Prosthetic Treatment Research Articles

Exploring Intra-Articular Administration of Monoclonal Antibodies as a Novel Approach to Osteoarthritis Treatment: A Systematic Review.

Biological drugs, including monoclonal antibodies, represent a revolutionary strategy in all fields of medicine, offering promising results even in the treatment of osteoarthritis (OA). However, their safety and efficacy have not been fully validated, highlighting the need for in-depth studies. Therefore, we provided a comprehensive systematic review of the intra-articular use of monoclonal antibodies for the treatment of OA in animal models, reflecting ongoing efforts to advance therapeutic strategies and improve patient outcomes. A systematic literature search was conducted in December 2023 following the PRISMA guidelines, using the Web of Science, Google Scholar, and PUBMED databases. Out of a total of 456, 10 articles were included in the study analyzing intra-articular antibodies and focusing on various targets, including vascular endothelial growth factor (VEGF), nerve growth factor (NGF), interleukin 4-10 (IL4-10), tumor necrosis factor α (TNF-α), a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5), and matrix metalloproteinase 13 (MMP-13). Most studies administered the antibodies weekly, ranging from 1 to 10 injections. Animal models varied, with mean follow-up periods of 8.9 ± 4.1 weeks. The methods of assessing outcomes, including pain and morpho-functional changes, varied. Some studies reported only morphological and immunohistochemical data, while others included a quantitative analysis of protein expression. In conclusion, monoclonal antibodies represent a promising avenue in the treatment of OA, offering targeted approaches to modulate disease pathways. Further research and clinical trials are needed to validate their safety and efficacy, with the potential to revolutionize the management of OA and reduce reliance on prosthetic interventions.

Changes in the levels of cytokines IL-1β, IL-4, IL-8, and IL-10 in dental orthopedic fixed prosthetics

Despite significant advances in materials science, introduction of new methods and principles of prosthetic treatment into the practice of dentists, complications after prosthetics with fixed structures are encountered. The result of dental prosthetics of patients with defects of hard tissues of teeth depends not only on the chosen construction and materials from which they are made, but is closely connected with the functional activity of the immune system. Cytokines are an important factor of mucosal immunity. The cytokine system represents one of the key components of mucosal immunity. It regulates normal physiological functions, restoration of haemostasis in the interaction of physical, chemical and biological factors on the body and participates in the pathogenesis of allergic, autoimmune, and autoinflammatory processes. The aim of the study is to compare the content of IL-1â, IL-8, IL-10, and IL-4 in unstimulated saliva and gingival fluid in patients during adaptation to metal-ceramic and oxide ceramic tooth-supported constructions. In the period from 2021-2024, we examined 3 groups of patients aged 46±2 years: group 1 – comparison group, patients without dental constructions in the oral cavity (25 people); group 2 – patients treated with tooth-supported metal-ceramic (MC) crowns (25 people); and group 3 – patients treated with tooth-supported zirconium dioxide (ZrO2) crowns (25 people). On the basis of IL-1â, IL-8, IL-10, and IL-4 we concluded that the mucosal immunity of oral mucous membranes is less affected by the structures made of oxide ceramics compared to the crowns made of metal-ceramics. Similar patterns of changes in the levels of IL-1â, IL-8, and IL-4 in saliva and gingival fluid in patients who underwent dental rehabilitation were found, which allows us to use only saliva in order to eliminate the complexity and specificity of gingival fluid sampling. Also, changes in cytokine indices in saliva and gingival fluid at different stages of prosthodontics reflect the level of reaction of oral mucosal immunity, which can serve as a criterion of the quality of the performed dental treatment.

Edentulism complications in patients eligible for hybrid prosthetic treatment. A cross-sectional study

Edentulism complications in patients eligible for hybrid prosthetic treatment. A cross-sectional study

Relationship Between Oral Hypofunction and Nutritional Status in Patients Treated With Maxillofacial Prostheses.

