One-piece versus two-piece ceramic dental implants

In this narrative review, a structured comparison between one-piece and two-piece zirconia dental implants is highlighted. Ceramic dental implants have long ceased to be hype; on the contrary, they can offer a significant addition to the daily dental implant practice. Not only do their favourable aesthetics play a significant role, but their ability to work completely metal-free is of added value, particularly for patients with a proven allergy for Grade 5 titanium. Furthermore, the fact that peri-implantitis seems to appear only incidentally is an important supporting argument for their use as well. Whereas the original design of zirconia implants was formerly always of a one-piece/one-phase structure (the monobloc design), nowadays, two-piece/two-phase designs (the so-called hybrid concept) are also widely utilised to restore missing teeth. Both concepts have advantages and disadvantages, scientifically as well as clinically.For this paper, relevant articles from the recent scientific literature were selected from PubMed. The aim was to identify and summarise what has previously been published on one-piece versus two-piece ceramic implants. This article will compare the benefits and drawbacks of one-piece versus two-piece ceramic implants based on clinical- (design, different sizes, surgical protocol, prosthetics), scientific- (loading and eventual complications) and patient-related (costs and long-time perspectives) criteria.

The Vertical Soft Tissue Thickness and Subcrestal Implant Placement as Factors for Peri-implant Crestal bone Stability

Aim The aim of this prospective study was to determine the influence of vertical soft tissue thickness on bone level changes in platform-switched implants placed eqicrestally or subcrestally and restored with screw-retained or cement-retained restorations. Methods Platform-switched bone-level implants were placed in a single stage manner in the posterior mandibular region. Implant sites were divided into thick (control) and thin (test) vertical soft tissue groups. The implants in the control group were placed equicrestally. The implant sites from the control group were randomly allocated to receive equicrestally or subcrestally placed implants. Bone remodeling/loss was radiographically measured at baseline, three months postoperatively and six months after delivery of final prosthetic restoration. Results The mean crestal bone loss values three months postoperatively and six months post prosthetic restoration were higher in sites with thin versus sites with thick gingiva. In implant sites with thin gingiva, subcrestally placed implants presented less bone loss than eqicrestally placed implants. Conclusion Platform switched implants are prone to more bone loss when they are placed in sites with thin soft tissue, regardless of the type of final restoration (screw-retained or cement-retained). Subcrestal placement of platform-switched implants can prevent crestal bone loss in sites with vertical soft tissue thickness < 3 mm.    

[The sampling of plaque specimens in oral microbiology]

Sampling is the first and most important step in the bacterial analysis of periodontal or endodontal infections. Sterile paperpoints are the ultimate tool to perform the sampling. Sampling is preferably done under continuous CO2-flushing, to preserve an anaerobic environment for the bacteria. For the dilution and the transport of the bacteria, Reduced Transport Fluid (RTF) is the most reliable fluid, when culturing is indicated. In all other cases, sterile physiologic water is sufficient.

[Halitosis--foetor ex ore]

BACKGROUND

An overview is presented on the etiology, diagnosis, and therapy of halitosis.

METHODS

Results are given of our multidisciplinary halitosis outpatient department started in 1994. The team consists of ENT specialists and paradontologists, occasionally assisted by a psychiatrist. The oral odor is confirmed with a halitometer (Interscan Corporation, Model RH-17E USA). 491 Patients, nearly the same number of males as females, mostly between 20 and 50 years of age were seen.

RESULTS

Oral causes (87%) were due to tongue coating (51%), gingivitis (17%), paradontitis (15%), or combinations of factors (17%). The other 13% involved causes related to ENT problems (4%), both ENT and oral (3%), digestive tract (1%), and presumed psychiatric pathology (5%).

CONCLUSIONS

Many patients underwent diagnostic and therapeutic aimed interventions to no avail prior to their arrival in our halitosis clinic. Usually advising the patient to maintain better oral hygiene is sufficient.

An inventory of patients' response to treatment at a multidisciplinary breath odor clinic

OBJECTIVE

This study was undertaken to assess patients' response to their treatment at a multidisciplinary oral malodor clinic.

METHOD AND MATERIALS

In 4 years, a multidisciplinary breath odor clinic in Belgium examined 406 patients. The team consisted of an ear, nose, and throat specialist, a periodontologist, occasionally a specialist in internal medicine, and, more recently, a psychiatrist. After the initial visit, each patient was scheduled for a follow-up appointment 2 to 6 months later; however, only 143 patients (35%) showed up for this control visit. The remaining 65% of the patients answered a mailed questionnaire.

RESULTS

About half of the patients who returned no longer had complaints, while 17% reported no improvement. This group was characterized by imaginary bad breath and manifest psychologic problems. There was also disbelief of their cure, although clinical examination (organoleptic evaluation and volatile sulfide measurement by means of a portable monitor) did not reveal any oral malodor. Some also insufficiently performed the recommended oral hygiene measures (tongue brushing and interdental cleaning). Most of the patients who returned the questionnaire were disappointed by the suggestion that their halitosis was the result of insufficient oral hygiene.

CONCLUSION

Better education of both the public and dental professionals as to the most frequent cause of halitosis, insufficient oral hygiene, might elevate the level of compliance by patients.

[Halitosis, foetor ex ore]

OBJECTIVE

To review the results of a multidisciplinary approach on halitosis.

DESIGN

Descriptive.

SETTING

University Hospital Leuven, Belgium.

METHODS

Review of the data on etiology, diagnosis and therapy of halitosis, obtained by a multidisciplinary team consisting of ENT specialists, periodontologists and a psychiatrist. Malodour was confirmed by a halimeter.

RESULTS

491 patients, equally males and females, with a concentration between 20-50 years of age were seen. Oral causes (87%) were due to tongue coating (51%), gingivitis (17%), periodontitis (15%) or combinations 17%). The other 13% causes were due to ENT-related problems (4%), both ENT and oral (3%), digestive tract (1%) and presumed psychic (5%).

CONCLUSION

Halitosis is a rather unknown medical problem that often can be solved by a multidisciplinary approach.