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Aim The aim of this prospective study was to determine the influence of vertical soft tissue thickness on bone level changes in platform-switched implants placed eqicrestally or subcrestally and restored with screw-retained or cement-retained restorations. Methods Platform-switched bone-level implants were placed in a single stage manner in the posterior mandibular region. Implant sites were divided into thick (control) and thin (test) vertical soft tissue groups. The implants in the control group were placed equicrestally. The implant sites from the control group were randomly allocated to receive equicrestally or subcrestally placed implants. Bone remodeling/loss was radiographically measured at baseline, three months postoperatively and six months after delivery of final prosthetic restoration. Results The mean crestal bone loss values three months postoperatively and six months post prosthetic restoration were higher in sites with thin versus sites with thick gingiva. In implant sites with thin gingiva, subcrestally placed implants presented less bone loss than eqicrestally placed implants. Conclusion Platform switched implants are prone to more bone loss when they are placed in sites with thin soft tissue, regardless of the type of final restoration (screw-retained or cement-retained). Subcrestal placement of platform-switched implants can prevent crestal bone loss in sites with vertical soft tissue thickness < 3 mm.

Objectives: The purpose of our study is to retrospectively analyze and compare the patterns of maxillofacial-related injuries among rides of electric-powered bikes (E-bikes) and electric-powered scooters (E-scooters), the associated risk factors, and the required treatment. Materials and methods: The medical files of all riders presenting to the emergency department at the Tel Aviv Sourasky Medical Center between 2019 and 2020 with oral- and maxillofacial-related injuries due to E-bike and E-scooter accidents were reviewed. Results: A total of 320 riders sustained oral- and maxillofacial-related injuries due to trauma involving E-bikes and E-scooters during the study period. E-scooter riders were involved in 238 accidents (74.5%) while E-bike riders accounted for the remaining 82 accidents (27.5%). Eighty-four out of 320 riders (26.25%) were hospitalized and required surgical interventions. Most of the 232 riders (72.5%) who reported not wearing a protective helmet during the index accident were E-scooter riders. In addition, 39 riders (18.66%) were riding either of these electric-powered vehicles under the influence of alcohol. Conclusions: E-bike riders are more likely to sustain a maxillofacial fracture than E-scooter riders. Not wearing a protective helmet and riding under the influence of alcohol are major risk factors for maxillofacial injuries.

Aim: The current paper aims to review mandibular flexure and its clinical implications in the field of oral rehabilitation. Mandibular flexure is a deformity of the mandible, which occurs during jaw movements. Methods and Materials: An electronic database search was conducted using the PRISM model, with a total of 49 articles included. Results: Mandibular flexure affects various stages of oral rehabilitation treatments. Effects of mandibular flexure are more significant in periodontal patients, and in implant-supported restorations, compared to natural teeth, due to differences in the force absorption by the periodontal ligament. Various adjustments must be made to the prosthodontic framework to enable long-term survival of the restorative treatments. Conclusions: Dental practitioners should pay attention to the following: (1) digital impressions are preferred over conventional; (2) mouth opening should be kept to a minimum (as possible, up to 10–20 mm) while also avoiding any anterior movements of the mandible (protrusion); (3) the number of abutment teeth should be kept to a minimum; (4) structures in the lower jaw should be splitted; (5) non-rigid connectors should be used to reduce the effort exerted; (6) in periodontal patients, the preference is for short-span restorations and non-rigid connectors; (7) in implant-supported restorations, it is preferable to divide the framework into two or three segments, utilizing rigid materials with a low elastic modulus. There is no agreement in the literature about the preferred location of the implants in the jaw.

Objectives Zygomatic complex (ZMC) fractures comprise up to 40% of all facial fractures. Misaligned bone fragments and misplaced fixation hardware traditionally detected postoperatively on plain radiographs of the skull might require re-operation. The intraoperative O-Arm (Medtronic, USA) is a three-dimensional (3D) computed tomographic imaging system. Materials and Methods This retrospective single-center study evaluated the utility of O-Arm scanning during corrective surgeries for ZMC and zygomatic arch (ZA) fractures from 2018 to 2020. Three females and 16 males (mean age, 31.52 years; range, 22-48 years) were included. Fracture instability (n=6) and facial deformity (n=15) were the most frequent indications for intraoperative 3D O-Arm scan. Results The images demonstrated that all fracture lines were properly reduced and fixed. Another scan performed at the end of the fixation or reduction stage, however, revealed suboptimal results in five of the 19 cases, and further reduction and fixation of the fracture lines were required. Conclusion Implementation of an intraoperative O-Arm system in ZMC and ZA fracture surgeries assists in obtaining predictable and accurate results and obviates the need for revision surgeries. The device should be considered for precise operations such as ZMC fracture repairs.