Introduction Patients who have jaw or tongue defects owing to head and neck cancer or congenital disease suffer from oral dysfunction such as speech, swallowing, and mastication. Although maxillofacial prostheses are applied to improve oral functions, their oral functions remain compromised compared to those of patients without jaw or tongue defects. On the other hand, it has been reported that oral hypofunction could lead to malnutrition in the general elderly. However, to date, no reports have evaluated the relationship between oral function and nutritional status in patients with maxillofacial prostheses. In this study, we comprehensively evaluated oral function according to the examination items for oral hypofunction. We assessed which functions were related to nutritional status in patients with jaw defects caused by tumors or congenital diseases who are candidates for maxillofacial prosthetic treatment. Methods Patients who underwent prosthetic treatment at the Department of Maxillofacial Prosthodontics, Aichi-Gakuin University Dental Hospital, between May 2021 and January 2024 and who were doing well were included in the study. Oral function was assessed with seven tests according to the criteria of the Japanese Society of Geriatric Dentistry, and nutritional status was evaluated using the Mini Nutritional Assessment Short-Form (MNA-SF). Patients were classified according to age and type of deficiency. Additionally, the presence or absence of oral hypofunction and malnutrition or risk of malnutrition were assessed. The impact of oral hypofunction tests and defect status on the risk of malnutrition was evaluated using a logistic regression model. Results Oral hypofunction and malnutrition or risk of malnutrition were more frequent in the elderly group by age. Regarding the type of defect, the rate of oral hypofunction and malnutrition or risk of malnutrition was highest in the tongue defect group. Results of the logistic regression analysis indicated that nutritional status was associated with tongue deficiency, tongue-lip motor function, tongue pressure, and swallowing function. Conclusion The nutritional status of maxillofacial prosthetic wearers was associated with oral hypofunction. Particularly, malnutrition and risk of malnutrition were increased with tongue defects and deficiencies in tongue-lip motor function, tongue pressure, and swallowing.

Analysis of Dental Prosthetic Treatment in Patients with Cancer Aged 65 Years and Older after Expanded Health Insurance Coverage: A Retrospective Clinical Study.

Background and Objectives: With increases in cancer incidence and the number of cancer survivors, the demand for cancer management is growing. However, studies on dental prosthetic treatment for patients with cancer are rare. We aim to investigate the dental prosthetic treatment in patients with cancer aged ≥65 years after expanded health insurance coverage. Materials and Methods: This retrospective study included patients who were treated with implants and removable dentures at Ulsan University Hospital in South Korea between June 2015 and June 2023. Data on age, sex, cancer location, comorbid systemic diseases, number of remaining teeth, dental prosthetic treatment history, type of dental prosthetic treatment, and insurance coverage status were extracted from patient medical records and panoramic radiographs. The influence of multiple variables on dental prosthetic treatment was analyzed using the Chi-square and Fisher's exact tests. Results: The study included 61 patients with cancer (32 men, 29 women; average age: 70.9 years). Among them, 56 (91.8%) had insurance coverage benefits, and 34 (55.7%) received treatments such as implants, removable partial dentures, or complete dentures for the first time. Treatment types included 37 (60.7%) cases of implant prostheses and 24 (39.3%) conventional removable dentures. No statistical differences were observed in the type of dental prosthetic treatment according to sex, age, cancer location, number of systemic diseases, and dental prosthetic treatment history (p > 0.05). Patients with <10 remaining teeth received treatment with conventional removable dentures, which was statistically significant (p < 0.001). Conclusions: Of the 61 patients, 56 (91.8%) received insurance benefits, and 34 (55.7%) underwent dental prosthetic treatment for the first time. Within the limitations of this retrospective study, the expanded health insurance coverage alleviated the unmet demand for dental prosthetic treatment. As cancer prevalence continues to increase, expanding customized health insurance coverage is crucial to meet this demand.

Implant-Supported Vertical Soft Tissue Augmentation for Severe Hard and Soft Tissue Deficiencies at Malpositioned Implants: A Case Report of a Mucogingival and Restorative Approach.

The management of severe mucogingival deformities surrounding malpositioned implants represents a complex issue with a high risk of aesthetic failure. The present case report describes a mucogingival and restorative approach for the treatment of severe localized peri-implant tissue deficiencies with interproximal bone loss combined with an interproximal gingival recession on the adjacent natural tooth. This consists of maintaining a non-restorable malpositioned implant, submerging it through one or multiple vertical soft tissue augmentations, according to the defect severity, and delivering a tooth supported bridge involving the adjacent natural teeth. The step-by-step surgical technique adopted for implant submergence and vertical soft tissue grafting, as well as the subsequent surgical and prosthetic interventions, are described, presenting results at 5 years from implant submergence and 3 years from prosthetic finalization.

