Displaying publications 41 - 58 of 58 in total

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  1. Nimbalkar S, Oh YY, Mok RY, Tioh JY, Yew KJ, Patil PG
    J Prosthet Dent, 2018 Aug;120(2):252-256.
    PMID: 29551374 DOI: 10.1016/j.prosdent.2017.10.021
    STATEMENT OF PROBLEM: Buccal corridor space and its variations greatly influence smile attractiveness. Facial types are different for different ethnic populations, and so is smile attractiveness. The subjective perception of smile attractiveness of different populations may vary in regard to different buccal corridor spaces and facial patterns.

    PURPOSE: The purpose of this study was to determine esthetic perceptions of the Malaysian population regarding the width of buccal corridor spaces and their effect on smile esthetics in individuals with short, normal, and long faces.

    MATERIAL AND METHODS: The image of a smiling individual with a mesofacial face was modified to create 2 different facial types (brachyfacial and dolicofacial). Each face form was further modified into 5 different buccal corridors (2%, 10%, 15%, 22%, and 28%). The images were submitted to 3 different ethnic groups of evaluators (Chinese, Malay, Indian; 100 each), ranging between 17 and 21 years of age. A visual analog scale (50 mm in length) was used for assessment. The scores given to each image were compared with the Kruskal-Wallis test, and pairwise comparison was performed using the Mann-Whitney U test (α=.05).

    RESULTS: All 3 groups of evaluators could distinguish gradations of dark spaces in the buccal corridor at 2%, 10%, and 28%. Statistically significant differences were observed among 3 groups of evaluators in esthetic perception when pairwise comparisons were performed. A 15% buccal corridor was found to score esthetically equally within 3 face types by all 3 groups of evaluators. The Indian population was more critical in evaluation than the Chinese or Malay populations. In a pairwise comparison, more significant differences were found between long and short faces and the normal face; the normal face was compared with long and short faces separately.

    CONCLUSIONS: The width of the buccal corridor space influences smile attractiveness in different facial types. A medium buccal corridor (15%) is the esthetic characteristic preferred by all groups of evaluators in short, normal, and long face types.

  2. Chong WX, Lai YX, Choudhury M, Amalraj FD
    J Prosthet Dent, 2022 Nov;128(5):1114-1120.
    PMID: 33685653 DOI: 10.1016/j.prosdent.2021.01.010
    STATEMENT OF PROBLEM: The presence of biofilms on maxillofacial silicone increases the risk of infections and reduces durability. Whether silver nanoparticles (AgNPs) with potent antimicrobial effects help reduce biofilm formation is unclear.

    PURPOSE: The purpose of this in vitro study was to assess the antimicrobial effect of sub 10-nm AgNPs in maxillofacial silicone against Staphylococcus aureus, Candida albicans, and mixed species biofilms containing both and to test the effectiveness of different AgNP concentrations against all 3 biofilms in vitro.

    MATERIAL AND METHODS: Silicone disks (M511; Technovent Ltd) containing 0.0% (control), 0.1%, and 0.5% AgNPs were fabricated and treated with S. aureus, C. albicans, and mixed species strains of both in 24-well culture plates containing appropriate media. Each well received a 0.1-mL aliquot of the standardized suspension of microorganisms. The plates were incubated for 21 consecutive days, and colony-forming units per milliliter (CFU/mL) were measured on the first, third, fifth, seventh, fifteenth, and twenty-first day with the Miles and Misra method. Data were analyzed by 2-way ANOVA and the paired t test to evaluate the relationship between AgNP concentration, microbial strain, and time (α=.05). Mean CFU/mL differences for each time and for each biofilm category were assessed by repeated measure ANOVA.

    RESULTS: AgNPs decreased the mean CFU/mL in both concentrations compared with the control. The 0.1% concentration showed sustained efficacy throughout the test, while the 0.5% concentration had high efficacy initially with a gradual decrease. However, the results were inconsistent for the mixed biofilm. The paired sample t test at day 3 and 15 and day 3 and 21 showed statistically significantly different results (P

  3. Abdelrehim A, Sulaiman E, Sofian H, Salleh NM
    J Prosthet Dent, 2023 Nov 16.
    PMID: 37980225 DOI: 10.1016/j.prosdent.2023.10.014
    STATEMENT OF PROBLEM: Intraoral scanning of implants supporting complete arch prostheses is limited because of the lack of geometric heterogeneity and unique reference points, creating inherent errors in the image stitching process by the scanner software program.

