Context:A key determinant for clinical success is the diagnosis of the bone density in a potential implant site. The percentage of boneimplant contact is related to bone density, and the axial stress contours around an implant are affected by the density of bone. Evidence Acquisition: A number of reports have emphasized the importance of the quality of bone on the survival of dental implants. The volume and density of the recipient bone have also been shown to be determining criteria to establish proper treatment plans with adequate number of implants and sufficient surface area. Previous clinical reports that did not alter the protocol of treatment related to bone density had variable survival rates. To the contrary, altering the treatment plan to compensate for soft bone types has provided similar survival rates in all bone densities. Results: When bone density decreases and bone become softer, the implant surface in contact with the bone decreases, therefore treatment plan should be modified by changing the drilling protocol, using gradual loading and reducing the force on the prosthesis or increasing the loading area with increasing implant number, implant position, implant size, implant design (deeper and more threads with more pitch, squared shape) and implant body surface condition. Conclusions: Once the prosthetic option, key implant position, and patient force factors have been determined, the bone density in the implant sites should be evaluated to modify the treatment plan. Inappropriate implant number or design in poor quality bone results in higher failure rates. Changing the treatment plan and implant design is suggested, based on bone density to achieve higher survival rates.Keywords:Bone Density; Dental Implant; Implant Design Implication for health policy/practice/research/medical education: Providing the long-term survival rate and higher success rate of dental implant in poor bone quality/Ideal treatment planning based on making proper decisions; make a selection based on a scientific approach, rather than on advertising or marketing opinion.
Background. This study was designed to compare the viability of autogenous bone grafts, harvested using different methods, in order to determine the best harvesting technique with respect to more viable cells. Methods. In this animal experimental study, three harvesting methods, including manual instrument (chisel), rotary device and piezosurgery, were used for harvesting bone grafts from the lateral body of the mandible on the left and right sides of 10 rabbits. In each group, 20 bone samples were collected and their viability was assessed using MTS kit. Statistical analyses, including ANOVA and post hoc Tukey tests, were used for evaluating significant differences between the groups. Results. One-way ANOVA showed significant differences between all the groups (P=0.000). Data analysis using post hoc Tukey tests indicated that manual instrument and piezosurgery had no significant differences with regard to cell viability (P=0.749) and the cell viability in both groups was higher than that with the use of a rotary instrument (P=0.000). Conclusion. Autogenous bone grafts harvested with a manual instrument and piezosurgery had more viable cells in comparison to the bone chips harvested with a rotary device.
Background: Radiography is as a part of periodontal examination. Early detection of periodontal disease is important in the prevention of tooth loss and patient's general health. Objectives: The objective of this study was to compare diagnostic accuracy of cone-beam computed tomography (CBCT) with digital direct intraoral radiography, in assessment of periodontal osseous lesions. Materials and Methods: Fifty interproximal bone losses were evaluated in this study. First, direct digital intraoral radiography (SoproLa Ciotat-France) was taken, and then CBCT (Newtom 3G, Verona. Italy) was carried out. Periodontal flap surgery was done to achieve the gold standard. The distance between cementoenamel junction (CEJ) and the bottom of the vertical pattern of bone loss or the most coronal level of bone in horizontal pattern was measured. These measurements were analyzed by paired t test. The intraclass correlation coefficient (ICC) was used to evaluate the degree of agreement between observers. Results: Accuracy is higher with CBCT in evaluating vertical dimension of periodontal bony defects (0.53 ± 0.59 to 0.56 ± 0.45) (P < 0.001). ICC shows high level of agreement between observers in two image modality. Conclusions: We conclude that CBCT and digital images can be used in periodontal bone assessments; each modality should be chosen based on defect type and patient's specific characteristics.
Background: Tracking various biomarkers in serum, gingival crevicular fluid (GCF), and saliva has been introduced as a diagnostic tool for periodontal disease detection. Objectives: The aim of this study was to compare salivary lactate dehydrogenase (LDH) levels in subjects with periodontal disease and levels in subjects without periodontal disease. Materials and Methods:In this case-control study, 170 patients at Hamadan faculty of Dentistry, including patients with periodontal disease and patients with normal periodontium, were selected and divided into test and control groups. Unstimulated saliva was collected in the same situation from the test and control groups. Each saliva sample was analyzed to measure salivary LDH level on the day of collection, by using commercially available kits according to the manufacturers' instructions. A statistical T-test was employed to evaluate significant differences among groups.
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