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Purpose: To evaluate the masticatory efficiency of dentate and rehabilitated complete denture patients in various facial forms. Materials and Methods: A total of 60 subjects were selected for the study; 30 subjects belonged to the dentate group (D Group) and 30 subjects belonged to the completely edentulous group rehabilitated with conventional complete dentures (CECD Group). All patients were divided into a subgroup (brachyfacial, mesofacial, and dolichofacial facial forms) using facial index measurement and cephalometric analysis. After the subjects were divided into groups, masticatory efficiency testing was performed with spectrophotometric analysis using diluted expectorate of chewed natural beetroot test food (10, 15, and 20 strokes). The mean absorbance value was considered as the mean masticatory efficiency from which the average masticatory efficiency percentage was determined using a masticatory efficiency percentage equation and considered as the masticatory efficiency of that particular subject. Results: Statistical analysis revealed that in the D Group, brachyfacial subjects exhibited the highest masticatory efficiency (70.9 ± 12.64%), followed by mesofacial (60.6% ± 10.66%) and dolichofacial (34.3% ± 10.81%) subjects. In the CECD groups, the results for brachyfacial were highest (52.7% ± 8.11%), followed by the mesofacial (42.3% ± 6.52%), and dolichofacial (29.3% ± 7.76%) subjects. Conclusions: Along with other determinant factors, facial form plays an influential role on masticatory efficiency. Brachyfacial subjects exhibited the highest masticatory efficiency, followed by mesofacial and dolichofacial subjects in both study groups. [ABSTRACT FROM AUTHOR]

This article reports a case of maxillary rehabilitation with implant-supported fixed dental prostheses on six zirconia implants. A woman with impacted maxillary canines attended our dental clinic seeking a metal-free maxillary restoration. After the extraction of both impacted maxillary canines and the placement of autogenous bone graft, six two-piece zirconia implants with straight abutments were placed in the anterior maxilla. Two zirconia fixed dental prostheses with porcelain veneering, separated at the midline, were placed on these zirconia implants. The 10-year follow-up monitored the adequate evolution of both implants and restorations with no signs of peri-implant disease. [ABSTRACT FROM AUTHOR]

Objectives: This case series aimed to assess the efficacy of a novel horizontal ridge augmentation modality using histology. Combinations of "sticky bone" and tenting screws without autologous bone were used as augmentative materials. Method and materials: Five individuals presenting healed, atrophic, partially edentulous sites that required horizontal bone augmentation before implant placement were enrolled. Patients underwent the same augmentation type and 5 months of postoperative reentry procedures. The first surgery served as implant site development, whereas the biopsy and corresponding implant placement were performed during reentry. The bone was qualitatively analyzed using histology and histomorphometry and quantitatively evaluated using CBCT. Results: Four individuals healed uneventfully. Early wound dehiscence occurred in one case. Histology showed favorable bone substitute incorporation into the newly formed bone and intimate contact between de novo bone and graft material in most cases. Histomorphometry revealed an average of 48 ± 28% newly formed bone, 19 ± 13% graft material, and 33 ± 26% soft tissue components. The CBCTbased mean alveolar ridge horizontal increase was 3.9 ± 0.6 mm at 5 months postoperatively. Conclusions: The described augmentation method appears suitable for implant site development resulting in favorable bone quality according to histology. However, clinicians must accommodate 1 to 2 mm of resorption in augmentative material width at the buccal aspect. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether complete dentures (CDs) relined with long-term resilient liners (LTRLs) favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to conventional CDs. Materials and Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in PROSPERO (the International Prospective Register of Systematic Reviews; CRD42021258700). The population, intervention, comparison, and outcome (PICO) purpose was to determine whether CDs relined with LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to CDs. Searches were performed in the PubMed/MEDLINE, Embase, Scopus, Lilacs, BBO, and OpenGrey databases. Manual searches were also performed to identify additional primary studies. Results: Overall, 3,953 articles were found. After removing duplicates, reading the articles, and applying the inclusion and exclusion criteria, 15 articles were selected for qualitative analysis, totaling 422 patients with follow-up periods ranging from 1 week to 3 years. Among these, 8 studies assessed masticatory function using different methods, 2 assessed satisfaction, 1 assessed quality of life, and 4 assessed more than one outcome. Through qualitative analysis, LTRLs showed satisfactory results in most studies when compared to CDs in relation to masticatory function, satisfaction, and quality of life. Conclusions: LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to CDs. [ABSTRACT FROM AUTHOR]

Traditionally, metal-ceramics, metal-reinforced acrylics, and--more recently--full-contour or layered zirconia have been the materials of choice for definitive fixed implant-supported rehabilitations. Polymethyl methacrylate (PMMA) is commonly used in implant dentistry for the fabrication of implant-supported interim prostheses and as milled or 3D-printed prototypes. This article describes a novel protocol to prosthetically restore a completely edentulous patient following a digital workflow, with fixed, screw-retained, implant-supported prostheses fabricated from CAD/CAM milled PMMA, with no metal substructure. After a 2-year follow-up in terms of esthetics, phonetics, function, and biologic tissue response, the outcome remains functional and free of mechanical, biomechanical, or biologic complications. The aim of this article is to illustrate the feasibility of using milled PMMA as a viable definitive prosthetic material for the fixed implant rehabilitation of edentulous patients. [ABSTRACT FROM AUTHOR]

Purpose: To determine the influence of partial edentulous distal extension and the use of removable partial dental prostheses in partially edentulous areas on the force exerted on the anterior teeth. Materials and Methods: A total of 83 volunteer patients participated in this study. The occlusal force was measured using an occlusal force measuring sheet in the patient's mouth. The occlusal forces and ratios were compared using the Wilcoxon signed-rank test (P < .05). Results: The force exerted on the anterior teeth increased significantly as the number of remaining teeth decreased in an edentulous distal extension. The force exerted on the anterior teeth decreased significantly with the use of a removable partial dental prosthesis. Conclusions: In a clinical setting, when the number of remaining teeth in a partial edentulous distal extension decreases, the burden on the anterior teeth increases. Our findings suggest that, for patients with partial edentulous distal extension, using a removable partial dental prosthesis is effective in preserving the residual anterior teeth by reducing excessive force. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study which evaluated the effectiveness and accuracy of a proposed duplication technique in terms of one- and three-dimensional discrepancies between an original abutment and polyurethane duplicates obtained through a conventional workflow in single-implant rehabilitation. Topics covered include master cast with the Giroform System, abutment duplication and the influence of duplication on crown marginal and internal adaptation.

