Maxillofacial Implants Research Articles

An Analysis of Scientific Research Trends in Oral Implantology Between 2016 and 2022.

The present study aims to evaluate the trends of oral implant-related research in design and topics between the range of 2016 to the end of 2022. The electronic search was conducted in MEDLINE via Pubmed. Papers published in Clinical Oral Implant Research, Clinical Implant Dentistry and Related Research, and International Journal of Oral Implantology as well as previously European Journal of Oral Implantology, International Journal of Oral and Maxillofacial Implants, and Journal of Oral Implantology between January 1, 2016, and December 30, 2022, were retrieved. Articles were classified according to their study design and major subjects. The Joinpoint regression model was used to determine changes in the trends of study designs and topics. Statistical significance was defined as a p-value <.05. A total of 3382 articles were analyzed in this study. In the specified period, in vivo, prospective cohort, retrospective case control, randomized clinical studies in the design and prosthetic complications, peri-implant hard tissue studies in the topic experienced a significant decreasing pattern in the number of published articles as well as the total number of articles. Case reports and series, retrospective cohort, nonrandomized clinical studies in the design and outcomes of implant-related treatment plans, immediate implant placement, and peri-implantitis in the topic experienced a significant decreasing pattern followed by a significant increasing pattern with a turning point between 2017 and 2020. Considering the limitations of this scientific topical trend analysis, it can be concluded that the recent pandemic affected the research path in oral implantology in many ways.

Nanostructured Titanium with Ultrafine‐Grained Structure as Advanced Engineering Material for Biomedical Application

Titanium and its alloys are popular materials for medical application, particularly in implant devices, where high mechanical properties and osseointegration are critical factors for successful implantation. In this work, the progress in the studies of nanostructured commercially pure Grade 4 titanium (nanoTi) is demonstrated, in which an ultrafine‐grained structure with nanoscale grain size is formed using severe plastic deformation processing. Nanostructured Grade 4 Ti has a very high strength, and its physical nature and strengthening mechanisms are analyzed herein. NanoTi proved also to have very high osseointegration during in vivo experiments. At the same time, the highest biofunctionality is demonstrated by the etched nanoTi samples with pronounced surface roughness, the latter being revealed from precise roughness measurements. The present study provided convincing evidence of accelerated bone formation on nanoTi, which is very promising for manufacture of dental and maxillofacial implants.

Bibliometric Analysis of 100 Most Cited Articles in Middle East and North Africa (MENA) Region on Implant Prosthodontics.

This study aims to conduct a comprehensive analysis and scientometric evaluation of the top 100 most cited publications in the field of implant prosthodontics, authored by individuals affiliated with nations of the Middle East and North Africa (MENA) region. In October 2023, the 100 most cited articles were gathered from the Web of Science database using the bibliometric research technique. The analysis was conducted on bibliometric indicators, including the distribution of articles over time, authorship, design of study, field of study, nature of research, contribution from various countries in MENA, international research collaboration, and most frequently used keywords by authors. Chi-square and one-way analysis of variance were used for statistical analysis. VOSviewer software was used to analyze the bibliometric network for co-occurrence among countries, coauthors, and common keywords. The results revealed that the top 100 most cited articles from MENA countries on the topic of implant prosthodontics, published between 1995 and 2020, had received an average of 73.31 citations each. About one-third of the papers were published in the top 4 journals. The journal with the most published articles was Clinical Oral Implant Research, followed by the International Journal of Oral & Maxillofacial Implants, the International Journal of Prosthodontics, and the Journal of Oral and Maxillofacial Surgery. Saudi Arabia had the distinction of producing the greatest number of highly cited papers. The co-occurrence network analysis using VOSviewer software identified 10-15 related clusters. Research studies with multiple authors received significantly more citations (P < 0.05). Significant relationships were observed between the number of citations and journal type (open access vs. non-open access; P < 0.05), and also articles published in dental journals received the most citations and were statistically significant (P = 0.001). Over the last decade, there has been a significant surge in research related to implant prosthodontics. Among the countries in the MENA region, Saudi Arabia has distinguished itself by leading in terms of overall research output. This resource would benefit academicians, clinicians, and researchers in prosthodontics, oral surgery, and periodontic specialties of dentistry.

