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ObjectiveTo determine the prevalence and correlation of various risk factors [radiation dose, periodontal status, alcohol and smoking] to the development of osteoradionecrosis (ORN).Patients and methodsThe records of 1023 patients treated with IMRT for oral cavity cancer (OCC) and oropharyngeal cancer (OPC) between 2004 and 2013 were retrospectively reviewed to identify patients who developed ORN. Fisher exact tests were used to analyze patient characteristics between ORN patients with OCC and OPC. Paired Wilcoxon tests were used to compare the dose volumes to the ORN and contralateral non-ORN sites. To evaluate an association between ORN and risk factors, a case-control comparison was performed. One to 2 ORN-free patients were selected to match each ORN patient by gender, tumor site and size. General estimation equations models were used to compare the risk factors in ORN cases and matched controls.Results44 (4.3%) patients developed ORN during a median follow-up time of 52.5months. In 82% of patients, ORN occurred spontaneously. Patients with OPC are prone to develop ORN earlier compared to patients with OCC (P=0.03). OPC patients received a higher Dmax compared to OCC patients (P=0.01). In the matched case-control analysis the significant risk factors on univariate analysis were poor periodontal status, history of alcohol use and radiation dose (P=0.03, 0.002 and 0.009, respectively) and on multivariate analysis were alcohol use and radiation dose (P=0.004 and 0.026, respectively).ConclusionIn our study, higher radiation dose, poor periodontal status and alcohol use are significantly related to the risk of developing ORN.

PurposeMedication-related osteonecrosis of the jaws (MRONJ) is a well-described complication of antiresorptive and antiangiogenic medications. Although osteonecrosis can be associated with other inciting events and medications, such as trauma, infection, steroids, chemotherapy, and coagulation disorders, these are rarely reported in the literature.Materials and methodsThis is a six case series of MRONJ associated with medications other than antiresorptive or antiangiogenic drugs.ResultsPatient demographics, inciting event, location, stage, imaging findings, and outcome are reported.ConclusionWith the continued development and clinical use of new biologic medications for diseases such as cancer and rheumatoid arthritis, it is important to continue to evaluate their effects on the oral cavity. The degree of risk for osteonecrosis in patients taking these new classes of drugs is uncertain but warrants awareness and monitoring.

Purpose: To analyze and compare the frequency, type and location of maxillary sinus septa in patients with a dentate and an edentulous posterior maxilla using cone beam computed tomography (CBCT) imaging. Materials and Methods: The study consisted of 100 maxillary sinuses: 50 from patients with a dentate and 50 from patients with an edentulous posterior maxilla. The aim was to assess the frequency, morphology and location of maxillary sinus septa in axial, sagittal, and coronal CBCT images. Images were only included in this study provided that patients were older than 30 years of age, at least one maxillary sinus was completely visible in the field of view (FOV) and the sinus membrane exhibited a mucosal thickening of a maximum 4 mm. Differences regarding age, sex, side, septa location, and type of dentition (dentate/ edentulous posterior maxilla) were analyzed. Results: The mean age of the 100 patients (66 women, 34 men) was 58.3 years. A total of 60 sinus septa were found in exactly half of the evaluated sinuses. The major part of the septa was found on the floor of the maxillary sinus (n = 34/56.7%). Of these, the majority was located in the posterior maxilla in the region of the second molars (n = 27/79.4%). The most common orientation of the septa was coronal (63.3%), followed by septa in relation to the infraorbital canal (23.3%). Regarding the status of the dentition in the posterior maxilla in relation to the distribution of sinus septa, septa were present in 26 (52%) dentate and in 24 (48%) edentulous regions. Thus, for a potential influence of the status of the dentition in the posterior maxilla on the frequency of sinus septa, no significant impact was found (P = .69). Conclusion: Sinus septa are frequent anatomical structures, and are found equally often in patients with a dentate and an edentulous posterior maxilla. This is of clinical relevance, as patients with missing teeth in the posterior area of the maxilla are often in need of a sinus floor elevation (SFE) procedure when dental implant placement is intended. As sinus septa are reported to be an important reason for surgical complications during SFE, a three-dimensional radiographic examination using CBCT prior to surgery might be helpful for diagnostic evaluation and treatment planning. [ABSTRACT FROM AUTHOR]

Prosthetic rehabilitation of the edentulous maxilla is known to be challenging and requires meticulous planning. The purpose of this article is to describe a novel classification system, the Lip-Tooth-Ridge (LTR), that offers a guidepost for treatment planning the edentulous maxilla for fixed or removable prostheses. This tool will help clinicians identify the final prosthetic design and will provide a case-specific risk assessment guide regarding two different areas. A high (HER) or low (LER) esthetic risk will be determined based on lip dynamics, as well as a high or low structural risk according to the prosthetic space availability. [ABSTRACT FROM AUTHOR]

Purpose: To assess outcomes of treating completely edentulous patients with a fixed implant-supported profile prosthesis, utilizing a graftless approach, for the maxilla and for the mandible, with an emphasis on patientrelated outcomes, specifically maximum occlusal force, patient satisfaction, and impact on quality of life. Materials and Methods: This was a cross-sectional study with the following inclusion criteria: completely edentulous patients rehabilitated with a fixed implant-supported profile denture, utilizing a graftless approach. Patients fulfilling the inclusion criteria were asked to participate in the study during their follow-up visits; hence, a consecutive sampling strategy was used. To measure maximum occlusal force, a digital occlusal force gauge was used. Subjects were asked to answer a paper survey distributed in the clinic. The survey contained general demographic questions, visual analog scale (VAS) categories, and Oral Health Impact Profile-14 (OHIP-14). Results: The mean VAS score was 8.9 out of a possible 10. The mean OHIP-14 score was 7.5 out of a possible 56. The mean maximum occlusal force recorded in the anterior region was 108 Ncm. The mean maximum occlusal force recorded in the posterior region was 205 Ncm. Conclusion: Results indicated that patients treated with a graftless approach reported high satisfaction and impact on quality of life. Regarding maximum occlusal force values, significant differences between men and women were reported. The impact on quality of life seemed to improve when patients presented completely edentulous at the time of treatment as opposed to terminal dentition. Finally, significant positive correlations were detected between satisfaction and impact on quality of life, impact on quality of life and posterior maximum occlusal force, anterior and posterior maximum occlusal force, and complications and anterior maximum occlusal force. [ABSTRACT FROM AUTHOR]