The color is a major factor in determining inflammation status in most gingival indices. Current indices have limitations mainly due to subjective nature. Digital color analysis can provide objective and accurate measurements. Thus, the present study aimed to assess by digital tool the gingival color in the different stages of an active periodontal treatment.Forty patients (19 males and 21 females) diagnosed with periodontitis (stage III/ IV, grade C) and treated surgically were included in the study. Clinical data (probing depth, bleeding on probing, clinical attachment level, gingival index, and gingival recession) and photographs by digital single-lens-reflex (DSLR) camera were recorded before initial periodontal treatment, which included scaling and root surface debridement (T0); the same parameters were then re-evaluated 6-8 weeks (T1) and 3 months after periodontal surgery (regenerative/resective) (T2). Differences between clinical parameters were calculated. The color space defined by the International Commission on Illumination (CIELab) was used to analyze gingival color.In 56 periodontal surgical sites, 168 photographs were taken. The a*-value of the CIELab color system (higher a*- value translate to a stronger red color) was significantly reduced between T0 to T1 and further decreased at T2 (32.01, 29.28, and 27.45 respectively). Significant improvement in clinical parameters were found between T0 to T1 and T1 to T2. Sub-analysis of two distinct surgical interventions revealed that only regenerative procedure improved the a*-value, which was significantly correlated with pocket depth reduction.Photometric analysis can be used to assess gingival color change during periodontal treatment of patients with periodontitis.Gingival inflammation is a major factor in periodontal assessment; nevertheless, all current gingival inflammation indices are partially subjective and only semi-quantitative. The digital photometric analysis may allow for accurate and objective gingival color assessment during periodontal treatment.

AIMS To examine the associations of self-reported presence of tinnitus with subtypes of temporomandibular disorders (TMD) as assessed by Axis I of the Diagnostic Criteria for TMD (DC/TMD) and with psychologic characteristics as assessed by Axis II. METHODS This retrospective controlled study included 108 consecutive TMD patients referred to the Tel Aviv University Orofacial Pain Clinic. Each patient received full Axis I and Axis II diagnoses according to the DC/TMD. The patients were asked about currently experiencing tinnitus. Pearson chi-square test and Fisher exact test were used to test the associations between categorical variables. Mann-Whitney test was used to assess differences in continuous variables between categories. A P value < .05 was considered statistically significant. RESULTS Thirty-three (30.6%) TMD patients reported experiencing tinnitus. There was a significantly higher prevalence of myofascial pain with referral (P = .008) and nonspecific physical symptoms (P = .014) among the TMD patients who reported tinnitus. In addition, those patients reported significantly longer pain duration compared to TMD patients without tinnitus (P = .039). CONCLUSION This study emphasizes the necessity of assessing both Axes I and II according to the DC/TMD in future studies and supports creating a standardized tinnitus screener tailored to TMD patients for future studies on tinnitus in TMD patients.

Introduction Dental trauma and congenital anodontia are common causes of anodontia in the anterior maxilla. The proposed restorative treatment constitutes a challenge for many dentists, particularly if it is a question of a young patient who has not yet completed skeletal and dental development. Current treatments for anterior maxillary anodontia include: fixed or removable partial dentures; orthodontic closure of interdental spaces; and dental implants. Dental implants do not move with the dento-alveolar complex during the growth period of the maxilla. Therefore, many researchers maintain that implants should be postponed until after adolescence, in order to prevent complications, such as infra-occlusion, that would require the replacement of the abutment and crown-implant restoration, or even invasive treatments, such as the removal of the implant in the future. The objective of this literature review is to investigate the aetiology of the phenomenon, and outcome. Results Continuous tooth eruption is not affected by age, so considerable changes may occur due to eruption of adjacent teeth. In addition, both women and men are affected by this phenomenon and, usually, there is no significant difference in the amount of growth between the short face and the long face. Conclusion It can be concluded that continuous facial skeletal growth and teeth eruption are evident in the second and third decades. Where possible, it is advisable to delay placement of an anterior maxillary implant in the adolescent patient.

