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BACKGROUND This study explored the clinical effects of whole-process digitalization (WD)-assisted immediate implant placement (IIP) and immediate restoration (IR) in the aesthetic zone and clarified the clinical procedures. MATERIAL AND METHODS Patients who received maxillary aesthetic region IIP and IR treatment were randomly distributed into WD-assisted and conventional groups. Postoperative assessment included implant accuracy, marginal bone loss, aesthetic evaluation, and patient satisfaction evaluation. The aesthetic evaluation included visual analog score (VAS), pink aesthetic score (PES), and white aesthetic score (WES). Numerical data, measurement data, and grade data were analyzed by χ² test, t test, and Mann-Whitney U test. RESULTS The WD-assisted group exhibited decreased implant accuracy, including coronal deviation, apical deviation, angular deviation, and depth deviation, compared with the conventional group (P<0.05). The marginal bone loss in both the mesiodistal direction and the buccolingual direction were significantly lower in the WD-assisted group than in the conventional group (P<0.05). The VAS, PES, and WES were all significantly higher in the WD-assisted group than in the conventional group at 3, 6, and 12 months after surgery (P<0.05). Patients in the WD-assisted group also reported a higher satisfaction level than those in the conventional group (P<0.05). CONCLUSIONS WD-assisted IIP and IR treatment in the aesthetic zone increased implant accuracy, decreased marginal bone loss, improved aesthetic effect, and increased patient satisfaction compared with conventional treatment. Therefore, WD-assisted IIP and IR treatment constitutes a promising approach in clinical oral implantology.

Objectives: To draw up guidelines for ENT management associated with dental implant surgery with or without sinus lift., Materials and Methods: The methodology followed the rules of laid down by the French Health Authority (HAS): "Methodological bases for drawing up professional recommendations by formalized consensus". The chosen method was the RAND/UCLA "RAND appropriateness method" (short version)., Results: In the pre-implantation check-up, it is recommended to systematically screen for sinonasal pathology on medical interview and to favor 3D CT or cone-beam imaging. It is recommended that imaging include the entire maxillary sinus when the patient does not have sinonasal history or functional signs on interview. Otherwise, examination of all sinonasal cavities is recommended. This attitude enables simultaneous analysis of maxillary infrastructure for pre-implantation work-up and assessment of sinonasal cavity status. Sinus mucosal incidentalomas are very common in the healthy population and must be assessed with reference to the clinical, endoscopic and radiological context., Conclusion: This formalized expert consensus establishes a common base of knowledge, to clarify the issues and clinical situations and to standardize practices., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Radiation therapy for the treatment of head and neck cancer can injure normal tissues and have devastating side effects. Hyperbaric oxygen (HBO) is known to reduce the severity of radiation-induced injury by promoting wound healing. While most of the research in literature has focused on its efficacy in osteonecrosis, HBO has other proven benefits as well. The aim of this review was to identify the various benefits of hyperbaric oxygen therapy in patients who have undergone radiation for head and neck cancer. An electronic database search was carried out to identify relevant articles and selected articles were reviewed in detail. The quality of evidence for each benefit, including preserving salivary gland function, preventing osteonecrosis, dental implant success, and overall quality of life, was evaluated. Evidence showed that HBO was effective in improving subjective symptoms of xerostomia, swallowing, speech and overall quality of life. There was no conclusive evidence to show that HBO improved implant survival, prevented osteonecrosis, or improved salivary gland function. The high costs and accessibility of HBO therapy must be weighed against the potential benefits to each patient., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Purpose: To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons., Materials and Methods: This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon., Results: A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival., Conclusion: Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.

This paper, the first of two, provides an introduction to implant dentistry for the general dental practitioner. CPD/Clinical Relevance: Implant placement and restoration is becoming more common place in general dental practice to the point where it may already be considered a routine treatment option.

