Installation Of Implants Research Articles

Atrophic maxilla and osseointegrated implants: a systematic review

Introduction: In the scenario of the dental implants, what makes implantology unique is the ability to achieve this goal, however, the more teeth a patient loses the more challenging the task becomes. Osteoporosis may be a risk factor for the use of implants. Alternative approaches such as guided surgery and placement of short implants are progressively supplanting more invasive bone regeneration procedures. There are some drugs that help in the treatment of postmenopausal osteoporosis, they are calcitonin, bisphosphonates and the selective modulators of estrogen receptors. Objective: Foi realizar uma revisão sistemática sobre as principais considerações e desfechos clínicos da maxila atrófica no cenário dos implantes dentários osseointegrados, osteoporose e o uso dos bifosfonatos. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October 2022 to January 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2005 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 225 articles were found, and 65 articles were evaluated in full and 31 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 45 studies with a high risk of bias and 90 studies that did not meet GRADE. In the scenario of atrophic maxilla issues, it was concluded that osteoporosis is a metabolic condition that affects alveolar bone density, but does not present problems for the installation of osseointegrated implants, provided there is enough bone mass in the region where the tooth will be implanted. The rehabilitation of atrophic maxilla through dental implants is still challenging, however, alternatives such as guided surgery and the installation of short implants are progressively supplanting the more invasive bone regeneration procedures. Some drugs that help in the treatment of postmenopausal osteoporosis, are calcitonin, bisphosphonates, and the selective modulators of estrogen receptors. Bisphosphonates have been the best drug associated with significant improvement in the quality of life of patients with bone diseases such as Paget's disease, bone metastases, osteogenesis imperfecta, hypercalcemia, and even severe osteoporosis.

УСОВЕРШЕНСТВОВАНИЯ ПРОТОКОЛА ОПЕРАЦИИ ОДНОМОМЕНТНОЙ ДЕНТАЛЬНОЙ ИМПЛАНТАЦИИ ПАЦИЕНТОВ ПРИ ПОТЕРЕ ЗУБОВ

Subject. The technique of immediate dental implantation, analysis of its results and treatment protocol improvement.
 Aim. To increase the effectiveness of the rehabilitation of patients with chronic periodontitis and traumatic tooth fracture (with indications for extraction) based on the improvement of the protocol for the operation of one-stage dental implantation. 
 Methodology. In the period from 2020 to 2022, on the basis of the Department of Oral Surgery and Maxillofacial surgery department of the RUDN University and Sechenov University, the immediate dental implantation was performed in 20 patients with a diagnosis of Chronic periodontitis and tooth fracture (K.04.5, S02.5 ICD-10) (with indications for their removal ) with the installation of 20 dental implants: Osstem Implant (South Korea) – 10 units (50%), IRIS (Russia) – 10 units (50%). In all cases, the gingival cuff shapers were installed simultaneously. If necessary, osteoplastic materials and gingival autografts were used. The installation of dental implants was carried out with a depth of 2–3 mm, depending on the jaw section, and was displaced orally with a minimum distance to the vestibular cortical plate of 1.5 mm.
 Results. At the end of our study, no complications were identified, 100% integration of implants was obtained, as well as their 100% survival and stability, both according to CBCT data, and according to the results of a follow-up examination 12 months after permanent prosthetics restorations. 
 Conclusion. According to the results of our study, immediate implantation made it possible to carry out a full-fledged rehabilitation of patients if tooth extraction was necessary, to reduce the overall treatment time in the absence of complications in the postoperative period.

