Innovative collagen matrix for soft-tissue generation announced at EAO 2017 | Dental Tribune International

Innovative collagen matrix for soft-tissue generation announced at EAO 2017 | Dental Tribune International:



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Bony biomaterial may keep kids from outgrowing their implants

Bony biomaterial may keep kids from outgrowing their implants:



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Grand Central Station for Dentists

Grand Central Station for Dentists:



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Dental Miscellany !

For some dental miscellany check out

http://www.crookedbrains.net/2013/11/coolest-tooth-inspired-products-designs.html

Thanks to Dr.Shirish Waghulde for this one !

Bio Patch Regrows Bone

Bio Patch regrows bone:
An interesting new development in bone engineering. Hopefully some of this technology will reach our clinics soon!

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Interesting Solution to the Flossing Problem !

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Hello ! Sorry for the long absence !

Hello everybody and sorry for the long absence ! We've had some problems with spam and hacking in the Implant Sutra blog that forced me to take some time off. I'm back ! I'm grateful to all of you who continued to visit and who motivated me to get back to blogging .
Thanks !

Evidence insufficient to recommend routine antibiotics for joint replacement patients, experts say

Evidence insufficient to recommend routine antibiotics for joint replacement patients, experts say

Please read and save for future reference ! The latest recommendations for a commonly encountered clinical situation.

How Videogames Could Help Train the Next Generation of Robotic Surgeons

From Wired
I wonder when robotic surgery will be a reality in dentistry! OMFS will most probably be the place it will make it's first impact. In the meantime I'm going to get started on my video games!


How Videogames Could Help Train the Next Generation of Robotic Surgeons: Doling out death in the virtual world of first-person-shooter games might help the next generation of surgeons save lives in the real world. A new study used simulators to compare the robotic surgery skills of med school residents against college and high school students who spend a lot of their time playing video games -- and the video gamers won.

Periodontist Group Develops Diabetes Educational Material

Periodontist Group Develops Diabetes Educational Material: In honor of November, American Diabetes Month, the New Jersey Society of Periodontists developed this great brochure that can help your patients understand the diabetes/periodontal disease connection. If you have a blog or use social media for your dental practice, we recommend sharing these images so your patients can learn more about how their oral [...]

A very nice and informational brochure. Print it out for your patients or put it up on your wall. 

Surgical Rehearsal Platform Makes Virtual Operations Possible (Interview)

Surgical Rehearsal Platform Makes Virtual Operations Possible (Interview):
Medicine is continuously learning from other fields, perhaps the best example being aviation. It is from aviation that we gained the benefits of checklists, integrated ICUs and ORs, and – most recently – simulators. The first computer-based flight simulators came out 50 years ago and only now are we getting up to speed in terms of developing systems that enable surgeons to rehearse operations in advance.
This past June Medgadget met up with the Surgical Theater team at The White House and discussed how they are turning this vision into a reality – or, rather, the other way around. Their flagship product, the Selman Surgical Rehearsal Platform (SRP), allows surgeons to “pre-live the future” by practicing procedures on their actual patients’ anatomies using pre-operative MRI and CT images. We heard from them recently because the SRP has reached a few milestones in the past six months, including its first purchase by University Hospitals (UH) Case Medical Center in Cleveland and submission for FDA approval.
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Vertical Augmentation of the Posterior Mandible

Vertical augmentation of the posterior mandible remains challenging. A variety of approaches have been tried. Among them are:

• Short Implants
• Vertical augmentation using block grafts (autogenous,alloplastic as well as xenogenic).
• Vertical augmentation using tenting screws, and a mixture of autograft and bovine bone mineral covered with a titanium reinforced PTFE membrane barrier.This is quite popular.
• Vertical augmentation as above but using the implants themselves as tenting screws.
• Tilted implants where feasible.
• Transverse placement to avoid the IAN.
• Nerve repositioning/relocation.
• Subperiosteal implants if the resorption is down to basal bone. Not commonly used currently due to the high rate of failure and complications, technique sensitivity and lack of validating studies.

Another technique which does not enjoy the popularity it deserves is the interpositional graft. As far as techniques go I would rate it as moderately difficult but the results are phenomenal and complications are few. This has also been popularised by Ole Jensen as the "smile osteotomy" in his book The Osteoperiosteal Flap

Here is an illustration from the book that illustrates the procedure

The case presented below differs in some respects.