    PURPOSE: The purpose of this in vitro study was to evaluate the significance of geometric heterogeneity on complete arch implant scanning by using a novel auxiliary geometric device. Three different clinical simulations were tested to assess its significance. The study also assessed whether scans produced using the auxiliary device would meet a clinically acceptable threshold.

    MATERIAL AND METHODS: A total of 60 scans (n=20) were performed using an intraoral scanner in 3 different clinical simulations: 2 parallel implants, 4 parallel implants, and 4 implants with a 30-degree posterior angulation of the distal implants. Scanning alternated between using the auxiliary geometric scanning device (test groups; 4IP+, 4IA+, 2IP+) and not using the device (control groups; 4IP-, 4IA-, 2IP-). A reference scan for each model was prepared from a high precision laboratory scanner. The scans were analyzed for accuracy in 3-dimensional deviation, interimplant distance deviation, and angular deviation by using an inspection software program. The effect of the auxiliary device was statistically analyzed by comparing scans of the same group using the paired t test for normally distributed data and the Wilcoxon Signed Rank test when data were not normally distributed (α=.05).

    RESULTS: Significant effects of the auxiliary geometric device were found in 3-dimensional, distance and angular deviations (P

  4. Giok KC, Veettil SK, Menon RK
    J Prosthet Dent, 2023 Oct 10.
    PMID: 37827970 DOI: 10.1016/j.prosdent.2023.08.022
    STATEMENT OF PROBLEM: Different varieties of fiber and metal intraradicular posts have been used for the restoration of endodontically treated teeth with insufficient sound tooth structure. Evidence on the comparative efficacy of posts in a clinical setting is insufficient to provide clear clinical guidelines and recommendations.

    PURPOSE: The purpose of this systematic review with network meta-analysis was to assess the comparative efficacy of fiber and metal posts used for the restoration of endodontically treated teeth.

    MATERIAL AND METHODS: A search was conducted for trials published in Medline, Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until November 2022. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022384340). A network meta-analysis was performed on data from randomized controlled trials that assessed the comparative efficacy of fiber posts and metal posts for the restoration of endodontically treated teeth. Subgroup analyses were performed to compare all the varieties of fiber and metal posts. The types of posts were ranked according to their efficacy using the Surface Under the Cumulative Ranking (SUCRA) system. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the level of certainty of evidence.

    RESULTS: Twenty-five articles were included in the quantitative analysis. Fiber posts (RR=0.15 [95% CI: 0.06, 0.33]) significantly prevented tooth fracture as compared with no posts. Prefabricated carbon fiber posts (RR=0.06 [95% CI: 0, 0.54]) ranked highest followed by custom glass fiber posts (RR=0.15 [95% CI: 0.04, 0.52]) and prefabricated glass fiber posts (RR=0.22 [95% CI: 0.07, 0.62]) in the outcome of tooth fracture. Metal posts (RR=0.24 [95% CI: 0.12, 0.46]) ranked higher than fiber posts (RR=0.39 [95% CI: 0.27, 0.56]) in the outcome of debonding. Custom gold alloy posts (RR=0.12 [95% CI: 0.03, 0.48]), prefabricated gold alloy posts (RR=0.04 [95% CI: 0.00, 0.87]), and prefabricated titanium posts (RR=0.21 [95% CI: 0.10, 0.45]) had higher rankings in the outcome of debonding or loss of retention of a post followed by custom glass fiber posts (RR=0.37 [95% CI: 0.21, 0.63]) and prefabricated glass fiber posts (RR=0.38 [95%CI: 0.25, 0.58]). Prefabricated glass fiber posts (RR=0.40 [95% CI: 0.20, 0.81]) had statistically significant differences in the outcome of secondary caries. The GRADE approach determined a moderate level of certainty of evidence.

    CONCLUSIONS: The use of a fiber post when indicated results in reduced risk of tooth fracture as compared with no post. Prefabricated carbon fiber posts, prefabricated glass fiber posts, and custom glass fiber posts reveal a lower risk of tooth fracture. Overall, the use of prefabricated glass fiber posts had a lower risk of tooth fracture, debonding, and secondary caries. However, more trials with longer follow-up periods are recommended to enhance the certainty of evidence.

