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This clinical study aimed to clinically and radiographically compare the implant survival rate and peri-implant tissue response between immediate and delayed loading protocols for unsplinted implant retained mandibular overdentures. Twenty patients were enrolled to participate in this study. Each subject was randomly assigned to 1 of 2 treatment groups: test group patients' implants (n = 10), which were immediately loaded, and control group patients' implants (n = 10), which were conventionally loaded. Locator abutments were torqued to 15 Ncm at delivery. Attachments were picked up intraorally immediately after implant placement for the test group and at 3 months for the control group, and 3-lb retention inserts were placed. Marginal bone levels based on cone beam computed tomography fixed reference points were recorded at baseline and 12 months. Modified plaque index, gingival index, and implant stability quotients were recorded at baseline, 3 months, and 12 months. After 12 months, implant survival rate was 100% in both groups. Marginal bone levels, keratinized mucosa, modified plaque index, and gingival index were significantly different among the groups at 3- and 12-month intervals, whereas no significant differences were found in implant stability quotients between the groups. The fact that implant survival rate was 100% in both treatment groups suggests that, within the limitations of this study, immediate loading protocol for unsplinted implant retained mandibular complete overdenture is as predictable, safe, and successful as the delayed loading protocol. Implementing the immediate loading protocol for mandibular implant retained overdentures could shorten treatment time, which could lead to better patient's satisfaction.

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PURPOSE: Several studies reported better outcomes when restoring edentulous mandible with unsplinted IODs compared to CCDs; however, it is not clear if these outcomes remain when the full literature is considered. The aim of this systematic review is to compare conventional complete dentures (CCDs) to unsplinted implant-retained overdentures (IODs) with regard to efficacy, satisfaction and quality of life. STUDY SELECTION: The main question addressed was: How do CCDs compare to unsplinted IODs with regard to efficacy, satisfaction and quality of life? Three databases were electronically searched to identify articles comparing CCD to unsplinted IOD. Twenty-six articles were selected and reviewed in full. Of these selected articles, twenty-five compared CCDs restoring function in both arches to a maxillary CCD opposing a mandibular IOD retained by two unsplinted implants. Only one articles compared a maxillary CCDs to a maxillary IOD. RESULTS: Outcome measures varied among the studies, including the Oral Health Impact Profile (OHIP), visual analogue scales (VAS), and masticatory performance tests. Overall, IODs were associated with significantly better patient's masticatory performance and quality of life as indicated by Oral Health as Related to Quality of Life (OHRQoL). Mandibular unsplinted IODs were more likely than CCDs to be associated with improved OHRQoL for edentulous patients and were associated with significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew. CONCLUSIONS: Results of this systematic review indicate the superiority of IODs retained by two unsplinted mandibular implants when compared to CCDs with regards to efficacy, satisfaction and quality of life.

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Impression techniques for implant restorations can be implant level or abutment level impressions with open tray or closed tray techniques. Conventional implant-abutment level impression techniques are predictable for maximizing esthetic outcomes. Restoration of the implant traditionally requires the use of the metal or plastic impression copings, analogs, and laboratory components. Simplifying the dental implant restoration by reducing armamentarium through incorporating conventional techniques used daily for crowns and bridges will allow more general dentists to restore implants in their practices. The demonstrated technique is useful when modifications to implant abutments are required to correct the angulation of malpositioned implants. This technique utilizes conventional crown and bridge impression techniques. As an added benefit, it reduces costs by utilizing techniques used daily for crowns and bridges. The aim of this report is to describe a simplified conventional impression technique for custom abutments and modified prefabricated solid abutments for definitive restorations.

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The scarcity of full-time clinical faculty members in dental schools across the country is a major crisis confronting dentistry. Dental schools are experiencing critical faculty shortages and are struggling to maintain appropriate faculty to student ratios. The adage of "doing more with less" applies, in many ways, to dental schools and their mission of educating future dentists. Solutions to the problem have included plans to recruit, develop, and mentor faculty members. However, progress has been slow. Dental schools have created incentive programs to help with faculty shortages and develop future educators in dentistry. This requires commitment and resources and will take years before these efforts and their impact can be assessed. Creative solutions need to be developed both nationally and locally to reverse the trend more rapidly.

