Objectives
To prospectively evaluate, as part of an ongoing randomized pilot trial, the clinical outcomes of two‐piece zirconia implants in comparison with titanium implants 80 months after delivery of all‐ceramic (lithium disilicate) single‐tooth restorations.
Material and methods
The original sample included 31 (16 zirconia and 15 titanium) implants in 22 healthy patients. In addition to evaluating implant survival and success, a number of clinical or radiographic parameters were statistically analyzed: plaque index (PI), bleeding on probing (BOP), pink esthetic score (PES), and marginal bone loss (MBL). Both implant groups were compared using a Mann–Whitney U test.
Results
Three implants (2 zirconia and 1 titanium) had been lost, so that 28 implants (14 zirconia and 14 titanium) in 21 patients could be evaluated after a mean of 80.9 (SD: 5.5) months. All surviving implants had remained stable, in the absence of any fixture or abutment fractures and without any chipping, fracture, or debonding of crowns. The zirconia implants were associated with PI values of 11.07% (SD: 8.11) and the titanium implants with 15.20% (SD: 15.58), the respective figures for the other parameters being 16.43% (SD: 6.16) or 12.60% (SD: 7.66) for BOP; 11.11 (SD: 1.27) or 11.56 (SD: 1.01) for PES; and 1.38 mm (SD: 0.81) or 1.17 mm (SD: 0.73) for MBL.
Conclusions
No significant differences were found between the clinical outcomes of two‐piece zirconia and titanium implants based on the aforementioned parameters after 80 months of clinical service. Our results should be interpreted with the limited sample size in mind.
Background Recent evidence suggests that medication-related osteonecrosis of the jaw (MRONJ) can be caused by a number of anti-resorptive and anti-angiongenic agents not limited to bisphosphonates. A working knowledge of these medications is important for dental practitioners.Methods A total of 129 general dental practitioners (GDPs) were surveyed regarding their awareness of MRONJ and its causes.Results More than 90% of the GDPs sampled were unaware of anti-resorptive and anti-angiogenic medications other than bisphosphonates that had the potential to cause MRONJ. Just over 40% of the sampled GDPs were confident to treat patients on oral bisphosphonates in primary care. Much of the reluctance to manage these patients was due to lack of accessible guidelines and unclear protocols.Conclusions The results demonstrate GDP attitudes to patients taking bisphosphonates and highlight how further education is needed to increase confidence to perform simple exodontia amongst this cohort of patients in a primary care setting. As there continues to be a shift to providing dentoalveolar services in primary care, we must ensure that those performing the treatments have a greater understanding of potential MRONJ risks and have guidance as to when to refer.
Incorporating a premaxillary osteotomy into the secondary ABG surgical protocol can be a safe technique that gives excellent surgical exposure for fistula repair.
Background: The qualified dentists in the United Kingdom (UK) are not expected to be competent in practising implant dentistry without further training in the subject and there is now greater emphasis on postgraduate training in Dental Implantology. There are three main education pathways at present, yet their training standards vary significantly. This study aims to identify UK postgraduate academic qualifications and continuing professional development (CPD) courses available in the field of Dental Implantology and evaluates the current standard of the postgraduate training programmes against the Training Standards in Implant Dentistry (TSID) guidelines from Faculty of General Dental Practice (FGDP (UK)). Results: There were eight master level courses with varying types of qualification and study mode. The mean duration and tuition fee of the courses were 2.50 years and £23,635.50 per course, respectively. There were eight postgraduate diploma part-time courses with the mean duration of 2.00 years, and the mean tuition fee of £20,177. 08 per course. The mean duration for two postgraduate certificate part-time courses was 1.00 year with the mean tuition fee of £9441.50. However, there were no full-time study options for these courses. All courses identified stated their compliance with TSID guidelines. The mean duration for 13 CPD courses identified was 0.94 years and all courses were delivered in a part-time mode. Eleven of these courses were verifiable CPD courses, and two courses were providing certificates only. Not all courses were fully compliant with TSID guidelines. Ten courses clearly stated that they provide mentoring for implant placements, and the number of supervised cases varied considerably between 1 and 50. Conclusion: Development of FGDP (UK) TSID guidelines has led to a significant improvement in the quality of postgraduate education in Dental Implantology in the UK. However, not all courses are fully compliant with these guidelines and the provision of mentoring for implant placements also needs to be standardised. Quality-assured training is directly related to patient safety, and therefore all UK postgraduate training pathways must ensure their compliance with the current guidelines.
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