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Objectives Total tooth loss is common in the aging population resulting in insufficient chewing function with subsequent weakening of the masticatory muscles. The study aims to evaluate the changes in thicknesses of the masseter and anterior temporal muscle in edentulous patients following the reconstruction of implant-supported fixed prostheses and compare them with the dentate individuals. Materials and methods The study was designed as a prospective, single-center, controlled clinical trial. A total of 60 participants were included in the present study. The patients were divided into two groups; Group I (Test Group): 30 edentulous patients who received implant-supported fixed prostheses, Group II (Control Group): 30 dentate individuals of an age and sex-matched group. Ultrasonography was used to measure the cross-sectional thickness of the left and right musculus masseter and anterior temporalis immediately after the cementation of the prosthetic rehabilitation (T1), on the 1st (T2) and 6th (T3) months after rehabilitation and at a single time point in the control group. Results The results showed that there were significant comparison differences in muscle thickness at the baseline measurements between groups while at the end of the 6th month, these differences were not significant. The muscle thicknesses of both the masseter and anterior temporalis muscles increased significantly at T2 and T3 compared to T1 in the test group. The asymmetry index between the left and right muscles in the test group and the asymmetry differences between groups also decreased significantly at the end of the 6th month. Conclusion The implant-supported fixed prostheses significantly increase the thicknesses of the masseter and anterior temporal muscle together with a decrease in the asymmetry between the left and right muscles. At six months, implant-treated patients showed similar muscle thicknesses compared to dentate individuals. Clinical relevance The findings suggest that implant-supported fixed prostheses can improve the masticatory function and facial symmetry of edentulous patients.

The aim of this cohort case series is to present a new subperiosteal implant device that uses CAD-CAM technologies together with 3D metal printing capabilities to produce direct bone-anchored dental prosthetic solutions for the management of atrophic edentulous alveolus and jaws. The clinical experience of 21 subperiosteal devices implanted over a 4-year period is presented. The results of this study showed 14 of the 21 cases were successful (66.7%), while 7 cases had complications including exposure of the metal frame (5 cases), mobility of the device (1 case) and 1 case failed for reasons unrelated to the device. Four of the 7 cases were successfully salvaged resulting in an overall success rate of 85.7% (18 /21 cases). This study supports the use of fully customized subperiosteal jaw implants as a simple and reliable alternative for dental rehabilitation of atrophic edentulous cases which would otherwise require bone grafts for conventional fixed dental implant solutions. With more research, the clinical potential for this device is significant as it not only avoids the need for complex and lengthy reconstructive jaw surgery but also allows for the placement of immediate prosthetic teeth at the time of implantation.

Background This study assessed the clinical outcomes of fixed and removable implant-assisted prostheses for the rehabilitation of atrophied distal extension mandibular ridges. Methods Thirty partially edentulous patients with atrophied distal extension mandibular ridges were randomized to three groups ( n  = 10/group). Group ALF received long implants following alveolar ridge augmentation to support fixed restorations. Group SF received short implants to support fixed restorations. Group OVD received two long implants to support a removable partial denture. The plaque index (MPI), gingival index (MGI), Pocket depth (PD), implant stability (IS), and crestal bone loss (CBL) were assessed: immediately after the prosthesis insertion (T0), six months (T6), and twelve months (T12) later. All groups were assessed for patient satisfaction after 12 months using a visual analogue scale (VAS) survey. Results Implant survival rates were 89.7%, 91.7%, and 85% in the ALF, SF, and OVD groups (Chi-square = 0.972, log-rank test, p  =.673). The ALF and SF groups had significantly greater plaque and gingival scores ( P  <.05) than the OVD group At T6 and T12. The ALF group exhibited significantly higher PD and IS values ( P ˂ 0.05) compared to the OVD group At T6 and T12. The OVD group had the greatest significant CBL values ( P  <.05) at T6 and T12, whereas the SF group presented the lowest significant values. The ALF and SF groups showed the highest significant satisfaction levels ( P  <.05) regarding appearance, esthetics, retention, stability, chewing, bolus quality, and occlusion. On the other hand, the OVD group expressed the highest significant satisfaction ( P  <.05) with surgery, healing, and cleaning. Conclusions Fixed restorations supported by either short implants or long implants inserted in augmented bone are equally successful in the rehabilitation of the atrophic posterior mandible, with improved patient satisfaction than implant-assisted partial dentures. Nevertheless, the SF group had favorable peri-implant soft tissue health and decreased marginal bone loss compared to the ALF group. Conversely, implant-assisted partial overdentures demonstrated favorable peri-implant soft tissue health and increased patient satisfaction regarding surgery and healing compared to fixed restoration. Trial registration Current Trial NCT05978115 (28/07/2023) “Retrospectively registered”.