  5. Patil PG, Seow LL, Uddanwadikar R, Pau A, Ukey PD
    J Prosthet Dent, 2023 Oct;130(4):586-596.
    PMID: 35086683 DOI: 10.1016/j.prosdent.2021.07.025
    STATEMENT OF PROBLEM: The 2-implant mandibular overdenture is a popular treatment for the edentulous mandible, but information on optimum implant positions and/or angulations and their stress and strain patterns is lacking.

    PURPOSE: The purpose of this finite element analysis study was to evaluate stress and strain distribution patterns in 2-implant mandibular overdentures with different positions and angulations of implants under unilateral and bilateral loading.

    MATERIAL AND METHODS: A cone beam computed tomography (CBCT)-based, 3-dimensional (3D) model of the mandible and an intraoral scanning-based 3D model of the denture were developed in the Mimics software program. A 3D model of a standard-sized implant with a low-profile overdenture attachment (LOCATOR) was developed in the Solidworks software program. Two implants were inserted in the 3D model of the mandible, with implants placed at different positions, 5, 10, 15, and 20 mm from the midline, and different distal angulations, 0-5, 0-10, 0-15, 5-5, 10-10, and 15-15 degrees (at 10-mm distance), in the 3Matics software program. Unilateral and bilateral vertical loads of 100 N were applied on the first molars in the ANSYS software program to record maximum von Mises stresses and strain values.

    RESULTS: The stresses in the implants were maximum when placed at a 20-mm distance (4.18 MPa under unilateral and 4.2 MPa under bilateral loading), while for the implants placed at 5 mm, 10 mm, and 15 mm, the indicated stresses were less than 2.46 MPa following an increasing trend with an increase in the distance. The stresses in the implants were maximum when placed at 15-15-degree angulations (0.93 under unilateral and 0.92 MPa under bilateral loading). For lower angulations, the stresses on the implants ranged from 0.05 to 0.87 MPa. No specific trend was observed in stresses and strains with 0-5-, 0-10-, and 0-15-degree angulations, but an increasing trend was observed with 5-5-, 10-10-, and 15-15-degree angulations under unilateral loading. Under bilateral loading, the stresses and strains on the implants and the mandible showed negligible variations across all 6 angulations.

    CONCLUSIONS: The most posterior position of implants (20 mm) exhibited the highest stresses and strains on the implants and the mandible under both loading conditions. Implants placed with 15-15-degree angulations exhibited the highest stresses. Stresses and strains were similar in implants with lower angulations.

  6. Soo SY, Lee SM, Tew IM, Mohd Dom TN, Yahya NA
    J Prosthet Dent, 2023 Jul 17.
    PMID: 37468369 DOI: 10.1016/j.prosdent.2023.06.003
    STATEMENT OF PROBLEM: A discrepancy between dentists' assessments and patients' expectations during prosthodontic treatment is inevitable. Incorporating dental patients' concerns about their prosthodontic treatment needs is essential during treatment planning, yet studies assessing these needs in adult dental patients are lacking.

    PURPOSE: The purpose of this study was to develop and validate a novel instrument, termed the questionnaire on perceived prosthodontic treatment needs (PPTN), that assesses perceived prosthodontic treatment needs in adults.

    MATERIAL AND METHODS: The PPTN was developed following a literature review, consultation with healthcare workers, and patient interviews. It included 15 questions and a self-rated need for prosthodontic treatment, categorized on a Likert scale. A cross-sectional descriptive study was completed on 193 dental patients seeking or receiving prosthodontic treatment.

    RESULTS: Three perceived prosthodontic treatment need factors were identified (psychosocial impact, esthetic concern, and function) by using exploratory factor analysis. A higher PPTN score indicated greater perceived prosthodontic treatment needs. The identified factors represent 67.8% of the variance with eigenvalues of >1. The PPTN had a high degree of internal consistency and reliability, as the final questionnaire received a Cronbach alpha of 0.75 and an intraclass coefficient of 0.75 with a 95% confidence interval of 0.68 to 0.80 (F(192, 576)=3.94, P

  7. Yacob N, Ahmad NA, Safii SH, Yunus N, Abdul Razak F
    J Prosthet Dent, 2023 Jul;130(1):131.e1-131.e7.
    PMID: 37210224 DOI: 10.1016/j.prosdent.2023.04.017
    STATEMENT OF PROBLEM: How the build orientation of a 3-dimensionally (3D) printed denture affects microbial adhesion is unclear.