Enhancing bioactivity and biocompatibility of polyetheretherketone (PEEK) for dental and maxillofacial implants: A novel sequential soaking process

Polyetheretherketone (PEEK) exhibits excellent biocompatibility, fatigue resistance, and an elastic modulus similar to bone, presenting broad application prospects in the field of dental and maxillofacial implants. However, the bioinertness of PEEK limits its applications. In this study, we developed a method to generate biocompatible and bioactive PEEK through a simple sequential soaking process, aimed at inducing bone differentiation and enhancing antibacterial properties. Initially, a three-dimensional (3D) porous network was introduced on the PEEK surface by soaking in concentrated sulfuric acid and water. Subsequently, the sulfonated PEEK surface was treated with oxygen plasma, followed by immersion in a dopamine solution to coat a polydopamine (PDA) layer. Finally, polydopamine phosphate ester-modified 3D porous PEEK was obtained through the reaction of phosphoryl chloride with surface phenolic hydroxyl groups. Systematic studies were conducted using scanning electron microscopy, X-ray photoelectron spectroscopy, water contact angle analysis, cell proliferation and adhesion, osteogenic gene expression detection, alkaline phosphatase staining, alizarin red staining, and bacterial culture. Overall, compared to unmodified PEEK, the modified PEEK significantly enhanced in vitro cell proliferation and adhesion, osteogenic differentiation, and antibacterial properties. The simple surface modification measures combined in this study may represent a promising technology and could facilitate the application of PEEK in dental and maxillofacial implants.

Bibliometric Analysis of Dental Implantology Journals From 1991 to 2023.

Dental implants are an established treatment option for varying edentulous conditions that has grown in popularity since the 1990s. This increased clinical application has shown a parallel increase in implant-related research. The objective of this paper was to perform a comprehensive bibliometric analysis of five dental implantology journals from 1991 to 2023. A search was done in the Web of Science database between 1991 and 2023 in five journals with a focus on dental implantology: Clinical Oral Implant Research, Clinical Implant Dentistry and Related Research, Implant Dentistry, The International Journal of Oral & Maxillofacial Implants, and International Journal of Oral Implantology. Results marked as a correction, retraction notice, retracted article, meeting abstract, or withdrawn publication were removed from the analysis. The time period analyzed was divided into four time periods, organized by decade: 1991 to 2000, 2001 to 2010, 2011 to 2020, and 2021 to 2023. Additionally, the top 100 cited papers were also exported separately. Authors and countries with most publications were tabulated from the Web of Science database. VOSviewer software was used to create network maps of keywords and title word occurrences for each of the time periods. HistCite software was used to analyze the number of publications and citation counts. Network maps of keywords and title word occurrences suggested an early focus on osseointegration and titanium implants between 1991 and 2000. Publications between 2001 and 2010 saw a focus on in vivo studies, implant surface, and peri-implantitis. Publications from 2011 and later saw a focus on bone regeneration, complications, and zygomatic implants. The USA ranked highest in total number of publications in all analyzed time periods. Within the limitations of the present study, a comprehensive bibliometric analysis from 1990 to 2023 was reported. Trends in keywords and titles of implant publications were identified in these journals, which mirrored the trends seen in clinical practice.

Vacuum Ultraviolet (VUV) Light Photofunctionalization to Induce Human Oral Fibroblast Transmigration on Zirconia.