Horizontal Bone Augmentation in the Mandible by Subperiosteal Tunneling Technique: Case Report

Bone augmentations for installation of dental implants are often necessary and often decreases patient acceptance of treatment due to increased morbidity. In this clinical case, we report the procedure of subperiosteal tunneling (tunnel technique) combining in situ xenogeneic graft, of slow absorption bovine origin, for horizontal augmentation in the mandible. Bone grafts, horizontal and vertical, are extremely important procedures for oral rehabilitation in implant dentistry, thus enabling the re-establishment of an adequate framework for the installation of implants with correct positioning, restoring function and aesthetics to our patients. The most commonly used therapy consists of raising a more invasive flap to expose the bone tissue and performing associated grafting techniques. However, in well-indicated cases, we have this tool at our disposal, where we can treat our patients with minimally invasive techniques, such as subperiosteal tunneling, with very favorable clinical results. The main advantage of this approach, in addition to the minimally invasive technique, is the preservation of the periosteum and blood supply to the flap, which may contribute to increased favorable wound healing and a reduced risk of flap dehiscence and membrane exposure. This tunnel approach to guided bone regeneration in horizontal bone gains, specifically adapted and filled with xenogeneic bone, resulted in a significant gain in bone volume in thickness, which allowed implant placement (average increase of 5.0mm observed on tomography). As for morbidity, the patient reported a better postoperative period in the reconstruction surgery compared to the implant installation surgery, measured by the visual analogue scale (VAS).

The technology of installation of breast implants in the subpectoral space while preservation attachment of the abdominal part of the pectoralis major muscle

The paper describes the technology of installing breast implants in the subpectoral cellular space while maintaining the attachment of the abdominal part of the pectoralis major muscle and evaluate the results of its application. A retrospective analysis of the results of primary breast augmentation in 762 patients operated by the authors in 2010–2020 was carried out.The space for the breast implant was formed following a certain sequence of actions. The boundaries of the receptacle were: inside – the place of attachment of the pectoralis major muscle to the sternum, outside – the abdominal part of the pectoralis major muscle and the pectoral fascia, passing to the bundles of the anterior serratus muscle, at the top – thoracoacromial vascular bundle, below – VI rib and fascial node, formed by the transition of the thoracic fascia and the aponeurosis of the abdominal part of the pectoralis major muscle to the anterior wall of the sheath of the rectus abdominis muscle. Conclusions. 1. The technology of installing implants in the subpectoral cellular space, while maintaining the distal attachment of its abdominal part, allows achieving the stability of the position of the implants and avoiding rotation and malposition of the implants. 2. In terms of up to 3–4 months after surgery, a higher location of implants on the chest is often observed. 3. The decision on the need and degree of mobilization of the abdominal part of the pectoralis major muscle should be made individually. 4. The technique cannot be used when the width of the implant base exceeds the width of the pectoralis major muscle at the level of the IV rib, and, therefore, limits the choice of larger implants.

Posição das foraminas linguais na tomografia computadorizada de feixe cônico e suas implicações na escolha das dimensões dos implantes dentários para sínfise mandibular

ABSTRACT Objective: To identify the lingual foramina in a Brazilian population of 210 individuals through Cone-Beam Computed Tomography images, in order to guide the installation of dental implants in the region of the mental symphysis. Methods: After identifying the lingual foramina on a parasagittal section, four measurements were taken: distance to the alveolar ridge, distance to the mandibular lower border, distance to the limit of the vestibular cortical, and alveolar ridge inclination angle. The measurements were compared in relation to gender by the Mann-Whitney test. The association between gender and the number of foramina was done by the chi-square test. Pearson’s correlation analyzed the linear relationship between age and number of foramina. Results: Lingual foramina are present in 99.6% of the research participants. In the upper-inferior direction, a mean distance to the alveolar ridge of 21.4 mm was noted, while the mean distance to the lower mandibular border was 13.1 mm. In the bucco-lingual direction, a mean distance from the lingual foramina to the vestibular cortical of 15.2 mm is noted. The inclination angle of the alveolar ridge had a mean of 25.4º. Regarding gender, the test was not significant only for the distance to the vestibular cortical. Conclusion: The lingual foramina had a descending way in 100% of cases, being positioned mainly in the middle thirds (66.5%) and lower thirds (32.7%) of the mandibular ridge height. The use of dental implants up to 13 mm in length and up to 4 mm in diameter in the region of the symphysis mentualis is recommended.

