European Journal of Molecular & Clinical Medicine

Periodontitis is a chronic inflammatory multifactorial disease that causes destruction to periodontium. Periodontal therapy plays a vital role in restoring lost periodontal structure. Lack of periodontal treatment ultimately leads to progression of periodontal destruction; thus, tooth mobility and loss of tooth occurs. Replacement of missing teeth by dental implant is considered as gold standard treatment method over the past decades. At present, Osseointegrated implants are the most widely used with various short comings. To overcome this, development of tissue engineered periodontal ligament cells surrounding the implant (Ligaplants) has now become the new therapeutic and promising tool in field of implant dentistry. Ligaplants improves the biological performance and increase the life of dental prosthesis, hence considered as new dimension in the field of implant dentistry. This review article highlights the existing and scientific literature available on ligaplants.

Aim: The purpose of this systematic review was to evaluate clinical studies on the follow-up survival of implants inserted in the zygomatic bone for maxillary rehabilitation for maxillofacial defects.
Methodology: A comprehensive search of studies published from 2000 to July 2022 and listed in the PubMed/MEDLINE, Embase, and Cochrane Library databases was performed in accordance with the PRISMA statement. Relevant studies were selected according to predetermined inclusion and exclusion criteria. The initial database search yielded 751 titles. After filtering, 313 abstracts were selected, culminating in 42 full text articles. Application of eligibility criteria led to the elimination of 17 articles. Hence 25 full-text articles were considered clinically relevant and were included.
Results: Calculations of the interval survival rates and cumulative survival rates of implants could be carried out on the data extracted from the final list of included studies for the different time intervals. These studies reported the insertion of a total of 1541 zygomatic implants and 33 implant failures. Failure generally occurred during the first year interval and was related to clinical complications, such as recurrent acute and chronic sinusitis. After a 36-month follow-up, the survival rate was 97.86%.
Conclusion: Additional studies with longer follow-up periods, including the number of zygomatic implants inserted and details of the variations in the surgical techniques used and the impact of the maxillary morphology are still required

Aim
The purpose of the present research was to assess the knowledge as well as preference related to material of choice amongst various dental practitioners between titanium and zirconia.
Methodology
The cross-sectional study was conducted where a set of questions was designed by the research group to form a questionnaire that covers the knowledge of the participants and their preferred material in various scenarios. The questionnaires were distributed online, electronically using Google forms to the dental practitioners and dental students. Dental students, interns, general practitioners, post-graduate students, specialists and consultants were included in the sample of this study. Statistical analysis was conducted where comparisons between the various groups were done utilizing the Chi-square test.
Results
308 (80.2%) participants chose Titanium implants while only 26 (6.8%) participants chose Zirconia, and 40 (10.4%) participants didn’t know, while the remaining 2.6% chose other materials. Comparing the biocompatibility of the Titanium and the Zirconia implants, 174 (45.3%) participants chose that both materials have the same biocompatibility, 77 (20.1%) chose Titanium as being more biocompatible, and only 45 (11.7%) chose Zirconia as being more biocompatible.
Conclusion
Titanium was the top choice for every given scenario except if the implant was to be placed in the anterior esthetic zone; which indicates the awareness of the participants of the esthetic benefits that Zirconia implants

The aim of this paper is to review different types of Straumann dental implants and
their effect on osseointegration. The major challenge for contemporary dental
implantologists is to provide oral rehabilitation to patients with healthy bone conditions
asking for rapid loading protocols or to patients with quantitatively or qualitatively
compromised bone. These charging conditions require advances in implant surface
design. The elucidation of bone healing physiology has driven investigators to engineer
implant surfaces that closely mimic natural bone characteristics. This article provides a
comprehensive overview of surface modifications of the Straumann dental implants that
beneficially alter to enhance osseointegration in healthy as well as in compromised bone.
This article discusses Straumann dental implants that have been successfully used for a
years. The Straumann Dental Implant System offers a wide range of implant lines with
diverse body and neck designs and different materials. This focuses on the Titanium
and Roxolid Tissue Level and Bone Level implants with a parallel-walled endosteal
design. These implants can be placed with the instruments from the Straumann
Surgical Cassette while using very similar surgical procedures.