Soft tissue adhesion and sealing around dental and maxillofacial implants, related prosthetic components, and crowns are a clinical imperative to prevent adverse outcomes of periodontitis and periimplantitis. Zirconia is often used to fabricate implant components and crowns. Here, we hypothesized that UV treatment of zirconia would induce unique behaviors in fibroblasts that favor the establishment of a soft tissue seal. Human oral fibroblasts were cultured on zirconia specimens to confluency before placing a second zirconia specimen (either untreated or treated with one minute of 172 nm vacuum UV (VUV) light) next to the first specimen separated by a gap of 150 µm. After seven days of culture, fibroblasts only transmigrated onto VUV-treated zirconia, forming a 2.36 mm volume zone and 5.30 mm leading edge. Cells migrating on VUV-treated zirconia were enlarged, with robust formation of multidirectional cytoplastic projections, even on day seven. Fibroblasts were also cultured on horizontally placed and 45° and 60° tilted zirconia specimens, with the latter configurations compromising initial attachment and proliferation. However, VUV treatment of zirconia mitigated the negative impact of tilting, with higher tilt angles increasing the difference in cellular behavior between control and VUV-treated specimens. Fibroblast size, perimeter, and diameter on day seven were greater than on day one exclusively on VUV-treated zirconia. VUV treatment reduced surface elemental carbon and induced superhydrophilicity, confirming the removal of the hydrocarbon pellicle. Similar effects of VUV treatment were observed on glazed zirconia specimens with silica surfaces. One-minute VUV photofunctionalization of zirconia and silica therefore promotes human oral fibroblast attachment and proliferation, especially under challenging culture conditions, and induces specimen-to-specimen transmigration and sustainable photofunctionalization for at least seven days.

Application of piezoelectric materials in the field of bone: a bibliometric analysis.

In the past 4decades, many articles have reported on the effects of the piezoelectric effect on bone formation and the research progress of piezoelectric biomaterials in orthopedics. The purpose of this study is to comprehensively evaluate all existing research and latest developments in the field of bone piezoelectricity, and to explore potential research directions in this area. To assess the overall trend in this field over the past 40 years, this study comprehensively collected literature reviews in this field using a literature retrieval program, applied bibliometric methods and visual analysis using CiteSpace and R language, and identified and investigated publications based on publication year (1984-2022), type of literature, language, country, institution, author, journal, keywords, and citation counts. The results show that the most productive countries in this field are China, the United States, and Italy. The journal with the most publications in the field of bone piezoelectricity is the International Journal of Oral & Maxillofacial Implants, followed by Implant Dentistry. The most productive authors are Lanceros-Méndez S, followed by Sohn D.S. Further research on the results obtained leads to the conclusion that the research direction of this field mainly includes piezoelectric surgery, piezoelectric bone tissue engineering scaffold, manufacturing artificial cochleae for hearing loss patients, among which the piezoelectric bone tissue engineering scaffold is the main research direction in this field. The piezoelectric materials involved in this direction mainly include polyhydroxybutyrate valerate, PVDF, and BaTiO3.

Zygomatic Implants: A 20-Year Bibliometric Analysis of Science Citation Index Expanded Publications (2001-2021)

Zygomatic implants provide a valuable treatment option for rehabilitation in severely resorbed maxilla. However, none of the several scientific papers on this topic have included a detailed analysis that characterized the research outputs regarding journals, authors, citations, and institutions. The purpose of this study was to evaluate the characteristics of publications on zygomatic implants published between 2001 and 2021. A systematic literature survey on zygomatic implants was performed on the Web of Science core collection. A bibliometric analysis of 520 studies retrieved from the survey, was conducted using Citespace IV and VOSviewer v1.6.16. The International Journal of Oral and Maxillofacial Implants had the highest number of publications and citations. The country with the most contributions to zygomatic implants between 2001 and 2021 was the United States. However, Shanghai Jiao Tong University in China was the largest contributor to the literature and the most cited institution. Aparicio was the most co-cited author on zygomatic implants. The bibliometric indicators in this study demonstrated upward trends in zygomatic implants. Further bibliometric analysis will also provide important guidance to authors wishing to contribute to the expanding literature on zygomatic implants.

Antibiotics in the non-surgical treatment of peri-implantitis.

