Assessment Of Marginal Bone Level Research Articles

Is cone-beam computed tomography (CBCT) an alternative to plain radiography in assessments of dental disease? A study of method agreement in a medically compromised patient population

ObjectivesPoor oral health and dental infections can jeopardize medical treatment and be life-threatening. Due to this, patients with head and neck malignancies, generalized tumor spread, organ transplant, or severe infection are referred for a clinical oral and radiographic examination. The aim of this study was to compare the diagnostic agreement of three radiographic modalities: intraoral radiographs (IO), panoramic radiographs (PX), and cone beam computed tomography (CBCT) for diagnosis of dental diseases.Materials and methodsThree hundred patients were examined with IO, PX, and CBCT. Periapical lesions, marginal bone level, and caries lesions were diagnosed separately by four oral radiologists. All observers also assessed six teeth in 30 randomly selected patients at two different occasions. Kappa values and percent agreement were calculated.ResultsThe highest Kappa value and percent agreement were for diagnosing periapical lesions (0.76, 97.7%), and for the assessment of marginal bone level, it varied between 0.58 and 0.60 (87.8–89.3%). In CBCT, only 44.4% of all teeth were assessable for caries (Kappa 0.68, 93.4%). The intra-observer agreement, for all modalities and diagnoses, showed Kappa values between 0.5 and 0.93 and inter-observer agreement varied from 0.51 to 0.87.ConclusionsCBCT was an alternative to IO in diagnosing periapical lesions. Both modalities found the same healthy teeth in 93.8%. All modalities were performed equally regarding marginal bone level. In caries diagnosis, artifacts were the major cause of fallout for CBCT.Clinical relevanceIntraoral radiography is the first-hand choice for diagnosing dental disease. For some rare cases where intraoral imaging is not possible, a dedicated panoramic image and/or CBCT examination is an alternative.

EVALUATION OF SUCCESS OF SINGLE DRILLING IMPLANT SYSTEM (CLINICAL AND RADIOGRAPHIC STUDY)

Introduction: Preparation of the implant osteotomy has been classically performed using drills of various shapes to conform the site to the implant's geometry. Drilling procedures may cause not only mechanical trauma to the bone but also heat-induced bone necrosis, thus representing a significant risk for failed osseointegration. As an alternative single drilling osteotomy is a technique that allows effective bone cutting with minimally traumatic procedures and less heat generation. Objectives: Evaluation of single drilling implant site preparation in affecting implant stability and crestal bone loss that takes place around the implant. Material and Methods: The study was conducted on thirteen patients having missing posterior mandibular teeth indicated for implant restoration. All implants were placed using single drilling osteotomy. After 3 months, final crowns were delivered. All implants were followed for 6 months. Clinically, each patient was evaluated for pain, swelling and stability of the implant. Radiographically, cone beam computed tomography (CBCT) was used for the assessment of marginal bone level and bone density. Results: There was a significant increase in bone density from immediate postoperative to the end of the 6 months. The mean of marginal bone level from immediately post-operative to the 3rd month was significant and from immediate to 6th month was significant. One case displayed swelling in the first week and the implant was removed (failure case) due to lack of oral hygiene maintenance by the patient. Conclusions: Single drilling osteotomy was a successful treatment procedure, with satisfactory clinical outcomes, and a low incidence of complications.

EVALUATION OF SELF OSTEOMIZING IMPLANTS FOR REPLACEMENT OF MANDIBULAR POSTERIOR TEETH (CLINICAL AND RADIOGRAPHIC STUDY)

