Tooth Loss Research Articles

Predictive value of tooth loss risk with 2018 new classification of periodontitis:a literature review

The occurrence, progression and treatment efficacy of periodontitis are affected by many factors. Development on accurate estimation of prognosis is essential for treatment plan determination. The application of the 2018 new classification of periodontitis is one of the most important advances in the prognosis and risk assessment of periodontitis. The predictive value of the new classification on tooth loss risk had been evaluated by several latest researches, however, consensus still lacks. This review focused on the predictive efficacy of the 2018 new classification of periodontitis on tooth loss risk in periodontitis patients, in order to provide scientific evidence for clinical application and further improvement of the new classification system.

Simplifying Oral health evaluation: a novel approach through single-item surveys

BackgroundThis study adopts a novel approach of using single-item surveys to simplify the assessment of oral health status and behaviors among Japanese private sector employees. We aimed to establish the validity of self-reported oral health in relation to clinical dental examinations, and to elucidate the relationship between oral diseases, health behaviors, and self-assessments. A secondary aim was to explore the association of self-rated oral health with oral health behaviors.Materials and methodsSelf-administered questionnaires and dental examinations were obtained from 2262 Japanese private sector employees. Workers self-rated their overall oral health status according to five choices: “very good,” “good,” “fair,” “poor,” or “bad.” Self-reports were then compared with the results of clinical dental examinations, which included measuring the oral hygiene index (DI-S), the number of decayed teeth, periodontal status (Community Periodontal Index) and number of missing teeth. Convergent validity was also tested by examining the correlations of self-reported oral health status with oral health behaviors.ResultsOverall, 30.8% of workers reported their oral health as “poor” or “bad.” “Poor” or “bad” oral health status was significantly correlated with missing teeth, periodontitis, and decayed teeth. However, lower correlations were found for gingivitis and the oral hygiene index. Most self-reported oral health behaviors were correlated with self-rated oral health; exceptions were “tooth brushing instructions received in a dental clinic,” “having a primary-care dentist,” and “habitual snacking between meals.”ConclusionsSelf-rated oral health provides reasonably valid data, and correlated well with clinically assessed oral health status, including dental caries, periodontal status, and tooth loss. Convergent validity was also found for oral health behaviors.Trial registrationClinical trial registration number: UMIN000023011 (UMIN-CTR).Date of clinical trial registration: 06/07/2016.

Assessment of Complications in Dental Implant Surgery.

Dental implant surgery has become a standard procedure for replacing missing teeth, boasting high success rates. However, complications can occur, affecting treatment outcomes. Understanding the nature and frequency of these complications is essential for optimizing patient care. To assess the prevalence and types of complications associated with dental implant surgery through retrospective research. Patient records were reviewed, focusing on demographics, medical history, surgical details, implant characteristics, and postoperative complications. Complications were categorized, and statistical analysis was performed to identify associations. Among 150 cases, infection (15.3%), implant failure (8.0%), and peri-implantitis (12.0%) were the most common complications. Complication rates varied significantly across age groups (P < 0.05), with younger patients experiencing higher rates. Complications in dental implant surgery, including infection, implant failure, and peri-implantitis, are prevalent. Age appears to influence complication rates. Strategies to mitigate complications and optimize treatment outcomes are crucial.

The importance of good health and well-being in Sekarkare Village, Probolinggo, East Java Village, Probolinggo, East Java

Background: Oral health is essential to total health and a satisfactory quality of life. One of the most contributingfactors is how a human being has an understanding of how to maintain oral health to improve the quality and well-being of life. Purpose: to provide and describe the community knowledge about the importance of replacing missing teeth using dentures and maintaining oral health to improve the quality of life. Methods: The event was carried out with an interactive educational concept by giving pre- and post-tests at the beginning and end of the event. There were at least 80 education participants, consisting of the people of Sekarkare village of various ages, from late adolescents to the elderly, along with village officials and guests from the Sekarkare Health Center. The activity was carried out at the village hallof Sekarkare Village, Dringu District, Probolinggo Regency, East Java. Results: The majority of people understand and are enthusiastic about participating in a series of counseling events. There is an increase in scores in the pre-test (59,06%) and post-test (65,58%) results. Conclusion: The existence of counseling events with interactive educational concepts can increase public enthusiasm for participating in events, making it easier for people to gain new knowledge.