The use of dental implants to restore edentulous areas has increased significantly since the 1970s and is now considered, by many, the gold standard restorative treatment. As such it has become increasingly important to understand what constitutes success for these rehabilitations. Increasing focus has been given to acknowledging the difference between success and survival: the two being potentially very different outcomes for such invasive and expensive treatment. This article aims to describe this distinction and ultimately the implications of this for both patient and clinician.

Purpose: The objective of this study was to assess the risk of bias of randomized controlled trials (RCTs) published in prosthodontic and implant dentistry journals., Materials and Methods: The last 30 issues of 9 journals in the field of prosthodontic and implant dentistry (Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, Implant Dentistry, International Journal of Oral & Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics, Journal of Dentistry, Journal of Oral Rehabilitation, and Journal of Prosthetic Dentistry) were hand-searched for RCTs. Risk of bias was assessed using the Cochrane Collaboration's risk of bias tool and analyzed descriptively., Results: From the 3,667 articles screened, a total of 147 RCTs were identified and included. The number of published RCTs increased with time. The overall distribution of a high risk of bias assessment varied across the domains of the Cochrane risk of bias tool: 8% for random sequence generation, 18% for allocation concealment, 41% for masking, 47% for blinding of outcome assessment, 7% for incomplete outcome data, 12% for selective reporting, and 41% for other biases., Conclusion: The distribution of high risk of bias for RCTs published in the selected prosthodontic and implant dentistry journals varied among journals and ranged from 8% to 47%, which can be considered as substantial.

Aim: To assess the accuracy of guided surgery compared with mental navigation or the use of a pilot-drill template in fully edentulous patients., Material and Methods: Sixty consecutive patients (72 jaws), requiring four to six implants (maxilla or mandible), were randomly assigned to one of the following treatment modalities: Materialise Universal(®) mucosa, Materialise Universal(®) bone, Facilitate(™) mucosa, Facilitate(™) bone, mental navigation, or a pilot-drill template. Accuracy was assessed by matching the planning CT with a postoperative CBCT. Deviations were registered in a vertical (depth) and horizontal (lateral) plane. The latter further subdivided into BL (bucco-lingual) and MD (mesio-distal) deviations., Results: The overall mean vertical deviation for the guided surgery groups was 0.9 mm ± 0.8 (range: 0.0-3.7) and 0.9 mm ± 0.6 (range: 0.0-2.9) in a horizontal direction. For the non-guided groups, this was 1.7 mm ± 1.3 (range: 0.0-6.4) and 2.1 mm ± 1.4 (range 0.0-8.5), respectively (P < 0.05). The overall mean deviation for the guided surgery groups in MD direction was 0.6 mm ± 0.5 (range: 0.0-2.5) and 0.5 mm ± 0.5 (range: 0.0-2.9) in BL direction. For the non-guided groups, this was 1.8 mm ± 1.4 (range: 0.0-8.3) and 0.7 mm ± 0.6 (range 0.0-2.9), respectively. The deviation in MD direction was significantly higher in the non-guided groups (P = 0.0002)., Conclusion: The most important inaccuracy with guided surgery is in vertical direction (depth). The inaccuracy in MD or BL direction is clearly less. For non-guided surgery, the inaccuracy is significantly higher., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: This study was performed to investigate the histologic and histomorphometric findings of 2 different types of implant., Materials and Methods: Resorbable blasting media (RBM) and sandblasted with larger grit and acid etched (SLA) surfaced implants (24 fixtures in each group) were installed in posterior maxilla of dogs. The initial stability was measured using Periotest (Periotest value [PTV]). After 6 or 12 weeks, fixtures with surrounding bone were harvested., Results: The average initial stability of the SLA group (-1.71 ± 2.9) was higher than that of the RBM group (-1.25 ± 3.21), but there was no significant difference. The mean PTV of the RBM surface was higher than the SLA surface at 12 weeks. The average bone-implant contacts were 67.6% ± 16.0% at 6 weeks and 82.7% ± 8.6% at 12 weeks in the SLA group and 69.9% ± 17.6% at 6 weeks and 78.3% ± 9.2% at 12 weeks in the RBM group., Conclusion: The SLA and resorbable blasting media (RBM) surface implants demonstrated good stabilities and healing processes of the surrounding bone in the posterior maxilla. Therefore, the two domestic implants could provide predictable clinical results.