Quality of Communication between Dental Technicians and Dentists during the Fabrication of Removable Partial Dentures in Casablanca, Morocco

Introduction: Communication between the dentist and the dental laboratory technician plays an essential role in the success of prosthetic treatment. The purpose of this study was to describe the quality of communication between dentist and dental technicians, and to highlight the different constraints encountered by the laboratory technician when making removable partial prostheses. Materials and Methods: This is a cross-sectional study conducted among 94 dental technician working in the private sector in Casablanca. To collect data an auto administrated questionnaire was distributed to the dental technicians. This tool included five sections : Identification, communication methods, prosthetic design, communication difficulties and the added value of digitizing the prosthetic chain. Data were statistically processed using SPSS 20 software. Results: A total of 94 dental technicians working in Casablanca were interviewed. All these laboratory technicians (100%) used the laboratory form as their main means of communication. Additional means of communication were used to complete missing information (phone, photo sharing, e-mail). 72.3% of dental technicians designed the metal framework for cast partial dentures themselves and 67% of prosthetists said that digitizing the prosthetic chain could improve dentist - dental laboratory technician communication. Conclusion: Effective communication between dentist and dental technician is essential for successful prosthetic treatment and patient satisfaction

Biomechanical Evaluation of the Osseointegration Levels of Implants Placed Simultaneously With Tibia, Femur, and Jaw Allogeneic Bone Grafts.

In implant-supported prosthetic treatments, the jaw bones may not always have enough bone to accommodate implants. Allogeneic grafts can also be preferred as an alternative to autogenous grafts in cases of vertical and horizontal bone deficiencies. The aim of this study is to evaluate the osseointegration levels of lathe-faced titanium implants placed together with allogeneic bone tissue transplants obtained from tibia, femur, and mandible bones using a biomechanical method. Twenty-eight female Sprague Dawley rats were included in the study. The subjects were divided into groups where bone transplantations were performed together with implant placement from the tibia (n=7), femur (n=7), and lower jaw (n=7) regions. Four rats (left and right) were used as donors. Grafts, along with implants, were surgically placed in the corticocancellous part of the metaphyseal parts of the tibia bones of rats. At the end of the 2-week experimental setup, all rats were killed, and the implants and surrounding bone tissues were subjected to biomechanical reverse torque analysis (N/cm), no statistical difference was detected in terms of bone-implant fusion between the groups in which the femur and tibia bones were transplanted (P>0.05), while the bone-implant fusion value in the group in which the lower jaw bone was transplanted was found to be statistically higher than the femur and tibia bones (P<0.05). Based on the limited results of this study, it can be thought that the lower jaw allogeneic jawbone has a higher osseointegration potential than allogeneic grafts obtained from the femur and tibia.

Bruxism among young adults (18-30 years) in Albania. A Case Study Analysis

Introduction: Various pathologies impact the stomatognathic apparatus and are affected by various pathologies, which affect both the dental system and the mastication muscles. A pathology with a high incidence is clenching of the teeth and jaws. The manifestation of this phenomenon is known as "Bruxism", usually linked with the stressful life that humanity is going through. The diagnosis of bruxism is made based on a previously defined protocol that includes anamnesis of disease, extra-intra oral examination, polysomnography. The bruxism can be managed following several procedures: psychological treatment through a psychologist and autosuggestion, drug treatment, and prosthetic treatment through relaxing splints. The aim of the study is to investigate the presence of Bruxism among young adults aged 18-30 years in Albania. Material and method This study adopts a cross-sectional approach, which encompasses obtaining specific information and advantages at a certain point in time regarding the presence of bruxism and dysfunctional disorders of the TMJ system. about a total of 762 subjects of the age group 18-30 years were interviewed and have completed the questionnaire, during the period October 2022-December 2023. Result and conclusion Out of 762 examined patients (students), approximately 32.3% were identified with bruxism. The results of the study showed that the majority of cases involved in our study, approximately 74,4% were female. The results of the study showed a statistically significant relationship between age and the presence of muscle pain (prevalence ofp=0.008, and the presence of ATM pain for subjects involved in our study (prevalence of p=0.008), as well as between age and the presence of bruxism at the subjects study (prevalence ofp=0.006).

