As there are insufficient studies available, comparing the success of one-piece and two-piece sin... more As there are insufficient studies available, comparing the success of one-piece and two-piece single implant-retained mandibular overdentures (SIMOs), hence this study was undertaken to compare the patient satisfaction and crestal bone loss with one-piece and two-piece SIMOs, with immediate loading protocols. The null hypothesis was that there would be no difference in patient satisfaction
Journal of Dentistry and Oral Hygiene, Dec 31, 2009
Ocular prosthesis is an artificial replacement of the eye. After enucleation, evisceration and ex... more Ocular prosthesis is an artificial replacement of the eye. After enucleation, evisceration and exenteration of the eye, the goal is to replace the missing tissues with an artificial prosthesis and restore the facial symmetry and normal appearance of the anophthalmic patient. Therefore the combined efforts of the ophthalmologist, the plastic surgeon, and the maxillofacial Prosthodontist are essential in order to restore the patient's quality of life. Custom made prostheses provide more esthetic and precise result when compared to stock eye prosthesis. Simplification of the technique with the commonly available materials makes it more ease to make it. This is a case report presenting the fabrication of eye prosthesis in a cost effective manner with a unique impression technique.
The aetiology for the development of temporomandibular disorders (TMDs) is multifactorial. This c... more The aetiology for the development of temporomandibular disorders (TMDs) is multifactorial. This chapter deals with several controversies that exist regarding the role of occlusion as main etiological factor for TMDs with the evidence of numerous studies for and against the role of occlusion in TMD. Insights have been provided regarding various concepts of occlusion and its relation to the disorders of the temporomandibular joint.
Clinical Implant Dentistry and Related Research, 2018
Background: An optimal shape of the thread design of the implants is required for equal distribut... more Background: An optimal shape of the thread design of the implants is required for equal distribution of stresses to the surrounding bone matrix and for stimulation and promotion of bone remodeling. Purpose: The study was construed with the aim of histomorphometric evaluation of bone stimulation generated by different microthread designed implants in enhancing osseointegration, and to assess the pattern of stress dissipation through a two-dimensional finite element analysis. Material and Methods: Computer Aided Designing of two type of microthreads, one V-shaped and the other Power-shaped microthreaded dental implants with only microthreads all along body of the implant from the neck to the apex was made and 30 implant prototypes were milled. Twodimensional finite elemental analysis (FEA) was carried out to assess the pattern of stress distribution in the bone around these implant designs and for In vivo study 24 implant prototypes were placed in rabbits tibia and femur, out of which 12 were with V-shaped microthreads and the other 12 were with Power-shaped microthreads. Histomorphometric analysis was carried out of the sections obtained from the enbloc specimen retrieved from the sacrificed rabbits. Results: FEA showed less stress around the V-shaped microthreaded implant model when compared to Power-shaped microthreaded implant model. Hitomorphometry showed statistical significance difference in new bone volume (BV) and Total BV for V-shaped microthreaded prototype implant. Conclusions: V-shaped microthreaded dental implant design can be preferred over Power-shaped microthreaded dental implant for proper stress distribution and for promoting osseointegration.
International Journal of Prosthodontics and Restorative Dentistry, 2016
Amputation of a finger will have considerable functional and psychological impact on an individua... more Amputation of a finger will have considerable functional and psychological impact on an individual. Although prosthetic rehabilitation incorporating implants is considered an ideal treatment option, the patient may not give consent due to apprehension toward surgical procedures. The ideal prosthesis should replace the missing part of the finger so precisely that it would not draw the attention of the observer. Fabrication of such a prosthesis will require great technical and artistic expertise. This paper presents a case of prosthetic rehabilitation of an amputated finger using a silicone finger prosthesis.
