КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ СПОСОБА ЗАМЕЩЕНИЯ КОСТНЫХ ДЕФЕКТОВ ЧЕЛЮСТЕЙ С ВОЗМОЖНОСТЬЮ ВРЕМЕННОГО ЗУБНОГО ПРОТЕЗИРОВАНИЯ НА ПЕРИОД ИНТЕГРАЦИИ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ

Background Guided bone regeneration (GBR)is used to influence on stabilization of dental implants in patients with insufficient bone quantity and anatomical problems.But many studies using GBR resulted in divergent results according to the efficiency of new bone quantity formation and implant survival. This research aimed to study the effects of GBR on the increase of bone quantity and short-term stabilization of dental implants in patients with insufficient bone support. Methodology The study included 26 patientsthat underwent the procedure for 40 dental implants from September 2020 to September 2021. In each case, the vertical bone support was intraoperatively measured, through the MEDIDENT Italia paradontal millimetric probe (Medident Italia, Carpi, Italy). The vertical bone defect was considered when the mean vertical depth between the abutment junction and the marginal bone wasgreater than 1mm up to 8mm. In the group with the presence of the vertical bone defect, GBR technique was used duringthe procedure of dental implantsrealized with synthetic bone graft, resorbable membrane, and platelet-rich fibrin (PRF), and the group was considered the study (GBR) group. The group of patients with no vertical bone defects(less than 1mm) and no need for any GBR technique usewas considered the control (no-GBR) group. The bone support was evaluated again intraoperatively after six months in both groups when the healing abutmentswere positioned. The vertical bone defect for each group in baseline and after six months is presented as mean±SD and compared using a t-test. A t-test for Equality of Means was used to calculate the mean depth difference (MDD) between baseline and six months values in each group (GBR and no-GBR) and also between both groups. P-value ≤ 0.05 is considered statistically significant. Results Overall 40 dental implants were placed, 20 of them were included in the GBR group and 20 in the no-GBR group. In the GBR group, a statistically significant greater mean vertical bone defect in baseline (day 1), compared to the no-GBR group was found (-4.46±2.76 vs -0.27±0.22; MDD = -4.19 [-5.44 to -2.94] p<0.001). At six months of follow-up in the GBR group, a new bone around the implant was formed, presenting a significantly lower bone defect compared to the baseline measure (-0.39±0.43 vs -4.46±2.76; MDD = -4.07 mm [-5.37 to -2.78]p<0.001). In six months, no statistically significant difference between GBR and no-GBR group in bone support was found (-0.39±0.43 vs -0.27±0.22; MDD = -0.19 [-0.40 to -0.03] p=0.10). In each group, only one implant failure was observed. Conclusions The use of GBR showed an important reduction of vertical depth defect between healing abutment and marginal bone predisposing similarshort-term stability and survival of dental implants. The use of GBR techniques could be essential in the stabilization of dental implants in patients with insufficient bone support.