Comparative Evaluation of Tear Strength and Tensile Strength of Different Types of Gingival Mask Materials: An In Vitro Study.

The implant-supported prosthetic treatment strategy is commonly chosen in modern dentistry to address tooth loss caused by a variety of conditions or dental defects. To achieve healthy and natural-looking results in implant dentistry, it is essential to replicate the peri-implant soft tissue.The gingival tissue that surrounds implants is quite accurately replicated by gingival masks. They facilitate more accurate prosthesis restoration design, enhance periodontal health, and promote oral cleanliness. Furthermore, gingival masks allow for the accurate observation of superstructure seating on implant analogs, which is essential for creating superstructures that fit perfectly. To evaluate the change in tear strength and tensile strength of three different gingival mask materials (esthetic mask auto mix, Gi-MaskandGingifast Rigid) available in the market at various time intervals. Total of 540 specimens were fabricated with 180 samples of each group. Changes in tensile strength and tear strength of three different gingival mask materials (esthetic mask auto mix, Gi-MaskandGingifast Rigid) at intervals of one day, three days, and seven days were measured by a universal testing machine. Statistical analysis was done using one-way ANOVA and Tukey Post Hoc test.We also performed correlation and regression analyses on tear and tensile strength. The null hypothesis, which is supported by these data, claims that there is no discernible variation in the tear strength and tensile strength of three distinct materials across various time intervals. Thus, the null hypothesis was rejected, and it was concluded that there was a significant change in the tear strength and tensile strength of these gingival mask materials at different time intervals. Esthetic mask auto mix has a high tear strength compared to Gi-Mask and gingifast rigid. Gi-Mask has the least tear strength among all three. Tensile strength decreases as time increases, but the Esthetic mask auto mixhas high strength compared to Gi-Mask and gingifast rigid. Selecting the right material for gingival masks is essential, taking into account the clinical scenario and the articulation time.Time influences gingival mask materials' tear strength and tensile strength, which impacts their performance and durability. Esthetic mask auto mix has a high tear and tensile strength compared to Gi-Mask and gingifast rigid.

Peculiarities of oral microbiota in patients with small and medium-sized dental defects and chronic periodontitis of moderate severity

BACKGROUND: Сhronic generalised periodontitis is one of the most widespread pathologies of the dento-mandibular system. To date, even if there is evidence of bacterial etiology, no biological markers have been developed to qualitatively assess the possibility of inflammation of periodontal tissues or its pathomorphosis to a more severe stage. AIMS: Study of peculiarities of oral microbiota in patients with acquired defects of dental rows in chronic generalised periodontitis of medium severity. MATERIALS AND METHODS: The study participants were 88 people with small/medium dental defects with no clinical signs of periodontal tissue inflammation (the first group) and chronic generalised periodontitis of medium severity (the second group). In order to assess the dental status, an index assessment of periodontal tissues and the intensity of tooth decay was carried out, and the degree of tooth mobility was determined. Using microbiological methods, biomaterial from the mucous membrane of the denture bed tissues was studied with determination of microorganisms composition. DNA of periodontal pathogens was detected and quantified by polymerase-chain reaction. Statistical analysis was performed using the Shapiro-Wilk criterion, t-criterion and χ2 criterion. RESULTS: The mean values of CFE and PMA indices in group 2 patients were 1.5 and 5.7 times higher, respectively, than in group 1. When analysing the composition of microorganisms in biological material from patients with chronic generalised periodontitis of moderate severity, Neisseria spp. were statistically significantly more common (p=0.002), Candida spp. (p=0.035), Enterobacterales (p=0.001), Enterococcus spp. (p=0.03) and statistically significantly lower Corynebacterium spp. (p=0.001) and S. salivarius (p=0.001). In the presence of partial defects of tooth rows in patients, the stated microorganisms formed persistent communities, the nature of symbiotic relations in which determined the clinical manifestations of inflammatory changes in the soft tissues of the periodontium. CONCLUSIONS: The increased incidence of Candida spp. and Enterobacterales in patients with acquired dental defects and periodontal soft tissue inflammation, as well as the formation of persistent relationships between them and antagonistic effects on oral autochthonous bacteria, is of interest for the development of targeted antimicrobial therapy in preparation for dental prosthetic treatment.