International Journal of Prosthodontics and Restorative Dentistry, 2020
The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the reh... more The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the rehabilitation of the single anterior missing tooth with dental implants. Critical assessment of the scientific evidence is required for the evidence-based practice of a particular treatment modality, which can be reviewed from the well-designed randomized clinical trials, cohort studies, observational studies, retrospective data reviews, etc. In order to fulfil the requirement for best patient care, the evidence-based clinical practice is utmost important. It is recommended to follow particular diagnostic strategies and treatments plans with each plan to be individualized so as to reflect the specific characteristics of individual clinical circumstances. Consensus guidelines have increasingly become an integral part of evidence-based medicine not only in individual and institutional clinical practices but also in serving as a framework with the aim of better patient outcomes and reduce variations, prevent errors, and increase clinicians' accountability in the healthcare practices and help researchers to identify gaps in the evidence and what key research questions have yet to be answered and further discussion and modifications when required by the plenary. The working group also prepared recommendations for future research. Disclosure All the group members were asked to reveal any conflicts of interest that could potentially influence the outcomes of the consensus deliberations based on limited scientific evidence and strict inclusion criteria. No such conflicts were identified. Six topics were discussed, which were as follows: Topic 1: Radiographic techniques in implant dentistry Topic 2: Contemporary surgical guidelines Topic 3: Restorative materials and techniques Topic 4: Implant loading protocols Topic 5: Optimizing esthetic outcomes in implant dentistry Topic 6: Digital-guided solutions Topic 1: Radiographic Guidelines for the Use of Diagnostic Imaging in Implant Dentistry for Anterior Single Implants Diagnostic imaging is an essential component of implant treatment planning. The introduction and widespread use of cross-sectional imaging in implant dentistry using cone-beam computed tomography (CBCT) over the last decade has enabled clinicians to
Purpose: This systematic review has been undertaken to highlight the unforgettable contributions ... more Purpose: This systematic review has been undertaken to highlight the unforgettable contributions of Prof. Brånemark Per-Ingvar (PI). It could be understood that reviewing his work would give an idea of growth of this treatment modality. Materials and Methods: An electronic search on the PubMed/Medline, Ebscohost, and Cochrane database was done using search term “Brånemark PI” to identify his publications. Articles published in English and only related to implants and osseointegration were included. Screening of the titles and abstracts were done according to inclusion criteria and suitable studies were included in the review. Results: The initial literature search resulted in 187 articles, out of which 92 articles were excluded due to not meeting the inclusion criteria and 16 articles excluded due to non-availability of even abstract also. A total of 79 articles were finally included in this review. Conclusion: Brånemark PI had a great vision of future; who considered edentulism as equal to amputation and came up with the concept of osseointegrated implants to overcome them. The innovations of Brånemark had assured the world that it is very much possible to provide implant-supported prosthesis in any situations for the rehabilitation of the individuals.
In the anterior region, the common reason for tooth loss is due to traumatic injury or congenital... more In the anterior region, the common reason for tooth loss is due to traumatic injury or congenital anomaly. Loss of a single tooth may cause functional and esthetic deficits to the patient. There are different treatment options available for replacing a missing incisor. Implant dentistry should be considered as first treatment alternative for replace a missing tooth. This case report presents the replacement of a missing maxillary left central incisor in a compromised site with dental implants along with bone graft followed by frenectomy to obtain a good clinical result and for better function and esthetics of the patient.
PURPOSE To assess the technical and biological complications of screw- and cement-retained implan... more PURPOSE To assess the technical and biological complications of screw- and cement-retained implant-supported full-arch dental prostheses. MATERIALS AND METHODS An electronic search was conducted on Medline/PubMed and Cochrane databases in February 2019; irrespective of any time restrictions using MeSH terms. All studies were first reviewed by abstract and subsequently by full-text reading. Further hand search was performed to identify other related references. Articles only related to cement-retained and/or screw-retained reconstructions in full-arch fixed dental prostheses (FDP) were included. RESULTS The initial literature search resulted in 3670 papers. 3478 articles remained after removing duplicate articles, and 3439 articles were further excluded by the reviewers after the abstract screening, which resulted in a selection of 39 studies. 12 studies were further excluded due to not fulfilling the inclusion criteria. Hand searching resulted in two additional papers being included...
Exact recognition of the anterior loop is very important to avert any injury to the neurovascular... more Exact recognition of the anterior loop is very important to avert any injury to the neurovascular bundle during surgical procedures. The purpose of this review was to evaluate the prevalence and length of the anterior loop in different populations. A comprehensive search of Medline/Pubmed and Cochrane database was done. The focused question was the presence of anterior loop (including loop length) of the inferior alveolar nerve in mental foramen region in CBCT images of the various subjects. Articles related to the presence of anterior loop (including loop length) were only included. Initial literature search resulted in 3024 papers, after removing duplicate articles, 2821 articles were left. Two thousand seven hundred eighty-four articles were further excluded by the reviewers after screening the abstracts which resulted in 37 studies. Hand searching resulted in 2 additional papers. Seven full-text articles were excluded for not fulfilling the inclusion criteria. Finally, 32 articles were included in the review. Two thousand five hundred three subjects with anterior loop were found, which approximates 38% with 48.4% bilateral, 27.8% right side, and 23.8% left side. The loop distribution in males and females was also found to be different. There was highly significant (P < 0.001; I2 = 98.81%) heterogeneity found in the included studies. Variations were found in the prevalence, length, gender, and side distribution of anterior loop in various populations. This systematic review highly recommends not relying on any average values and the clinician should compulsorily make use of imaging modalities available in each and every case, wherever surgical procedure is to be performed near mental foramen region.