Dental implant placement in the area of ectopic and impacted teeth

The paper presents two clinical cases demonstrating the effectiveness of using surgical templates for the installation of dental implants in the areas of ectopic and impacted teeth in case of patient's disagreement on their removal or other methods of treatment.

Temporomandibular Joint Disorders among Implant Patients in Relation to Bite Force

Background: The installation of dental implants may impair the temporomandibular joint’s ability to operate by altering bite force. Aim: The aim of this study was to compare dental implant patients with partially and fully dentate patients in terms of temporomandibular joint issues related to maximal bite force measurement. Materials and Methods: Ninety patients with dental implants aged 50–60 years old were compared to 90 with partial and 90 with complete dentition patients who were age and gender matched. The incidence and severity of temporomandibular joint problems among patients were assessed using Helkimo anamnestic and clinical dysfunction indices. By using a biting force sensor, maximum occlusal bite force was measured in accordance with the manufacturer’s instructions as reported at a US-based corporation. Statistical analysis of data was performed using the Statistical Package for the Social Sciences (SPSS) software program, version 22.0 (SPSS, Chicago, Illinois). Results: According to the data, patients in the fully dentate group had larger percentages of Helkimo anamnestic symptom-free and clinically no dysfunction than those patients in implant and partially edentulous groups. Patients in the partially edentulous group were more likely to have Helkimo anamnestic mild and severe symptoms, as well as clinical mild, moderate, and severe dysfunction than patients in the other two groups. These data, however, did not show a statistically significant association. Data analysis revealed that maximum bite force measurements were significantly different between groups for all Helkimo anamnestic and clinical indices. Conclusion: Following oral implant therapy, the function of the temporomandibular joint was affected. In addition, bite force measures decreased as temporomandibular disorder symptoms became more severe.

ПРОТОКОЛЫ ИНДИВИДУАЛЬНОЙ ГИГИЕНЫ РТА ПРИ ДЕНТАЛЬНОЙ ИМПЛАНТАЦИИ

Aim. Improving the quality of treatment of patients with defects in the dentition using orthopedic structures based on dental implants with development of individual oral hygiene protocols. Materials and methods. A survey of 82 patients using prostheses fixed on intraosseous dental implants was carried out. The results of treatment 5 years after the installation of implants were analyzed according to the criteria: the quality of oral hygiene and the presence of inflammation in the tissues surrounding the implant. Results. After fixation of prostheses based on dental implants, 73.2% of patients do not follow the recommendations on the oral care. Satisfactory level of oral hygiene in 57.3%, unsatisfactory - in 28.0% of patients using a manual toothbrush. The number of "successful" implants after 5 years is 41.5%, removed - 7.3%. Tissue inflammation was found in 36.5% of implants. Protocols for individual oral hygiene of patients using a toothbrush have been developed: before implantation; after surgery implantation early period; after implantation surgery late period; after completion of implant-supported prosthetics. Conclusions. The use of the toothbrush in the treatment of patients before and after dental implantation is a promising direction in improving its immediate and long-term results. The interactive functions of electric toothbrushes are considered as a tool for motivation and control of oral hygiene. The functionality of the toothbrush greatly simplifies hygienic care in hard-to-reach areas of dentures. The presence of seven modes and two nozzles helps to provide individual approach to oral hygiene, depending on the condition of the tissues.

РЕТРОСПЕКТИВНОЕ ИССЛЕДОВАНИЕ КАЧЕСТВА ЖИЗНИ ПАЦИЕНТОВ С РЕДУЦИРОВАННЫМИ АЛЬВЕОЛЯРНЫМИ ОТРОСТКАМИ, В РЕАБИЛИТАЦИИ КОТОРЫХ БЫЛИ ИСПОЛЬЗОВАНЫ МЕТОДЫ КОСТНОЙ ПЛАСТИКИ И ДЕНТАЛЬНОЙ ИМПЛАНТАЦИИ

