Aim: The purpose of the study was to evaluate the changes in peri-implant bone quality, crestal bone level and the implant stability (periotest) for mandibular implant retained overdentures with ball attachments using delayed and immediate loading protocols. Materials and methods: Two Alpha-Bio dental implants were placed in the anterior part of the mandible in ten completely edentulous patients. Five patients were loaded under immediate loading protocols and other five following delayed. Crestal bone loss and bone quality were assessed around each implant. Periotest values were recorded for each implant at 3, 6 and 12 months after loading. Results: Two implants were lost and were excluded from the study, however mean crestal bone loss around implants was 0.81 mm from the time of prosthetic loading to 12 months after prosthetic loading was seen and no significant result was found between the two groups for the crestal bone loss and the periotest values. Though the periotest value decreased (indicates increased stability) over the time period. The bone density changes were significant for both the groups at coronal level at all time intervals but at middle level significant only after 12 months of prosthetic loading, although individual variation was high. Conclusion: This study concluded that the changes in crestal bone level and periotest values were insignificant for the two groups. But, the implant stability increased over the time and the crestal bone loss was evident with decreased rate over the period of time. There was wide individual variation for the bone density changes but overall increase in the density was seen.

Background and objectives: Socket augmentation at the time of extraction is an attempt to reduce crestal bone loss, encourage socket fill, minimize horizontal ridge resorption, and ultimately reduce or eliminate the need for further ridge augmentation. The aim of this study is to evaluate the efficacy of naturally derived bovine hydroxyapatite, resorbable collagen membrane and collagen plug in ridge preservation as compared to an unassisted naturally healing extraction site. Methods: Twenty-two systemically healthy patients participated in the study. Seventeen completed the study and were included for analysis. One site in each patient was treated as control site and only received an atraumatic extraction procedure while the other site was subjected to a ridge preservation procedure following atraumatic extraction. Parameters, such as loss of ridge width, loss of ridge height were measured clinically, with the help of occlusal stents on pre- and postoperative models and radiographically with the help of AutoCAD software. These measurements were made at baseline as well as 6 months post-operative. Results: The treatment modality resulted in significant reduction in the amount of loss of ridge width and loss of ridge height in the test sites when compared to the control sites. The mean loss of ridge width was found to be 1.68 mm at the control sites and 1.07 mm at the test sites. The mean loss of ridge height was found to be 2.43 mm at the control sites and 1.45 mm at the test sites. All these differences were found to be statistically significant. Interpretation and conclusion: The results of this study suggest that a ridge preservation procedure carried out at the time of extraction is a reliable and predictable method to minimize the resorption of the alveolar bone that takes place postextraction and offers the patients a relatively easy, cost effective method that spares them the discomfort of further ridge augmentation procedures that might be necessary for an esthetic rehabilitation or implant placement.

Statement of problem: Given that meticulous implant prosthodontic procedures are recommended to obtain the best possible intraoral fit, the die systems used for multi-implant casts warrant further investigation. Die stone expansion and errors introduced by removable die casts may exceed the accuracy required for the passive fit of implant prosthesis. Purpose: The purpose of the study was to evaluate the linear dimensional accuracy between the implant master die and three conceptually different die systems, such as Pindex system, Accu-trac precision die system and conventional brass dowel pin system. Materials and methods: Thirty impressions of implant master die were made with polyether impression material. Ten experimental implant casts were fabricated for each of the three different die systems tested: Accu-trac precision die tray system, Pindex system and conventional brass dowel pin system. The solid experimental casts were sectioned and then removed from the die system 30 times. Linear distances between all six possible distances were measured from one center of the transfer coping to the other, using a coordinate measuring machine in millimeters up to accuracy of 0.5 microns. Data were tabulated and statistically analyzed by binomial nonparametric test using SPSS version 15. Results: Significant differences were found for distance A-B (p = 0.002), A-C (p = 0.002), A-D (p = 0.002) and B-D (p = 0.021) in conventional dowel pin system however, for Accutrac precision die tray system it was significant only for distance A-D (p = 0.002) but for Pindex system it was nonsignificant for all the distances measured. Conclusion: Within the limitations of this study, use of Pindex system is recommended when sectioned dies are needed for a multi-implant retained prosthesis.