Background: All-on-four protocols with tilted implants in the maxilla are used to rehabilitate the terminal dentition of the severe generalized periodontitis patients. Data on long-term biological complications are scarce. Methods: Eighty-four axial and forty-six tilted immediate implants have been placed in the extraction sockets of 23 patients according to a four–six implants protocol combined with ridge augmentation. Within 72 h, a provisional prosthesis was cemented to the implants; after 6 months, a cemented ceramic–metallic prosthesis was delivered. The patients were followed for up to 5 years. Results: The 5-year survival rate of the straight and tilted implants was 100% and 97.8, and the prosthetic one was 100%. Marginal bone loss (MBL) of the straight implants was 0.42 ± 0.67 and 0.59 ±1.01 mm on the mesial and distal sides; for the tilted, it was 0.37 ± 0.68 and 0.34 ±0.62 mm, and the differences were not statistically significant. Implant position, smoking, keratinized mucosal width, and cantilever did not affect MBL. Peri-implant mucositis involved 29.4% and 22.2% of the straight and tilted implants, respectively; peri-implantitis involved 5.8% and 4.4% of the straight and tilted implants, respectively, without statistical significance. Conclusions: This immediate loading protocol’s 5-year survival and success rates were high. No difference between the straight and tilted implants was found regarding survival, success rates, and MBL.

Background: In more than three decades of work of the Retrieval Bank of the Laboratory for Undemineralized Hard Tissue Histology of the University of Chieti-Pescara in Italy, many types of biomaterials were received and evaluated. The present retrospective review aimed to evaluate the histological and biological aspects of the evaluated bone substitute biomaterials. Methods: In the present study, the authors prepared a retrospective analysis after the screening of some databases (PubMed, Scopus, and EMBASE) to find papers published from the Retrieval Bank of the Laboratory for Undermineralized Hard Tissue Histology of the University of Chieti-Pescara analyzing only the papers dealing with bone substitute biomaterials and scaffolds, in the form of granules and block grafts, for bone regeneration procedures. Results: Fifty-two articles were found, including in vitro, in vivo, and clinical studies of different biomaterials. These articles were evaluated and organized in tables for a better understanding. Conclusions: Over three decades of studies have made it possible to assess the quality of many bone substitute biomaterials, helping to improve the physicochemical and biological properties of the biomaterials used in daily clinical practice.

Objectives: Repeated abutment disconnection/reconnection may compromise the mucosal barrier and result in crestal bone level changes. The clinical significance of this phenomenon is not yet clear, as most studies on this topic are short-term. Therefore, the aim of the present study was to evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss over a medium-term follow-up period. Material and methods: Twenty-one patients (6 men and 15 women) with a mean age 66.23 ± 9.35 year at the time of implant placement were included. All patients who received two adjacent nonsubmerged implants were randomly assigned into one of the two groups: definitive multiunit abutments (DEFs) connected to the implant that were not removed (test group) or healing abutments (HEAs) placed at surgery, which were disconnected and reconnected 3–5 times during the prosthetic phase (control group). Peri-implant marginal bone levels (MBL) were measured through periapical X-rays images acquired immediately after the surgery (baseline), at 4–7 months immediately after prosthetic delivery, and at 1-year and 3-year follow-up visits. Results: No implant was lost or presented bone loss of more than 1.9 mm during the 3-year follow-up; thus, the survival and success rate was 100%. Peri-implant mucositis was noticed in 38.1% DEFs and 41.9% of HEAs at the 3-year follow-up assessment. At the end of 3 years, the MBL was −0.35 ± 0.69 mm for participants in the DEFs group and −0.57 ± 0.80 mm for the HEAs group, with significant statistical difference between groups. Conclusions: Immediate connection of the multiunit abutments reduced bone loss in comparison with 3–5 disconnections noted in the healing abutments 3 years after prosthetic delivery. However, the difference between the groups was minimal; thus, the clinical relevance of those results is doubtful.