Purpose: To investigate the effect of core dental implant materials supporting single crowns on the probability of survival and failure modes., Materials and Methods: Thirty-six standard external-hex titanium implants (4.0 mm in diameter) were selected to restore single crowns and divided into two groups according to core material: commercially pure grade 2 titanium (G2) and grade 5 titanium-aluminum-vanadium alloy (Ti-6Al-4V) (G5). Abutments were screwed to the implants, and standardized maxillary central incisor metal crowns were cemented and subjected to step-stress accelerated life testing in water. Use-level probability Weibull curves and reliability for missions of 100,000 cycles at 150 N and 200 N (with 90% two-sided confidence intervals [CIs]) were calculated. Polarized light and scanning electron microscopes were used to determine the failure modes., Results: Use-level probability Weibull calculations showed beta values of 0.59 (CI, 0.31 to 1.11) and 1.22 (CI 0.81 to 1.84) for G2 and G5, respectively, and significantly higher characteristic strength and Weibull modulus for G5. The calculated reliability (90% CIs) for a mission of 100,000 cycles at 150 N showed that cumulative damage would lead to survival of 45% of implant-supported crowns of G2 and 98% of G5. At 200 N the probability of survival decreased to 0.03% for G2 and 21% for G5. Abutment screw fracture was the failure mode for all groups., Conclusion: Reliability, characteristic strength, and Weibull modulus were significantly higher for Ti-6Al-4V dental implants than for commercially pure (grade 2) titanium implants. Failure modes were similar for both groups.

Animal experiments are critical for the development of new human therapeutics because they provide mechanistic information, as well as important information on efficacy and safety. Some evidence suggests that authors of animal research in dentistry do not observe important methodological issues when planning animal experiments, for example sample-size calculation. Low-quality animal research directly interferes with development of the research process in which multiple levels of research are interconnected. For example, high-quality animal experiments generate sound information for the further planning and development of randomized controlled trials in humans. These randomized controlled trials are the main source for the development of systematic reviews and meta-analyses, which will generate the best evidence for the development of clinical guidelines. Therefore, adequate planning of animal research is a sine qua non condition for increasing efficacy and efficiency in research. Ethical concerns arise when animal research is not performed with high standards. This Focus article presents the latest information on the standards of animal research in dentistry, more precisely in the field of implant dentistry. Issues on precision and risk of bias are discussed, and strategies to reduce risk of bias in animal research are reported., (© 2015 Eur J Oral Sci.)

Aims and Objectives: To audit the content of dental practice websites offering dental implant services against a framework based on the GDC 2012 Guidelines for Ethical Advertising and other relevant advertising standards., Methods: An audit framework was constructed and applied to the top fifty websites resulting from a Google UK search using the search term 'dental implant specialist'., Results: Compliance with many elements of the GDC Guidance remains poor. Sixty-eight percent of websites claimed that the practitioner providing the service was a GDC registered specialist, though examples were found where this claim was unfounded. Fourteen percent of practice websites claimed that the service was being carried out by an 'implant specialist' and 16% claimed the practitioner was an 'implantologist'; the majority of sites using these terms (10%) involved practitioners that had no specialist status. The display of potentially misleading memberships and fellowships of a range of dental associations, academies, societies and foundations remains common (52%), as does the adoption of the title 'Dr' (60%)., Conclusion: Comparison with earlier studies indicates that compliance with recent GDC standards is generally improving, though whether the pace of improvement is seen as acceptable or not is something that policymakers and regulatory authorities may need to consider further.