Four electronic databases (MEDLINE via Pubmed; EMBASE via Ovid; EBSCO Dentistry and Oral Science Source), in addition to six related journals (Clinical Implant Dentistry and Related Research; Clinical Oral Implants Research; International Journal of Oral and Maxillofacial Implants; International Journal of Oral Implantology; Journal of Clinical Periodontology; Journal of Periodontology), were searched for publications until 2022. Randomised controlled trials (RCTs), evaluating the effectiveness of local or systemic antibiotics as an adjunct in the non-surgical treatment (NST) for peri-implantitis (PI), were assessed. The eligibility criteria included RCTs with a parallel group, split-mouth design and appropriate NST interventions over a three to twelve month period. Data were extracted from RCTs to capture a multitude of primary outcomes, including: implant success rate, radiographic marginal bone loss rate, periodontal health changes and PI resolution. Risk of bias assessments were made using the Cochrane Collaboration's tool, by two authors independently and in duplicate. RCTs with similar observation periods and interventions were included in the meta-analyses. Random-effects meta-analyses of mean differences or relative risks with 95% confidence intervals were calculated, in additional to data heterogeneity calibration through I2 statistics. Following the screening of 270 papers, six RCTs were included, which resulted in the evaluation of 391 patients (375 implants). Adjunctive local antibiotic therapy at disease sites showed statistically significant periodontal outcomes; improvements in success rate (risk ratio = 9.89; 95% CI 2.39-40.84), probing pocket depth (mean difference (MD) = 0.6 mm; 95% CI 0.42-0.78) and bleeding on probing (MD = 0.15%; 95% CI 0.10-0.19). Conversely, adjunctive systemic antibiotics improved probing pocket depths (MD = 1.15 mm; 95% CI 0.31-1.99) and probing attachment levels only (MD = 1.10 mm; 95% CI 0.13-2.08). Across the six included RCTs, the bone loss rate and PI resolution rate determined no significant differences between the groups; mirrored in the single studies and in the meta-analysis. Disease resolution ranged from 2 to 65%. Two of the studies were found to be at low risk of bias and four presented with some concerns. Adjunctive antibiotics aid NST. However, the heterogeneity of study methods and low quality of current RCTs evidenced, deem their role in NSTs of PI as inconclusive.

Long-Term Results of Anodic and Thermal Oxidation Surface Modification on Titanium and Tantalum Implants

Tantalum and titanium are two of the most popular materials used in dental implants today. These materials are highly biocompatible, durable, and long-lasting, making them ideal for use in dental and maxillofacial implants. The ceramic oxide layer that covers the surface of titanium and tantalum implants (TiO2,TaO2) is formed through an electrochemical growth from the inside of the metal and subsequently altered through heat treatment. The aim of this retrospective study was to evaluate the long-term survival of the oxide ceramic-coated titanium dental implants. The secondary purpose was to evaluate the production process and the cost of the coated tantalum and titanium implants, and to complete these retrospective investigations with the results of our previous work concerning the titanium oxide coating. The structural, physical, and chemical properties as well as the corrosion resistance of the Ti/TiO2 surface were investigated; XPS, SIMS, and XRD techniques were used. Patients who received tantalum oxide-coated (Ta/TaO2) dental implants, titanium oxide-coated (Ti/TiO2) dental implants, or titanium oxide-coated (Ti/TiO2) osteosynthesis plates for rehabilitation at the Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University between 1995 and 2005 were included in this retrospective study. Data collection was performed between June 2021 and December 2021. The cost of the tantalum implant was 25 times that of the titanium implant. Only 21 implants were inserted in 10 patients. The survival rate (min. 16 years) was 95%. Twelve patients with a total of sixty-four TiO2-coated implants were observed. The mean implant survival rate was 95%. Our conclusion was that, regardless of the shape of the implant, the Ti/TiO2 coating proved its excellent durability over the years. The “tantalum issue” is increasingly relevant nowadays, since instead of implants made of pure tantalum metal, implants with a porous tantalum surface have come to the fore.