Background - Presently, dental implants are favourable treatment alternatives for
completely or partially edentulous patients. Research has reported substantial improvement
in attitude of patients toward dental implants, however in developing nations with poorer
access to dental care, acceptance of this treatment alternative isn’t yet completely known.
Objective: A survey from a representative sample of Indian population was made to assess
the level of public awareness, sources of information, need for information and
expectations from dental implants in semi urban southern part of India.
Material and Methods: A cross-sectional survey involving 377 adult patients was
conducted via systematic multi-choice questionnaire at a tertiary care medical university in
southern part of India. The data collected was interpreted using SPSS version 20. A pvalue
of <0.05 was considered statistically significant.

Aim: The present paper aims to highlights the prosthodontic management of patients with
some common systemic disorders.
Background: The increase in life expectancy, more desire for improved standard of life
and increased importance to esthetics has resulted in many ambulatory patients with
systemic health disorders walking into the dental clinics.
Results: Systemic diseases can have a local manifestation with no apparent systemic
symptoms or may present with both local as well as systemic reactions. Accordingly, the
assessment of medical risks and its relationship to oral health becomes a major area of
concern.
Conclusion: Dental specialists have a responsibility to contribute to overall health by
subsequent maintenance of the oral health.
Clinical significance: As certain systemic disorders may produce a pernicious effect on the
oral health, it is incumbent for the dental specialists to be aware of the several systemic
conditions and also to consider them in the treatment plan

The aim of this study is to retrospectively analyse the prevalence of diabetes mellitus and hypertension among patients undergoing  dental implant treatment in a dental hospital. All the patients reported in the month of June 2019 to March 2020 for implant placement was chosen for the study. Implant placement data of patients with diabetes mellitus and hypertension was collected from the dental hospital record system. Result data was tabulated in excel and statistical analysis was done using Statistical Software for the Social Sciences (SPSS) software. The non parametric Chi square test was done for statistical analysis. The prevalence of diabetes mellitus in patients undergoing implant placement is 4.2%, hypertension is 2.2% and coexisting diabetes mellitus and hypertension is 1.7% with a higher incidence in the male population and more common in the age group of 40 to 60 years. Knowledge about the prevalence of these conditions will be helpful to the clinician for proper management setup and precise diagnosis before implant therapy can prevent surgical and postoperative complications resulting in long term success of dental implants

Background and Aim: Crestal bone is a routine phenomenon around newly installed implant in the jaw bone. It shows different pattern as per patients habits and oral hygiene. Many clinical approaches have been discussed over the years to deal with this issue. Severe bone loss can eventually lead to implant mobility and exfoliation. The sole
endeavour of present study was to assess peri-implant bone loss in implant supported over dentures patients. It was completed utilizing cone beam computed tomography. Materials & Methods: Firstly, twenty new completely edentulous patients were selected from the regular opd of the department. Complete dentures were fabricated by usual manner. Two implants were decided to be placed in the bilateral canine regions in the mandibular arch. Standard osteotomy procedures were utilized for it. Authors planned to evaluate crestal bone losses around these implants. All four surfaces (mesial, distal, buccal, lingual) of implants were analyzed for bone loss at different time intervals. Bone losses were estimated after two months, four months and six months. Group one, group two and group three implants included in which crestal bone loss around all surfaces evaluated after two
months, four months and six months respectively. Cone beam computed tomography was used to calculate bone levels around each implant at the time period of two months, four months and six months. Informed consent was taken from the patients. Statistical Analysis and Results: Statistical analysis was done by statistical software Statistical Package for the  Social Sciences (SPSS). The resultant data was sent to suitable statistical tests to achieve p values, mean, standard deviation, standard error an 95% CI. P ≤ 0.05 was considered as statistically significant. All patients were further separated into five age groups. 2 patients were selected in the age range of 45-52 years. P value was not significant here. 4 patients were noticed in the age range of 52-58 years. P value was not significant for this age group. Total nine patients were identified in the age range of 59-65 years. Level of significance evaluation by pearson chi-square test [for group I and group III] shown significant values of p for all four studied surfaces [mesial, distal, buccal, lingual].Conclusion: Within the limitations of the study, authors concluded that there was obvious crestal bone loss around the implant surfaces. These losses were identified in all three time intervals of study. Relative crestal bone loss was minimum in the first two months on implant placement and maximum in the first six months on the implant placement. Authors also noticed significant differences in bone losses in first two and first six month of implant placement. However, CBCT assessment also verified that this relative increase of bone loss in six months was very minute.