Preserving natural dentition and enhancing prosthetic rehabilitation with Cu-Sil denture: A case report

Background: A specific type of transitional denture called a Cu-Sil denture provides a therapy alternative for people who have a lot of natural teeth still in place and do not want to have them extracted. This is particularly salutary for cases where people may feel tone-conscious about the negative impact of tooth loss on their appearance and emotional well-being. Purpose: The purpose of this case report is to provide prosthetic rehabilitation for a partially edentulous patient while conserving the remaining natural teeth and their supporting structures. Case: With only three teeth (12, 13, and 14) remained in the maxillary arch, a 63-year-old man complained to the department of prosthodontics that he had difficulties speaking and eating since he had been missing both upper and lower teeth for a period of five years. Case management:This case report represents a simple method to fabricate a Cu-Sil denture in a partially edentulous patient. Conclusion: Cu-Sil dentures present a promising alternative for partially edentulous patients, offering a method to preserve and support the remaining natural teeth while providing effective prosthetic rehabilitation. The relining material, silicone, functions as a cushion to support the remaining natural teeth. Additionally, the use of a chairside soft-tissue liner in the basic removable partial denture helps to stabilize and retain the existing natural teeth.

Outcomes of apexification in immature traumatised necrotic teeth and risk factors for premature tooth loss: A 20-year longitudinal study.

To evaluate the long-term survival of immature traumatized incisors with pulp necrosis and apical periodontitis after endodontic treatment with two apexification techniques (calcium hydroxide apexification and MTA-apical plug) and to identify major factors affecting the survival of these teeth. Records of 2400 children and adolescents were screened for presence of traumatic dental injuries to immature incisors where endodontic treatment with the two apexification techniques was performed during January 2003 and December 2022, compared to a control group of mature teeth treated with conventional endodontic techniques. The studied variables were age; sex; apexification technique, presence of luxation and hard tissue injuries; preoperative root development stage (RDS), preoperative and postoperative periapical index (PAI), the time-point for tooth loss, and overall survival time in years. Kaplan-Meier estimates were used to graphically present the survival functions and Cox proportional hazard model to calculate hazard ratios (HR, 95% CI). The median survival time was 10 years for calcium hydroxide apexification, 16.1 for MTA-apexification, for luxation injuries other than intrusions and avulsions 15.5 years, for intrusions 12.5 years and for avulsions 6.8 years. The variables with significant negative impact on tooth survival were calcium hydroxide apexification, avulsion and postoperative PAI 3-5. No significant relationships were found for the variables MTA apexification, concussion; subluxation; lateral luxation; extrusion, intrusion, hard tissue injuries, preoperative RDS and PAI scores and postoperative PAI 1-2. After adjustment, the risk for premature tooth loss was 13.5 times higher in calcium hydroxide apexification, approximately 2 to 4 times higher in PAI 3-5, and 5.6 times higher in avulsions. Calcium hydroxide apexification, avulsion, and postoperative PAI 3-5 were identified as prognostic variables with significant negative impact on the risk for premature tooth loss.

Peningkatan Pengetahuan Lansia Anggrek Bulan Untuk Pencegahan Kehilangan Gigi

Dental and oral health for elderly is crucial and has impact on the individual’s general health. Physical decline in the elderly is characterized by skin starting to shrink, hair beginning to change colour, loss of bone density, ability to see up to loss of mucous teeth. Tooth loss can interfere with the function of chewing, speaking and aesthetics. This condition can be aggravated by poor dental and oral hygiene. Therefore, dental health education is important to provide elderly an information about how to maintain oral health and prevent dental problem. The method used in this research is by providing education through power point media, given to Anggrek Bulan Elderly Community in November 25th 2023. Evaluation of participants’ knowledge was carried out before and after education by giving assessment sheet in the form of multiple choices to determine the level of community knowledge. Based on evaluation results, it was found that there was an increase in knowledge among the participants. This can be seen in average value of post-test results which has increased.