Article Title and Bibliographic Information: Assessment of the quality of reporting in abstracts of systematic reviews with meta-analyses in periodontology and implant dentistry. Faggion CM Jr., Liu J, Huda F, Atieh M. J Periodontal Res 2014; 49(2):137-42., Reviewer: Argy Polychronopoulou, DDS, MS, ScM, ScD PURPOSE/QUESTION: What is the reporting quality of meta-analysis results of abstracts of systematic reviews in periodontology and implant dentistry journals?, Source of Funding: The authors received no funding for this study, Type of Study/design: Meta-epidemiological study, Level of Evidence: Level 3: Other evidence, Strength of Recommendation Grade: Not applicable., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

Periprosthetic joint infection is a rare but serious complication. Its management requires the collaboration between general practitioner, orthopaedic surgeon and infectious disease specialist. A delay in the diagnosis can result in complications, requiring complex surgical procedures. Identification of the causative pathogen and its susceptibility pattern is crucial, because it guides both the choice of antimicrobial treatment and the surgical strategy. Antimicrobial treatment without proper micro- biological sampling must be avoided. Swabs from open wounds are not helpful, because microorganisms belonging to the skin flora will grow. The target audience of this review article on periprosthetic joint infections is the general practitioner.

Objective: To evaluate the methodological approaches used to assess the quality of studies included in systematic reviews (SRs) in periodontology and implant dentistry., Materials & Methods: Two electronic databases (PubMed and Cochrane Database of Systematic Reviews) were searched independently to identify SRs examining interventions published through 2 September 2013. The reference lists of included SRs and records of 10 specialty dental journals were searched manually. Methodological approaches were assessed using seven criteria based on the Cochrane Handbook for Systematic Reviews of Interventions. Temporal trends in methodological quality were also explored., Results: Of the 159 SRs with meta-analyses included in the analysis, 44 (28%) reported the use of domain-based tools, 15 (9%) reported the use of checklists and 7 (4%) reported the use of scales. Forty-two (26%) SRs reported use of more than one tool. Criteria were met heterogeneously; authors of 15 (9%) publications incorporated the quality of evidence of primary studies into SRs, whereas 69% of SRs reported methodological approaches in the Materials/Methods section. Reporting of four criteria was significantly better in recent (2010-2013) than in previous publications., Conclusion: The analysis identified several methodological limitations of approaches used to assess evidence in studies included in SRs in periodontology and implant dentistry., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Proper scientific reporting is necessary to ensure the correct interpretation of study results by readers. The main objective of this study was to assess the quality of reporting in abstracts of systematic reviews (SRs) with meta-analyses in periodontology and implant dentistry. Differences in reporting of abstracts in Cochrane and paper-based reviews were also assessed., Methods: The PubMed electronic database and the Cochrane database for SRs were searched on November 11, 2012, independently and in duplicate, for SRs with meta-analyses related to interventions in periodontology and implant dentistry. Assessment of the quality of reporting was performed independently and in duplicate, taking into account items related to the effect direction, numerical estimates of effect size, measures of precision, probability and consistency., Results: We initially screened 433 papers and included 146 (127 paper-based and 19 Cochrane reviews, respectively). The direction of evidence was reported in two-thirds of the abstracts while strength of evidence and measure of precision (i.e., confidence interval) were reported in less than half the selected abstracts. Measures of consistency such as I(2) statistics were reported in only 5% of the selected sample of abstracts. Cochrane abstracts reported the limitations of evidence and precision better than paper-based ones. Two items ("meta-analysis" in title and abstract, respectively), were nevertheless better reported in paper-based abstracts., Conclusion: Abstracts of SRs with meta-analyses in periodontology and implant dentistry currently have no uniform standard of reporting, which may hinder readers' understanding of study outcomes., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The paper presents guidelines for one-step immediate implantation with simultaneous loading by means of provisional crown and subsequent ceramic restoration placement.