Purpose: To determine the extent of dental disease and associated treatment costs designed to mitigate the risk of medication-related osteonecrosis of the jaws (MRONJ) among older, socially disadvantaged veterans prior to physician's administration of antiresorptive medication for osteoporosis or malignant bone disease. Materials and Methods: This prospective study based on over seven years (2008-2015) of data describes the type and volume of disease, treatment, work-load measures, and costs using Veterans Affairs databases. Results: One hundred fifty-two outpatients (94% male, mean age 69 ± 12 years) were referred by physicians for clinical/radiographic examination and treatment. Sixteen had a healthy dentition and 17 were completely edentulous with satisfactory prostheses. Three edentulous patients required prosthesis adjustment, 116 dentate individuals required restoration of carious teeth (mean 6.3 ± 5.7) and multiple quadrant (mean 3.1 ± 1.0) scaling/subgingival curettage. In the latter group, 75 required extractions (mean 6.0 teeth, range 1-23). Clinician's (dentist and dental assistant) costs for providing care and preventive education over the 7-year timespan came to almost $132,700. Conclusion: Older veterans requiring initiation of antiresorptive bone medication harbor extensive, untreated dental disease requiring immediate treatment. An appropriate physician-to-dentist referral network and provision of oral care and patient education prior to initiation of medication can potentially moderate the risk of jaw osteonecrosis. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the application of computer-aided design and rapid prototyping (CAD/RP) for removable partial denture (RPD) frameworks and evaluate the fitness of the technique for clinical application.Materials and Methods: Three-dimensional (3D) images of dentition defects were obtained using a lab scanner. The RPD frameworks were designed using commercial dental software and manufactured using selective laser melting (SLM). A total of 15 cases of RPD prostheses were selected, wherein each patient received two types of RPD frameworks, prepared by CAD/RP and investment casting. Primary evaluation of the CAD/RP framework was performed by visual inspection. The gap between the occlusal rest and the relevant rest seat was then replaced using silicone, and the specimens were observed and measured. Paired t test was used to compare the average thickness and distributed thickness between the CAD/RP and investment casting frameworks. Analysis of variance test was used to compare the difference in thickness among different zones.Results: The RPD framework was designed and directly manufactured using the SLM technique. CAD/RP frameworks may meet the clinical requirements with satisfactory retention and stability and no undesired rotation. Although the average gap between the occlusal rest and the corresponding rest seat of the CAD/RP frameworks was slightly larger than that of the investment casting frameworks (P < .05), it was acceptable for clinical application.Conclusion: RPD frameworks can be designed and fabricated directly using digital techniques with acceptable results in clinical application. [ABSTRACT FROM AUTHOR]

Purpose: Edentulous patients benefit significantly from implant-supported overdenture prostheses. The purpose of this systematic review was to evaluate the cost-effectiveness of implant-supported overdentures (IODs) for edentulous patients.Materials and Methods: The search was limited to studies written in English and included an electronic and manual search through MEDLINE (Ovid, 1946 to November 2015), Embase (Ovid, 1966 to November 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (to November 2015), and PubMed (to November 2015). Two investigators extracted the data and assessed the studies independently. No meta-analysis was conducted due to the high heterogeneity within the literature.Results: Of the initial 583 selected articles, 10 studies involving 802 participants were included. Of these, 6 studies had a high risk of bias and the rest had an unclear risk of bias. Implant-supported prostheses were more cost-effective when compared to conventional dentures and fixed implant-supported prostheses. Overdentures supported by two implants and magnet attachment were reported as cost-effective.Conclusion: Implant-supported overdentures are a cost-effective treatment for edentulous patients. More clinical studies with appropriate scientific vigor are required to further assess the cost-effectiveness of implant-supported overdentures. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this trial was to compare short-term patient preference for two mandibular complete denture (CD) fabrication techniques: neutral zone (NZ) and conventional (CV).Materials and Methods: A prospective, within-subject, randomized crossover trial was performed on a sample of 37 edentulous patients with complete denture experience. Two new sets of CDs were made for each patient, one set with a CV and one with a NZ mandibular denture. After consecutively wearing each set for at least 2 months after the last adjustment visit, patients indicated their preference (CV, NZ, or none). Associations and comparisons were made using the generalized linear model (GLM) and Fisher exact test between preference and sex, age, period of edentulousness, tissue quality, prosthodontic diagnostic index (PDI), and oral health-related quality of life (OHRQoL) differences of the two interventions assessed using the 20-item oral health impact profile (OHIP-20). Significance was determined at P = .05.Results: A total of 15 (40%) patients preferred NZ, 8 (22%) preferred CV dentures, and 14 (38%) had no preference. Although more women preferred NZ over CV dentures (50% versus 27%), difference in preference according to sex was not significant (P = .359). Neither was difference in preference and PDI scores significant (P = .603). Preference could not be strongly associated to period of edentulousness, age, tissue scores, and differences in OHIP-20 scores (P > .05), except for OHIP-20 scores and NZ preference (P < .001). Better fit, comfort, and eating were reasons patients preferred a type of denture. These reasons were identified for both types of denture. Appearance and speech were not identified as reasons for a particular preference.Conclusion: Based on preference expressed by patients, there is no difference between NZ and CV mandibular dentures. Denture preference could not be related to patient variables over the study's time frame. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this noninterventional, retrospective study was to benchmark the outcomes of patients with partial fixed prostheses supported by implants treated at the University of Toronto at least 10 years earlier. A study protocol for assessing outcomes on like patients developed at the University of Bern, Switzerland, was followed. Materials and Methods: All patients who had received at least one implant before 2002 were considered eligible to be included in the study (n = 298). The treatment histories were recorded from the patient chart of the participants, or from the participants' dentists by consent. Calibrated clinicians examined the study participants clinically and radiologically and recorded peri-implant mucosal status and observable technical and mechanical failures. Past adverse events were identified in the patient charts. Independent assessors measured bone levels on digitized radiographs. Statistical analysis included descriptive statistics at implants, teeth, and study participant levels, respectively. Results: Of the 298 eligible patients, 121 attended a clinical examination (41%), while 12 declined (4%). The 121 study participants had received 321 implants between 1983 and 2001. The implants showed a success rate of 88.9% and a survival rate of 94% after an average of 17.5 years (SD 5.2, range 10 to 28 years). Approximately 5% of the surviving implants showed signs, or were associated with a prior history, of peri-implantitis. The distance from the implant shoulder to the first bone contact varied from -3 mm to 7 mm (mean = 1.52 mm [SD 1.57], median = 2.2 mm). Approximately half of the study participants had experienced at least one defect of their superstructure, representing a 52% "success rate," while the survival rate was 70%. The majority were very satisfied or satisfied with the treatment (102/121). Conclusion: A high proportion (94%) of conventional machined Brånemark System implants placed between 1983 and 2001 remained in function after an average of 17.5 years. The original superstructures predominantly fabricated as prefabricated acrylic teeth and acrylic resin reinforced with a cast palladium-silver alloy core were still in place for 70% of the participants, and 48% of the superstructures had never undergone any form of repairs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the anatomy of the mandibular posterior region to develop an anatomical categorization for implant-prosthodontic planning. Materials and Methods: Using cone beam computed tomography scans, 313 cross-sectional views of edentulous posterior mandibular sites were evaluated with respect to the anatomical ridge morphology. Virtual implant planning was performed, and the need for bone grafting was assessed. The level of complexity for planning implants in those positions was assessed. Sites were classified as straightforward, advanced, or complex sites based on the need for bone grafting. Results: Five well-defined cross-sectional configurations were observed: straight (53.6%), oblique (26.2%), s-shape (7.4%), hourglass shape (1.9%), and basal bone (10.8%). There was a statistically significant association between the ridge shape and the feasibility of placing an implant with or without bone grafting; the straight and oblique ridge shapes were more likely to be associated with a favorable anatomy for implant placement. Conclusion: The ridge shape significantly influenced the ease or difficulty of placing an implant. The s-shape, hourglass, and basal bone posterior mandibular cross-sectional shapes were associated with a higher degree of difficulty. [ABSTRACT FROM AUTHOR]