International Journal of Prosthodontics and Restorative Dentistry, 2020
The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the reh... more The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the rehabilitation of the single anterior missing tooth with dental implants. Critical assessment of the scientific evidence is required for the evidence-based practice of a particular treatment modality, which can be reviewed from the well-designed randomized clinical trials, cohort studies, observational studies, retrospective data reviews, etc. In order to fulfil the requirement for best patient care, the evidence-based clinical practice is utmost important. It is recommended to follow particular diagnostic strategies and treatments plans with each plan to be individualized so as to reflect the specific characteristics of individual clinical circumstances. Consensus guidelines have increasingly become an integral part of evidence-based medicine not only in individual and institutional clinical practices but also in serving as a framework with the aim of better patient outcomes and reduce variations, prevent errors, and increase clinicians' accountability in the healthcare practices and help researchers to identify gaps in the evidence and what key research questions have yet to be answered and further discussion and modifications when required by the plenary. The working group also prepared recommendations for future research. Disclosure All the group members were asked to reveal any conflicts of interest that could potentially influence the outcomes of the consensus deliberations based on limited scientific evidence and strict inclusion criteria. No such conflicts were identified. Six topics were discussed, which were as follows: Topic 1: Radiographic techniques in implant dentistry Topic 2: Contemporary surgical guidelines Topic 3: Restorative materials and techniques Topic 4: Implant loading protocols Topic 5: Optimizing esthetic outcomes in implant dentistry Topic 6: Digital-guided solutions Topic 1: Radiographic Guidelines for the Use of Diagnostic Imaging in Implant Dentistry for Anterior Single Implants Diagnostic imaging is an essential component of implant treatment planning. The introduction and widespread use of cross-sectional imaging in implant dentistry using cone-beam computed tomography (CBCT) over the last decade has enabled clinicians to
Clinical Implant Dentistry and Related Research, 2018
Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 i... more Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 implant placed cross arch in maxilla and in mandible respectively, restored with screw retained prosthesis. Materials and Methods: Total of 30 patients were randomized, with 15 in group1 with an average of 45 Ncm insertion torque with delayed loading and 15 in group 2 with above 65 Ncm inertion torque with immediate loading with equal number of male and female in each group following parallel design with 3 implants in maxillary and 2 implants in mandibular arch placed which was supported by a 3Dimensional finite analysis comparing the stress dissipation around implants of this concept-"Simplif5y" with All-on-4 concept. Results: Von Mises strain recorded in the bone in the maxillary and mandibular arch models were higher in All-on-four than that in the "simpli5y", which was vice-versa in the framework. Three-year post loading marginal peri implant bone loss for the group 1 was less than group 2. Conclusions: These results, suggest that in both delayed loading and immediate loading protocol that cross arch prostheses can be successfully supported by 3 and 2 implants in maxillary and mandibular arch respectively-"Simpli5y" concept of full mouth restoration.
Clinical Implant Dentistry and Related Research, 2018
Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 i... more Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 implant placed cross arch in maxilla and in mandible respectively, restored with screw retained prosthesis. Materials and Methods: Total of 30 patients were randomized, with 15 in group1 with an average of 45 Ncm insertion torque with delayed loading and 15 in group 2 with above 65 Ncm inertion torque with immediate loading with equal number of male and female in each group following parallel design with 3 implants in maxillary and 2 implants in mandibular arch placed which was supported by a 3Dimensional finite analysis comparing the stress dissipation around implants of this concept-"Simplif5y" with All-on-4 concept. Results: Von Mises strain recorded in the bone in the maxillary and mandibular arch models were higher in All-on-four than that in the "simpli5y", which was vice-versa in the framework. Three-year post loading marginal peri implant bone loss for the group 1 was less than group 2. Conclusions: These results, suggest that in both delayed loading and immediate loading protocol that cross arch prostheses can be successfully supported by 3 and 2 implants in maxillary and mandibular arch respectively-"Simpli5y" concept of full mouth restoration.
