Purpose: The aim of this study was to compare the clinical and radiographical outcomes of two loading protocols of mandibular overdentures supported by two unsplinted implants. Materials and methods: Twenty completely edentulous patients were included in the study. Patients were categorized in two groups each containing 10 patients. In group A, patients received at least two implants in symphysis areas inserted after a minimal flap reflection, and 2 months after implant placement, a mandibular complete denture was connected to the implants using ball attachments. In second group, prosthesis was loaded immediately after placing the implants in symphysis areas without any flap reflection. Patients were examined at 1, 12, 24 and 48 weeks after loading. At postoperative visits, occlusion was checked and the need for any prosthesis maintenance was recorded. Mobility of the implants, radiolucency around the implant and amount of crestal bone loss was checked and measured for both groups during the checkup sessions. Also any prosthetic problems were recorded. Results: After 12 months of loading, in both group no implant failure was reported and the survival rate was 100% in immediate and delay loading groups. Average of bone resorption in control group at the end of study was 0.84 ± 0.05 mm and in the test group was 0.84 ± 0.03 mm. In all patients after every 6 months the plastic O-rings were changed due to frictional wearing. In test group, in three patients the mandibular denture fractured, while, in control group it happened in two patients. In the test group, two patients experienced unbearable pain, while, in the control group seven patients experienced unbearable pain and they needed analgesics. None of the patients in test group experienced edema, swelling and discomfort after surgery due to flapless surgery, while in the control group four patients experienced edema and swelling after surgery. Conclusion: The results of this study suggest that immediate loading of two implants supporting mandibular overdenture has outcomes comparable with conventional loading protocols. This clinical approach offers good stability and comfort while keeping high implant success rate.

Purpose: Sinus perforations are one of the most common complications during sinus augmentation procedures. Preoperative prediction of the antral membrane thickness would be of practical importance and serves as an additional information for surgical planning. The purpose of this study was to analyze a possible correlation and comparison between gingival phenotype and the residual ridge height on the dentulous and the edentulous side to the thickness of the healthy sinus mucosa. Materials and methods: Twenty-five consecutive patients were included in the study; preoperative cone beam computed tomography (CBCT) scanning was performed to radiographically evaluate the gingival phenotype (GP), the height of the residual ridge (RRH) at the edentulous side and the dentulous side and thickness of the schneiderian membrane (SMT). The smallest RRH, highest SM and gingival thickness values were recorded. These values were classified as follows: RRH < or >3.5 mm; SM < or >1 mm; and GP <1.5 or >2 mm. Results: On the edentulous side, Strong correlations of GP with SM (r = 0.833, p < 0.001) and moderate between RRH with SM (r = 0.620, p = 0.001) and RRH with GP (r = 0.596, p = 0.001) were noted. On the dentulous side, strong correlations of GP with SM (r = 0.832, p < 0.001) and moderate between RRH with SM (r = 0.643, p = 0.001) and RRH with GP (r = 0.601, p = 0.001) were noted. Conclusion: Within the limitations of the study, the gingival phenotype (GP) presents to be a reliable measure to predict the thickness of the SM and suggested that the GP, SM, RRH may be important factors for sinus perforation.

Since, the inception of the vast field of implantology in 1969, this method still remains a popular and reliable one for the replacement of missing teeth. Over the years designs by various researchers have been introduced as well as modifications to the surface of the titanium being used. Characteristics of titanium implant surfaces have been modified by additive methods (e.g. titanium plasma spray) to increase the surface area and provide a more complex surface macrotopography. Subtractive methods (e.g. blasting, acid etching) have also been used to increase the surface area and to alter its microtopography or texture. The field of surface modifications is vast and constantly evolving to keep up with technology, incorporation of biologically active substances, drugs and growth factors is an area of ongoing research. This review article entails the various surface modifications and the latest surface treatments that the world of oral implantology has to offer.

A study of the implant to abutment connection is of paramount importance as it is the primary determinant of the strength and stability of the implant supported restoration, which in turn determines the restoration's prosthetic stability. Traditionally, the Branemark's external hexagon has been widely used but its significant complications like abutment screw loosening, rotational misfit at implant-abutment interface and microbial penetration have led to modification of the external hexagon and the development of the internal implant-abutment connections. This review describes the various implantabutment connections that have evolved overtime from the traditional external hexagon.

After exposing a submerged implant to the oral environment, bone loss occurs downwards along the implant body and stops at some predefined position. A current area of hot debate is the significance of the implant abutment interface and its influence on crestal bone level in relation to the first thread. In recent years, the microgap which exists at the connection between the implant body and the restorative abutment has been implicated. Recently, it has been suggested that the presence and position of the microgap may not be the principal cause of bone resorption phenomenon, but instead that it is due to the relative diameters of the abutment and the implant platform. It appears desirable to incorporate features into implant design which reduce microleakage or limit its effects. A tapered implant abutment creates a microseal and the hermetic seal produced eliminates the microgap preventing the passage of bacteria. Hence platform switching may limit or confine the effect.

Dental implants are considered an essential treatment modality for replacement of both single and multiple teeth. Titanium abutments which have been used as gold standard exhibit a dull grayish hue and give an unnatural appearance. The mechanical advantage together with esthetic gain over the conventional abutments has made zirconia abutments the stateof- the-art option available for use in the present day. This article intends to review these zirconia abutments for its property and its clinical implication in the modern day practice.

Challenges often confront the surgeon when placing implants into the maxillary arch due to lower bone density. This can be further complicated due to the proximetry of the maxillary sinus especially when immediate implant placement is contemplated at time of extraction. This article will review the use of rotary osteotomes for improvement of bone site density and quality to allow implant placement in the maxillary posterior.

Oral rehabilitation with dental implants, from the simplest to the most complex, has become a frequent procedure in dental offices. Currently, clinical excellence involves placing implants in diameter and size appropriate. In order to achieve this goal, it is often necessary to reconstruct the alveolar process of the patient. One of the techniques used for this purpose today is distraction osteogenesis, which has proven to be an effective and predictable technique. The objective of this article is to present a clinical case of partial reconstruction of the alveolar bone, using mini-implants to anchor the bone block that will be moved. This variation of the conventional technique minimizes the risks inherent in using conventional distractors.

The posterior maxilla is a challenging site for dental implant rehabilitation. Anatomic limitations in this region provide challenges that may affect successful osseointegration and the fabrication of a functional and esthetic implant-supported prosthesis. The technique of sinus floor elevation has expanded prosthetic options by enabling the placement of additional implant support in maxillary segments with atrophic ridges and pneumatized sinuses.