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PubMed1998

An osteometrical study of the cranium and mandible of the lesser mouse deer (Chevrotain), Tragulus javanicus.

The lesser mouse deer (Tragulus javanicus) is one of the most primitive ruminants. Skulls of lesser mouse deer were measured to evaluate their growth. The age was estimated from the eruption and attrition of molars on the mandible. A total of 95 specimens was divided into five age groups, and the growth pattern in each sex was established for some measurements. The relative growth coefficients were calculated for the head and body length and several parts of the cranium and mandible against the profile length. Sexual dimorphism could not be found on the skull in any age group except for measurements related to the upper canine. However, females showed a higher value in head and body length in the oldest group. This feature was consistent with an interpretation of mouse deer society as monogamous. Growth was more rapid in length than in width. Various statistical analyses showed that the visceral cranium related to masticatory facility was much better developed than the neurocranium. However, observations on the shape of the mandible ramus and of the premolars implied that the masticatory function was not suitable for taking roughage. This speculation agreed with previous reports on the feeding habits and digestive organs of the mouse deer.

Age Determination by Teeth↗
PubMed2000

Geographical variation of mandible size and shape in the Japanese wild pig (Sus scrofa leucomystax).

The mandibles of the Japanese wild pigs (Sus scrofa leucomystax) from various geographical locations, which have been stored in the University of Tokyo and National Science Museum, Tokyo were examined. The mandibles from northern localities were larger in size than those from southern localities. The Oita population was significantly smaller than the Honshu populations. The Mie population was smaller than the Hyogo population in length from the angle of the mandible. In the multivariate analysis, the Kyushu populations could be obviously distinguished from the Honshu populations in the principal component charts. However, each Honshu population did not show the locality-specific distribution of the principal component plots.

Animals↗
PubMed2007

Development of the mouse mandibles and clavicles in the absence of skeletal myogenesis.

In this report we employed double-knock-out mouse embryos and fetuses (designated as Myf5-/-: MyoD-/- that completely lacked striated musculature to study bone development in the absence of mechanical stimuli from the musculature and to distinguish between the effects that static loading and weight-bearing exhibit on embryonic development of skeletal system. We concentrated on development of the mandibles (= dentary) and clavicles because their formation is characterized by intramembranous and endochondral ossification via formation of secondary cartilage that is dependent on mechanical stimuli from the adjacent musculature. We employed morphometry and morphology at different embryonic stages and compared bone development in double-mutant and control embryos and fetuses. Our findings can be summarized as follows: a) the examined mutant bones had significantly altered shape and size that we described morphometrically, b) the effects of muscle absence varied depending on the bone (clavicles being more dependent than mandibles) and even within the same bone (e.g., the mandible), and c) we further supported the notion that, from the evolutionary point of view, mammalian clavicles arise under different influences from those that initiate the furcula (wishbone) in birds. Together, our data show that the development of secondary cartilage, and in turn the development of the final shape and size of the bones, is strongly influenced by mechanical cues from the skeletal musculature.

Animals↗
PubMed2004

Mandibular widening by distraction osteogenesis in the treatment of a constricted mandible and telescopic bite.

OBJECTIVE: Documentation of the application of mandibular widening by distraction osteogenesis and orthodontics. PATIENTS: Three patients with telescopic bite resulting from an extremely constricted mandible related to hypoglossia-hypodactyly syndrome. INTERVENTION: Mandibular widening by distraction osteogenesis using an extraoral device and subsequent orthodontic treatment. RESULTS: The extremely constricted mandible and telescopic bite were dramatically improved by mandibular widening using distraction osteogenesis and subsequent orthodontics. Two of the three patients had transient complications; one reported temporomandibular joint pain and the other showed evidence of periodontal damage. CONCLUSION: Mandibular widening by distraction osteogenesis is an effective technique for the treatment of telescopic bite resulting from an extremely constricted mandible.

Child↗
PubMed2000

A 3-D FEM analysis of single and multiple screw-root dental implant fixed in a mandible.