Aims: The use of cast partial dentures (CPDs) has been decreased and its importance has been decl... more Aims: The use of cast partial dentures (CPDs) has been decreased and its importance has been declined in the teaching curriculum. The purpose of this survey was to evaluate the attitudes of dental professionals toward conditions using CPDs in private practice in India. Settings and Design: Descriptive survey Materials and Methods: This survey consists of eight close-ended questions concerning the use of CPD by dental professionals practicing in India. The URLs of the questionnaire were shared via E-mail to dentists practicing throughout India, to obtain a response of 384 which is a predetermined sample size. Statistical Analysis Used: Statistical analysis was done using counts and percentages and the results were further analyzed statistically by the Chi-square test. Results: Nearly 42.79% of general dental practitioners (GDPs), 47.26% of prosthodontists, and 9.95% of other specialist dentists responded to the questionnaire. GDPs mostly preferred removable partial dentures (RPDs) (71.87%) and fixed partial dentures (57.22%), whereas prosthodontists preferred mostly implant (60.91%). GDPs mostly preferred flexible dentures (62.42%), whereas prosthodontists preferred CPDs 62.84%. Almost 52.50% of the GDPs mostly raised a cost issue and 63.11% of the prosthodontists had difficulty in adjustment with CPDs. Nearly 63.46% of the dentists told that implant-supported restorations are better options compared to CPDs; still, majority of the dentists (53.23%) were in favor that more importance for teaching CPDs in graduation curriculum should be given. Conclusions: This survey shows that in India a significant proportion of GDPs (71.87%) preferred RPDs, mostly flexible dentures (62.42%) due to their low cost compared to CPDs. Prosthodontists mostly preferred implants (60.91%) because they are more confident and better trained in these. It is recommended that more importance be given in teaching implants along with CPDs in graduation curriculum so that practitioners can better educate their patients about implants and their advantages over flexible dentures and their utilization in cases where patients are not willing for CPDs.
Journal of Oral Biology and Craniofacial Research, 2019
Background: Rapid increase of products containing titanium leads to the increases in percutaneous... more Background: Rapid increase of products containing titanium leads to the increases in percutaneous and permucosal exposure of populations to the titanium. Purpose: Evaluate the various material compositions in five commercially available dental implant systems and correlate the obtained material contents with allergic conditions seen with implants. Material and methods: A total of 25 implant, with 5 samples each in 5 groups of commercially available dental implants (MKIII, Myriad, Nobel Replace, MIS and Alpha Dent) were used in the study. Positive Material Identification (PMI) testing was done to analyse the amount of different metals (percentage by mass) present in the dental implants. Results: Highest titanium content, 99.47% by mass was found in sample 2 (Myriad) and least, 89.04% by mass in sample 5(Alpha dent). Nickel was found only in sample 5 (Alpha dent) in 0.079% by mass and zinc in sample 4 (MIS) in0.084% by mass, chromium was found in sample 1 (MK III) in 0.263% by mass and in sample 2 in0.273% by mass. Conclusions: Implant composition should be made mandatory to be disclosed on the implant packet and before implant placement patch test for the allergen present in the particular implant can be done for the patient's health benefit and long term clinical success of dental implants.
Clinical Implant Dentistry and Related Research, 2018
Purpose: Evaluation of the available research on PEEK materials to find that whether PEEK materia... more Purpose: Evaluation of the available research on PEEK materials to find that whether PEEK material has favorable properties and can enhance osseointegration, so that they can be utilize as implants material. Materials and Methods: An electronic and structured systematic search was undertaken in May 2018, without any restrictions of time in the Medline/Pubmed, Sci-hub, Ebscohost, Cochrane, and Web of Science databases. To identify other related references further hand search was done. Articles related to PEEK and their applications in implants were only included. Articles not available in abstract form and article other than English language were excluded. Results: Initially, the search resulted in 153 papers. Independent screenings of the abstracts were done by the reviewers to identify the articles related to the question in focus. Sixty-two studies were selected out of which 10 were further excluded due to not in English language. Two additional papers were obtained after hand searching, and finally 54 articles were included in the review. Conclusions: Surface modification of PEEK seems to enhance the cell adhesion, proliferation, biocompability, and osteogenic properties of PEEK implant materials. PEEK had also influence the biofilm structure and reduces the chances of periimplant inflammations. Further research and more number of controlled clinical trials on PEEK implant is required in near future so that it can replace titanium in future.