    PURPOSE: The purpose of this in vitro study was to compare the adherence of Streptococcus spp. and Candida spp. on 3D-printed denture bases prepared at different build orientations with conventional heat-polymerized resin.

    MATERIAL AND METHODS: Resin specimens (n=5) with standardized 28.3 mm2 surface area were 3D printed at 0 and 60 degrees, and heat-polymerized (3DP-0, 3DP-60, and HP, respectively). The specimens were placed in a Nordini artificial mouth (NAM) model and exposed to 2 mL of clarified whole saliva to create a pellicle-coated substratum. Suspensions of Streptococcus mitis and Streptococcus sanguinis, Candida albicans and Candida glabrata, and a mixed species, each at 108 cfu/mL were pumped separately into the model for 24 hours to promote microbial adhesion. The resin specimens were then removed, placed in fresh media, and sonicated to dislodge attached microbes. Each suspension (100 μL) was aliquoted and spread on agar plates for colony counting. The resin specimens were also examined under a scanning electron microscope. The interaction between types of specimen and groups of microbes was examined with 2-way ANOVA and then further analysis with Tukey honest significant test and Kruskal-Wallis post hoc tests (α=.05).

    RESULTS: A significant interaction was observed between the 3DP-0, 3DP-60, and HP specimen types and the groups of microbes adhering to the corresponding denture resin specimens (P

  8. Patil PG, Lim HF
    J Prosthet Dent, 2023 Jul;130(1):14-18.
    PMID: 34774303 DOI: 10.1016/j.prosdent.2021.08.005
    Fabricating a new crown to retrofit with an existing removable partial denture (RPD) is a complex procedure for both clinician and dental laboratory technician. The presented technique facilitates the fabrication and retrofitting of a metal-ceramic crown onto the principal abutment of the existing RPD by using 2-step intraoral scanning (with and without the RPD in place) and 2 different 3-dimensionally printed casts. The technique enables the dental laboratory technician to precisely reproduce the retentive areas, guiding planes, and rest seats on the retrofitted crown.
  9. Buzayan MM, Elkezza AH, Ahmad SF, Mohd Salleh N, Sivakumar I
    J Prosthet Dent, 2023 Sep 23.
    PMID: 37748996 DOI: 10.1016/j.prosdent.2023.08.027
    STATEMENT OF PROBLEM: The fabrication of facial prostheses is complicated and time-consuming because of the need for accurate impressions of the facial defects and surrounding tissues. Inaccuracies can arise from soft-tissue compression, involuntary patient movements, and insufficient support for the impression material. Various 3-dimensional (3D) imaging and scanning techniques, including photogrammetry, have been introduced, but their accuracy remains insufficiently evaluated.

    PURPOSE: The purpose of this in vitro study was to evaluate and compare the accuracy of 3D digital casts generated by 4 photogrammetry software programs (Agisoft Metashape, 3DF Zephyr, Meshroom, and Polycam) and casts from 2 conventional impression materials (alginate and polyvinyl siloxane [PVS]) for the fabrication of nasal maxillofacial prostheses.

    MATERIAL AND METHODS: A stone cast of a patient's nose was used as the basis for generating a reference digital 3D cast and another 54 test 3D casts. The reference cast was created by scanning the stone cast using a FARO Optor Lab 3D scanner. The 54 test 3D casts were generated and divided into 6 test groups as follows: Agisoft group: 9 3D casts generated using Agisoft Metashape, a commercial personal computer (PC) software program; 3DF Zephyr group: 9 3D casts generated using 3DF Zephyr, a commercial PC software program; Meshroom group: 9 3D casts generated using Meshroom, a free PC software program; Polycam group: 9 3D casts generated using the Polycam, a commercial Android cloud application; PVS group: 9 3D casts generated indirectly by 3D scanning a gypsum cast made from a polyvinyl siloxane (PVS) impression of the stone nose cast; and Alginate group: 9 3D casts generated indirectly by scanning a master cast made using alginate impressions of the stone nose cast. Deviation measurements of the produced specimens were analyzed using the Geomagic Control X software program, and statistical comparisons were performed employing the Kruskal-Wallis test (α=.05).