Quality assurance of stereolithography based biocompatible materials for dental applications

Additive Manufacturing (AM) is increasingly being used in healthcare sectors for its potential to fabricate patient-specific customized implants, and specifically in dentistry, AM finds its applications in maxillofacial implants, dentures, and other prosthetic aids. However, in most applications, AM is largely being used for prototyping purposes. The full-scale realization of AM can only be achieved if the downsides of AM are addressed and resolved. Hence this paper focuses on providing a detailed analysis of surface quality, dimensional accuracy, and mechanical properties of the biocompatible material produced, using the Stereolithography (SLA) method for a dental application. For quality analysis, test artefacts were produced, and the quality was assessed before and after the sterilization process. The results suggest that micro-surface roughness essential for cell growth is similar for all build inclinations and well within the control limit required for effective bone regeneration. Multi-scale surface characterization revealed that the sterilization process involving heat can potentially alter the micro-roughness features of resin-based materials. The results from the dimensional analysis show that the SLA parts produced had negligible dimensional deviations from the CAD model to the printed parts and were unaffected by the sterilization process. The tensile test results suggest that the part orientation does not affect the tensile strength and that the sterilization process seems to have an insignificant effect on the tensile properties of the SLA parts. Furthermore, the results were validated by producing a membrane barrier for Guided Bone Regeneration (GBR). The validation results showed that excess resin entrapment was due to the geometrical design of the membrane barrier. In conclusion, this paper provides an overview of quality variations that can help in optimizing the AM and sterilization process to suit dental needs.

Biocompatibility and osseointegration properties of a novel high strength and low modulus β- Ti10Mo6Zr4Sn3Nb alloy.

Introduction: Ti6Al4V titanium alloy is widely used in producing orthopedic and maxillofacial implants, but drawbacks include high elastic modulus, poor osseointegration performance, and toxic elements. A new medical titanium alloy material with better comprehensive performance is urgently needed in the clinic. Methods: Ti10Mo6Zr4Sn3Nb titanium alloy (referred to as Ti-B12) is a unique medical ß titanium alloy material developed by us. The mechanical properties of Ti-B12 depict that it has advantages, such as high strength, low elastic modulus, and fatigue resistance. In our study, the biocompatibility and osseointegration properties of Ti-B12 titanium alloy are further studied to provide theoretical guidance for its clinical transformation. Results and Discussion: The titanium alloy Ti-B12 displays no significant effect on MC3T3-E1 cell morphology, proliferation, or apoptosis in vitro. Neither Ti-B12 titanium alloy nor Ti6Al4V titanium alloy depicts a significant difference (p > 0.05); Ti-B12 material extract injected into the abdominal cavity of mice does not cause acute systemic toxicity. The skin irritation test and intradermal irritation test reveal that Ti-B12 does not cause skin allergic reactions in rabbits. Compared to Ti6Al4V, Ti-B12 titanium alloy material has more advantages in promoting osteoblast adhesion and ALP secretion (p < 0.05). Although there is no significant difference in OCN and Runx2 gene expression between the three groups on the 7th and 14th days of differentiation induction (p > 0.05), the expression of Ti-B12 group is higher than that of Ti6Al4V group and blank control group. Furthermore, the rabbit in vivo test present that 3months after the material is implanted in the lateral epicondyle of the rabbit femur, the Ti-B12 material fuses with the surrounding bone without connective tissue wrapping. This study confirms that the new β-titanium alloy Ti-B12 not only has low toxicity and does not cause rejection reaction but also has better osseointegration performance than the traditional titanium alloy Ti6Al4V. Therefore, Ti-B12 material is expected to be further promoted in clinical practice.