Immediate Implant Placement at an Inflammatory Periapical Cyst Site in the Aesthetic Area

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area, and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 × 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, and insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure, with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in cases of cystic periapical lesions represents a good valid alternative to standard treatment.

Pengaruh Pendidikan dan Pelatihan Kesehatan Gigi dan Mulut serta Gigi Tiruan Pada Lansia di Panti Werdha Berea Kedoya

Elderly are people aged 60 years or more. According to Riskesdas, the highest prevalence of tooth loss in Indonesia is in the age group over 60 years, specifically at 30.6%. Prosthodontic treatment can improve a patient's oral health, improve their masticatory and speech functions, and improve their aesthetics. However, the use of dentures requires proper care. The elderly need to be aware of how to maintain oral health and care for dentures to ensure its longevity. The purpose of this activity is to increase knowledge and change attitudes and behaviors concerning dental health care, denture care and oral hygiene in the elderly. In this activity, audio visual training techniques are applied by using powerpoint and videos as training tools to improve the retention of counseling materials by the elderly and avoid saturation. The delivery of materials is conducted using a language that is easily understood by the elderly. Based on the results of the pretest and posttest, this activity shows an increase in knowledge as well as the enthusiasm of the participants in asking questions about counseling and training related to maintaining oral health and the mouth as well as dentures. A good level of success can be achieved through this activity as it is supported by appropriate methods and good communication between the implementing team and the community.

Does Free Fibular Flap Reconstruction Affect the Quality of Life in Pediatric Patients With Various Extend of Mandible Defects?

The long-term outcomes in pediatric patients with various extents of mandible defects have not been well-documented. A retrospective case series in which this study looked at pediatric patients under the age of 13 who had mandibular reconstruction with free fibular flap and had not received another operation in the previous 6 months. The eating, swallowing, speech function, and quality of life are evaluated with EORTC QLQ-H&N35 after the mandible growth spurt has occurred. A total of 7 patients were included in this study with operation ages ranging from 6 years 1 month to 12 years 2 months. The etiology of malignant tumors was found in 2 patients and benign tumors in 5 patients. The mandibular defect distribution consists of 1 class Ic, 1 class II, 2 class IIc, 2 class III, and 1 class IVc. All patients reported no swallowing or speech difficulties. However, transient eating trouble was seen in 1 patient due to the extensive defect size that causes tooth loss. Only 1 patient received dental rehabilitation. The patients displayed an overall good quality of life with an average score of 2.857. Free fibular flap for mandibular reconstruction in children who have not reached their mandibular growth peak have a satisfying outcome, both in their function and quality of life.

Anti-Inflammatory Activity of No-Ozone Cold Plasma in Porphyromonas gingivalis Lipopolysaccharide-Induced Periodontitis Rats.

Periodontitis is an inflammatory disease caused by Porphyromonas gingivalis (P. gingivalis) in the oral cavity. This periodontal disease causes damage to the periodontal ligament and alveolar bone and can cause tooth loss, but there is no definite treatment yet. In this study, we investigated the possibility of using no-ozone cold plasma to safely treat periodontitis in the oral cavity. First, human gingival fibroblasts (HGFs) were treated with P. gingivalis-derived lipopolysaccharide (PG-LPS) to induce an inflammatory response, and then the anti-inflammatory effect of NCP was examined, and a study was conducted to identify the mechanism of action. Additionally, the anti-inflammatory effect of NCP was verified in rats that developed an inflammatory response similar to periodontitis. When NCP was applied to PG-LPS-treated HGFs, the activities of inflammatory proteins and cytokines were effectively inhibited. It was confirmed that the process of denaturing the medium by charged particles of NCP is essential for the anti-inflammatory effect of NCP. Also, it was confirmed that repeated treatment of periodontitis rats with NCP effectively reduced the inflammatory cells and osteoclast activity. As a result, this study suggests that NCP can be directly helpful in the treatment of periodontitis in the future.