Purpose: The aim of this systematic review was to assess the methodologic and statistical quality of prospective case series of treatment interventions of dental implant surgery and prosthodontics published between 2004 and 2008., Materials and Methods: Prospective case series were identified following detailed searches of the Medline, EMBASE, and CINAHL databases. Identified studies were independently assessed by two nonblinded reviewers for 10 key methodologic and statistical domains. Information was collected using a customized data collection sheet., Results: The initial search yielded 1,484 studies. Following application of inclusion criteria, 31 prospective case series reports that did not present the same patient material were identified for this review. Interexaminer agreement was assessed for all domains (median kappa score, 0.84). All disagreements were resolved by discussion. The source of funding was unclear in 20 studies (65%). Treatment protocol was adequately described in 21 studies (68%), and eligibility criteria were adequately reported in 24 studies (77%). Only two studies (6.5%) tested the intraexaminer/interexaminer reliability of at least one outcome of interest. Inferential statistical analysis was presented in 21 studies. However, this analysis was only considered appropriate in 12 studies (57%). Confidence intervals were reported in four studies (13%)., Conclusions: Prospective case series of treatment interventions of dental implant surgery and Prosthodontics are poorly analyzed and rarely test the reliability of outcome measures. These particular studies have limited external validity and appear to provide little unbiased evidence to support clinical decision-making.

The use of dental implants has increased substantially over the past decade, as have the number of implant-related complications. One of the contributing factors is inadequate training in the prevention, recognition, and treatment of complications. Comprehensive training on implant surgical procedures that includes patient selection, risk management, and complications allows dentists to incorporate implant placement into their practices with less risk to patients and less risk of serious legal consequences.

Modern dental education should have in on one hand the necessary education and training to make modern dentists capable of implementing population and individual preventive strategies, and on the other make them competent to satisfy current public demands to most patients. Amongst the restorative procedures most demanded by patients implant therapy has reached a clear pre-dominance. Although specialists have traditionally rendered this therapeutic procedure, in simple cases there is seldom need for extensive surgical procedures and therefore there is a clear need to introduce these studies in modern dental curricula. To facilitate the harmonisation and convergence of dental education in Europe, the Association for Dental Education in Europe and DentEd have defined a set of competencies for the graduating dentist in the EU. Using the same framework, we herein define the agreed competencies in implant dentistry, within the different domains, for both the undergraduate and the postgraduate student. Within a context of a competence-based curriculum implant dentistry should be taught as part of the major and supportive competencies described with a strong emphasis on inter-disciplinarity and integration.

The use of dental implants has become a widely accepted and well-documented treatment option offering to both patients and dentists an alternative to traditional treatment modalities and at the same time opening a brand new area in dental postgraduate education. As such, it is necessary to define the competencies that the graduate student/dentist will need at the different levels of clinical practice in Implant Dentistry and the educational pathways that are required to convey those competencies in a structured manner. The present position paper provides an initial suggestion for the knowledge, skills and behaviour necessary for a graduate student to practice implant dentistry at the different levels of clinical complexity. An outline of the necessary competencies and structure of various levels of postgraduate university courses is provided together with different educational approaches to support them. The present paper should be evaluated as a platform for discussion for future development of postgraduate curricula in implant dentistry rather than a manual on how to design and operate such curricula.