Editorial: Latest News from the IJP Editorial Board

Irena Sailer, Editor-in-Chief: As the year 2022 slowly comes to its end, we have some exciting news to share with you for 2023. It was a very active and productive year for the IJP Editorial Board team thanks to many excellent submissions to the journal. We would like to thank all authors for considering the IJP for their valuable and timely research. We are aware that the speed of the review and publication process is crucial for all authors and a major factor for their satisfaction. Unfortunately, the review process can sometimes be lengthy, and additional statistical reviews cost even more time—this is a part of the publication process that is difficult to control. Yet, the speed at which the accepted work appears online for consideration by the scientific community is where publication procedures can be influenced. To increase the speed of publication and to make submission to the IJP even more attractive in the future, we have established a new “online-as-soon-as-accepted” publication process at the IJP. It will become fully active as of the beginning of 2023. This new process will increase the visibility of your research in the early stages (in the submitted format) and offer the opportunity to be cited long before the fully laid-out version of the manuscript appears in one of the journal issues. Of course, the layout of the work will only be a compromise for a short period of time after online publication, as the first published version of the manuscript will be replaced by the finally laid-out version as soon as the latter is available. This change was a major improvement of the entire publication process and could only be established for the journal with the tremendous help of the Chicago Quintessence team. We as editors are very grateful for it, as it will help us stay competitive with other prosthodontic journals. Please spread the word in your scientific communities! Another change to happen in the near future concerns the Associate Editor Board. Dr Clark Stanford has recently become Editor-in-Chief of the International Journal of Oral & Maxillofacial Implants and will therefore step down from his position as the representative of the Americas on the Editorial Board of the IJP. We are of course very sad to lose such a great Associate Editor, but we congratulate Clark for his appointment and thank him very much for the immense support that he has given the journal over so many years! In the meantime, we have found a fantastic new Associate Editor for the Americas— Dr Kenneth Malament. Dr Malament will be officially presented in the first issue of 2023, and he is so well known in the prosthodontics community that an introduction seems almost unnecessary. His acceptance of our invitation truly moved me. I remember how Dr Malament’s work was dominating the literature at the beginning of my academic career, when I first started diving into the scientific literature in the field of prosthodontics and all-ceramic restorations. I was truly impressed by his meticulous and thorough reports of the long-term data achieved with different types of ceramic restorations documented in his private clinic. For each one experienced with clinical research, it is clear what an enormous effort it must have been for Dr Malament and his team to assess all the parameters of the clinical outcomes over many years in such a standardized way, and to then further analyze the outcomes in collaboration with a unique statistician and methodologist, Dr Sigmund S. Socransky, to help us understand the possibilities and limitations of all-ceramic restorations. As both an academic and a clinical practitioner, Kenny Malament is a true asset to the prosthodontics community and the IJP. We are very pleased and honored to have him join the IJP team, and we very much look forward to a fruitful collaboration in the years to come! In conclusion, 2023 promises to be a great year. Have a nice end of 2022 all! On behalf of the entire Editorial Board team, Irena Sailer, Editor-in-Chief

APPLICATION AND SUCCESS RATES OF ZIRCONIA- A REVIEW

Purpose: This review aimed to evaluate the application and success rate of zirconia in various fields of dentistry. Materials and Methods: electronic databases were searched for original studies reporting on the application, performance and success rates of various zirconia based prosthesis, including PubMed, Cochrane Library, and Science direct.The electronic search was accompanied with manual searches of the bibliographies of all retrieved full text articles and reviews as well as hand search of the following journals: International Journal of Prosthodontics, Journal of Oral Rehabilitation, International Journal of Oral &amp; Maxillofacial Implants, Journal of Indian Prosthodontic Society, and Clinical Oral Implants Research.

