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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Oral Health".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 31412

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Dr. Paolo Cappare

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Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy IRCCS San Raffaele Hospital, Milan, Italy
Interests: dental implant; digital impression; prosthodontics; intraoral scanning; oral hygiene; rehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Today, oral implantology is one of the most successful dental branches, involving an ever-increasing number of patients with very good and predictable results in most clinical situations. Full-arch fixed rehabilitation of the jaws, also in immediate loading protocols, is well-described also at long-term follow-up.

The increasing spread of minimally invasive techniques has allowed the rehabilitation of patients suffering from bone atrophy of the jaws even without the use of bone grafting techniques.

However, still today, peri-implantitis is a major and growing problem, despite the various maintenance protocols proposed in the literature.

At the same time, there is a growing need for implant prosthetic rehabilitation in patients who are affected by general pathologies, sometimes in poor general health conditions, or in old age.

The objective of this Special Issue is to provide an update of the current knowledge in implant maintenance protocols also in the light of the management of peri-implantitis. It is also intended to focus on the management and rehabilitation of patients in old age, patients suffering from systemic diseases, or who take particular drugs (such as anticoagulants).

At the same time, it aims to show the most recent technological achievements in the world of implant–prosthetic rehabilitation, in order to obtain results with better reproducibility, predictability and success rate.

This Special Issue welcomes all types of studies and reviews considering the perspectives of different stakeholders on implant maintenance and implant–prosthetic rehabilitation in all its facets.

Dr. Paolo Cappare
Guest Editor

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Keywords

Dental implant
Prosthodontics
Digital dentistry
Implant maintenance
Periodontology
Tilted implant
Elderly patients

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Published Papers (9 papers)

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Research

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17 pages, 10038 KiB

Open AccessArticle

In Vitro and In Vivo Evaluation of Nanostructured Biphasic Calcium Phosphate in Granules and Putty Configurations

by Jhonathan R. B. Nascimento, Suelen C. Sartoretto, Adriana T. N. N. Alves, Carlos F. A. B. Mourão, Victor R. Martinez-Zelaya, Marcelo J. Uzeda, José M. Granjeiro, Pietro Montemezzi, Monica D. Calasans-Maia and José A. Calasans-Maia

Int. J. Environ. Res. Public Health 2021, 18(2), 533; https://doi.org/10.3390/ijerph18020533 - 11 Jan 2021

Cited by 6 | Viewed by 3129

Abstract

Synthetic biphasic calcium phosphate (BCP) granules and powder are biocompatible biomaterials with a well-known capacity for osteoconduction, presenting very satisfactory clinical and histological results. It remains unanswered if the putty configuration impacts the biological response to the material. In this study, we aimed to compare the cytocompatibility and biocompatibility of nanostructured BCP in the putty configuration (moldable nanostructured calcium phosphate, MnCaP) on the healing of critical-sized bone defects (8 mm) in rat calvaria. Cytocompatibility was determined through the viability of fibroblast cells (V-79) to the extracts of different concentrations of MnCaP. Forty-five Wistar rats were randomly divided into three groups (n = 15)—clot, MnCaP, and commercial biphasic calcium phosphate in granules configurations (Nanosynt^®)—and subdivided into three experimental periods (1, 3, and 6 months). Histological, histomorphometric, and microtomographic analyses allowed the evaluation of newly formed bone, residual biomaterial, and connective tissue. The in vitro evaluation showed that MnCaP was cytocompatible. The histomorphometric results showed that the Nanosynt^® group granted the highest new-formed bone values at six months (p < 0.05), although the biomaterial volume did not differ between groups. The putty configuration was easier to handle, and both configurations were biocompatible and osteoconductive, presented similar biosorption rates, and preserved the calvaria architecture. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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17 pages, 1886 KiB

