Immediate Implant Placement with Different Interradicular Osteotomies in the Mandible: A Randomized Clinical Study.

AIM: To assess the implant stability and amount of marginal bone loss in immediate implant placement (IIP) in mandibular molars by using pre-extractive interradicular implant bed preparation vs conventional post-extractive interradicular implant bed preparation. MATERIALS AND METHODS: This randomized clinical trial was conducted on fourteen patients who had an immediate dental implant at the mandibular molar area by two different techniques. All patients were divided randomly into two equal groups: Group I (control) was treated with conventional post-extractive interradicular implant bed preparation, and group II (test) was treated by pre-extractive interradicular implant bed preparation All surgeries were performed by the same surgeon. All patients were followed up clinically at immediate post-surgery (T0), 7 days (T1), 3 weeks (T2), 90 days (T3), and 3 months after loading (T6) for healing and to evaluate the marginal bone loss radiographically at T0, T3 and T6. Descriptive and bivariate statistics were computed using the SPSS version (SPSS, IBM Inc., Chicago, IL), and p ≤ 0.05 was considered an indicator of statistical significance. RESULTS: A total of 7 female and 7 male patients with a mean age of 32.07 ± 5.87 years. Radiographically, there is no significant statistical difference in comparing between two groups for the marginal bone loss. However, there was a highly significant statistical difference (p < 0.001) in each group between different interval periods (T0, T3, T6) with mean start 5.27 ± 0.53, and 5.19 ± 0.72 at (T0) reaching 7.60 ± 0.89 and 7.09 ± 0.96 at (T3) and slightly decrease of 7.52 ± 0.79 and 7.02 ± 0.79 in (T6) with radiographic evaluation, and it represented clinically in each group with mean 3.57 ± 0.313 and 4.0 ± 0.58 at (T0) increase to 6.55 ± 0.395 and 6.52 ± 0.45 at (T6) for both group respectively. There is no statistically significant difference in soft tissue healing with an average mean of 4.57 ± 0.24 and 3.57 ± 0.509 (p = 0.001) when comparing between both groups respectively. CONCLUSION: Both techniques seem useful for dental implant placement in badly decayed mandibular molars. However, pre-extracted interradicular implant bed preparation for IIP might offer advantages in terms of primary implant stability and bone preservation. However, further studies are needed to confirm these findings. CLINICAL SIGNIFICANCE: Both techniques are alternative methods for the treatment of badly decayed mandibular molars by immediate dental implant except for minor complications that do not interfere with dental implant placement. How to cite this article: Alzaibak LMA, Abdel-Monem TM, Elgohary NM, et al. Immediate Implant Placement with Different Interradicular Osteotomies in the Mandible: A Randomized Clinical Study. J Contemp Dent Pract 2024;25(4):303-312.

Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study.

AIM: To compare between the rehabilitation of atrophied maxilla with fixed prosthesis using two posterior zygomatic implants and two conventional anterior implants or four implants inserted according to the all-on-four concept regarding the patient quality of life and satisfaction after one year of prosthesis insertion. MATERIALS AND METHODS: Thirty-six patients with atrophic edentulous maxillae were randomized into two groups: Group I (rehabilitated with fixed prostheses supported by two zygomatic and two conventional implants in the anterior region) and group II (fixed prostheses on four implants in the anterior region following an all-on-four concept). One year after the placement of the definitive prostheses, patients completed oral health impact profile-14 and satisfaction questionnaires. RESULTS: All patients were satisfied regarding retention, stability, occlusion, comfort, cleaning, speaking, chewing, bolus quality, appearance, handling, prosthesis apart, and embarrassing, with no significant significance between two groups except satisfaction with surgical procedures and healing period. CONCLUSIONS: Using two distally tilted zygomatic implants or all-on-four concept to rehabilitate atrophied maxilla by fixed detachable prosthesis could be considered a promising functional and esthetic treatment option regarding the patient satisfaction. CLINICAL SIGNIFICANCE: Traditionally, treatment of maxillary atrophied ridges was done by bone grafting or sinus-lifting techniques; however, using all-on-four concept or zygomatic implants was a successful treatment as it has high success rates and highly satisfied by the patients. How to cite this article: Nagib MA, Ibrahim AM, Abdel-Rahman FH, et al. Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study. J Contemp Dent Pract 2024;25(2):141-147.

Comparison between platelet rich fibrin as space filling material versus xenograft and alloplastic bone grafting materials in immediate implant placement: a randomized clinical trial.