• The interpositional graft used was a FDBA Bone Block from Tata Bone Bank in Mumbai not autogenous bone or particulate graft material..
• No bone plates were used to stabilise the fragments. In some cases this may be necessary.

The "smile" osteotomy

Mobilising the the fragment vertically. Note that the coronal fragment is still pedicled to the lingual mucosa. The incision in the soft tissue is vestibular rather than crestal. One can use a bur, peizosurgery saw or oscillating saw for this cut..One can easily create a gap of 5 to 6mm or more using this technique. 

Maintaining the gap with a graft: Here we have used a block of FDBA from the Tata Tissue Bank in Mumbai. Alternatively one can use autograft harvested from the chin or ramus , or practically any kind of allograft or xenograft by itself or mixed with autograft. In case of particulate autograft it may be necessary to stabilise the coronal fragment with plates and screws. This may be needed even in case of block grafts if the fragments do not maintain position. 

Three or four months later the graft is on its way to being replaced by the body's own bone and one can see the margins of the osteotomy have been bridged over. The increase in vertical height is evident.

Implants have been placed .

A Classic "Royally" treated

What do you think of this "bed of Nails"?

Christensen pins implant makers !

Upfront as always Gordon Christensen makes a strong point. Follow the link to this article in drbicuspid.com
http://www.drbicuspid.com/index.aspx?sec=sup&sub=rst&pag=dis&itemId=311794&wf=1380

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Is Bruxism a Risk Factor for Dental Implants? A Systematic Review of the Literature

I haven't read the original study but the abstract seems interesting. The authors attempt to answer a question that we all have asked ourselves at some time or another. But we still don't have a useful classification system for Bruxism or Parafunction that allows us to categorise patients in some clinically relevant fashion.....
If someone has access to the original paper I would appreciate if you could mail it to me !
Is Bruxism a Risk Factor for Dental Implants? A Systematic Review of the Literature:

Abstract

Purpose

To systematically review the literature on the role of bruxism as a risk factor for the different complications on dental implant-supported rehabilitations.

Material and Methods

A systematic search in the National Library of Medicine's Medline Database was performed to identify all peer-reviewed papers in the English literature assessing the role of bruxism, as diagnosed with any other diagnostic approach (i.e., clinical assessment, questionnaires, interviews, polysomnography, and electromyography), as a risk factor for biological (i.e., implant failure, implant mobility, and marginal bone loss) or mechanical (i.e., complications or failures of either prefabricated components or laboratory-fabricated suprastructures) complications on dental implant-supported rehabilitations. The selected articles were reviewed according to a structured summary of the articles in relation to four main issues, viz., “P” – patients/problem/population, “I” – intervention, “C” – comparison, and “O” – outcome.

Results

A total of 21 papers were included in the review and split into those assessing biological complications (n = 14) and those reporting mechanical complications (n = 7). In general, the specificity of the literature for bruxism diagnosis and for the study of the bruxism's effects on dental implants was low. From a biological viewpoint, bruxism was not related with implant failures in six papers, while results from the remaining eight studies did not allow drawing conclusions. As for mechanical complications, four of the seven studies yielded a positive relationship with bruxism.

Conclusions

Bruxism is unlikely to be a risk factor for biological complications around dental implants, while there are some suggestions that it may be a risk factor for mechanical complications.

Something to think about !

ADA News 2012 Conference:

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Must See Video!

A very dramatic representation of the difference in strength between a PFM and a ful contour zirconia crown. Worth watching !

Bone-to-implant contact after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios in mini pigs

Bone-to-implant contact after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios in mini pigs:

Abstract

Objectives

The objective was to test the hypotheses: (i) no differences in bone-to-implant contact formation, and (ii) no differences between the use of autogenous mandibular or iliac bone grafts, when autogenous bone, Bio-Oss mixed with autogenous bone, or Bio-Oss is used as graft for the maxillary sinus floor augmentation.