A prospective cohort study on factors related to dental care and continuation of care for older adults receiving home medical care.

Information on the effects of dental treatment must be identified and factors that hinder the continuation of dental treatment must be identified to provide appropriate domiciliary dental care (DDC). This study aimed to clarify the treatment outcomes of DDC for older adults and the factors that impede the continuation of such care. This prospective study was conducted at a Japanese clinic specializing in dental care for older adults. The functional status, nutritional status, oral assessment, details of the dental treatment, and outcomes after 6months of older adults receiving DDC were surveyed. The Oral Health Assessment Tool (OHAT) was used for oral assessment. Cox proportional hazards analysis was used to analyze the factors at the first visit that were associated with treatment continuation. A total of 72 participants (mean age, 85.8 ± 6.9) were included. Twenty-three participants (31.9%) could not continue treatment after 6months. The most frequently performed procedures were oral care and dysphagia rehabilitation, followed by prosthetic treatment, then tooth extraction. The percentage of participants with teeth that required extraction after 6months and the total OHAT score decreased significantly. The Barthel Index, Mini Nutritional Assessment Short-Form, and rinsing ability were significantly associated with treatment continuation. Furthermore, instrumental activities of daily living (ADL) and the OHAT "tongue" sub-item were correlated with treatment continuation. In conclusion, DDC improved the oral health status of older adults after 6months. Factors that impeded treatment continuation were decreased ADL, decreased nutritional status, difficulty in rinsing, and changes in the tongue such as tongue coating.

Associations between Dental Anxiety Levels, Self-Reported Oral Health, Previous Unpleasant Dental Experiences, and Behavioural Reactions in Dental Settings: An Adult E-Survey.

Background and Objectives: The aim of this study was to investigate the prevalence of dental anxiety, its association with self-reported oral health, and sociodemographic factors in adults that are critical for improving oral health and well-being. Materials and Methods: An online survey was conducted via social media, with 1551 adults (76.5% women, 23.5% men) participating nationwide. Data collected included demographic data, Modified Dental Anxiety Scale (MDAS) scores, and associations between dental anxiety, negative experiences, and self-reported oral health. The analysis included psychophysiological, behavioural, and emotional responses and avoidance of dental visits, using descriptive and generalised linear regression models. Results: This study found that the mean score of the MDAS was 9.70 ± 5.11 out of 25, 19.1% of the participants reported no dental anxiety, and 7.8% suffered from dental phobia. Gender, age, and socioeconomic status had no significant effect on the prevalence of anxiety. Although more than half of the participants reported negative dental experiences, particularly in childhood, anxiety levels were unaffected. However, those who rated their oral health as excellent or very good had lower anxiety scores (p = 0.008, p = 0.024). Among the dental procedures, oral surgery (58.7%) and prosthetic (restorative) dental treatments (15.2%) caused the most anxiety. Avoidance behaviour correlated with increased anxiety (p ≤ 0.001), as did postponing dental visits until severe pain occurred (p = 0.011). Conclusions: These results emphasise the significant prevalence of dental anxiety in adults, particularly for surgical procedures and drilling, posing challenges in patient management. Tailored strategies are essential to reduce anxiety, improve patient well-being, and optimise dental service delivery and treatment efficacy.

Content comparison of utility and effectiveness instruments to the Prosthetic Interventions Core Outcome Set: a step to inform the benefits measured in lower-limb prosthetic health economic evaluations

Purpose Health Economic Evaluations (HEEs) calculate a cost-benefit ratio using utility and effectiveness instruments. It is unknown whether existing instruments measure the items of the Prosthetic Interventions Core Outcome Set (PI-COS) that represent the benefits most important to lower-limb prosthesis users and funders. Comparing the content of existing instruments against the PI-COS will support instrument selection for future prosthetic HEEs. Materials and methods Utility and effectiveness instruments used to evaluate prosthetic interventions were identified and their International Classification of Functioning, Disability and Health framework (ICF) linking results were extracted. Content of each instrument was compared to the PI-COS through three metrics: content density, content diversity and bandwidth. Results Of the 130 utility and effectiveness instruments, 24 had previously been linked to the ICF. The instrument with the greatest bandwidth (i.e., broadest content coverage of the PI-COS) was the SF-36 given it linked to 6 of the 14 items of the PI-COS. Combining PROMIS subscales and short-forms allow measurement of a greater range of the PI-COS items. Conclusions There is no perfect fit instrument providing coverage of the PI-COS using the metrics of content density, content diversity and bandwidth. The PROMIS instrument may provide increase coverage of the PI-COS in future HEEs.