A Transient Heat Transfer Analysis of Thermal Necrosis-Aided Dental Implant Removal

A prevalent and widely favoured solution for replacing lost teeth is the use of dental implants. The removal of dental implants, even when they are osseointegrated but unsuccessful, can be traumatic, resulting in the loss of healthy bone and adding complexity to the treatment procedure. Reducing the trauma associated with implant removal can be achieved by intentionally weakening the bone-implant attachment. To achieve this objective, a suggested approach involves utilising thermal necrosis to aid in the minimally invasive removal of implants. The objective of this study was to use finite element analysis to explore the optimal power output for intentionally inducing thermal necrosis in a dental implant. SolidWorks software was utilised to create a three-dimensional model of a dental implant assembly, which includes an abutment, screw, and implant body integrated into a segment of mandibular bone. The model was subsequently analysed using ANSYS software, applying device powers ranging from 5 to 40 W in 5 W increments on the top surface of the abutment. The results of the study showed that there was a considerable elevation in the temperatures of the bone and implant, even when employing the low power settings commonly used in electrosurgical procedures. Elevating the power level has led to a decrease in the time required for the bone and implant to reach 47°C, the initial temperature at which bone necrosis occurs. However, it is crucial to take into account the significant temperature rise in the implant body at higher power levels. The implementation of lower power settings could present a viable approach to achieving controlled osteonecrosis.

Cognitive decline in Sprague-Dawley rats induced by neuroplasticity changes after occlusal support loss.

Tooth loss is closely related to cognitive impairment, especially affecting cognitive functions involving hippocampus. The most well-known function of the hippocampus is learning and memory, and the mechanism behind is neuroplasticity, which strongly depends on the level of brain-derived neurotrophic factor (BDNF). While research has delved into the possible mechanisms behind the loss of teeth leading to cognitive dysfunction, there are few studies on the plasticity of sensory neural pathway after tooth loss, and the changes in related indicators of synaptic plasticity still need to be further explored. In this study, the bilateral maxillary molars were extracted in Sprague-Dawley rats of two age ranges (young and middle age) to establish occlusal support loss model; then, the spatial cognition was tested by Morris Water Maze (MWM). Quantitative real-time PCR (qPCR) and Western Blotting (WB) were used to detect BDNF, AKT, and functional proteins (viz., PSD95 and NMDAR) of hippocampal synapses. Golgi staining was used to observe changes in ascending nerve pathway. IF was used to confirm the location of BDNF and AKT expressed in hippocampus. MWM showed that the spatial cognitive level of rats dropped after occlusal support loss. qPCR, WB, and IF suggested that the BDNF/AKT pathway was down-regulated in the hippocampus. Golgi staining showed the neurons of ascending sensory pathway decreased in numbers. Occlusal support loss caused plastic changes in ascending nerve pathway and induced cognitive impairment in rats by down-regulating BDNF and synaptic plasticity.

The Diagnosis and Initial Management of Children Presenting With Premature Loss of Primary Teeth Associated With a Systemic Condition.