Purpose: To compare the 3D accuracy of three scanning strategies and conventional impressions using an edentulous model with six implants. Materials and Methods: An edentulous maxillary master model was fabricated with six equigingival internal connection implants at 0 degrees of angulation. Ten conventional open-tray splinted implant-level impressions were made and poured in stone. A master model and conventional casts were digitized with a reference scanner. Digital impressions were made by calibrated clinicians with a TRIOS 3 intraoral scanner ([IOS] 3Shape) according to three scanning strategies: DIG1 (occlusal-palatal-lingual), DIG2 (S-type motion from buccal to palatal), and DIG3 (scanning two half arches and connecting them at the midline). Each technique was repeated 10 times on the master model. Deviations from the STL datasets (N = 40) were compared to those of the reference master model using the Hexagon Metrology software system PC-DMIS CAD++. Linear distortions (dX, dY, dZ), global linear distortion (dR), and angular distortions (Absdθx, Absdθy) were calculated. Kruskal-Wallis test and mixed linear and logistic regression models were used to compare the original and binary distortion measures between the techniques. Results: The mean dR ranged from 91 μm (conventional method) to 183 μm (DIG1). The mean angular distortion ranged from 0.20 degrees (Absdθx for DIG2) to 0.69 degrees (Absdθy for DIG3). No scan pattern resulted in a more accurate reproduction in any of the measured parameters than the conventional impression method. There were significant differences between the methods for all distortion measures. Conclusions: No group reproduced the 3D position of the six-implant master model below the thresholds for both global linear and angular distortions. All the digital strategies tested were less accurate than the conventional open-tray splinted implant-level impression technique. [ABSTRACT FROM AUTHOR]

The design and manufacture of a stackable surgical guide for implant placement with immediate prosthetic loading of completely edentulous cases is described in this dental technique. To achieve this, the stackable attachment is designed using free-form designing software, which is later joined to the implant placement guide and the dental prosthesis. This technique should provide the patient with a same-day implant and an esthetic restoration accurately placed in the predesigned position of the centric occluding relationship. It also reduces the number of visits and prosthetic complications related to the improper implant position. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to evaluate the performance of implants placed with the All-on-4 technique after a mean time in function of 9 years. A total of 34 patients with 156 implants were selected for this study: 18 patients underwent tooth extraction on the day of implant placement (Group D), and 16 patients were already edentulous (Group E). A periapical radiograph was taken at a mean follow-up of 9 years (range: 5 to 14 years). Success and survival rates and the prevalence of peri-implantitis were calculated. Statistical analysis was used to assess comparisons between groups. After a mean follow-up of 9 years, the cumulative survival rate was 97.4% and the success rate was 77.4%. The difference between the initial and final radiographs resulted in a mean marginal bone loss (MBL) of 1.3 ± 1.06 mm (range: 0.1 to 5.3 mm). No differences were seen between Groups D and E. Peri-implantitis affected 15 implants (9.6%) in 9 patients (26.5%). This study shows that the All-on-4 technique is a reliable treatment method for both edentulous patients and patients requiring tooth extractions, with results maintained over a long follow-up period. The present MBL results are similar to those around implants in other rehabilitation types. [ABSTRACT FROM AUTHOR]

Horizontal and vertical ridge augmentation via the bone shell technique provides predictable outcomes. The external oblique ridge is the most-used donor site for bone plate harvesting, followed by the mandibular symphysis. The lateral sinus wall and the palate have also been described as alternative donor sites. This preliminary case series reports a bone shell technique that used the coronal segment of the knife-edge ridge as a bone shell in five consecutive edentulous patients (20 sites) with severe mandibular horizontal ridge atrophy and adequate ridge height. The follow-up period was 1 to 4 years. The average horizontal bone gains at 1 mm and 5 mm below the newly formed ridge crest were 3.6 ± 0.76 mm and 3.4 ± 0.92 mm, respectively. Ridge volume was sufficiently restored in all patients to enable implant placement in a staged approach. In 2 of the 20 sites, additional hard tissue grafts were required at implant placement. The advantages of utilizing the relocated crestal ridge segment are as follows: The donor and recipient sites are the same, no major anatomical structures are compromised, periosteal releasing incisions and flap advancement are not required for primary wound closure, and the risk of wound dehiscence is minimized due to reduced muscle tension. [ABSTRACT FROM AUTHOR]

Albers-Schönberg disease is a rare bone syndrome characterized by increased bone density and infectious complications after dental extraction or minor surgery. The prosthodontic management of such edentulous patients with osteomyelitis is very challenging and requires special strategies due to a high risk of failure and worsening of the condition. This clinical report describes the rehabilitation of a 31-year-old edentulous woman presenting with Albers-Schönberg disease, secondary chronic osteomyelitis, maxillary hypoplasia, compromised oral conditions, temporomandibular disorders, and psychologic distress. The treatment included a mandibulectomy and removable prostheses. A crucial element for the successful long-term treatment and quality of life improvement observed in this patient was the 1-year transitional phase with interim dentures and frequent follow-up appointments. The complications and management proposed during a 10-year follow-up are presented. [ABSTRACT FROM AUTHOR]

Purpose: To assess oral health-related quality of life (OHRQoL) and patient satisfaction with a three-implant-retained mandibular overdenture. Materials and Methods: In this randomized crossover clinical trial, 20 edentulous patients received a new set of conventional complete dentures (CDs; baseline). Subsequently, three implants were placed in the anterior mandible: two were placed in the canine regions bilaterally and one in the midline. After successful osseointegration, CDs were attached to the implants using resilient attachments. The overdenture was retained either by three implants (test group) or two implants (control group). The sequence of treatment was randomized such that each patient experienced both treatment options for 6 months each. OHRQoL was assessed at baseline and after 6 months of function for each treatment option using the Oral Health Impact Profile (OHIP-14) and visual analog scale (VAS) scores. Statistical analyses were performed using Friedman and Wilcoxon signed rank tests. Results: CD resulted in significantly higher OHIP-14 and VAS scores (25.25 + 6.42, 8.55 + 1.73) compared to both the control group (11.15 + 5.39, 4 + 2; P < .001) and the test group (6.25 + 4.02, 2.06 + 1.48; P < .001). Similarly, significantly higher mean OHIP-14 and VAS scores were noted for the control group compared to the test group (P < .001). Conclusions: Overdentures retained by three implants resulted in better OHRQoL scores and higher patient satisfaction compared to overdentures retained by two implants and CDs. [ABSTRACT FROM AUTHOR]

With increasing age and edentulism, numerous esthetic changes occur to the perioral region. The upper lips lose definition, flatten, and lengthen, the cupid's bow is lost, and the oral commissures descend. The nasolabial folds deepen, marionette lines become prominent, vertical rhytids around the lips form, and chin rhytids form. Chronic exposure to UVA radiation from the sun can lead to photodamage, characterized by wrinkles, lentigines, actinic keratoses, and other pigment changes. In addition, edentulism leads tojaw atrophy, which often compromises soft tissue support. Removable dentures, the conventional treatment to restore missing teeth, not only replace teeth, but also provide support to the lips via the labial flange. Implant-supported Axed prostheses are a very popular option to restore completely edentulous arches; these prostheses are flangeless, providing no bulk to the lips. Addressing changes in the perioral region due to aging and edentulism requires a combination of treatments, with each addressing different issues. Onabotulinum toxin A can be used to treat dynamic perioral and chin rhytids, and upturn the corners of the mouth. Hyaluronic acid filler can be used to treat deep nasolabial folds, marionette lines, and re-volumize the lips. Chemical peels can treat photodamaged skin, static rhytids, and other dermatologic pathologies. The subnasal lip lift, developed by Cardoso and Sperli in 1971, has become an increasingly common technique used to rejuvenate the upper lip in elderly and edentulous patients. This case report describes an elderly patient who was treated with a combination of subnasal lip lift, hyaluronic acid filler, onabotulinum toxin A, and chemical peel to achieve superior perioral esthetics. This case highlights the synergy of each procedure when done in combination to achieve highly effective results. [ABSTRACT FROM AUTHOR]