    RESULTS: The results showed that the 3DF Zephyr group had the smallest deviation measurements (median: 0.057 mm ±0.012) among the 4 photogrammetry software programs, while the alginate impression group had the largest deviations (median: 0.151 mm ±0.094) of the 2 conventional impression materials. Significant differences were observed among the 4 photogrammetry software programs and the 2 conventional impression materials (H=39.41, df=5, P.05).

    CONCLUSIONS: Photogrammetry software programs, specifically Agisoft Metashape and 3DF Zephyr, demonstrated better accuracy than conventional impression materials in creating nasal digital casts. Photogrammetry has the potential to improve workflow and reduce patient discomfort during the fabrication of maxillofacial prostheses. Further research is needed to validate these findings in clinical settings.

  10. Kher U, Nimbalkar S, Patil PG, Mehta N
    J Prosthet Dent, 2023 Oct 18.
    PMID: 37863756 DOI: 10.1016/j.prosdent.2023.09.024
    Bony defects in the esthetic zone, especially in the maxillary anterior region, increase the complexity of surgical and prosthetic procedures. Moving teeth with preprosthetic osseous distraction techniques can be an alternative nonsurgical option to traditional regenerative or reparative surgical therapies to increase bone volume. Healthy peri-implant bone, periodontium, and adjacent teeth provide a favorable environment for implant restorations. The esthetic rehabilitation of the maxillary region after the removal of 2 ankylosed central incisors is presented. The lateral incisors were moved mesially to the central incisor positions, and implants placed in the lateral incisor positions after new healthy bone had been induced.
  11. Tew IM, Soo SY, Pow EHN
    J Prosthet Dent, 2023 Nov 23.
    PMID: 38000966 DOI: 10.1016/j.prosdent.2023.10.028
    STATEMENT OF PROBLEM: Reports on digitally fabricated complete dentures are increasing. However, comprehensive evidence-based research on their cost-efficiency and patient-reported outcome measures (PROMs) is lacking.

    PURPOSE: The purpose of this systematic review was to compare the cost-effectiveness and PROMs between digitally and conventionally fabricated complete dentures.

    MATERIAL AND METHODS: An electronic search of publications from 2011 to mid-2023 was established using PubMed/Medline, EBSCOhost, and Google Scholar. Retrospective, prospective, randomized controlled, and randomized crossover clinical studies on at least 10 participants were included. A total of 540 articles were identified and assessed at the title, abstract, and full article level, resulting in the inclusion of 14 articles. Data on cost, number of visits, patient satisfaction, and oral health-related quality of life were examined and reported.

    RESULTS: The systematic review included 572 digitally fabricated complete dentures and 939 conventionally fabricated complete dentures inserted in 1300 patients. Digitally fabricated complete dentures require less clinical time with a lower total cost, despite higher material costs compared with the conventional fabrication technique. Digitally and conventionally fabricated complete dentures were found to have significant effects on mastication efficiency, comfort, retention, stability, ease of cleaning, phonetics, and overall patient satisfaction, as well as social disability, functional limitation, psychological discomfort, physical pain, and handicap.

    CONCLUSIONS: Digitally fabricated complete dentures are more cost-effective than conventionally fabricated dentures. There are various impacts of conventionally and digitally fabricated complete dentures on PROMs, and they are not better than one another.

  12. Saker S, El-Kholany N, El-Gendy A, Fadhil ON, Maria OM
    J Prosthet Dent, 2014 Apr 22.
    PMID: 24767901 DOI: 10.1016/j.prosdent.2013.07.030
    This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
  13. Patil PG, Seow LL, Uddanwadikar R, Pau A, Ukey PD
    J Prosthet Dent, 2024 Feb;131(2):281.e1-281.e9.
    PMID: 37985307 DOI: 10.1016/j.prosdent.2023.10.023
    STATEMENT OF PROBLEM: The 2-implant mandibular overdenture (2IMO) is a popular treatment for patients with mandibular edentulism. However, information on the influence of implant positions on crestal strain is lacking.

    PURPOSE: The purpose of this in vitro study was to evaluate the crestal strain around 2 implants to support mandibular overdentures when placed at different positions.

