Posterior Mandibular Area Research Articles

Decoding Cystic Lesions in Mixed Dentition through Step-by-step Diagnosis

Abstract Radicular cysts are the most often documented inflammatory cysts in the adult population, although their incidence in children is regarded as unusual. This study presents a 12-year-old female patient, who had an asymptomatic radicular cyst along with a retained and decayed deciduous tooth in the left posterior mandibular area, the cyst. The patient underwent cystic enucleation after a clinical and radiographic evaluation which led to a provisional diagnosis that was corroborated by the histological findings. In this article, the differential diagnosis and treatment of a radicular cyst in a pediatric patient is discussed.

Finite element analysis (FEA) of stress distribution in platform-switched short dental implants.

The distribution of stress on short platform switched dental implants is of interest. Hence, the mandibular posterior molar area was modelled using a three-dimensional finite element method (FEM) with a continuous 1.5 mm cortical bone thickness and an inner cancellous bone core. The implants used in the study were 5 mm long, 4.5 mm wide and 3.5 mm wide at the abutments. 120 N of force was applied in both the vertical and oblique (20° and 35°) directions to create a realistic simulation. ANSYS Workbench was generated for each model. Von Mises stress was assessed in the cortical and cancellous bones at varying depths. Ten noded tetrahedron elements with three degrees of freedom per node were employed to interpret translations on the x, y, and z axes. The stress-based biomechanical behaviour of platform switched short osseo-integrated implants varied across all 5 positions in FEM simulations, based on the depth of implant placement, the direction of applied force, and the shape of the bone. Data shows that opposite forces to the vertical forces caused more damage. Thus, the implantation of subcrestal implants resulted in reduced stress on the cortical and cancellous bone.

A CBCT Assessment of Orthodontic Mini-Implant Placement

ABSTRACT Objectives: This study compares the precision of cone beam computed tomography (CBCT) and two-dimensional radiography for mini-implant implantation. Materials and Method: For 30 sites (in 15 patients between the ages of 13 and 26 years), the buccal interradicular region among the 2nd premolar and 1st molar was found to be the best location for mini-implants. Next, two groups of the mini-implant implantation process were created. Mini-implants were positioned at the CBCT data-identified sites in the CBCT group. Mini-implants were inserted in the RVG group by using two-dimensional digital radiography and a specially constructed guide. To assess the precision of the mini-implant implantation, post-placement CBCT images were acquired. The obtained data were statistically analyzed. Result: The two groups showed a statistically considerable variation in the mini-implant placement’s departure from the optimal height. Due to the smaller interradicular space and decreased convenience in the posterior mandibular area, two out of 15 mini-implants in the RVG group demonstrated root contact in the mandibular jaw Conclusion: The two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement even though CBCT accurately visualizes the interradicular space in three dimensions.

Application of Implant Healing Abutment Supporting Vertical Bone Augments in the Posterior Mandibular Area.

To address the problem of insufficient bone mass in the implant area, we focused on the vertical increment of the posterior mandibular area to increase bone mass with the aid of a healing abutment. Data of patients with insufficient vertical bone height in the posterior mandibular area were collected, and vertical increment of alveolar bone operations was performed with the aid of a healing abutment. Preoperative residual alveolar bone height, immediate postoperative alveolar bone height, and 6-month postoperative alveolar bone height were recorded, with peri-implant soft tissue results 6 months after surgery using the modified plaque index and sulcus bleeding index. Twelve patients, aged 42-73 years, with an average age of 55.91 ± 11.58 years, received vertical bone augmentation in the posterior mandibular region supported by implant healing abutments. Fifteen SLA TSIII OSSTEM implants were utilized in the 12 patients; one patient failed in vertical bone augmentation at one site (H0 = 0 mm). The vertical bone augmentation effect of two patients at two sites was 0 mm < H0 < 1 mm, and the vertical bone augmentation effect of 12 sites in nine patients was H0 ≥ 1 mm. The implant success rate was 93.3%, and the mean vertical bone gain was 2.91 mm. Peri-implant soft tissue parameters are as follows: mean modified plaque index, 1.92; mean modified sulcus bleeding index, 1.21; and mean probing depth, 3.18. No clinically observable complications occurred. Bone augmentation supported by the implant healing abutment showed the characteristics of "platform transfer", with good formation of the implant-bone interface. The bone augmentation surgery was completed at the same time as the implant placement, which reduced the pain of multiple operations and shortened waiting times. We provide a novel idea to solve the problem of insufficient vertical bone height in the posterior mandibular region.