Materials and methods. Orthopedic treatment of patients with complete absence of teeth was carried out at the Department of Orthopedic Dentistry of the University Dental Center of KhNMU. 36 elderly patients (6075 years old) with edentulous jaws received treatment, including 13 men (36.11%) and 23 women (63.89%). Patients were divided into three groups: the first group (n = 14) determination of the central ratio of the jaws using the "Centrofix" device; the second group (n = 13) using hard base trays with wax-carborundum rollers; the third group (n = 9) using the "KaVo ARCUSevo" facial arch. To assess chewing efficiency, a chewing test according to Rubinov I.S. (1957) was used. Relevance. With increasing life expectancy, the prevalence of complete edentulism is also rising. Prosthetic rehabilitation in cases of total tooth loss remains a critical and highly relevant area of orthopedic dentistry. In Ukraine, the average prevalence of complete edentulism ranges from 8.4% to 18.0%, and in individuals over 60 years of age, it reaches 25.2% to 46.7%. Although dental implants offer an effective treatment option for edentulous patients, their widespread use remains limited, particularly among the elderly population, due to high costs and the invasiveness of the surgical phase. In contrast, removable prosthetics are more accessible, cost-effective, and suitable for patients with contraindications to implant placement. Removable dentures are relatively simple to fabricate and allow treatment to be completed within a shorter timeframe. Objective. To explore methods for improving the effectiveness of prosthetic treatment in patients with complete edentulism through accurate determination and fixation of the centric relation in the oral cavity. Participants and methods. Prosthetic treatment for patients with complete edentulism was conducted at the Department of Orthopedic Dentistry, University Dental Center of Kharkiv National Medical University. The study involved 36 elderly patients aged 60–75 years, including 13 men (36.11%) and 23 women (63.89%). Patients were divided into three groups: Group 1 (n = 14): Centric relation determined using the “Centrofix” device; Group 2 (n = 13): Centric relation established with hard base trays and wax-carborundum rollers; Group 3 (n = 9): Centric relation registered using the “KaVo ARCUSevo” facebow. Chewing efficiency was assessed using the I. S. Rubinov’s masticatory test (1957). Results. The study assessed the effectiveness of different methods for determining the centric relation in patients with complete edentulism. In the first group, where the “Centrofix” device was used, the chewing efficiency coefficient for edentulous maxillae classified as Type I according to Schröder was 16.67%, which was twice as high as that of the third group and statistically significant (p&lt;0.05). For mandibular edentulism classified as Type I according to Keller, the coefficient reached 13.89% (p&lt;0.05). The quality of life in this group improved by 21.42%. In the second group, where rigid base trays with wax-carborundum rollers were employed, the chewing efficiency reached 72.83% for maxillary edentulism Type I according to Schröder. This result significantly exceeded those of both the first and third groups (p&lt;0.01). The quality of life among patients in this group improved by 53.85%, representing the highest improvement across all groups. The third group, where the “KaVo ARCUSevo” facebow was used, demonstrated the lowest chewing efficiency. The quality of life in this group improved by 33.34%; however, the results were not statistically significant (p&gt;0.05). Conclusion. The findings indicate that the method used to determine the centric relation in patients with edentulous jaws has a direct impact on treatment outcomes. The most notable improvement was observed in the second group, where the use of rigid base trays with wax-carborundum rollers resulted in a significant increase in both chewing efficiency and quality of life (p&lt;0.01). In comparison, the “Centrofix” device and the “KaVo ARCUSevo” facebow were less effective, with lower improvements in functional outcomes and patient-reported quality of life. Therefore, the method involving rigid base trays with wax-carborundum rollers proved to be the most effective among those studied.

Background: Implant stability is considered one of the most important factors affecting healing and successful osseointegration of dental implants. The aims of the study were to measure the implant stability quotient (ISQ) values during the healing period and to determine the factors that affect implant stability. Materials and methods: Thirty patients enrolled in the study (17 female, 13 male). They received 44 Implantium® Dental Implants located as the following: 22 implants in maxillary jaw, 22 implants in mandibular jaw from them 17 implants in segment and 27 in posterior segment. The bone density determined using interactive CT scan and classified according to the Misch bone density classification (29 implants in (D3), 15 implants in (D4)). Resonance frequency analysis was used for direct measurement of implant stability on the day of implant placement and 8, 16 and 24 weeks after implant placement. Results: The lowest mean of average ISQ was at the 8th week (69.5) and then the mean increased to reach at the 24th week (76.8). Mandibular implants showed significantly higher ISQ values than maxillary implants. Implants placed in the posterior segment of the jaw had significantly higher ISQ values than implants in the segment. A significant, positive linear correlation was observed between the implant diameter and the implant stability (r=0.343 p<0.001). Conclusion: Resonance frequency analysis was non-invasive diagnostic tool for detecting changes in implant stability during the healing period. The factors that affect implant stability were implant diameter and implant location (maxilla mandible, anterior posterior).

Introduction: Implant stability is usually measured with resonance frequency analysis (RFA) and damping capacity assessment (DCA). This study aimed to measure primary and secondary stabilities using 3 devices that are based on these methods, namely; RFA (Osstell®) and DCA (Periotest® and AnyCheck®) to assess the correlations of the measurements obtained by these devices and the correlations between implant stability and insertion torque. Material and Methods: This observational prospective study included 35 dental implants. The implant stability was measured using the 3 devices. Mann–Whitney U test and unpaired t-test assessed the relationship between implant stability and insertion torque, while the Spearman and Pearson correlations measured the correlation between readings collected via the 3 devices for the primary and secondary stabilities. Results: For the primary stability, there was a strong positive correlation between Osstell® and AnyCheck® and moderate negative correlations between Periotest® and both Osstell® and AnyCheck®. While for the secondary stability, strong correlations with similar patterns were observed among the 3 devices. The stability measurements showed significant relationships with the insertion torque. Conclusions: The 3 devices are reliable in measuring implant stability; also, high insertion torque can lead to improved implant stabilities (primary and secondary).