The article presents an analysis of domestic and foreign publications that analyze the organization of periodontal care for rural residents in different regions. Data on the quality and availability of dental care, risk factors for oral diseases are considered.

The rural population, in comparison with the urban population, has even fewer opportunities to receive dental care,since dental institutions, where the most qualified personnel and the latest equipment are concentrated, are located mainly in cities. Diversity of geographical and economic conditions of rural population, state of communications, accessibility of transport, etc. they aggravate the inequality of residents of different localities in the possibilities of obtaining dental care, so the specifics of the forms and methods of its provision in rural areas is primarily in the approximation of General dental care to the entire rural population.

In this article a review of maxillary sinus anatomy and techniques for floor elevation which is considered a vital part of restoring the posterior maxilla is discussed. Tatum is the pioneer for lateral antrostomy which is being practised till date for sinus lift. Crestal approach which is a conservative
method, proposed by Summers, provides another effective way of placing implant fixture in the atrophic maxilla

The rural population, in comparison with the urban population, has even fewer opportunities to receive dental care, since dental institutions, where the most qualified personnel and the latest equipment are concentrated, are located mainly in cities. Diversity of geographical and economic conditions of rural population, state of communications, accessibility of transport, etc. they aggravate the inequality of residents of different localities in the possibilities of obtaining dental care, so the specifics of the forms and methods of its provision in rural areas is primarily in the approximation of General dental care to the entire rural population.

Dental implants are commonly used in situations for replacement of natural teeth. Despite many advances, techniques, and implant-design, implant failure is a significantconcern for the patient and dentist. The dental implants are designed that best suits the various types of bone. Different etiology for the implant failure and their contributing factors has been discussed in this review article. The purpose of this concise review is to discuss the etiology of implant failure by highlighting the various classification put forth by different authors

Implant Surgeon Gary Greenstein,* † John Cavallaro,* ‡ and Dennis Tarnow* § A proficient knowledge of oral anatomy is needed to provide effective implant dentistry. This article addresses basic ana- tomic structures relevant to the dental implantologist. Pertinent muscles, blood supply, foramen, and nerve innervations that may be encountered during implant procedures are reviewed. Caution must be exercised when performing surgery in certain regions of the mouth. Furthermore, numerous suggestions are provided regarding the practical application of anatomy to facilitate successful implant therapy Review Practical Application of Anatomy for the Dental Implant Surgeon Gary Greenstein,* † John Cavallaro,* ‡ and Dennis Tarnow* § A proficient knowledge of oral anatomy is needed to provide effective implant dentistry. This article addresses basic ana- tomic structures relevant to the dental implantologist. Pertinent muscles, blood supply, foramen, and nerve innervations that may be encountered during implant procedures are reviewed. Caution must be exercised when performing surgery in certain regions of the mouth. Furthermore, numerous suggestions are provided regarding the practical application of anatomy to facilitate successful implant therapy Review 
Practical Application of Anatomy for the Dental Implant Surgeon Gary Greenstein,* † John Cavallaro,* ‡ and Dennis Tarnow* § A proficient knowledge of oral anatomy is needed to provide effective implant dentistry. This article addresses basic ana- tomic structures relevant to the dental implantologist. Pertinent muscles, blood supply, foramen, and nerve innervations that may be encountered during implant procedures are reviewed. Caution must be exercised when performing surgery in certain regions of the mouth. Furthermore, numerous suggestions are provided regarding the practical application of anatomy to facilitate successful implant therapy
A proficient knowledge of oral anatomy is needed to provide effective implant dentistry. This article addresses basic anatomic structures relevant to the dental implantologist. Pertinent muscles, blood supply, foramen, and nerve innervations that may be encountered during implant procedures are reviewed. Caution must be exercised when performing surgery in certain regions of the mouth. Furthermore, numerous suggestions are provided regarding the practical application of anatomy to facilitate successful implant therapy.

