No abstract

Purpose: To compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves. Materials and methods: Any partially edentulous patients requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: Surgical template with or without metallic sleeves. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results: No implants failed, and no complications were experienced. Forty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). Conclusion: With the limitations of the present study, surgical templates without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used with caution in the molar region only in case of reduced interarch space. Further research is needed to confirm these preliminary results.

The objective of the present study was to evaluate the efficacy of Oral Balance saliva substitute in alleviating dry mouth symptoms in a sample of patients with secondary Sjögren's syndrome. Twenty-one consecutive secondary Sjögren's syndrome patients with dry mouth complaints and hyposalivation were included in this study. Patients used a lactoperoxidase-system-containing gel (Biotène Oral Balance) for 4 weeks. The effects on subjective oral symptoms were recorded by means of a 7-items questionnaire which contained questions regarding dry mouth sensation and its effect on chewing, swallowing, taste, speech, burning sensation and denture retention. The severity of symptoms was assessed using a visual analogical scale. Oral symptom scores and unstimulated whole salivary flow were recorded at baseline and after 4 weeks' use of the product. Two patients withdrew from the study, because of nausea and unpleasant taste caused by the product. Nineteen patients (all women, mean age 52.7 years) participated throughout the entire study. Wilcoxon signed-ranked tests indicated significant improvements in visual analogical scale scores posttreatment for 5 of the 7 items on the oral dryness questionnaire, although no increase in salivary flow was found. However, the improvement in certain variables did not take a positive course in all cases. Patients with lower salivary flow at baseline tended to have greater improvement in oral symptoms. The study suggests that the use of Oral Balance gel is effective in alleviating the dry mouth symptoms in secondary Sjögren's syndrome patients, but a randomized controlled trial is needed to assess the placebo effect.

Sicca symptoms and reduced lacrimal and salivary flow were common manifestations in rheumatoid arthritis and should be given adequate consideration during management of patients with rheumatoid arthritis.