Resonance frequency analysis (RFA) allows assess implant stability by measuring implant oscillation frequency on the bone. RFA is an objective and non-invasive method for implant stability measurement, although scarce evidence has been provided so far on its reliability.Objectives: Assess the Osstell ISQ system’s reliability (i.e., its measurement reproducibility and repeatability) by means of the intraclass correlation coefficient (ICC) as statistical method.Study Desing: Implants stability registers were completed by means of Osstell ISQ on 85 implants on 23 patients. Six measurements were completed on each implant by means of two different SmartPegs (types I and II); that is, three consecutive measurements with each transducer.Results: Average ISQ was 72.40, 72.22 and 72.79, and 72.06, 72.59 and 72.82 in the first, second, and third measurements with SmartPegs I and II, respectively. Equal values or differences below three ISQ points were observed in 52.9% and 62.4% of the cases with SmartPegs I and II, respectively. The intraclass correlation coefficient was 0.97 for both SmartPegs, and repeatability and reproducibility also reached 0.97 for both SmartPegs.Conclusions: The RFA system Osstell ISQ presents almost perfect repeatability and reproducibility after intraclass correlation coefficient analysis. Osstell ISQ measurements are highly reliable regarding reproducibility. Therefore, one measurement proves enough. Key words:Dental implants, RFA, ISQ, implant stability, Osstell.

Objectives:Implant primary stability is one of the important factors in achieving implant success. The osteotome technique may improve primary stability in patients with poor bone quality. The aim of this study was to compare implant stability using two different techniques namely osteotome versus conventional drilling in the posterior maxilla.Materials and Methods:In this controlled randomized clinical trial, 54 dental implants were placed in 32 patients; 29 implants were placed in the osteotome group and 25 in the conventional drilling group. Implant stability was assessed at four time intervals namely at baseline, one, two and three months after implant placement using resonance frequency analysis (RFA).Results:Primary stability based on implant stability quotient (ISQ) units was 71.4±7 for the osteotome group and 67.4±10 for the control group. There was no statistically significant difference between the two groups in implant stability at any of the measurement times. In each group, changes in implant stability from baseline to one month and also from two months to three months post-operatively were not significant but from one month to two months after implant placement, implant stability showed a significant increase in both groups.Conclusion:The results of this study revealed that in both techniques, good implant stability was achieved and osteotome technique did not have any advantage compared to conventional drilling in this regard.

BACKGROUND: One of the most common problems of the dental system in the residential and senile age is the complete absence of teeth. This pathology affects up to 35% of patients aged 5570 years, and at the age of 75 years and older, more than 50% of patients have toothless jaws. A small vestibule of the oral cavity due to atrophy of the alveolar process on the lower jaw is an important reason for unsatisfactory fixation of a complete removable prosthesis, and therefore prosthetics of this group of patients is a complex clinical problem.&#x0D; AIM: Study: to optimize the surgical stage of treatment during the operation of deepening the vestibule of the mouth by the method of apically displaced flap in the complete absence of teeth on the lower jaw by using the gel preparation Emalan (Zelenaya dubrava, Russia) based on collagen.&#x0D; MATERIAL AND METHODS: The results of the study of 28 patients aged 67 to 76 years with complete absence of teeth in the lower jaw, whose treatment was carried out on the basis of the dental clinic Prime Dentistry of Ryazan, were analyzed. The study included elderly and senile patients, according to the WHO age classification. Patients were not assigned by gender. All patients were equally divided into 2 groups.&#x0D; Clinical evaluation of the early postoperative period was carried out for 10 days after surgery on the 2nd, 5th and 10th days. A verbal descriptive pain scale was used to assess the intensity of pain.&#x0D; In order to control the presence of an inflammatory reaction in the postoperative period, local thermometry was performed locally using an infrared scanner.&#x0D; RESULTS: Examination on the 2nd day showed that patients of both the main and comparison groups had slightly pronounced edema of the surrounding soft tissues. No increase in body temperature was recorded in both groups. Assessing the postoperative wound, on the 2nd day, all patients of the comparison group had marked hyperemia and swelling of the mucous membrane in the area of the surgical wound, and in patients of the main group such changes were detected less frequently. On the 5th day, no mucosal edema was observed in patients of the main group, and hyperemia was noted twice. In the comparison group, swelling and hyperemia of the mucous membrane in the wound area were recorded in almost half of the group. Examination of the wound defect on the 10th day showed that in the main group in all patients the wound was epithelized, whereas in the comparison group the signs of epithelization were weakly expressed. When studying the dynamics of local thermal symmetry using an IR scanner, carried out three times: on the eve of the operation, on the 2nd and 5th days after the intervention, a difference in indicators was noted between the main group and the comparison group. Patients assessment of the intensity of pain in the postoperative period using a verbal descriptive pain scale showed the following results. After complete cessation of anesthesia, most patients of the main group had slight discomfort in the wound area. Patients of the comparison group mainly complained of severe pain. On the 2nd day and on the 5th day after surgical intervention, some patients of the comparison group had complaints of mild pain in the wound, all other patients, including patients of the main group, had no pain.&#x0D; CONCLUSION: The use of collagen-based gel preparation Emalan to close wound postoperative defects with open methods of deepening the vestibule of the mouth gives positive results in the healing process of the wound defect in the form of absence or significant reduction of pain syndrome, reduction of inflammatory reaction in the wound and acceleration of epithelization.