Implant therapy has evolved into an important part of daily dental practice. Appropriate knowledge of diagnostic and therapeutic options with dental implant therapy is, therefore, mandatory for dental students. The present consensus paper describes the theoretical knowledge as a foundation to the teaching of implant dentistry at the undergraduate level. Students need a solid basic knowledge about biological prerequisites and clinical procedures leading to successful implant treatment and, in particular, an understanding of the importance of embedding implants into the overall treatment concept. Among others this includes aspects of bone and soft tissue integration of dental implants, as well as aspects of materials that are used in implant dentistry. The students should also be able to differentiate between low, medium and high-risk situations, which assumes that they have knowledge about a proper clinical examination. Furthermore, the students need to be able to inform the patient about the different treatment options and their advantages and disadvantages. Frequently, a choice has to be made between an FDP anchored on teeth and an implant-borne reconstruction. This is highly influenced by the long-term prognosis of the different treatment options. In order to perform implant placement in uncomplicated cases and to give appropriate patient information, adequate knowledge of surgical procedure and surgical complications is mandatory. Furthermore, the dentist needs to be competent in evaluating clinical situations and in advising patients about the suitability of the different options, e.g. removable or fixed reconstructions. It is possible that peri-implant tissue destruction may be a more common finding during long-term service of implant-borne reconstructions than was previously believed. The dentist needs knowledge about etiology and pathogenesis of peri-implantitis and should know how to provide an effective maintenance care programme. In cases of peri-implantitis the student should be knowledgeable regarding suitable interventions.

Learning in academic settings is strongly related to the way the students are tested or examined. Assessment therefore must be integrated in the curriculum design, coordinated and should reflect the learning outcomes of the education. Assessment within the field of implant dentistry must fulfil four major objectives: complete and direct the learning process with feedback (formative), ensure that students are adequately prepared (summative), assess attitudes and skills such as critical thinking, reflection and self-assessment ability, and supply continuous feedback to teachers on curricular content and impact. Different assessment methods should be used to assess different levels of competencies throughout the curriculum. Various forms of written or oral assessment methodologies are applicable at earlier stages in the curriculum. At intermediate levels, interactive assessment methods, such as patient simulations (paper based or virtual) and more could encourage the necessary synthesis of several disciplines and aspects of the theoretical knowledge. At higher levels of competence, documentation of clinical proficiency by means of reflective portfolios and diaries is an appropriate assessment method with both formative and summative potential. The highest level of competence requires performance assessment using structured, objective, clinical criteria. The group strongly encourages the use of reflective forms of assessment methods which engage the students in a process of self-appraisal, identification of individual learning needs and self-directed learning. The ultimate goal of this would be to allow the student to develop a lifelong learning attitude.

This paper constitutes a summary of the consensus documents agreed at the First European Workshop on Implant Dentistry University Education held in Prague on 19-22 June 2008. Implant dentistry is becoming increasingly important treatment alternative for the restoration of missing teeth, as patients expectations and demands increase. Furthermore, implant related complications such as peri-implantitis are presenting more frequently in the dental surgery. This consensus paper recommends that implant dentistry should be an integral part of the undergraduate curriculum. Whilst few schools will achieve student competence in the surgical placement of implants this should not preclude the inclusion of the fundamental principles of implant dentistry in the undergraduate curriculum such as the evidence base for their use, indications and contraindications and treatment of the complications that may arise. The consensus paper sets out the rationale for the introduction of implant dentistry in the dental curriculum and the knowledge base for an undergraduate programme in the subject. It lists the competencies that might be sought without expectations of surgical placement of implants at this stage and the assessment methods that might be employed. The paper also addresses the competencies and educational pathways for postgraduate education in implant dentistry.