Editorial: Evolution

Clark M. Stanford, DDS, PhD, MHA: The International Journal of Oral & Maxillofacial Implants (JOMI), your green journal, continues to evolve. Over the past 6 months, the editorial staff and I have been able to move the editorial process into a new phase of rapid review and response. As I mentioned in the editorial in the third issue this year, building on legacies is key, but authors in the competitive space want the best in clinical and research implant sciences to be published. Fast. They want, like the rest of our societies, a rapid response. In the past 3 months, we have moved from an average total review time of more than 180 to 365 days to less than 60 days. As mentioned in the last editorial, this has meant that the editor-in-chief has needed to be very focused on efficiency and assessment of articles that are not just confirmatory but the very best in contemporary, high-quality clinical science. I want to express to the many authors who have submitted their work to JOMI, only to hear a negative response: Thank you. Thank you for your trust in us and for submitting your work. Our role is, in turn, to provide a respectful but rapid response to your work and provide an answer, allowing you to respond, revise, or move on. It kind of sounds like dating to me. We kick the tires and try out ideas, but it isn’t always a good fit, and that is okay. We evolve. The key is professional civility and respect. Professional civility is the framework of our specialties working in a collaborative manner around the best in patient care. This can be in the educational, clinical, and/or research spaces. The key is respect for each other. Without respect, we cannot evolve as a discipline providing the best in tooth replacement therapy and regardless of our differences, we cannot provide the upmost in patient safety. Losing professional civility between the general provider community and the specialties or between the specialties themselves, in the end, endangers patient safety. Professional civility = Patient safety. More than 20 years ago, the National Academy of Sciences published a groundbreaking report on the lack of safety in the US health care system: “To err is human: Building a safer health system” (https://pubmed.ncbi.nlm.nih.gov/25077248/) outlined a series of recommendations. More than 20 years later, we are only incrementally better. Evolution moves either in spurts, novel mutations, or incremental changes. The key for implant dentistry to learn from this report is that patient safety is grounded in open communication between all providers and the acceptance of all providers to have the ability to provide care (surgical and/or prosthetic) based on a risk-based, evidence-based diagnostic criterion where the team communicates clearly around the best care for the patient (and not the egos in the room). Egos can maim and can even kill. The key for us as a multi- and interdisciplinary profession is to respect the education and experience we each have, to set our professional egos on the curb, and to utilize all the tools of professional civility to communicate, educate, and collaborate with all members of our wonderful dental profession providing tooth replacement therapy through the provision of oral implant care. It is all about patient care. As an educator and clinical prosthodontist, I highly value the education and experience of my collaborators on my team (fellow surgical and orthodontic specialists), and like a version of Jurassic Park, I fully recognize it is the expertise of every team member that has allowed the evolution of care, along with the evolution of implant systems, to continue to improve patient care outcomes. I don’t want to see sharp, unexpected, uncleanable prostheses with Tyrannosaurus-like “implant support-teeth.” We have evolved through professional civility, technology, and mutual education. We are positioned to defend our provision of care through this evolution to our patients for the best in patient care outcomes. The National Academy of Science report in 2000 outlined that failures in communication and collaboration within the healthcare team were leading to patient endangerment. We have and we must continue to evolve as a team to a stronger future. I know we will get there. Will you join me? Thank you. Clark M. Stanford, DDS, PhD, MHA Editor-in-Chief

Influence of Surface Roughness on Biodegradability and Cytocompatibility of High-Purity Magnesium.

High-purity magnesium (Mg) is a promising biodegradable metal for oral and maxillofacial implants. Appropriate surface roughness plays a critical role in the degradation behavior and the related cellular processes of biodegradable Mg-based metals. Nevertheless, the most optimized surface roughness has been questionable, especially for Mg-based oral and maxillofacial implants. Three representative scales of surface roughness were investigated in this study, including smooth (Sa < 0.5 µm), moderately rough (Sa between 1.0–2.0 µm), and rough (Sa > 2.0 µm). The results indicated that the degradation rate of the Mg specimen in the cell culture medium was significantly accelerated with increased surface roughness. Furthermore, an extract test revealed that Mg with different roughness did not induce an evident cytotoxic effect. Nonetheless, the smooth Mg surface had an adversely affected cell attachment. Therefore, the high-purity Mg with a moderately rough surface exhibited the most optimized balance between biodegradability and overall cytocompatibility.