Purpose: To assess the three-dimensional (3D) accuracy and clinical acceptability of implant definitive casts fabricated using a digital impression approach and to compare the results with those of a conventional impression method in a partially edentulous condition. Materials and Methods: A mandibular reference model was fabricated with implants in the first premolar and molar positions to simulate a patient with bilateral posterior edentulism. Ten implant-level impressions per method were made using either an intraoral scanner with scanning abutments for the digital approach or an open-tray technique and polyvinylsiloxane material for the conventional approach. 3D analysis and comparison of implant location on resultant definitive casts were performed using laser scanner and quality control software. The inter-implant distances and interimplant angulations for each implant pair were measured for the reference model and for each definitive cast (n = 20 per group); these measurements were compared to calculate the magnitude of error in 3D for each definitive cast. The influence of implant angulation on definitive cast accuracy was evaluated for both digital and conventional approaches. Statistical analysis was performed using t test (α = .05) for implant position and angulation. Clinical qualitative assessment of accuracy was done via the assessment of the passivity of a master verification stent for each implant pair, and significance was analyzed using chi-square test (α = .05). Results: A 3D error of implant positioning was observed for the two impression techniques vs the reference model, with mean ± standard deviation (SD) error of 116 ± 94 μm and 56 ± 29 μm for the digital and conventional approaches, respectively (P = .01). In contrast, the inter-implant angulation errors were not significantly different between the two techniques (P = .83). Implant angulation did not have a significant influence on definitive cast accuracy within either technique (P = .64). The verification stent demonstrated acceptable passive fit for 11 out of 20 casts and 18 out of 20 casts for the digital and conventional methods, respectively (P = .01). Conclusion: Definitive casts fabricated using the digital impression approach were less accurate than those fabricated from the conventional impression approach for this simulated clinical scenario. A significant number of definitive casts generated by the digital technique did not meet clinically acceptable accuracy for the fabrication of a multiple implant-supported restoration. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to compare clinical and radiographic outcomes of the interpositional (inlay) augmentation technique in atrophic posterior partially edentulous mandibles using three different types of block bone grafts: autogenous bone block harvested from the iliac crest, deproteinized bovine bone mineral block, and collagenated equine bone block. A total of 115 patients were included with a 4.2-year mean after-loading follow-up. Data seem to suggest that heterologous bone blocks are similar in results to autogenous bone blocks, so they might be considered preferable as they avoid invasive harvesting surgeries. [ABSTRACT FROM AUTHOR]