This study aims to compare the incidence of biologic and mechanical complication rates and the survival rates after at least 5 years of implants and implant-supported fixed complete dental prostheses (IFCDPs) placed during second-stage surgery using four and six implants. A total of 77 patients (33 men, 44 women) with a mean age of 60.6 ± 8.8 years (range: 39 to 80 years) were included, and the total of 92 IFCDPs were classified into two groups: 51 received four implants, and 41 received six implants. No implant failed in the four-implant group (0/204), and one implant failed in the six-implant group (1/246), with no statistically significant differences (P > .05). One prosthetic failure occurred in the four-implant group (1/51), and one failure occurred in the six-implant group (1/41). Both groups experienced some technical and biologic complications, with no statistically significant differences between the groups (P > .05). For both groups, veneer or resin fracture was the most frequent mechanical complication, and mucositis was the most frequent biologic complication. The use of four or six implants may represent a predictable treatment option in the rehabilitation of completely edentulous patients with IFCDPs in the medium-term. [ABSTRACT FROM AUTHOR]

This case report describes a novel approach combining orthodontic and implant digital treatment planning workflows to enable prosthetically driven implant placement before orthodontic treatment is performed or completed. The computer-assisted implant placement is performed using a static surgical guide based on the future positions of the teeth after completion of orthodontic treatment. This innovative approach allows for select partially edentulous patients to undergo fixed prosthetic rehabilitation before orthodontic treatment is completed. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the accuracy, working time, and patient satisfaction of digital impressions (DI) vs conventional impressions (CI) taken for removable prostheses on edentulous arches. Materials and Methods: A systematic search of the literature was conducted in electronic databases. The English language was filtered with no limitation on publication date. The search was performed up to June 2022. Only in vivo studies comparing DI and CI techniques for the fabrication of complete removable prostheses were included. The primary outcome was accuracy (in terms of trueness and precision), working time (scanning time), and patient satisfaction of DI procedures. Results: After title and abstract screening, six articles were considered eligible for inclusion. All articles investigated the trueness of DI, while no study evaluated the accuracy in terms of precision. The discrepancies between DI and CI were primarily in the peripheral areas. Only one article focused on the working time for scanning procedures. Patient satisfaction was surveyed in just one study. Lack of standardization of the CI procedures and sample size collection were observed in all studies. Conclusions: The scientific evidence so far collected on IOS for complete edentulous arches is not exhaustive, in particular when dealing with scanning time and patient satisfaction. Regarding accuracy, digital scanning in edentulous patients seems to be a predictable procedure within the limits of the attached mucosa. [ABSTRACT FROM AUTHOR]

Purpose Materials and Methods Results Conclusions To evaluate the effects of repeated abutment manipulation on the prevalence of peri‐implant diseases.A total of 27 edentulous patients (n = 108 implants) immediately restored with double‐crown retained implant‐supported prostheses were identified for this retrospective study. The test included the one‐abutment, one‐time care concept (n = 18 patients, n = 72 implants, OAOT) and the control abutment replacement (n = 9 patients, n = 36 implants, AR). A mixed effects model regression was conducted for the variable diagnosis (healthy, peri‐implant mucositis, and peri‐implantitis) with predictors abutment replacement (presence/absence), number of abutment replacement, category of keratinized mucosa (KM) (2 < KM ≥2 mm), and radiographic bone loss (BL).After 3–15 years (mean 10.2 ± 2.8 years), the prevalence of peri‐implant mucositis and peri‐implantitis in patients in the AR group was 11.1% and 88.9%, corresponding to 22.2% and 55.6% at the implant level, respectively. In OAOT group, none of the implants showed peri‐implant mucositis, whereas the prevalence for peri‐implantitis at patient and implant level amounted to 5.6% and 5.6%, respectively. The increased number of abutment replacements was significantly associated with the increased probability to diagnose peri‐implant mucositis and peri‐implantitis (OR: 6.13; 95% CI [2.61, 14.39]) (p < 0.001), whereas the presence of keratinized mucosa was not founded as a significant cofounder. The estimated mean BL in AR group was 1.38 mm larger than in OAOT group (p = 0.0190).The OAOT concept was associated with a lower prevalence of peri‐implant diseases. [ABSTRACT FROM AUTHOR]

Transferring the intraoral situation accurately to the dental laboratory is crucial for fabricating precise restorations. This study aimed to compare the dimensional accuracy of a new hydrophilic quadrofunctional vinyl polysiloxane (VPS) and polyether (PE), in combination with different impression techniques (mono-phase single step or dual-phase single step). The reference model simulated a partially edentulous mandible. Stainless-steel precision balls were welded to specific teeth and were used to detect dimensional deviations. Fifteen impressions were made for each of the following four test groups: (1) VPS mono-phase, (2) PE mono-phase, (3) VPS dual-phase, and (4) PE dual-phase. Global accuracy was measured by deviations from the reference model, while local accuracy focused on the trueness and precision of abutment tooth surfaces. Statistical analysis was conducted using ANOVA (α = 0.05). All distances were underestimated, with the highest global inaccuracies for the cross-arch distance, ranging from −82 µm to −109 µm. The abutment tooth surfaces showed excellent local accuracy for all the materials and techniques, with crown surface trueness < 10 µm and precision < 12 µm. Inlay surfaces had higher inaccuracies (trueness < 15 µm, precision < 26 µm). Within the limitations of this study, all impression materials and techniques can be used to produce models with clinically acceptable accuracy. [ABSTRACT FROM AUTHOR]