In recent years, more and more attention has been paid to the problems of using dental implants in complex anatomical conditions due to bone deficiency. The probability of a favorable outcome after the treatment is quite high, which in turn is supported by the long-term results obtained after using various approaches in the rehabilitation of patients with a reduced volume of jaw bone tissue. Of course, the rehabilitation of such patients is difficult not only in terms of surgical preparation, but also in terms of orthopedic benefits, which impose restrictions on the capabilities of the patient's chewing and speech apparatus. In turn, the patient is faced with the task of maintaining as long as possible the result that the doctor originally sought, namely, using various methods of bone grafting, to create the necessary amount of bone tissue for the installation of implants, which are later used for orthopedic constructions, largely replenishing the functional characteristics. previously lost dentition. There are many studies that are devoted to modern methods of rehabilitation of patients with reduced alveolar processes of the jaws, however, only a small part affects the observation of delayed results of treatment of patients using bone grafting methods in combination with dental implantation. One of the advantages of this study is the ability to follow in dynamics what happens to these patients over a time period of up to 10 years, how strong the adaptive capabilities of the body are after major surgical interventions, what patient management tactics turned out to be the most effective. The assessment of the quality of life of such patients makes it possible to fully determine the feasibility of the operations and techniques to restore the function of the masticatory-speech apparatus. The duration of the positive result obtained directly depends on the further interaction between the doctor and the patient. The key point is the dispensary observation of the patient, as a result of which the doctor gains clinical experience, and therefore the ability to predict further complications with one or another approach to the rehabilitation of patients in this category. On the other hand, for an objective assessment of the treatment performed, it is necessary to determine a common denominator that reflects the quality of life of our patients, therefore, the article presents the results of chewing assessment, as a fundamental criterion for the quality of life for most of these patients, using the SF-36 questionnaire, which is a kind of translator between subjective feelings of the patient and an objective assessment of the doctor.

Findings on chin development and anatomy: a review of the literature

Annotation. The anatomy of the chin is of increasing interest in the community of maxillofacial surgeons. Features of development, bone structure, blood supply and innervation of the chin region are studied, as a rule, independently of each other and require generalization of knowledge. The purpose of the study was to collect data on the chin area, compare and summarize them; identify aspects of chin anatomy and development that require further study. Articles published in the 2000-2021 scientometric databases Pubmed and Medline were selected for analysis. Articles related to the development, blood supply, innervation and structure of the chin bone were considered. The main conclusions from the identified sources related to the following. The chin is a specific and new formation of a modern person, which has peculiarities of development, bone structure, blood supply and innervation. The reviewed articles contained scattered data and often revealed only one aspect of chin morphology. Some of them are related to ontogeny, others describe isolated facts about blood supply or bone structure without showing the relationship between development and morphology. Many studies have been conducted to identify the influence of the features of the chin structure on orthodontic treatment, installation of implants, and only a few of them are devoted to the healing of this area after trauma or the features of the development of various diseases. Since the chin area is a specific and new formation compared to other parts of the lower jaw, studies of various bone pathology in this area are necessary. Many publications are devoted to the study of the blood supply of the chin area, feeding holes and channels on the lingual surface of the lower jaw, and these data are widely used in surgical practice. The innervation of the chin, the influence of structural features on the healing of fractures and grafts, the difference in the healing of the bones of individual areas of the lower jaw are usually not described and require in-depth study.

Surgical restoration of interocclusal space and maxillary sinus floor elevation for prosthetic purposes

Aim: To report on a surgical procedure with osteotomy in the posterior region of the maxilla and lifting of the maxillary sinus floor for the installation of implants and rehabilitation with implant-supported crowns. Case report: A 54-year-old female patient was admitted to the dental clinic, complaining that she was dissatisfied with her smile and the missing teeth. After the clinical, radiographic, and tomographic examinations, a well as a case study of a semi-adjustable articulator, multidisciplinary planning was carried out using surgical, endodontic, periodontic, orthodontic, and prosthetic approaches. A lack of interocclusal space was observed in the posterior region of the maxilla. After osteotomy in tuberosity, maxillary sinus lift using an autogenous bone graft was performed, and three implants were installed. After the osseointegration period, provisional crowns were placed, followed by definitive metal-ceramic crowns. Conclusion: The surgical techniques used in this clinical case made it possible to install implants in a single clinical session for prosthetic rehabilitation.