Successful New Dental Implant Installation in aHealed Site of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Case Report.

The purpose of this case report was to present a rare clinical case of successful new dental implant installation in the site of previously healed medication-related osteonecrosis of the jaw (MRONJ). An 80-year-old female patient with history of oral bisphosphonate (BP) therapy presented with pain and swelling of gingiva in the right posterior mandible. One of the three implants placed 15 years ago in the right mandibular posterior area was removed 6 months before the visit to our hospital, which led to worsening of the symptoms. After clinical and radiographic examination, the patient was diagnosed with stage 2 MRONJ. Along with antibiotic therapy, the patient underwent surgical intervention via sequestrectomy and removal of the remaining two implants. Adequate soft and hard tissue healing without any complications and signs of recurrence was confirmed, and implant installation with simultaneous bone grafting and prosthesis fabrication were done in the explantation sites of MRONJ. By the 7-year follow-up, no implant failure has been observed, and installation of implants was successful in the previously healed MRONJ site. Dental implant installation is possible in a patient with history of failed implant due to MRONJ. However, a careful treatment planning is needed before implantation in a previously healed site of MRONJ to reduce the potential risks of MRONJ recurrence and implant failure.

Survival Rate of Dental Implants in the Irradiated Jaw Bones of Patients with Oral and Head &amp;amp; Neck Malignancies

Purpose: This study aimed to analyze and report the survival rate of dental implants in patients who underwent radiation therapy for head and neck malignancies. Materials and Methods: A total of 23 patients (male:female ratio = 13:10; mean age 61 years, range, 44–86 years) who underwent dental implant placement after radiation therapy between 2010 and 2020 were enrolled in this study. The cumulative survival rate (CSR) was analyzed using the Kaplan–Meier method, considering variables such as the location of the dental implant, radiation dose, and types of cancers that patients had. Implant placement was considered successful if it showed no mobility, did not cause pain or bleeding, or a minimal marginal bone level change at follow-up.Results: There were two cases of death during the follow-up period. Seven of the 83 implants failed. Among the seven failure cases, four implants were applied in the posterior mandibular area, one in the anterior mandibular area, and two in the posterior maxillary area. When each variable was considered, the CSR of the implant was 91.6%. The correlation between CSR, implant location, and the types of cancer was statistically significant. However, there was no correlation between the CSR and average radiation dose.Conclusion: The survival of implants in the irradiated area of the jaw was lower than that in the normal jawbone. The survival rate of the implants in the irradiated maxillary jaw was lower than that of the implants in the mandible. Additionally, the radiation dose was not significantly correlated with implant failure rate. Also, when compared between patients who had oral cavity cancer and other head and neck cancers, implant survival in patients with oral cavity cancer was lower than that in patients with other head and neck cancers.

Effectiveness of ultra-wide implants in the mandibular and maxillary posterior areas: a 5-year retrospective clinical study.