In the article, the authors reveal the significance of traumatic occlusion in patients using fixed bridges fixed on dental implants. In the study, the authors use the method of occlusionography to reveal traumatic occlusion in the area of bridges fixed on dental implants. Selective grinding is carried out in the position of central occlusion from the occlusal surface of bridges and antagonist teeth. Radiographically, the authors assessed the degree of bone resorption in the area of implants at various times of the study. The examined patients were divided into 3 groups, of which group I consisted of 8 patients using bridges with implant support, group II - 10 patients with single artificial crowns on implants, group III - 13 patients using metal-ceramic bridges with based on devitalized teeth and implants. The appropriate distribution of patient groups was aimed to obtain comparative results of selective grinding in different clinical cases. The results of the study revealed a significant improvement in the processes of osseointegration in the area of implants using the method of selective grinding. Radiographically confirmed the normalization of the processes of osseointegration and the formation of mature bone tissue in the elimination of traumatic occlusion in the area of bridges fixed on dental implants.

Background: Treatment planning for implants includes a through radiographic and clinical examination. This study compared ridge mapping, direct surgical exposure and CT scan for alveolar ridge assessment before dental implant insertion. Materials & Methods: The present study was conducted on 60 patients who were selected for dental implants placement of both genders. Patients were divided into 3 groups of 20 each. In group I, direct surgical exposure, in group II CT scan and in group III ridge-mapping procedure was performed at 3 mm and 6 mm from alveolar crest.
Results: The mean measurement of alveolar ridge at 3 mm in group I was 3.92 mm, in group II was 4.02 mm and in group III was 3.90 mm. The difference between groups was non- significant (P> 0.05). The mean measurement of alveolar ridge at 6 mm in group I was 6.46 mm, in group II was 6.54 mm and in group III was 6.44 mm. The difference between groups was non- significant (P> 0.05).
Conclusion: Authors found that all the methods revealed similar results hence any of these methods may be used in alveolar ridge assessment before inserting dental implants.

Presently, the replacing of missing tooth via dental implants has become a widespread treatment modality. Dental implants inserted at the posterior region of the maxilla exhibit the lowest success rates as the low density bone in this area often jeopardize rigid fixation of the implant. For long-lasting clinical outcome of implant therapy it is necessary to achieve primary implant stability osseointegration. Other factors, such as bone quality and quantity, surgical techniques are important for achieving primary stability. Maintaining sufficient bone density and bone bulk are also essential factors to achieve bone-to-implant contact for obtaining a biomechanically stable implant. Recently, a new technique is developed which enhances the bone density around dental implants known as Osseodensification (OD), that creates an autograft layer of condensed bone at the periphery of the implant bed by the aid of specially designed burs rotating in a clockwise and anti-clockwise direction. This relatively new concept with universally compatible drills has been proposed to help in better osteotomy preparation, bone densification, and indirect sinus lift and also achieve bone expansion at different sites of varying bone densities. This procedure has also shown improvement in achieving better implant primary stability and better osteotomy than conventional implant drills. Numerous studies have been performed on this new surgical technique. The purpose of this review article is to discuss in detail on OD procedure.