Material and methods

Bilateral sinus floor augmentation was performed in 40 mini pigs with: (A) 100% autogenous bone, (B) 75% autogenous bone and 25% Bio-Oss, (C) 50% autogenous bone and 50% Bio-Oss, (D) 25% autogenous bone and 75% Bio-Oss, or (E) 100% Bio-Oss. Autogenous bone was harvested from the iliac crest or the mandible and the graft composition was selected at random and placed concomitant with the implant placement. The animals were euthanized 12 weeks after surgery. Bone-to-implant contact was estimated by stereological methods and summarized as median percentage with 95% confidence interval (CI). Bone-to-implant contact formation was evaluated by fluorochrome labelling and assessed by median odds ratios (OR) with 95% (CI).

Results

Median bone-to-implant contact was: (A) 42.9% (95% CI: 32.1–54.5%), (B) 37.8% (95% CI: 27.1–49.9%), (C) 43.9% (95% CI: 32.6–55.9%), (D) 30.2% (95% CI: 21.6–40.3%), and (E) 13.9% (95% CI: 11.4–16.9%). Bone-to-implant contact was significantly higher for A, B, C, D as compared to E (P < 0.0001). Bone-to-implant contact was not significantly influenced by the ratio of Bio-Oss and autogenous bone (P = 0.19) or the origin of the autogenous bone (P = 0.72). Fluorochrome labelling revealed extensive variation in bone-to-implant contact formation over time. The labelling at weeks 2–3 was significantly increased with A compared to E (OR = 8.1 CI: 5.0–13.1, P < 0.0001), whereas E showed a significantly increased labelling at weeks 8–9 compared to A (OR = 0.5 CI: 0.3–0.7, P = 0.0028).

Conclusions

The hypothesis of no differences in bone-to-implant contact between the various treatment modalities was rejected since the bone-to-implant contact was significantly increased with autogenous bone or Bio-Oss mixed with autogenous bone as compared to Bio-Oss. Early bone-to-implant contact formation was more advanced with autogenous bone. No differences between the use of mandibular or iliac bone grafts were observed since the bone-to-implant contact was not significantly influenced by the origin of the bone graft.

Significance of keratinized mucosa around dental implants: a prospective comparative study

Significance of keratinized mucosa around dental implants: a prospective comparative study:

Abstract

Objective

The aim of this investigation was to evaluate the significance of keratinized mucosa (KM) around dental implants both clinically and biochemically for 12 months.

Material and methods

Fifteen edentulous patients treated with implant-retained overdentures in edentulous mandible (four implants per patient). Based on the presence of keratinized mucosa on the buccal surfaces, implants were divided into two groups: Implants having minimal 2 mm of KM on their buccal surfaces and implants having no KM on their buccal surfaces. Thirty-six implants were included in the evaluations; 19 implants in 15 patients had minimal 2 mm of KM on their buccal surfaces and 17 implants in 15 patients had no KM on their buccal surfaces. Clinical measurements of Plaque Index, Gingival Index, probing depths, and Bleeding on Probing were performed and peri-implant crevicular fluid (PICF) were collected immediately before loading (baseline) and at 6th, 12th months after loading. Interleukin-1 beta (IL-1 β) and tumor necrosis factor-alpha (TNF-α) have been assessed in the crevicular fluid. Results were analyzed by repeated-measures of variance (ANOVA) and Wilcoxon signed rank tests.

Results

After 12 months of evaluation the results of ANOVA showed that implants with KM had lower levels of TNF-α total amounts than implants without KM (P < 0.05). Additionally, TNF-α total amounts were significantly higher at 12^th month compared to baseline for implants without KM (P < 0.05). Plaque index and Gingival index values were also found significantly higher for implants without KM (P < 0.05). For IL-1 β and PICF volume levels the differences between the implant groups were non significant, whereas the differences between the periods were significant. (P < 0.05) Additionally, both of the groups had higher levels of PII and BoP scores when compared to baseline (P < 0.05).

Conclusions

The results of this study showed that an adequate band of keratinized mucosa was related with less plaque accumulation and mucosal inflammation as well as pro-inflammatuar mediators, suggesting that it may be critical especially for plaque control and plaque associated mucosal lesions around dental implants.

These Silently Screaming Dental Mannequins Are What Nightmares Are Made Of [WTFriday]

These Silently Screaming Dental Mannequins Are What Nightmares Are Made Of [WTFriday]:

These synthetic heads don't need to be anywhere near the Uncanny Valley to be terrifying. Our friends at Oobject have assembled 12 of the creepiest prosthetic mouths in dentistry. More »