Hypochlorous Acid: A Review Block, Michael S.; Rowan, Brian G.
Journal of oral and maxillofacial surgery,
09/2020, Volume:
78, Issue:
9
Journal Article
Peer reviewed
Open access
The surgeon needs to have an inexpensive, available, nontoxic, and practical disinfectant that is effective in sanitizing against the COVID-19 (Coronavirus Disease 2019) virus. The purpose of this ...article was to review the evidence for using hypochlorous acid in the office setting on a daily basis. The method used to assemble recommendations was a review of the literature including evidence for this solution when used in different locations and industries other than the oral-maxillofacial clinic facility. The results indicate that this material can be used with a high predictability for disinfecting against the COVID-19 (Coronavirus Disease 2019) virus.
Dental Implants: The Last 100 Years Block, Michael S.
Journal of oral and maxillofacial surgery,
January 2018, 2018-01-00, 20180101, Volume:
76, Issue:
1
Journal Article
Peer reviewed
The present article on the history of dental implants spans beyond the past 100 years of the American Association of Oral and Maxillofacial Surgeons. It was not until the materials and methods became ...less traumatic to the bone that implants could become firmly attached to the surrounding bone. This phenomenon is now used to replace single and multiple teeth and restore the patient to function and well-being. Many of the methods used to increase denture function are still used with modifications to augment the environment for an implant. These technological changes have allowed patients to be treated efficiently, with the same need for a good treatment plan and physical evaluation by the clinician.
Patients may need removal of their teeth with placement of implants for rehabilitation. The clinical problem is the status of the remaining teeth and how this affects the timing for implant placement ...and the method for provisionalization. The importance of this review is to document the different strategies including sequential tooth removal and grafting and the use of teeth to provide a fixed provisional rather than a removable provisional, to provide surgeons with a reference to maintain patient function during their rehabilitation.
Pubmed.gov was the information source. Years reviewed included 1990 to 2022. Inclusion criteria included only articles in peer–reviewed journals. Variables evaluated included the success for placing implants immediately into extraction sites, and the methods to transition between steps in their rehabilitation. Data collected were results of systematic reviews and independent clinical series, as well as case reports of prosthetic methods for transitioning.
The search used terms which included implants in extraction sites (n = 205) and transitioning teeth to implants (n = 153). Twenty-one articles were reviewed involving extraction sites and 19 articles reviewed concerning transitioning from teeth to implants. The placement of implants immediately into extraction sites did have a relative risk for failure compared to implant placement in healed sites. The use of non-restorable teeth to support a fixed provisional prosthesis was successful; however, variability in reporting prevented a statistical analysis.
The surgeon needs to utilize teeth to provide support during treatment phases in order to provide the patient with a fixed provisional prosthesis to allow for implant integration and to provide time for graft healing. Specific methods used for transitioning do not have a significant evidence base to recommend one method but routine prosthetic techniques have been used and are reported in case reports.
Clinicians have to decide which implant system to use for their patients. Factors influencing a clinician's choice of a specific implant are not well-established.
The purpose of this study was to ...identify factors that may influence clinician's choice of implant.
This cross-sectional study used a survey instrument that was sent to dentists. Inclusion criteria included if the doctor's name was the addressee and if their website indicated they utilize implants. Exclusion criteria included if the email address was directed to individuals other than the clinician or if the respondent does not place implants as indicated by their website.
The predictor variable was the provider type (oral and maxillofacial surgeon, general dentist, prosthodontist, or periodontist).
The outcome variables were factors that may influence clinician's choice of implants, measured by their ranked responses.
Age and sex were the covariates.
The survey data were evaluated as group in total and separated for each provider type. Factors affecting clinical choice were ranked. A mean score was determined. Responses were evaluated using analysis of variance with significance at P value < .05 to determine if there were differences among the groups.
After applying inclusion and exclusion criteria, the final study sample consisted of 353 clinicians, of whom 230 (65.1%) responded to the survey. Factors scored as extremely or somewhat important were ranked from high to low as follows: clinical trial evidence (92%), ease of use (88%), familiarity with system (73%), restorative dentist's preference (72%), cost (63%), sales representative (59%), key opinion leader (66%), a laboratory's preference (45%), implant company providing continuing education (66%), and implant company can grow practice (65%). There were differences among providers for the factors that influence choice of implant for cost (P value = .02), sales representative (P value = .015), the key opinion leader (P value = .01), laboratory preference (P value = .002), providing continuing education (P value = .02), and implant company can grow my practice (P value = .035).
Four factors that highly influenced provider's choice of a specific implant were evidence for success, ease of use, cost, and familiarity with the implant.