Automated tooth segmentation and identification on dental radiographs are crucial steps in establishing digital dental workflows. While deep learning networks have been developed for these tasks, their performance has been inferior in partially edentulous individuals. This study proposes a novel semi-supervised Transformer-based framework (SemiTNet), specifically designed to improve tooth segmentation and identification performance on panoramic radiographs, particularly in partially edentulous cases, and establish an open-source dataset to serve as a unified benchmark. A total of 16,317 panoramic radiographs (1589 labeled and 14,728 unlabeled images) were collected from various datasets to create a large-scale dataset (TSI15k). The labeled images were divided into training and test sets at a 7:1 ratio, while the unlabeled images were used for semi-supervised learning. The SemiTNet was developed using a semi-supervised learning method with a label-guided teacher–student knowledge distillation strategy, incorporating a Transformer-based architecture. The performance of SemiTNet was evaluated on the test set using the intersection over union (IoU), Dice coefficient, precision, recall, and F1 score, and compared with five state-of-the-art networks. Paired t-tests were performed to compare the evaluation metrics between SemiTNet and the other networks. SemiTNet outperformed other networks, achieving the highest accuracy for tooth segmentation and identification, while requiring minimal model size. SemiTNet's performance was near-perfect for fully dentate individuals (all metrics over 99.69%) and excellent for partially edentulous individuals (all metrics over 93%). In edentulous cases, SemiTNet obtained statistically significantly higher tooth identification performance than all other networks. The proposed SemiTNet outperformed previous high-complexity, state-of-the-art networks, particularly in partially edentulous cases. The established open-source TSI15k dataset could serve as a unified benchmark for future studies. [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this study was to evaluate incidental findings in the mandible after the placement of dental implants using a new cone–beam computed tomography (CBCT) software. Methods: The initial sample consisted of 2872 CBCT scans of patients of both sexes. The parameters evaluated in this study were the location of the implants in the mandible, implant length, anatomical relationship of the implant with the mandibular canal, presence or absence of damage to the adjacent teeth, presence or absence of implant fractures, and presence or absence of bone support. Fisher's exact test was performed to compare the variables. The significance level was set at p = 0.05. Results: Out of 2872 CBCT scans, 214 images of patients with an average age of 44.5 years were included. The most frequent location of the implants was the posterior region (93.5%), with 54% of the implants having a length between 9 and 14 mm. It was found that 92% of the implants were positioned above the mandibular canal. Damage to adjacent teeth was observed, with no correlation with the implant positioning (p = 1.000). In 100% of cases of implants in the anterior region, there was bone support. Fracture was observed in 1.7% of implants with a length between 9 and 14 mm. Conclusions: The installation of implants in the mandible occurs more frequently in the posterior region, with a high presence of bone support and a low incidence of damage to adjacent teeth, anatomical structures, and fractures. [ABSTRACT FROM AUTHOR]

This study aimed to optimize space closure efficiency by comparing the forces and moments exerted by different designs of clear aligners (CAs) during the movement of maxillary canines into the premolar extraction space. The forces and moments were measured using a multi-axis force/moment transducer on the maxillary right canine. The CAs were fabricated from thermoformed polyethylene terephthalate glycol. The following four edentulous space designs were tested: the edentulous space was left intact (Group 1); the edentulous space was replaced with a premolar pontic (Group 2); the edentulous space was replaced with a half-sized premolar pontic (Group 3); and the edentulous space was replaced with a rectangular column beam (Group 4). The maxillary right canine was moved 0.25 mm distally. All groups experienced buccodistal and intrusive forces; compared with the other groups, Group 1 showed significantly greater intrusive and smaller distal forces, and Group 4 showed significantly greater distal forces. All groups experienced distal tilting, lingual inclination, and mesial rotational moments. These findings suggest that modifying the thickness and extent of the adjacent teeth in the edentulous area of the CA can improve local stiffness, thereby reducing the tipping of the teeth into the edentulous space. This study emphasizes the importance of the CA design in controlling forces and moments for effective orthodontic treatment. [ABSTRACT FROM AUTHOR]

Background: Oral rehabilitation through prosthetic management after cancer resection is a conservative and effective modality in improving patients' oral health-related quality of life. However, it is challenging to obtain sufficient retention for hemimaxillectomy and edentulous cases without the use of Osseo-integrated implants. Purpose: This case aims to explain the oral rehabilitation management of post-hemimaxillectomy for edentulous patients using a hollow bulb obturator and long-term soft liner. Case: A 63- year-old female presented to the Universiti Malaya postgraduate dental clinic and complained of a loose obturator during speaking and eating and high resonance during speaking. Seven years ago, she underwent hemimaxillectomy surgery of the left hard palate for the removal of squamous cell carcinoma. Upon examination, she had an edentulous maxillary arch, with a large palatal defect; the lateral border of the defect was lined with a skin graft. The mandibular arch was partially dentate with three teeth remaining (33, 35, 43). Case Management: First, elective root canal treatment of the mandibular canines was done to use them as abutments for a mandibular overdenture. Next, a maxillary hollow bulb obturator and a mandibular overdenture were constructed. Then, after evaluating the airspace on the defect site, the lateral and posterior borders of the obturator were modified to be better utilized for retention. Conclusion: Oral rehabilitation of hemimaxillectomy cases with a hollow bulb obturator without the use of Osseo-integrated implants can be a viable option for improving patients' mastication, and speech, after assessing the retention factors, including the seal, available undercuts, and occlusion. [ABSTRACT FROM AUTHOR]

Statement of problem: Atrophied jaw is a condition where there is insufficient bone quantity and quality. Several treatment plans are available for treating atrophied jaws, including subperiosteal implants. Purpose: To evaluate the spectrum of subperiosteal implants for severely atrophied jaws using digital technology. Materials and methods: An electronic and manual search was conducted in the PubMed, Scopus, and Google Scholar databases. Publications of cohort studies, case series, and case reports written in English without data restrictions that reported on subperiosteal implant management of patients with severely atrophied jaws in a completely and partially edentulous population. Results: A total of 26 articles, comprising 302 cases, were analyzed. In patients with severely atrophied jaws. The success rate was 87.7%, the surviving rate was 95.3%. The most common complications were biological, such as dehiscence and framework exposure. The rates of biologic complications were 11.5%, and the rates of prosthetic problems were 5.9%. Conclusions: Subperiosteal implants designed and constructed using digital technology are a promising treatment in the short term. Attention should be directed to decrease the biological complication. Correct designing, implanting, fixing, and patient selection and maintenance are critical for the success of the treatment. Longer prospective studies with larger population are needed to view the effect on hard and soft tissue. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key points Plain language summary Peri‐implantitis poses significant challenges in clinical practice, necessitating effective therapeutic strategies. This case report presents a comprehensive treatment approach for managing peri‐implantitis, focusing on resective surgery, including implantoplasty and long‐term maintenance.We describe the case of a 50‐year‐old female patient with peri‐implantitis affecting a maxillary full‐arch implant‐supported rehabilitation. The treatment strategy involved resective surgery with implantoplasty, a new maxillary overdenture, and a regular maintenance care schedule of three to four visits per year. Clinical and radiographic assessments were performed over a 10‐year follow‐up period.Post‐treatment, all maxillary implants demonstrated no probing depths exceeding 4 mm, absence of bleeding on probing or suppuration, minimal plaque accumulation, and no further bone loss. Resective surgery with implantoplasty seems to have effectively provided submucosal decontamination and created a supra‐mucosal implant surface conducive to oral hygiene. Despite regular maintenance, some mandibular implants exhibited bone loss during the follow‐up period and were managed using the same approach as for the maxillary implants.The comprehensive treatment approach yielded favorable long‐term clinical and radiographic outcomes, underscoring the effectiveness of the combined strategies in managing peri‐implantitis. Nevertheless, the potential for recurrence or the development of peri‐implantitis in new implants, even after a decade of successful treatment and strict maintenance, highlights the importance of ongoing, diligent care and regular evaluations to promptly diagnose and address these issues.Why is this case new information? The long‐term effectiveness of peri‐implantitis treatments, particularly involving implantoplasty, remains under‐documented. This case provides insights from a 10‐year follow‐up on the efficacy of a comprehensive approach for managing peri‐implantitis. Furthermore, these findings illustrate the potential for new peri‐implantitis to develop, regardless of sustained peri‐implant health and rigorous maintenance. This finding highlights the critical role of continuous monitoring for the early diagnosis and treatment of new implants exhibiting peri‐implantitis. The long‐term effectiveness of peri‐implantitis treatments, particularly involving implantoplasty, remains under‐documented. This case provides insights from a 10‐year follow‐up on the efficacy of a comprehensive approach for managing peri‐implantitis. Furthermore, these findings illustrate the potential for new peri‐implantitis to develop, regardless of sustained peri‐implant health and rigorous maintenance. This finding highlights the critical role of continuous monitoring for the early diagnosis and treatment of new implants exhibiting peri‐implantitis.What are the keys to the successful management of this case? The success of this case hinged on a comprehensive treatment approach that combines surgical intervention associated with implantoplasty to remove implant threads, thereby creating smoother surfaces, less retentive for plaque accumulation. A critical aspect of this approach was also the redesign of prosthetic components to improve hygiene accessibility, continuous monitoring, and consistent maintenance care. What are the primary limitations to success in this case? The primary challenge in achieving success in this case was the prevention of new implants with peri‐implantitis, despite the patient's consistent adherence to the maintenance program. Moreover, a critical evaluation of implant characteristics, particularly their susceptibility to mechanical failures, is paramount when performing implantoplasty. Furthermore, aligning patient expectations with the realistic esthetic and functional outcomes of the treatment is often challenging. Peri‐implantitis, an inflammatory disease affecting dental implants, is quite challenging to treat. This case report describes how a 50‐year‐old woman with this condition was successfully treated and maintained over 10 years. The approach included a surgical method called resective surgery, which involved reshaping the bone defect (osteoplasty) and smoothing the implant surface (implantoplasty). Additionally, she was fitted with a new upper denture and had regular follow‐up visits three to four times a year. After ten years, her upper implants were stable with no signs of infection or further bone loss, and they were easy to keep clean. Some of her lower implants did experience inflammation with progressive bone loss during this time, but they were managed using the same surgical procedure as for her upper implants. This 10‐year case report highlights positive and stable clinical results after resective surgery for treating peri‐implantitis and the importance of an interdisciplinary approach and regular check‐ups for maintenance, early diagnosis, and management of peri‐implantitis over the long term. [ABSTRACT FROM AUTHOR]