BACKGROUND: This study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla. MATERIALS AND METHODS: Thirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test. RESULTS: This study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness. CONCLUSION: PRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness. TRIAL REGISTRATION: The study was listed on www. CLINICALTRIALS: gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).

Comparison between Effect of Bisphosphonates, Concentrated Growth Factors or Combination on Rabbits' Tibial Bone Defects Healing: An Experimental Study.

AIM: This study was designed to evaluate the effect of bisphosphonates (BIS) or concentrated growth factors (CGF) or a combination of them on bone defect healing. MATERIALS AND METHODS: Bone defects of 3-mm width and 6-mm depth were prepared in 24 rabbit tibias unilaterally, then randomly divided into the following four equal groups: 1. Group I: No treatment 2. Group II: Treated by BIS 3. Group III: Treated by CGF 4. Group IV: Treated by BIS + CGF Animals were equally sacrificed at 4 weeks, and at 6 weeks then tibias were processed for hematoxylin and eosin (H&E) and Masson's trichrome (MTC) staining. The data were subjected to one-way analysis of variance (ANOVA) followed by post hoc Tukey test and unpaired Student's t-test. RESULTS: In group IV, the quality of newly formed bone was better than any other group with increased mineralization and decreased collagen, followed by group III, then group I, while group II showed the least favorable results. The statistical analysis showed a significant difference between groups. CONCLUSION: Mixing BIS with CGF showed the best healing, and bone quality results, followed by CGF-treated group, then control, and finally, BIS-treated group. CLINICAL SIGNIFICANCE: Using CGF as a scaffold and mixing it with BIS could help accelerate the healing of bone defects, reduce healing time, and minimize the risk of infection.

Comparison between Modified Bone-splitting Technique and Distraction Osteogenesis in Horizontal Alveolar Ridge Expansion: Randomized Clinical Study.

AIM: This study aimed to compare modified ridge splitting (RS) and distraction osteogenesis (DO) for horizontal ridge expansion clinically (bone width, pain, and soft tissue healing) and radiographically (bone width). MATERIAL AND METHODS: This randomized clinical trial was conducted on fourteen patients who had a partial edentulous narrow mandibular posterior alveolar ridge (not less than 4-mm width and 12-mm height). All patients were divided randomly into two equal groups: Group I was treated with a modified bone-splitting technique, and group II was treated with DO technique by the fabricated device as AlveoWider®, and without any graft material for both groups. All patients were followed up clinically to evaluate the increase of bone width at preoperative measurement (T0) and 6 months postoperative (T6), and radiographically by cone-beam computed tomography (CBCT) at T0, 3 months postoperative (T3), and T6. Descriptive and bivariate statistics were computed using the SPSS version (SPSS, IBM Inc., Chicago, IL, USA), and p ≤ 0.05 was considered an indicator of statistical significance. RESULTS: All patients were female. Patients' ages ranged from 18 to 45 years, with a mean age of 32.07 ± 5.87 years. Radiographically, there is no significant statistical difference in comparing between two groups for the creation of a horizontal alveolar bone; however, there was a highly significant statistical difference (p < 0.001) in each group between different interval periods (T0, T3, and T6) with mean start 5.27 ± 0.53, and 5.19 ± 0.72 at T0 reaching to 7.60 ± 0.89 and 7.09 ± 0.96 at T3, and slightly decreases to 7.52 ± 0.79 and 7.02 ± 0.79 in T6 with radiographic evaluation, and it represented clinically in each group with mean 3.57 ± 0.313 and 4.0 ± 0.58 at T0 increase to 6.55 ± 0.395 and 6.52 ± 0.45 at T6 for both groups, respectively. There is a statistically significant difference in soft tissue healing with the average mean of 4.57 ± 0.24 and 3.57 ± 0.509 and pain with an average mean of 1.66 ± 0.22 and 4.74 ± 0.55 with p = 0.001 and p < 0.001 when comparing between both groups, respectively, that is, p = 0.001 is considered to be statistically significant. CONCLUSION: Both techniques seem to be useful as augmentation techniques for dental implant placement in a narrow alveolar ridge. Techniques are sensitive and need good experience. The modified splitting technique has fewer complications, less pain, and better soft tissue healing when compared with the DO technique. CLINICAL SIGNIFICANCE: Both techniques are alternative methods for the treatment of the atrophic alveolar ridge with uneventful healing except for minor complications that do not interfere with dental implant placement.