Replacement of single tooth using a threaded titanium screw root coated with hydroxyapatite (HA) for faster bone apposition to implant site is common. Uncoated pure titanium is also used for osseointegration. Usually bone fixation of implant takes four to six months in either case. Quite often, a good number of teeth in a mandible or maxilla are replaced. Usually it is often said that bones appear to be well designed from the point of view of structural engineering. The "maximum-minimum law" claimed by Roux is a rational concept that states that bone provides maximum strength with a minimum of construction material. According to this proposition, stress distribution in bone will be almost uniform under a set of loading conditions. This was found to be true in the case of normal human mandibular bone as examined by some Japanese scientists. The present authors are interested in examining the stress distribution during multiple single tooth replacements using 3D-FEM technique to ascertain how the stress pattern changes with such implantation of three screws in a row in the human mandible, as we are in the process of clinical trial of hydroxyapatite coated and uncoated titanium implant. This will be of considerable interest to the dental surgeons, who prompted us to address this problem. Our results depicted the mean values of various stress in cortical and cancellous bone while applying the maximum masticatory load of 50 N in each teeth. The generated stress level is within the safe range of stress for bones. However, such screws cannot be applied to osteoporotic or other diseased mandible where bone strength may be quite low.

Bone Screws↗
PubMed2005

Immediate occlusal loading of double acid-etched surface titanium implants in 41 consecutive full-arch cases in the mandible and maxilla: 6- to 74-month results.

BACKGROUND: The high success rate of dental implants has changed the quality of life for many patients. Immediate loading finds its application in some clinical cases and certainly adds another modality of treatment for the implant patient. Starting with a few implants immediately loaded with a bar overdenture in the mandible, the concept of immediate loading evolved to loading multiple implants in both the maxilla and mandible. METHODS: In this investigation, 41 consecutive patients who needed full-arch restorations were treated with 343 double acid-etched surface implants between May 1998 and March 2004. The sample included smokers and bruxers. Twenty-three mandibular and 26 maxillary cases were treated, loading the implants within 48 hours, by using resin provisional prostheses, metal-reinforced provisional prostheses, or definitive prostheses (metal-acrylic or metal-ceramic). All implants were followed for 12 to 74 months. Follow-up consisted of clinical as well as radiographic examination. Furthermore, resonance frequency analysis was done in most of the implants during the last 2 years. RESULTS: The success rate obtained was 99.42% (only two mandibular implants that are still surviving were considered failures). The bone level was measured every year. The average radiographic bone level change was 0.56 mm at 12, 0.76 mm at 24, 0.84 mm at 36, 0.82 mm at 48, 0.83 mm at 60, and 0.94 mm at 72 months. CONCLUSION: A high success rate can be achieved when double acid-etched surface implants are immediately loaded with fixed full-arch restorations in the maxilla and mandible.

Acid Etching, Dental↗
PubMed2005

Digital volume tomography in the diagnosis of periodontal defects: an in vitro study on native pig and human mandibles.

BACKGROUND: The aim of this study of native pig and human mandibles was to investigate the accuracy and quality of the representation of periodontal defects by intraoral radiography (IR), panoramic radiography (PR), computed tomography (CT), and digital volume tomography (DVT) in comparison with histologic specimens. METHODS: Following the standardized preparation of periodontal defects (14 dehiscences, fenestrations, 2- to 3-walled intrabony defects, respectively; Class I, II, and III furcation involvement) in six pig and seven human mandibles, IR, PR, CT, and DVT were performed. The histologic specimens were produced by cutting blocks with the individual defects out of the mandibles, embedding them in acrylic, and producing sagittal and axial microsections. The intrabony defects were measured using appropriate software on the digitized IR and PR images programs. The histologic sections were measured by reflecting stereomicroscopy. The statistical comparison between the measurements of the radiographic images and those of the histologic specimens was performed with Pearson's correlation coefficient. The quality of the radiographic images was determined through the subjective perception and detectability of the intrabony defects by five independent observers. RESULTS: All intrabony defects could be measured in three planes in the CT and DVT scans. Comparison with the histologic specimens yielded a mean deviation of 0.16 +/- 0.10 mm for the CT scans and 0.19 +/- 0.11 mm for the DVT scans. On the IR and PR images, the defects could be detected only in the mesio-distal and craniocaudal planes. In comparison with the histologic specimens, the IR images revealed a mean deviation of 0.33 +/- 0.18 mm and the PR images a mean deviation of 1.07 +/- 0.62 mm. The quality rating of the radiographic images was highest for the DVT scans. CONCLUSIONS: Overall, the CT and DVT scans displayed only a slight deviation in the extent of the periodontal defects in comparison with the histologic specimens. Both radiographic imaging techniques permitted imaging of anatomic osseous structures in three planes, true to scale, and without overlay or distortion. The DVT scans showed the best imaging quality.

