Our aim was to describe socio–economic and behavioural factors related to caries experience in school children in Sassari, Sardinia (Italy). Four hundred and three 12–year–old schoolchildren were randomly selected and their teeth clinically examined after air drying, under standard light using a plain mirror and WHO community periodontal index for treatment needs (CPITN) ballpoint probe. The clinical DMFS index was recorded following a diagnostic threshold, CPITN following the WHO indications. A questionnaire concerning oral hygiene habits (OHH), the onset of toothbrushing habits (OTH), frequency of dental check–ups (DCU), sweet food and soft drink consumption and socio–economic background factors, i.e. parents'' occupational status (SOCFAM) and parents'' age, was filled in by children and parent(s)/guardian(s). The caries prevalence was 61.6%. A positive skewness of DMFS was observed. Regarding caries, a significant linear trend (p<0.05) was found among odds ratios at each exposure level in SOCFAM, OHH, OTH and CPITN. A logistic regression model for caries was constructed using related factors. CPITN (gingival conditions) gave a significant contribution in the predictive model (p = 0.01). Gender acted as an effect modifier on CPITN, so logistic regression models were constructed for males and females separately. CPITN was the only statistically significant covariate in males and OHH the only one in females. Our results confirm a high caries prevalence and also a need for preventive and educational programmes for caries in Sardinia.
Alveolar-ridge augmentation, anterior aesthetics, and digital technologies are probably the most popular topics in the dental-implant field. The aim of this report is to present a clinical case of severe atrophy of the anterior maxilla in a younger female patient, treated with a titanium membrane customized with computer-aided design/computer-aided manufacturing (CAD/CAM), simultaneous guided implant placement, and a fully digital workflow. A young female patient with a history of maxillary trauma was treated and followed-up for 1 year after implant placement. A narrow implant was inserted in a prosthetically driven position with the aid of computer-guided surgery. In the same surgical section, a customized implantable titanium mesh was applied. The scaffold was designed according to the contralateral maxillary outline in order to recreate a favorable maxillary bone volume. Finally, highly aesthetic, CAD/CAM, metal-free restorations were delivered using novel digital technologies.
The achievement of the optimal implant position is a critical consideration in implant surgery, as it can facilitate the ideal prosthesis design and allow adequate oral hygiene maintenance. The switch from bone-driven to prosthetic-driven implant placement, through a comprehensive diagnosis and adequate treatment plan, is a prerequisite for long-term successful implant-based therapy. The aim of the present case report is to describe a step-by-step prosthetic retreatment of a patient with primary treatment failure due to incorrect dental implant placement. Although dental implants achieve high survival rates, the success of implant prosthetic therapy significantly relies on an appropriate implant position. Malpositioned implants can cause damage to vital structures, like nerves or vessels. Moreover, improper implant positioning can result in esthetic, biological, and technical complications and can, in extreme situations, render the desired prosthetic rehabilitation impossible to achieve.
BackgroundA fundamental pre-requisite for the clinical success in dental implant surgery is the fast and stable implant osseointegration. The press-fit phenomenon occurring at implant insertion induces biomechanical effects in the bone tissues, which ensure implant primary stability. In the field of dental surgery, the understanding of the key factors governing the osseointegration process still remains of utmost importance. A thorough analysis of the biomechanics of dental implantology requires a detailed knowledge of bone mechanical properties as well as an accurate definition of the jaw bone geometry.MethodsIn this work, a CT image-based approach, combined with the Finite Element Method (FEM), has been used to investigate the effect of the drill size on the biomechanics of the dental implant technique. A very accurate model of the human mandible bone segment has been created by processing high resolution micro-CT image data. The press-fit phenomenon has been simulated by FE analyses for different common drill diameters (DA = 2.8 mm, DB = 3.3 mm, and DC = 3.8 mm) with depth L = 12 mm. A virtual implant model has been assumed with a cylindrical geometry having height L = 11 mm and diameter D = 4 mm.ResultsThe maximum stresses calculated for drill diameters DA, DB and DC have been 12.31 GPa, 7.74 GPa and 4.52 GPa, respectively. High strain values have been measured in the cortical area for the models of diameters DA and DB, while a uniform distribution has been observed for the model of diameter DC . The maximum logarithmic strains, calculated in nonlinear analyses, have been ϵ = 2.46, 0.51 and 0.49 for the three models, respectively.ConclusionsThis study introduces a very powerful, accurate and non-destructive methodology for investigating the effect of the drill size on the biomechanics of the dental implant technique.Further studies could aim at understanding how different drill shapes can determine the optimal press-fit condition with an equally distributed preload on both the cortical and trabecular structure around the implant.
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