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PURPOSE: To evaluate the time needed to remove a glass reinforced fiber post versus a titanium post. METHODS: 40 extracted anterior teeth were mounted in acrylic blocks then treated endodontically. They were randomly assigned to three groups. The teeth were sectioned horizontally, with the coronal portion removed. The fiber posts were cemented with resin cement and the titanium posts were cemented with glass ionomer or resin cement. The fiber posts were removed by coring them out internally. The titanium posts were removed by creating a trough around the post then vibrating with ultrasonic energy. The teeth were examined visually and radiographically to ensure complete removal of the post and cement. Removal time included the time to make radiographs necessary to ensure complete removal. RESULTS: Post-cement combination significantly affected the median rank of the removal time (Kruskal-Wallis test; H = 12.709; P = 0.002). The mean rank removal time of titanium posts cemented with resin cement were significantly higher than the mean rank of the other two post-cement combinations (Dunn's multiple comparison test; P < 0.05). There was no significant difference between the other two combinations.

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The risk of infectious disease transmission is an inherent part of dental practice. Fortunately, such risks can be greatly reduced through modern infection control practices. Such practices include the use of various measures, including administrative, engineering, and work practice controls. Such measures should be codified in an office infection control plan, which should form the basis for the daily infection control activities of the staff. This article discusses some of the measures that should be taken to safeguard the health of dental healthcare workers and patients.

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Dentists in the private sector, as well as their academic counterparts, must comply with a variety of federal, state, and local regulations. The scope of this regulation ranges from specifying who may engage in the practice of dentistry to the disposition of extracted teeth. In this review, some requirements imposed by various regulatory agencies are described. Because of the importance of state and local oversight, each clinician must determine what state and local requirements exist for them. A number of states have enacted various regulations that are more stringent than the federal versions. It is necessary, therefore, to seek appropriate local counsel regarding applicable statutes and regulations.

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Missing teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. When it is necessary to replace anterior or posterior teeth, a properly designed and fabricated rotational path removable partial denture can be both successful and esthetically pleasing to the patient. However, while a patient's functional and esthetic needs can be met successfully, rotational path removable partial dentures can be more demanding for the laboratory technician to fabricate and for the dentist to seat in the mouth. Rotational path removable partial dentures frequently are overlooked as a viable means of treating missing teeth. This article reviews the principles of rotational path removable partial dentures, as well as their categories, advantages, and disadvantages, in the hope that more dentists will consider them when the need arises.

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Humankind has developed and used ceramics throughout history. It currently has widespread industrial applications. Dental ceramics are used for fabricating highly esthetic prosthetic denture teeth, crowns, and inlays. However, ceramic's biocompatibility and compressive strength are offset by its hardness and brittleness. Nonetheless, a single crystal sapphire aluminum oxide endosseous implant was developed in 1972 as an alternative to metal. It was more esthetic than its metallic counterparts and was eventually produced in a variety of shapes and sizes. Clinical studies demonstrated its excellent soft and hard tissue biocompatibility, yet the range of problems included fractures during surgery, fractures after loading, mobility, infection, pain, bone loss, and lack of osseointegration. Ultimately, single crystal sapphire implants fell into irredeemable disfavor because of its poor impact strength, and dentists and surgeons eventually turned to other implant materials. However, bioactive ceramic coatings on metal implants have kept ceramics as a key component in dental implantology.

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The first use of polymethyl methacrylate (PMMA) as a dental device was for the fabrication of complete denture bases. Its qualities of biocompatibility, reliability, relative ease of manipulation, and low toxicity were soon seized upon and incorporated by many different medical specialties. PMMA has been used for (a) bone cements; (b) contact and intraocular lens; (c) screw fixation in bone; (d) filler for bone cavities and skull defects; and (e) vertebrae stabilization in osteoporotic patients. The many uses of PMMA in the field of medicine will be the focus of this review, with particular attention paid to assessing its physical properties, advantages, disadvantages, and complications. Although numerous new alloplastic materials show promise, the versatility and reliability of PMMA cause it to remain a popular and frequently used material.

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Vitallium is a base metal alloy that has been used in dentistry and medicine since 1929. This article will focus on the historical perspectives of Vitallium and include the dental and medical applications used today. The physical and chemical properties of Vitallium will be discussed, with particular emphasis on the biocompatibility of the metal. Finally, the future uses of Vitallium will be examined, as will the potential dangers in fabricating prostheses using this base metal alloy.

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