Animals↗
PubMed2006

Digital volume tomography in the diagnosis of peri-implant defects: an in vitro study on native pig mandibles.

BACKGROUND: The aim of this study of native pig mandibles was to investigate the accuracy and quality of the representation of peri-implant defects by intraoral radiography (IR), panoramic radiography (PR), computer tomography (CT), and digital volume tomography (DVT). METHODS: The examination was carried out on 19 native pig mandibles. In the toothless sections of the mandibles, one or two implants were inserted. Following the standardized preparation of peri-implant defects (11 each of dehiscences, fenestrations, and 2- to 3-walled intrabony defects), IR, PR, CT, and DVT were performed. The peri-implant defects were measured using appropriate software on the digitized IR and PR image programs. As a control method, the peri-implant bone defects were measured directly using a reflecting stereomicroscope with measuring ocular. The statistical comparison between the measurements of the radiographic scans and those of the direct readings of the peri-implant defects was performed with Pearson's correlation coefficient. The quality of the radiographic scans was determined through the subjective perception and detectability of the peri-implant defects by five independent observers. RESULTS: In the DVT and CT scans, it was possible to measure all the bone defects in three planes. Comparison with the direct peri-implant defect measurements yielded a mean deviation of 0.17+/-0.11 mm for the DVT scans and 0.18+/-0.12 mm for the CT scans. On the IR and PR images, the defects could be detected only in the mesio-distal and cranio-caudal planes. In comparison with the direct measurements of the peri-implant defects, the IR images revealed a mean deviation of 0.34+/-0.30 mm, and the PR images revealed a mean deviation of 0.41+/-0.35 mm. The quality rating of the radiographic images was highest for the DVT scans. CONCLUSIONS: Overall, the CT and DVT scans displayed only a slight deviation in the extent of the peri-implant defects. Both radiographic imaging techniques permitted imaging of peri-implant defects in three planes, true to scale, and without overlay or distortion. The DVT scans showed the best imaging quality.

Alveolar Bone Loss↗
PubMed2005

Phylogeny of Japanese stag beetles (Coleoptera: Lucanidae) inferred from 16S mtrRNA gene sequences, with reference to the evolution of sexual dimorphism of mandibles.

As a first step in reconstructing the phylogeny of world stag beetles (Coleoptera: Lucanidae), phylogenetic relationships among the major members of Japanese stag beetles were explored by analyzing a sequence of 1030 nucleotides from the mitochondrial 16S ribosomal RNA (16S rRNA) gene. A total of 20 species and three additional subspecies representing 13 genera were examined to provide basic information on the phylogeny of world Lucanidae. The resultant phylogenetic tree indicates that the family Lucanidae is monophyletic, and contains two major lineages: one consists of the genera Platycerus, Aesalus, Ceruchus, and Nicagus, and the other includes Dorcus, Rhaetulus, Prosopocoilus, Aegus, Neolucanus, Prismognathus, Lucanus, Figulus, and Nigidius. Generic members of the latter lineage are further divided into the following four sublineages: i) Figulus and Nigidius; ii) Prismognathus and Lucanus; iii) Aegus and Neolucanus; and iv) Dorcus, Rhaetulus, and Prosopocoilus. These molecular phylogenetic relationships are used as a basis for a preliminary exploration of the evolution of sexual dimorphism in the shape of the mandible. The results of this investigation suggest that strong sexual dimorphism with well-developed mandibles in males evolved independently at least twice, once in the genus Aegus and once in the ancestor of the Lucanus-Prismognathus and Dorcus-Rhaetulus-Prosopocoilus clades. Alternatively, it is possible that sexual dimorphism of mandibles has undergone secondary loss in the genera Figulus and Nigidius.

Animals↗
PubMed1992

Radiologic findings of diseases involving the maxilla and mandible.

The purpose of this pictorial essay is to illustrate the radiologic appearances of diseases involving the maxilla and mandible. The high prevalence of dental disease results in inflammatory, infectious, and reactive processes that must be distinguished from more serious conditions with similar radiologic features. Because of their association with odontogenic tissues, lesions of the maxilla and mandible may have radiologic findings not seen in other bones. Furthermore, nonodontogenic cysts and tumors that occur elsewhere in the skeleton may exhibit unique radiologic characteristics when associated with teeth. This pictorial essay presents the radiologic characteristics of inflammatory lesions, developmental abnormalities, fibroosseous lesions, benign cysts and tumors, and malignant lesions of the maxilla and mandible.