    MATERIAL AND METHODS: Edentulous mandibles were 3-dimensionally (3D) designed separately with 2 holes for implant placement at similar distances of 5, 10, 15, and 20 mm from the midline, resulting in 4 study conditions. The complete denture models were 3D designed and printed from digital imaging and communications in medicine (DICOM) images after scanning the patient's denture. Two 4.3×12-mm dummy implants were placed in the preplanned holes. Two linear strain gauges were attached on the crest of the mesial and distal side of each implant (CH1, CH2, CH3, and CH4) and connected to a computer to record the electrical signals. Male LOCATOR attachments were attached, the mucosal layer simulated, and the denture picked up with pink female nylon caps. A unilateral and bilateral force of 100 N was maintained for 10 seconds for each model in a universal testing machine while recording the maximum strains in the DCS-100A KYOWA computer software program. Data were analyzed by using 1-way analysis of variance, the Tukey post hoc test, and the paired t test (α=.05).

    RESULTS: Under bilateral loading, the strain values indicated a trend with increasing distance between the implants with both right and left distal strain gauges (CH4 and CH1). The negative (-ve) values indicated the compressive force, and the positive (+ve) values indicated the tensile force being applied on the strain gauges. The strain values for CH4 ranged between -166.08 for the 5-mm and -251.58 for the 20-mm position; and for CH1 between -168.08 for the 5-mm and -297.83 for the 20-mm position. The remaining 2 mesial strain gauges for all 4 implant positions remained lower than for CH4 and CH1. Under unilateral-right loading, only the right-side distal strain gauge CH4 indicated the increasing trend in the strain values with -147.5 for the 5-mm, -157.17 for the 10-mm, -209.33 for the 15-mm, and -234.75 for the 20 mm position. The remaining 3 strain gauges CH3, CH2, and CH1 ranged between -28.33 and -107.17. For each position for both implants, significantly higher (P

  14. Ahmed N, Khalid S, Vohra F, Halim MS, Al-Saleh S, Tulbah HI, et al.
    J Prosthet Dent, 2024 Feb;131(2):187-196.
    PMID: 35277267 DOI: 10.1016/j.prosdent.2021.11.035
    STATEMENT OF PROBLEM: The recurrent esthetic dental (RED) proportion has been a benchmark for the rehabilitation of the maxillary anterior teeth of North American patients. While it has been evaluated in other populations, the global application of RED proportions in the rehabilitation of maxillary anterior teeth is unclear.

    PURPOSE: The purpose of this systematic review was to examine the existing evidence on dental proportion to evaluate the existence of RED proportions in the esthetic smile in different geographic regions.

    MATERIAL AND METHODS: A systematic search was conducted by reviewing different databases. The focused question was "Does RED proportion exist in esthetically pleasing smiles in different populations around the world?" The search included articles with a combination of MeSH keywords based on dental proportion from January 2000 to July 2020. The titles and abstracts were identified by using a search protocol. Full text of the articles was independently evaluated. The systematic review was modified to summarize the relevant data. The general characteristics, outcomes, and quality of studies were reviewed and analyzed systematically.

    RESULTS: Seventeen studies were selected from the reviewed articles. Three studies were conducted in Europe, 10 in South Asia, and 4 in Western Asia. Eleven studies found that the mean perceived ratio of anterior teeth was not constant when progressing distally. Five studies reported that the ratio was constant in a small percentage of their populations, and 1 suggested that the ratio was constant if it remains between 60% and 80%. The central-to-LI and Ca-to-LI proportion values were not constant. Overall, the Ca-to-LI proportion values were higher than the central-to-LI proportions.

    CONCLUSIONS: RED proportions were not found in the successive widths of maxillary anterior teeth among the reviewed data from different geographic regions. RED proportions are not the only standard for restoring esthetic smiles worldwide, and anterior tooth proportions differ among populations based on their race and ethnicity.

  15. Abdelrehim A, Etajuri EA, Sulaiman E, Sofian H, Salleh NM
    J Prosthet Dent, 2022 Nov 07.
    PMID: 36357194 DOI: 10.1016/j.prosdent.2022.09.010
    STATEMENT OF PROBLEM: Attaining a passive fit in implant restorations is desirable but clinically difficult to achieve, especially in screw-retained prostheses. At a certain magnitude, this misfit will not cause mechanical and biological complications, but the exact level has yet to be determined.

    PURPOSE: The purpose of this systematic review was to gather, compare, and appraise studies that attempted to determine the biological and mechanical tolerance of misfits.