Ultra-wide implants may be used as a replacement if existing implants fail. This study was conducted to evaluate the factors influencing the prognosis and failure of ultra-wide implants. Patients and. This study evaluated whether sex, age, site, diameter, length, additional surgery, implant stability (primary and secondary), and reason for ultra-wide implant placement affect the 5-year survival and success rates and marginal bone loss (MBL) of ultra-wide implants. Seventy-eight ultra-wide implants that were placed in 71 patients (39 males and 32 females) from 2008 to 2010 were studied. One-way ANOVA analysis was conducted to evaluate the statistical significance of MBL according to the patient's sex, implant site, and diameter. Independent sample t-tests were used to determine the statistical significance of MBL analysis which was used to determine the significance of the 5-year success and survival rates related to the variables. One-way ANOVA was conducted to evaluate the statistical significance of sex, implantation site, diameter, and MBL. Independent sample t-tests were used to evaluate the correlation between implantability and MBL for implantation reasons, while additional surgery, length, and Kaplan-Meier analysis were used to evaluate 5-year survival and success rates. The mean age of patients was 54.2 years with a survival rate of 92.3% and a success rate of 83.3% over a mean 97.8-month period of observation. MBL averaged 0.2 mm after one year of prosthetic function loading and 0.54 mm at the time of final observation. Success rates correlated with primary stability (P=0.045), survival rates correlated with secondary stability (P=0.036), and MBL did not correlate with any variables. Ultra-wide implants can be used to achieve secure initial fixation in the maxillary and mandibular molar regions with poor bone quality or for alternative purposes in cases of previous implant failure.

Stress distribution in bone around an implant-supported three-unit fixed dental prosthesis using two different computer-aided designing/computer-aided milling provisional crown materials: Milled polymethylmethacrylate and milled polyetheretherketone – A finite element analysis

Background: Occlusal loading of osseointegrated implants is believed to be an essential determining factor in the long-term success of an implant treatment. Numerous studies have been conducted on the evaluation of stress distribution by definitive restoration materials for Implant-supported fixed prosthesis, but very few have evaluated provisional restoration materials for the same. This study aims to evaluate the influence of provisional restoration material – Milled Polymethylmethacrylate (PMMA) and Milled Polyetheretherketone (PEEK), over stress distribution on the peri-implant bone around an implant-supported three-unit, fixed dental prosthesis using finite element analysis method. Materials and Methods: Three-dimensional models of a pair of bone-level implant system and titanium base abutments were created using the standard tessellation language data of original implant components. A bone block representing the mandibular posterior area was created, and the implants were placed in the bone block with 100% osseointegration in the 2nd premolar to 2nd molar region. A superstructure of an implant-supported 3-unit bridge was modeled on top of the abutments, each crown to be 8 mm in height and with an outer diameter of 6 mm in 2nd premolar region and 10 mm in 1st molar and 2nd molar region. Two different models were created according to combinations of provisional restoration materials, namely, Milled PMMA and Milled PEEK based on. In each model, the implants were loaded vertically (300 N) and obliquely (150 N at 30°). The stress distribution in the cortical bone, cancellous bone, and implant was evaluated through the von Mises stress analysis. Results: The results showed no difference in stress distribution due to the different provisional restorations – Milled PMMA and Milled PEEK. In addition, the vertical load resulted in higher stress values in the implant components, cortical bone, and cancellous bone in both PEEK and PMMA models as compared to oblique loading. Conclusion: The new polymer, PEEK was seen to provide comparable stress generation in the current study without exceeding the physiological limits of peri-implant bone. Thus, it can be considered as a good alternative to PMMA resin as a provisional crown material since it provides certain additional benefits.

Evaluation of lingual concavities in the posterior mandibular area using Cone beam computed tomography scans in an Egyptian population- A cross-sectional study

Evaluation of lingual concavities in the posterior mandibular area using Cone beam computed tomography scans in an Egyptian population- A cross-sectional study