Cysts↗
PubMed2001

Gene expression and immunohistochemical localization of decorin and biglycan in association with early bone formation in the developing mandible.

We investigated the expression of the small proteoglycans, decorin and biglycan, which are associated with osteoblast differentiation, and how this relates to the expression of osteocalcin and bone sialoprotein (BSP) early in the formation of bone in the rat mandible by immunohistochemistry and in situ hybridization. The mandibles of rat fetuses were collected on embryonic days 14 (E14) to E18. In situ hybridization showed that gene expression of decorin, biglycan, osteocalcin and BSP was not apparent in the developing mandible at E 14, but was expressed by newly differentiated osteoblasts at E15. The expression of these mRNAs increased linearly as the number of osteoblasts increased in specimens from E16 to E18. Immunohistochemistry showed that newly differentiated osteoblasts expressed biglycan moderately, decorin weakly, and osteocalcin and BSP faintly. The unmineralized bone matrices among the osteoblasts showed prominent staining for decorin, weak staining for osteocalcin and BSP, and very weak staining for biglycan. When the intercellular matrix was mineralized at E16, the mineralized bone matrix showed more prominent staining for osteocalcin and BSP, but lacked staining for decorin and biglycan. The same staining profile was observed during the subsequent phases of bone formation at E17 and E18. These results indicate that decorin, biglycan, osteocalcin and BSP are expressed at the gene and protein level by newly differentiated osteoblasts before the onset of matrix mineralization and that they could play a role in the earliest stages of bone formation. Negative proteoglycan staining in the mineralized bone matrix suggests that a loss of, or a sharp decrease in proteoglycans occurs concomitant with bone matrix mineralization.

Animals↗
PubMed2002

Effects of simvastatin on bone regeneration in the mandibles of ovariectomized rats and on blood cholesterol levels.

The purpose of this study was to evaluate the effects of simvastatin on guided bone regeneration in the mandibles of ovariectomized rats, and to observe their blood cholesterol levels. Seventy female rats were divided into two groups: control and treated, both groups containing normal and ovariectomized rats. A month after ovariectomy a bone defect was created in the mandible, and was covered by a polytetrafluoroethylene membrane. The treated groups received simvastatin orally for 15 or 30 days. The rats were sacrificed 15, 30 or 60 days after surgery, at which time a blood sample was extracted for blood cholesterol level analysis and the mandible was extracted for densitometric, histological and morphometric analysis. All specimens underwent analysis of variance. The ovariectomized animals had higher cholesterol levels than the treated normal animals, and no significant difference was found between the different treatment periods and the sacrifice times. The densitometric, histological and morphometric analysis showed that the treated ovariectomized animals developed more new bone than the control ovariectomized rats, but no significant difference was observed between the treatment periods. It can be concluded that the deficiency of estrogen increased the level of blood cholesterol and that the simvastatin aided new bone formation in the ovariectomized animals.

Absorptiometry, Photon↗
PubMed2002

Effects of selenium on the structure of the mandible in experimental diabetics.

In the treatment of diabetes-induced pathologies, beneficial results have been obtained with administration of antioxidants. Selenium is an antioxidant and essential trace element in living organisms. The aim of this study was to investigate the possible effects of selenium on the structural alterations of the mandible due to diabetes. In this study thirty-nine Wistar rats were used and a control, a selenium given control, a diabetic and a selenium given diabetes groups were formed. Experimental diabetes was induced by a single i.p. injection (50 mg/kg) of streptozotocin (STZ). The diabetic + selenium and the control + selenium groups were injected with a daily dose of 5 micro mol/kg/day sodium selenite (i.p.) for 4 weeks while the diabetic and the control groups were injected with distilled water. Mandibles of all the animals were excised and examined at the 5th week. High blood glucose level and low body weight in the diabetic group were not significantly affected by selenium administration. Furthermore, a negligible increase in blood glucose level was observed in the selenium given control group. Densitometric analysis revealed a significant reduction in bone density and presence of resorption in the diabetic and the selenium given control groups as compared to the selenium given diabetes and the control groups. In X-ray diffraction analysis, the reduction in peak intensity of the reflected light in both the diabetic and the selenium given control groups indicated a possible alteration in the crystallinity or a poor crystalline substance. Histological investigation showed that there was progressive resorption, trabecular and cortical irregularity and vascular proliferation in the diabetic and the selenium given control groups, whereas a more healthy appearance was detected in the selenium given diabetes group. The results of this study suggest the positive effects of selenium on diabetes-induced structural alterations in the mandible. However, the unexpected results in the selenium given control group necessitate further studies on the mechanism of selenium effects in organisms.