    MATERIAL AND METHODS: The review protocol was published in the Prospective Register for Systematic Reviews (PROSPERO; registration no. CRD42021268399) and follows the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search was conducted through PubMed, Ebscohost, and Web of Science followed by a manual search up to December 2021.

    RESULTS: A total of 413 manuscripts were identified by electronic and manual search. After removing duplicates, nonrelevant titles, and abstract screening, 62 manuscripts were eligible for full-text assessment. Finally, a total of 13 articles (1 cross-sectional study, 1 retrospective and prospective, 7 in vitro studies, and 4 animal studies) met the eligibility criteria and were included in this review. A wide range of tolerable misfits were reported. Vertical misfit up to 1 mm and horizontal misfit up to 345 μm were associated with no adverse outcomes.

    CONCLUSIONS: The current literature provides inadequate data to determine a clinical threshold of an acceptable misfit. However, this review demonstrated that the mechanical response to misfit is more critical than the biological response.

  16. Xin YH, Ying TJ, Syeed MS, Veettil SK, Menon RK
    J Prosthet Dent, 2023 Feb 28.
    PMID: 36863936 DOI: 10.1016/j.prosdent.2023.01.007
    STATEMENT OF PROBLEM: Symptomatic denture stomatitis (DS) is a painful oral mucosal disorder that can impair quality of life in denture wearers. A complete cure of DS is difficult to achieve, and the most efficacious regimen to treat DS has not yet been conclusively established.

    PURPOSE: The purpose of this network meta-analysis was to assess the comparative efficacy of interventions used for the treatment of DS.

    MATERIAL AND METHODS: A search was conducted for trials published in Medline, Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until February 2022 (PROSPERO Reg no: CRD42021271366). Network meta-analysis was performed on data from randomized controlled trials that assessed the comparative efficacy of any form of intervention for the treatment of DS in denture wearers. Agents were ranked according to their effectiveness in the treatment of DS based on outcomes using surface under the cumulative ranking (SUCRA).

    RESULTS: A total of 25 articles were included in the quantitative analysis. Topical antifungal agents (risk ratio [RR]=4.37[95% confidence interval [CI]: 2.15,8.90), topical antimicrobial agents used along with systemic antifungal agents (RR=4.25[95% CI: 1.79,10.33]), systemic antifungal agents (RR=4.25[95% CI: 1.79,10.10]), photodynamic therapy (RR=4.25[95% CI: 1.75,8.98]), and topical plant products (RR=3.40[95% CI: 1.59,7.26]) were found to effectively improve DS. Microwave disinfection concurrently administered with topical antifungal agents (RR=7.38(95% CI: 2.75,19.81), microwave disinfection 7.38[95% CI: 2.75,19.81]), topical antifungal agents (RR=4.88[95% CI: 1.92,12.42]), topical plant products (RR=4.49[95% CI: 1.70,11.82]), systemic antifungal agents together with topical antimicrobial agents (RR=3.85[95% CI: 1.33,11.10]), topical antimicrobial agents (RR=3.39[95% CI: 1.17,9.81]), systemic antifungal agents (RR=3.37[95% CI: 1.21,9.34]), and photodynamic therapy or photochemotherapy (PDT) (RR=2.93[95% CI: 1.01,8.47]) were found to effectively resolve mycological DS. Topical antifungals ranked highest in the SUCRA ranking for clinical improvement, whereas microwave disinfection concurrently administered with topical antifungal agents ranked highest for mycological resolution. None of the agents demonstrated significant side effects except for topical antimicrobial agents which demonstrated altered taste and staining of oral structures.

    CONCLUSIONS: Available evidence suggests that topical antifungals, microwave, and systemic antifungals are effective in the treatment of DS, but confidence in these findings is low because of the limited number of studies and a high risk of bias. Additional clinical trials are needed on photodynamic therapy, topical plant products, and topical antimicrobials.

  17. Patil PG, Seow LL
    J Prosthet Dent, 2022 Nov 18.
    PMID: 36411113 DOI: 10.1016/j.prosdent.2022.09.007
    STATEMENT OF PROBLEM: The 2-implant mandibular overdenture (2IMO) is a popular treatment for patients with an edentulous mandible, but information on the effect of the optimum implant position on the peri-implant crestal bone level with immediate loading protocols is lacking.

    PURPOSE: The purpose of this prospective clinical study was to evaluate correlations between different implant positions and crestal bone loss and between interimplant distance and the crestal bone loss in patients with 2IMOs with immediate loading protocols at 1-year follow-up.