METASTASIS OF BREAST CANCER IN JAWS: A CASE REPORT

Osseous metastasis in jaws is an unusual clinical event. A 43-year-old woman with a medical history of breast cancer diagnosed in 2017 was treated with total mastectomy. Bone scintigraphy showed no metastasis after initial treatment. However, in 2020, the patient noted pain during mastication in molar right area. The tooth 48 was removed, and antibiotics were prescribed. Due to persistent and more severe pain, she was referred to an oral medicine clinic. The intraoral examination revealed a localized soft tissue exophytic mass involving 46/47 gingival area. The computed tomography showed a bilateral, osteolytic, and ill-defined lesion in the posterior mandibular area. An intraosseous incisional biopsy was performed in the right retromolar area. The histopathologic (H.E) and immunohistochemical exams confirmed a metastasis of breast cancer in the jaw. After 5 sessions of a combined treatment with CMF and zoledronic acid, a partial resolution of the tumor was observed. Osseous metastasis in jaws is an unusual clinical event. A 43-year-old woman with a medical history of breast cancer diagnosed in 2017 was treated with total mastectomy. Bone scintigraphy showed no metastasis after initial treatment. However, in 2020, the patient noted pain during mastication in molar right area. The tooth 48 was removed, and antibiotics were prescribed. Due to persistent and more severe pain, she was referred to an oral medicine clinic. The intraoral examination revealed a localized soft tissue exophytic mass involving 46/47 gingival area. The computed tomography showed a bilateral, osteolytic, and ill-defined lesion in the posterior mandibular area. An intraosseous incisional biopsy was performed in the right retromolar area. The histopathologic (H.E) and immunohistochemical exams confirmed a metastasis of breast cancer in the jaw. After 5 sessions of a combined treatment with CMF and zoledronic acid, a partial resolution of the tumor was observed.

Evaluation Of Histopathological Lesion In Oral And Maxillofacial Department At Tertiary Care Hospital Peshawar

Around the world, maxillofacial disorders are distributed widely. The oral and maxillofacial area is affected by a wide variety of illnesses, from inflammatory lesions to benign and malignant cancers. Objective: This is a base line study that will aid in the diagnosis and management of oral healthcare and also guide recommendations and associated research in the local population in the future. Methods: In this descriptive observational study, 124 patients with orofacial lesions reported at the Hayat Abad medical complex, Department of Oral Maxillofacial and Dental Surgery between 2021 and 2022 were analyzed. Result: A total of 124 orofacial lesions were found, of which 47 were malignant and 57 benign, with the posterior mandible being the most commonly affected area. The pathology that affected most frequently was squamous cell carcinoma. In the fourth, fifth, and sixth decades of life, the soft tissue lesion affected 41% of males and 37% of females. These included squamous cell carcinoma well-differentiated in 32 (25.80%), fibrous epulis in 11 (8.8%), and pyogenic granuloma in 16 (12.90%) of cases. Conclusion: With the posterior mandibular area being the most common site, oral squamous cell carcinoma affects adolescents and the elderly with the most incidence rate.

A Retrospective Investigation of Determining the Factors of Dental Implant Survival Rate

Aim: Dentists have developed as both a novel potential treatment for the majority of the patients, and they are projected to play aa significant part in oral rehabilitation in future. The latest research was carried out to evaluate several parameters influencing the chance of survival of dental work. Methods: The current investigation was carried out in Services Hospital, Lahore. This study includes 5300 individuals who had dental implants implanted between June 2020 and May 2021. Individuals with hormonal imbalances, chronic infectious illnesses, immunosuppressive medication, pregnant women, drug and alcohol abusers, and suffering from chronic periodontal disorders have also been excluded. Name, age, gender, length of implant, diameter of implant, placement of implant, and biomechanical properties were among the parameters reported. Results: There were 2900 men and 2500 women among 5400 individuals. Highest implantation losses (56) were observed in patients above the age of 59 (males – 560, females – 740). There were 21 unsuccessful implantations in the 41-year-old age category (males 760, women 560). There were 46 unsuccessful implants in the age category 40–61 years (males – 1600, women – 1100). The change remained not statistically substantial (P = 0.22). Implant with a length of more than 12.6 mm (44/720) failed the most, followed by implant with a length of 11 mm (23/1670) and 11–11.6 mm (63/2870). The increase was statistical implication (P 0.06). Fasteners with just a diameter of 4.77 mm (17/1640) and implantation with a length of 5.77–3.6 mm (53/2700) failed the most (33/1050). Conclusion: The existence rate of prostheses is resolute by limitations just like age, entrenched length, diameter, bone quality, also implanted location. Researchers discovered that implants more than 12.6 mm in height and 4.76 mm in diameter, put in the mandibular posterior area of Type III bones, had the highest failure rate. Keywords: Dental Implant Survival Rate, potential treatment.