It is proven that after every extraction of one or more teeth the alveolar bone of the respective region undergoes resorption and atrophy. Therefore ridge preservation techniques are often employed after tooth extraction to limit the volume of the alveolar bone that is going to be resorbed. There are many benefits in employing a flapless ridge preservation procedure. The purpose of this article is to present the literature concerning flapless ridge preservation techniques with collagen plugs for occlusion of the socket. The term ‘socket-plug technique’ is introduced to include these techniques. The basic steps of the ‘socket-plug technique’ are: •   Atraumatic tooth extraction •   Preservation of soft tissue architecture with the flapless technique •   Placement of the appropriate biomaterials in the extraction site •   Collagen plug stabilization   A case is presented to illustrate the steps used in this technique.

The use of implantable devices as direct adjuncts to orthodontic treatment as compared to the use of conventional dental implants is relatively less in number. Currently, a limited number of such devices are used to aid in orthodontic treatment. The options include conventional titanium endosseous dental implants, palatal implants, titanium miniscrews (also known as micro- or mini-implants), and mini-bone plates. Integration of dental implants or implantable devices into contemporary orthodontic practice has the following possible advantages: Serving as a means of increasing orthodontic anchorage, virtually eliminating patient compliance issues with regard to wearing of appliances, decreasing overall treatment time, and occasionally permitting orthodontic treatments previously thought to be impossible without surgery. This article is a review of the currently available options for use of implantable devices as sources of temporary skeletal anchorage in orthodontics.

In this article, a review of the development of implants in orthodontic treatment and use of dental implants is done. The use of implants has greatly increased over the last three decades, largely as a consequence of their successful longterm osseointegration. This has led to increased orthodontic use with appropriate modifications in the design, when required.

Esthetic parameters have become integral aspects in defining success and failure of an implant. All-ceramic abutments have started to play a major role in achieving an esthetically successful result. The material itself, however, is not the exclusive determinant for esthetic success. It is the appropriate design and proper handling of the material and the abutment that enables the clinician to achieve esthetic outcomes that were not possible with traditional metal alloys. The focus of this systematic review was to assess the published data on the zirconia dental implant abutment.

Root form dental implants have a high success rate and are commonly used for replacement of missing teeth, however failures occasionally occur, such implants must be removed. Like teeth, dental implants also establish microflora soon after placement and stable implants showed no significant shifts in the composition, whereas failing implants showed presence of Gram-negative anaerobic bacteria. This article reviews the microflora associated with dental implants.

Edentulism of a long standing nature leading to severe alveolar ridge atrophy with a resultant thin ridge often pose a great challenge to the clinicians for rendering implant supported prosthesis in that region. The ideal treatment in such a scenario will be the ridge expansion procedure for achieving an increase in the available bone volume at the implantation site. The space thus created between the bony walls renders an ideal regenerative and implant-integrating condition. The use of a piezosurgical device for performing a piezoelectric alveolar ridge expansion procedure permits a precise and tactile controlled osteotomy facilitating implant placement in anatomic situations previously impossible in a single stage surgical procedure. This case report demonstrates the ease of mandibular ridge splitting with the use of piezosurgical principle facilitating immediate implant placement in a severely resorbed thin edentulous alveolar ridge.

Traditional loading protocols required the patient to wait 3 to 6 months for the implants to integrate into the jaw bone before the final prosthesis was placed on it. Newer techniques have advised placing of implants and loading them immediately or even at the same appointment. Such procedures utilize guided implant placement stents and CAD/CAM for fabrication of the final prosthesis. This results in increased treatment cost for an average Indian patient. Thus, developing a popular, cost-effective technique for fixed implant supported prosthesis is the need of the hour. This paper presents an innovative method for stent fabrication and prosthetically driven implant placement and fabrication of fixed implant supported prosthesis within 24 hours following implant placement.

Aim: Extraction site reconstruction is essential for alveolar ridge preservation, keeping in mind future placement of implants. In an attempt to preserve the alveolar bone and to avoid ridge augmentation prior to implant placement, numerous biocompatible regenerative materials have been used immediately following tooth extraction to fill the socket. Methodology: This article is a pilot trial presenting early trends of the comparative use of two forms of calcium sulfate, i.e. medical grade (Dentogen)® and nano-crystalline (Nanogen)® as bone graft materials in immediate extraction sockets of three cases, based on histological and radiological assessments. Results: At the end of 4 months following grafting, the extraction sites in all the three cases revealed no significant difference between the two materials. Radiographic assessment revealed an almost complete graft resorption and replacement with spongy bone with bone density comparable to the surrounding bone. Histopathological assessment revealed that 100% of the bone was vital with 52% trabecular bone and 48% bone marrow. Conclusion: Calcium sulfate both medical grade and nanocrystalline form hold a valid premise for use as regenerative materials in extraction sockets with no significant differences seen between them in this pilot trial.