Failure rate of inferior alveolar nerve block among dental students and interns

Background: Dental implants are considered the gold standard replacement for missing natural teeth. The successful clinical performance of dental implants is due to their ability to osseointegrate with the surrounding bone. Most dental implants are manufactured from Titanium and it alloys. Titanium does however have some shortcomings so alternative materials are frequently being investigated. Effective preclinical studies are essential to transfer the innovations from the benchtop to the patients. Many preclinical studies are carried out in the extra-oral bones of small animal models to assess the osseointegration of the newly developed materials. This does not simulate the oral environment where the dental implants are subjected to several factors that influence osseointegration; therefore, they can have limited clinical value.Aim: This study aimed to develop an appropriatein-vivomodel for dental implant research that mimic the clinical setting. The study evaluated the applicability of the new model and investigated the impact of the surgical procedure on animal welfare.Materials and methods: The model was developed in male New Zealand white rabbits. The implants were inserted in the extraction sockets of the secondary incisors in the maxilla. The model allows a split-mouth comparative analysis. The implants’ osseointegration was assessed clinically, radiographically using micro-computed tomography (µ-CT), and histologically. A randomised, controlled split-mouth design was conducted in 6 rabbits. A total of twelve implants were inserted. In each rabbit, two implants; one experimental implant on one side, and one control implant on the other side were applied. Screw-shaped implants were used with a length of 8 mm and a diameter of 2 mm.Results: All the rabbits tolerated the surgical procedure well. The osseointegration was confirmed clinically, histologically and radiographically. Quantitative assessment of bone volume and mineral density was measured in the peri-implant bone tissues. The findings suggest that the new preclinical model is excellent, facilitating a comprehensive evaluation of osseointegration of dental implants in translational research pertaining to the human application.Conclusion: The presented model proved to be safe, reproducible and required basic surgical skills to perform.

Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratchet from the dental implant kit and ISQ values generated from the Osstell device. Results: Twenty patients (13 female and 7 male) with an age range of 25-65 years received twenty immediate dental implants. The insertion torque value ranged from 15 to 50 N/cm with a mean of 28 N/cm. At the same time, the ISQ values ranged between 50 and 80 ISQ values, with a mean of 63 ISQ values. The results showed a statistically significant positive correlation between the insertion torque of the dental implant measured by torque rachet and ISQ values checked with Osstell. Conclusion: The insertion torque can be used as a reliable method to estimate the primary stability of the immediately inserted dental implants in the maxillary non-molar sites comparable to the Osstell device ISQ values. In addition, torque ratchet is readily available in the dental implant kit at no additional cost, making it a valuable choice over the Osstell device.

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