A 3-Year Prospective Clinical Study to Evaluate the Outcome of Single-Piece Implant-Prosthetic Complex after Immediate NonFunctional Loading in the Maxillary Anterior and Mandibular Posterior Areas in Varied Bone Densities.

Context:There is limited evidence on the outcome of single-piece implant-prosthetic complex after immediate nonfunctional loading in varied bone densities.Aim:The aim of this study was to report the outcome of single-piece implant-prosthetic complex with a novel cervical platform design in the anterior and posterior jaws 3 years after loading.Setting and Design:Prospective clinical study.Materials and Methods:The present study included placement of 90 single-piece implants in the anterior and the posterior jaws in varied bone densities. After immediate loading, survival and marginal bone loss was recorded at regular intervals.Statistical Analysis:Independent sample t-test and paired t-test were done (P = 0.05).Results:Group I, annual marginal bone loss at the end of one, 2 and 3 years was 0.21, respectively, in both bone densities. Group II, annual marginal bone loss in D2 regions was 0.75,0.38 and 0.18; 0.64, 0.28 and 0.18 in D3 regions at the end of 1, 2, and 3 years, respectively. Group I showed no statistically significant difference in marginal bone loss between D2 and D3 bone annually in contrast to Group II. Intragroup comparisons of mean between baseline and various time intervals showed statistically significant bone loss in both bone densities.Conclusion:Three years after loading, single-piece implants with the novel cervical platform design provided survival rates of 93% in the maxillary anteriors and 91% in the mandibular posteriors. D3 bone showed more marginal bone loss than D2 bone.

Comparison of cone-beam computed tomography and digital panoramic radiography for detecting peri-implant alveolar bone changes using trabecular micro-structure analysis.

ObjectivesWe compared changes in fractal dimension (FD) and grayscale value (GSV) of peri-implant alveolar bone on digital panoramic radiography (DPR) and cone-beam computed tomography (CBCT) immediately after implant surgery and 12 months postoperative.Materials and MethodsIn this retrospective study, 16 patients who received posterior mandibular area dental implants with CBCT scans taken about 2 weeks after implantation and one year after implantation were analyzed. A region of interest was selected for each patient. FDs and GSVs were evaluated immediately after implant surgery and at 12-month follow-up to examine the functional loading of the implants.ResultsThere were no significant differences between DPR and CBCT measurements of FD values (P>0.05). No significant differences were observed between FD values and GSVs calculated after implant surgery and at the 12-month follow-up (P>0.05). GSVs were not correlated with FD values (P>0.05).ConclusionThe DPR and reconstructed panoramic CBCT images exhibit similar image quality for the assessment of FD. There were no changes in FD values or GSVs of the peri-implant trabecular bone structure at the 12-month postoperative evaluation of the functional loading of the implant in comparison to values immediately after implantation. GSVs representing bone mass do not align with FD values that predict bone microstructural parameters. Therefore, GSVs and FDs should be considered different parameters for assessing bone quality.

Orthokeratinized versus parakeratinized odontogenic keratocyst: Our institutional experience.

