Patients without a treatment history of dental implants placed more importance on the preservation of healthy teeth. Because patients, in particular those without a treatment history of dental implants, are anxious about surgery, we should provide them with more information on treatment than we already do and explain the risks of treatment to them. To keep the credence between doctors and patients, informed consent and patient education on treatment are six important concerns.

Purpose: The aim of the present study was to use finite elemental analysis (FEA) to evaluate bone stress near an implant placed at the border between the mandible and fibular graft in mandibular reconstruction. Materials and Methods: A fibular model (FM) and transplantation model (TM) were constructed for FEA. In TM, mandible was on the mesial side and the fibular graft was on the distal side. The implant was positioned at the center of both bone models. In TM, it was placed on the border between the mandible and fibular graft. A 10-mm implant was used in the monocortical model and a 15-mm implant was used in the bicortical model. The loading force was set at 100 N, the angle was set at 90˚, and the loading position was set as center, mesial, or distal on the upper surface of the prosthesis. Von Mises equivalent stress values of the bone near the implant collar and apex at the middle line between buccal and lingual side were measured. Results: In all models, stress values were significantly lower with center loading than with distal loading and mesial loading. In center loading, the stress values were significantly lower in the bicortical model than in the monocortical model. There were no significant differences in stress values between FM and TM in all conditions. Conclusions: Bone stress was least with the center loading position, which was further decreased by bicortical fixation. There was no increase in mechanical stress associated with placing an implant at the border between the mandible and the fibular graft.

Soft tissues are important for aesthetic considerations in implant therapy. The purpose of this study was to investigate soft tissue augmentation by using porous poly-DL-lactic acid (PDLLA) shaped as a tablet, with a diameter of 5.0 mm and a height of 2.0 mm. Porous PDLLA was implanted between the periosteal and epithelial tissues in 25 rats that were sacrificed at 1, 2, 4, 12, and 24 weeks. The average height of the PDLLA scaffolds at approximately 24 weeks was 1.85 ± 0.08 mm, and the molecular weight decreased with time. Sinusoidal capillaries at 1 week, connective tissues at 4 weeks, and necrotic tissues at 24 weeks were observed more than other periods. At 24 weeks, the connective tissue surviving in the pores was confirmed to contain blood vessels; therefore, blood vessels are considered to be critical for the survival of soft tissue in scaffold pores. In this study, PDLLA was found to be useful for soft tissue augmentation in the long term. Although the molecular weight of PDLLA decreased with time, the height of the PDLLA scaffolds was preserved. The connective tissue surviving in the pores of the scaffolds at 24 weeks were associated with blood vessels. Further studies are necessary to investigate the optimal scaffold shape and surface characteristics to improve the penetration of blood vessels.

.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(−)CS. The patients replied "I don't know" about peri-implantitis most often in all groups; however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(−)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.