Journal of Dental Implants
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   Table of Contents - Current issue
July-December 2019
Volume 9 | Issue 2
Page Nos. 49-98

Online since Monday, January 13, 2020

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Peri-implant bone loss: Unavoidable or can it be slowed? p. 49
Sharat Shetty
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In the words of the pioneering Indian implant dentist p. 51
Firoze Dara Mirza
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Awareness, knowledge, and attitude of dental practitioners to the one-stage protocol of dental implant loading: A sub-Saharan African perspective p. 53
Kolawole Obagbemiro, John Ademola Adeoye, Yetunde Olusola Ajayi, Patricia Adetokunbo Akeredolu
Objectives: Dental implant therapy is still considered an evolving field in the sub-Saharan Africa, with most dental surgeons skilled in implant placement favoring the delayed loading protocol (>3 months) even in the rehabilitation of missing anterior teeth. This study aims to evaluate the current level of knowledge and attitude of Nigerian general dental practitioners toward the immediate loading protocol of dental implants. Materials and Methods: This is a descriptive, cross-sectional survey conducted among Nigerian dental practitioners. Self-administered, pretested questionnaires were used to collect data regarding their knowledge and attitude to immediate loading of implants. Data collected were analyzed using the Statistical Package for the Social Sciences version 22 (IBM Corp, Armonk, NY, USA) Results: A total of 237 dentists completely filled the questionnaires. Nearly 46% of the participants had good knowledge on the procedure and advantages offered by the immediately loading dental implants with provisional restorations, whereas 81% had negative reservations toward implant placement using the protocol. In addition, this study found a statistically significant association (P < 0.05) between the knowledge and attitude of the dental practitioners regarding the protocol. Conclusion: There is slighlty poor knowledge and significant negative attitude of dentists toward the immediate implant loading protocol in Nigeria. Improved information dissemination from general dental practitioners to patients, and practice of the protocol in indicated cases by implantologists is expected with increased awareness and subsequent training on its use and viability.
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Outcomes of intentional perforation of the maxillary sinus floor during implant placement: A single-center, prospective study in 57 subjects p. 60
Vallabhdas Santosh, Parushuram Bhukya, Bhagyasri Medisetty, Viswa Chandra Rampalli, P Anuup Kumaar
Context: An essential precondition for successful implant therapy is the presence of an adequate quantity and quality of bone. Aims: The purpose of this study was to radiographically evaluate the bone formation around the dental implants which were placed at different depths into the maxillary sinus by intentional perforation of maxillary sinus floor during implant placement and its effect on implant survival rate. Settings and Design: A total of 86 implants of varying dimensions were placed in maxillary premolar and molar region by intentional perforation of the maxillary sinus floor during implant placement in 57 patients. Subjects and Methods: They were divided into three groups G1, G2, and G3 based on the depth of penetration into the maxillary sinus (region by [IS] compartment) (IS-G1-1 mm; G2-2 mm; G3-3 mm). The following parameters were evaluated-torque, bone density, and bone fill after 6 months of implant placement. Statistical Analysis Used: The comparison among groups for repeated measures data was made by ANOVA repeated measures test. The correlation between two parameters, i.e., torque and bone fill was done by Karl Pearson's correlation test Results: No significant differences were observed among the three groups for torque, bone fill, and bone density from baseline to 6 months. The correlation between torque and bone fill revealed R = 0.198, P = 0.293 which was statistically insignificant Conclusions: There were minimal failure rates and complications observed at the end of the study period. The survival rate of implants was not influenced either by torque or by the depth of penetration of implant into the maxillary sinus.
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Implant prosthodontics: Challenges, complications, and solutions p. 66
Ali Tunkiwala, Udatta Kher
Contemporary implant dentistry needs to provide solutions to our patients that are not only functional but also esthetically correct and have the inbuilt strength and mechanisms to provide longevity without any major biologic or hardware complications. In case such complications occur, there must be a well laid out pathway for their management. This article discusses common hardware issues with implant dentistry and ways to prevent them and manage them.