As there are insufficient studies available, comparing the success of one-piece and two-piece sin... more As there are insufficient studies available, comparing the success of one-piece and two-piece single implant-retained mandibular overdentures (SIMOs), hence this study was undertaken to compare the patient satisfaction and crestal bone loss with one-piece and two-piece SIMOs, with immediate loading protocols. The null hypothesis was that there would be no difference in patient satisfaction
Journal of Dentistry and Oral Hygiene, Dec 31, 2009
Ocular prosthesis is an artificial replacement of the eye. After enucleation, evisceration and ex... more Ocular prosthesis is an artificial replacement of the eye. After enucleation, evisceration and exenteration of the eye, the goal is to replace the missing tissues with an artificial prosthesis and restore the facial symmetry and normal appearance of the anophthalmic patient. Therefore the combined efforts of the ophthalmologist, the plastic surgeon, and the maxillofacial Prosthodontist are essential in order to restore the patient's quality of life. Custom made prostheses provide more esthetic and precise result when compared to stock eye prosthesis. Simplification of the technique with the commonly available materials makes it more ease to make it. This is a case report presenting the fabrication of eye prosthesis in a cost effective manner with a unique impression technique.
The aetiology for the development of temporomandibular disorders (TMDs) is multifactorial. This c... more The aetiology for the development of temporomandibular disorders (TMDs) is multifactorial. This chapter deals with several controversies that exist regarding the role of occlusion as main etiological factor for TMDs with the evidence of numerous studies for and against the role of occlusion in TMD. Insights have been provided regarding various concepts of occlusion and its relation to the disorders of the temporomandibular joint.
Clinical Implant Dentistry and Related Research, 2018
Background: An optimal shape of the thread design of the implants is required for equal distribut... more Background: An optimal shape of the thread design of the implants is required for equal distribution of stresses to the surrounding bone matrix and for stimulation and promotion of bone remodeling. Purpose: The study was construed with the aim of histomorphometric evaluation of bone stimulation generated by different microthread designed implants in enhancing osseointegration, and to assess the pattern of stress dissipation through a two-dimensional finite element analysis. Material and Methods: Computer Aided Designing of two type of microthreads, one V-shaped and the other Power-shaped microthreaded dental implants with only microthreads all along body of the implant from the neck to the apex was made and 30 implant prototypes were milled. Twodimensional finite elemental analysis (FEA) was carried out to assess the pattern of stress distribution in the bone around these implant designs and for In vivo study 24 implant prototypes were placed in rabbits tibia and femur, out of which 12 were with V-shaped microthreads and the other 12 were with Power-shaped microthreads. Histomorphometric analysis was carried out of the sections obtained from the enbloc specimen retrieved from the sacrificed rabbits. Results: FEA showed less stress around the V-shaped microthreaded implant model when compared to Power-shaped microthreaded implant model. Hitomorphometry showed statistical significance difference in new bone volume (BV) and Total BV for V-shaped microthreaded prototype implant. Conclusions: V-shaped microthreaded dental implant design can be preferred over Power-shaped microthreaded dental implant for proper stress distribution and for promoting osseointegration.
International Journal of Prosthodontics and Restorative Dentistry, 2016
Amputation of a finger will have considerable functional and psychological impact on an individua... more Amputation of a finger will have considerable functional and psychological impact on an individual. Although prosthetic rehabilitation incorporating implants is considered an ideal treatment option, the patient may not give consent due to apprehension toward surgical procedures. The ideal prosthesis should replace the missing part of the finger so precisely that it would not draw the attention of the observer. Fabrication of such a prosthesis will require great technical and artistic expertise. This paper presents a case of prosthetic rehabilitation of an amputated finger using a silicone finger prosthesis.