Head and neck radiotherapy in patients with oral rehabilitation by dental implants: analysis of implant survival

Radiotherapy (RT) plays an important role in the treatment of patients with head and neck cancer. Clinical changes in the surrounding healthy tissue are often inevitable. The deleterious effects on the bones of the jaws have been considered a contraindication for rehabilitation with dental implants. However, in recent years, the installation of implants in irradiated patients has been consolidated as a valuable treatment option. The aim of this study was to evaluate the effect of RT on the survival of osseointegrated dental implants in patients with head and neck cancer. The applied methodology involved an electronic search in the MEDLINE database during the last five years. We identified 67 scientific documents related to the keywords: "radiotherapy", "dental implants" and "head and neck cancer", four articles were selected and reviewed, composing this analysis. It is concluded that dental implants installed in irradiated bone in the oral cavity have a high survival rate, 97.37%, provided that rigorous monitoring is instituted in RT in order to be successful in the long term. The percentage of dental implant failures tended to be higher in the group of irradiated patients.

Implant therapy in a higher education institution: changes or paradigms?

Since the 1970, dental rehabilitation of partially or totally edentulous patients has been an increasingly used practice, due to improved materials and methods and high rates of survival and success. Objective: This study aimed to evaluate patients from the Faculty of Dentistry of the University of Passo Fundo, between 2015 and 2018, with indication and installation of dental implants. Material and methods: Data on age and gender of the patients, indication and region of the implants, technique, type of connection and shape of the implants, bone density, need for grafting and image modality used for surgical planning were collected from dentistry records. Results: In total, 55 patients and 105 implants were evaluated. The age group ranged from 21 to 82 years, and women were the majority group (64%). Among the implant indications, 71% of the patients had only one tooth missing, and the lower first molars comprised most of the implants performed (21%). The conventional surgical technique was the most used (86%), as well as the cylindrical shape cone morse model. Conclusion: The proper selection of indications for implants seeks to be based on scientific evidence, and the protocols are essential to achieve high success rates.

Clinical case of peri-implantitis after orthodontic treatment

The materials of the article contain a description of the clinical and radiological picture of peri-implantitis. The operation of dental implantation was performed at the beginning of the retention period in orthodontic treatment. Plastic crowns on temporary abutments were made a few days after the surgical stage. As a result of immediate occlusal load and installation of dental implants in the early stages of the retention period of orthodontic treatment, their disintegration occurred.

Grafting in peri-implant bone defects by in-situ polymer deposition using a 3D pen – in vitro/ ex vivo study

Guided Bone Regeneration (GBR) aims to gain or maintain bone volume due to the use of barrier membranes that act for this purpose. This research aims at grafting polymeric filaments into preformed peri-implant bone defects in porcine condyles in vitro/ex vivo, stabilized and grafted with poly(lactic acid) (PLA) and poly(vinyl alcohol) (PVA) polymeric filaments, printed in-situ with a 3D printing pen. Nine porcine condyles received bone defects of 8 mm diameter and 7 mm depth, where occurred the installation of conical implants of 3.5x10 mm. After forming the bone gap region, above the apical bone anchorage, we divided the Poof Bodies (PB) according to the polymeric fill used: G.Control – without filling in the bone gap; G.PLA – with PLA scaffolds and G.PVA – with PVA scaffolds. In another step, the PVA and PLA 3D membranes were compared with the dense polytetrafluoroethylene membrane (PTFE-d). Subsequently, the SkyScan 1172 microtomograph (Bruker-μCT, Kontich, Belgium) analyzed the PB. The analysis corresponding to the total porosity revealed no statistical difference between G.Control (70.44%), G.PLA (59.99%), and G.PVA (57.66%). The closed porosity showed a statistical difference between G.Control (75.509%) and G.PVA (189.19%) and between G.PVA and G.PLA (79,093%). This study demonstrated the possibility of the polymeric filaments of PVA and PLA to fill the bone defects created, revealing an intimate contact on the surface of the implants used. The data suggested a higher porosity of the PVA filament when applied to bone defects or membrane shape.