    MATERIAL AND METHODS: A total of 24 participants (13 men, 11 women, mean ±standard deviation age 63.25 ±10.76 years) were treated with 2IMOs (48 Ti-Zr implants) by a single operator between August 2015 and October 2020. The implant diameters (3.3 mm or 4.1 mm) and lengths (10 mm or 12 mm) were selected based on the crestal bone width, and the implants were placed, if possible, in the canine regions. Implant positions and interimplant distance (mm) were measured intraorally with dividers. Prefabricated mandibular dentures were immediately loaded with the LOCATOR-attachments by using a direct intraoral pickup procedure. Crestal bone-level changes were measured with a software program on the mesial and distal sides of each implant from periapical radiographs made with a paralleling technique (at baseline and 1-year follow-up). The measurement values were normalized. The Spearman rho correlation test and paired samples t tests were used for data analysis (α=.05).

    RESULTS: The mean ±standard deviation position of the implants from the midline was 8.78 ±2.25 mm (9.00 ±2.22 mm right side, 8.56 ±2.31 mm left side), and the mean interimplant distance was 16.94 ±4.03 mm. At 1-year follow-up, the mean ±standard deviation crestal bone loss was 0.50 ±0.47 mm (n=48) (0.57 ±0.65 mm mesial, 0.43 ±0.53 mm distal). The mean ±standard deviation crestal bone loss was 0.46 ±0.4 mm with Ø3.3-mm implants (n=42) and 0.9 ±0.8 mm with Ø4.1-mm implants (n=6) (P=.005). Implant positions were negatively correlated (rs=-0.37) with the crestal bone loss, and the correlation was significant (P=.009). Interimplant distances were also negatively correlated with crestal bone loss (rs=-0.60; P=.002). Bone loss on the mesial side was positively correlated with that on the distal side rs=0.20; however, the correlation was not significant (P=.16).

    CONCLUSIONS: A weak and negative correlation was found between the implant position from the midline and the crestal bone loss and also between the interimplant distance and crestal bone loss in patients provided with 2IMOs with immediate loading protocols.

  18. Patil PG, Seow LL, Uddanwadikar R, Pau A, Ukey PD
    J Prosthet Dent, 2022 Jun 03.
    PMID: 35667890 DOI: 10.1016/j.prosdent.2022.04.018
    STATEMENT OF PROBLEM: The edentulous mandible is commonly treated with a 2-implant overdenture. A change in diameter of the implants may affect the biomechanical behavior of the overdenture, but information on these effects is lacking.

    PURPOSE: The purpose of this 3D finite element analysis study was to evaluate the biomechanical behavior of 2-implant mandibular overdentures (2IMO) and their individual components by using implants of different diameters.

    MATERIAL AND METHODS: A 3D mandibular model was obtained from the cone beam computed tomography (CBCT) images of a 59-year-old edentulous man, and a 3D denture model was developed from intraoral scanning files in the Mimics software program. A 3D model of different diameters of implants (2.5 mm, 3.0 mm, 3.5 mm, and 4.0 mm) with a LOCATOR attachment was developed in the Solidworks software program. Two same-sized implants were inserted in the mandibular model at 10 mm from the midline in the 3Matics software program. A vertical load of 100 N was applied on the first molar region on the right side or both sides in the ANSYS software program. The maximum von Mises stresses and strains were recorded and analyzed.

    RESULTS: Stresses within the implants decreased with an increase in diameter (from 2.5 mm to 3 mm, 3.5 mm, and 4.0 mm) of the implants. The highest stresses were observed with 2.5-mm-diameter implants (0.949 MPa under unilateral and 0.915 MPa under bilateral loading) and the lowest with Ø4-mm implants (0.710 MPa under unilateral and 0.703 MPa under bilateral loading). The strains on the implants ranged between 0.0000056 and 0.0000097, and those on the mandible ranged between 0.0000513 and 0.0000566 across all diameters of the implants without following a specific trend.

    CONCLUSIONS: In 2IMO, the stresses in the implants and mandible decreased with an increase in the diameter of the implants. The implants of lesser diameter (2.5 mm) exhibited the highest stresses and strains, and the implants of the largest diameter (4 mm) exhibited the lowest stresses and strains under unilateral and bilateral loading conditions.

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