Publications by authors named "Nikitas Sykaras"

11 Publications

  • Page 1 of 1

Removal of damaged implant components with a custom-made screwdriver.

J Prosthet Dent 2020 Sep 17. Epub 2020 Sep 17.

Assistant Professor, Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.

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http://dx.doi.org/10.1016/j.prosdent.2020.05.010DOI Listing
September 2020

Color changes of polyetheretherketone (PEEK) and polyoxymethelene (POM) denture resins on single and combined staining/cleansing action by CIELab and CIEDE2000 formulas.

J Prosthodont Res 2020 Apr 15;64(2):159-166. Epub 2019 Dec 15.

Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, FL, United States.

Purpose: The purpose of study was to investigate the long-term effect of staining and/or cleansing solutions on the color stability of two non-metal removable partial denture materials.

Methods: One hundred disks (25×3mm) of polyoxymethylene (POM) and polyetheretherketone (PEEK) were immersed in water, wine, coffee, cleanser and combo bath, simulating normal daily use. Color parameters in the CIELAB system was measured every 30 cycles up to 240 using a contact colorimeter and color differences estimated using ΔE and ΔE formulas. Two-way repeated measures ANOVAs and regression analyses were performed at α=0.05.

Results: Regression analysis indicated a strong R between color changes and number of cycles, for both materials. Tests of within-subjects effects for the ΔE revealed significant differences among cycles and between the materials in the wine and coffee baths (p<0.001). Significant materialXcycles interactions were also recorded with all staining baths. ΔE values were lower than ΔE up to 63.6%. Tests within and between-subjects effects for the ΔE gave similar but not the same with ΔE results.

Conclusions: ΔE found to correlate well with ΔE. Long term exposure of both materials showed a progressive discoloration in all except control baths. POM discolored more than PEEK in coffee, and combo baths but not in cleanser. Discoloration was smaller in combo bath (where a cleanser was also used) indicating the effectiveness of a cleanser to prevent long term discoloration of both materials.
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http://dx.doi.org/10.1016/j.jpor.2019.06.005DOI Listing
April 2020

Group 3 ITI Consensus Report: Patient-reported outcome measures associated with implant dentistry.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:270-275

Universidad Inter Continental, Mexico City, Mexico.

Objectives: The aim of Working Group 3 was to focus on three topics that were assessed using patient-reported outcome measures (PROMs). These topics included the following: (a) the aesthetics of tooth and implant-supported fixed dental prostheses focusing on partially edentulous patients, (b) a comparison of fixed and removable implant-retained prostheses for edentulous populations, and (c) immediate versus early/conventional loading of immediately placed implants in partially edentate patients. PROMs include ratings of satisfaction and oral health-related quality of life (QHRQoL), as well as other indicators, that is, pain, general health-related quality of life (e.g., SF-36).

Materials And Methods: The Consensus Conference Group 3 participants discussed the findings of the three systematic review manuscripts. Following comprehensive discussions, participants developed consensus statements and recommendations that were then discussed in larger plenary sessions. Following this, any necessary modifications were made and approved.

Results: Patients were very satisfied with the aesthetics of implant-supported fixed dental prostheses and the surrounding mucosa. Implant neck design, restorative material, or use of a provisional restoration did not influence patients' ratings. Edentulous patients highly rate both removable and fixed implant-supported prostheses. However, they rate their ability to maintain their oral hygiene significantly higher with the removable prosthesis. Both immediate provisionalization and conventional loading receive positive patient-reported outcomes.

Conclusions: Patient-reported outcome measures should be gathered in every clinical study in which the outcomes of oral rehabilitation with dental implants are investigated. PROMs, such as patients' satisfaction and QHRQoL, should supplement other clinical parameters in our clinical definition of success.
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http://dx.doi.org/10.1111/clr.13299DOI Listing
October 2018

Creating natural-looking removable prostheses: combining art and science to imitate nature.

J Esthet Restor Dent 2012 Jun 15;24(3):160-8. Epub 2011 Nov 15.

Department of Oral and Maxillofacial Surgery, Center for Implant Dentistry, University of Florida, Gainesville, FL, USA.

Unlabelled: Patient awareness of dental appearance has increased, resulting in more demanding esthetic requests. There is also strong evidence that increased esthetics is highly significant for complete denture acceptance and success. Taking notice of patients' perceptions of natural appearance and esthetics, the clinician can incorporate their preferences in the construction of individualized dentures that will be harmonized with their facial characteristics. Despite the evolution of materials and techniques, the vast majority of dentures still fail to look natural. Thus, producing prostheses that defy detection and successfully restore the appearance of edentulous patients remains a challenge for the clinician. This paper presents a clinical case where immediate loading of implants supporting a mandibular overdenture was combined with an opposing conventional maxillary denture to satisfy the high functional and esthetic demands of the patient. It also emphasizes the individualized esthetic performance through customization during their fabrication while taking into consideration the various clinical parameters affecting rehabilitation of the edentulous jaw.

