Compendium (Newtown, Pa.). Supplement最新文献

Plaque removal is an important part of good oral hygiene. Many short-term studies have compared the effectiveness of an electric toothbrush in plaque removal to that of a conventional, manual toothbrush. Previous studies proved the electric toothbrush to be more effective on a short-term basis; however, little is known about its long-term effects. In a study that examined 32 patients over a 12-month period, the authors found electric toothbrushing to be more effective in plaque removal. The study measured the differences in abrasion, gingival recession, gingival bleeding, and plaque scores. The study also concluded that no significant gingival abrasion was caused by electric toothbrushing.

Despite anecdotal reports that challenge hydroxyapatite (HA)-coated implant survivability, the experience in the placement of these implants over 9 years at Loma Linda University School of Dentistry has been favorable. The results of these implant placements are presented and analyzed in this article. After 7 years, the survival rate of HA-coated custom and stock blade-form implants is 97%. At 5 years, the survival rate for all upper HA-coated root form implants is 98%, and for all HA-coated implants placed in the lower jaw it is 99%. For implants placed in maxillary type 4 bone, there was a 32.6% failure rate among uncoated implants, but a rate of 14.9% in HA-coated implants. The causes of implant failure are often related to factors other than the type of implant, such as iatrogenic factors and poor oral hygiene.

Removing plaque from interproximal areas is critical in preventing periodontal disease recurrence. Studies have shown the INTERPLAK counter-rotational powered brush is more proficient at this than conventional methods. To compare the effectiveness of the counter-rotational powered brush with conventional methods on midradicular and interproximal surfaces, periodontal surgery patients who were in supportive periodontal therapy were grouped into those using the counter-rotational powered brush device and those using conventional methods. Various measures of periodontal health indicated that over the 6-month study period, the counter-rotational powered brush resulted in a 40% to 60% improvement in clinical periodontal conditions compared with a 15% to 40% improvement with conventional methods.

Unlike titanium dental implants, hydroxyapatite (HA)-coated implants have the ability to form a chemical bond with bone. Clinicians must understand the chemical, physical, and mechanical properties of HA, as well as the differences between superior and inferior HA coatings. In fact, because not all HA coatings are the same, there are guidelines to analyze the coatings according to chemical composition, density, crystallinity, levels of impurities, surface roughness, and tensile and shear strengths. HA coatings have shown definite advantages over uncoated implants, but improvements are still needed in areas such as attachment, porosity, and crystallinity.

Numerous studies have found hydroxyapatite (HA) to be a favorable material for dental implant coatings. Quality HA-coated implants have been shown to heal faster, attach more completely to the bone, and resist flaking and dissolution. However, as with natural teeth, good oral hygiene and proper professional maintenance are essential. To ensure the success of the implant, clinicians must understand that HA coatings vary according to thickness, porosity, attachment strength, and crystallinity, and must recognize the essential features of a quality coating.

The dental profession has in the past overreacted to anecdotal reports of both positive and negative outcomes involving implants. Because implant complications usually involve multiple variables, it is necessary to isolate these variables as much as possible when structuring a study to assess implant success vs failure. The methodology used in a study of Omniloc implants is reported, including detailed criteria for patient exclusion, patient demographics, statistical method, measurement indices, control procedures, and success criteria.

There have previously been no studies on the cost effectiveness of the use of a counter-rotational toothbrush (INTERPLAK Home Plaque-Removal Instrument), which has been demonstrated to be more effective than ordinary toothbrushes in reaching plaque-removal and gingival-health goals. Killoy et al studied the costs of required periodontal treatment for 32 patients with moderate periodontitis at two corporate capitation dental centers. The subjects were divided into two groups, a test group that brushed with a counter-rotational toothbrush and one that brushed with a manual toothbrush. Probing depth, attachment levels, and plaque and bleeding indexes in the test brush group were better than those in the control group. The end result was a mean reduction of $535 in the cost of periodontal treatment that had been planned before using the counter-rotational brush over 18 months, while the group using the manual brush experienced a mean increase of $11 in required treatment over original plans. Furthermore, the test group reached a state of gingival health, but the control group did not. The study concluded that the counter-rotational brush is cost effective.

An oral and maxillofacial surgery practice placed and evaluated 690 hydroxyapatite-coated dental implants from 1985 to 1993. Many implants were placed in patients with compromised conditions, such as lack of bone height or width. Advanced surgical procedures were used. Factors that were considered in assessing the success of the implants included anatomic position, sex of the patient, and length of the implant. The study showed that although shorter implants were more likely to fail than longer implants, the cumulative survival rate up to 88 months was 96.5%.