Osseointegration is critical for the success of dental implants. Surface modifications of dental implants play a crucial role in enhancing osseointegration and implant stability. This in-vitro study aims to evaluate the influence of various surface modifications on dental implant stability. Dental implants with different surface modifications were prepared and subjected to in-vitro testing. Surface modifications included sandblasting, acid etching, and plasma spraying. Implant stability was assessed using resonance frequency analysis (RFA) and pull-out tests. Statistical analysis was performed to compare the stability of implants with different surface modifications. The results showed that implants with sandblasted and acid-etched surfaces exhibited significantly higher stability compared with those with only a machined surface. The mean RFA values for sandblasted and acid-etched implants were 75 ± 5 and 80 ± 6, respectively, whereas machined implants recorded a mean RFA value of 60 ± 4. Similarly, pull-out tests demonstrated higher maximum tensile strengths for sandblasted and acid-etched implants compared with machined implants. Surface modifications, such as sandblasting and acid etching, significantly enhance dental implant stability in vitro. These modifications promote better osseointegration, which is crucial for the long-term success of dental implants in clinical practice.

Objective: To determine the implant stability in osseodistraction‐generated (ODG) bone after a 2‐month consolidation period, assessed by resonance frequency analysis (RFA).Material and methods: Twenty healthy, non‐smoker female patients received 71 dental implants, 39 placed in native bone and 32 in ODG bone, after an 8‐week consolidation period. Primary and secondary stability of the implants was assessed by means of the Osstell®mentor device. The average value of six measurements was considered for the statistical analysis at each time point.Results: The age of the patients who received implants in ODG was not significantly different from that of those receiving implants in pristine bone (48.0±10.9); [X=1.6; 95% confidence interval (CI)=−7.7–10.9].Although implants placed in both bone types indicated good primary stability, a statistically significant difference in favour of implants placed in pristine bone could be identified in terms of osteogenic distraction (OD) (Xi−Xj=3.4; 95% CI=1.7–5.8). After a 1.5‐month integration period, none of the implants failed, but implant stability still recorded higher values for implants located in the pristine bone (Xi−Xj=2.5; 95% CI=0.5–4.4).A positive linear correlation could be established between the implant stability quotient (ISQ) values at implant placement (primary stability) and the post‐integration ISQ score (secondary stability) for both bone types, but only 16% of the post‐integration ISQ in the ODG bone could be attributed to the primary stability.Conclusions: Within the limitations of this study, OD bone offers – after a 2‐month consolidation period – high primary and secondary stabilities after implant placement.

The objective of this study was to compare the effects of preparing for implant site osteotomy with conventional drilling or piezosurgery on the stability of oral implants after a 5 month follow-up period. Thirty patients participated in this randomized clinical trial and received two implants in posterior mandible in bone of the same quality. All surgical procedures were performed by the same surgeon. Implant stability amounts were measured by resonance frequency analysis using the Osstell Mentor device and are reported in the format of implant stability quotient (ISQ) values at baseline and 90 and 150 days after surgery. All implants were well osseointegrated. Differences in ISQ levels were statistically significant in the piezosurgery group at all time intervals, whereas those in the conventional drill group were not significant as analyzed by analysis of variance. The significance of differences between the two groups in each time interval was assessed with Student's t test. In the second interval (90 days), there were statistically significant differences in ISQ levels between the two groups at the buccal, lingual side of implants and mean of two measurements, but at baseline and 150 days, there were no significant differences between these techniques. The early increase of ISQ values in piezoelectric sites shows that piezosurgery is a less traumatic bone osteotomy method with a shorter inflammatory phase and little resorption compared with sites prepared by conventional drilling. ISQ values of up to 60-65 at the time of insertion of the implant predict a good prognosis for immediate implant loading. In this study, the ISQ values were almost always higher than this, offering the safe condition for immediate or early loading protocols after the piezoelectric method of implant site osteotomy. These results may increase predictability of immediate-loading procedure in oral implantology.