Introduction: Edentulism is the partial or total loss of teeth, it is irreversible and disabling due to its sequelae in the masticatory, phonetic and aesthetic function that affect the quality of life. Objective: To establish the impact of edentulism and sociodemographic factors on the quality of life of the Salvadoran population. Materials and methods: Secondary cross-sectional analysis of data in 3322 users of the Public Health System of El Salvador, aged 15 to > 60 years. The variables under study were sociodemographic, edentulismo and quality of life. Edentulism was determined by clinical examination using the Oral Impact on Daily Performance scale. The statistical analysis was performed using χ2, OR, multiple regression analysis and set the significance threshold at p < 0.05. Results: Partial edentulism in the upper jaw was present in 68.24% people, partial edentulism in the lower jaw was present in 72.42% people and complete edentulism was observed in 2.02% people. There were significant sex differences and a relationship between sex and quality of life (p < 0.004); the self-perception of severe/very severe impacts was greater in women. People without education or with primary or secondary education only were the most affected (p < 0.05). Tooth loss increases with age, affecting quality of life in a severe/very severe manner. Complete edentulism had greater impacts on quality of life in terms of eating (25.64%), speaking (21.15%), and socializing/enjoying contact with people (10.90%). A severe/very severe impact on quality of life of teeth lost was reported mainly by those over 60 years of age, with an average of 11 missing posterior teeth, 6 missing anterior teeth and 13 missing teeth per patient. Those missing up to 6 anterior teeth were times more likely to perceive severe/very severe impacts on quality of life than those without any missing teeth (OR:5.788). Edentulism affected the quality of life of those examined, especially the loss of upper anterior teeth. [ABSTRACT FROM AUTHOR]

Background: Hyoid bone is attached to the mandible, tongue, larynx, temporal bone, and cervical spine via different types of muscles or ligaments. The tongue, mandible, and hyoid system play a crucial role in swallowing function. This within subject study aimed to evaluate the impact of mandibular implant overdentures on the displacement of the hyoid bones during the swallowing process. Methods: Twenty five healthy edentulous subjects were selected for participating in the study. New complete dentures were constructed for all the participants. Subsequently two dental implants were inserted in the canine regions of the participant's mandibular arch. In order to retain the mandibular prosthesis in place, ball attachments were incorporated into the mandibular dentures to convert them into implant overdentures. Using 10 ml of thin liquid bolus, videofluoroscopy swallowing examination was performed in three different oral conditions: without complete dentures (WCD), with complete denture (CDs), and with a mandibular implant overdenture (IODs). ANOVA with Bonferroni test was used to analyze the data in order to determine how the hyoid displacement varied throughout different oral conditions. Results: Compared to complete dentures, mandibular implant overdentures showed a significant decrease (P < 0.05) in both anterior hyoid displacement and duration of hyoid maximum anterior excursion (DOHMAE). However, there was a non-significant difference (P > 0.05) between the two oral circumstances in terms of superior hyoid displacement or duration for hyoid maximum elevation (DOHME). There is no penetration or aspiration for both complete denture and implant overdenture oral conditions. Conclusion: Implant retained overdentures have a positive effect on hyoid displacement during swallowing of thin liquid bolus consistency relative to conventional complete dentures. Trial registration: Retrospectively registered (NCT06187181) 02/1/2024. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions To investigate the influence of different denture‐bearing conditions on the masticatory function and patient‐reported outcome measures (PROMs) of complete denture wearers.Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non‐atrophic (NAT) (Classes I and II) (n = 24) and atrophic (AT) (Classes III and IV) (n = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health‐related quality of life (OHIP‐EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann–Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi‐square test.Higher masticatory performance was observed in the NAT group (p < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (p < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (p > .05). Regarding the quality of the CD, baseline results were significantly (p < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (p > .05).The denture‐bearing conditions seems to impact masticatory function, but the PROMs are barely affected. [ABSTRACT FROM AUTHOR]

