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The closure of oroantral communications (OACs) is challenging. The study aimed to assess the effect of titanium meshes in the outcome of OAC closure by local flaps. This is a prospective randomized, nonblinded clinical trial. Patients with a delay and large (≥7 mm 2 ) OAC were studied. Patients were randomly divided into 2 groups: in group 1, patients underwent OAC closure through a modified Rehrmann buccal advancement flap with a titanium mesh, and in group 2, the modified Rehrmann buccal advancement flap. The primary predictive factor was the use of titanium mesh. Dehiscence (the breakdown of the edge of flaps without the complete reopening of the defect) was a primary outcome. The defect's reopening was considered a secondary outcome. Nineteen patients in group 1 and 20 in group 2 were studied. In 2 months after treatments, the prevalence of dehiscence in group 1 was 3, and 10 patients in group 2 ( P =0.041). In group 1, patients did not show OAC exposure. However, OAC exposure was observed in 2 patients in group 2. This study demonstrates that using titanium mesh in combination with a modified Rehman flap decreases the prevalence of dehiscence compared with a flap alone., (Copyright © 2023 by Mutaz B. Habal, MD.)

Background/purpose: The use of dental implants in restoring function, esthetics, speech, and health of oral tissues has been growing in recent years. Evaluating marginal bone resorption and the survival rate of implants placed with different torques values is crucial. The primary aim of the present study was to evaluate the effect of different insertion torque values on marginal bone loss around dental implants placed in the posterior region of the mandible., Materials and Methods: 37 patients were involved in this study. Patient data (age, gender), implant characteristics (length, diameter), insertion torque values, gingival biotype, and bone quality were recorded, and parallel periapical radiographs measured marginal bone loss. The relationship between variables was obtained using independent t-tests, Pearson correlations, and regressions., Results: The present study found a positive and significant correlation between implant insertion torque and marginal bone loss (MBL)around the dental implants during the first year after placement. Furthermore, patients with D2 bone density at the implant placement site and thin gingival biotype also had significantly higher MBLs from baseline until crown delivery and first-year follow-up than those with D3 bone density and thick gingival biotypes, respectively., Conclusion: A lower torque is necessary for high-risk patients to increase implantation success due to identifying patients with an increased risk for MBL., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Rehabilitation of an edentulous posterior maxilla with dental implants is challenging, and sinus floor augmentation could be considered as an important surgical procedure for bone augmentation in this region before implant placement. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with simplified processing: its application in sinus floor augmentation has been widely investigated in literature. However, the biological properties and actual efficacy of this product remain controversial. This study assessed the effect of sinus floor augmentation with PRF versus freeze-dried bone allograft (FDBA) on stability of one-stage dental implants. This split-mouth randomized clinical trial evaluated 10 patients who required bilateral sinus floor augmentation. PRF and L-PRF membrane were used in one quadrant while FDBA and collagen membrane were used in the other quadrant. Implant stability was assessed by resonance frequency analysis (RFA) immediately, and 2, 4, and 6 months after implant placement. The implant stability quotient (ISQ) was compared over time and between the two groups using repeated measures ANOVA and independent sample t-test. The mean ISQ significantly increased over time in both groups (p < 0.001). The increase was greater in the PRF group (p < 0.05). Within the limitations of this study, PRF yielded superior results compared with FDBA regarding the stability of one-stage dental implants.