This case series aimed to assess the feasibility of a custom-made decompression appliance fabricated using a digital workflow to decompress odontogenic cysts. Additionally, the treated cysts were assessed for volumetric changes.A three-dimensional (3D) reconstruction software (CoDiagnostiX version 10.4) was used to obtain the master cast STL (Standard Tessellation Language) file by placing a customized virtual implant to create a recess for the tube of the decompression device. The decompression appliance was planned using Dental Wings Open Software (DWOS). Following rapid prototyping, the tube of the appliance was perforated using round burs. In cases where the appliances were designed to replace teeth, denture teeth were added using the conventional workflow. The appliances were delivered on the day of the cystostomy. Following decompression, cyst enucleation was performed. Cyst volume was assessed by manual segmentation of pre- and post-operative cone-beam computed tomography (CBCT) reconstructions using slice-by-slice boundary drawing with a scissors tool in the 3DSlicer 4.10.2 software. Percentage of volume reduction was calculated as follows: volume reduction/pre-operative volume × 100.Six odontogenic cysts in six patients (5 male, 1 female; age 40 years, range: 15-49 years) with a pre- and post-operative cyst volume of 5597 ± 3983 mmsup3/supand 2330 ± 1860 mmsup3/suprespectively (plt; 0.05) were treated. Percentage of volume reduction was 58.84 ± 13.22 % following a 6-month-long decompression period.The digital workflow described in this case series enables the delivery of decompression appliances at the time of cystostomy, thus effectively reducing the volume of odontogenic cysts. The resulting bone formation established a safe zone around the anatomical landmarks; therefore, during enucleation surgery, complications to these landmarks can be avoided.

Aim: Long-term studies addressing the outcomes of single immediate implantation and provisionalization at the maxillary esthetic zone are needed. The current study aimed to assess such outcomes along a follow-up period of up to 18 years. Materials and methods: The current study is a continuation follow-up of our previously published up to 6-year follow-up study, dated between the years 2002–2008, performed in a private clinical practice in Tel-Aviv, Israel. A total of 15 patients (23 implants) who had been treated for single-tooth replacement at the maxillary esthetic zone since 2002, underwent clinical and radiographic follow-up evaluations. Primary outcomes included mean Marginal Bone Levels (MBL), with Bleeding on Probing (BOP), implant success rate, prosthetic and esthetic complications evaluated as secondary outcomes. Results: The implant success rate was at 100%. Bone remodeling processes were observed over the follow-up period, with 0.9 mm mean marginal bone loss observed during the first 6 years of observation, followed by −0.13 ± 0.06 mm mean loss after 6 to 18 years. The last finding suggests bone deposition, as reported by other studies (Donati et al., 2012). At the final radiographic evaluation, a mean MBL of 1.35 mm ± 0.16 was demonstrated. No differences with respect to implant type or site were found. A generalized absence of BOP and esthetic complications occurred in two cases as a result of continuous adjacent teeth eruption versus obvious implant ankylosis. Conclusions: Adhering to careful clinical protocols and 3D bone to implant considerations while immediately placing an anterior implant, this treatment approach offers both stable and esthetically acceptable results for the replacement of missing teeth at the maxillary esthetic zone.

UV photofunctionalization of Zirconia-based materials for abutment fabrication is a promising approach that might influence the formation of a sound peri-implant seal, thus promoting long-term soft and hard tissue implant integration. This study aimed to evaluate the effect of UV treatment of test specimens made by two different ZnO2-based ceramic materials on the hydrophilicity, cell cytotoxicity, and proliferation of human gingival fibroblasts (HGFs). Two Zirconia-based materials, high-translucent and ultra-translucent multi-layered Zirconia (Katana, Kuraray Noritake, Japan), were used to prepare a total of 40 specimens distributed in two equally sized groups based on the material (n = 20). The same surface finishing protocol was applied for all specimens, as suggested by the manufacturer. Half the specimens from each group were treated with UV-C light for 48 h. Water contact angle (WCA), fibroblast cytotoxicity, and proliferation were investigated. The WCA values for the high-translucent Zirconia ranged from 69.9° ± 6.4° to 73.7° ± 13.9° for the treated/non-treated specimens and from 79.5° ± 12.8° to 83.4° ± 11.4° for the ultra-translucent multi-layered Zirconia, respectively. However, the difference was insignificant (F(16) = 3.50, p = 0.292). No significant difference was observed for the fibroblast cytotoxicity test. The results for proliferation revealed a significant difference, which was material-dependent (F(8) = 9.58, p = 0.005). We found that UV surface photofunctionalization of ZrO2-based materials alters the human gingival fibroblast cell viability, which might produce favourable results for cell proliferation.