International Journal of Prosthodontics and Restorative Dentistry, 2020
The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the reh... more The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the rehabilitation of the single anterior missing tooth with dental implants. Critical assessment of the scientific evidence is required for the evidence-based practice of a particular treatment modality, which can be reviewed from the well-designed randomized clinical trials, cohort studies, observational studies, retrospective data reviews, etc. In order to fulfil the requirement for best patient care, the evidence-based clinical practice is utmost important. It is recommended to follow particular diagnostic strategies and treatments plans with each plan to be individualized so as to reflect the specific characteristics of individual clinical circumstances. Consensus guidelines have increasingly become an integral part of evidence-based medicine not only in individual and institutional clinical practices but also in serving as a framework with the aim of better patient outcomes and reduce variations, prevent errors, and increase clinicians' accountability in the healthcare practices and help researchers to identify gaps in the evidence and what key research questions have yet to be answered and further discussion and modifications when required by the plenary. The working group also prepared recommendations for future research. Disclosure All the group members were asked to reveal any conflicts of interest that could potentially influence the outcomes of the consensus deliberations based on limited scientific evidence and strict inclusion criteria. No such conflicts were identified. Six topics were discussed, which were as follows: Topic 1: Radiographic techniques in implant dentistry Topic 2: Contemporary surgical guidelines Topic 3: Restorative materials and techniques Topic 4: Implant loading protocols Topic 5: Optimizing esthetic outcomes in implant dentistry Topic 6: Digital-guided solutions Topic 1: Radiographic Guidelines for the Use of Diagnostic Imaging in Implant Dentistry for Anterior Single Implants Diagnostic imaging is an essential component of implant treatment planning. The introduction and widespread use of cross-sectional imaging in implant dentistry using cone-beam computed tomography (CBCT) over the last decade has enabled clinicians to
Purpose: This systematic review has been undertaken to highlight the unforgettable contributions ... more Purpose: This systematic review has been undertaken to highlight the unforgettable contributions of Prof. Brånemark Per-Ingvar (PI). It could be understood that reviewing his work would give an idea of growth of this treatment modality. Materials and Methods: An electronic search on the PubMed/Medline, Ebscohost, and Cochrane database was done using search term “Brånemark PI” to identify his publications. Articles published in English and only related to implants and osseointegration were included. Screening of the titles and abstracts were done according to inclusion criteria and suitable studies were included in the review. Results: The initial literature search resulted in 187 articles, out of which 92 articles were excluded due to not meeting the inclusion criteria and 16 articles excluded due to non-availability of even abstract also. A total of 79 articles were finally included in this review. Conclusion: Brånemark PI had a great vision of future; who considered edentulism as equal to amputation and came up with the concept of osseointegrated implants to overcome them. The innovations of Brånemark had assured the world that it is very much possible to provide implant-supported prosthesis in any situations for the rehabilitation of the individuals.
In the anterior region, the common reason for tooth loss is due to traumatic injury or congenital... more In the anterior region, the common reason for tooth loss is due to traumatic injury or congenital anomaly. Loss of a single tooth may cause functional and esthetic deficits to the patient. There are different treatment options available for replacing a missing incisor. Implant dentistry should be considered as first treatment alternative for replace a missing tooth. This case report presents the replacement of a missing maxillary left central incisor in a compromised site with dental implants along with bone graft followed by frenectomy to obtain a good clinical result and for better function and esthetics of the patient.
PURPOSE To assess the technical and biological complications of screw- and cement-retained implan... more PURPOSE To assess the technical and biological complications of screw- and cement-retained implant-supported full-arch dental prostheses. MATERIALS AND METHODS An electronic search was conducted on Medline/PubMed and Cochrane databases in February 2019; irrespective of any time restrictions using MeSH terms. All studies were first reviewed by abstract and subsequently by full-text reading. Further hand search was performed to identify other related references. Articles only related to cement-retained and/or screw-retained reconstructions in full-arch fixed dental prostheses (FDP) were included. RESULTS The initial literature search resulted in 3670 papers. 3478 articles remained after removing duplicate articles, and 3439 articles were further excluded by the reviewers after the abstract screening, which resulted in a selection of 39 studies. 12 studies were further excluded due to not fulfilling the inclusion criteria. Hand searching resulted in two additional papers being included...
Exact recognition of the anterior loop is very important to avert any injury to the neurovascular... more Exact recognition of the anterior loop is very important to avert any injury to the neurovascular bundle during surgical procedures. The purpose of this review was to evaluate the prevalence and length of the anterior loop in different populations. A comprehensive search of Medline/Pubmed and Cochrane database was done. The focused question was the presence of anterior loop (including loop length) of the inferior alveolar nerve in mental foramen region in CBCT images of the various subjects. Articles related to the presence of anterior loop (including loop length) were only included. Initial literature search resulted in 3024 papers, after removing duplicate articles, 2821 articles were left. Two thousand seven hundred eighty-four articles were further excluded by the reviewers after screening the abstracts which resulted in 37 studies. Hand searching resulted in 2 additional papers. Seven full-text articles were excluded for not fulfilling the inclusion criteria. Finally, 32 articles were included in the review. Two thousand five hundred three subjects with anterior loop were found, which approximates 38% with 48.4% bilateral, 27.8% right side, and 23.8% left side. The loop distribution in males and females was also found to be different. There was highly significant (P < 0.001; I2 = 98.81%) heterogeneity found in the included studies. Variations were found in the prevalence, length, gender, and side distribution of anterior loop in various populations. This systematic review highly recommends not relying on any average values and the clinician should compulsorily make use of imaging modalities available in each and every case, wherever surgical procedure is to be performed near mental foramen region.