BackgroundThe aim of this study was to investigate the clinicians’ experience on maintaining the primary stability of implants with aggressive threads belonging to a novel dental implant system.Material and MethodsThree hundred implants with aggressive threads were inserted in fresh bovine ribs mimicking Type IV bone by five clinicians which were classified according to their previous experience of total number of implant insertion. An independent examiner measured the primary stability of all implants after insertion by using resonance frequency analysis (RFA), electronic percussive testing (EPT) and removal torque methods.ResultsNo significant differences were detected between the stability values measured by the clinicians (p< 0.05) except the Periotest values (PTVs) of the non-experienced clinician. PTVs of the non-experienced clinician were significantly higher than the PTVs of the expert and good clinicians (p >0.05). Significantly higher stability values were detected in the secondary insertion of the non-experienced clinician as compared to her initial insertion values (p >0.05). No significant differences were detected between the first and second measurements of the other clinicians (p< 0.05).ConclusionsWithin the limitations of this ex-vivo study, it may be concluded that experience does not play an important role in maintaining the stability of implants with aggressive threads. Key words:Implantology, experimental design, osseointegration.

INTRODUCTION: The clinical measurement of implant stability and osseointegration is important to be able to assess success in implant dentistry. It is now possible to measure implant stability at any time during the course of implant treatment and loading. OBJECTIVE: This study was designed to compare the implant stability of both the immediately and the early loaded dental implants in the posterior mandible by resonance frequency analysis using Osstell ISQ. MATERIALS AND METHODS: Fourteen patients were included in this study (n=14). They were divided in two groups; group I (n=7) and group II (n=7). Group I: Seven patients having missing mandibular molars received an implant in the posterior mandible followed by immediate loading of provisional restoration (immediate loading). Group II: Seven patients having missing mandibular molars received an implant in the posterior mandible and the provisional restoration delivered one month post-insertion (early loading). All patients received dentium superline implant system with an SLA (sandblasted and acid etched) surface. Implant stability quotient (ISQ) was measured using resonance frequency analysis by the OsstellTM device (Osstell Mentor) wireless device. The implant stability was measured immediately post-operative and on intervals of 1, 3 and 6 months. RESULTS: The mean implant stability values in immediate and early loading immediately post-operatively was 69.0±10.71, 61.86±14.22 respectively. There was an increase after 3rd month to be 71.29±2.14, 75.86±3.18 respectively. The implant stability continued to increase after 6th month to be 71.29±4.61, 77.71±1.60 respectively. The increase in implant stability after 3rd and 6th month was statistically significant. CONCLUSION: The mean implant stability quotient (ISQ) increased throughout the follow-up period. KEY WORDS: implant stability, immediate loading, resonance frequency analysis.

The aim of this research was to evaluate the primary stability, the marginal bone loss, the survival, and the success criteria, of 4-mm-length implants compared with implants of conventional length supporting fixed prostheses. Ten patients were selected for treatment of their atrophic edentulous jaws. Each patient received the following treatment: six dental implants were inserted, two anterior implants of conventional length (10-mm) in the interforaminal area and four posterior short implants of 4-mm length (Standard Plus, Roxolid, SLActive, Institut Straumann AG). The implants supported screw-retained fixed complete dentures. Examinations were conducted at day 0, three, six, and twelve months after surgery for the evaluation of the implant primary stability, secondary stability, crestal bone loss and survival by clinical evaluations, insertion torque values, resonance frequency analysis (RFA), and periapical radiography, respectively. Sixty implants were inserted in ten patients. Mean insertion torque was slightly lower for 4-mm implants than 10-mm implants (38.1Ncm vs. 42.2Ncm) but without statistically significant difference. Implant stability was similar for extrashort and conventional implants. Marginal bone loss was similar for both groups for all the time periods. One short implant was lost before loading. The survival rates twelve months after implant placement were of 97.5% and 100% for short and conventional implants, respectively. Similarly, implant stability as measured by RFA was nonsignificantly lower for the 4-mm implants compared to the 10-mm implants. The marginal bone loss was lower for short implants three, six, and twelve months after the surgery without statistical significant difference. Within the limitations of this study, we conclude that short dental implants (8mm or less in length) supporting single crowns or fixed bridges are a feasible treatment option with radiographic and clinical success rates similar to longer implants for patients with compromised ridges. Long-term data with larger number of implants and subjects are needed to confirm these preliminary results.

Impact of Age-Related Bone Density Variations on Dental Implant Stability and Success Rates: A Retrospective Analysis.

Resonance Frequency Analysis of Dental Implants With 2 Types of Surface Treatment Submitted to Immediate Loading: A Prospective Clinical Study.