The purpose of this study is to evaluate mandibular osteotomy procedures during orthognathic surgery, with an emphasis on the complications of the two leading procedures: intraoral vertical ramus osteotomy (IVRO) and sagittal split osteotomy (SSO). We conducted a retrospective cohort study by extracting the records of patients who underwent either IVRO or SSO procedures during orthognathic surgery in a single center between January 2010 and December 2019. A total of 144 patients were included (median age of 20.5 years, 52 males). The IVRO:SSO ratio was 118:26 procedures. When referring to all surgeries performed, IVRO procedures were associated with shorter hospitalization than the SSO procedures, while the overall durations of surgery and follow-up periods were comparable. In contrast, when referring only to bimaxillary procedures, the duration of the IVRO bimaxillary procedures was significantly shorter than the SSO bimaxillary procedures. There were 53 complications altogether. Postoperative complications consisting of skeletal relapse, temporomandibular joint dysfunction, sensory impairment, and surgical-site infection were significantly fewer in the IVRO group. Both types of osteotomies have acceptable rates of complications. IVRO appears to be a safer, simpler, though less acceptable procedure in terms of patient compliance.

The aim of the present clinical study was to assess and compare the histomorphometric results and efficacy of freeze-dried bone allograft (FDBA) in combination with platelet-rich fibrin (PRF), and PRF as a sole grafting material for socket preservation. Ninety patients in need of tooth extraction and implant restoration were included in this study. The participants were randomly divided into three groups based on post-extraction clinical protocol: socket preservation procedure with allograft in combination with a PRF membrane (PRFm), PRF as a sole grafting material, and a control group. A total of 90 implants were placed four months post-extraction. During the surgical re-entry a bone biopsy was harvested with a trephine drill. Histological samples were prepared and analyzed for percentage vital bone and connective tissue. One-way ANOVA with Bonferroni post-hoc analysis were used to assess the results. Both test groups revealed a significantly higher percentage of vital bone formation compared to the control group. No statistically significant differences regarding vital bone formation and connective tissue quantity between the tested groups were observed (FDBA + PRFm: 3.29 ± 13.03%, and PRF: 60.79 ± 9.72%). From a clinical and histological point of view, both materials in the test groups are suitable for the filling of post-extraction sockets without bone defects. Both of the tested groups revealed a significantly higher percentage of vital bone formation compared to the control group.

Aim: The current study aims to assess levels of knowledge among Israeli dentists about rare diseases with orofacial manifestations, and whether occupational, regional and social factors influence those levels. Materials and Methods: A total of 309 Israeli dentists participated in an online survey that provided basic demographic information pertaining to their knowledge about rare diseases, their clinical experience with rare diseases, what further information they considered necessary, and which sources of information they most frequently utilize. Results: Young age, country of dental education, practicing in both public and private settings, as well as the number of hours allocated to dental studies and the opportunity to acquire information on rare diseases with orofacial manifestations, all seem to affect the level of knowledge. Conclusions: Developments in the field of rare disease are constantly ongoing, and improvements in post-graduate dental studies about them should keep pace. The results of the current study reveal the areas upon which such curricula should focus with respect to dental practitioners.

