Biomedical subjects

Liran Levin

Publications and source records attributed to Liran Levin.

30 records · Page 2Linked to original sources

PubMed2005

Self-assessed dental status, oral behavior, DMF, and dental anxiety.

The purpose of this study was to evaluate the relation between self-assessed dental status, oral behavior, dental anxiety, and DMF scores. The study was conducted among young army personnel (eighteen to twenty-one years old) who arrived at a single military dental clinic for dental screening. A questionnaire was used to collect the data anonymously. The questionnaire included self-assessment of dental status and behavior, as well as the Dental Anxiety Scale (DAS). Dental caries status was evaluated using the World Health Organization (WHO) caries diagnostic criteria for decayed, missing, and filled teeth (DMFT). A total of 393 young adults were examined (98.3 percent response rate). Approximately one-third brushed their teeth once a day or not at all. Of the participants, 10.7 percent assessed their dental status as "Poor" and 46.3 percent as "Fair." Furthermore, 25.5 percent assessed their dental treatment needs as high. The average DAS score was 7.14. The average DMF score was 6.2. There was a correlation between self-reported tooth status, participants' assessment of their dental treatment needs, and DMF score (p<0.0001). Anxious participants assessed their dental treatment needs as higher (p=0.05). The dental practitioner could ask patients to assess their dental status prior to treatment or appointment. These findings will help the practitioner to accomplish more effective time and patient management.

Adolescent↗

PubMed2004

Rehabilitation of an irradiated mandible after mandibular resection using implant/tooth-supported fixed prosthesis: a clinical report.

Patients undergoing mandibular resection often have facial asymmetry and cosmetic disfigurement, which include a retruded, deviated mandible, motor and sensory deficiencies, and abnormal intermaxillary relationship and occlusion. An implant-supported fixed prosthesis can be an optimal treatment modality. However, there is a problem in creating a repeatable, stable plane of occlusion and maxillomandibular relationship. This report describes the treatment sequence and considerations to rehabilitate a patient undergoing mandibular resection and radiotherapy with an implant-supported fixed prosthesis.

Aged↗

PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthdontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adolescent↗

PubMed2004

Post-traumatic use of dental implants to rehabilitate anterior maxillary teeth.

The treatment sequel of post-traumatic teeth for the use of dental implants in the anterior maxillary region to rehabilitate anterior maxillary missing teeth was evaluated. Files of 53 healthy patients reporting anterior dental trauma were reviewed. All patients had an anterior maxillary dental implant because of tooth loss after trauma. At initial examination, 18 patients (34%) had root canal treatment and an inflammatory lesion, 15 (28.3%) had a missing tooth on admission, 12 (22.6%) had a prior operation (i.e. root-end surgery or crown lengthening), 4 (7.5%) presented an ankylotic root, and 4 (7.5%) had a root remnant not suitable for rehabilitation, with no inflammatory periapical lesion. Treatment sequences and complications were recorded. Augmentation procedure (i.e. onlay bone graft or guided bone regeneration) was performed in 43 patients (81.1%), and 2 patients (3.8%) had orthodontic extrusion prior to tooth extraction and implantation. Implants were placed immediately in 25 patients (47.2%) and 4 (7.5%) had immediate loading at the time of implantation. Complications and postoperative incidents (fistula, inflammation, swelling hematoma, etc.) were observed in 24 patients (45.3%). There was no difference in complication and postoperative incident rates with regards to the implantation technique. Complications were found at the prosthetic phase in seven patients (13.2%; six fistula and one implant failure). When patients were divided into two groups, with and without an inflammatory lesion, a significantly lower complication and postoperative incident rate were found in the non-inflammatory group (P = 0.057). This study reaffirmed the necessity for scrupulous diagnosis of teeth and alveolar bone after a traumatic injury. Treatment is multidisciplinary, requiring surgical, orthodontic, endodontic, operative, and prosthetic compliance. A specially designed treatment plan for each patient is necessary. General rules do not apply.