Core Journal Analysis of the Literature in the Field of Prosthodontics: A Bibliometric Study

This study analyzes the data in the field of Prosthodontics and used the bibliometric technique i.e. Bradford’s Law of Scattering to identify the core journals. The literatures in the field of Prosthodontics in the MEDLINE data which is covered in the PubMed are considered. This study is framed to identify the core journals and its subject-wise coverage of journals and country of publication in the discipline of Prosthodontics. A total of 41524 records covered in the field of Prosthodontics in the study period i.e. from the year 2010 to 2019. It is found that a total of 62.03% of records are journal articles. Sixty-Three journals in the Zone-1 and Zone-2 were identified as core journals in the field of Prosthodontics. It is also found that the United States published 20 core journals out of 63 core journals in the field of Prosthodontics. The United States is dominated in the first position in the study of core journal analysis and followed by the countries i.e. England, Germany, China, India, Brazil, etc. The most frequently cited journal articles are published in the Dentistry subject journals; followed by Prosthodontics subject journals, Oral &amp; Maxillofacial Implants subject journals, etc.

A challenging journey of maxillofacial implants placement and rehabilitation in an irradiated exenterated socket

Rehabilitation of a post-exenterated orbital defect is a necessity, to restore a patient's esthetic appearance and help overcome the associated psychosocial stigma. An implant supported prosthesis enjoys a better patient acceptance due to its superior retention and stability. This clinical report highlights the challenges faced in planning, designing and placement of maxillofacial implants in the supra-orbital rim of an exenterated socket post-radiotherapy along with the management of the unexpected complications which developed subsequently. Administration of hyperbaric oxygen therapy, fabrication of a digitally designed surgical guide to ensure predictable implant placement, selection of surface treated implants for better biomechanical anchorage, and a gentler surgical technique for recovery of irradiated hard and soft tissues were measures undertaken during the treatment phase. An effort has been made to point-out the fact that despite the various approaches adopted in an irradiated patient, success of implant placement in such a situation remains a challenge.

A bibliometric analysis of the studies on dental implant failure.

To identify top 30 studies related to dental implant failures based on bibliometric analysis. The bibliometric study was conducted at Aga Khan University, Karachi from April 2021 to June 2021 and comprised database search on Google Scholar used key words "dental implant failures" for studies published between 1990 and 2020. The selected studies were reviewed based on citation count for which the cut-off date was June 1, 2021. The top 30 papers on dental implant failures had median citation count of 153 (range: 41-1583. Most of the studies were retrospective 11(36.7%), followed by literature reviews 6(20%). The top three contributing journals were the 'International Journal of Oral Maxillofacial Implants' 6(20%), the 'Clinical Oral Implants Research' 5(16.7%) and 'Clinical Implant Dentistry and Related Research' 3(10%). Goteborg University, Sweden, contributed the maximum number of most cited papers 8(26.7%). Most of the papers in the top-cited on dental implant failures were retrospective studies, and there was only one clinical trial.

Development and validation of a parametric human mandible model to determine internal stresses for the future design optimization of maxillofacial implants

Large segmental mandible bone defects still represent a challenge for endogenous regeneration. Despite the bone's capacity to heal in many clinical situations, bone defects over a critical size do not heal spontaneously. An emerging treatment of critically sized mandibular defects is the implantation of individually manufactured scaffolds consisting of biodegradable magnesium alloys. Biomedical engineers faced the challenge of developing a scaffold structure that not only provides sufficient stability, but also stimulates and promotes bone growth while considering the degradation of the magnesium alloy. The porosity of the scaffold must also support bone ingrowth and neovascularization.For an optimal design and subsequent structural optimization knowledge of external load cases is essential. However, currently the muscle and joint forces of the mandible cannot be measured directly.The aim of our study was therefore the development of a parametric human mandible model to determine the relevant boundary conditions for the subsequent structural optimization of individual jawbone implants. Using a model-based approach, determining the essential external load of the mandible as a function of the age and sex of a patient individually and the realistic simulation of the mechanical stress for patient-specific loads and anatomies has been realized. The developed model is successfully validated by evaluating the deformations and stresses of the lower jaw of a possible patient and comparing them with the results of dental research.Based on the results of the modelling, in a subsequent optimization process section forces at the interface between the bone tissue and jawbone implant can be determined and used to optimize the design of the jawbone implant.