Clinical Significance: Implant-retained overdentures can significantly improve the patients' function. The esthetic performance of these restorations however, may not be satisfying the patients' expectations and demands. Customizing the artificial gingival areas and individual staining of the prefabricated acrylic teeth may improve the esthetic performance creating natural-looking removable prostheses.
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http://dx.doi.org/10.1111/j.1708-8240.2011.00493.xDOI Listing
June 2012

Esthetic and functional combination of fixed and removable prostheses.

Gen Dent 2012 Mar-Apr;60(2):e47-54

Center for Implant Dentistry, University of Florida in Gainesville, USA.

When creating optimally esthetic contemporary prosthetic restorations, clinicians should balance patient preferences and requests with functional and esthetic demands. Beyond fulfilling the treatment objectives of restoring function and optimizing esthetics, the combination of fixed and removable dental prostheses should also blend seamlessly into the oral environment. Treatment planning and proper design of the prostheses is of paramount importance, while knowledge of material science and laboratory steps is needed to guarantee successful execution of clinical procedures. This article provides methods and techniques for improvement of the esthetic outcome through the description of clinical and laboratory steps of a clinical case.
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January 2013

A novel surgical template design in staged dental implant rehabilitations.

J Oral Maxillofac Res 2012 1;3(2):e5. Epub 2012 Jul 1.

Department of Prosthodontics, University of Athens Athens Greece.

Background: The philosophy of a gradual transition to an implant retained prosthesis in cases of full-mouth or extensive rehabilitation usually involves a staged treatment concept. In this therapeutic approach, the placement of implants may sometimes be divided into phases. During a subsequent surgical phase of treatment, the pre-existing implants can serve as anchors for the surgical template. Those modified surgical templates help in the precise transferring of restorative information into the surgical field and guide the optimal three-dimensional implant positioning.

Methods: This article highlights the rationale of implant-retained surgical templates and illustrates them through the presentation of two clinical cases. The templates are duplicates of the provisional restorations and are secured to the existing implants through the utilization of implant mounts.

Results: This template design in such staged procedures provided stability in the surgical field and enhanced the accuracy in implant positioning based upon the planned restoration, thus ensuring predictable treatment outcomes.

Conclusions: Successful rehabilitation lies in the correct sequence of surgical and prosthetic procedures. Whenever a staged approach of implant placement is planned, the clinician can effectively use the initially placed implants as anchors for the surgical template during the second phase of implant surgery.
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http://dx.doi.org/10.5037/jomr.2012.3205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886099PMC
January 2014

Restoration-guided implant rehabilitation of the complex partial edentulism: a clinical report.

J Oral Maxillofac Res 2010 1;1(1):e8. Epub 2010 Apr 1.

Private practice, Agrinio Greece.

Background: The hard and soft tissue deficiency is a limiting factor for the prosthetic restoration and any surgical attempt to correct the anatomic foundation needs to be precisely executed for optimal results. The purpose of this paper is to describe the clinical steps that are needed to confirm the treatment plan and allow its proper execution.

Methods: Team work and basic principles are emphasized in a step-by-step description of clinical methods and techniques. This clinical report describes the interdisciplinary approach in the rehabilitation of a partially edentulous patient. The importance of the transitional restoration which sets the guidelines for the proper execution of the treatment plan is especially emphasized along with all the steps that have to be followed.

Results: The clinical report describes the diagnostic arrangement of teeth, the ridge augmentation based on the diagnostic evaluation of the removable prosthesis, the implant placement with a surgical guide in the form of the removable partial denture duplicate and finally the special 2-piece design of the final fixed prosthesis.

Conclusions: Clinical approach and prosthesis design described above offers a predictable way to restore partial edentulism with a fixed yet retrievable prosthesis, restoring soft tissue and teeth and avoiding an implant supported overdenture.
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http://dx.doi.org/10.5037/jomr.2010.1108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886043PMC
January 2014

Effect of recombinant human bone morphogenetic protein-2 on the osseointegration of dental implants: a biomechanics study.

Clin Oral Investig 2004 Dec 29;8(4):196-205. Epub 2004 Jul 29.

Department of Fixed Prosthodontics, Dental School, Athens University, Athens, Greece.

Background: Bone augmentation procedures in combination with dental implants enhance osseointegration in areas that demonstrate localized bone deficit. Clinical confirmation of a biomechanically stable interface is essential for functional implant loading.

Purpose: The aim of this study was to evaluate biomechanically the effect of recombinant human bone morphogenetic protein (rhBMP)-2 on implant osseointegration and correlate it with periotest and radiographic measurements.

Materials And Methods: Hollow cylinder implants were filled with absorbable collagen sponge soaked with rhBMP-2 or left empty and implanted in dog mandibles. The animals were followed for 4, 8, and 12 weeks, periotest assessment was performed at the end of each time interval, and specimens were collected for pullout biomechanical testing and radiographic evaluation of bone-implant contact levels.