Background Individuals who are edentulous have a lower intake of fruit, vegetables, fiber, and protein compared with their dentate counterparts because tooth loss is accompanied by a decrease in ability to chew. Whether or not a combination of prosthetic rehabilitation and simple dietary advice produces improvement in dietary intake among edentulous persons is unclear. We aim to investigate the effect of a simultaneous combination of simple dietary advice delivered by dentists and provision of new complete dentures on dietary intake in edentulous individuals who request new dentures. Methods/design Through a double-blinded, parallel, randomized controlled trial in which 70 edentate persons who request new complete dentures will be enrolled, eligible study participants will be randomly allocated to either a dietary intervention group receiving dietary advice or to a control group receiving only advice on the care and maintenance of dentures. Outcome measures include daily intake of nutrients and food items, assessed using a brief self-administered diet history questionnaire; antioxidant capacity, determined using blood and urine samples; nutritional status, assessed with the Mini-Nutritional Assessment-Short Form; oral health-related quality of life, assessed with the Japanese version of the Oral Health Impact Profile-EDENT and the Geriatric Oral Health Assessment Index; subjective chewing ability; masticatory performance, assessed using a color-changeable chewing gum and a gummy jelly; patient self-assessment of dentures; mild cognitive impairment, assessed with the Japanese version of the Montreal Cognitive Assessment; and functional capacity, assessed with the Japan Science and Technology Agency Index of Competence. Outcome measures, except for antioxidant capacity, are to be implemented at three time points: at baseline and at 3 and 6 months following intervention. Antioxidant capacity data are to be collected twice: at baseline and at 3 months following intervention. Differences between the groups at 3 and 6 months and within-group changes are to be compared using the paired t test. Discussion Simple dietary advice that can be implemented by a dentist would be more practical in clinical practice than tailored dietary counseling. The results of this study will provide beneficial information on dietary intake changes for both edentulous individuals requesting new complete dentures and dentists. Trial registration University Hospital Medical Information Network Center Unique Trial Number: UMIN000017879 . Registered on 12 June 2015.

The aim of the present study was to evaluate and compare the traditional “All on Four” technique with digital smile designed computer-aided “All on Four” rehabilitation; with a 4-years follow-up. The protocol was applied to a total of 50 patients randomly recruited and divided in two groups. Digital protocol allows for a completely virtual planning of the exact position of the fixtures, which allows one to perform a flapless surgery procedure with great accuracy (mini-invasive surgery) and also it is possible to use virtually planned prostheses realized with Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) (methods for an immediate loading of the implants. After 4 years from the treatments 98% of success were obtained for the group of patients treated with the traditional protocol and 100% for the digital protocol. At each time interval a significant difference in peri-implant crestal bone loss between the two groups was detected; with an average Marginal Bone Loss (MBL) at 4 years of 1.12 ± 0.26 mm in the traditional group and 0.83 ± 0.11 mm in the digital group. Patients belonging to the digital group have judged the immediate loading (92%), digital smile preview (93%), the mock-up test (98%) and guided surgery (94%) as very effective. All patients treated with a digital method reported lower values of during-surgery and post-surgery pain compared to patients rehabilitated using traditional treatment. In conclusion, the totally digital protocol described in the present study represents a valid therapeutic alternative to the traditional “All on Four” protocol for implant-supported rehabilitations of edentulous dental arches.

Objectives. The goal of this study was to evaluate bone changes around endosseous implants in partially edentulous patients. Materials and Methods. A total of 632 two-stage implants were placed in 252 patients. The implants had straight emergence profile, ZirTi surface, 3.3 to 5 mm diameter, and 8.5 to 13 mm length. Bone levels were assessed on orthopantomography immediately after surgery and after 36 months and marginal bone loss (MBL) was calculated from their difference. Results. Cumulative survival rate was 98.73%. Overall MBL was 0.8 mm ± 0.03 (mean ± SEM). Higher MBL was observed around implants in the maxilla than in the mandible (P<0.007). A relation between implant diameter and MBL (P<0.0001) was observed in male and, more limitedly, female patients. Older patients had higher MBL in the maxilla, but not in the mandible (P<0.0001). MBL progressively increased with age in male patients, but reached a peak already in the 50–60 years age group in the female subset (P<0.001). Conclusions. The overall MBL is consistent with the available literature. Site difference and patient age and gender appear to significantly affect MBL, representing important factors to be considered during implant placement.

The aim of the present study is to compare the histological aspects of bone formation in atrophic posterior mandibles augmented by autologous bone block from chin area with corticocancellous bone block allograft used as inlays with the sandwich technique. Materials and Methods. Sixteen patients with bilateral partial edentulism in the posterior mandible were selected. The residual bone height, preliminarily measured by computed tomography scans, ranged between 5 and 7 mm from the inferior alveolar nerve. All patients required regeneration procedure with autologous bone block from chin area (control group) versus bone block allograft Puros (Zimmer Dental, 1900 Aston Avenue, Carlsbad, CA, USA) (test group). Histological and histomorphometric samples were collected at the time of implant positioning in order to analyze the percentage of newly formed bone, the residual graft material, and marrow spaces/soft tissue. Results. No statistically significant differences between the two groups were found regarding the percentage of newly formed bone. The percentage of residual grafted material was significantly higher in the test group, whilst the percentage of marrow spaces was higher in control group. Conclusions. In conclusion, both procedures supported good results, although the use of bone blocks allograft was less invasive and preferable than harvesting bone from the mental symphysis.