Absorptiometry, Photon↗
PubMed2006

Effect of rostrocaudal mobility of the mandible on feed digestibility and fecal particle size in horses.

OBJECTIVE: To evaluate the effect of rostrocaudal mobility (RCM) of the mandible during extension and flexion of the atlanto-occipital joint on weight gain, feed digestibility, and fecal particle size in horses. DESIGN: Randomized controlled trial. ANIMALS: 34 pregnant mares housed in 1 barn. PROCEDURES: Horses were randomized into a treatment (n = 17) or control (17) group. All horses were sedated, and the distance between the rostral portions of the upper and lower incisor arcades was determined during extension and flexion of the atlanto-occipital joint; mandibular RCM was calculated as the difference between these values. In the treatment group, measurements were made after dental floating. Body weight was recorded 1 day before dental floating and at intervals after mandibular RCM determination for a period of 24 weeks. Feces were collected from each horse during two 5-day periods. Samples of feed and feces were analyzed to determine feed digestibility; particle size analysis was performed on dried fecal samples. RESULTS: Data obtained from each group of horses revealed that RCM of the mandible did not affect weight gain, feed digestibility, or particle size in feces; there were no differences among breeds. Controlling for age and number of dental lesions did not significantly affect results. CONCLUSIONS AND CLINICAL RELEVANCE: In horses, RCM of the mandible did not appear to affect weight gain, feed digestibility, or fecal particle size. On the basis of these and other published data, the assumption that dental abnormalities affect digestion detrimentally in horses needs to be reevaluated.

Animals↗
PubMed2000

A study of the position of the mandibular foramen in adult black Zimbabwean mandibles.

OBJECTIVES: To determine the position of the mandibular foramen on dry adult mandibles and hence provide valuable information for dental and other health practitioners for successful inferior alveolar nerve anaesthesia. DESIGN: A cross sectional study. SETTING: Department of Anatomy, Faculty of Medicine, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe. SUBJECTS: 38 dry mandibles from adult black Zimbabweans. MAIN OUTCOME MEASURES: The anterior and posterior rameal widths, upper and lower rameal heights and the height of the lingula were measured with respect to the position of the mandibular foramen. The distribution of the foramen in relation to the occlusal plane was determined. RESULTS: The results showed that the position of the mandibular foramen was highly individualistic but on average lies at about 2.56 mm (right) and 2.08 mm (left) behind the midpoint of rameal width and at approximately 3 mm superior to the midpoint of rameal height on both sides. The mean anterior and posterior rameal widths were respectively 18.95 +/- 0.41 and 14.30 +/- 0.35 while the mean rameal heights were respectively 22.50 +/- 0.50 (upper) and 28.44 +/- 0.65 (lower). The distribution of the foramen in relation to the occlusal plane was 47.1% at the same level with the occlusal plane, 29.4% above, and 23.5% below the plane. There was no side variation in the position of the foramen in relation to the occlusal plane, in the dimensions of the ramus and in the size of the mandibular foramen but individual variations exist. The height of the lingula however showed great variation. The mean height was 8.40 +/- 0.39 (right) and 8.36 +/- 0.38 (left). CONCLUSION: The study has shown similarities and differences between the rameal dimensions and the position of the mandibular foramen in adult black Zimbabwean mandibles and those of other subpopulations. The clinical significance of accurately locating the mandibular foramen during a local anesthetic block of the inferior alveolar nerve is discussed.

Adult↗
PubMed2005

Pattern of bone loss in dry mandibles of individuals who died before 1957.