DETEKSI DINI KANKER SERVIKS DAN SAFARI KELUARGA BERENCANA DI EKS KAWEDANAN BOJA

Family Planning is one of the efforts to reduce maternal mortality, so that Indonesia is committed to participating in signing of the global development of the Millennium Development Goals (MDG's) but the evaluation of the MDG's achievements in Indonesia shows that the target achievement has not been satisfactory so that it is continued with the Sustainable development Goals / SDG's program. In 2018 the population of childbearing age in Kendal district, there were 273,848 women out of 503,710 people, while Fertile Age Couple (FAC) was 188,118, who became new family planning (FP) acceptors 124,869 (66.38%). This is still far from the national achievement target, namely the coverage of FAC to become family planning acceptors of 87%. Another problem that arises in FAC is the high incidence of cervical cancer, this condition is caused because the patient comes at an advanced stage. Family planning safaris and early detection of cervical cancer are important things that must be done. This service method uses field studies, Focus Group Discussion (FGDs), counseling and papsmer examination. The target of community service is FAC in Ex Kawedanan Boja. Health education about family planning and early detection of cervical cancer can change behavior. The number of acceptors 60 people with IUD contraception 16 (26%), Implant 26 (43.3%) and Failed 3 (8.3%), the failure to install this contraceptive device was due to inflammation of the cervix. 3 people (17.65%) were positive while negative 14 people (82.35%).Counseling can improve understanding and change the behavior of FAC regarding early detection of cervical cancer and the installation of free implants and IUDs on acceptors through family planning safari.

Assessment of Bone Density around Dental Implants Using Two Platelet-Rich Fibrin Protocols (A Comparative Clinical Study)

Aims: The current study aimed to compare bone density means around dental implants covered with one of two platelet rich fibrin preparation protocols (Standard-Platelet Rich Fibrin and Advanced-Platelet Rich Fibrin) using standard intraoral digital periapical radiographs. Materials and methods: A total of ten male patients with an age range of 28-51 years participated in this split-mouth clinical study. The patients were divided into two groups based on the platelet rich fibrin (PRF) protocol to be used with dental implant insertion into positive control (S-PRF) and study group (A-PRF). Each patient represented the two groups in which he received 2 dental implants; ten implants for each group (a total of 20 dental implants) of standard length and diameter in the posterior mandibular extraction sites of ipsilateral or contralateral side. In the positive control group, the standard PRF protocol was to be used to prepare the PRF clot. In the study group, the advanced PRF protocol was to be used to prepare the PRF clot. Both PRF membranes were to be instilled inside the osteotomy bed during dental fixture installation. Following the installation of dental implants and as a basis for comparison between both groups, densitometric analysis of bone around dental implants at immediate, four, eight and twelve weeks scheduled visits were made. Results: Total densitometric analysis results showed no significant difference within S-PRF group, within A-PRF group and between both groups, with the highest mean (167.07) being at twelve weeks after surgery in the A-PRF group. Conclusions: Both S-PRF and A-PRF, similarly enhanced and maintained bone density (synergistic effect) throughout the of study and as disclosed by densitometric values. The use of PRF in its current forms seems to be an accepted minimally invasive approach with good clinical results.