Open AccessArticle

One Abutment One Time: A Multicenter, Prospective, Controlled, Randomized Study

by José Vicente Ríos-Santos, Gregorio Tello-González, Pedro Lázaro-Calvo, Francisco Javier Gil Mur, Blanca Ríos-Carrasco, Ana Fernández-Palacín and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2020, 17(24), 9453; https://doi.org/10.3390/ijerph17249453 - 17 Dec 2020

Cited by 9 | Viewed by 3579

Abstract

Aim: (PRIMARY) Assess the changes in bone level (6 and 12 months after implant placement) between the test (definitive abutment (DEF)) and control (healing abutment (HEA)) groups. (SECONDARY) Assess the changes in bone level (6 and 12 months after implant placement) between the 1 mm high abutment group and 2 mm abutment group. Evaluate changes in implant stability recorded with analysis of the resonance frequency (RFA) Osstell system, at 6 and 12 months after implant placement, between the control group (HEA) and test (DEF). For the DEF group, the abutment was placed at the time of the surgery and was never removed. For the HEA group, the abutment was removed three times during the manufacture of the crowns. The abutments used were 1 mm high (Subgroup A) and 2 mm high (Subgroup B). Materials and methods: A total of 147 patients were selected between 54.82 ± 11.92 years old. After implant placement, patients were randomly distributed in the DEF and HEA group. After the implant placement, a periapical radiograph was taken to assess the peri-implant bone level; the same procedure was carried out 6 and 12 months post-placement. To compare the qualitative variables between the groups (HEA/DEF), the Chi-square test was used; for quantitative (MANOVA). Results: After a year, the accumulated bone loss was 0.48 ± 0.71 mm for the HEA group and 0.36 ± 0.79 mm for the DEF group, without statistical significance. Differences were only found due to timing (time) between 0 and 6 months (=0.001) and 0 and 12 months (0.001), with no differences attributable to the study groups (DEF and HEA). The accumulated bone loss (1 year) was 0.45 ± 0.78 mm for the 1 mm abutment group and 0.41 ± 0.70 mm for the 2 mm abutment group (p = 0.02). No differences were observed in implant stability between groups. Conclusions: The “One Abutment—One Time” concept does not reduce peri-implant bone loss compared to the connection–disconnection technique. The height of the abutment does influence bone loss: the higher the abutment, the lower the bone loss. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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11 pages, 2384 KiB

Open AccessArticle

Impacts of Thresholds of Gray Value for Cone-Beam Computed Tomography 3D Reconstruction on the Accuracy of Image Matching with Optical Scan

by Se-Won Park, Ra Gyoung Yoon, Hyunwoo Lee, Heon-Jin Lee, Yong-Do Choi and Du-Hyeong Lee

Int. J. Environ. Res. Public Health 2020, 17(17), 6375; https://doi.org/10.3390/ijerph17176375 - 1 Sep 2020

Cited by 10 | Viewed by 2772

Abstract

In cone-beam computed tomography (CBCT), the minimum threshold of the gray value of segmentation is set to convert the CBCT images to the 3D mesh reconstruction model. This study aimed to assess the accuracy of image registration of optical scans to 3D CBCT reconstructions created by different thresholds of grey values of segmentation in partial edentulous jaw conditions. CBCT of a dentate jaw was reconstructed to 3D mesh models using three different thresholds of gray value (−500, 500, and 1500), and three partially edentulous models with different numbers of remaining teeth (4, 8, and 12) were made from each 3D reconstruction model. To merge CBCT and optical scan data, optical scan images were registered to respective 3D reconstruction CBCT images using a point-based best-fit algorithm. The accuracy of image registration was assessed by measuring the positional deviation between the matched 3D images. The Kruskal–Wallis test and a post hoc Mann–Whitney U test with Bonferroni correction were used to compare the results between groups (α = 0.05). The correlations between the experimental factors were calculated using the two-way analysis of variance test. The positional deviations were lowest with the threshold of 500, followed by the threshold of 1500, and then −500. A significant interaction was found between the threshold of gray values and the number of remaining teeth on the registration accuracy. The most significant deviation was observed in the arch model with four teeth reconstructed with a gray-value threshold of −500. The threshold for the gray value of CBCT segmentation affects the accuracy of image registration of optical scans to the 3D reconstruction model of CBCT. The appropriate gray value that can visualize the anatomical structure should be set, especially when few teeth remain in the dental arch. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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14 pages, 10867 KiB