Background "SOS teeth" are teeth that need to be treated first, and represent dental teeth with deep caries seen clinically and radiographically which may require root canal treatment or extraction. The aims of the present research were to study the associations of SOS teeth with: socio-demographic parameters, dental attendance patterns, health-related habits among young to middle-aged adults. Methods This cross-sectional records-based research analyzed data from the Dental, Oral, Medical Epidemiological (DOME) repository that captures comprehensive socio-demographic, medical, and dental databases of a nationwide sample of 132,529 records of dental attendees to military dental clinics for 1 year aged 18 to 50 years. Results SOS teeth had a significant positive association in the multivariate analysis with male sex [OR 1.137, 95% Confidence Interval (CI): 1.079–1.199], rural versus urban Jewish locality [OR 1.748 (1.082–2.825)], and consumption of sweetened beverages [OR 1.415 (1.337–1.496)]. SOS teeth retained significant negative associations (protective parameter) with academic [OR 0.647 (0.592–0.708)] and technicians (OR 0.616 (0.556–0.682)] compared to high school education, high [OR 0.437 (0.401–0.476)], and medium (OR 0.648 (0.598–0.702)] versus low socio-economic status, urban non-Jewish versus urban Jewish locality [OR 0.746 (0.693–0.802)], Asia (OR 0.658 (0.452–0.959)], North America (OR 0.539 (0.442–0.658)] and Israel [OR 0.735 (0.686–0.788)] versus western Europe birth countries. Conclusions Health authorities should be familiar with this profile of the patient who is vulnerable to SOS teeth and formulate policies and allow the appropriate implementation of strategies in those in high-risk populations.

Background: This study aims to evaluate whether there is a correlation between implant stability, bone density, vital bone formation and implant diameter and length. Methods: Ninety patients were enrolled in this study. They underwent a socket preservation procedure with allograft or PRF and after 4 months, a total of 90 implants were placed. CBCT scans were assigned prior to implant placement in order to assess the bone density. During the surgical re-entry, a bone biopsy was harvested with a trephine drill. Immediately after implant insertion, the primary stability was measured. The secondary stability was measured 4 months after implant placement. Results: Primary stability showed a significant positive linear correlation with bone density (r = 0.471, p &lt, 0.001) as well as with percentage of new bone formation (r = 0.567, p &lt, 0.001). An average significant association of secondary stability with bone density (rs = 0.498, p &lt, 0.001) and percentage of newly formed bone (r = 0.477, p &lt, 0.001) was revealed. The mean values of primary stability in all three implant sizes, regarding the diameter of the implants, were similar (narrow 67.75, standard 66.78, wide 71.21) with no significant difference (p = 0.262). The same tendency was observed for secondary stability (narrow 73.83, standard 75.25, wide 74.93), with no significant difference (p = 0.277). Conclusions: The study revealed a high correlation between primary and secondary implant stability, and bone density, as well as with the percentage of vital bone formation. Implant length and diameter revealed no linear correlation with the implant stability.

In recent years, dental malpractice claims have increased dramatically worldwide. The present study aimed to categorise and analyse claims related to implant dentistry that resulted in legal decisions in Israel, seeking to contribute to dental risk management and improve patient safety.This study analysed legal claims registered by Medical Consultants International between 2005 and 2015. Only closed cases in which a decision was made were included. The parameters studied included patient age and sex, date of the complaint, treatment setting (private/public clinic), description of the adverse event and type of negligence claimed.The cohort included 709 settled claims out of a total of 1066 that were litigated against dental practitioners in Israel during the study period. Of the patients included, 60.0% were women and 63.9% were aged 40 to 59 years. The most common treatment-related damage was neural injury in 133 patients (18.7% of the cohort). Unplanned changes in the treatment plan and violation of autonomy were the most frequent documentation-/information-related claims (66.3% and 32.7%, respectively). The legal responsibility of the dental practitioner was acknowledged in 89.0% of cases. Dental practitioners working in the private sector were more likely to be sued due to violation of autonomy than those working in public clinics.Although the main cause for lawsuits was actual bodily injury, the high percentage of documentation-/information-related malpractice claims calls for increased awareness of patients' autonomy and rights. Practitioners should dedicate a significant part of the entire treatment time to preoperative diagnosis and planning.

In January 2021, Israel started vaccinating healthcare workers (HCWs) and individuals older than 65 years with COVID-19 vaccines. Scientific literature points to vaccine hesitancy as being a major health concern. During time of pandemics, increased consciousness of health behaviors may be encountered. The current study aimed to assess attitudes to general vaccines and to COVID-19 vaccines in particular among adult (&gt, 18) Israeli general public, and among Israeli dentists and dental hygienists. Cross-sectional surveys were filled out by a total of 501 participants (361 Israeli adults &gt, 18 years, 73 dental hygienists, and 67 dentists). Along with basic demographics, participants responded to the Hebrew VAX, COVID-VAX and HCS scales. Group comparisons were analyzed using t tests and ANOVAs with Scheffe’s test used for post hoc comparisons. Dental hygienists demonstrated significantly higher anti-vaccinations approaches than both dentists (p &lt, 0.01) and the general public (p &lt, 0.05). In all groups, attitudes towards the COVID-19 vaccines were more negative compared to attitudes towards general vaccines, with hygienists demonstrating significant negative attitudes compared to dentists (p &lt, 0.05). The general public (p = 0.56) and hygienists demonstrated increased health awareness compared to dentists (p &lt, 0.05). As health awareness has increased during the COVID-19 pandemic primary strategies to combat vaccine hesitancy should be implemented in the general public, and in particular, an dental teams.