Results: Periotest assessment did not provide evidence of statistically significant differences between the two groups and correlated well with the radiographic bone-implant contact levels. The pullout test revealed a higher correlation between force/displacement and displacement/energy for the experimental group, suggesting that the addition of rhBMP-2 did influence the rate of osseointegration.

Conclusion: The results from the pullout test support the potential role of rhBMP-2 in clinical applications by promoting a biomechanically mature interface at 12 weeks. However, radiographic and periotest assessment of the bone-implant interface did not provide evidence of the differences observed with biomechanical testing.
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http://dx.doi.org/10.1007/s00784-004-0270-7DOI Listing
December 2004

Osseointegration of dental implants complexed with rhBMP-2: a comparative histomorphometric and radiographic evaluation.

Int J Oral Maxillofac Implants 2004 Sep-Oct;19(5):667-78

Department of Fixed Prosthodontics, Dental School, Athens University, Athens, Greece.

Purpose: To evaluate the effect of rhBMP-2 on implant osseointegration using histomorphometric and radiographic imaging analyses and determine the diagnostic accuracy of periapical radiographs regarding clinical bone-implant contact levels.

Materials And Methods: Hollow-cylinder implants were filled with an absorbable collagen sponge soaked with recombinant human bone morphogenetic protein-2 (rhBMP-2) or left empty and implanted in the mandibles of dogs. Animals were followed for 2, 4, 8, or 12 weeks. At the end of each time interval, the animals were sacrificed and specimens were collected for histomorphometric and radiographic evaluation of the bone-implant contact levels.

Results: Both groups exhibited the same mean histologic bone-implant contact on the outer surface of the implant, except for the 4-week group. The radiographic evaluation of bone-implant contact overestimated the actual osseointegration levels by at least 30%, a significant amount.

Discussion: The osteoinductive and regenerative potential of rhBMP-2 is of clinical benefit in cases where bone augmentation is indicated and improved levels of osseointegration are expected. Radiographic evaluation has been the most widely employed technique in clinical practice for assessing bone levels around dental implants and comparing changes over time. However, there is a limit to the diagnostic accuracy of conventional radiographs when compared to the data obtained by histologic analysis.

Conclusion: Application of rhBMP-2 within the confined boundaries of the hollow chamber of the implant had a limited effect on the osseointegration level along its outer surface, perhaps because of physically restricted diffusion. Radiographic evaluation resulted in the overestimation of bone-implant contact, and poor correlation with the histomorphometric data was found.
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December 2004

Implant materials, design, and surface topographies: their influence on osseointegration of dental implants.

J Long Term Eff Med Implants 2003 ;13(6):485-501

Department of Oral and Maxillofacial Surgery and Pharmacology, Baylor College of Dentistry-The Texas A&M University System Health Science Center, Dallas, Texas 75246, USA.

The purpose of this review is to describe commonly used dental implants with reference to their material composition, design factors, and surface topographies. The review includes a discussion of the biological principle of osseointegration and how this process of bone-implant interaction is influenced by different implant materials, designs, and surface characteristics
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http://dx.doi.org/10.1615/jlongtermeffmedimplants.v13.i6.50DOI Listing
April 2004

Bone morphogenetic proteins (BMPs): how do they function and what can they offer the clinician?

J Oral Sci 2003 Jun;45(2):57-73

Department of Fixed Prosthodontics, Dental School, Athens University, Athens, Greece.

Bone Morphogenetic Proteins (BMPs) form a unique group of proteins within the Transforming Growth Factor beta (TGF-beta) superfamily of genes and have pivotal roles in the regulation of bone induction, maintenance and repair. They act through an autocrine or paracrine mechanism by binding to cell surface receptors and initiating a sequence of downstream events that have effects on various cell types. Differentiation of osteoprogenitor mesenchymal cells and up-regulation of osteoblastic features occur under the influence of cytokines and growth factors that are expressed with the direct or indirect guidance of BMPs acting at the transcriptional level or higher. The Smads family of proteins has been identified as the downstream propagator of BMP signals, whereas hedgehog genes are possible modulators of BMP expression. The inflammatory response observed during wound repair and fracture healing, results in by-products that interact with BMPs and affect their biologic potential. Additive, negative or synergistic effects are observed when homodimeric or heterodimeric forms of BMPs interact with BMP receptors. Storage within the bone matrix allows for their involvement in the modeling/remodeling process by mediating coupling of osteoblasts and osteoclasts. Micro-environmental conditions, dose, possible carrier materials and geometrical parameters of delivery matrix are critical determinants of the pharmacokinetics of BMP action and the biologic outcome during wound repair. Because of their osteogenic potential, BMPs are of tremendous interest as therapeutic agents for healing fractures of bones, preventing osteoporosis, treating periodontal defects and enhancing bone formation around alloplastic materials implanted in bone.
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http://dx.doi.org/10.2334/josnusd.45.57DOI Listing
June 2003