Open AccessArticle

Evaluation of the Effectiveness of the Use of the Diode Laser in the Reduction of the Volume of the Edematous Gingival Tissue after Causal Therapy

by Elisabetta Polizzi, Giulia Tetè, Claudia Targa, Barbara Salviato, Francesco Ferrini and Giorgio Gastaldi

Int. J. Environ. Res. Public Health 2020, 17(17), 6192; https://doi.org/10.3390/ijerph17176192 - 26 Aug 2020

Cited by 24 | Viewed by 2680

Abstract

Aim: The aim of this study was to evaluate and compare two different techniques for the treatment of plaque-induced gingivitis, demonstrating whether the causal therapy supported by diode laser can allow a resolution of the edema caused by gingivitis in less time compared to the single traditional causal therapy. Materials and methods: Twenty-five patients between 20 and 60 years of age with a specific diagnosis of gingivitis were evaluated at the CLID-HSR oral hygiene department. Once the clinical parameters (bleeding index, plaque index, recession, and clinical attack level) were recorded, each of them was subjected to a professional oral hygiene session and instructed in correct home hygiene procedures. Through a split-mouth protocol for each individual patient, hemi-arches were treated by simple randomization to be treated with causal therapy supported by the action of the diode laser (experimental therapy) and which with traditional causal therapy (control therapy). A first intraoral scan was performed before therapy (T0), which was repeated 20 min after rinsing with CHX. The intraoral scans were repeated at a control 7 (T1) and 14 days (T2) after the session. For each intraoral scan, a volumetric value was calculated, proportional to the edema of the gingival tissues, using special digital software. The operator who carried out the volumetric measurements on the software was not aware of the therapy implemented on each half-arch. The operator who carried out the statistical analysis was not aware of the therapy applied to each group. The collected data were statistically compared in order to detect any differences between the volumetric variations between the two therapy groups and within the therapy groups over time. After evaluating the distribution of data by means of the Kolmogorov-Smirnov statistical test, the appropriate nonparametric tests were chosen to carry out the statistical comparisons. Results: Based on the analysis of the gingival-periodontal health parameters and the volumetric value of the treated areas, no statistically significant differences were detected between the areas treated with the adjuvant action of the diode laser compared to those treated with causal therapy alone. Conclusions: With the limitations of this study, in accordance with the statistical results obtained, diode laser therapy does not allow a faster resolution of gingival edema compared to traditional therapy; the two treatment techniques for plaque-induced gingivitis, therefore, have the same efficacy. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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9 pages, 2678 KiB

Open AccessArticle

A Simple and Safe Approach for Maxillary Sinus Augmentation with the Advanced Surgical Guide

by Seoung-Won Cho, Byoung-Eun Yang, Kyeong-Jun Cheon, Won-Seok Jang, Ju-Won Kim and Soo-Hwan Byun

Int. J. Environ. Res. Public Health 2020, 17(11), 3785; https://doi.org/10.3390/ijerph17113785 - 27 May 2020