Background: Long-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture. Methods: Eighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level < 0.05. Results: Independent t-test revealed a significant difference between the two groups with p -value = 0.0141 regarding primary stability and p-value < 0.001 regarding secondary stability, as roxolid implant group was statistically higher stability than titanium group in both. Paired t- test showed a statistically significant difference in roxolid implant group with p-value = 0.0122 however, there was non-statistically significant difference in titanium group with p-value = 0.636. Mann Whitney test showed a significant difference between the two groups regarding amount of change in stability with p value = 0.191. roxolid implant group showed a higher amount of change in stability than the titanium implant group. Conclusion: Within the limitation of this study, it could be concluded that: Roxolid implants showed promising results regarding primary and secondary stability compared to conventional Titanium implants and can be a better alternative in implant retained maxillary overdentures. Trial registration: Retrospectively NCT06334770 at 26–3-2024. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively evaluate peri-implant bone loss and health status associated with the long-term use of laser surface-treated implants. Methods: For control study, total of 23 titanium ASTM F136 grade 23 implants were placed in the edentulous molar area of the mandible. When the Implant Stability Quotient (ISQ) ≥ 70 and insertion torque value (ITV) ≥ 35–50 Ncm at the insertion site, an immediate provisional restoration was connected to the implant within a week after surgery. The definitive restorations were placed 2 months after surgery for all implants. 13 implants were immediately loaded, while 10 implants were conventionally loaded. For comparative study, Radiographs were taken from third years for and then annually for the subsequent eight years to monitor marginal bone loss. Results: After eight year of implant installation, the average change in vertical bone loss was 0.009 mm (P < 0.001), while the average change in horizontal bone loss 8 year after implant placement was 0.026 mm (P < 0.001). The mean marginal bone loss was < 0.2 mm on average. Conclusions: In this retrospective study, laser-treated implants exhibit a low rate of bone absorption around the implants. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to assess the influence of color temperature and illuminance of ambient light on the accuracy of different intraoral scanners (IOSs) in complete‐arch implant scans. Methods: An edentulous model with six implants and scan bodies was digitized by using a laboratory scanner (DW‐7‐140; Dental Wings) to obtain a reference mesh. Fifteen scans were performed employing two intraoral scanners (Trios 4;3Shape A/S and i700; Medit Co) at two illuminances (500 and 1000 lux) and three color temperatures (3200, 4400, and 5600 K). Scanning accuracy was measured by using a 3D metrology software program (Geomagic Control X). Kruskal–Wallis, one‐way ANOVA, and pairwise comparison tests were used to analyze the data (α =.05). Results: Significant differences in trueness and precision values were found among the different IOSs under the same ambient lighting condition and among the different lighting conditions for a given IOS (p <.05) except for trueness in i700 groups (p >.05). Conclusions: The influence on the accuracy of color temperature and illuminance varied depending on the intraoral scanner. An optimal ambient scanning light condition was not found; this should be adjusted based on the specific IOS system used. 3200 K of ambient light influences the precision of i700 when performed at 1000 lux, decreasing the accuracy. The variation of color temperature at the same illuminance does not affect the scanning accuracy of TRIOS 4, which obtained better accuracy in all scans at 1000 lux. [ABSTRACT FROM AUTHOR]

Aim: To introduce an objective method to evaluate the accuracy of implant position assessment in partially edentulous patients by comparing different techniques (conventional impression, intraoral scan, CBCT) to a reference 3D model obtained with an industrial scanner, the latter mimicking the clinical situation. Materials and Methods: Twenty‐nine implants were placed in four human cadaver heads using a fully guided flapless protocol. Implant position was assessed using (a) a conventional impression, (b) an intraoral scan, and (c) CBCT and compared to an industrial scan. Three‐dimensional models of intraoral scan body and implant were registered to the arch models and the deviation at implant shoulder, apex, and the angle of deviation were compared to each other as well as to the reference model. Results: The three assessment techniques showed statistically significant deviations (p <.01) from the industrial scan, for all measurements, with no difference between the techniques. The maximum deviation at the implant shoulder was 0.16 mm. At the implant apex this increased to 0.38 mm. The intraoral scan deviated significantly more than the CBCT (0.12 mm, p <.01) and the conventional impression (0.10 mm, p =.02). The maximum implant angle deviation was 1.0°. The intraoral scan deviated more than the conventional impression (0.3°, p =.02). Conclusion: All assessment techniques deviated from the reference industrial scan, but the differences were relatively small. Intraoral scans were slightly less accurate than both conventional impressions and CBCT. Depending on the application, however, this inaccuracy may not be clinically relevant. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop a structured light scanning system with a planar mirror to enhance the digital full‐arch implant impression accuracy and to compare it with photogrammetry and intraoral scanner methods. Materials and Methods: An edentulous maxillary stone cast with six scan bodies was scanned as the reference model using a laboratory scanner. Three scanning modalities were compared (n = 10): (1) self‐developed structured light scanning with a mirror (SSLS); (2) intraoral scanner (IOS); and (3) photogrammetry system (PG). The scanners were stopped for 1 min after each scan. Six scan bodies were analysed within each scan model. Linear deviations between the scan bodies (1–2, 1–3, 1–4, 1–5, and 1–6) and 3D mucosal deviations were established. The overall deviation was calculated as the mean of all linear deviations. "Trueness" represented the discrepancy between the test and reference files, while "precision" denoted the consistency among the test files. Kruskal–Wallis and Mann–Whitney U tests were used for statistical analyses. Results: Significant overall linear discrepancies were noted among the SSLS, PG, and IOS groups (p <.001). SSLS showed the best overall trueness and precision (6.6, 5.7 μm), followed by PG (58.4, 6.8 μm) and IOS (214.6, 329.1 μm). For the 3D mucosal deviation, the trueness (p <.001) and precision (p <.001) of the SSLS group were significantly better than those of the IOS group. Conclusions: The SSLS exhibited higher accuracy in determining the implant positions than the PG and IOS. Additionally, it demonstrated better accuracy in capturing the mucosa than IOS. [ABSTRACT FROM AUTHOR]

