Assessment of Posterior Maxillary Alveolar Bone for Immediate Implant Placement: A Quantitative and Qualitative Analysis.

OBJECTIVES: The aims of this study were to evaluate posterior maxillary alveolar bone dimensions and to compare these dimensions in males and females. MATERIALS AND METHODS: The sample consisted of 102 cone beam computed tomography (CBCT) images for 62 male patients (mean age 29.92 ± 9.04 years) and 40 female patients (mean age 29.70 ± 9.54 years). Four distances and three densities were measured; a multivariate analysis of variance and Mann-Whitney's U test were applied to compare the differences between sexes. RESULTS: For the first maxillary molar, there were significant differences between males and females in terms of coronal width (13.95 ± 1.31 and 13.22 ± 1.159 mm, respectively) and middle width (14.28 ± 1.43 and 13.57 ± 1.478 mm, respectively). However, no significant difference was found regarding height (7.93 ± 3.8 mm for both) or apical width (14.68 ± 2 mm for both). Regarding the second maxillary molar, significant differences between males and females were found in terms of coronal width (14.66 ± 1.63 and 13.54 ± 1.512 mm, respectively), middle width (14.35 ± 1.825 and 13.25 ± 1.52 mm, respectively), and height (7.29 ± 3.00 and 8.66 ± 3.16 mm, respectively), whereas the gender dimorphism regarding apical width had borderline significance (14.09 ± 1.731 mm; p = 0.048). No significant differences were found regarding density. CONCLUSION: The minimum average alveolar bone height for the second maxillary molar region was 7.29 ± 30 mm with significant gender dimorphism. Therefore, CBCT scans should be recommended prior to immediate implant placement.

Insufficient Evidence to Ascertain the Long-Term Survival of PEEK Dental Prostheses: A Systematic Review of Clinical Studies.

INTRODUCTION: Polyetheretherketone (PEEK) is a polymer that is used in the construction of orthopaedic and dental implants. It is also used to construct removable and fixed dental prostheses due to its superior mechanical and esthetic properties compared to conventional materials. This systematic review aims to analyse and appraise the literature concerning PEEK dental prostheses critically. METHODS: The following focused question was constructed 'Are dental prostheses made of PEEK inferior to those made of other materials in terms of clinical- and patient-reported outcomes?'. The CONSORT (Consolidated Standards of Reporting Trials) tool was used for the quality assessment of the randomised clinical trials. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) quality assessment tool was used to assess the quality of observational studies and the case reports were evaluated using the CARE (Case Report) guidelines. RESULTS: A total of 12 studies were included in this review. Two case studies received an overall grade of medium and the overall quality of six studies was graded as 'low'. All three observational studies and the only randomised controlled trial received scores of 'medium'. CONCLUSION: PEEK-based dental prostheses may provide a viable and more esthetic alternative to conventional prosthodontic appliances. However, within the limitations of this study is the evidence to ascertain the long-term viability of PEEK-based dental prostheses. Future studies should focus on conducting large-scale, multicenter trials to compare the survival rate of PEEK prostheses to that of conventionally available prosthodontic appliances.

Effect of Attachment Type, Maximum Occlusal Force, and Denture Deformation on Marginal Bone Loss of Two-Implant Overdentures: A Short-Term Clinical Trial.

PURPOSE: This study aimed to investigate the effect of attachment type, maximum occlusal force, denture deformation, and other confounding factors on marginal bone loss of two-implant overdentures after 1 year. MATERIALS AND METHODS: Ninety edentulous patients received two implants in canine areas of the mandible using the computer-guided flapless surgical technique. Three months later, overdentures were connected to the implants with bar, resilient telescopic, and resilient stud attachments. Marginal bone loss was evaluated using standardized digitized periapical radiographs. Maximum occlusal forces were evaluated using a digital bite-force meter. Denture base deformation (denture strains, µm) was evaluated using strain gauges bonded to the polished surface of the denture at the level of the attachments. Regression analysis was adopted to find the relation between marginal bone loss and the following confounders (age, sex, mandibular bone height, period of edentulism, number of previous dentures, attachment type, maximum occlusal force, and denture strains). RESULTS AND CONCLUSION: Telescopic overdentures showed the highest marginal bone loss and maximum occlusal force, followed by bar overdentures, and stud overdentures demonstrated the lowest values. The highest denture strains were noted with bar overdentures, followed by telescopic overdentures, and stud overdentures showed the lowest strains. Age (P = .022), mandibular bone height (P = .023), number of previous dentures (P = .004), maximum occlusal force (P ≤ .001), and denture strains (P = .048) were significantly correlated with marginal bone loss. For every 1-year increase in age, there was a decrease in bone loss by 0.3%. For every 1-mm increase in bone height, there was an increase in bone loss by 1%. For every one increase in the number of worn dentures, there was a decrease in bone loss by 4.2%. For every 10-N increase in maximum occlusal force, there was an increase in bone loss by 6.4%. For every 10-µm increase in denture strains, there was an increase in bone loss by 0.21%. Sex, time of edentulism, and attachment type did not demonstrate a significant correlation with marginal bone loss.