Cited by 10 | Viewed by 3654

Abstract

Objective: The development of digital dentistry has contributed to the astonishing advancement of implant dentistry. Furthermore, digital technology is expected to be applied extensively to sinus augmentation, which is an advanced technique for implant surgery. This study introduces a simple method for a safer and more precise lateral window opening for sinus augmentation using a navigation program. Methods: Five eligible patients with residual alveolar bone of 4 mm or less are presented, requiring lateral approach for sinus augmentation. Navigation system was opted for the sinus lift with simultaneous implant placement. Virtual planning started with establishing the adequate position of the lateral window based on the radiographic images and the scanned file of the dentition. The position of the window was indicated on the guide within the program. Afterwards, the virtually designed surgical guide was fabricated either with 3D printer or milling machine for the actual surgery. Results: All the patients who underwent surgery with the surgical guide showed no sign of clinical complications including pain, swelling, nausea, epistaxis, or early loss of the implants. Results of radiographic evaluation also showed adequate placement of the implants in a pre-planned position, and the sinus window was also formed in the desired location. Conclusion: Lateral window opening combined with digital navigation system is believed to be a promising technique for a more precise as well as safer sinus augmentation. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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9 pages, 1725 KiB

Open AccessArticle

Dynamic Navigation in Dental Implantology: The Influence of Surgical Experience on Implant Placement Accuracy and Operating Time. An in Vitro Study

by Gerardo Pellegrino, Pierantonio Bellini, Pier Francesco Cavallini, Agnese Ferri, Andrea Zacchino, Valerio Taraschi, Claudio Marchetti and Ugo Consolo

Int. J. Environ. Res. Public Health 2020, 17(6), 2153; https://doi.org/10.3390/ijerph17062153 - 24 Mar 2020

Cited by 39 | Viewed by 4397

Abstract

Aim: the aim of this in vitro study was to test whether the implant placement accuracy and the operating time can be influenced by the operator’s experience. Materials and methods: sixteen models underwent a (Cone Beam Computer Tomography) CBCT and implant positioning was digitally planned on this. The models were randomly assigned to four operators with different levels of surgical experience. One hundred and twelve implant sites were drilled using a dynamic navigation system and operating times were measured. Based on postoperative CBCTs, dental implants were virtually inserted and superimposed over the planned ones. Two-dimensional and 3D deviations between planned and virtually inserted implants were measured at the entry point and at the apical point. Angular and vertical errors were also calculated. Results: considering coronal and apical 3D deviations, no statistically significant differences were found between the four operators (p = 0.27; p = 0.06). Some vectorial components of the deviation at the apical point and the angular errors of some operators differed from each other. Conclusions: within the limitations of this study, dynamic navigation can be considered a reliable technique both for experienced and novice clinicians. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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20 pages, 12107 KiB

Open AccessArticle

New Application of Osteogenic Differentiation from HiPS Stem Cells for Evaluating the Osteogenic Potential of Nanomaterials in Dentistry

by Giulia Tetè, Paolo Capparè and Enrico Gherlone

Int. J. Environ. Res. Public Health 2020, 17(6), 1947; https://doi.org/10.3390/ijerph17061947 - 16 Mar 2020

Cited by 16 | Viewed by 3901

Abstract

Objective: HiPS stem cells are commonly used for the study of medical disorders. The laboratory in which this study was conducted uses these cells for examining the treatment and cure of neurodegenerative diseases. Bone regeneration poses the greatest challenge for an oral surgeon both in terms of increased implant osseointegration and reducing bone healing times. The aim of this study was to validate the protocol in the literature to produce and then test in vitro osteoblasts with different nanomaterials to simulate bone regeneration. Method: hiPS clones (#2, #4, and #8) were differentiated into an osteoblast cell culture tested for alizarin red staining and for alkaline phosphatase testing at 14, 21 and 28 days, after the cells were plated. Results: The cells showed diffuse positivity under alizarin red staining and the alkaline phosphatase (ALP)-test, showing small formations of calcium clusters. Conclusion: Despite the limitations of our study, it is a starting point for further protocols, laying a solid foundation for research in the field of bone regeneration through the use of stem cells. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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8 pages, 1936 KiB

Open AccessArticle

An fMRI Study on Self-Perception of Patients after Aesthetic Implant-Prosthetic Rehabilitation

by Francesca Cattoni, Giulia Tetè, Riccardo Uccioli, Fabio Manazza, Giorgio Gastaldi and Daniela Perani

