The use of dental implants has revolutionized the treatment procedure for over last 25 years. Implants now have been widely accepted by patients as their treatment plan and have become a routine procedure by dental surgeons. Owing to the remarkable success, there have been various researches going on to find out factors responsible for the failure of implants. With the growing use of tobacco among patients, its ill effects on bone quality and quantity it arises a keen interest to associate effect on the success of implants. To establish a relationship between smoking and implant success and its long term survival and compare the result with non-smokers based on the literature. Relevant clinical studies and reviews published in English literature published between 1990 and 2012 were reviewed. The articles were located through EBSCO host and manually through the references of peer reviewed literature. Most of the literatures supported the fact that smoking is a prominent risk factor affecting the success of implants. Studies reported that implant failure and its complications associated are twice in smokers as compared to non-smokers. Literatures also revealed that maxillary implant are more affected than mandibular in smokers. Studies suggested that effects of smoking were reversible in smokers who followed the smoking cessation protocol prior to the procedure. Smokers have a greater chances of implant failure and more prone to the complications following implants and related procedures. Surgeons should stress on counseling of patient willing for implant for smoking cessations protocols.

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Purpose: The pattern of entry of mental nerve into the mental foramen after its emergence from the inferior alveolar nerve bundle is an important presurgical landmark in the mandibular premolar region. Various patterns of entry of mental nerve have been identified. As panoramic radiographs are routinely used in presurgical evaluation, the present study was undertaken to evaluate the various entry patterns of mental nerve into the mental foramen. Materials and Methods: Total 300 panoramic radiographs taken for routine diagnostic purposes were selected for the study. The radiographs were assessed independently by two observers and the position and the entry pattern of the mental nerve on the left and right side were recorded. The entry patterns recorded were categorized as straight, looping, or perpendicular. Results: The study revealed that the most common pattern of entry of mental nerve was a straight one accounting for a total of 79% on at least one side of the total radiographs examined, followed by the presence of an anterior loop on at least one side in 21% and perpendicular pattern on at least one side in 6% of the total radiographs examined. Conclusion: Panoramic radiography may not be a very reliable imaging modality for identifying the presence of anterior loop which needs to be determined for preoperative planning of surgical procedures in the mandibular premolar region. Other modalities, such as cone beam CT, can be used for better visualization of the area.

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Dental implants have been shown to be an excellent method for replacing natural teeth. Dental implants like natural teeth can be affected by microorganisms. Various terms have been proposed to describe inflammation around dental implant. The ones that are commonly used include peri-implantitis and peri-implant mucositis. Studies were conducted that described the bacteriology of dental implants. Most studies reported that the microbiota associated with stable implants is similar to the one seen in periodontal health. Similarly, bacteria associated with failing implants have also been studied. These studies predominantly showed that the bacteria associated with failing implant are similar to the ones seen in periodontal disease. One should be very cautious in placing dental implants in subjects with significant periodontal disease as there is a risk for failure. Implants are not immune for infections. The present review briefly describes the bacteriology associated with stable and failing implants.

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An assessment of whether to rehabilitate a tooth requiring endodontic treatment or to replace it with a dental implant can often involve a challenging and complex decision making process. This paper discusses the literature pertaining to both treatment modalities and identifies key issues that need careful consideration in planning the most appropriate course of care in a given clinical situation. A need to appreciate advances across both disciplines is highlighted, allowing the development of effective interdisciplinary evidence-based treatment strategies to maximize treatment outcome.

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Preprosthetic surgeries after dental implant placement in mandibular anterior area for overdenture prosthetic needs are specially designed procedures. Sublingual salivary gland hyperplasia makes routine procedures less effective. In the present paper, bilateral sublingual salivary glands removal with simultaneous lowering floor of mouth after dental implant placement in anterior mandibular area is explained.

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Purpose of the Study: Compromised inter-arch space stand as a difficult clinical situation for placement of implants in opposite arch. This study aims towards finding out efficacy of posterior maxillary segmental osteotomy (PMSO) in providing adequate interarch space. Materials and Methods: The study comprised of five patients with supraerrupted maxillary posterior teeth. All patients underwent PMSO under GA. Postoperative interarch distance measured and compared with the preoperative value. Main results: On an average, about 4 mm of clearance was achieved from the existing pre-operative clearance, which facilitated restoration of dentition in the opposing arch. The results were stable without complications over 16-18 months post-operatively. Conclusion: PMSO is a simple quick alternative technique and can be combined with implant placement and a successful technique for increasing the interocclusal clearance, and thereby facilitating restoration of the dentition in the opposite arch.