International Journal of Prosthodontics and Restorative Dentistry, 2020
The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the reh... more The Branemark Osseointegration Center, India, gathered seven experts for 1 day to discuss the rehabilitation of the single anterior missing tooth with dental implants. Critical assessment of the scientific evidence is required for the evidence-based practice of a particular treatment modality, which can be reviewed from the well-designed randomized clinical trials, cohort studies, observational studies, retrospective data reviews, etc. In order to fulfil the requirement for best patient care, the evidence-based clinical practice is utmost important. It is recommended to follow particular diagnostic strategies and treatments plans with each plan to be individualized so as to reflect the specific characteristics of individual clinical circumstances. Consensus guidelines have increasingly become an integral part of evidence-based medicine not only in individual and institutional clinical practices but also in serving as a framework with the aim of better patient outcomes and reduce variations, prevent errors, and increase clinicians' accountability in the healthcare practices and help researchers to identify gaps in the evidence and what key research questions have yet to be answered and further discussion and modifications when required by the plenary. The working group also prepared recommendations for future research. Disclosure All the group members were asked to reveal any conflicts of interest that could potentially influence the outcomes of the consensus deliberations based on limited scientific evidence and strict inclusion criteria. No such conflicts were identified. Six topics were discussed, which were as follows: Topic 1: Radiographic techniques in implant dentistry Topic 2: Contemporary surgical guidelines Topic 3: Restorative materials and techniques Topic 4: Implant loading protocols Topic 5: Optimizing esthetic outcomes in implant dentistry Topic 6: Digital-guided solutions Topic 1: Radiographic Guidelines for the Use of Diagnostic Imaging in Implant Dentistry for Anterior Single Implants Diagnostic imaging is an essential component of implant treatment planning. The introduction and widespread use of cross-sectional imaging in implant dentistry using cone-beam computed tomography (CBCT) over the last decade has enabled clinicians to
Clinical Implant Dentistry and Related Research, 2018
Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 i... more Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 implant placed cross arch in maxilla and in mandible respectively, restored with screw retained prosthesis. Materials and Methods: Total of 30 patients were randomized, with 15 in group1 with an average of 45 Ncm insertion torque with delayed loading and 15 in group 2 with above 65 Ncm inertion torque with immediate loading with equal number of male and female in each group following parallel design with 3 implants in maxillary and 2 implants in mandibular arch placed which was supported by a 3Dimensional finite analysis comparing the stress dissipation around implants of this concept-"Simplif5y" with All-on-4 concept. Results: Von Mises strain recorded in the bone in the maxillary and mandibular arch models were higher in All-on-four than that in the "simpli5y", which was vice-versa in the framework. Three-year post loading marginal peri implant bone loss for the group 1 was less than group 2. Conclusions: These results, suggest that in both delayed loading and immediate loading protocol that cross arch prostheses can be successfully supported by 3 and 2 implants in maxillary and mandibular arch respectively-"Simpli5y" concept of full mouth restoration.
Clinical Implant Dentistry and Related Research, 2018
Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 i... more Background and Purpose: To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 implant placed cross arch in maxilla and in mandible respectively, restored with screw retained prosthesis. Materials and Methods: Total of 30 patients were randomized, with 15 in group1 with an average of 45 Ncm insertion torque with delayed loading and 15 in group 2 with above 65 Ncm inertion torque with immediate loading with equal number of male and female in each group following parallel design with 3 implants in maxillary and 2 implants in mandibular arch placed which was supported by a 3Dimensional finite analysis comparing the stress dissipation around implants of this concept-"Simplif5y" with All-on-4 concept. Results: Von Mises strain recorded in the bone in the maxillary and mandibular arch models were higher in All-on-four than that in the "simpli5y", which was vice-versa in the framework. Three-year post loading marginal peri implant bone loss for the group 1 was less than group 2. Conclusions: These results, suggest that in both delayed loading and immediate loading protocol that cross arch prostheses can be successfully supported by 3 and 2 implants in maxillary and mandibular arch respectively-"Simpli5y" concept of full mouth restoration.