Objective: To introduce a novel split-thickness flap design without periosteal and vertical releasing incisions for horizontovertical ridge augmentation. Method and Materials: Three patients with generalized chronic periodontitis presented posterior partial edentulism with class C alveolar defects according to the horizontal, vertical, and combination (HVC) classification. In all three cases, implant placement and simultaneous horizontovertical ridge augmentation utilizing a novel split-thickness flap design was performed. Hard tissue reconstruction was followed by additional soft tissue grafting at membrane removal if optimal peri-implant soft tissue stability could not be ensured. Following abutment connection, fixed implant-retained partial dentures were fabricated. Results: The healing procedure after surgeries was uneventful in all cases, without any serious local or systemic adverse events. After 9 months of healing, complete pocket resolution without gingival recession was observed at neighboring teeth with periodontal attachment loss. A comparison of the mean bone to implant/screw contact at first surgery and at membrane removal demonstrated a mean crestal bone regeneration of 3.08 ± 1.25 mm. At 12 months after prosthetic loading, signs of positive bone remodeling and crestal bone maintenance were shown on intraoral radiographs in all cases. Radiographic results showed maintained alveolar crest contours during 60 months of follow-up in all three cases. Conclusion: The clinical and radiographic observations of the three presented cases demonstrate that the guided bone regeneration technique utilizing titanium membranes in combination with autologous and xenogeneic grafting materials applied with the presented split-thickness flap resulted in predictable three-dimensional reconstruction of hard tissues. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to review the indications for implant placement, early outcomes, and associated risk factors. Materials and Methods: A retrospective cohort study design was used. The study was composed of a group of 509 consecutive patients, which represented the total number of patients treated from 2012 to 2014 in the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium. The authors analyzed the indications for implant placement and the potential risk factors for early implant failure. Results: A total of 509 patients received 1,139 dental implants. The group consisted of 240 men and 269 women, with a median age of 58 years. The most frequent indication for implant placement was restoration of a partially edentulous arch (80.1%, n = 408). For 152 implants (13.3%), additional bone-augmentation or sinus elevation procedures were required. Early failures were recorded for 52 (4.6%) implants in 33 patients (6.5%). Smoking, male gender, total edentulism, implant diameter, and bone augmentation surgery were found to be associated with early implant failure. Conclusion: Patients referred for implant placement were more likely to be partially edentulous and older than 50 years. Single-tooth replacement in the posterior mandible was the most frequent indication (24.4%) for treatment. This study found an early success rate of 95.4% and identified risk factors for early failures. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this randomized clinical trial was to radiographically compare peri-implant marginal bone level changes between immediately loaded implants without the removal of an abutment placed at the time of surgery (IL), delayed loaded nonsubmerged implants (NS), and delayed loaded submerged implants (SI). Materials and Methods: Patients’ edentulous sites were randomly allocated to the three groups of implants so that each patient received one implant of each group. Digital periapical radiographs were obtained at baseline as well as three (T1), six (T2), and nine (T3) months after implant insertion. The mesial and distal bone crest levels adjacent to each implant were measured, and the mean values were calculated for each implant at each period. The data were statistically analyzed by repeated measures analysis of variance (ANOVA) and the Tukey test (P < .05). Results: The patient sample comprised 15 subjects (13 women and 2 men; mean age: 47.7 years) with partially edentulous sites in the mandibular posterior area. Forty-five implants were inserted (15 IL implants, 15 NS implants, and 15 SI implants). There was no statistically significant difference between the three groups with regard to changes in the marginal bone level during the follow-up period. The study achieved a 93.3% cumulative survival rate for both delayed loaded groups (NS and IS) and a 100% survival rate for the IL group. Conclusion: In the 9-month period following the implants, no statistically significant differences were found between immediately and delayed loaded implants or between submerged and nonsubmerged implants in bone level changes in patients with partial posterior mandibular edentulism. [ABSTRACT FROM AUTHOR]

Purpose: To correlate soft tissue thickness and peri-implant bone remodeling of platform-switching implants. Materials and Methods: This comparative prospective trial evaluated, for up to 3 years after implant loading, the influence of soft tissue thickness on changes in peri-implant marginal hard tissue levels. Any patient who was partially edentate in the mandible and required at least two adjacent implant-supported restorations was recruited at the University of Valencia in Spain. A 3-mm tissue punch biopsy, which corresponded to a diameter slightly smaller than the coronal diameter of the implants, was performed using a circular mucotome. Afterward, implants with a length of 10 to 13 mm and a diameter of 3.8 mm were inserted. Outcome measures were implant and prosthesis survival rates, marginal hard tissue changes, any complications, and results of morphologic and histomorphometric analyses. Correlation between mucosa width components (epithelium, connective tissue, and epithelium and connective tissue) and radiographic bone loss at 1 and 3 years after loading was performed at the patient level. Statistical significance was set at P ≤ .05. Results: A total of 26 samples in 26 patients with 68 implants were analyzed. The specimens were divided into two groups: group 1 (16 patients, 40 implants), with thin mucosa (≤ 2 mm), and group 2 (10 patients, 28 implants), with thick mucosa (> 2 mm). Two dropouts (two specimens) were recorded at the 3-year follow-up. None of the implants or definitive prostheses failed during the healing period, resulting in an overall implant and prosthesis cumulative survival rate of 100%. No major biologic or mechanical complications were recorded. The mean (standard deviation, SD) epithelium thickness was 430.33 (250.21) μm; the mean (SD) connective tissue thickness was 1,324.31 (653.46) μm, and the mean (SD) mucosa thickness was 1,751.29 (759.53) μm. Comparisons of radiographic bone loss between group 1 and group 2 failed to show any statistically significant differences at the 1-year (P = .290) or 3-year (P = .090) follow-up examinations. Conclusion: The initial mucosa thickness surrounding a bone-level platform-switching implant seems not to influence the pattern of physiologic marginal bone loss. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of osteonecrosis of the jaw (ONJ) occurring in an implant area possibly related to denosumab, a relatively new antiosteoporotic agent. Materials and methods: Two months following the extraction of both maxillary first molars, a bilateral maxillary sinus floor elevation was performed on a 64-year-old female patient under a biannual 60 mg denosumab antiosteoporotic treatment. Seven months later, two implants were inserted in a single-stage procedure in each of the grafted sinuses. After 3 months, the implants underwent prosthetic rehabilitation at one side, and a series of failures that led to an ONJ instalment at the other side. Results: The ONJ persisted over 7 months and was only resolved by a surgical approach consisting of a piezoelectric osteotomy and platelet-rich fibrin with a tension-free wound closure. Conclusions: A cumulative effect of denosumab is likely to be associated with a jaw osteonecrosis, which in this case was manageable using a surgical approach with no need to interrupt the appropriate drug treatment course. [ABSTRACT FROM AUTHOR]

This technical protocol outlines the use of computer-assisted image-guided technology for the preoperative planning and intraoperative procedures involved in implant-retained facial prosthetic treatment. A contributing factor for a successful prosthetic restoration is accurate preoperative planning to identify prosthetically driven implant locations that maximize bone contact and enhance cosmetic outcomes. Navigational systems virtually transfer precise digital planning into the operative field for placing implants to support prosthetic restorations. In this protocol, there is no need to construct a physical, and sometimes inaccurate, surgical guide. The report addresses treatment workflow, radiologic data specifications, and special considerations in data acquisition, virtual preoperative planning, and intraoperative navigation for the prosthetic reconstruction of unilateral, bilateral, and midface defects. Utilization of this protocol for the planning and surgical placement of craniofacial bone-anchored implants allows positioning of implants to be prosthetically driven, accurate, precise, and efficient, and leads to a more predictable treatment outcome. [ABSTRACT FROM AUTHOR]