Summery: This study aimed to compare the rate of post-surgical infection following single-dose antibiotic prophylaxis with or without post-surgical antibiotics versus post-surgical administration of antibiotics alone. The study consisted of three groups; Group 1 received single-dose antibiotic prophylaxis orally (2 g amoxicillin 1 h before surgery). Group 2 received one dose of prophylactic antibiotic (2 g amoxicillin 1 h before surgery) with additional doses after surgery (500 mg amoxicillin, q8h for 5 days). Group 3 received post-surgical antibiotics alone (500 mg amoxicillin, q8h for 5 days). 450 patients were enrolled. Post-surgical infection was seen in 9 patients of group 1, 11 patients of group 2, and 7 patients of group 3. There was no significant difference in the rate of postoperative infection among the study groups (p value = 0.62). The number of failed implants was 2 in group 2, and 1 in group 3. Subgroup analysis showed no significant difference in infection rates among the three groups regarding concomitant guided bone regeneration. However, there was a significant difference in the rate of post-surgical infection between smokers and non-smokers (p < 0.001). Within the limitations of the study, it seems that a single preoperative dose of antibiotics is sufficient for reducing surgical site infections, adequately and should be preferred after implant placement whenever appropriate., (Copyright © 2022 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Purpose: Cessation versus continuation of antiplatelet drugs in patients undergoing dental implant surgery is a controversial issue. The present study evaluated postoperative bleeding during and after dental implant surgery in patients taking aspirin (ASA) or clopidogrel., Material and Methods: The present study is a case-and-crossover study. Patients who were using antiplatelet drugs and receiving 2 bilateral dental implants in the posterior region of the mandible were studied. During session 1, dental implants were placed without stopping the intake of antiplatelet drugs. During session 2, antiplatelet drugs were stopped for 5 days. In group 1, platelet activity was measured by an assay based on flow cytometry and represented the platelet reactivity index. In group 2, platelet function analysis was used to monitor the antiplatelet effect of ASA. Bleeding severity was assessed using a visual analog scale for 72 hours after dental implant placement during sessions 1 and 2. Use of antiplatelet drugs was the predictive factor of the study and bleeding severity and platelet function were the outcomes of the study., Results: Twenty-two patients composed group 1 (clopidogrel 75 mg) and 20 composed group 2 (ASA 80 mg). In group 1, bleeding severity was 4.86 ± 0.77 during session 1 and 4.59 ± 0.66 during session 2. Data analysis showed no difference in bleeding severity between sessions 1 and 2 in group 1 (P = .72). In group 2, bleeding severity was 4.05 ± 0.94 during session 1 and 3.9 ± 0.85 during session 2. There was no difference in bleeding severity between sessions 1 and 2 in patients taking ASA (P = .19)., Conclusion: The results suggest that continuing the intake of antiplatelet drugs did not increase bleeding after placement of dental implants., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Purpose: Implant fracture is a serious complication, which leads to treatment failure. The purpose of this study is to estimate the incidence of implant fractures and identify factors associated with them., Materials and Methods: In this retrospective cohort study, the sample was derived from 2 implant centers. The predictors were grouped into the following categories: demographic, location of implant, physical characteristic of implant, implant-abutment connection, type of prosthesis, type of retention, and outcome variable (time to implant fracture). The Kaplan-Meier test was used to estimate implant survival. A Cox regression model was applied to evaluate the time-to-event effect of variables on implant fracture., Results: Of 18,700 implants, 37 (0.002%) had fractures. The 1- and 5-year risk of implant fracture was 0.38 per 1,000 and 1.46 per 1,000, respectively. Implant fractures more often occurred in the premolar and molar area (94.6%) than in the anterior of the jaws. The Pearson correlation test did not show any correlation between age, implant diameter, or implant length and time of fracture (P > .05). Analysis of the data by the log-rank test showed a significant difference for survival between cemented and screw-retained crowns (P = .001). The Cox regression model showed a hazard ratio of 0.23 for tapered implants versus cylindrical fixtures and for screw-retained crowns (hazard ratio, 296.54) versus cemented crowns., Conclusions: According to this study, conical implants and screw-retained prostheses may have lower survival rates due to implant fracture., (Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to evaluate the effects of exposing dental implants to the maxillary sinus cavity. This is a retrospective study. Thirteen patients with 18 implants that had radiographic evidence of implant exposure to the maxillary sinuses participated in this study. We evaluated the patient's radiographs immediately after implant insertion and 12 months after operation with the patient's clinical signs and symptoms due to sinusitis. Thirteen patients with 18 implants in the maxillary sinus had no signs and symptoms of sinusitis. Radiography showed thickening of the sinus membranes in 2 patients. All penetrated implants were successfully integrated, and there were no radiographic signs of bone loss or other complications.The exposure of implants to the maxillary sinuses caused no problems in the maxillary sinuses, and bone formation occurred in THE maxillary floor when penetration of maxillary sinuses occurred without tearing of the membrane.