One of the most common challenges faced by the dental professionals is resorbed alveolar ridges which can be in horizontal and vertical dimension . Alveolar distraction osteogenesis is one of the mode of treatment for improving the deficient areas of alveolar ridges.
Alveolar distraction osteogenesis is biological process which involves progressive incremental traction between the vascularized bone segments in order to gain new bone formation. Osteotomy is usually performed which is followed by placing a osteo-distractor device which controls the separation process. By using this technique, the use of bone graft can be avoided as it produce same character and morphology of bone. It results into growth of the soft tissue with development of new bone on deficient ridge. As bone height is restored by this technique ,it is feasible to place longer dental implants. 
This review discuss about ride augmentation and various procedure which are performed to restore resorbed alveolar ridge. It emphasize on importance of alveolar distraction osteogenesis with some history of the technique on the basis of evidences available.
To conclude, distraction osteogenesis is an efficient method to restore the alveolar ridge height for better adaptability of dental implants.

The rural population, in comparison with the urban population, has even fewer opportunities to receive dental care, since dental institutions, where the most qualified personnel and the latest equipment are concentrated, are located mainly in cities. Diversity of geographical and economic conditions of rural population, state of communications, accessibility of transport, etc. they aggravate the inequality of residents of different localities in the possibilities of obtaining dental care, so the specifics of the forms and methods of its provision in rural areas is primarily in the approximation of General dental care to the entire rural population.

The sinus membrane perforationcombined withexposing dental implant into the maxillary sinus is considered as a potential risk factor for implant failure and sinus complication.The present studyinvestigated the incidence of intentional sinus membrane perforation by dental implant in different depths and the possible risk factors associated with membrane perforations and assessed the implant osseointegratin and the survival rate of implants placed in the posterior maxillain a dog model. A total of 32 titanium implants were placed in the bilateral maxillary first molar areas of 16 adult mongrel dogs with different penetrating depths of implants into the maxillary sinus cavities (group A: 0 mm; group B: 1 mm; group C: 2mm; group D: 3 mm). The sample, block biopsies were harvested six months after surgery and evaluated by Biomechanical analysisandradiographic observation.After six months healing period, no signs of inflammatory reactions or complications were observed in any maxillary sinus of the sixteen doges. The results showed that the posterior maxillary edentulous areas with reduced bone height may be successfully rehabilitated with implants that penetrate the Schneiderian membrane and extended into the maxillary antrum. During the 6-monthes observational period in canines, despite the different protrusion extent, penetration of dental implant into the maxillary sinus with membrane perforation did not compromise the dental implant osseointegation processes and the sinus health. It was also found out when penetrating depth into the sinus is less than 2 mm, the apical portion of implant could be re-covered by regenerating membrane.No significant differences were found among groups regarding implant stability, bone-to-implant contact (BIG) and bone area in the implant threads (BA). In conclusion, invading the maxillary sinus by dental implant is not necessarily associated with significant complications as was generally expected, and stable osseointegrated dental implant that perforate the sinus without apparent immediate complication cannot be considered a harmful factors that necessitate its immediate removal, so could be left provided that they were initially stable.

The use of dental implants has gained immense popularity and inside acceptance. A secure implant primary stability is positively associated with a successful implant integration and long-term successful clinical outcome. The aim of this study was to assess the effect of primary stability in success of dental implants. The present retrospective study was conducted among 1263 patients who had undergone implant therapy in the Department of Implantology, Saveetha Dental College and Hospitals, Chennai from June 2019 to March 2020. Data regarding bone type, bone density of the implant site were collected and analysed. In the present study, most of the type of bone density seen commonly was D2 bone and around 42.79% of the patients had D2 type of bone density in the lower posterior region. The next commonly seen bone density was D1 and in the lower posterior and lower anterior region with 8.51% and 2.36% respectively. In association with the gender and the bone density males had more bone density than females. Most of the type of bone density seen was D2 ( 34.12% in males and 30.58% in females, followed by D1 type of bone density ( 6.93% in males and 6.62% in females). Positive correlation was obtained between bone density and primary implant stability. The correlation was found to be statistically significant (p=0.000). The present study showed a strong relationship between bone density and the primary implant stability.