This paper provides arguments for the introduction of implant dentistry into the undergraduate curriculum. The survival of teeth is very high when disease is diagnosed and treated properly and maintenance is taken care of. Nevertheless, tooth replacements by fixed and removable prostheses are highly prevalent. It is expected that dentists will face a dramatically increased need to care for elderly patients and partially edentulous patients. Hence, the demand for implant reconstructions will be substantial and more appropriately trained and competent health professionals will be needed. Increasing demands of the patient regarding aesthetics and function will influence the demands for implant therapy. The improvement of oral function and subjective chewing comfort, the preservation of tooth structures or existing reconstructions and the replacement of missing, strategically important teeth are major indications for implant placement. From both a biological and an economical point of view, the single tooth replacement with an implant is the first choice in situations with no or minimally restored neighbouring teeth compared with conventional bridgework. Stability of full dentures represent a major problem especially for the mandible. It is well documented that placement of two implants supporting an overdenture substantially improve chewing capacity, increase quality of life and is a simple and cost-effective treatment thus rendering such treatment a 'standard of care' procedure. There is no doubt that dental students should learn to incorporate the indication of oral implants in their overall treatment planning. Therefore, they will have to understand the basic aspects of healing and tissue integration, basic biomechanical and material science principles as well as surgical and prosthetic techniques. They will have to be able to monitor continuously the peri-implant tissues, render appropriate supportive therapy and cope with biological and technical complications. While it is evident that the surgical procedure per se may require additional competence, the remainder of the aspects mentioned should be taught in the dental curriculum. This should include the attribution of responsibility for maintenance of implants and handling of biological and technical complications. Moreover, it is desirable to include the surgical technique for implant placement for 'straightforward' cases into the dental curriculum. The levels and limitations to which the various aspects of implant dentistry and related skills are to be taught are determined by the academic community. Obviously, ethical and legal aspects of implant dentistry should not be forgotten.

The state of complex forensic-medical expertise in implantological stomatology was analyzed in the article. The questions of assessment of medical aid quality with the use of score system of risk degree and factors determination are considered. The authors suggest to use the score system of unfavorable outcomes with the purpose of objectification of expert conclusions.

The aim of this study was to retrospectively analyse the clinical performance of hybrid bridges and their effect on periodontal health. All the bridges in this study were delivered by undergraduate dental students at the University Dental School and Hospital Cork. The recall protocol took the form of a questionnaire and a full clinical examination of the abutments, retainers and contra lateral control teeth. In all, 22 patients with 25 bridges were examined. The periodontal response was generally favourable and soft tissue alteration was minimal. The outcome of the performance hybrid bridges is not encouraging, as 32% (8) of the bridges failed and 68% (17) were in service with a mean duration of clinical service of 48 months.

This study evaluated in vitro the retention of intracanal cast posts cemented with dual-cure resin varying the application method of the primer/adhesive solution and luting agent in the prosthetic space prepared to receive the posts. Sixty endodontically treated maxillary canines had their crowns discarded, and their roots were embedded in acrylic resin. The prosthetic spaces were prepared with Largo burs mounted on a low-speed handpiece coupled to a parallelometer in order to maintain length and diameter of intraradicular posts constant and to guarantee that the preparations were parallel after casting. Two groups (n = 30) were randomly formed according to the device used to apply the adhesive system: microbrush or standard bristle brush (control). Each group was divided into 3 subgroups (n = 10) according to the technique used to place the luting agent into the root canal: using only a lentulo spiral before setting the post, applying it onto the post surface, or combining both methods. After 72 hours, the tensile force required to dislodge each post was determined by a universal testing machine (Instron 4444) set at a speed of 1 mm/min. The results indicated that the use of the microbrush yielded higher bond strength values (0.1740 +/- 0.04 kN) than those recorded for the bristle brush tip (0.1369 +/- 0.04 kN, p < 0.001). Bonferroni's test demonstrated a higher retention (p < 0.001) in radicular post cemented with the technique that combined both methods (lentulo + post: 0.1787 +/- 0.03 kN) than that obtained with lentulo (0.1461 +/- 0.065 kN) or post (0.1416 +/- 0.03 kN) alone. The interactions between the adhesive system and luting agent application techniques presented statistical difference (p < 0.001). It was concluded that the best performance in terms of tensile strength among the tested conditions was obtained when the adhesive system was applied with a microbrush and the luting agent was taken into the root canal with lentulo spirals alone (0.1961 +/- 0.04 kN) and combining both methods (lentulo + post: 0.1911 +/- 0.02 kN).