Objective: To compare the accuracy of implant position, using a combination of static and dynamic computer‐assisted implant surgery (CAIS), with either static, dynamic, or freehand implant placement, in fully edentulous arches. Materials and Methods: Twenty‐one patients with a total of 88 fixtures were included. Implants were divided equally into four groups: a combination of static and dynamic CAIS (SD group), static CAIS (S group), dynamic CAIS (D group), and freehand placement (FH group). Angular deviation, as well as the 3D platform and apex deviations, were measured for all groups. Furthermore, the direction of implant deviation was recorded and compared. Results: The FH group showed significantly more deviation compared to all groups, considering all the aspects, and at both the implant platform and apex. A significant difference in angular deviation between the SD and S groups (p <.001), and between the SD and D groups (p <.001) was noted, favoring the SD group. When evaluating implant distribution, the FH group showed a tendency towards the buccal, apical, and distal directions at platform and apex, while in the D group, implants shifted more to the buccal. In contrast, the SD group did not show a trend toward any specific direction. The S and SD groups did not show a statistical significance considering any direction. Conclusions: The combination of static and dynamic CAIS increases the accuracy of implant placement in fully edentulous arches when compared with either static or dynamic CAIS alone, as well as freehand placement. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to compare the accuracy of dental implant placement in a single tooth gap, including the postextraction site and healed site, using a task‐autonomous robotic system and a dynamic navigation system. Materials and Methods: Forty partially edentulous models requiring both immediate and conventional implant placement were randomly divided into a robotic system group and a navigation system group. The coronal, apical, and angular deviations of the implants were measured and assessed between the groups. Results: The deviations in immediate implant placement were compared between the robotic system and dynamic navigation system groups, showing a mean (±SD) coronal deviation of 0.86 ± 0.36 versus 0.70 ± 0.21 mm (p =.101), a mean apical deviation of 0.77 ± 0.34 versus 0.95 ± 0.38 mm (p =.127), and a mean angular deviation of 1.94 ± 0.66° versus 3.44 ± 1.38° (p <.001). At the healed site, significantly smaller coronal deviation (0.46 ± 0.29 vs. 0.70 ± 0.30 mm, p =.005), apical deviation (0.56 ± 0.30 vs. 0.85 ± 0.25 mm, p <.001), and angular deviation (1.36 ± 0.54 vs. 1.80 ± 0.70 mm, p =.034) were found in the robotic system group than in the dynamic navigation group. Conclusions: The position in both immediate and conventional implant placement was more precise with the task‐autonomous robotic system than with the dynamic navigation system. Its performance in actual clinical applications should be confirmed in further trials. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the cross‐sectional and prospective associations between self‐reported functionality of complete dentures (FCD), satisfaction with complete dentures (SCD) and the ability to chew hard food (ACHF) on the one hand and the frailty index (FI) on the other hand among edentulous community‐dwelling older Japanese people. Methods: The study examined 770 edentulous participants of the Nihon University Japanese Longitudinal Study of Aging. The self‐reported FCD, SCD and ability to chew six groups of food (from hardest to softest) with complete dentures were the independent variables at the baseline. The FI was computed including 40 deficits as the dependent variable at the baseline and 4 years later. Cross‐sectional and prospective generalized linear regression models were fitted controlling for age, gender, marital status, education, working status and area of residence. Results: The use of non‐functional complete dentures and dissatisfaction with complete dentures were both associated with a higher FI cross‐sectionally (3.9% [95% CI 2.2–5.6] and 3.2% [95% CI 1.5–4.9], respectively) and prospectively (3.9% [95% CI 2.0–6.0] and 3.3% [95% CI 1.3–5.3], respectively). Regarding the ability to chew, a higher FI at baseline was observed among those able to chew food of Group 2 (1.9%, [95% CI 0.1–3.7]) and Groups 4–6 (1.9%, [95% CI 0.1–3.7]), and a progressive increment in the FI, as the participants reported being able to chew softer groups of food at the follow‐up (Group 2: 2.2% [95% CI 0.05–4.3]; Group 3: 3.6% [95% CI 1.2–6.0]; and Groups 4–6: 3.4 [95% CI 0.7–6.1]). Conclusion: Self‐reported use of non‐functional complete dentures, dissatisfaction with dentures and a reduced ACHF with complete dentures were associated with a higher FI both cross‐sectionally and prospectively. [ABSTRACT FROM AUTHOR]

Objective: This prospective study is part of a randomised clinical trial and reports the changes in masticatory performance (MP) and bite force, and explores their influential factors, 1 year after the provision of mandibular overdentures retained by four titanium–zirconium mini implants. Methods: Edentulous patients received conventional complete dentures, followed by placement of four mini implants (Straumann® Mini Implant System) in the anterior mandible and converting the conventional prosthesis into a mandibular overdenture. Treatment protocols were randomised using a 2×2 factorial design combining different surgical (flapped vs. flapless) and loading (immediate vs. delayed) protocols. MP was assessed using a two‐colour mixing ability test and a colorimetric analysis to measure the level of colour mixing (Variance of Hue–VoH). Maximum voluntary bite force (MBF) was measured by a digital gnathodynamometer in the posterior and anterior regions. Sex, age, surgical and loading protocols and ridge morphology were tested as independent variables. MP and MBF tests were performed at baseline (pre‐treatment) and the 3‐, 6‐ and 12‐month after implant loading. Descriptive statistics, independent t‐test, and linear mixed‐effect model (LMM) regression were used for data analysis. Results: Seventy‐four participants were assessed and 73 completed the 1‐year follow‐up. Statistically significant improvements in functional parameters were observed in all follow‐up periods compared to baseline (p <.001). The flapless protocol was associated with higher improvement in MP at the 3‐month follow‐up (p =.004), while less resorbed ridges were associated with better MP (p =.038) and higher MBF (p <.001). Conclusion: The mandibular overdenture protocol using four titanium–zirconium mini implants was effective in improving MP and MBF of edentulous patients, compared to pre‐treatment values. The findings also suggest that improvements in chewing function and bite force are impacted by clinical factors since better outcomes were observed for flapless surgeries and less resorbed edentulous ridges. CLINICAL TRIAL REGISTRATION: ClinicalTrials.Gov ID NCT04760457. [ABSTRACT FROM AUTHOR]

This case report aims to present the successful restoration of the atrophic partially edentulous posterior mandible using custom-made subperiosteal implants. The fixed prosthesis restoration was achieved using computer-aided design and computer-aided manufacturing technologies and 3D metal printing methods. The partially edentulous 58-year-old patient expressed a preference not to undergo bone augmentation procedures. The patient with teeth in the anterior mandible was treated with 2 separate custom-made subperiosteal implants. A custom-made implant was fabricated from sintered titanium using machined subperiosteal implants with a universal external connection. Subperiosteal implants offer several advantages over conventional bone grafting plus intraosseous implant placement techniques, such as the simple, 1-step procedure for atrophic jaws, streamlining the treatment process and reducing the overall time involved. Treatments using subperiosteal implants can be an alternative solution for individuals with severely atrophic jaws. Longer term studies in a larger sample are warranted to corroborate previous reports. [ABSTRACT FROM AUTHOR]

Most edentulous patients prefer fixed restoration or detachable prostheses over conventional complete dentures. The case report aims to address and discuss the clinical and laboratory steps of implant-supported, bar-retained maxillary overdenture and mandibular implant-supported, metal-acrylic resin, screw-retained, fixed complete denture. Impression techniques and laboratory steps are discussed and demonstrated to minimize the postfabrication or insertion complication. It lets you achieve the passive fit of the prosthesis that maintains the osseointegration by reducing stress on implants and the surrounding bone. [ABSTRACT FROM AUTHOR]

Background: Immediate rehabilitation is a considerable therapeutic challenge but is necessary for edentulous patients with oronasal fistulas, especially those with inadequate residual bone and a history of radiotherapy. Case presentation: We report a rare case of a 63-year-old patient who was missing the majority of his maxillary teeth and who had a defect due to palatal mucoepidermoid carcinoma resection. The patient also received radiotherapy twice within one year postoperatively. An implant-supported prosthesis with an obturator was fabricated immediately. Conclusion: This technique improved patients' oral function, enhanced the aesthetic effect, and increased their confidence. [ABSTRACT FROM AUTHOR]

Thanks to the use of new digital technologies and innovations in materials, there has been an increasing interest in subperiosteal implants. These implants are considered to be helpful for the rehabilitation of severe jaw atrophies, as they overcome some disadvantages of endosseous implantology. In the present clinical retrospective study, 18 patients were treated and the clinical outcomes of the treatment were recorded after 12 months of follow-up. [ABSTRACT FROM AUTHOR]