Aims: The use of cast partial dentures (CPDs) has been decreased and its importance has been decl... more Aims: The use of cast partial dentures (CPDs) has been decreased and its importance has been declined in the teaching curriculum. The purpose of this survey was to evaluate the attitudes of dental professionals toward conditions using CPDs in private practice in India. Settings and Design: Descriptive survey Materials and Methods: This survey consists of eight close-ended questions concerning the use of CPD by dental professionals practicing in India. The URLs of the questionnaire were shared via E-mail to dentists practicing throughout India, to obtain a response of 384 which is a predetermined sample size. Statistical Analysis Used: Statistical analysis was done using counts and percentages and the results were further analyzed statistically by the Chi-square test. Results: Nearly 42.79% of general dental practitioners (GDPs), 47.26% of prosthodontists, and 9.95% of other specialist dentists responded to the questionnaire. GDPs mostly preferred removable partial dentures (RPDs) (71.87%) and fixed partial dentures (57.22%), whereas prosthodontists preferred mostly implant (60.91%). GDPs mostly preferred flexible dentures (62.42%), whereas prosthodontists preferred CPDs 62.84%. Almost 52.50% of the GDPs mostly raised a cost issue and 63.11% of the prosthodontists had difficulty in adjustment with CPDs. Nearly 63.46% of the dentists told that implant-supported restorations are better options compared to CPDs; still, majority of the dentists (53.23%) were in favor that more importance for teaching CPDs in graduation curriculum should be given. Conclusions: This survey shows that in India a significant proportion of GDPs (71.87%) preferred RPDs, mostly flexible dentures (62.42%) due to their low cost compared to CPDs. Prosthodontists mostly preferred implants (60.91%) because they are more confident and better trained in these. It is recommended that more importance be given in teaching implants along with CPDs in graduation curriculum so that practitioners can better educate their patients about implants and their advantages over flexible dentures and their utilization in cases where patients are not willing for CPDs.
Journal of Oral Biology and Craniofacial Research, 2019
Background: Rapid increase of products containing titanium leads to the increases in percutaneous... more Background: Rapid increase of products containing titanium leads to the increases in percutaneous and permucosal exposure of populations to the titanium. Purpose: Evaluate the various material compositions in five commercially available dental implant systems and correlate the obtained material contents with allergic conditions seen with implants. Material and methods: A total of 25 implant, with 5 samples each in 5 groups of commercially available dental implants (MKIII, Myriad, Nobel Replace, MIS and Alpha Dent) were used in the study. Positive Material Identification (PMI) testing was done to analyse the amount of different metals (percentage by mass) present in the dental implants. Results: Highest titanium content, 99.47% by mass was found in sample 2 (Myriad) and least, 89.04% by mass in sample 5(Alpha dent). Nickel was found only in sample 5 (Alpha dent) in 0.079% by mass and zinc in sample 4 (MIS) in0.084% by mass, chromium was found in sample 1 (MK III) in 0.263% by mass and in sample 2 in0.273% by mass. Conclusions: Implant composition should be made mandatory to be disclosed on the implant packet and before implant placement patch test for the allergen present in the particular implant can be done for the patient's health benefit and long term clinical success of dental implants.
Clinical Implant Dentistry and Related Research, 2018
Purpose: Evaluation of the available research on PEEK materials to find that whether PEEK materia... more Purpose: Evaluation of the available research on PEEK materials to find that whether PEEK material has favorable properties and can enhance osseointegration, so that they can be utilize as implants material. Materials and Methods: An electronic and structured systematic search was undertaken in May 2018, without any restrictions of time in the Medline/Pubmed, Sci-hub, Ebscohost, Cochrane, and Web of Science databases. To identify other related references further hand search was done. Articles related to PEEK and their applications in implants were only included. Articles not available in abstract form and article other than English language were excluded. Results: Initially, the search resulted in 153 papers. Independent screenings of the abstracts were done by the reviewers to identify the articles related to the question in focus. Sixty-two studies were selected out of which 10 were further excluded due to not in English language. Two additional papers were obtained after hand searching, and finally 54 articles were included in the review. Conclusions: Surface modification of PEEK seems to enhance the cell adhesion, proliferation, biocompability, and osteogenic properties of PEEK implant materials. PEEK had also influence the biofilm structure and reduces the chances of periimplant inflammations. Further research and more number of controlled clinical trials on PEEK implant is required in near future so that it can replace titanium in future.
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