056.Influence of patient parameters on implant treatment options

DR. JIHAD ABDALLAH, DR. ANDRE ASSAF**
Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon

A large number of treatment options are available today to most partially and completely edentulous patients because implant dentistry can provide additional foundation units. The existing edentulous co2006nditions may also be modified by bone augmentation (GBR, sinus lifts, ridge splitting, etc.) to allow placement of more implants on the arch and in a more strategic position. Moreover, and because immediate loading of implants has become an additional surgical and prosthetic option, it might be used to provide a valuable answer to a multitude of specific situations and demands that can no longer be ignored today.

Regardless of whether implant loading is delayed or immediate after placement, implant care always varies according to the patient's desires, psychological state, bone availability, area visibility, occlusion and stress factors, the interarch space, financial status and general health. The prosthesis might restore only the lost crown or also a part of the root or a relatively more important volume of lost soft tissues. It might replace a single lost tooth or may need to restore a partial edentulism with one-implant per lost tooth or with FPD's completely implant-supported or implant-tooth-supported or even with cantilever units.

As to the full arch edentulism, complete implant overdentures can be constructed. Fixed full arch reconstructions with individual crowns or splinted retainers can also be used. It is mainly in those situations that patients seek immediate temporization at the time of implant placement due to esthetic, functional and psychological reasons.

Many illustrating clinical cases are presented. The considerations related to the patient at the time of planning the treatment will be handled so to justify the retained surgical and prosthetic options. A realistic treatment is usually the most successful one.
Saudi Dental Journal 2006;18(SI)-Abstr.056

057.Single implant vs. fixed partial denture: A critical dilemma

DR. ESAM TASHKANDI
  College of Dentistry, King Saud University, Riyadh, Saudi Arabia
 

The busy dental clinician will invariably be confronted with clinical situations that require the replacement of a missing single tooth. The traditional forms of prosthetic replacements, be it fixed or removable, have stood the test of time. However, sometimes we become too de-sensitized when it comes to amount of irreversible destruction which occurs during tooth preparation for fixed replacement. Furthermore, the expected longevity and survival of these replacements and the concurrent difficulty in maintenance and hygiene are often overlooked. The relative ease and predictability of utilizing dental implants has no doubt caused a paradigm shift in how we replace missing teeth and practice dentistry in general. Therefore, the two aims of this presentation are to firstly present a guided tour through the entangled forest of the dental literature comparing the two most frequently used methods of replacing single missing teeth. The second part of the presentation is dedicated to taking a peek into the optimistic future of the dental implant world stressing the simplicity and the predictability of this mode of treatment.
Saudi Dental Journal 2006;18(SI)-Abstr.057

058.Efficacy of trimeprazine tartrate when compared to Midazolam as oral sedative of pediatric dental patients

DR. ADEL H. AL-HARBI
Ajyad General Hospital,Makkah, Saudi Arabia

To compare the effectiveness of 3.8 mg/kg trimeprazine tartrate and 0.5 mg/kg midazolam administered orally in controlling the behavior of uncooperative pediatric dental patients. Thirty-two uncooperative pediatric dental patients with age range 37-66 months were randomly assigned to one of two treatment groups of sixteen patients each. The patients received either 3.8mg/kg oral trimeprazine tartrate or 0.5mg/kg oral midazolam. The effectiveness of each drug on patient's behavior was evaluated using the Houpt (1985) Scoring System. Oral midazolam has significantly shorter time of onset (29.7 ± 9.9 min) as compared to oral trimeprazine (60.9 ± 16.9 min). Dental treatment was achieved successfully in 93.8% of the children sedated with oral trimeprazine and 75% with oral midazolam. According to Mann-Whitney test incidence of sleep was significantly higher in trimeprazine group. During the early stages of the dental treatment the scores of movement and crying were significantly higher in trimeprazine group. Towards the restorative phase, this trend was reversed with more movement and crying for midazolam group. Both oral trimeprazine and oral midazolam are effective sedative agents to manage uncooperative pediatric dental patients. However, there is a difference observed as regards their effects on sleep, movement and crying.
Saudi Dental Journal 2006;18(SI)-Abstr.058

059.Changes in dentists selection of treatment in response to the modification of the public payment system

DR. HASSAN S. HALAWANY
College of Dentistry, King Saud University,Riyadh, Saudi Arabia

 
Background: This study evaluates the impact of modifying the payment system of the governmental insurance coverage on dentist's selection of treatment with publicly insured children compared to their treatment selection with privately insured children in the sate of Michigan.

Methods: Two groups of dentists were followed in two periods of observation. The first group (76 pediatric dentists and 4,173 general practitioners) was followed in the first 27 months period of observation before the start of the modified payment system (from October 1, 1997 until December 31, 1999). The second group (83 pediatric dentists and 4,481 general practitioners) was followed in the 27 months period after the start of the modified payment system (from October 1, 2000 until December 31, 2002). The study compared the service mix (restorations, stainless crowns, pulp therapy, and extraction) of these dentists with 772,375 children (two control groups (publicly insured children with regular payment system, and privately insured children) and one treatment group (publicly insured children with the modified payment system).

Results: Dentists did not change their service mix (not more than 2% for any treatment category) with the two control groups between both periods of observation. However, they changed their service mix significantly with the treatment group, where they selected more restorations than other categories, despite the increase in the selection of extraction with older age groups.

Conclusion: Dentists changed their pattern of treatment selection with publicly insured children after modifying the payment system of the governmental coverage, be closer to their patterns of selection with privately insured children.
Saudi Dental Journal 2006;18(SI)-Abstr.059

DR. ABDULLAH AL-DAFAAS* ,  DR. SAAD AL-NAZHAN**

*King Fahad Security Forces College,
**College of Dentistry, King Saud University, Riyadh, Saudi Arabia

Aim: To investigate the clinical, radiographic and histologic healing response of experimentally induced furcal perforations in dogs' teeth contaminated with saliva and repaired with MTA with or without artificial floor (calcium sulfate). Results were compared to amalgam.

Methodology: Seventy-two mandibular and maxillary premolar teeth of 9 beagle's dogs were used. The pulp extirpation was done, the root canals were cleaned and filled with gutta-percha and AH26 under aseptic condition. Furcal perforations were created in 66 teeth using round bur # 4. The perforations were left open to salivary contamination for 4 weeks. The teeth were randomly divided into 6 experimental groups. Group 1 (6 teeth) without perforations served as negative controls, group 2 (6 teeth) with perforation served as positive control, group 3 (15 teeth) the perforations were repaired with MTA alone, and group 4(15 teeth) with calcium sulfate under MTA, group 5(15 teeth) the perforations were repaired with amalgam alone, and group 6 (15 teeth) with calcium sulfate under amalgam. Pulp chambers of all experimental teeth were filled with same material used to repair the perforation. Clinical and radiographic examinations were done before and after repair. Animals were sacrificed after 4 months. The teeth and the surrounding structure were processed for light microscopic examination.

Results: The clinical, radiographic, and histological findings showed that the MTA alone has better success rate compared to the other groups.

Conclusion: The use of calcium sulfate as an internal matrix under MTA or amalgam for repair of delayed furcal perforation did prevent material extrusion but did not enhance the healing process.
Saudi Dental Journal 2006;18(SI)-Abstr.060