Alveolar Ridge Augmentation↗

PubMed2004

A radiographic evaluation of cervical bone loss associated with immediate and delayed implants placed for fixed restorations in edentulous jaws.

BACKGROUND: Placement of dental implants is considered a successful and predictable procedure. An important biological benefit is the preservation of bone height following implantation. The purpose of this study was to examine the cervical bone loss (CBL) and its correlation with implant characteristics and anatomic factors, 1 to 8 years post-implantation of immediate and delayed implants. METHODS: A total of 381 implants (144 immediate and 237 delayed) were placed in 44 edentulous patients (53 jaws) for fixed ceramometal restoration from 1989 to 1996. The mean mesial and distal cervical bone resorption of each implant was measured using panoramic radiographs, by an objective examiner using a computerized scanner before second stage surgery and 1 to 8 years (mean 3.5 years) follow-up. The length of the implant served as an internal standard. The examiner had no prior information on the examined implants. RESULTS: Total CBL was 0.78 +/- 1.22 mm. There was a significant difference (P = 0.049) between CBL of immediate implants compared to delayed ones. Implants > 13 mm showed a significantly (P < 0.001) lower CBL than shorter implants. Hydroxyapatite-coated implants had a higher CBL (P < 0.001) compared to commercially pure titanium implants (P < 0.001). The CBL of maxillary implants was higher than mandibular implants (P < 0.001). Step-wise multiple regression pr.obability tests demonstrated that implant location followed by coating, length, and timing of placement were the most important parameters for implant success (R2 = 0.102). CONCLUSION: Cervical bone loss around dental implants is influenced by location, coating, length, and implant timing.

Adult↗

PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthodontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adult↗

PubMed2004

The relationship between dental caries status and oral health attitudes and behavior in young Israeli adults.

The aim of this study was to investigate the epidemiologic relationship between oral health attitudes and behavior as measured by the Hiroshima University-Dental Behavioral Inventory (HU-DBI) and dental caries status using the DMF in a sample of young Israeli adults. The HU-DBI (in Hebrew) was used to survey 123 young Israeli army recruits (eighteen and nineteen years old). All participants submitted to a clinical and radiographic dental examination. Dental caries status was evaluated using the World Health Organization (WHO) caries diagnostic criteria for decayed, missing, and filled teeth and surfaces (DMFT and DMFS, respectively). Data were statistically analyzed. DMFT and DMFS scores, which measure dental disease, ranged from 0 to 24 (average 6.77) and from 0 to 48 (average 10.95), respectively. There were sixteen (13 percent) caries free (DMF=0) participants. When relating the different DMF values to the HU-DBI responses, a statistically significant relation was found between seven items and DMF scores or their components and indices. The HU-DBI score ranged from 2 to 9 (mean 5.8, SD=1.5). Low DS and DT values significantly correlated with a high total HU-DBI score (p<0.05); that is, subjects with low levels of dental disease had more positive oral health attitudes and behavior. In young Israeli adults, dental disease, as measured by DMF scores or their components, were related to HU-DBI, which demonstrate the relationship of dental caries status with oral health behavior. Special emphasis should be given to improving patients' oral health attitudes and behaviors by providing patient education during treatment.

Adult↗

PubMed2003

Reduction of viable bacteria in dentinal tubules treated with clindamycin or tetracycline.

AIM: We sought to evaluate and compare the antibacterial effect of clindamycin and tetracycline in bovine dentinal tubules. METHODS: Dentinal tubules of 32 cylindrical bovine root specimens were infected with Streptococcus sanguis N1. Clindamycin 2% or tetracycline 2% (Ledermix) was placed in the root canal for 1 week. Powder dentin samples obtained from within the canal lumina by using International Standards Organization No. 25 to No. 31 burs were examined for the presence of vital bacteria after the brain-heart infusion plates were inoculated and the colony-forming units were counted. The potent effect of the medicaments was also evaluated through the use of the agar diffusion test. RESULTS: Heavy bacterial infection was observed in the control bovine root specimens at the layer close to the lumen. This decreased rapidly from layer to layer up to the deepest layer tested (300-400 microm), which contained several hundred colony-forming units. Clindamycin significantly reduced the amount of viable bacteria in each dentin layer compared with the positive control and tetracycline (P <.01). The agar diffusion test, wherein dilutions in increments of 1/3 and 1/9 were used, revealed that both medicaments had antibacterial activity, but clindamycin was significantly better. In the 1/27 dilution, clindamycin had a minor effect and tetracycline had no effect at all. CONCLUSION: Under the experimental conditions used in this study, the commercial preparations of clindamycin were more effective than those of tetracycline (Ledermix) in the agar diffusion test and clindamycin penetrated into dentinal tubules up to 400 microm. Thus, it has the potential to serve as an effective intracanal medicament in persistent infections when other medicaments fail.