Background: In recent years, worldwide dental malpractice claims have dramatically increased. The purpose of the present study is to analyze periodontal therapy related claims in Israel that led to legal decisions. Methods: This retrospective cohort study includes malpractice claims against dental practitioners related to periodontology between 2005 and 2019. Only closed cases where a final decision was made were included. The chi-square test or Fisher exact test for categorical variables were performed and a p value of &lt, 0.05 was considered statistically significant. Results: During the study period there were 508 legal claims related to periodontal disease. Most plaintiffs were women (63.4%), and 71.3% of the patients were &gt, 35 years old. Most claims (82.8%) were settled out of court and ended in compromise. Claims concerning the treatment of periodontal disease by periodontists accounted only for 4.5% (23/508) of the cases while 95.5% (485/508) of the claims were for complications secondary to another treatment. Prosthodontic treatment was involved with the highest number 54.5%, followed by dental implants 17.7%, and endodontics 11.6%. The allegations were related to pain and distress (84.8%), aggravation of existent periodontal disease (83.3%), tooth loss (78.1%), and violation of autonomy (47%). Conclusions: The main cause for lawsuits was related to aggravation of periodontal disease during prosthetic or implant therapy and related to suspected faulty or inexistent preoperative diagnosis and planning. Practical implications: Periodontal consultation before dental treatment may reduce malpractice risks, adverse events, and un-necessary changes of treatment plans.

Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician’s choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.

Both types of surgical guides – with and without metal sleeves are founded beneficial in clinical studies. The aim of this in vitro study was to compare time of surgical procedure in dental implantology depending of used type of the surgical guide. Ten three dimensional (3D) printed models of lower jaws were prepared based on complete virtual model of patient clinical conditions with missing teeth 37, 46 and 47. Five of this models were used for implant sites preparation performed with use of surgical guide without metal sleeves and dedicated surgical kit, and next five were used for the same procedure performed with surgical guide with metal sleeves and dedicated surgical kit. Time of implant site preparation were measured and noted. Statistical analysis was performed using Student’s t test for independent samples. Difference of time in both groups were founded as statistically significant (t=-9.94; df =28; p=0.0000). Type of surgical guide is important factor which can impact on time of implant site preparation and all surgical procedure.

The aim of our randomized clinical study was to analyze the influence of surgical experience and bone density on the accuracy of static computer-assisted implant surgery (CAIS) in edentulous jaws using a mucosa-supported surgical template with a half-guided implant placement protocol. Altogether, 40 dental implants were placed in the edentulous jaws of 13 patients (novice surgeons: 18 implants, 6 patients (4 male), age 71 &plusmn, 10.1 years, experienced surgeons: 22 implants, 7 patients (4 male), age 69.2 &plusmn, 4.55 years). Angular deviation, coronal and apical global deviation and grey level measurements were calculated for all implants by a blinded investigator using coDiagnostiX software. 3DSlicer software was applied to calculate the bone volume fraction (BV/TV) for each site of implant placement. There were no statistically significant differences between the two study groups in either of the primary outcome variables. There was a statistically significant negative correlation between angular deviation and both grey level measurements (R-value: &minus, 0.331, p &lt, 0.05) and BV/TV (R-value: &minus, 0.377, p &lt, 0.05). The results of the study suggest that surgical experience did not influence the accuracy of implant placement. The higher the bone density at the sites of implant placement, the higher the accuracy of static CAIS.

