Intricate Assessment and Evaluation of Long-term Implant Success as affected by Clinicomicrobial and Salivary Diagnostics in Type II Diabetic Patients: A Longitudinal Study.

INTRODUCTION: Replacement of missing teeth by dental implants is one of the most common methods employed these days. Because of significant advancement in the design of implants and modifications in the procedure of dental implant surgery, the survival rate of the dental implants has reached up to approximately 95%. Osseointegration is one of the important factors affecting the survival of dental implants. Apart from these, the body's physiologic alterations can also predispose the dental implants for failure. Diabetes is one such metabolic disease characterized by abnormal or delayed wound healing. Hence, we assessed the clinicomicrobial and salivary profile of diabetic patients undergoing rehabilitation by dental implants. MATERIALS AND METHODS: This study included diabetic patients who underwent dental implant surgeries for prosthetic rehabilitation. Follow-up records of the patients' up to 1 year were maintained. Various clinicoradiographic and periodontal parameters were measured at various time intervals during follow-up time; 25 mL of salivary and blood sample was taken from all the subjects and was sent to the laboratories for assessment of various salivary biomarkers. All the results were analyzed by Statistical Package for the Social Sciences software. RESULTS: The mean level of interleukin-p at baseline time was found to be 2.38 and 2.21 in diabetic group and control group respectively. While comparing the levels of osteoprotegerin in both study groups, a significant correlation was obtained. In diabetic and control group, 62 and 61 years was the mean age of the patients respectively. No significant correlation was obtained while comparing the microbial flora of diabetic and control group. CONCLUSION: In both diabetic and nondiabetic patients, similar microbial, salivary marker, and clinicoradiological patterns were seen. CLINICAL SIGNIFICANCE: Diabetic patients who maintain their body's metabolic rate show similar success rate of dental implants as seen in nondiabetic patients.

In vitro Assessment of Clasps of Cobalt-Chromium and Nickel-titanium Alloys in Removable Prosthesis.

BACKGROUND: It has been since a long time that the use of base-metal alloys has significantly increased in the area of prosthetic science. One of the factors contributing for the increasing use of base-metal alloys is the increasing and high cost factor of noble metals. Although numerous materials have been tried since the recent past, Cobalt-Chromium (CoCr) alloys still form the most commonly used ones because of the numerous advantages they offer. Titanium alloys are also significantly being used in this field because of their high resistance strength and high corrosion resistance. Therefore, we aimed to evaluate the flexure strength and fatigue resistance of clasps made up of CoCr alloys and Nickel-titanium (NiTi) alloys. MATERIALS AND METHODS: We evaluated the retentive forces of CoCr and NiTi clasps two different sizes engaging retentive undercuts of different depths (0.25 and 0.50 mm). Mandibluar second premolar was prepared to frame the prosthesis for missing mandibular first and second molar. A total of 50 clasps were included in the study out of which 30 were NiTi clasps and 30 CoCr clasps. We evaluated the loading of the force at the rate of half Newton(N)/second at the central part of the specimen until fracturing of the specimen occurred and finally measurement of the modulus of elasticity was also done. Statistical analysis was carried out; unpaired "t" test was used for evaluating the level of significance. RESULTS: The mean load needed for CoCr clasps was 0.7450 and for NiTi clasp was 0.6140 Kgf for producing a deflection of 0.25 mm. As far as flexibility is concerned, more value was seen in NiTi group than CoCr group. For deflecting the clasp up to 0.50 mm, the mean load needed for CoCr clasps was 1.4102 and for NiTi clasp was 0.8260 Kgf. The results were statistically significant. While measuring the flexibility, more value (p < 0.05) was seen in NiTi group than in CoCr group. NiTi alloy clasps had mean flexural strength of 1640 MPa and modulus of elasticity of 32 GPa. CONCLUSION: For producing deflection of 0.25 and 0.50 mm, the mean loading force was higher for NiTi alloys. Although being increasingly used these days, NiTi alloys have limited use as compared with CoCr alloys due to high cost of titanium and certain other limitations.

Surgical templates for dental implant positioning; current knowledge and clinical perspectives.

Dental implants have been used in a variety of different forms for many years. Since the mid-20(th) century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.