Introduction:The odontogenic keratocyst (OKC) is quite unique among odontogenic cysts in its specific histological features and in clinical characteristics. The OKC has two variants orthokeratinized odontogenic cyst (OOC) and parakeratinized odontogenic cyst (POC), and POC is considered to be more aggressive and has a high recurrence rate. Therefore, OKC has generated considerable controversy with regard to its true nature.Aim:The purpose of this study was to determine the differences between POC and OOC variants of odontogenic cysts on the basis of clinical as well as radiological features.Materials and Methods:A total of 85 cases were included in the present study. There was a marked difference in the age of occurrence, sex, location and radiological presentation of both these entities.Results:Our institutional experience suggests that POC is more common than OOC and both the variants were commonly found in males. Most of the cases of POC were found in the third decade of life and most of the cases of OOC were frequently seen in the second, fourth and fifth decades. Mandibular posterior area was frequently occurring in both variants. Left side involvement was seen in maxilla and right side in mandible in both variants. Most of the cases were clinically diagnosed as OKC.Conclusion:The treatment and prognosis varies in both the variants of OKC, hence such epidemiological studies are helpful to ensure proper treatment for these distinct entities.

Influence of guided bone regeneration on marginal bone loss of implants in the mandible posterior region: a 10-year retrospective cohort study

Objective: To investigate the effect of guided bone regeneration (GBR) on marginal bone loss (MBL) in the region of the mandibular posterior tooth by using a retrospective cohort study, in order to provide reference for clinical practice. Methods: The research subjects were patients who received dental implants from October 2008 to June 2011 in the region of the mandibular posterior tooth at the Department of Oral Implantology, School of Stomatology, The Fourth Military Medical University. According to whether GBR was performed or not and the time of implant insertion, the patients were divided into the controls group (patients without bone grafting), simultaneous GBR implantation group, and delayed GBR implantation group. On this basis, the MBL was measured according to radiographs by comparing the marginal bone level from that of immediate postoperation 10 years ago. General data was collected and compared among groups, including modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), and gingival papilla height. Results: The controls group (patients without bone grafting), implantation group, and delayed GBR implantation group followed 58, 76, 26 implants in 26, 32, 13 patients aging at (46.5±9.9), (45.5±10.7), (58.3±6.4) respectively. The duration of the follow-up was (11.2±0.7), (11.1±0.8), (11.1±0.9) years respectively. The 10-year implant survival rate was 100% (58/58), 100% (76/76), 100% (26/26). The MBL was (0.91±0.28), (0.84±0.27), (1.01±0.27) mm respectively. The MBL difference of patients with simultaneous GBR implantation and delayed GBR implantation showed statistical significance (P<0.05), but these two groups showed no statistical significance compared with the controls group (P>0.05). The mPI, mSBI, PD, and gingival papilla height of the three groups all had no significance on statistics (P>0.05). Conclusions: It can be concluded that there is no difference in long-term marginal bone resorption between simultaneous and delayed implantation with or without GBR (using autologous blood mixed with granular bone meal) in the posterior mandibular area.

1-Year Post-loading of Short and Ultrashort Implants in Posterior Mandibular and Maxillary Regions

BACKGROUND: Short implants have been proposed as an option for management of deficient alveolar ridges without the need for complex augmentation procedures. AIM: In this study, we aim to assess the use of short and ultrashort implants for the management of deficient alveolar ridges in posterior mandibular and maxillary areas with a 1-year post-loading follow-up. METHODOLOGY: Ten patients were recruited in this trial with a total of 14 implants to be placed. The patients all needed implants in the maxillary/mandibular posterior regions for prosthetic rehabilitation with deficient alveolar ridge heights. Implants of 5 mm diameter and lengths either 6 or 8.5 mm were to be placed in the edentulous spaces after proper radiographic assessment. Two-stage surgeries were followed with ¾ months between implant placement and loading. The follow-up lasted for a year to allow for peri-implant clinical assessment and radiographic analysis. RESULTS: All patients showed uneventful healing and no infection, wound dehiscence or inflammation was noted. Prosthetic rehabilitation was successful and satisfactory to the patients. None of the cases showed excessive marginal bone loss and stability was maintained at acceptable levels to the end of the follow-up period. CONCLUSION: Within the limitations of this study, short and ultrashort implants seem like a valid option for management of posterior edentulous regions with deficient ridge heights.

