Maxillary and mandibular overdentures retained by two unsplinted narrow-diameter titanium-zirconium implants - A clinical pilot study.

OBJECTIVES: To evaluate the survival rates and marginal bone loss of narrow-diameter titanium-zirconium implants supporting complete maxillary and mandibular overdentures up to 3 years after loading. MATERIALS AND METHODS: Ten completely edentulous patients who were dissatisfied with their complete dentures were enrolled. Two narrow-diameter implants were placed in the canine region of the maxilla and mandible. After second-stage surgery, implant-supported overdentures (palatal-free) attached by parallel alignable stud-attachments were placed. Patients were followed periodically for up to 36 months. Standardized radiographs were taken at baseline, 12 and 36 months to analyze mean marginal bone level changes around the implants. RESULTS: The Kaplan-Meier survival rates were 100% for mandibular and 68.0% (SE ± 10.9%) for maxillary implants at 36 months (p = .008). Six maxillary implants failed after loading; no mandibular implants were lost. Five implants failed due to loss of osseointegration. One implant fractured. The mean marginal bone level changes around the analyzed implants (n = 28, 9 patients) were -0.71 ± 0.82 mm in the mandible and -2.08 ± 1.52 mm in the maxilla at the 36-month follow-up. The difference in marginal bone level changes between the maxilla and mandible was significant (p = .019) at the 12- and 36-month follow-ups. CONCLUSION: Two narrow-diameter titanium-zirconium implants with stud-attachments showed a highly satisfactory outcome in the mandible. The maxillary implants showed a high failure rate and significantly more bone loss over time than the mandibular implants. The minimal concept of two implants and an overdenture should be limited to the edentulous mandible.

Effects of mobile learning on writing panoramic radiograph reports: a quasi-experimental trial in dental education.

BACKGROUND: In dentistry, the reporting of panoramic radiographs is particularly challenging, as many structures are depicted in one image and pathologies need to be identified completely. To enhance the learning process for these interpretations, the advantages of the increasingly popular education method of mobile learning could be used. Therefore, this study aimed to determine the effectiveness of learning to report panoramic radiographs using an application (app) on a mobile device. METHODS: The existing e-learning programme 'PantoDict' was further developed into a mobile app with a new training section. Participants of a dental radiology course were divided into two groups, one of which additionally had the chance to practise reporting panoramic radiographs using the app. A test to assess the knowledge gained was conducted at the end of the semester; the course and the app were also evaluated. RESULTS: The group that used the app showed significantly better results in the test than the control group (p < 0.05). Although the app group approved a high satisfaction using the app as an additional supplement to the course, this did not result in a higher overall satisfaction with the course. Further, these students observed that the traditional face-to-face seminar could not be replaced by the app. CONCLUSION: By using the PantoDict app, students were offered better training options for writing reports on panoramic radiographs, which resulted in significantly better test results than the results of the control group. Therefore, the mobile app is a useful supplement to classical education formats within the context of a blended learning approach.

An innovative PantoDict program for reporting panoramic radiographs using automatic speech recognition in dental education: a randomized observer-blinded study.

OBJECTIVE: The objective of this study was to assess the effect of an e-learning program including automatic speech recognition on outcomes assessment in interpreting panoramic radiographs at a dental school. STUDY DESIGN: For instruction in reporting findings on panoramic radiographs, 36 participants were divided randomly into 3 seminar groups. Group A used the new PantoDict digital e-learning program for training. Group B used both PantoDict and conventional face-to-face classroom instruction. Group C used conventional instruction only. After attending 3 seminars, all students completed an examination on reporting a panoramic radiograph and evaluated the course. RESULTS: Both groups using PantoDict (groups A and B) had significantly higher examination scores than the conventional group (P ≤ .002). However, students in group C were more likely than those in group A to agree that their knowledge and confidence improved following the seminars. Students in group A would have preferred an instructor for the first seminar. The evaluation confirmed that students were satisfied with the e-module regarding usability and didactics. Most students indicated that they would like to use PantoDict all the time. CONCLUSIONS: The e-learning program with automatic speech recognition is a useful device for completing radiology reports and can be used as a complementary tool in face-to-face teaching.

Effect of drain application on postoperative complaints after surgical removal of impacted wisdom teeth-a randomized observer-blinded split-mouth clinical trial.