PURPOSE. The aim of this prospective clinical study was to compare the influence of palatal vault forms on accuracy and speed of intraoral (IO) scans in completely edentulous cases. MATERIALS AND METHODS. Based on the palatal vault form, participants were divided into three equal groups (n = 10 each); Class I: moderate; Class II: deep; Class III: flat palatal vault. A reference model was created for each patient using polyvinylsiloxane impression material. The poured models were digitized using an extraoral scanner. The resultant data were imported as a solid CAD file into 3D analysis software (GOM Inspect 2018; Gom GmbH, Braunschweig, Germany) and aligned using the software's coordinate system to determine its X, Y, and Z axes. Five digital impressions (DIs) of maxilla were captured for each patient using an intraoral scanner (TRIOS; 3Shape A/S, Copenhagen, Denmark) and the resultant Standard Tessellation Language (STL) scan files served as test models. Trueness was evaluated by calculating arithmetic mean deviation (AMD) of the vault area between reference and test files while precision was evaluated by calculating AMD between captured scans to measure repeatability of scan acquisition. The scan time taken for each participant was also recorded. RESULTS. There was no significant difference in trueness and precision among the groups (P = .806 and .950, respectively). Average scan time for Class I and III palatal vaults was 1 min 13 seconds and 1 min 37 seconds, respectively, while class II deep palatal vaults showed the highest scan time of 5 mins. CONCLUSION. Palatal vault form in edentulous cases has an influence on scan time. However, it does not have a substantial impact on the accuracy of the acquired scans. [ABSTRACT FROM AUTHOR]

Background: In older patients with progressive neurodegeneration, replacing fixed implant-supported prostheses (FIP) with implant overdentures (IOD) has been proposed to prevent future mucosal injury and create an oral environment that is easier for caregivers to clean. However, there have been no reports on the progress after replacing FIP with IOD. In this report, we present the progress of an older patient with Parkinson's disease in whom FIP was replaced with IOD. Case presentation: An 81-year-old male patient with Parkinson's disease presented to our outpatient clinic with bruxism and crossbites. FIPs, with five Brånemark system implants, were placed in the bilateral lower molars. The FIP was replaced with an IOD with two locator attachments to create an oral environment that was easier for caregivers to clean and allow easy recovery of masticatory function if residual teeth were fractured in the care environment. As his systemic condition deteriorated, treatment was changed from outpatient to in-home visits. During dental care visits, professional oral cleaning and denture repair were continued, and good nutritional status was maintained. However, the patient developed cholecystitis and was hospitalized. During hospitalization, gastrostomy was performed because he developed aspiration pneumonia. After discharge from the hospital, the patient remained in bed all day and could not wear an IOD, resulting in buccal mucosa ulceration due to abrasion of the locator abutment. We decided to replace the abutment with cover screws; however, not all the implants could sleep submucosally. Although regular oral cleaning was resumed, new ulcers developed even when cover screws were installed. Additionally, swelling and drainage were observed at the peri-implant mucosal site where peri-implantitis had once occurred during an outpatient visit. The patient was readmitted to the hospital for a urinary tract infection, and subsequent visits were abandoned. Conclusions: By replacing FIP with IOD in an older patient with Parkinson's disease, we addressed a barrier to caregiver-provided oral management. The removable prosthesis facilitated smooth oral care by caregivers and functional recovery in the event of trouble with residual teeth. However, it could not completely avoid the recurrence of buccal mucosal ulcers or peri-implantitis. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the amount of distortion using computer-guided implant surgery with 3D printed surgical guides in limited edentulous spaces. Materials and methods: 25 bone level self-tapping implants (Straumann® BL and BLT) were randomly inserted in either distal or intercalary posterior mandibular edentulism using a fully digital protocol and 3D printed surgical guides. Amount of inaccuracy was evaluated after superimposing the 3 coordinates of virtually planned and final implant images, which were obtained using intra-oral scans and scan bodies. Four evaluation parameters were considered: origo-displacement, error depth, apical displacement and angle between the planned and the placed implant. Results: The average of distortion was 0.71 mm for the origo-displacement, 0.36 mm for the error depth, 0.52 mm for the horizontal displacement and 3.34º for the error angle. Conclusion: The major reason of exclusion was CBCT artifacts. Results of this study were aligned with the results of previous studies concerning partially edentulous spaces. CAD/CAM manufacturing process did not result in significant distortion whilst the biggest part of distortions originated from the surgical process. The learning curve in computer-guided implant surgery presented an important source of inaccuracy. Trial registry: This trial is registered to the ClinicalTrials.gov Protocol Registration. Name of the registry: ClinicalTrials.gov Protocol Registration. Trial registration number: NCT06277076. Date of registration: February 17, 2024 Retrospectively registered. URL of trial registry record: https://register.clinicaltrials.gov/NCT06277076. [ABSTRACT FROM AUTHOR]

Occlusal plane determination plays an evident role in successful rehabilitation of completely edentulous patients. The most commonly used method is by using Camper’s plane. But the posterior reference point of Camper’s plane is debatable according to available literature. The aim of this study was to determine the most reliable posterior reference point for Camper’s plane. A cross‑sectional study was conducted, in which 60 dentulous subjects with age ranging from 18 to 25 years were selected according to the inclusion criteria. The Fox plane was inserted and lateral photographs were taken. A screen protractor was used to measure the angle between the occlusal plane and three ala–tragus lines. All three ala–tragus lines had the inferior border of ala of the nose as the anterior point of reference and for posterior reference, they used superior, middle, or inferior point of the tragus. The ala–tragus line using the inferior point of the tragus had the least mean angle with the occlusal plane. One‑way analysis of variance (ANOVA) test obtained a P-value of < 0.0001, and therefore, a statistically significant difference was present among all three lines. Also, post hoc Tukey’s honestly significant difference test for intergroup comparison of difference in angle among three different lines with the occlusal plane showed a significant P-value on comparing all three groups between each other. The ala–tragus line formed using the inferior point of the tragus was most parallel to the occlusal plane in dentate patients. Therefore, the inferior point of the tragus should be used for Camper’s plane. [ABSTRACT FROM AUTHOR]

Objectives: The present study was conducted to evaluate the reproducibility of Lekholm and Zarb classification system (L&Z) for bone quality assessment of edentulous alveolar ridges and to investigate the potential of a data‐driven approach for bone quality classification. Materials and Methods: Twenty‐six expert clinicians were asked to classify 110 CBCT cross‐sections according to L&Z classification (T0). The same evaluation was repeated after one month with the images put in a different order (T1). Intra‐ and inter‐examiner agreement analyses were performed using Cohen's kappa coefficient (CK) and Fleiss' kappa coefficient (FK), respectively. Additionally, radiomic features extraction was performed from 3D edentulous ridge blocks derived from the same 110 CBCTs, and unsupervised clustering using 3 different clustering methods was used to identify patterns in the obtained data. Results: Intra‐examiner agreement between T0 and T1 was weak (CK 0.515). Inter‐examiner agreement at both time points was minimal (FK at T0: 0.273; FK at T1: 0.243). The three different unsupervised clustering methods based on radiomic features aggregated the 110 CBCTs in three groups in the same way. Conclusions: The results showed low agreement among clinicians when using L&Z classification, indicating that the system may not be as reliable as previously thought. The present study suggests the possible application of a reproducible data‐driven approach based on radiomics for the classification of edentulous alveolar ridges, with potential implications for improving clinical outcomes. Further research is needed to determine the clinical significance of these findings and to develop more standardized and accurate methods for assessing bone quality of edentulous alveolar ridges. [ABSTRACT FROM AUTHOR]