No abstract

Various invasive and non-invasive methods have been used for measuring primary implant stability. Periotest damping device, and resonance frequency analysis (RFA) with the Osstell device have been classified as non-invasive methods.In this clinical randomized trial, a general correlation of primary implant stability was recorded using both the Osstell and Periotest device at the day of implant installation and 3 month after healing for the submerged and non submerged   loading protocols. The gender of included patients were investigated in the correlation of the two devices.Eighty completely edentulous patients were recruited, all patients were of age ranging from 50 to 69 years old. A single implant was installed in the midline of the completely edentulous mandible to improve retention of their lower denture. After implant installation, Implant Stability was recorded using the osstel and periotest device. Patients were then randomized into two groups using sealed envelopes; Submerged (S), and Non Submerged (NS). All ISQ and PTV were recorded at the day of implant installation, and 3 month after healing for both groups.When the ISQ was correlated to the (PTV), there was a moderate negative statistically significant correlation between the two readings, correlation coefficient= -0.466, p=0.000 . There tends to be a weak negative correlation between the two devices in the male group ,while there tends to be no correlation between the two devices in the female group After 3 month healing, there was no statistically significant correlation of the readings with in both groups ;NS and S ; Correlation coefficient =-0.014, -0.430, p=0.942, 0.052 respectively.   A strong negative statistically significant correlation between the two devices for the female group for both, NS and the S group. While there was no statistically significant correlation with in the male group for both groups.The present study concluded that there is a significant negative correlation between the two devices when recording primary implant stability, while this significance is lost after 3 month of loading when recording secondary implant stability. Gender would affect the implant stability recording, this would mainly due to the difference in bone density between the male and female group.

Objective Treatment of temporomandibular disc displacement with reduction is controversial. This study assesses the use of an anterior positioning splint with botulinum toxin in the lateral pterygoid muscle (BTX) for such cases. Methods Twelve joints were included; groups I and II received BTX injection while group II also received an anterior positioning splint. Pain scores and clicking status were recorded at regular intervals then a postoperative MRI was done after 4 months. Results Clinical improvement was noted in both groups. Mean pain scores dropped significantly and clicks in the twelve joints disappeared in 83% of group I and 33% of group II. MRIs showed significant disc position improvement with the higher mean change (1.33 ± 0.76) in group I. Group I showed better improvement of discal position and only one joint regained a click. Patients of group II reported discomfort from the splint which may have caused psychological distress and so worst pain scores. Conclusions Group I  showed slightly better results but the cost of BTX injections and the complications of the splint should be kept in mind and the decision of treatment selection made according to each condition.

Background: Implant overdenture retained by two implants installed in the interforaminal area of the completely edentulous mandible has become the standard of care for completely edentulous patients. Various attachments have been used to retain a mandibular implant retained over denture, the ball attachment has been the most commonly used un-splinted attachment to retain a mandibular overdenture owing to its low cost and simplicity. A newly introduced attachment made from polyetherketoneketone (PEKK) which have reported to have high chemical and mechanical resistance to wear and high tensile, fatigue and flexural strengths. The aim of this in vitro study is to analyze the distribution of stresses around the two installed implants in the inter-foraminal area of a completely edentulous mandible using strain gauges utilizing an implant retained overdenture with two different types of attachments one with a nylon cap and the other with a PEKK cap. Materials and Methods: A clear heat cured acrylic completely edentulous mandibular model has been used in this in vitro study to fabricate a lower conventional acrylic denture following conventional steps. In the canine region bilaterally two dummy implants were installed and attached to the model using self-cure acrylic resin. The acrylic resin was prepared around each implant into a box shape with a thickness of 1mm into four surfaces; buccal, lingual, mesial and distal. Strain gauges of length 5mm, resistance of 120.4±0.4 Ω and a gauge factor of 2.09 ± 1 %, were attached to each surface. The same lower acrylic denture was used for pickup of the two attachments; the ball and CMLOC attachment. The implant retained overdenture retained by the each attachments was subjected to unilateral and bilateral vertical static load of 100N using a universal testing machine. The wires of the strain gauges were connected to the strain meter to record the micro-strain using a special software, 10 readings were recorded for each attachment. Results: when the implant retained overdenture have been subjected to unilateral loading, the loading side have recorded a higher statistically significant mean micro-strain than the unloaded side retained by both attachments, The overdenture retained with ball attachment have shown a significant increase in micro-strain on the loaded side than that with the CM LOC attachment, while for the unloaded side the overdenture retained with CMLOC attachment induced more micro strain than the ball attachment. While during bilateral loading, a statistically significant higher mean (3448)

Objectives To compare the changes in implant stability for the nonsubmerged and submerged protocols for a single-implant retained mandibular overdenture using Cendres and Metaux Locator attachment throughout a 24-month follow-up. Materials and Methods Eighty edentulous patients who were seeking to install a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into two groups using sealed envelopes: the nonsubmerged and submerged groups. After 3 months of healing period, randomization using sealed envelopes was performed and patients were randomized to receive the Cendres and Metaux Locator attachment. The periotest readings were recorded using the Periotest M device, every 3 months for the first year and annually in the second year. The scope of this clinical trial focused only on results of the Cendres and Metaux attachment. Statistical Analysis The Mann–Whitney U-test was used for comparison between study groups for independent samples. Two-sided p-values less than 0.05 were considered statistically significant. Results There was no statistically significant difference between the mean periotest readings of both groups throughout the 24-month follow-up. Both groups showed an improvement in mean periotest readings with the submerged group tending to show greater stability at 6, 12, and 24-month follow-ups. Conclusions The nonsubmerged and the submerged healing protocols resulted in reliable periotest readings with the submerged group showing greater improvement than the nonsubmerged, although this improvement is nonsignificant when using the Cendres and Metaux attachment for a single mandibular overdenture.