OBJECTIVES: The aim of this randomized observer-blinded split-mouth-study is to objectively assess the influence of a rubber drain on postoperative swelling using 3D face scans as measurement method and additionally evaluate pain, trismus and complications after the osteotomy of lower third molars. MATERIAL AND METHODS: Seventy-two patients with symmetrically impacted lower wisdom teeth were recruited. Before the operation, patients rated pain using the visual analogue scale, the interincisal distance was measured, and 3D face scans were taken with an optical scanner. Each patient underwent two procedures which were at least 30 days apart. On one side, a rubber drain was inserted randomly before closure, the contralateral control side was closed without drainage. On the third and tenth postoperative day, face scans to quantify the swelling, pain evaluation and trismus measurements were performed. Due to loss of follow-up, 32 patients were excluded which resulted in 40 out of 72 patients remaining in the study. RESULTS: There was no statistical difference in using a drain on swelling and trismus on the third and tenth day (p > 0.05). Pain was slightly worse on the third day on the treatment side, but the difference was not significant (p > 0.05). We observed no differences in the number of wound infections. CONCLUSIONS: The insertion of a rubber drain does not have any influence on swelling, pain or trismus and has no impact on the number of wound infections. CLINICAL RELEVANCE: The use of a rubber drain cannot be recommended as no reduction of postoperative discomfort was detected.

Introduction of mini-clinical evaluation exercise in teaching dental radiology-A pilot study.

INTRODUCTION: Workplace-based assessments are methods that can be applied for assessing competence and performance. One of these methods is the mini-clinical evaluation exercise (mini-CEX). This study was conducted to determine the role of mini-CEX in students' performance assessment on panoramic X-ray reporting at dental radiology course. MATERIALS AND METHODS: A workshop as training for the assessors and the participants was conducted before the primary test. All participants (n = 36) were randomly allocated into six groups. Each group had three seminars in which every student reported a panoramic X-ray. Students were directly observed and rated by an assessor on a modified mini-CEX rating form. Then, a self-assessment of the students and a systematic feedback session were performed. Finally, the students and the assessors were evaluated for the acceptability and satisfaction with this tool. RESULTS: The mean duration of the assessment and the feedback decreased significantly from the first seminar to the third seminar (P < .0001). Comparison of the results of the mini-CEX of all three assessments showed that students displayed a significantly better performance in evaluating the upper jaw and the soft tissue (P < .05). There was no significant improvement for the other aspects of the rating form. Overall, both students and assessors reported a high level of satisfaction in using the mini-CEX rating form. CONCLUSION: Due to the objectivity and transparency of the assessment, the mini-CEX helped to improve the performance on reporting panoramic X-rays. Besides that, the structured feedback had major impact on the improvement. Overall, the assessors and the participants reported a high level of satisfaction using the rating form. Therefore, the mini-CEX may be an effective method for performing workplace-based assessments to evaluate students' performance on reporting panoramic X-rays.

Intraosseous stability of dental implants in free revascularized fibula and iliac crest bone flaps.

The aim of this study was to investigate the influence of two different microvascular reanastomized bone transplants on primary (PS) and secondary stability (SS) of dental implants. Totally 96 implants (Bone Level, Institut Straumann AG, Basel, Switzerland) were inserted in fibula (n = 50) and iliac crest (n = 46) in mean of 97.7 SD 75.6 weeks after performing reconstructive surgery. For measuring PS and SS the resonance frequency (RFA) analysis was used in mesiodistal and vestibulo-oral direction to quantify the implant stability quotient (ISQ). Mean values (ISQ) for PS in fibula was about 79.48 SD 2.41 and in iliac crest 61.10 SD 3.34 as well as SS in fibula was about 75.59 SD 5.10 and in iliac crest 73.63 SD 5.34. Statistically significant differences between both flaps were found for PS in mesiodistal and vestibulooral direction (p < 0.001). Between the primary and SS a significant decrease was recognized in fibula flap (p < 0.01) as well as an increase in iliac crest flap (p < 0.001). Statistically no difference was found between both bone flaps for SS (p = 0.076). The implant stability in fibula and iliac crest flap after osseointegration is similar to each other. Therefore, it is not important for choosing the suitable donor side.

Computer-assisted zygoma reconstruction with vascularized iliac crest bone graft.

BACKGROUND: The reconstruction of zygoma is a challenge with regard to aesthetic and reconstructive demands. METHODS: Pre-operative CT data were imported into specific surgical planning software. The mirror-imaging technique was used. A surgical guide transferred the virtual surgery plan to the operation site, whereby it fitted uniquely to the iliac donor site. A postoperative CT scan was obtained for comparing the actual postoperative graft position and shape with the pre-operative virtual simulation. RESULTS: A mean difference of 0.71 mm (SD ± 1.42) for the shape analysis and 3.53 mm (SD ± 3.14) for the graft position was determined. The calculation of the closest point distance showed a surface deviation of < 2 mm for the shape analysis with 83.6% of values and for the graft position with 35.7% of values. CONCLUSION: Virtual surgical planning is a suitable method for zygoma reconstruction with vascularized iliac crest bone graft, with good accuracy for restoring the three-dimensional anatomy.