Introduction: Osseointegration, defined as a direct structural and functional connection between ordered living bone and the surface of a load-carrying implant, is critical for implant stability and is considered a prerequisite for implant loading and long-term clinical success of endosseous dental implants. Primary stability following implant placement is essential for osseointegration and is mainly influenced by the following main factors density, quantity of bone at the implant site and implant design. Moreover, implant surface topography is a key factor in the achievement of osseointegration, the most common modification of implant topography is surface roughness. This is achieved by acid etching, sandblasting, or oxidization. Objectives: To evaluate the effectiveness of using MPM, compared to the use of bone graft alone, to assess the exact effect of each in enhancing the osteogenic differentiation and bone formation. Materials and methods: This clinical study was performed on a total of eleven patients (14 implants), with missing mandibular posterior teeth indicated for implant restoration. Implants were placed according to manufacturer's instructions. After 3 months, final crowns were delivered. All implants were followed up for 6 months. Clinically, each patient was evaluated for pain, swelling and stability of the implant. Radiographically, cone beam computed tomography (CBCT) was used for the assessment of marginal bone level and bone density. Results:There was a significant increase in bone density from the preoperative phase to the end of the 6 months. The mean of marginal bone level loss from the preoperative period to the 3rd month was significant as well as from the preoperative period to the 6th month. One case displayed periimplantitis and mobility in the first month of follow up and hence it was removed and regarded as failure case. Conclusions: Self osteomizing implants are a good choice for replacing missing mandibular posterior teeth with satisfactory clinical outcomes and a low incidence of complications.

EVALUATION OF DENTAL IMPLANTS USING A MODIFIED THREAD GEOMETRY IN THE MANDIBULAR PREMOLAR REGION

Introduction: Modern implantology is changing direction towards the development of new implant macrodesigns that are able to provide a high level of physico-mechanical characteristics. This study examines the mechanical aspect of implants. In particular, macrodesign such as thread shape, pitch and depth. Objectives: To evaluate clinically and radiographically fin thread design implant osseointegration and primary stability in mandibular premolar region. Materials and methods: A clinical study was conducted on thirteen patients with missing mandibular premolar teeth. The magic fc implants with fin thread were inserted. After 3 months, final crowns were delivered. All implants were followed for 6 months. Clinically, each patient was evaluated for pain, swelling and stability of the implant. Radiographically, cone beam computed tomography (CBCT) was used for the assessment of marginal bone level and bone density. Results:There was a significant increase in bone density from immediate postoperative to the end of the 6 months. The mean of marginal bone level from immediately post-operative to the 3rd month was significant and from immediate to 6th month was significant. One case displayed swelling in the first week and the implant was removed (failure case) due to lack of oral hygiene maintenance by the patient. Conclusions: Magic FC implants with fin thread were a successful treatment procedure, with satisfactory clinical outcomes, and a low incidence of complications.

EVALUATION OF DENTAL IMPLANTS IN MANDIBULAR NARROW RIDGES USING BONE EXPANSION AND BENDING TECHNIQUE

INTRODUCTION: Narrow dentoalveolar ridges remain a challenge for the successful placement of implants; success depends largely on the quality and quantity of the available bone in the recipient site. This however may be compromised or unavailable which necessitates the need to manipulate the residual bone by contouring or making dimensional changes to create an intra-bony cavity to form a receptor site for an implant while preserving bone integrity and viability.OBJECTIVES: Evaluation of the success of dental implants in mandibular narrow ridges (≤ 5mm) after using bone expansion and cortical bone bending technique with a new design of bone expander.MATERIALS AND METHODS: This clinical study was performed on a total of eight patients with mandibular narrow ridges (≤ 5mm). All implants were followed for 6 months. Clinically, each patient was evaluated for pain, tenderness or discomfort, presence of swelling or infection and mobility of the implant. Also, radiographic investigations were performed for the assessment of marginal bone level, bone width and the bone density around the implant. An implant stability and assessment of the osseointegration progress evaluation was conducted using the resonance frequency analysis technique (Osstell) immediately after implant placement and after three months and after six months.RESULTS: There was a statistically significant increase in the bone density around the implants throughout the evaluation period and there was increase in implant stability quotient after six months was statistically significant (p=0.008). There were significant decreases in the mean of marginal bone level changes by time in all cases, the increase in bone width quotient after six months was statistically significant p < 0.001.CONCLUSIONS: using the newly designed star shape bone expanders as a bone expansion and bending technique, showed an adequate clinical and radiographic performance in the mandibular narrow ridges.