Background and objective Pediatric dentists face a serious challenge when encountering cases of primary teethlost too soon due to systemic disorders such as diabetes mellitus, congenital heart disease, and chronic kidney disease. Prompt identification and treatment are necessary to minimize problems in these patients. This study aimed to better understand and enhance clinical outcomes in pediatric dentistry treatment by investigating diagnostic modalities and early therapy methods for kids wholose their primary teeth too soon because of systemic disorders. Methodology We conducted a retrospective observational study to examine the early loss of primary teeth in children aged 6-10 years with a history of systemic diseasesat Naseer Teaching & MMC-General Hospital, Peshawar; Hayatabad Medical Complex, Peshawar; DHQ Teaching Hospital, Kohat; and Fauji Foundation Hospital, Multan from January to December 2022. After carefully gathering data from medical records, a sample of 360 patients meeting the inclusion criteria was examined. SPSS Statistics version 27 (IBM Corp., Armonk, NY) was used for the statistical analysis. Demographic characteristics, clinical manifestations, and management approaches were compiled using descriptive statistics. For categorical data, frequency distributions and percentages were determined, and for continuous variables, means and standard deviations (SD) were calculated. Regression analysis was conducted to analyze relationships between related variables and treatment outcomes. A p-value <0.05 was considered statistically significant. Results The majority of patients were aged between six and eight years, and the cohort had an equal gender distribution. Dental problems including malocclusion (n=175, 48.61%) and early tooth loss (n=245, 68.06%) were common, as were systemic illnesses like genetic disorders (n=45, 12.50%) and endocrine abnormalities (n=67, 18.61%). Diagnostic procedures were often carried out, such as radiographic exams (n=256, 71.11%) and blood tests (n=123, 34.17%). Dietary supplements (n=60, 16.67%) and dental procedures (n=75, 20.83%) constituted the bulk of the treatment. Significant treatment outcomes that demonstrated the efficacy of the therapies were as follows: high patient satisfaction (n=213, 59.17%), improved oral health (n=255, 70.83%), and symptom relief (n=187, 51.94%). Conclusion Our findingshighlight the significant impact of certainpractical methods for identifying and treating early tooth loss in pediatric patients with systemic illnesses, leading topatient satisfaction in terms of symptom relief and enhanced dental health.

Oral health and cognitive function: Insights from longitudinal ageing study in India (LASI) - A cross-sectional analysis

IntroductionThe oral cavity is related to nervous system diseases, and oral issues have a bidirectional correlation with cognitive dysfunction. Thus, this study aims to explore the association between oral health problems and cognitive dysfunction in community-dwelling Indian older adults. Materials and MethodsUtilizing data from LASI, a nationally representative cohort study, this study involved 30,726 participants aged ≥60 years. The oral health problems of study participants were self-reported. Cognitive impairment was assessed using composite score, and a score of less than -1.5 SD was defined as the presence of cognitive impairment. ResultsIn univariate analysis, significant associations were observed between oral health problems (loss of some natural teeth, OR: 1.33, 95 % CI: 1.15–1.52, p < 0.001; lost all natural teeth, OR: 2.33, 95 % CI: 1.97–2.76, p < 0.001) and ease of chewing solid food [Fairly well (OR: 1.51, 95 % CI: 1.33–1.71, p < 0.001) and not at all (OR: 2.37, 95 % CI: 2.11–2.67, p < 0.001)] with cognitive impairment. In multivariate analysis, adjusted for various factors, a significant association persisted between loss of all natural teeth (OR: 1.62, 95 % CI: 1.34–1.95, p < 0.001) and the ability to chew solid food. Specifically, individuals reporting chewing solid food “Fairly well” (OR: 1.34, 95 % CI: 1.16–1.52, p < 0.001) and those unable to chew at all (OR: 1.73, 95 % CI: 1.51–1.97, p < 0.001) with cognitive impairment. ConclusionThe findings of this study underscore a compelling connection between oral health issues and cognitive impairment. Consequently, it is imperative to proactively identify and address oral health problems in older adults.

Histological Evaluation of Alveolar Ridge Preservation Using Different Bone Grafts: Clinical Study Analysis Part II.