Purpose: Implant-retained overdentures are the first choice of rehabilitation for edentulous mandibles. Bone morphology and anatomical landmarks may be influenced by the location and angulation of implants and distances between the implants. The purpose of this study was to investigate stress distribution characteristics and to compare stress levels of three different attachment designs of three-implant-retained mandibular overdentures with three different interimplant distances. Materials and Methods: Three photoelastic mandibular models with three implants were fabricated using an edentulous mandible cast with moderate residual ridge resorption. The center implants were embedded parallel to the midline, and the distal implants were aligned at a 20-degree angulation corresponding to the center implants. Distances between the center and distal implants were set at 11, 18, and 25 mm at the photoelastic models. Bar, bar-ball, and Locator attachment-retained overdentures were prepared for the models. Vertical loads were applied to the overdentures, and stress levels and distribution were evaluated by a circular polariscope. Results: The greatest observed stress level was moderate for the tested overdenture designs. The Locator attachment system showed the lowest stress level for the 11-mm and 25-mm photoelastic models. The bar attachment design transmitted less stress compared with the other tested designs for the 18-mm photoelastic model. Conclusion: Stresses were observed on the loaded side of the photoelastic models. The lowest stress was found with the Locator and bar attachments for the 11-mm photoelastic model, which transmitted little or no discernible stress around the implants. [ABSTRACT FROM AUTHOR]

Digital technology has been widely used in the field of implant dentistry. From a surgical standpoint, computer-guided surgery can be utilized to enhance primary implant stability and to improve the precision of implant placement. From a prosthetic standpoint, computer-aided design/computer-assisted manufacture (CAD/CAM) technology has brought about various restorative options, including the fabrication of customized abutments through a virtual design based on computer-guided surgical planning. This case report describes a novel technique combining the use of a three-dimensional (3D) printed surgical template for the immediate placement of an implant, with CAD/CAM technology to optimize hard and soft tissue healing after bone grafting with the use of a socket sealing abutment. [ABSTRACT FROM AUTHOR]

Purpose: To report on the clinical outcome of 129 zygomatic implants placed in 37 patients with severely resorbed partially or completely edentulous maxillae. Materials and Methods: Patients who received zygomatic implants between 2007 and 2014 were included in this retrospective analysis. All patients were treated using the same surgical protocol, the sinus slot technique. The following data were recorded: sex, age, race, medical history, etiology, addictions, degree of bone atrophy, type and size of zygomatic implants, number of implants placed, type of prosthesis, survival rate, and success of implants and complications. Follow-up included standardized clinical and tomography examinations. Results: Thirty-seven consecutive patients (25 women, 12 men; mean age 55.64 years [range 40 to 77 years]) were treated. All were in need of oral reconstruction and had maxillary atrophy that warranted zygomatic implant placement. One hundred twenty nine zygomatic implants were placed in these 37 patients. Two of the implants failed, resulting in a cumulative survival rate of 98.44%. Maxillary sinusitis was the most common complication found (21.62%); however, neither of the implant failures was related to sinusitis or smoking. Conclusion: The zygomatic implant is a reliable option for treatment of the severely resorbed maxilla. [ABSTRACT FROM AUTHOR]

This preliminary clinical and radiographic study examined the survival of, the marginal bone loss (MBL) around, and the influence of prosthetic abutment height (AH) on MBL around hybrid implants placed in two groups of partially edentulous patients: healthy (HPs) and periodontally compromised (PCPs) patients. A total of 93 patients requiring single or multiunit implant restoration, in the mandible or maxilla, were treated while undergoing cement-retained prosthetic restoration. A total of 54 implants (35 in the maxilla and 19 in the mandible) were placed in 45 HPs, and 56 implants (31 in the maxilla and 25 in the mandible) in 48 PCPs. All 110 hybrid implants positioned in pristine bone provided a 100% survival rate in both HPs and PCPs. No statistical differences were recorded comparing the MBL values of maxillae with those of mandibles. In HPs and PCPs, a similar and limited amount of MBL was recorded, and it was found that the higher the AH, the less MBL. In conclusion, results indicate that the hybrid implants examined could reduce the risk of peri-implantitis due to their coronal machined surfaces and improve osseointegration due to their apical rough surfaces. [ABSTRACT FROM AUTHOR]

The goal of this investigation was to evaluate the efficacy of dental implants with a surface that was sandblasted with large grit and acid etched in a human model. Seven patients volunteered to allow the biopsy of a small implant in exchange for complete dental rehabilitation at no cost. All biopsy sites received soft and hard tissue reconstruction, and this report provides observation of successful bone-to-implant contact and successful prosthesis construction for the patient. The patients enthusiastically reported improved quality of life as a result of participation in this study. The surgeons’ confidence in this implant was reflected by the clinical and histologic result of the study. [ABSTRACT FROM AUTHOR]