Purpose: Bone expansion is one of the quickest, simplest, and most reliable methods of alveolar ridge augmentation for implant placement. This systematic review is designed to investigate the outcomes of the bone expansion technique for horizontal ridge augmentation. Methods: The protocol of study has been prospectively registered into PROSPERO (CRD42023414686). Pubmed, Embase, Web of Science, and Scopus databases were searched. Human original articles utilizing different bone expansion procedures for horizontal ridge augmentation without the use of bone materials or combined with vertical ridge augmentation techniques were included in the study. Qualitative and quantitative synthesis have been conducted. I-squared was used to assess heterogeneity. Meta-regression, forest plots random-effect model, and weighted mean difference were used for analysis. Leave-one-out influence analysis for finding outliers. Egger’s publication bias test and Funnel plots were used to address publication bias. Results: 3291 records were identified. Ten articles were included in this study after screening. The survival and complication rates of implants placed simultaneously with bone expansion was 100% 100% (95% CI: 99-100%) and 0% (95% CI: 0-1%), respectively. The meta-regression revealed that by each month passing from the implant placement the survival probability would be decreased significantly by 0.08% (95% CI: 0.009–0.15%; P = 0.03). The weighted mean ridge width difference before and after the osseodensification was 1.55 mm (95% CI: 0.92–2.17 mm). Conclusion: Based on the study’s limitations it can be concluded that the bone expansion procedure can be considered an efficient and safe method regarding the survival and complication rates of placed implants. Trial registration number: N/A. [ABSTRACT FROM AUTHOR]

Context: Short implants are acceptable treatment options for atrophic ridges; however, they increase the crown-to-implant (C/I) ratio compared to regular length implants. The study aimed to assess the correlation between the C/I ratio and marginal bone loss (MBL) in single short implants at the posterior of the mandible. Aims: The study aimed to assess the correlation between the C/I ratio and MBL in single short implants at the posterior of the mandible. Settings and Design: Cross-sectional study. Materials and Methods: This cross-sectional study assessed short implants with 6 mm lengths at the posterior of the mandible. The long-cone peri-apical digital radiographs were taken immediately after loading and 24 months later. Age, gender, implant diameter, gingival biotype, and implant brands were the study variables, and the C/I ratio was the predictive factor. The mean MBL at 2 years was considered the study outcome. Statistical Analysis Used: The Pearson correlation test was applied to assess the correlation between MBL and C/I. Results: Seventy implants (36 Straumann and 34 SGS implants) were studied. A significant difference was observed in the mean MBL between the two implant brands (P < 0.001). Besides, a correlation was found between MBL and the C/I ratio (P = 0.002). Conclusions: It seems that the C/I ratio is associated with an MBL increase in single short implants at the posterior of the mandible. [ABSTRACT FROM AUTHOR]

Purpose: The stability and density of the grafted bone in the maxillary sinus are essential for dental implant survival. This study aimed to compare bone density following mineralized allogeneic bone and deproteinized bovine bone and evaluate the volumetric changes as the secondary outcome. Materials and Methods: In this prospective cohort study, subjects were randomly allocated into two groups of mineralized bone and deproteinized bone to augment the maxillary sinus. Subjects underwent CBCT immediately after augmentation and 9 months later. The relative bone density was the primary outcome, and the volumetric change after 9 months was the secondary outcome of the study. The authors used an independent t test for assessing the bone density and volumetric change between the two groups. Results: Fifty patients were studied (n = 25 in each group). At 9 months after sinus elevation, the mean bone density was 237.20 ± 55.72 Hounsfield units (HU) in group 1 (mineralized bone) and 634.8 ± 166.11 HU in group 2 (deproteinized bone). There was a substantial difference statistically for the mean of HU between groups 1 and 2 (P < .001). The mean volume change was 0.25 ± 0.13 cm3 in group 1 (mineralized bone) and 0.06 ± 0.05 cm3 in group 2 (deproteinized bone). Assessment of the data showed a substantial difference in the mean volume change at 9 months after sinus elevation between groups 1 and 2 (P < .001). Conclusion: Considering the results of this study, the deproteinized bone was associated with higher relative bone density than the mineralized bone 9 months after sinus elevation. The volume change of the deproteinized bone was less than the mineralized bone in the study time. [ABSTRACT FROM AUTHOR]