Feasibility study of cone-beam CT for the analysis of cortical bone thickness in the posterior area of the jaw bone

Objective: To investigate the feasibility of cone-beam CT (CBCT) in evaluating the thickness of cortical bone in jaw bone. Methods: Sixty patients [twenty-three for males and forty-seven for females, at an average age of (43.8±1.7) years] from Center of Stomatology, The First Affiliated Hospital of USTC & Anhui Provincial Hospital with 63 operational regions were included in the present study. Totally 63 bone sections from these areas were all selected at last. Case Viewer and oral dynamic system were used for the measurements in sections and CBCT graphs of the cortical bone thicknesses at alveolar ridges. Paired samples t test was performed to compare the difference between CBCT measurement and Case Viewer measurement. Results: The cortical bone thicknesses measured by Case Viewer were (1.20±0.75), (0.68±0.46) and (1.48±0.77) mm in the posterior, maxillary posterior and mandibular posterior areas, respectively. The cortical bone thicknesses measured by dynamic navigation software were (1.14±0.77), (0.64±0.24) and (1.41±0.83) mm in the posterior, maxillary posterior and mandibular posterior areas, respectively. There were no significant differences between either the two methods or the different areas (P>0.05). Conclusions: CBCT would be a useful equipment for the analysis of cortical bone thickness with a reliable and convincible accuracy.

Association of Dental Implants Success in Bone Density Classification of Postmenopausal Women with Osteoporosis - A Clinical and Radiographic Prospective Study

Introduction: Osteoporosis according to postmenopausal women is a major health problem increasing yearly. Thus, there is a growing need to assess the success of dental implants among these patients. Aim: Evaluation of dental implants success between 6 and 12 months follow-up on postmenopausal women with osteoporosis by means of clinical and radiographic assessment. Materials and Methods: A total of 30 female patients aged between 46 and 65 years were diagnosed with osteoporosis and treated with Vitamin D3 and Calcium (Vit D3 and Ca). The sample was divided into two groups: Group 1- 15 female patients diagnosed with osteoporosis (bone density of D2) and treated with (Vit D3 and Ca) and group 2- 15 female patients diagnosed with osteoporosis (bone density of D3) and treated with (Vit D3 and Ca). A total of 60 dental implants were placed in the mandibular posterior area. Implant loading was done after 6 months. Follow up intervals were 6 to 12 months after loading. Results: According to the study, compromised survival was in two implants in the osteoporosis group with a bone type of D2 with a rate of 3.3%, and compromised survival in the osteoporosis group with bone type of D3 was 11 implants with a rate of 18.3%. The success was in 52 implants, with a rate of 86.7%. Conclusion: Placing dental implants in postmenopausal female patients with osteoporosis and treating with (Vit D3 and Ca) is a safe treatment option for missing teeth, despite the bone density type. More researches about implant with osteoporosis patients are recommended.

A Six-Year Prospective Comparative Study of Wide and Standard Diameter Implants in the Maxillary and Mandibular Posterior Area.

Background and Objectives: The aim of our study was to test whether wide diameter (6 mm) implants perform differently from standard diameter (4 mm) implants in terms of marginal bone level and survival rate. Materials and Methods: Our sample comprised 72 patients who underwent surgery; a total of 80 implants were placed in the maxillary or mandibular molar region. Patients were divided into two groups according to the diameter of the implant, and were followed up for six years after the final setting of the prosthetics. In the test group, 40 implants with 6-mm diameter were inserted; in the control group, 40 standard diameter implants were inserted. Using panoramic radiographs, we investigated mesial and distal marginal bone levels around the implant fixtures. Results: After the first implant surgery, three implants, including one wide diameter and two standard diameter implants, failed due to lack of osseointegration. We did not note any fixture fracture during the six-year follow-up. After loading, we observed a six-year survival rate of 97.29% with no statistically significant difference from standard diameter implants, with a survival rate of 94.87%. Conclusions: This study shows that 6-mm diameter implants may be considered in the presence of adequate alveolar ridge width in the posterior maxillary and mandibular regions.