Purpose: Success rates for maxillary implant treatment are lower than for mandibular treatment because of the presence of poorer bone quality or quantity in the maxilla. The purpose of this study was to determine favorable implant positions in the maxilla using implant simulation software and clinical anatomical morphology together with bone quality data obtained by computed tomography (CT).Materials and Methods: A convenience research sample of 10 edentulous subjects was recruited, and research information from right and left edentulous sites was obtained from each subject. The height, width, angulation, and Hounsfield unit value of the maxillary alveolar bone were measured using CT data obtained from the subjects.Results: Bone height in the incisor area was significantly greater than in the molar area, and bone width in the incisor area was significantly narrower than in the molar area. The average bone quality in the maxillary molar area was significantly higher when compared with the premolar and incisor areas. The angle between the occlusal plane and the bisector of the alveolar bone in the incisor area was reduced when compared with the molar area.Conclusion: The premolar region appears to be the most favorable area in the maxillary arch for implant placement with regard to bone height, width, angulation, and quality. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this multicenter single mandibular implant study was to compare the clinical outcome of an immediately loaded implant placed in the midline of an edentulous mandible with the clinical outcome when closed healing and delayed loading is chosen. Here, the patient recruitment period and the main reasons for exclusion were analyzed.Materials and Methods: Patient recruitment was performed at nine German universities. Rather conservative inclusion and exclusion criteria, including denture satisfaction, denture status, a psychologic symptom checklist, and a defined bone height in the posterior mandible, had to be fulfilled. It was initially calculated that 230 persons would have to be screened within 13 months to include 180 persons in the trial.Results: Within 13 months (December 2012 to December 2013), 201 patients were screened for possible inclusion in the trial and 148 met the inclusion criteria. Finally, after the recruitment period was extended by 2.5 months, 224 patients were screened and 169 were included. Of those screened, 55 (24.6%) did not meet the inclusion criteria and were excluded. Another 4 patients (1.8%) were excluded based on their psychologic symptom checklist score, while 5 others (2.8%) showed signs of noncompliance. A further 8 patients (4.4%) decided not to participate and withdrew their informed consent, and another 3 (1.3%) were no longer available after screening. Another 2 patients were excluded due to medical contraindications and 1 due to an insufficient mandibular denture. In 34 cases (15.2%), the residual bone height did not comply with McGarry type II or III.Conclusion: Within the limitations of this patient recruitment period, it can be concluded that residual bone height is the most important factor when considering elderly edentulous patients for implant therapy. The psychologic symptom checklist score was less important. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate patient satisfaction and clinical outcomes among subjects with mandibular overdentures supported by one or two immediately placed dental implants 5 years after loading. Materials and Methods: Thirty-six subjects (16 men and 20 women) received one or two dental implants in the anterior mandible, and all implants were loaded the day of surgery. Subjects were scheduled for follow-up 3-, 6-, and 12 months after implant placement and thereafter annually for 4 more years. Patient satisfaction scores were measured with the Oral Health Impact Profile-EDENT (OHIPEDENT) questionnaire. Results: Seventeen subjects (7 male and 10 female) with a mean age of 59.4 years (range, 44 to 74 years) were available for the 5-year follow-up examination. Nine subjects with 10 failing implants were excluded during the first year and nine subjects were lost to follow-up. No implants failed between the 12- and 60-month follow-up examinations, and the need for denture maintenance was low. Mean peri-implant bone change was 0.92 mm, and the Spearman test failed to show correlation between the insertion torque value and implant stability quotient. Patient satisfaction scores increased significantly when compared with baseline values and continued to be high for both groups, with no significant differences. Conclusion: Ten implants in nine subjects failed early, but no failures were observed after the 12-month examination. No significant differences were found between subjects in the two groups with respect to implant survival rates and peri-implant bone loss, and patient satisfaction scores continued to be high. Although patient satisfaction and implant success were high during the 12- to 60-month period, the results should be interpreted with caution because of the high number of failing implants and patients lost to followup. More research is needed to study outcomes of treatment with immediately loaded mandibular implant overdentures. [ABSTRACT FROM AUTHOR]

Purpose: A novel approach for the study of early bone formation around dental implants in the miniature pig was evaluated. In addition to the traditional histologic and histomorphometric analysis, the expression of the osteogenic genes was analyzed both at the messenger ribonucleic acid (mRNA) and protein level. Materials and Methods: Mandibular premolars and the first molar were extracted in six miniature pigs. After 3 months of healing, 36 specially designed bone chamber implants were placed. Three different implant surface configurations were used: titanium SLA, titanium SLActive, and titanium zirconium SLActive (Roxolid). Each hemi-mandible received three randomly allocated implants (one for each surface type) on both sides of the arch, in a split-mouth design. Three animals were sacrificed after 3 days and another three after 2 weeks of healing post–implant insertion. For each animal the right hemi-mandible underwent qualitative histologic and quantitative histomorphometric analysis. The left hemi-mandible underwent immunohistofluorescence (IHF) analysis. β-catenin, Runx2, osteopontin, and osteocalcin were analyzed by IHF; osterix, and osteocalcin mRNA expression was also evaluated by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Results: At 3 days after the implantation, all implants were surrounded by blood clot. No provisional matrix or bone was observed inside the chamber. Infection or degenerative lesions were absent. At 2 weeks, the histomorphometric analysis showed no significant difference between the groups concerning the bone area. qRT-PCR showed that Ti SLActive had the highest osteocalcin mRNA expression followed by Ti SLA and Roxolid SLActive. Osterix mRNA expression was higher on Ti SLA and Roxolid SLActive compared to Ti SLActive. The differences were not statistically significant. IHF was only found positive for osteocalcin at 2 weeks. At 3 days, osteocalcin was detected only on native bone. At 2 weeks, osteocalcin was expressed highest by Ti SLActive followed by Roxolid SLActive and TiSLA; however, there was no statistically significant difference between the groups in the osteocalcin expression level. Conclusion: The present methodology allowed evaluation of changes in gene expression during the early phase of osteogenesis that seem to be related to the quality of the surface. Further studies with higher power and more specific antibodies are needed to confirm these preliminary findings. [ABSTRACT FROM AUTHOR]

Autogenous bone harvesting is a well-documented surgical procedure. Autogenous mandibular bone harvesting carries a risk of anatomical structural damage because the surgeon has no three-dimensional (3D) control of the osteotomy planes. The aim of this case series was to describe the results of mandibular bone block harvesting applying computer-guided surgery. A sample of 13 partially dentate patients presenting bone deficiencies in the horizontal and/ or vertical plane were selected for autogenous mandibular bone block graft. The bone block dimension was planned through a computer-aided design (CAD) process, defining ideal bone osteotomy planes to avoid damage to anatomical structures (nerves, teeth roots, etc) and to generate a surgical guide that imposed the 3D working direction to the bone-cutting instrument. The bone block dimension was always related to the defect dimension to be compensated. A total of 13 mandibular bone blocks were harvested to treat 16 alveolar defects (9 vertical and 7 horizontal). The mean planned mesiodistal dimension of the bone block was 24.8 ± 7.3 mm, the mean height was 8 ± 1 mm, and the mean thickness was 4 ± 2 mm. None of the treated patients experienced neurologic alteration of their alveolar nerve function. The preliminary data from this case series suggested that computer-guided bone harvesting could be a concrete opportunity for clinicians to obtain an appropriate volume of autogenous bone in a safe manner. [ABSTRACT FROM AUTHOR]

