Browsing by Author "Alhammadi, Sara"

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Clinical outcomes of single implant supported crowns versus 3‑unit implant‑supported fixed dental prostheses in Dubai Health Authority: a retrospective study
(2021) Alhammadi, Sara; Milosevic, Alexander
Background: This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs). Methods: This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations. Results: A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient’s age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001). Conclusions: Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.
The Restoration of Severe Generalized Dental Erosive Wear using Direct Composite: A Case Report
(2021) Alhammadi, Sara; Milosevic, Alex
Introduction: This case report describes a conservative restorative approach in the management of severe generalized tooth wear. Case report: The male, aged 57 years, was mainly concerned with the poor appearance of his teeth with short and discolored upper incisors. History revealed that he suffered from gastric reflux for 25 years, for which he was prescribed Ranitidine and was advised to self-medicate with cider vinegar. Furthermore, he divulged that he ground his teeth at night and during the day and had a high intake of carbonated cola drinks. On examination, dentine was exposed in several areas, and to a significant extent, on the incisal aspects of the lower incisors, the palatal surfaces of the upper incisors, and the occlusal surfaces of the molars. Mandibular tori were present. The primary diagnosis was erosive tooth wear with elements of attrition and abrasion. The intervention included dietary advice and restoration with direct composite resin at an increased occlusal vertical dimension of 1.5mm on the retruded axis. The patient reported no functional problems and was pleased with the aesthetic result. Conclusion: Vinegar is promoted to have health benefits, especially with respect to glucose response, but the dental implications are overlooked. This paper reviews the literature on vinegar as a medicament and considers its role as a co-factor for erosion in this case. The clinical steps used to restore the eroded dentition by direct composite are described. The use of this approach is a safe, conservative and successful treatment option without recourse to complex and biologically costly conventional alternatives. The application of direct composite in tooth wear cases meets the European consensus requirements.