Immediate function on the day of surgery compared with a delayed implant loading process in the mandible: A randomized clinical trial over 5 years

Objectives: To appraise the feasibility of loading four implants with a pre-existing denture converted to a fixed dental prosthesis (FDP) on the day of implant surgery compared with waiting for 3- to 4-month healing. Methods: Patients with an edentulous, fully healed mandible were recruited in a faculty clinic to partake in a blinded two-arm parallel randomized controlled trial (RCT). The participants received four parallel intraforamina mandibular implants with a moderately rough titanium surface (Brånemark System Mk III or Mk IV TiUnite; Nobel Biocare AB, Goteborg, Sweden). The implants € were loaded on the same day by converting the participants’ pre-existing denture in the experimental group. The implants were placed using a one-stage surgery procedure, and the participants’ pre-existing denture were soft-relined in the control group. For both groups, the permanent 10- to 12-unit FDP consisting of a type-3 cast precious alloy veneered with acrylic and artificial teeth was placed 3–4 months after implant surgery. All participants have been recalled annually for 5 years for appraisal of bone loss and registration of adverse events. Results: Thirty-five of the original 42 participants (83%) returned for clinical and radiological examinations at the 5-year follow-up recall. No selective dropout or specific reasons for dropout was identified in the two study arms; leaving n = 17 (Intention-to-treat group, ITT) in the experimental group, alternatively n = 13 as per protocol group (PP), and n = 18 participants in the control group (ITT = PP). At study commencement, five of the participants assigned to the experimental group did not receive their planned intervention. In the control group, one implant failed to osseointegrate and another failed due to bone loss after 5 years. The crestal bone level changes over 5 years were identical in the experimental and control groups, that is, 1.2 mm (SD = 0.7). There were no differences between the two study arms with regard to incidence of biological and technical adverse events. Conclusions: Implants in the anterior mandible loaded immediately with a converted pre-existing denture appear to yield analogous clinical outcomes compared with waiting for 3–4 months over the first 5 years following implant surgery

How reliable are AI-Assisted cephalometric programs in assessing measurements involving bilateral landmarks?

Abstract Objective Recent advancements in technology have promoted artificial intelligence (AI) to automatically detect landmarks on lateral cephalograms. This study aimed to evaluate the reliability of an AI-assisted cephalometric analysis program (Webceph, Gyeonggi-do, Republic of Korea) in the assessment of cephalometric measurements involving bilateral landmarks.Materials and methods Fifty-one high-quality cephalograms were used and inclusion/exclusion criteria were applied. Two researchers manually traced the cephalograms after which an AI-assisted cephalometric analysis program (Webceph) was applied. Both intra-and inter-operator reliability were tested. Independent Sample t-tests were used to compare the means of measurements.Results The inter- and intra-class correlation coefficients were 0.80 which indicated 'good' reliability. Statistically significant differences were found in the gonial angle and effective mandibular length measurements (p0.05). The results suggest that, while AI-assisted programs provide reliable measurements, differences in certain measurements may be attributed to inherent AI algorithm limitations. Clinicians should verify and, if needed, correct bilateral landmark locations after the initial AI digitisation.Conclusion AI-driven cephalometric analysis holds promise for improving diagnostic efficiency and precision. However, limitations and further AI advancements require consideration to ensure appropriate clinical use

Color stability of different composite resin materials bleached with three bleaching agents

The aim of this study was to compare the color stability of 3 proprietary carbamide peroxide bleaching agents on composite resins. Specimens were prepared with a polytetrafluoroethylene plate. After initial color measurements, bleaching agents were applied to each composite resin for 2 weeks. Second color measurements were made. Tested specimens including control group were immersed into distilled water for a - 4 month follow-up period. Third and fourth color measurements were made again after 2 weeks and 4 months of follow-up period. Friedman (p<.01), Kruskal Wallis (p<.05) and Wilcoxon Tests were used for statistically evaluation. The most significant color change was seen at the Ormocer group (p<.011). The most significant color change ΔE values were obtained for the Ormocer-Voco group and color changes remained stable after 4 months of immersion in distilled water. Slight color changes values were obtained for nanohybrid and fine particle hybrid composite resins