Patients receiving full arch implant borne maxillary prostheses require functional, esthetic, and long term success. The importance of this review is to document the difficulty with implant ...maintenance, the prevalence of peri-implant disease, and the improvement in biologic health when using a prosthesis that can be maintained to minimize plaque. The objective is to provide surgeons with a reference to optimize surgical procedures that can result in improved hygiene and long term maintenance, as well as acceptable functional and esthetic goals.
Pubmed.gov was the information source. Years reviewed included 1990-2022. Inclusion criteria included only articles in journals referenced in pubmed.gov. The reports excluded were case reports, reports that only included implant survival, and articles without a statistical analysis to generate meaningful conclusions. Biological complications included bone loss, hygiene difficulty, mucositis and recession, the incidence of peri-implantitis, and how complications related to patient co-morbidities. Data collected included outcomes of the study including statistical significance.
The search identified articles for review using terms which included full arch maxillary restorations (n = 736), long term success with full arch maxillary prostheses (n = 22), ceramic full arch restorations (n = 102), and complications with full arch restorations (n = 231). From this search, 53 articles were collated that satisfied the inclusion criteria. Factors found to be significant contributors to biological complications included bone loss and peri-implant disease, difficulty with daily hygiene access, plaque and biofilm coverage, and the need for continued maintenance for long term implant health.
The surgeon needs to place implants to allow a full arch maxillary prosthesis to be fabricated with full access to the implants for maintenance, which should decrease the incidence of biological complications. With excellent maintenance full arch implant restorations can have limited peri-implant disease.
Surgeons placing implants use navigation for implant placement accuracy. The importance of this review is to document the sources of error that are involved with navigation so surgeons can recognize ...factors to decrease error. The objective is to provide surgeons with a reference to optimize navigation.
Pubmed.gov was the information source. Years reviewed included 2010 to 2022. The inclusion criteria included only articles in peer–reviewed journals. In vitro results were included only if they involved testing of variables microgap, cone beam computerized tomography (CBCT) accuracy evaluation, or accuracy of printed models. Variables were searched and evaluated. Data collected included the objectives and outcomes of the study including statistical significance. The conclusions made by the authors were confirmed by evaluating the data analysis, and then these conclusions were listed in each error-related topic.
The search used terms which included guided implant surgery complications (n = 4,029), accuracy of CBCT scanners (n = 319), accuracy of implant navigation (n = 983), and the error between drills and static guides (n = 3). From this search, 70 articles were collated that satisfied the inclusion criteria. There are multiple sources of error that are less than 1 mm, including but not limited to errors associated with the scanner and method for scanning, errors associated with merging scanned files with the CBCT scan, errors using different guide stent fabrication methods, errors associated with intraoperative techniques, the learning curve, and planning error. If small errors are not taken into consideration, implant placement errors can exceed 1-2 mm of platform location and angulation errors in excess of 8°.
The surgeon needs to take into consideration controllable factors that will result in the avoidance of implant malposition and thus be able to effectively utilize navigation for accurate implant placement.
The purpose of the present report is to contrast and compare 2 methods of dental implant placement. One method uses computed tomography data for computer-aided design and computer-aided manufacturing ...to generate static guides for implant placement. The second method is a dynamic navigation system that uses a stereo vision computer triangulation setup to guide implant placement. A review of the published data was performed to provide evidence-based material to compare each method. Finally, the indications for each type of method are discussed.
Long Term Is Longer Than You Think Block, Michael S.
Journal of oral and maxillofacial surgery,
June 2023, 2023-06-00, 20230601, Volume:
81, Issue:
6
Journal Article
IMPORTANCELong-term success with a dental implant restoration relies on a stable connection between the abutment and the implant. The purpose of this article is to review current knowledge of the ...abutment interface, identify problems that develop due to wear and mismatch of parts, and use a problem list to propose a solution. The objective was to provide a concise overview that clinicians can then use to choose a system that addresses the problems of the abutment implant interface. OBSERVATIONSManufacturing methods will result in surface variations across the surface of the abutment and implant. Microgaps change in dimension upon function due to wear. Bacterial leakage can lead secondary to functional wear, and the microgap will get larger. The increase in the microgap with function has been clinically verified. Micromotion will result in larger areas of surface gap in both flat and conical connections, with gaps larger than the size of bacteria. CONCLUSIONS AND RELEVANCEFor an ideal abutment, an implant system must have high tolerances for manufacturing with minimal gap formation along the abutment to implant surface; a connection that is resistant to micromotion; screws that have minimal deformation during loading; and a microgap less than 1 micron which is maintained during implant function.
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