Background This study aimed to evaluate the trueness of implant placement with fully guided (FG) implant placement protocol versus partial-guided (PG) protocol. Methods The study recruited 16 fully edentulous patients with adequate maxillary bone volume. Each patient received six implants; three were planned for each side of the maxilla to support a full-arch implant-supported fixed prosthesis 3 (FP3). Patients were randomly assigned to one of two intervention groups: Group 1 (PG group), drilling was done using a surgical guide, but implant placement was done without the guide. In group 2 (FG group), both drilling and implant placement were done through the surgical guide. The spatial relationship (entry, apex, and angle deviation) between planned and placed implants was evaluated using pre- and postoperative CBCT data. Results The FG approach resulted in statistically significantly higher overall trueness in entry, apex, and angle deviation across multiple implant sites, with a statistically significant difference of 0.030, 0.013, and 0.036, respectively, though differences at individual implant sites were not consistently significant. Conclusion This trial supported the fully guided implant placement protocol for enhancing the trueness of implant positioning in the rehabilitation of edentulous maxillary arches. Clinicians should weigh the benefits of this increased trueness against practical considerations. Trial registration The current study was registered at ClinicalTrials.gov (NCT06542562) on August 5, 2024.

Objective This study aimed to evaluate the clinical performance (degree of trueness) of a novel scan body “tooth-modified Scan body” (TMSB)& conventional scan body (CSB) in implant-supported full arch screw retained cases. Methods Seven edentulous arches (two maxillae, five mandibles) in 6 patients were rehabilitated with monolithic zirconia screw-retained implant prostheses supported by 4 ( n  = 1) and 5 implants ( n  = 6) for a total amount of 34 implants. Implant locations were scanned by intra-oral scanner (IOS) using two types of scan bodies, conventional scan bodies (CSB) in group (1) and tooth-modified scan bodies (TMSB) in group (2). 68 implant positions (representing the total sample size) were captured and compared to the relative reference scans regarding angular and Euclidian deviation (ΔEUC). Results The ΔEUC deviation Of TMSB group had lower values (M = 61.46, SD = 42.12) than that Of CSB group (M = 97.97, SD = 56.69). This difference was statistically significant ( p  = .005), 95% Confidence interval. The angular deviation of TMSC group had lower values (M = 0.85, SD = 0.69) than that Of CSB group (M = 1.3, SD = 1.06) which was statistically significant ( p  = .033), 95% Confidence interval. There was a correlation between the type of Jaw and both angular and ΔEUC deviation of both groups, which was statistically significant. Conclusion A tooth-modified scan body (TMSB) may improve the ease and trueness of full-arch implant scanning, even in challenging mandibular arches. Clinical trial registry date Retrospectively registered in 20/ 12/ 2023. Clinical trial registry number NCT06177782.

The aim was to: (1) compare changes among primary and secondary implant stability between immediate and early loaded implants in edentulous maxilla, (2) evaluate oral health-related quality of life (OHRQoL), and (3) determine patient satisfaction with 6 implant supported fixed full-arch dentures. A prospective, randomized controlled clinical trial was conducted on 24 edentulous maxilla patients. The BLT SLActive implants in 12 patients were immediately loaded with temporary restorations while 12 patients did not receive temporary restorations. Definitive (final) dentures were delivered to all patients after 6 weeks. Stability of the implants were assessed by insertion torque (IT) and resonance frequency analysis (RFA). Oral Health Impact Profile-19 ( OHIP-19) questionnaire was used to evaluate OHRQoL and a visual analogue scale (VAS) was used for patient satisfaction. The IT value of implants assigned for immediate and early loading group was 27.17 ± 9.55 Ncm and 25.01 ± 11.06 Ncm, respectively. Changes in implant stability from baseline to week 6 were similar in both groups when measured by Penguin ( P = .881) and Ostell ( P = .828). Patients in the immediate loading group reported significantly lower OHIP physical pain scores ( P = .016) and OHIP psychological disability score ( P = .046), and the patients reported significantly higher VAS function score ( P = .009) and VAS esthetics score ( P = .009). Implant loading protocols do not have a significant effect on the change in implant stability 6 weeks after implantation; however, immediate loading significantly improves OHRQoL as well as satisfaction of patients with maxillary edentulism treated by fixed full-arch dentures. Future trials will determine the role of immediate loading protocol in clinical scenarios with various amounts of available jaw bone using different numbers of implants to retain a fixed prosthetic restoration in the edentulous maxilla.