Purpose: To verify whether single-implant-supported mandibular overdentures improve thickness discrimination.Materials and Methods: A selection of edentulous patients treated with single-implant-supported overdentures underwent interocclusal thickness discrimination tests using dedicated metal strips. Fifteen patients were included, and recordings were repeated five times: with complete dentures in place before placement of implants, the day of the prosthetic connection, and 1 month, 1 year, and 6 years after the connection.Results and Conclusion: Thickness discrimination improved at the 1-month recall recording, while after 1 year, it remained stable at low levels. [ABSTRACT FROM AUTHOR]

Since 2020, another type of epidemic disease, 'red lower jaw disease' (RLJD), has broken out in yellow catfish Pelteobagrus fulvidraco every spring in China, causing large-scale deaths and significant economic losses. This new disease has the characteristics of strong infectivity, high mortality and a single host. To prevent and control RLJD, epidemiological investigation, transmission electron microscopy (TEM), virome sequencing, Koch's rule verification and epidemic factor investigation were studied in this article. The clinical symptoms of diseased yellow catfish were pale gill filaments, hyperaemia and swelling of the spleen and kidney. TEM results revealed that a large number of 35–40 nm spherical virus particles without envelope structure were found in the cytoplasm of spleen cells. The liver, spleen and kidney of the diseased fish had serious lesions. After virome sequencing, the calicivirus reads in the unique virus reads accounted for 99.5% of the unique virus reads in the diseased fish, which provided a relevant reference value for identifying the pathogen of RLJD. The full-length sequence of yellow catfish calicivirus (YCCV) obtained at 7405 bp, including the RNA-helicase domain, RdRp-1 domain and d1iqqa domain. At the same time, both PCR and TaqMan fluorescence quantitative PCR detection method of YCCV were established. Through the artificial infection test, YCCV was verified as the pathogen for RLJD. It was also found that YCCV mainly harmed the fish within 1 year, whereas the fish above 2 years had good resistance. The water temperature of the RLJD outbreak was mainly concentrated at 18 °C–24 °C. In the current study, after YCCV was verified as the pathogen of RLJD, epidemic factors including fish age and water temperature were studied, to the best of our knowledge, for the first time to provide a relevant theoretical basis for the pathogenic mechanism and prevention and control measures of yellow catfish RLJD. • The pathogen of Pelteobagrus fulvidraco red lower jaw disease is yellow catfish calicivirus. • The calicivirus can cause typical clinical symptoms and serious tissue lesions. • P. fulvidraco is the unique host of yellow catfish calicivirus. • The infection of calicivirus is influenced by yellow catfish age and water temperature. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral-health-related quality of life (OHRQoL) and systemic health. Materials and methods: A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP-14] and OHIP-49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health-related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health-related outcomes. Meta-analysis was conducted on available quantitative data. Results: The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta-analysis showed significant improvement of OHIP-49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP-14 = 10.52, OHIP-49 = 56.02, GOHAI = 5.40, p < .01 for all). Non-rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution. Conclusions: Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of different types of rehabilitation with fixed or removable full-arch implant-supported prosthesis designs in terms of implant loss and success in patients with at least one edentulous jaw, with tooth loss mainly due to periodontitis. Materials and methods: Clinical studies with at least 12 months reporting on implant loss and implant success were searched. Meta-analysis was conducted to estimate cumulative implant loss considering different prostheses designs. Results: A total of 11 studies with unclear to low risk of bias were included in the analysis. Estimated cumulative implant loss for fixed prostheses within 1 year and 5 years was 0.64% (95% confidence interval [CI]: 0.31%-1.31%) and 1.85% (95% CI: 0.85%-3.95%), respectively. The corresponding values for removable prostheses amounted to 0.71% (95% CI: 0.22%-2.28%) and 4.45% (95% CI: 2.48%-7.85%). Peri-implantitis affected 10%-50% of the patients restored with implant-supported fixed prostheses. Conclusions: Based on the limited low-quality data, the present analysis points to a low and similar cumulative implant loss within 1 year for patients with tooth loss mainly due to stage IV periodontitis restored with either removable or fixed implantsupported full-arch prosthesis. At 5 years of functioning, there was a tendency for better outcomes using fixed designs. [ABSTRACT FROM AUTHOR]

Aim: The aim was to evaluate the efficacy and effectiveness of tooth-supported fixed prostheses in partially edentulous patients with stage IV periodontitis. Material and Methods: Randomized and controlled clinical trials (RCTs and CCTs) and prospective/retrospective cohort studies or case series were searched in three databases. Survival rate of abutment teeth was considered the primary outcome. Meta-analyses were performed whenever possible. Results: Twenty-four publications were included. No RCTs or CCTs compared the efficacy of tooth-supported fixed prostheses between patients with severe periodontitis or non-periodontitis patients. Most of the data retrieved were derived from case series. The incidence of abutment-tooth loss after a follow-up period from 2 to 35.4 years was low (n = 17 studies; weighted mean incidence (WMI) = 4.8%; confidence interval (CI) [3.2, 6.5]). The corresponding figure for prostheses failure was WMI = 6.9% (n = 18; 95% CI [4.1, 9.7]). Technical complications seemed to be more frequent than biological complications (caries, endodontic failure, root fracture, etc.). Periodontal outcomes tended to remain stable over time. Conclusion: Tooth-supported fixed prostheses seemed to be a valid treatment approach to restore masticatory function in patients with stage IV periodontitis once periodontal therapy has been accomplished. However, the comparative efficacy of this treatment among periodontitis and non-periodontitis patients is unclear due to the absence of clinical trials. [ABSTRACT FROM AUTHOR]