To compare histologically the percentage of bone formation 12-20 weeks after ridge augmentation using 2 different techniques. Tooth loss is associated with 3-dimensional bone remodeling and ridge atrophy. Ridge preservation procedures can prevent alveolar bone volume loss. Different techniques and materials are used to preserve the alveolar ridge. Computer-generated randomization software was used to assign 2 ridge preservation techniques for 11 extraction sites. In group I, type I bovine Achilles tendon collagen plugs with bioactive resorbable calcium apatite crystals (CPCAC) were placed, and in group II, cortico-cancellous bone chips (CCBC) mix and an expanded polytetrafluoroethylene (ePTFE) barrier membrane were placed. The histomorphometric studies were performed using a computer-based image analysis system (ImageJ 1.4, National Institute of Health, Bethesda, Md) to calculate the pixel area of bone tissue and the remaining bone graft material. The histomorphometric data were analyzed using a Student t test to compare the measurements between the 2 experimental groups. This parametric statistical test was employed to determine if there were any statistically significant differences in the quantitative histological parameters between the groups. The sockets that received CPCAC showed a lower (31.89%) percentage of native bone surface area compared with the CCBC group (43.87%). However, the difference was not statistically significant (P < .05). In addition, the CPCAC group showed evidence of foreign-body reaction. The CCBC graft covered with an ePTFE barrier may induce more bone formation with minimal inflammation in an extraction socket compared with a collagen plug with calcium apatite crystals. In addition, histological analysis of the CPCAC graft showed evidence of foreign-body reaction, which indicates a negative clinical impact.

Data-driven prediction model for periodontal disease based on correlational feature analysis and clinical validation

ObjectivesThis study aimed to investigate the performance and reliability of data-driven models employing correlational feature analysis and clinical validation for predicting periodontal disease. MethodsThe 7th Korea National Health and Nutrition Examination Survey (n = 10,654) was used for correlation analysis to identify significant risk factors for periodontitis. Periodontal prediction models were developed with the selected factors and database, followed by internal validation with 5-fold cross-validation and 1000 bootstrap resampling. External validation was conducted with clinical data (n = 120) collected through self-reported questionnaires, clinical periodontal parameters, and radiographic image analysis. Predictive performance was assessed for logistics regression, support vector machine, random forest, XGBoost, and neural network algorithms using the area under the receiver operating characteristic curves (AUC) and other performance metrics. ResultsCorrelation analysis identified 16 features from over 1000 potential risk factors for periodontitis. The best data-driven model (XGBoost) showed AUC values of 0.823 and 0.796 for internal and external validations, respectively. Modeling with clinical data revealed those same measures to be 0.836 and 0.649, respectively. In addition, the data-driven model could predict other clinical periodontal parameters including severe bone loss (AUC = 0.813), gingival bleeding (AUC = 0.694), and tooth loss (AUC = 0.734). A patient case study about prognostic predictions revealed that the probability of periodontitis can be reduced by 6.0 % (stop smoking) and 0.6 % (stop drinking) on average. ConclusionsData-driven models for predicting periodontitis and other periodontal parameters were developed from 16 risk factors, demonstrating enhanced prediction performance and reproducibility in internal–external validations.

Comparative Evaluation of Shear Bond Strength of Bonded Space Maintainers Using Ormocers, Nanofilled and Glass Fiber-reinforced Adhesive Composites.

Space maintainers (SMs) are used to preserve the space created by premature loss of primary teeth. The most commonly used is the band and loop (B&L) SM. As this SM has several drawbacks, such as poor esthetics and gingival health, laboratory procedures for fabrication, and multiple seating procedures, various bonded SMs were introduced. This study aims to compare the shear bond strength of bonded SMs using ormocer, nanofilled, and short glass fiber-reinforced adhesive composites with the conventional B&L SM luted with type I glass ionomer cement (GIC). Sixty intact extracted primary molars were randomly divided into four groups (n = 15). In group I (control), conventional B&L SMs were luted with type I GIC, whereas ormocer, nanofilled, and glass fiber-reinforced composites (GFRC) were used to bond the SMs in groups II, III, and IV, respectively. Shear bond strength of all the specimens was analyzed using a universal testing machine, and the obtained data were subjected to statistical analysis. The highest shear bond strength, that is, 68.82 ± 16.81 MPa, was exhibited by GFRC, followed by 51.04 ± 23.28 MPa with nanofilled composite, 45.3 ± 18.27 MPa with ormocer, and the least in the control group, that is, 42.17 ± 17 MPa. Glass fiber-reinforced resin composite has better resistance against shear force than the other three study materials, and this was significantly higher (p = 0.001) than conventional B&L SMs. Barathi D, Jampanapalli SR, Patloth T, et al. Comparative Evaluation of Shear Bond Strength of Bonded Space Maintainers Using Ormocers, Nanofilled and Glass Fiber-reinforced Adhesive Composites. Int J Clin Pediatr Dent 2024;17(6):695-701.