Challenges in Managing an Edentulous Down Syndrome Patient: A Case Report

Patients with Down Syndrome (DS) are caring, affectionate, and quite social. However, the prosthetic management of edentulous patients with DS depends on the level of their disability, developmental delay and neurobehavioral problems. Muscle hypotonia can affect patient gestures and handling of their prostheses. In addition, intraoral manifestations need to be taken into consideration when designing removable complete dentures, such as macroglossia and maxillo-mandibular sagittal and transverse skeletal misalignment. Dentist is asked to be consistent and to establish a gradual and an atraumatic approach based on the cooperation of the patient and his or her parents, and on the importance of follow ups in the integration of removable prostheses to improve the quality of life and the oral health of these individuals. This article presents the prosthetic treatment of an edentulous 29-year-old female patient with DS and a moderate intellectual disability.

Clinical-statistical study on oral rehabilitation methods using dental implants.

The development of dental implantology is based on a thorough examination of the interaction of implants with the surrounding tissues, as well as methods of stimulating osteogenesis around implants. The most common approach to restore lost dentition in terms of function and aesthetics is now represented by implants. The objective of our study was to comparatively assess the efficiency of prosthetic treatments performed on implants alone versus on implants in conjunction with abutment teeth. The study was carried out over seven years (2016-2023), with evaluations at one, two, three, and five years. For this analysis, MedCalc® version 12.5.0.0 (MedCalc® Software, Mariakerke, Belgium) was utilised as the medical statistical software. When using dental implants and natural teeth abutments for prosthodontic reconstruction, the failure rates rise approximately 43 times when compared to dental implant rehabilitation; similarly, osteoporosis and diabetes mellitus increase failure rates by 32 and 20 times, respectively. Gingival inflammation is a frequent event (almost 50% frequency) observed during follow-up of patients who had prosthetic restoration using dental implants alone as well as implants and abutment teeth. For both groups, difficulties usually arise two years later.

Intraoral scanner-based virtual facebow transferring: A chairside dental technique.

Accurately mounting dental casts on an articulator is an essential step in prosthetic treatments. In digital dentistry, virtual articulator mounting procedures rely on virtual facebow records. However, virtual facebow records usually require devices like face scanners or jaw motion tracking systems that are not commonly available in most dental practices. The present technique report describes a straightforward intraoral scanner-based virtual facebow transfer approach. In this technique, a reference facebow joint support was first scanned and aligned with a virtual articulator. Then, a patient's facebow joint support and bite fork assembly were scanned chairside with an intraoral scanner and aligned with the virtual articulator by matching common features with the reference facebow joint support. After aligning the patient's intraoral scans with the patient's bite fork scan that was already superimposed on the virtual articulator, a virtual mounting process was achieved. Once the corresponding reference facebow joint supports have been generated, this technique can be easily implemented with most facebow systems and be seamlessly integrated into daily clinical practice as only an intraoral scanner and a conventional facebow were required.

Etiology and clinical treatment strategies for second primary molars without permanent tooth germs

Congenital tooth agenesis is a type of craniofacial developmental anomaly with reduced number of teeth, which is caused by disturbances in tooth germ development. If the number of missing teeth is less than six (excluding the third molars), it is termed as hypodontia. The second premolars are most commonly affected. When the second premolars are missing, the second primary molars are more prone to suffer from retention, infraocclusion, caries, pulpitis, or periapical periodontitis. Without timely prevention and appropriate treatment, congenital loss of second premolars may cause adverse effects on the patients' tooth arrangement, occlusal function, craniofacial development, and even future prosthetic treatment. This review summarises the aetiological and diagnostic features of the agenesis of second premolars, and discusses the clinical considerations of retaining or extracting the second primary molars without permanent tooth germs, when the absence of permanent tooth germs is fully established or not, so as to provide references for dentists.