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The tremendous success of osseointegration and predictability of implant treatment modality in the mandible prompted its investigations in the maxillary segment too for verifying whether similar success rates can be achieved. This review of literature gives us an idea about the various treatment modalities and investigations carried out by various researchers as an attempt to find out the predictability and longevity of immediate implant loading in the maxilla. The basic nomenclature, advantages and disadvantages of immediate loading, immediate loading and its relationship to osseointegration, its influence on primary stability, and micro-motion are considered and discussed. Over-emphasis has been placed on prosthodontically driven implant modality keeping the end-result and final outcome in mind. Few guidelines have been proposed that would help in the successful implementation of implant restorations.

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Background: The purpose of this study was to clinically evaluate the peri-implant soft tissue health and to radiographically evaluate the bone height mesial and distal to the Alpha-bio ^® SFB platform switched implants for 1 year; post-prosthesis insertion at 3 month regular intervals. Materials and Methods: A total of 2 Alpha-bio ^® SFB platform switched implants were placed on selected patients during this study. A two-stage surgical approach was used for healed or immediate extraction sites - for implant insertion and prosthetic rehabilitation under strict aseptic conditions. The patients were subjected to clinical parameters like plaque index, gingival index, and sulcular bleeding index. Standardized radiographs were taken at different intervals and subjected to computer assisted image analysis for assessment of bone loss mesial and distal to the implant. Results: Implant sites of both patients showed an increase in the plaque, gingival, and bleeding scores at each interval compared to the baseline, followed by a decrease in the average plaque, gingival, and bleeding scores in all patients for teeth as well as implants, indicating that neither of the sites had an increased tendency for soft tissue inflammation. No mobility was associated with any of the implants. Width of keratinized mucosa remained constant throughout the study for either of the patients. The total bone loss was lesser for immediate post-extraction implants. Conclusion: This short-term study showed that Alpha-Bio SFB ^® implants could be effectively used for single tooth replacement both in conventional healed ridges or immediately post-extraction in fresh extraction sockets.

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Severely resorbed alveolar ridge in aesthetic zone of maxilla can compromise the successful implant placement and aesthetic outcome. This study reports a case of severely deficient maxillary alveolar ridge being only 1.2 mm of bone width and implant site requires a hard tissue base foundation: To fulfill this requirement, mandibular ramus block bone is used to improve bone width. After 5 months of the graft surgery, 6.8 mm gain in bone width was noticed, implant was placed and till now it was fighting fit in terms of function and aesthetics.

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Purpose: The placement of implants in the alveolar bone remains a challenge because of the resorption of the residual ridge resulting in insufficient bone volume in one or more dimensions. Need of the hour is to review the various options to rehabilitate posterior atrophic maxilla with/without bone modification procedures. Study Selection: MEDLINE/PubMed searches were conducted using the terms atrophic maxilla, implants, buttresses, grafts, maxillary sinus, osteotomy as well as combinations of these and related terms. The few articles judged to be relevant were reviewed. Results: Appropriate treatment planning is crucial and various factors need to be considered before placing implants in atrophic alveolar bone Bone grafting, osseodistraction and sinus lifts are invasive procedures. In addition, they add complexity and increase the number of surgical phases required for implant therapy. Different therapeutic alternatives, such as, short implants, or implants placed in specific anatomical areas like the pterygoid region, the tuber or the zygoma has allowed patient treatment to be expedited and minimally invasive. Conclusion: Important aspects that need to be considered for implant placement in posterior atrophic maxilla are discussed in this article and both surgical and non-surgical options are suggested. There is no consensus as to which treatment modality is superior to the other in literature. The decision to opt for either of the options, therefore, depends upon patient factors, and ultimately, the expertise and skill of the clinician.

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Present paper aims to discuss and emphasize the importance of maintenance programs for oral implants among general dental practitioners for successful implant dentistry. Bacterial plaque accumulation around the endosseous dental implants results in inflammatory changes in the surrounding soft tissues and if not controlled, has shown to develop the progressive destruction of the supporting tissues, which may ultimately compromise its future. Maintaining the permucosal seal of soft tissue to implant surface and healthy tissue around oral implants is the prerequisite to its success and hence, it is important to introduce an effective preventive regimen and a therapeutic intervention should be initiated as early as possible when a pathological condition of peri-implant tissues is diagnosed.