Assessment of marginal bone level around immediately loaded single implant used to retain mandibular overdenture with bollard coping vs locator attachments

Assessment of marginal bone level around immediately loaded single implant used to retain mandibular overdenture with bollard coping vs locator attachments

Reliability of marginal bone level measurements on digital panoramic and digital intraoral radiographs

ObjectivesThe aim of this study was to evaluate the reliability of bitewing and panoramic radiographs in marginal bone level measurements in terms of inter- and intra-observer agreement.MethodsFifty paired bitewing and panoramic images were used. Eight observers measured marginal bone level at the mesial and distal surfaces of tooth 25 and tooth 35. Thus, in total 100 radiographs of 400 measurements were obtained for each observer. To evaluate intra-observer agreement, three observers re-evaluated the radiographs after a minimum of 1 month. Intra-class correlation coefficient (ICC) was applied to evaluate the inter- and intra-observer agreement. The t test was applied to assess possible difference in measurement between bitewing and panoramic radiographs.ResultsThe mean ICC value of inter-observer agreement was 0.85 for bitewing and 0.66 for panoramic radiographs. The mean intra-observer agreement was 0.92 and 0.76 for bitewing and panoramic radiographs, respectively. There was no statistically significant difference between bitewing and panoramic radiographs in measurements of marginal bone level on maxillary tooth 25, whereas a statistically significant difference was found between the two image modalities on mandible tooth 35.ConclusionBitewing examination should be the choice of image modality for assessment of marginal bone level at premolar region due to good to excellent reliability and low radiation dose. However if a panoramic radiograph already exists, a rough estimation of marginal bone level at premolar region is clinically acceptable bearing in mind that the bone height of the mandible premolar region might be overestimated as compared to bitewing radiograph.

Marginal bone level and survival of short and standard-length implants after 3 years: An Open Multi-Center Randomized Controlled Clinical Trial.

The present multi-center randomized controlled clinical trial sought to compare the marginal bone level (MBL) changes and survival of 6- and 11-mm implants. Ninety-five patients receiving a total of 209 dental implants were enrolled. Subjects were randomly allocated to two cohorts: test (4.0×6mm; N=108) or control (4.0×11mm; N=101) implant groups. To be randomized, all edentulous sites were anatomically qualified to receive 11mm implant. Two to three implants were placed in maxillary or mandibular posterior regions and loaded with splinted provisional restoration after 6weeks and definitive restoration 6months thereafter. Test and control implants were followed by clinical and radiographic examinations on an annual basis up to 3years. Radiographic assessment of MBL 3years after loading revealed the bone to be located at 0.27mm (±0.40) and 0.44mm (±0.74) apical to the implant platform in the test and control groups, respectively. During the 3years of follow-up since loading, 0.04mm (±0.43) MBL gain and 0.02mm (±0.76) of MBL loss were observed in the 6-mm (test) and 11-mm (control) groups, respectively. The MBL's for test and control were significantly different (p=0.000) in favor of short implants. The cumulative survival rates from placement after 3years were 96% and 99% for the 6- and 11-mm implants, respectively, with no statistical significance. Reconstruction of partially edentulous posterior maxilla or mandible with 6- or 11-mm implants led to stable marginal bone level and high implant survival rate after 3years.

EVALUATION OF IMMEDIATELY LOADED KNIFE THREAD IMPLANTS FOR THE REPLACEMENT OF MANDIBULAR SINGLE- ROOTED TEETH (CLINICAL &amp; RADIOGRAPHIC STUDY)