Analysis of Variance↗

PubMed2003

Dental and oral trauma and mouthguard use during sport activities in Israel.

The purpose of the present study was to evaluate the occurrence of oral and dental injuries in young Israeli population engaged in diverse sport activities. The participants' awareness of the use of protective devices, such as mouthguards, during sport activities was also evaluated. A population of 943 young adults, 95% males and 5% females (ages 18-19), was surveyed. A questionnaire was distributed relating to the type of sport activity practised, past oral and dental injuries over their lifetime, specifying the time and type of sports in which the injury occurred and the use and awareness of the protective devices. Of the total population examined, 850 (90%) were active in at least one type of sport, either as professionals or as amateurs. The analysis included the population that regularly participated in at least one sporting activity. The most commonly practised sports were soccer (54% of all active participants) and basketball (50%). The total number of dental and oral injuries experienced during all sport activities was 229, affecting 27% of the participants of whom 73 (9%) suffered dental injuries. Most dental injuries occurred during the basketball and soccer training sessions and matches reaching 42 and 41% of the total number of injuries, respectively, and affected 7.2 and 6.6% of the basketball and soccer players. Traumatic dental injuries in other sports occurred in less than 7% of the participants in these activities. Only 27% of the participants were aware of the protective devices, such as a mouthguards, and only 3% actually used these devices. These results point to the high risk of potential dental and oral injury during sport activities, the little knowledge about the benefits of using mouthguards and their limited utilization. The importance of public health education to increase the awareness of protective measures and devices and their actual use in Israel is the main focus. It should be a combined duty of dentists and sports physicians and of the coaches to encourage the use of protective devices during training and games.

Adolescent↗

PubMedDate not supplied

Smoking and complications of onlay bone grafts and sinus lift operations.

PURPOSE: To compare the incidence of complications related to onlay bone grafts (OBGs) and sinus lift operations (SLOs) among smokers and nonsmokers. MATERIALS AND METHODS: Data from 143 operations performed during the years 1995 to 2003 were analyzed. There were 64 OBGs and 79 SLOs. Patients were divided into 3 groups: nonsmokers, mild smokers (up to 10 cigarettes per day), and heavy smokers (more than 10 cigarettes per day). Duration of smoking (less or more than 10 years) was recorded. OBG complications were classified as minor (hematoma, swelling, inflammation, or temporary paresthesia) or major (graft exposure or mobility). For the SLO, perforations of the schneiderian membrane were the main intraoperative complication; postoperative complications mostly consisted of swelling, acute or chronic sinus infection, or bleeding. RESULTS: Of smokers having OBG, 50% experienced complications, compared to 23.1% of nonsmokers. Major complications were observed in one third of the smokers, compared to only 7.7% in nonsmokers. There was also a tendency toward complications in former smokers, although this relationship was not statistically significant. There was no relationship between SLO complications and smoking or a past smoking habit. DISCUSSION: In the present study, smokers demonstrated significantly higher postoperative complications following OBG operations. Smoking did not influence the results in the SLO group. There was no statistically significant difference between complications and past smoking. This finding indicates that the risk of complications can be reduced up to the normal nonsmoker complication rate when smoking ceases. CONCLUSIONS: This study established a relationship between OBG complications and smoking in this patient population. A higher incidence of complications was found in the smoking group. There was no significant influence of smoking on SLO complications.