Mandibular Overdentures When Treating Failing Dentition With Immediate Prosthetic Loading.

Patients may present with failing mandibular dentition either involving the entire arch, partial arch that currently has a partial denture to replace the prior missing teeth or wearing a full denture. Finances may limit restoration of the arch with an All-on-X concept and the patient's goals are a stable prosthesis that does not move whenconcept and the patient's goals are a stable prosthesis that does not move when eating or speaking is the patient's expressed goal. Overdentures can fulfil that goal and provide a stable restored arch at a lower treatment cost than treatment with a fixed hybrid prosthesis. Traditionally, when these type cases have been treated, the remaining dentition has been extracted, depending on availability of bone, implants are placed. Those typically were left to osseointegrate and loaded several months later with a delayed loading approach. This requires relining the denture and the patient having a loose, non-stable prosthesis during that healing phase. An alternative approach utilizes immediate activation of the implants with overdenture attachments thus, providing an immediate stable retentive full arch mandibular removable prosthesis (overdenture) by immediate activation of overdenture attachments (ie.Locators) aids the patient in their goals without delays in treatment. This article will present two case examples of mandibular arches with failing dentition related to caries and periodontal issues and their treatment with immediate implant placement and loading with Locator attachments. Long-term follow-up of 1-year 8-months in one case and 33-months in the other case demonstrate crestal bone stability with this immediate overdenture loading protocol.

ИСПОЛЬЗОВАНИЕ ЦИФРОВЫХ ТЕХНОЛОГИЙ ПРИ РЕАБИЛИТАЦИИ ПАЦИЕНТОВ С ПЕРВИЧНОЙ АДЕНТИЕЙ

Abstract. Introduction. Number of patients with hypodontia has increased at orthodontic appointments. According to different authors, the frequency of tooth rudiments absence ranges from 2 % to 16.5 %. The highest rank is held by maxillary lateral incisors hypodontia. Due the increased patients’ aesthetic requirements, it is a difficult task, especially with the alveolar ridge bone deficiency. Treatment of such patients requires a multidisciplinary approach and the use of digital technology. The aim of the study is to improve the treatment effectiveness for patients with hypodontia, using digital planning, surgical templates, intraoral scanning, and the CAD/CAM modelling of metal-free screw-retained crowns on dental implants. Materials and Methods. The clinical study was performed in the dental office PreziDent (Cheboksary) in 2018-2023. The total number of patients was 24 people (female), aged 16 to 34 years. There were two groups (n=12). The first group patients had their missing teeth replaced using dental implantation without using any digital technology. In the second group, those with the use of digital technologies. Gingival condition of the dentition defect area was assessed: Severity of stippling phenomenon degree, density gingival margin adherence to the structural materials, vacuum capillary resistance by Kulazhenko, and Mülleman-Cowell bleeding index. SPSS 13.0 software package was used for the statistical processing of the results obtained. Results and Discussion. The first stage of treatment included orthodontic treatment, bracket placement and canine distalization. Some patients were fitted with orthodontic miniscrews in the subclavicular region. After creating gaps for the future lateral incisors, a surgical template was fabricated and dental implants were placed. Four months after implantation, the bracket system was removed and the implant temporary crowns were placed; six months later, CAD/CAM digital metal-free prosthetics were placed. Not a single case of implant loss was detected. An algorithm framework was developed for managing patients with maxillary lateral incisor hypodontia. Conclusions. Using computer programs for planning dental implantation and in navigation surgery allows installing dental implants most accurately and making digital metal-free prosthetic constructions by computer-aided modelling and manufacturing. Thus, the risk of complications is reduced and an effective functional and aesthetic state of dentoalveolar system is achieved in patients with primary anodontia.