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Managing perimucositis and peri-implantitis with melatonin: A new approach p. 77
Rosy Raheja, Tanu Mahajan
Melatonin (n-acetyl-5-methoxytryptamine) is a substance secreted by multiple organs including the pineal gland, retina, bone marrow, the gastrointestinal track, and the immune system. Its main function is the regulation of the circadian rhythm (day–night cycles). It plays an anti-inflammatory, antioncotic, and immunomodulatory role by scavenging free-radicals and through interactions with cell membrane and intracellular proteins. Melatonin is capable of entering the oral cavity by diffusing into the saliva from blood. As the majority of the melatonin remains bound to serum albumin, the amount of melatonin in saliva is approximately one-third of that present in the blood. The existence of MT1 receptors on healthy and cancerous oral mucosal cells is suggestive that melatonin may act as an anti-inflammatory or antioncotic agent in the oral cavity; for example, its anti-inflammatory effects have been reported on human gingival fibroblasts. Furthermore, intraperitoneal melatonin has been reported to reduce periodontitis in diabetic rats. Similarly, topical application of melatonin in diabetic patients has diminished the progression of periodontal bone loss as evident by the downregulation of pro-inflammatory factors. Hence, it has been suggested that melatonin may be used in the management of perimucositis and peri-implantitis in the field of dental implants. The aim of this review is to critically analyze and summarize the research focusing on the potential of melatonin in the fields of oral implantology.
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Esthetic rehabilitation of a partially edentulous patient with implants and tooth-supported fixed prosthesis p. 83
Manoj Shetty, Ruchir Kalra, Harsh Desai, Rakshith Hegde
Functional limitation, compromised esthetics, and poor quality of life are few of the consequences of missing teeth. Partial edentulism can be treated by either fixed or removable prosthesis. In compromised abutment situations, tooth-supported fixed dental prostheses are not indicated and patient satisfaction is low with a removable prosthesis. In such cases, implant-supported fixed dental prostheses help in restoring both the function and esthetic demands of the patient. The present case report describes a case of full-mouth rehabilitation in a partially edentulous situation with implant and tooth-supported restoration.
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Hemolacria and epistaxis as a complication of basal bone implant p. 87
Rajesh Sabnis, Shardul Lokare, Sruthi Janardhan Rao, Deepak Thakur, Mamta Patel
Although perceived as comparatively risk free, every treatment has its own share of risks and complications. This case report illustrates an incident of epistaxis and hemolacria after basal bone implant placement in an edentulous atrophic maxilla. Most standard complications such as sinusitis, soft-tissue infection, paresthesia, and oroantral fistula are well known. Few very rare complications such as cutaneous fistula in the left zygomatico-orbital area caused by aseptic necrosis at the apical part of the implant, infection, and peri-implantitis have also been reported in literature. This article presents an unusual complication of basal implant placement along with a review of literature.
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Socket shield technique, a novel approach for the esthetic rehabilitation of edentulous maxillary anterior alveolar ridges: A special case file p. 91
Sandeep Patel, Hiral Parikh, B Barun Kumar, Maneesha Das, Amrita Pandita, Abhishek Singh Nayyar
Implant placement in the maxillary anterior region has always been challenging for the implantologists. Different levels of gingival display, along with the uncertainty of soft- and hard-tissue changes postextraction make things highly predictable in this part of the alveolar ridges. This difficulty is augmented by the patient's desire to have teeth in this esthetic zone immediately. Researchers have devised certain techniques to address this issue and one such method of an immediate, highly esthetic rehabilitation is called the socket shield technique (SST). The use of cortical engagement in this region along with SST gives the operator an opportunity to immediately load the prosthesis with optimal esthetic outcomes. Another challenging issue secondary to implant therapy is peri-implant infections, including the more common peri-implantitis. The presence of rough implant surfaces, when exposed to the oral environment, leads to the formation of a kind of nidus, which, further, feeds soft- and hard-tissue loss. The presence of a periapical pathology from previous dentition may also infect the implant surface. An attempt was made in this case to utilize the SST along with the provision of smooth-surfaced dental implants, stabilized with cortical engagement, for the replacement of missing maxillary anterior teeth.
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A retrospective survey of an implant, designed to resist bone loss p. 95
Amos Ben Yehouda, Ofer Yaari
Introduction: A significant percent of dental implants tends to lose bone support during the years. Gravity implants were designed to improve the mechanical bone adaptation in an attempt to overcome the problem. The present manuscript is a retrospective observation of 1 year of 25 single-loaded Gravity implants. Materials and Methods: This was a retrospective study of files of patients who completed their treatment and were loaded for 1 year. The measurement of changes in the bone level was done according to the X-ray documentations that were found in the files of patients treated in the clinic of Kibutz Bror Chail. The schedule of dental implants' follow-up in this clinic includes parallel periapical X-ray films at the stage of implant installation, the stage of loading, and at the end of a year of loading. A Student's t-test was used to compare the bone level at the stage of loading and after 1 year of loading. Results: Twenty-five cases of one single-loaded implant per patient were included in the study. It was shown that most of the bone loss that was documented at the end of the healing phase was reconstructed (72%) during 1 year of loading. Conclusions: According to this retrospective study, it can be concluded that implant design that enables bone loading by compressive stress may result in the reconstruction of the initial loss.
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