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Aim: To evaluate the influence of placement two implants on the retention of maxillary obturator. One implant was placed on the resected and one in the non-resected side of the patient. Materials and Methods: Twenty maxillary edentulous patients of both sexes, aged 45-70 years, with unilateral maxillary defects were selected for the study. The patients had completely dentulous mandibular arch. Two implants were placed for each patient: One in the first premolar region of the healthy side and one in the area of second molar of the defect side. For all patients, retention was measured before superstructure placement for the two maxillary osseointegrated implants using soft liner alone, after placement of ball attachments without soft liner, and after placement of superstructure with soft liner. All measures of retention were performed after 3 months of obturator insertion using forcimeter gauge. Results: The results of this study showed that there was a significant difference when using two implants with soft liner in comparison with soft liner or implants alone, with P < 0.05 using one-way analysis of variance (ANOVA) test. Conclusion: The use of only two strategically placed implants in the remaining bone of the resected and non-resected side of unilateral maxillary defect can significantly affect obturator retention.

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Background: The successful replacement of missing tooth by titanium implants duly integrated into the tissues is a major breakthrough in Dentistry. From the moment that implant systems with rigorous scientific methodology were introduced, eliminating the pre-existent empiricism, long-term studies of effectiveness have been presented. Objective: The aim of this study was to evaluate the success rates of osseointegrated implants and implant-supported prostheses performed by students of implant dentistry at the Brazilian Dental Association - Goiás Section - between 2006 and 2007. Materials and Methods: Sixty patients who received 232 implants were evaluated. These patients were followed up by clinical and radiographic examination to evaluate the survival rate of implants and prostheses. Also, the patients answered a questionnaire regarding their satisfaction with the treatment. Results: Clinical signs and radiographic findings showed the following: No implant had mobility, one patient reported pain in the region of one implant, eight implants had exposure of the head, one patient complained of paresthesia mandibular, five implants had exudate, one implant had exposure of the threads, and no implant showed radiolucency in radiographic image. 57.9% of patients who answered the questionnaire considered the treatment "excellent." The complications of prostheses showed the occurrence of fracture of porcelain in two prostheses, fracture of the resin in one prosthesis, loosening of one screw implant, abutment misfit in three prostheses, two abutments released from the crown, and and there was oral exposure of the abutments teeth in 2 prostheses. Of the 232 implants evaluated in 60 patients, 4 implants were lost and removed, corresponding to a survival rate of 98.28%. Conclusions: The use of Brånemark system implants seems to be a successful alternative in the treatment of various types of edentulism.

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Purpose of the Study: Dental implants are becoming a popular choice replacing the missing teeth. Use of dental implant over last decade has increased. Today, dental implant treatment is highly predictable and renders itself as a valid option for completely or partial edentulous patients. Nowadays, it is not uncommon to see a patient walking into a practice with already implant being placed in him or asking for implants placement. Therefore, it has become mandatory for the general dental practitioner to be familiar with dental implants. This study was aimed to assess the basic knowledge about dental implants among private dental practitioners of North Karnataka region, India. Materials and Methods: Multiple choice questionnaires were framed regarding some basic knowledge about dental implants. Dental practitioners were asked record their responses. Simple percentage evaluation was done for the responses obtained. This data formed the basis for assessment. Results: The results are reported by summarizing responses to each of the 15 questions in the survey. Conclusion: Highly didactic clinical and laboratory dental implant training modules should be structured and implemented at undergraduate level as well as post-doctoral level. This will enable private dental practitioner, to practice dental implantology with confidence.

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Background: The aim of this study was to investigate the reliability of bone profile tool for assessment of bone quality of potential implant sites using interactive computed tomography (CT) software. Materials and Methods: CT examinations of 80 patients with 150 potential implant sites in the maxillae and mandible were included. Trabecular bone density was evaluated using Hounsfield unit (HU) values in rectangular regions of interest on axial dicom images and on reformatted cross-sectional images. Bone density profile line measurement was made at three sites in each reformatted image. Results: The HU bone density values with profile line method were highly correlated with values from the rectangular region of interests (ROIs) in cross-sectional images. Conclusion: This study suggests that the profile line method might be a valid and useful tool for pre-implant trabecular bone density assessment.

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The ameloblastoma is a true neoplasm of odontogenic epithelial origin. Surgical resection of the ameloblastoma is well documented and accepted treatment modality. Vertical distraction of alveolar process is an efficient method for augmentation. This method of providing additional bone and soft tissue for implant placement is becoming more common. This clinical report describes the use of distraction osteogenesis and fixed implant supported prosthesis to treat a postsurgical alveolar defect as a result of resection of unicystic ameloblastoma in anterior mandibular region. As a result of alveolar distraction, a segment of mature bone was transported vertically in order to lengthen the crest for better implant anchorage. Further clinical and experimental studies of the technique with long-term followup to confirm bone and implant stability as it relates to alveolar height is needed.

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