OBJECTIVE: To map out the pattern of periodontal disease in individuals who died before 1957 and were not exposed to formal dental services. DESIGN: Descriptive cross-sectional study. SETTING: National Museums of Kenya. SUBJECTS: The skeletons of people who died before independence are preserved at the National Museums of Kenya in Nairobi. Sixty four out of the 170 dry mandibles stored at the Museum were assessed for periodontal bone loss using a calibrated ruler. RESULTS: All the 64 mandibles assessed were of individuals who died before 1957. Two thousand two hundred and seventy four sites were examined. Most of the subjects were adults aged 30-45 years and the age range was 18-80 years. Majority of the mandibles examined were of the ethnic group from Central Kenya. Of the teeth examined, premolars and molars were the teeth most frequently preserved intact in the sockets. The total mean bone loss for all teeth was 2.51 (SD 1.15) with a range of 0.85-5.80. When the different sites were examined, values for bone loss were 2.59 for mesial surfaces; 2.55 buccal surfaces; 2.38 for distal surfaces. Three categories were identified as follows:- 70% of the individuals had minimal or no bone loss, 26.5% had 3-4 mm or moderate bone loss and 3.5% had >5 mm bone loss or advanced bone loss. Further analysis showed that when bone loss of >3 mm was examined, only 28.12% of the individuals were in this group, 10.93% had >4 mm bone loss and 3.12% had 5 mm or more bone loss. The first molars were the teeth most commonly affected by bone loss of 3mm or more followed by second molars then the premolars. CONCLUSIONS: In this group of individuals mainly from Central Kenya, the bone loss pattern showed that only a small number had experienced periodontal destruction as recorded by bone loss levels. Three groups were identified; those who had no or minimal destruction, those who had experienced moderate destruction and those where obvious bone destruction was evident. Thus susceptibility to periodontal disease is evident in a small proportion of individuals even in populations not exposed to modern diet and formal dental services. Periodontal destruction seems to affect a fraction of the population even when older populations are examined, thus it would save on resources both human and physical if these susceptible individuals could be identified early and treatment provided.

Adolescent↗
PubMed1998

[Bone mineral density (BMD) distribution in edentulous mandible--a measuring system for bone mineral content with computed radiography (CR)].

The purpose of this study was to develop a measuring system for bone mineral density(BMD) using computed radiography and to measure BMD distribution in the edentulous mandible. Nine 2-3 mm thick sequential cross-sectional bone slices were obtained from five cadaveric mandibles. Each slice in cross-sectional view on X-ray image was divided into 64 elements and BMD distribution was investigated. The results were as followed: 1. BMD measuring system: The accuracy was 1.4%(relative error) and the reproducibility was 1.1%(CV). 2. BMD distribution in edentulous mandible: 1) BMD varied from slice to slice, decreasing from anterior to posterior in both cortical and cancellous bone on the inferior and lingual side. The BMD of buccal cancellous bone was relatively higher than that of the lingual side and remained fairly constant throughout. The BMD of buccal cortical bone showed a slight posterior increase. 2) Greater individual variation of BMD was observed near mental foramen and in incisor lingual and inferior cancellous bone. Our system demonstrated excellent precision and reproducibility BMD distribution varied near regions of muscle attachment and the mandibular canal. Further, it was suggested that strong implant stability in the molar region may be obtained by installation of the fixtures in the buccal cancellous area.

Bone Density↗
PubMedDate not supplied

Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 5-year follow-up study.

PURPOSE: The purpose of this study was to report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks and to compare their performance with that of prostheses provided with conventional cast frameworks. MATERIALS AND METHODS: On a routine basis, a consecutive group of 824 edentulous patients were provided with fixed prostheses supported by implants in the edentulous mandible. In addition to conventional gold-alloy castings, patients were at random provided with 2 kinds of laser-welded titanium frameworks. In all, 155 patients were included in the 2 titanium framework groups. A control group of 53 randomly selected patients with conventional gold-alloy castings was used for comparison. Clinical and radiographic 5-year data was collected for the 3 groups. RESULTS: All followed patients still had fixed prostheses in the mandible after 5 years. The overall cumulative success rates were 95.9% and 99.7% for titanium-framework prostheses and implants, respectively. The corresponding success rates for the control group were 100% and 99.6%, respectively. Bone loss was 0.5 mm on average during the 5-year follow-up period. The most common complications for titanium frameworks were resin or tooth fractures, gingival inflammation, and fractures of the metal frames (10%). One of the cast frameworks fractured and was resoldered. Loose and fractured implant screw components were few (< 1%). CONCLUSION: Even though the cast frameworks had a higher success rate, the overall titanium framework treatment result was well in accordance with the result of the control group. The test groups performed better after clinicians had gained some experience with the technique, and laser-welded titanium frameworks seem to be a viable alternative to conventional castings in the edentulous mandible.

Adult↗