INTRODUCTION: Dental implants primary or initial stability originates from the engagement with the cortical bone mechanically, whereas the secondary stability signifies the stability biologically by means of osseointegration through the bone formation and remodeling from the cancellous bone. Osseodensification is an innovative biomechanical technique to prepare the site. It uses Densifying Burs to produce low plastic deformation owing to its non-removal densifying method of site preparation, which preserves the bone enhancing the host site. OBJECTIVES: To evaluate the osseodensification (OD) technique used in implant site preparation by using the newly designed burs (Densah burs), and its effect on enhancing implant primary and secondary stability. MATERIALS AND METHODS: Twenty dental implants were placed in ten patients; each patient received one implant using the new Osseodensification drilling technique and one implant using the conventional drilling technique in the posterior maxillary ridge. Osstell was used in measuring resonance frequency (ISQ-scale) which is used to determine the amount of implant stability. RESULTS: The results showed a significant improvement in both primary and secondary stability using densah burs. Conclusion: Densah burs produce better bone quality around the implant than conventional drills, and therefore, there is an improvement in the primary and secondary stability.
INTRODUCTION:There is a variety of treatment modalities for oroantral defects based on repair of soft tissue component only of the defect. However, bone regeneration is needed to allow for later restoration of the missing tooth. OBJECTIVE:The aim of this study was to evaluate the efficacy of zirconia porous scaffold in oroantral defects. MATERIALS AND METHODS:This study was conducted on ten patients suffering from oroantral defects of more than three weeks duration and having a width of at least five millimeters (mm). The patients were treated with placement of a custom made zirconia porous scaffold along with buccal advancement flap after a virtual surface for bone model was reconstructed from the cone-beam computed tomography and printed by stereolithography 3D printing method. RESULTS: Clinically, there was a significant improvement in wound healing in 80% of the cases across the follow up period with only 20% of the patients the wound didn't heal due to infected wound margins and the full scaffold was lost prior to the end of the follow-up period and required further treatment later on. Pain intensity decreased throughout the follow-up period with the maximum pain intensity was only immediately postoperative. Radiographically, there was a significant increase in bone density from the baseline by 41.2 percentage change. CONCLUSION: Zirconia porous scaffold is a biocompatible material that enhances new bone formation in closure of oroantral fistulas through its high porosity and clear interconnected porous surface which are a suitable environment for osteoblastic activity.
INTRODUCTION: The success of implant therapy depends primarily on appropriate treatment planning and properly performed implant placement surgery.Guided implant surgery (template based guided cavity preparation and guided implant insertion) is effective to guide the implant placement.This can be achieved by means of a surgical guide Stent.Stents are designed in conventional methods or stereolithography which allows the fabrication of surgical guides from 3D computer generated models for precise placement of the implants. OBJECTIVES: Assess the accuracy of stereolithographic surgical stent to orientate implant insertion in mandibular free-end saddle areas. MATERIALS AND METHODS: A total of 12 implants will be placed in patients having mandibular free end-saddle areas selected from the outpatient section of the department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, after virtual implant planning with implant studio software, the implants will be inserted using stereolithographical design of surgical stent then measuring the deviation between the planned implant position before the surgery and the actual position of placed implant after surgical procedure. RESULTS: Evaluation of the accuracy of placement was done by measuring the overall deviations between virtually planned and surgically placed dental implants.The mean of total angular difference in implant with stereolithographic stent were 10.9 ± 9.4°.While The Mean of total coronal differences in stereolithographic guided implant were 0.96 mm ± 0.7 mm.The Mean of total apical differences in stereolithographic guided implant were 1.8 ± 1.3 mm CONCLUSIONS: The stereolithographic surgical template was sufficiently accurate in transferring the planned implant position to the surgical field relative to the implant angulation and point of entrance.
OBJECTIVE:The purpose of this study was to to assess the influence of computer-assisted mandibular reconstruction with iliac crest bone graft regarding the functional and morphological outcomes compared to the virtually performed surgery. Furthermore, the reliability of the measured values was evaluated. MATERIALS AND METHODS:The study is a prospective case series for computer-assisted mandibular reconstruction patients with iliac crest graft. Primary outcome variable was the functional and morphological outcome variables when correlated to the virtual preoperative values. The secondary outcome was deciding the reliability of the utilized evaluation methodology. All recorded data were documented, tabulated, computed, and analyzed using inter-class coefficient (ICC) test . Statistical significance was set at the 5% level. RESULTS: Nine consecutive patients were enrolled in this study. A highly statistically significant degree of agreement between the preoperative and postoperative measurements was recorded regarding all of the angular and linear parameters (P<0.001). Furthermore, an extreme degree of reliability was reported when the evaluation methodology was scrutinized. (ICC=0.9). CONCLUSION: Computer-assisted reconstruction showed accurate postoperative condylar position and morphological orthognathic measurements in mandibular resection cases with iliac crest graft reconstruction. Furthermore, the study showed the reliability of the chosen methodology to evaluate the computer-assisted reconstruction procedure.
BACKGROUNd: Osseodensification is a means of biomechanical site preparation. It results in low plastic deformation which preserves the bone, enhances healing and shortens the healing period OBJECTIVE: Evaluate osseodensification effect for implant site preparation in mandibular narrow ridges using Densah burs in a non-cutting anti-clockwise direction on increasing bone density and ridge width. MATERIAL AND METHODS:This trial is a clinical trial in which fourteen subjects (30-44 years) with missing mandibular teeth had their implant sites prepared using Densah Bur in an anti-clockwise non-cutting direction. Bone width and density were gauged by using cone beam computed tomography (CBCT) scan before, immediately postoperative and after 4 months. ANOVA with repeated measures and Paired t-tests were used for statistics. RESULTS: Immediate postoperative bone width increased by 45.16%, 19.72%, 8.51% and 22.27% in the cervical, middle, apical parts and in average, respectively (P<0.001). Four months postoperative bone width increased by 43.92%, 18.72%, 8.51% and 21.66% in the cervical, middle, apical parts and in average, respectively (P<0.001). Bone density increased 10.3% immediately postoperative (P=0.212) and 15.06% after 4 months (P<0.001). CONCLUSION: Osseodensification technique is effective in increasing ridge width and bone density when used for implant site preparation in mandibular narrow ridges. DENTAL Implants, Ossseodensification, Mandibular ridge, Densah burs
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