Rehabilitation Using Implants with Sloped Platform Edge vs. Standard Platform with Guided Bone Regeneration: A Randomized Control Clinical Trial.

The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped platform-SLP) and control group (standard design implants with guided bone regeneration-GBR). The primary outcome was bone loss (6 months after finishing the prosthetic treatment). Secondary outcomes included the following: patient-reported outcome measures (PROMs), post-operative edema, keratinized mucosa width, and pink aesthetic score (PES). The average bone loss at 6 months was 0.23 ± 0.15 mm and 1.03 ± 0.37 mm in the SLP and GBR groups, respectively. The SLP group was characterized by lower pain intensity the first 7 days (p < 0.001), lower post-operative edema (p < 0.001), lower consumption of NSAIDs on days 1, 3, 5, and 7 (p = 0.002, <0.001, <0.001, and 0.008), and lower total OHIP-14 (p = 0.047) on day 7. The keratinized mucosa width was 3.7 (3.4-4.0) mm and 2 (1.4-2.0) mm in the SLP and GBR groups, respectively. The preservation of the mesial, distal papillae, and the level of soft tissue correspondence were significantly higher in the SLP group (p = 0.003, 0.038, <0.001). In the SLP group, more natural color and better texture of soft tissues were found (p = 0.048, p = 0.041). The use of implants with a sloped platform resulted in superior outcomes compared to the standard-design implants with GBR.

Registration of jaw centric relation with different deprogramming devices

BACKGROUND: There are several methods to register jaw centric relation for diagnosis and therapy of dysfunctional disorders of the temporomandibular joint. However, there is insufficient information in the literature regarding the choice of the optimal way to determine this indicator. AIM: To compare different methods for recording jaw centric relation according to the data of the computed tomography of temporomandibular joint. MATERIALS AND METHODS: The study includes participants with increased abrasion of hard tooth tissues and symptoms of musculoskeletal dysfunction of the temporomandibular joint. The main group (80 people) has been recorded jaw centric relation using deprogramming devices (Lucia jig — 1stsubgroup, Kois deprogrammer — 2ndsubgroup, sheet calibrator — 3rd subgroup, deprogrammer in combination with M. Rocаbado kinesiotherapy elements — 4th subgroup). The control group included 20 participants, who had not had deprogramming before registration of jaw centric relation. The results were monitored using computed tomography of temporomandibular joint and subsequent assessment of the sizes of the TMG articular gap in the coronary and sagittal sections at 3 stages of the study: diagnostic, after registration of jaws central relation and prosthetic treatment and 6 months after prosthetic rehabilitation. Since there were no more than 50 observations in each group, the Shapiro–Wilk W-test was used to verify compliance with the norm. RESULTS: According to the data obtained, the parameters of the temporomandibular joint gap have changed in the main group of the 1th subgroup, where indicators are approaching the physiological norm (98% of cases). In the 2ndsubgroup, 90% of the participants show a tendency to conform to the physiological norm. The exception is 10% of the participants with no tendency of improvement. The smaller part (75%) of the participants of the 3rd subgroup observed compliance of the parameters of the articular gap with the criteria of the norm. The dimensions of the anterior part of the articular gap of the temporomandibular joint exceed the dimensions of the distal part, which indicates the anterior position of the temporomandibular joint. Some patients in this group (25%) showed no positive results of computed tomography measurements after jaws centric relation registration. In the 4th subgroup, the patients returned to normal values (100% of the cases). The positive effect of prosthetic treatment and restoration of the position of the articular heads of the temporomandibular joint were obtained in 45 % of the participants in the control group. However, in 55% of the participants the location of the articular gap of the temporomandibular joint did not improve. CONCLUSIONS: Lucia jig in combination with the M. Rokabado’s complex of cranial-postural kinesiotherapy is the most effective method to register jaw centric relation within this study. The remaining methods are also applied among prosthetic dentists and gnathologists. However, in each clinical situation, it is necessary to consider temporomandibular joint pathology indications, type and degree of severity as well as the technical and financial capacity of both doctor and patient.