НЕМЕДЛЕННАЯ УСТАНОВКА ИМПЛАНТАТОВ В ЛУНКУ УДАЛЕННОГО ЗУБА И НЕМЕДЛЕННОЕ ВРЕМЕННОЕ ПРОТЕЗИРОВАНИЕ - КАК МЕТОД СОВЕРШЕНСТВОВАНИЯ СТОМАТОЛОГИЧЕСКОЙ РЕАБИЛИТАЦИИ (ОБЗОР ДАННЫХ ЛИТЕРАТУРЫ И СОБСТВЕННОГО КЛИНИЧЕСКОГО ОПЫТА)

Abstract. According to the analysis of the dental services market, more than 2 million implants are installed annually in the world. Despite the actively developing dental implantation, dentists are cautious about installing an implant in the socket of an extracted tooth. Most often, the installation of implants is recommended 6-12 months after the extraction of teeth. Most dentists-implantologists avoid immediate implantation and prosthetics, referring to early postoperative complications and disintegration of implants. At the same time, immediate implantation makes it possible to change the strategy of an integrated approach to curation of target patients within the framework of biological compatibility, which is confirmed by the results of this study. The work is devoted to the analysis of the simultaneous implantation as a method of improving dental rehabilitation. The data of literary sources and own research on the issues of immediate implantation, its qualitative characteristics and clinical and functional capabilities are presented. The requirements for the quality and characteristics of implants are noted, the use of universal implant systems NobelBiocare, Straumann, Astra Tech, Miss, Konmet, etc., that meet all the criteria, allowing for simultaneous implantation with subsequent immediate loading, is considered. Based on the results of our own clinical studies, practical recommendations are proposed that should guide the planning and implementation of this method, which makes it possible to obtain positive long-term results. The advantages and disadvantages of one-stage implantation are presented - a method that can significantly reduce the duration of treatment, reduce the number of surgical interventions and visits to the doctor. It is noted that when using the method, a good aesthetic result is achieved, since the scalloped gingival contour is preserved, and the technology and bioacceptable materials allow the entire process of immediate implantation to be carried out within the framework of biological compatibility.

Anatomical and radiological approach to pterygoid implants in atrophic maxilla: A cross‐sectional study of 360 cone beam computed tomography examinations

AbstractObjectiveThis retrospective study aimed to analyse the anatomical dimensions of the pterygomaxillary region, installation angulations of pterygoid implants and bone density in the pterygoid pillar region by cone beam computed tomography (CBCT) examinations used in planning dental rehabilitation with implant‐supported prostheses in patients with atrophic jaws.Materials and MethodsWe analysed 360 CBCTs of patients with atrophic jaws using Xoran® software v.3.1.62 (Xoran Technologies). In addition, the angulation of virtual implants installed in the pterygomaxillary region was analysed in relation to the Frankfurt plan, as well as the length required for the installation of implants in this region.ResultsThe implant length installed in the pterygoid pillar varied between 13 and 20 mm, with an average of 16.17 mm (SD 2.16 mm). The pterygoid implant angulation on the latero‐lateral axis (frontal view) averaged 78.71° (SD. 3.58°) and 73.50° (SD 3.49°) in the anteroposterior direction (sagittal view). Bone density was found to be significantly higher in the pterygoid pillar region compared the maxillary tuberosity region (p < 0.05); the region of the tuberosity and pterygoid pillar had an average density value of 132.9 (SD 230.24) and 513.91 (SD 291.63) respectively.ConclusionAccording to the results of this study, a pterygoid implant with a minimum length of 13 mm should be used in the pterygomaxillary region to reach the pterygoid bone pillar.

Analysis of CBCT Bone Density Using the Hounsfield Scale

Assessing bone density in prospective dental implant sites is crucial both for choosing the implant type and for planning a drilling procedure that will ensure the implant’s primary stability and osseointegration. This study aimed to investigate possible differences between the bone densities of various edentulous sites in the maxilla and mandible. The study was conducted on a group of forty partly edentulous patients who underwent radiological examination by scanning the areas of interest using cone beam computed tomography (CBCT). Hounsfield units (HU) were analyzed using dedicated software. Higher HU were observed at the site of mandibular central incisors compared to the site of maxillary central incisors. The HU values in the mandibular first molars region were higher than those of the maxillary first molars. Buccal vs. lingual or palatal cortical HU values did not differ significantly. Within the limitations of this study, it can be stated that an objective assessment of site-specific bone density before the installation of dental implants may provide valuable clinical information for the selection of implant size and the planning of a patient-specific drilling protocol.