a mixture of titanium powder and an inlay wax binder was developed for moldless forming and sintering. The formability of the mixture, the dimensional changes after sintering, and the physical and mechanical properties of the sintered porous titanium were evaluated. A 90:10 wt % mixture of Ti powder and wax binder was created manually at 70°C. After debindering, the specimen was sintered in Ar at 1100°C without any mold for 1, 5, and 10 h. The shrinkage, porosity, absorption ratio, bending and compressive strength, and elastic modulus were measured. The bending strength (135-356 MPa), compression strength (178-1226 MPa), and elastic modulus (24-54 GPa) increased with sintering time; the shrinkage also increased, whereas the porosity (from 37.1 to 29.7%) and absorption ratio decreased. The high formability of the binder/metal powder mixture presents a clear advantage for fabricating tailor-made bone and hard tissue substitution units. Moreover, the sintered compacts showed high strength and an elastic modulus comparable to that of cortical bone.

Telescopic magnetic attachment for implant-supported denture: evaluation of splint effect.

PURPOSE: Retrievability, connecting strength, and ease of laboratory work are important but conflicting prerequisites for the success of an implant superstructure, particularly with regard to immediate function. To resolve this issue, a telescopic magnetic attachment system has been developed for implant-supported removable dentures. The splinting effect of the attachment was evaluated for stress distribution and elevation with an in vitro model of three implants in an edentulous mandible. MATERIALS AND METHODS: Two types of telescopic magnetic attachments were prepared; the inclination angles of the axial wall of the abutment were 2.5 and 6.0 degrees. Three types of three-unit superstructures--a screw-retained superstructure and two telescopic magnet-retained superstructures--were fabricated. Static loads of 24.5, 49, and 98 N were applied vertically at three loading points on one side of each occlusal table. The elevation was measured as the height at which the magnet-retained superstructure detached from the abutment (on the other side of the prosthesis). In addition, by means of strain gauges, the stress distribution around the implants was evaluated and compared among the superstructures with the same three loads applied at six different points. RESULTS: The magnet-retained superstructure with the axial wall inclined at 2.5 degrees did not detach from the abutment. The differences in stress distribution between the screw-retained and magnet-retained superstructures with a 2.5-degree inclination were found to be statistically insignificant. The magnet-retained superstructure with a 6-degree inclination detached from the abutment, and the stress was concentrated during loading to a cantilever site. CONCLUSION: Because of its stress distribution and elevation, the new telescopic magnetic attachment, which has properties such as splinting the implants, ease of fabrication, and retrievability, is expected to be a viable alternative for the retention of implant-supported removable dentures.

Survival of immediate implant restoration: a retrospective study through 9-year-observation.

PURPOSE: The purpose of this retrospective study was to assess the implant survival rate and the risk factors associated with implant failure in patients who had undergone immediate implant restoration. MATERIALS AND METHODS: We performed a retrospective review and an outcome assessment of all patients who received immediate implant restoration between 2000 and 2010 in our department at Tokushima University Hospital. The patients were divided into groups on the basis of the predictor variables: age, gender, implant location, and number of implants per jaw. The cumulative implant survival rate in the paired groups was determined by using Kaplan-Meier analysis and the log-rank test. Cox proportional hazards model was subsequently used to identify exposures associated with implant failure. RESULTS: Using the Kaplan-Meier method, the survival rates at 1, 3, and 9 years were calculated to be 98.8%, 98.0%, and 94.7%, respectively. No statistically significant association was observed between the implant survival rates and the predictor variables: gender, age, location, and number of implants. CONCLUSIONS: Immediate implant restoration is a reliable prosthetic procedure with an acceptable survival rate compared to the conventional implant procedure.

New glass polyalkenoate temporary cement for cement-retained implant restoration: evaluation of elevation and retentive strength.

The purpose of this study was to evaluate four luting agents for cement-retained implant restorations in two aspects: post-cementation elevation of the superstructure and the retentive strength before and after thermocycling and mechanical cycling. The four evaluated luting agents were: new glass polyalkenoate hard-type (GH) and soft-type (GS) cements, polycarboxylate hard-type (HH) and soft-type (HS) cements. Elevation and retentive strength were measured using a CCD laser displacement sensor and a universal testing machine respectively. Elevation increased in this order: GH, GS, HH, and HS. Thermal and mechanical stresses significantly decreased retentive strength, and the mean values exhibited by GH were significantly higher than the other luting agents. The novel glass polyalkenoate cements (hard- and soft-type) experimentally prepared in the present study augured well as luting agents by virtue of their reduced film thickness and their excellent post-cementation retention and elevation.

A new method to prevent the corrosion of dental metals, during disinfection using functional water: sacrificial protection.

PURPOSE: This paper demonstrates a simple method using sacrificial protection for preventing the corrosion of dental metals. METHODS: Dental metals are directly connected or/and wound with a pure commercial aluminum/zinc wire/plate with high ionization tendency, before their immersion into oxidizing functional water. CONCLUSION: Dental materials such as Co-Cr alloy wires, stainless steel, and Au-Ag-Pd alloys did not corrode when this method was used. Thus, this method is very simple and effective for preventing corrosion of dental metals during disinfection using functional water.

Implant prostheses and adjacent tooth migration: preliminary retrospective survey using 3-dimensional occlusal analysis.

Occlusal force analysis was retrospectively evaluated to clarify the proximal contact loss after fixed implant prosthesis placement. Twenty-eight patients (55 prostheses) with fixed implant prostheses in the posterior region were divided into 2 groups: proximal contact loss and unchanged groups. The occlusal force and its distribution were 3-dimensionally measured using the Dental Prescale system. A high proportion of lingual and anterior component forces and high occlusal force distribution in the intercanine region were observed in the contact loss group. The high occlusal force of the adjacent tooth may enhance the mesial migration.

[A case of dental implant treatment with sinus lift for the maxillary molar sites].

PATIENT: Implant treatment with sinus lift was conducted in a 53-year-old male patient who had bilateral edentulous posterior maxilla with a limited bone volume of the sinus floor. One year later, the mobility at the anterior teeth of the maxilla increased and then decreased due to occlusal adjustment. The left posterior teeth of the mandible were extracted due to severe periodontitis and two implants were placed. DISCUSSION: In this case, the patient was highly satisfied with the above treatment. When the eccentric movement is guided by natural teeth in implant oral rehabilitation, it is important for the long-term results to consider the change of the occlusal contact. CONCLUSION: Implant treatment with bone augmentation is useful to obtain excellent clinical results in spite of the commensurate difficulties for the patient.