As a result of the progress made in the area of endosseous implants in the last 15 years, the value of the subperiosteal implant has been minimized. Yet endosseous implants are not appropriate for all patients in need of implants. Well-designed subperiosteal implants have been reported to function successfully for many years. Among the relevant factors contributing to the success of this method are implant design, atraumatic surgery, understanding of the involved anatomic structures, accurate impression techniques, and appropriate occlusal adaptations of the final prosthesis. This report reviews a brief outlook of the literature about subperiosteal implants till date and also presents a case of maxillary subperiosteal implant prosthesis.

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Aim: The aim of this study was to determine awareness, knowledge, and attitude of patients toward dental implants as a treatment modality using a web-based questionnaire. Materials and Methods: A total of 106 edentulous or partially edentulous patients, aged 18-60 years, were included in the study. A close-ended objective type questionnaire consisting of 12 questions was designed using Google Forms application. Level of information and subjective and objective need for information about dental implants were objectively assessed. Interactive audio-visual dental implant educational sessions were planned, and a re-test was conducted using the same questionnaire. Results: Of the 106 patients, 45.3% were men and 54.7% were females. Nearly, 57.54% of the participants were <30 years of age, 34.90% were between 31 and 50 years, and 7.54% were >50 years. Overall moderate-to-severe deficit in knowledge was noted in all the three parameters. All the patients participated in the educational sessions, and only 83 patients took the re-test. Paired t-test comparing the pre- and post-test scores showed a statistically significant improvement in the level of information and subjective and objective need for information. Conclusions: A severe deficit in the level of information and subjective and objective need for information toward dental implants as a treatment modality was noted. A single interactive educational session using audio-visual aids was effective in improving patients' awareness, knowledge, and attitude. Utility of common electronic gadgets such as smartphones in knowledge, attitude, and practice studies need to be assessed.

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An accurate transfer of relationship of multi-unit implants from mouth to the master cast demands a rigid splinting of impression copings. Auto-polymerizing acrylic resin, the most commonly used material for such splinting, exhibits polymerization shrinkage resulting inaccurate transfer of spatial relationship of implants from mouth to the master cast. This article describes a simple laboratory and clinical procedure for minimizing this effect by sectional splinting approach. The technique utilizes the procedure of sectioning and rejoining of the resin between the impression copings, thus providing an adequate compensation for resin shrinkage. It assures an optimum accuracy of fit of one-piece cast implant framework while fabricating a full-mouth implant-supported prosthesis.

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Inferior alveolar nerve is the most critical anatomical landmark to be considered while placing mandibular posterior implant. Nevertheless, as more implant surgeries are performed, and in spite of accurate measurement of the available bone and computer-based navigational systems, accidents do occur. Moreover, an unexpected displacement of the implant or its armamentarium can damage the adjacent structures. This article presents a case where the implant depth gauge slipped into the medullary space mimicking a situation similar to inferior alveolar nerve injury. The importance of presurgical evaluation and precaution to prevent such happenings are also discussed.

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Aim: This study aims to determine the efficacy of commercially available spring loaded manual torque wrenches with that of friction loaded manual torque wrenches. Materials and Methods: Two spring loaded torque wrenches (MIS and the other Ospal) and two, friction loaded (Nobel Biocare and Myraid). Four implants of the same size and diameter of one company (MIS 4.2 mm × 13 mm) was used in the study. Femur bone of sacrificed goat and a dummy mandible made of polycarbonate were used. All four implants were placed once in femur bone of goat, and similarly in dummy mandible. Removal torque analysis was calibrated using these four torque wrenches. In Stage I, all four implants were placed on polycarbonate of mandible by following standard drilling protocol as prescribed by the manufacturer. All four implants were placed in goat bone in Stage II. Then, all four implants were removed from both polycarbonate of mandible and goat bone using four different torque wrench and removal torque analysis was recorded. The procedure was repeated 5 times each. Results: The data obtained had a significant difference between the spring loaded and friction loaded torque wrenches and reading obtained from friction loaded (Nobel Biocare, Myraid) torque was consistent compared to spring loaded (Ospal, MIS). The data obtained from spring loaded torque wrench showed much variables. Conclusion: Our results indicate that friction loaded torque wrenches produce more accurate results compared to spring loaded torque wrenches.

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The common complication of cement-retained implant restorations is the extrusion of the excess cement into the peri-implant sulcus, which may initiate a local inflammatory response leading to peri-implant disease and ultimate implant failure. This article presents a simple and time-saving method of controlling cement flow around implant abutments, minimizing the excess cement around implant-retained restorations.

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Various studies have proved the success of the osseointegration concept if proper and strict protocols are followed for the success. In clinical practice, certain situations arise that makes the clinician to modify his treatment modality, to favor the final outcome of the treatment.  This paper presents a clinical case report of re-osseointegration of the loosened bead implant occurred during the torque application to tighten the abutment during cementation, which was splinting along with the adjacent well-osseointegrated implant using fixed partial denture prosthesis. The clinical outcome suggests that proper stabilization of a loosened implant can re-osseointegrate the implant.

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