Aims: To compare tooth-(TSRP) and implant-supported (ISRP) removable prostheses in terms of abutment and prosthesis survival (PICO 1) and estimated cumulative survival of teeth/implants and prostheses (PICO 2) at ≥12-month post-prosthesis delivery in patients with stage IV periodontitis. Materials and Methods: Five databases were searched to identify RCTs, CCTs, single arms, prospective cohort studies, case series and retrospective studies. Duplicate screening was performed, and ranges for abutment and prosthesis survival were calculated. Results: Twenty-six studies were included in the qualitative assessment. Only one study with critical risk of bias comparing the two treatment modalities reported similar survival rates at 2 years. Overall, prospective studies on ISRPs indicated an implant survival rate ranging from 96.4% to 100% and a prosthesis survival rate of 100% with a follow-up from 12 to 54 months. Prospective studies on TSRPs indicated a tooth survival ranging from 85.71% to 100% at 1-to 10-years follow-up. Conclusions: The available evidence is of poor quality, and it does not allow to make robust conclusions on the efficacy of these rehabilitations in stage IV periodontitis patients. Particularly for TSRPs, careful patient selection is crucial and a certain number of biological and prosthetic complications should be expected. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip materials (digitally designed PEEK bar clip and regular Nylon bar clip). Materials and methods: An epoxy model was constructed for a completely edentulous mandible. Two implants were placed according to prosthetically driven implant placement by a computer-guided surgical stent. Bar clips were digitally designed, 3D printed, and pressed into Poly Ether Ether Ketone (PEEK). Pick up of PEEK and nylon clips was performed on the dentures fitting surface using self-cured acrylic resin. Each study group was subjected to an insertion and removal fatigue test simulating 3 years of patient usage. Retention values were recorded using the universal testing machine at initial retention and after 1, 2, and 3 years of simulated usage. For proper sample sizing, 24 models and dentures (12 for each group) were used. An independent sample t-test and repeated measures analysis of variance were used to compare the data. Results: There were statistically significant differences in retention between the PEEK and nylon bar clips at the beginning of the experiment (p = 0.000*). But after 3 years of simulated use, there was no significant difference in retention between the test groups (p = 0.055, NS). After 3 years of simulated use, the retention of PEEK clips decreased by − 58.66% recording 17.37 ± 1.07 N, while the retention of nylon clip increased by + 2.99% recording 16.56 ± 0.88 N. Conclusion: The digitally designed PEEK clip showed comparable retention results to the nylon clip after 3 years of simulated use. Clinical relevance: Maintenance of bar attachment with PEEK clip offers a clinical solution after the wear of normal plastic clips, which is a cheap solution that is easily fabricated and picked up into the denture. Digital fabricated PEEK bar retentive inserts can be used in cases of bar attachment wear. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the clinical and radiographic outcomes of 6‐mm short implants, placed in the posterior jaws and supporting splinted crowns, at 5 years after early loading. Materials and Methods: Forty‐five patients with 95 implants (diameter: 4 mm; length: 6 mm) were enrolled at three centres. Two to three implants were placed in either the maxillary or the mandibular posterior region in each patient and restored with screw‐retained splinted crowns at 6 weeks later. Clinical and radiographic outcomes were evaluated at implant placement, at loading, and at 6, 12, 24, 36, and 60 months after loading. Biological and mechanical complications were recorded. Marginal changes in bone level in relation to clinical parameters were evaluated using a generalized linear mixed model. Results: During the 5 years of follow‐up, the mean change in the marginal bone level (MBL) was 0.04 ± 0.14 mm. Four implants in four patients were lost before loading, one implant in one patient was lost at the 5‐year follow‐up, and two patients were lost to follow‐up. The survival and success rates were 88.4% (38/43) at the patient level. The incidence rates of peri‐implant mucositis and peri‐implantitis were 29.4% and 7.0%, respectively. The rate of technical complications was 14.0%. Conclusions: Over a 5‐year period, 6‐mm short implants supporting early loaded splinted crowns in maxillary or mandibular posterior regions showed stable MBLs and acceptable technical and biological complication rates. [ABSTRACT FROM AUTHOR]

Focal cemento osseous dysplasia (FCOD) is a subgroup of benign fibro osseous lesions, which occur in a single site of tooth-bearing areas of jaws. It is usually asymptomatic and noticed accidentally through routine radiological exams. There is often no need for treatment of such lesions. This case was a 28-year-old male patient with a mixed radiolucentradiopaque lesion in posterior part of his mandible. Based on radiographic examination, cemento ossifying fibroma (COF) was the first differential diagnosis. After the surgical removal of the lesion, histopathologic evaluation was made and the case was diagnosed as FCOD. Fortunately, after a few months of operation, there was no complication and complete bone formation was occurred. [ABSTRACT FROM AUTHOR]

Background: Refractory jaw osteonecrosis that occurs in osteoporotic or cancer patients treated with bisphosphonates is called medication-related osteonecrosis of the jaw but its underlying mechanism is unclear. Statins, therapeutic agents for dyslipidemia, lower blood low-density lipoprotein cholesterol. Fluvastatin promotes the healing of tooth extraction sockets and reduces the risk of developing medication-related osteonecrosis of the jaw-like lesions. We used a rat model to investigate whether injecting fluvastatin at extraction sites promoted the healing of medication-related osteonecrosis of the jaw-like lesions.Methods: Upper first molars of rats administered zoledronate and dexamethasone for 2 weeks were extracted. Two weeks after tooth extraction, rats with medication-related osteonecrosis of the jaw-like lesions (bone exposure) were included in this study. A single injection of fluvastatin was administered in the vicinity of the medication-related osteonecrosis of the jaw-like onset site in rats.Results: The distance between the edges of the epithelia, the length of the necrotic bone exposed toward the oral cavity, the area of the necrotic bone, and the necrotic bone ratio were significantly smaller in the fluvastatin-administered group compared with the saline group. A single application of fluvastatin near the site of medication-related osteonecrosis of the jaw onset showed a tendency to close the epithelium, reduce necrotic bone, and form new bone, even when symptoms had already developed.Conclusion: This study suggests that a single topical administration of fluvastatin may be a novel treatment for medication-related osteonecrosis of the jaw. [ABSTRACT FROM AUTHOR]

Due to the complexity of clinical manifestations and the lack of standardized diagnostic criteria, it is still difficult to distinguish the etiological types of congenital edentulousness corresponding to genetic defects. This paper studies the application of deep learning image processing and digital image processing in medical images in detail and analyzes the functions of congenital edentulous hotspot genes. The cases in the control group and the study group were collected, and the gene mutations of direct sequence MSX1, PAX9, AXIN2, and BMP were analyzed, and new pathogens were found. The experimental results suggest that PAX9 and MSX1 genes may have a synergistic effect in nonsyndromic congenital edentulous patients. In severely missing teeth, the role of PAX9 may be greater than that of MSX1. The experimental results will help us lay the foundation for further understanding of the disease in the future. [ABSTRACT FROM AUTHOR]