Analysis of Variance↗

PubMedDate not supplied

Marginal bone loss pattern around hydroxyapatite-coated versus commercially pure titanium implants after up to 12 years of follow-up.

PURPOSE: The purpose of this study was to compare the marginal bone loss (MBL), complications, and 12-year survival rates of commercially pure titanium (cpTi) and hydroxyapatite (HA)-coated implants placed in the maxilla. MATERIALS AND METHODS: The study group consisted of 120 patients (77 women, 43 men) treated from 1988 to 1997. A total of 388 implants (156 cpTi and 232 HA-coated) were placed in the maxilla. There were 126 immediate (32.5%) and 262 (67.5%) nonimmediate implants. Patients were evaluated annually. Mean follow-up was 60 +/- 32.3 months. MBL was measured on radiographs using the implant threads as the dimensional reference. MBL, complications, and 12-year survival and success rates were correlated with implant coating, time of implantation, implant dimensions, and position in arch. RESULTS: Total mean MBL was 1.07 +/- 2.16 mm. MBL was significantly lower with cpTi implants (0.55 +/- 1.04 mm) compared to HA-coated implants (1.51 +/- 2.71 mm) (P < .001). No statistical difference in regard to MBL was found between immediate and nonimmediate implants (0.86 +/- 1.8 mm vs 1.16 +/- 2.3 mm). The total 12-year survival rate was 91.4%. HA-coated implants had a significantly higher 12-year survival rate than cpTi implants (93.2% vs 89%; P < .03). Nonimmediate implants had a significantly higher failure rate (8.2%) than the immediate implants (1.3%) (P < .009). No correlation was found between type of implant coating and late implant failure. DISCUSSION: Immediate implants can serve as a predictable option, providing higher survival and success rates. HA-coated implants tended to fail less during the surgical phase, but had higher mean MBL compared to cpTi implants. CONCLUSIONS: HA-coated implants had greater MBL than cpTi implants but a higher 12-year survival rate. Immediate implants had a lower failure rate than the nonimmediate implants in this study population.

Adolescent↗

PubMedDate not supplied

Impact of smoking on marginal bone loss.

PURPOSE: To compare marginal implant bone loss (MBL), survival, and radiographic evidence of success of dental implants among smokers and nonsmokers. MATERIALS AND METHODS: Consecutive records of 161 patients (aged 23 to 89 years, mean 57 years) treated with a total of 646 implants between the years 1995 and 1998 were examined. Patients were divided into 3 groups: nonsmokers, moderate smokers, and heavy smokers. Tobacco exposure was calculated by cigarettes per day and by pack-years. Follow-up ranged from 1 to 7 years (mean 3.8 years). Postoperative panoramic radiographs obtained before implant exposure and annually thereafter were analyzed for MBL changes. The influence of smoking and other variables on MBL was analyzed at all implant sites. RESULTS: Generally, smokers had more MBL than nonsmokers (0.153 +/- 0.092 mm and 0.047 +/- 0.048 mm, respectively; P < .001). When each jaw was examined separately, smoking had a greater effect on MBL in the maxilla than in the mandible (0.158 +/- 0.171 mm versus 0.146 +/- 0.158 mm, respectively; P < .001). Furthermore, in the maxilla, heavy smokers had the greatest amount of MBL (0.1897 +/- 0.1825 mm), followed by moderate smokers (0.123 +/- 0.156 mm) and nonsmokers (0.0460 +/- 0.070 mm) (P < .001). In the mandible, there was no distinction between heavy and moderate smokers, and both had greater MBL than nonsmokers (P < .001). Only 3 of the 646 implants failed; the cumulative survival rate was 99.5%. Overall radiographic success rate was 93.2%. Nonsmokers had a higher radiographic success rate (97.1%) than smokers (87.8%) (P < .001). CONCLUSIONS: This study demonstrated a relationship between MBL and smoking habits. A higher incidence of MBL was found in the smoking group, and this was more pronounced in the maxilla.

Adult↗