&ldquo, SOS teeth&rdquo, are defined as the first priority teeth for treatment, that have distinct cavitation reaching the pulp chamber or only root fragments are present. These are teeth with severe morbidity, that may require pulp capping, root canal treatment, or extraction, and therefore should be treated first. The study aims to explore whether or not a metabolic syndrome (MetS) is associated with SOS teeth. To that end, we performed across-sectional records-based study of a nationally representative sample of 132,529 military personnel aged 18&ndash, 50 years, who attended the military dental clinics for one year. The mean number of SOS had no statistically significant association with: smoking (p = 0.858), alcohol consumption (p = 0.878), hypertension (p = 0.429), diabetes mellitus (p = 0.866), impaired glucose tolerance (p = 0.909), hyperlipidemia (p = 0.246), ischemic heart disease (p = 0.694), S/P myocardial infarction (p = 0.957), obstructive sleep apnea (p = 0.395), fatty liver (p = 0.074), S/P stroke (p = 0.589), and S/P transient ischemic attack (p = 0.095) and with parental history of: diabetes (p = 0.396)], cardiovascular disease (p = 0.360), stroke (p = 0.368), and sudden death (p = 0.063) as well as with any of the medical auxiliary examinations (p &gt, 0.05). Cariogenic diet was positively associated with SOS teeth (p &lt, 0.001). We conclude that SOS teeth had no statistically significant association with MetS components or with conditions that are consequences or associated with MetS. The only statistically significant parameter was a cariogenic diet, a well-known risk factor for caries and MetS.

This study was conducted to test possibilities of application of 3D printed dental models (DMs) in terms of their accuracy and physical properties. In this work, stone models of mandibles were cast from alginate impressions of 10 patients and scanned in order to obtain 3D printed acrylic replicas. The diagnostic value was tested as matching of model scans on three levels: peak of cusps, occlusal surface, and all teeth surfaces. The mechanical properties of acrylic and stone samples, specifically the impact strength, shore D hardness, and flexural and compressive strength were investigated according to ISO standards. The matching of models&rsquo, surfaces was the highest on the level of peaks of cusps (average lack of deviations, 0.21 mm) and the lowest on the level of all teeth surfaces (average lack of deviations, 0.64 mm). Acrylic samples subjected to mechanical testing, as expected, showed higher mechanical properties as compared to the specimens made of dental stone. In the present study we demonstrated that 3D printed acrylic models could be ideal representatives in the case of use as a diagnostic tool and as a part of medical records. The acrylic samples exhibited not only higher mechanical properties, but also showed better accuracy comparing to dental stone.

Repeatability and precision are major factors which have an influence on final implant treatment results. The aim of this study was to evaluate the repeatability of freehand implant procedures assisted with special plastic sleeves which are placed on the drill to guarantee the proper mesiodistal distance from the landmark&rsquo, s surface. Patient data required for implant treatment, including images of mandibles from CBCT scans and virtual models of soft tissues and teeth, were used to prepare complete virtual models of patient clinical conditions. The models were saved as STL files and 3D printed in five copies. Drilling procedures were done at positions 37, 46 and 47. Each model was scanned with pins in the osteotomies and compared using digital aligning of the models&rsquo, surfaces. The average deviation was &minus, 1.38 &plusmn, 1.4 mm. Average deviations on guide pins placed at position 37 were &minus, 0.46 &plusmn, 0.59 mm, at position 46 were &minus, 1.46 &plusmn, 0.88 mm (landmark&rsquo, s surface of both: distal tooth&rsquo, s surface), and at position 47 were the highest: &minus, 2.69 &plusmn, 1.62 mm (landmark&rsquo, s surface: surface of plastic sleeve). The following conclusion was drawn: Using universal plastic sleeves could improve implant procedure precision especially in the case of partially edentulous patients.

The aim of this study was to evaluate the association of COVID-19 factors and psychological factors with psychological distress among dental staff during the COVID-19 pandemic outbreak. A cross-sectional survey was conducted among 338 Israeli dentists and dental hygienists, who provided their demographic data, answered questions about COVID-19-related factors, and were assessed by subjective overload, self-efficacy, and psychological distress scales. Data were analyzed using a multivariate logistic regression. Results revealed that elevated psychological distress was found among those who have background illness, fear of contracting COVID-19 from patient, and a higher subjective overload. Lower psychological distress was associated with being in a committed relationship and having higher scores for self-efficacy. Given these results, gathered during times of an infectious disease outbreak, exploring psychological distress among dental staff is warranted as the effects may be long-term.