Int. J. Environ. Res. Public Health 2020, 17(2), 588; https://doi.org/10.3390/ijerph17020588 - 16 Jan 2020

Cited by 16 | Viewed by 2588

Abstract

Objectives: In this functional magnetic resonance (fMRI) study, we investigated the activation of cerebral pathways involved in the elaboration of self-retracting photos (SELF) and the same pictures of others (OTHER). Each of the photographs showed one of the participants during different stages of the rehabilitation: pre-treatment (PRE), virtual planning using “Smile-Lynx” smile design software (VIR), and post-rehabilitation (POST). Methods: We selected eighteen volunteers, both male and female, between 22 and 67 years of age, who previously underwent prosthetic rehabilitation. Each of them was subjected to an fMRI acquisition. Various stimuli were then shown to the subjects in the form of self-retracting photographs and photographs of other participants, all in pseudo-randomized order. We then carried out a two- stage mixed-effects group data analysis with statistical contrast targeting two main effects: one regarding the main effect of Identity (SELF vs. OTHER) and the other regarding the effect of the prosthetic rehabilitation phase (PRE vs. VIR vs. POS). All the effects mentioned above survived a peak-level of p < 0.05. Results: For the effect of identity, results reported the involvement of dorsolateral frontoparietal areas bilaterally. For the phase by identity effect, results reported activation in the supplementary motor area (SMA) in the right hemisphere. A stronger activation in observing self-retracting photos (SELF) post-treatment (POST) was reported compared to the other phases considered in the experiment. Conclusions: All the collected data showed differences regarding the main effect of Identity (SELF vs. OTHER). Most importantly, the present study provides some trend-wise evidence that the pictures portraying the subject in their actual physiognomy (POST) have a somewhat special status in eliciting selectively greater brain activation in the SMA. This effect was interpreted as a plausible correlate of an empathic response for beautiful and neutral faces. The present research suggests a possible way to measure self-perception of the subject after an appearance-altering procedure such an implant-prosthetic rehabilitation. However, future clinical studies are needed to investigate this matter further. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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Review

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15 pages, 2126 KiB

Open AccessReview

Accuracy of Portable Face-Scanning Devices for Obtaining Three-Dimensional Face Models: A Systematic Review and Meta-Analysis

by Hang-Nga Mai, Jaeil Kim, Youn-Hee Choi and Du-Hyeong Lee

Int. J. Environ. Res. Public Health 2021, 18(1), 94; https://doi.org/10.3390/ijerph18010094 - 25 Dec 2020

Cited by 20 | Viewed by 4045

Abstract

The use of three-dimensional face-scanning systems to obtain facial models is of increasing interest, however, systematic assessments of the reliability of portable face-scan devices have not been widely conducted. Therefore, a systematic review and meta-analysis were performed considering the accuracy of facial models obtained by portable face-scanners in comparison with that of those obtained by stationary face-scanning systems. A systematic literature search was conducted in electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for articles published from 1 January 2009 to 18 March 2020. A total of 2806 articles were identified, with 21 articles available for the narrative review and nine studies available for meta-analysis. The meta-analysis revealed that the accuracy of the digital face models generated by the portable scanners was not significantly different from that of the stationary face-scanning systems (standard mean difference (95% confidence interval) = −0.325 mm (−1.186 to 0.536); z = −0.74; p = 0.459). Within the comparison of the portable systems, no statistically significant difference was found concerning the accuracy of the facial models among scanning methods (p = 0.063). Overall, portable face-scan devices can be considered reliable for obtaining facial models. However, caution is needed when applying face-scanners with respect to scanning device settings, control of involuntary facial movements, landmark and facial region identifications, and scanning protocols. Full article

(This article belongs to the Special Issue Implant-Prosthetic Rehabilitation and Maintenance)

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