Context: The study aims to answer the following question: Among the patients who received a dental implant, is there any difference in marginal bone loss (MBL) between sandblasted and acid-etched (SLA) and resorbable blast media (RBM) implants? Aims: The study aimed to evaluate marginal bone loss in SLA and RBM implants one year after loading. Settings and Design: A Prospective Cohort Study. Methods and Material: In this prospective cohort study with a pre-protocol population, subjects were assigned into two groups: Subjects received SLA implants in group 1 and RBM in group 2. MBL was assessed 12 months after loadings through digital parallel radiographs. Statistical Analysis Used: An Independent t-test was used to compare MBL between the two groups. Results: Sixty-six implants were studied (each group 33 implants). The mean of MBL in the RBM group was significantly higher than the SLA group (1.39 ± 0.31 mm, 0.89 ± 0.26 mm, respectively, P < 0.001). MBL in the mesial sides of implants in the RBM group was significantly higher than the SLA group (1.28 ± 0.29 mm, 0.8 ± 0.29 mm, respectively, P < 0.001). Analysis of the data demonstrated a significantly higher mean of MBL in the distal sides of implants in the RBM group than in the SLA group (1.51 ± 0.35 mm, 0.97 ± 0.27 mm, respectively, P < 0.001). In both groups, the mean of MBL on the distal side was significantly higher than on the mesial side (P < 0.05). Conclusions: Within this study's limitation, RBM implants showed significantly more MBL than SLA implants. [ABSTRACT FROM AUTHOR]

Background: This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region. Main text: We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane's CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case–control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran's Q test and the I2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. Conclusions: Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Alveolar ridge resorption after tooth extraction may interfere with optimal dental implant placement. Purpose: This study aimed to compare the marginal bone loss (MBL) and thickness of the buccal aspect of the augmented site in simultaneous versus delayed implant placement following lateral ramus horizontal ridge augmentation in the posterior mandible. Materials and Method: This prospective cohort study was conducted on patients who required horizontal bone augmentation of the posterior mandible using lateral ramus autogenous bone graft. Patients were divided into two groups of simultaneous implant placement (group 1) and delayed implant placement (group 2). Cone-beam computed tomography (CBCT) images were obtained before augmentation, at the time of implant placement, and 10 months later (6 months after implant loading). MBL and thickness of the buccal aspect were evaluated over time. Results: There were 18 patients in the group 1 and 16 patients in the group 2. Analysis of the CBCT scans demonstrated that the mean MBL was 1.21±0.35mm in the group 1 and 1.08±0.19mm in the group 2, with no significant difference between the two groups (p= 0.19). Thickness of the buccal aspect of the augmented site at the time of implant placement was 1.85±0.20mm in the group 1 and 2.16±0.29 mm in the group 2, with a significant difference (p<0.001). However, data analysis regarding changes in the buccal plate thickness showed no significant difference between the two groups (p= 0.36). Conclusion: According to the results of this study, there was no significant difference in M-BL and post-operative changes in the thickness of the buccal aspect of the augmented sites with onlay lateral ramus bone blocks between simultaneous and delayed implant placement. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Marginal bone loss (MBL) is an important factor in dental implant failure. The number of implants may affect MBL. Purpose: The aim of this study was to compare MBL in patients who received two or three implants for replacement of three missing teeth in the posterior mandible. Materials and Method: This prospective cohort study evaluated patients who required replacement of three missing teeth in the posterior mandible with dental implants. The patients were assigned to two groups. In the group 1, the edentulous area was restored with two implants and a pontic while three implants were placed for this purpose in the group 2. The MBL was compared between the two groups at 12 and 24 months after loading. Results: Forty-two implants were studied in group 1 and 36 implants in the group 2. The mean MBL was 0.90±0.12mm in the group 1 and 0.89±0.12mm in the group 2 at 12 months after loading. The mean MBL was 1.00±0.10mm in the group 1 and 0.98±0.10mm in the group 2 at 24 months after implant loading. The mean of MBL was not statistically different between the two groups at 12 months and 24 months (p> 0.05). Conclusion: It seems that the use of two or three implants for replacement of three missing teeth in the posterior mandible is not associated with an increase in MBL. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Caffeine intake affects bone metabolism through inhibition of osteoblast proliferation. Purpose: This study aims to assess the effect of caffeine consumption on implant stability in the healing period of patients. Materials and Method: A prospective cohort study is designed to assess implant stability in the posterior of the maxilla. Patients were divided into two groups based on daily caffeine intake as group 1 with consumption of 400 mg/daily caffeine or more, and group 2 with consumption of 100 mg/daily caffeine or less. The implant stability was measured by resonance frequency analysis (RFA). The mean implant stability quotients (ISQs) were calculated. RFA measurements were made at 4, 6 and 8 weeks after implant placement. Results: A total of 102 patients were studied (51 in each group). The mean of ISQ was 43.49± 2.32 in the group 1 and 42.78±2.34 in the group 2 at four weeks after insertion. The mean of ISQ was 50.86±3.06 in group 1 and 51.37±2.44 in the group at six weeks after implant placement. At eight weeks after implant surgery, the mean of ISQ was 56.78±3.77 in the group 1 and 57.84±1.82 in the group 2. The mean of ISQ between the two groups at 4, 6 and 8 weeks after implant placement was not statistically different. (p= 0.13, p= 0.36 and p= 0.08 respectively) The repeated measure test indicated a similar increase in ISQ in various study times in the two studied groups (p=0.47, df=1, F=0.52). Conclusion: Acquired data suggest that caffeine intake may not have a negative effect on implant stability in the healing period at the posterior of the maxilla. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Despite the low failure rate of dental implants, recognition of the risk factors can enhance the predictability of failure. Purpose: The aim of this study was to evaluate the risk factors for early implant failure. Materials and Method: This retrospective cohort study was conducted on two groups of patients, the patients with a failed implant before loading and those without a failed implant. Age, gender, implant type, implant surface, implant length, bone type, type of surgery (one- or two-stage) and immediate (fresh socket) or delayed placement of implant were the variables to be assessed in this study. Results: Out of the 1,093 evaluated implants, 73 cases (6.68%) failed in early stages. The two groups were significantly different in terms of implant surface, fresh socket placement, prophylactic use of antibiotics, and bone density (p< 0.05). Age, gender, implant height, implant type (cylindrical or tapered) and one-stage or two-stage placement were not significantly different between the two groups (p> 0.05). Conclusion: It seems that prophylactic antibiotic therapy, implant surface, bone density and placement in fresh extraction socket may contribute to dental implant failure. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess the effect of increasing the drilling speed and depth during implant site preparation on bone viability. Materials and Methods: In this prospective cohort study, participants were divided into four groups based on the speed and depth of drilling at the first molar site in the mandible. Participants underwent drilling at Group 1: 1000 rpm and 10 mm depth, Group 2: 1500 rpm and 10 mm, Group 3: 1000 rpm and 13 mm, and Group 4: 1500 rpm and 13 mm. Obtained specimens were assessed histologically to the qualitative measurement of bone viability, and the percentage of vital bone were evaluated by histomorphometric analysis. ANOVA was used to compare age and the mean percentage of vital bone and Tukey's test as post hoc was applied for pairwise comparison of groups. Results: A total of 100 participants were studied in four groups (25 subjects in each group). Histological evaluation revealed a low level of bone viability maintenance in all groups. Histomorphometric analysis showed the mean percentage of vital bone was 9.5 ± 3.91% in Group 1, 8.86 ± 3.84% in Group 2, 8.32 ± 3.80% in Group 3, and 4.27 ± 3.22% in Group 4. A significant difference was noted in the mean percentage of bone viability among the four groups (P = 0.001). Conclusion: It seems that increasing the drilling speed or depth during dental implant site preparation does not affect the mean percentage of cell viability, while the increase in both depth and speed may decrease the percentage of viable cells. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative pain is an important concern for patients who need dental implants. This study aims to compare the experience of pain in patients who undergo tooth removal and dental implant surgery. Materials and Methods: This is a crossover study. Patients who underwent a simple tooth extraction and dental implant surgery were studied. The pain severity was assessed using a visual analog scale at 12, 24, 48, and 72 h after procedures. The repeated measure test was used to compare pain severity between two treatment sessions. Results: Forty patients were studied. Patients reported higher pain levels in a tooth extraction at study times than implant surgery (P = 0.001). Conclusion: It seems patients who had experience of tooth extraction and a dental implant placement reported significantly lower pain in implant surgery. [ABSTRACT FROM AUTHOR]

Marginal bone loss is a concern in the long-term prognosis of short dental implants. The aim of this prospective cohort study was to evaluate the loss when variable numbers of short implants were used in the posterior mandible. The subjects were allocated into three groups according to the number of short implants. The first group was given two, the second three, and the third four. Each patient had radiographs taken immediately after loading and repeated 36 months later. Twenty- three subjects with 65 implants were entered in the three groups. The mean (SD) marginal bone loss was 0.49 (0.04) mm in the two implant group, 0.41 (0.25) mm in the three implant group, and 0.35 (0.25) mm in the four implant group. There were significant differences in marginal bone loss among the three groups (p = 0.001), in that the fewer the number of short implant-supported fixed prostheses in the posterior mandible, the greater the marginal bone loss. When we used more short implants the amount of marginal bone loss decreased. [ABSTRACT FROM AUTHOR]