INTRODUCTION: Modern implantology is changing direction towards the development of new implant macrodesigns that are able to provide a high level of physico-mechanical characteristics and can offer a high level of primary implant stability that is important for long-term success of the immediate loading treatment protocols.OBJECTIVES: Clinical and radiographic evaluation of immediately loaded knife thread implants for the replacement of mandibular single- rooted teeth.MATERIALS AND METHODS: This study was conducted on ten adult patients with missing mandibular single rooted teeth. AnyRidge knife threaded tapered implants were inserted and immediately loaded with a non-occluding temporary crowns immediately after implant placement. After 3 months, final crowns were delivered. All implants were followed for 6 months. Clinically, each patient was evaluated for pain, tenderness or discomfort, presence of swelling or infection and mobility of the implant. Radiographically, standardized periapical x-ray films were taken then Image-J processing Program was used for the assessment of marginal bone level and bone density around the implant.RESULTS: In only one case moderate pain, peri-implant infection with suppuration and grade III mobility was registered in the first follow up month, that was regarded as a failure case and the implant was removed, resulting in implant survival rates of 90% after six months. There was a statistically significant increase in bone density around the implants throughout the evaluation period. The mean of peri-implant bone loss increased from immediately post-operative to the 3rd month. This increase was statistically significant. Then there was statistically insignificant decrease from the 3rd to the 6th months. CONCLUSIONS: Immediate non-occlusal loading of knife thread implants for the replacement of mandibular single rooted teeth was a successful treatment procedure, with satisfactory clinical outcomes, good survival rate (90%) and a low incidence of complications.

The accuracy and reliability of radiographic methods for the assessment of marginal bone level around oral implants.

To determine the accuracy and reliability of radiographic methods for assessment of the marginal bone level around oral implants in human cadavers. In three human cadavers two implants were placed according to the Instruction Manual for the Brånemark System. One implant was installed in the canine and one in the premolar region of the left mandible. For each implant, conventional and digital intra-oral paralleling radiography were performed. Digital images were printed with a Kodak 1200 Distributed Medical Imaging printer on blue transparent film, glossy and plain paper. Furthermore, digital scanographic, panoramic and tomographic images were taken with the Cranex Tome multimodal X-ray unit and printed on Agfa Drystar TM 1 B transparent films. All images were evaluated by five dental specialists. Data were statistically compared with real measurements of the marginal bone level on the human cadavers, performed by the same group of observers. Intra- and inter-observer variability were determined. Digital intra-oral images on glossy paper showed the smallest absolute difference between real and measured bone level, followed by digital intra-oral images on film and on plain paper, conventional intra-oral images on analogue film, panoramic, scanographic and tomographic images on film. The difference between real and radiographic measurements was not statistically significant (P>0.05) for all radiographic techniques. Intra- and inter-observer reproducibility was high for all techniques. The selected imaging techniques showed an acceptable accuracy for peri-implant bone level measurements with an overall error of less than 0.5 mm. Intra-oral images showed the smallest absolute differences.

The accuracy and reliability of radiographic methods for the assessment of marginal bone level around oral implants

OBJECTIVES To determine the accuracy and reliability of radiographic methods for assessment of the marginal bone level around oral implants in human cadavers. METHODS In three human cadavers two implants were placed according to the Instruction Manual for the Brånemark System. One implant was installed in the canine and one in the premolar region of the left mandible. For each implant, conventional and digital intra-oral paralleling radiography were performed. Digital images were printed with a Kodak 1200 Distributed Medical Imaging printer on blue transparent film, glossy and plain paper. Furthermore, digital scanographic, panoramic and tomographic images were taken with the Cranex Tome multimodal X-ray unit and printed on Agfa Drystar TM 1 B transparent films. All images were evaluated by five dental specialists. Data were statistically compared with real measurements of the marginal bone level on the human cadavers, performed by the same group of observers. Intra- and inter-observer variability were determined. RESULTS Digital intra-oral images on glossy paper showed the smallest absolute difference between real and measured bone level, followed by digital intra-oral images on film and on plain paper, conventional intra-oral images on analogue film, panoramic, scanographic and tomographic images on film. The difference between real and radiographic measurements was not statistically significant (P>0.05) for all radiographic techniques. Intra- and inter-observer reproducibility was high for all techniques. CONCLUSIONS The selected imaging techniques showed an acceptable accuracy for peri-implant bone level measurements with an overall error of less than 0.5 mm. Intra-oral images showed the smallest absolute differences.