Implants as an Option in the Esthetic Zone

Esthetic and Physical Changes of Innovative Titanium Surface Properties Obtained with Laser Technology

Aim: The purpose of the study was the evaluation of the esthetic and physical changes produced on colored titanium Grade 5 (Ti6Al4V) laser treated surfaces to be used in implant dentistry for esthetic success. Materials and methods: Colored titanium surfaces were obtained with laser treatment. The physical and topographic properties were evaluated by stereo, light, and electron microscopy and profilometric analyses. L*a*b* colorimetric coordinates were measured by spectrometry, and the superficial chemical characteristics were evaluated by energy dispersive X-ray analysis. Results: Within the complete palette of titanium colors, pinks (P1-P2), incarnadine (I), and white (W) obtained by laser were selected. The topography, texture, hues, saturation, roughness, and porosity of the samples were compared with those of machined (M) and sand-blasted and etched (SBAE) control surfaces. P1, P2, and I, similar in hue and roughness (Ra ≅ 0.5 μm), had a microgroove spacing of 56 μm and a decreasing porosity. The W sample with a “checkerboard” texture and a light color (L* 96.31) was similar to the M samples (Ra = 0.32 μm), but different from SBAE (Ra = 1.41 μm, L* 65.47). Discussion: The aspects of hard and soft tissue could result in an esthetic failure of the dental implant by showing the dark color of the fixture or abutment. The two different pinks and incarnadine surfaces showed favorable esthetic and physical features to promote dental implant success even in the maxillary anterior area with gingival recession, asymmetry, and deficiency. Conclusion: Titanium colored laser surfaces represent a valid alternative to those currently traditionally obtained and interesting and potential perspectives in the management of dental implants’ esthetic failure.

Esthetic failure in implant dentistry

The definition of failure for dental implants has evolved from lack of osseointegration to increased concern for other aspects, such as esthetics. However, esthetic failure in implant dentistry has not been well defined. Although multiple esthetic indices have been validated for objectively evaluating clinical outcomes, including failure of an implant-supported crown, only one author has determined a failure threshold. On the basis of objective indices, esthetic failures in implant dentistry can be categorized as pink-tissue failures and white-tissue failures. This article discusses esthetic failures, the factors involved in these failures, and their prevention and treatment.

Natural teeth used as provisionals in immediate implant loading in the maxilla: a case report

PURPOSE

The purpose of this article is to describe a clinical case in which the patient's natural teeth were extracted and used as provisionals immediately after the implants had been placed.

PATIENT PRESENTATION

A 52-year-old woman was treated with implants at the 2 maxillary central incisors using osseotite-tapered certain implants (Biomet 3I Inc., Palm Beach Gardens, FL), length: 15 mm, diameter: 4.1 mm; and the extracted teeth were used as provisionals.

RESULTS

After 4 months of using the temporary teeth, the treatment was concluded with the placement of 2 metal-free crowns on the implants and light polymerized resin on teeth 7 and 10.

CONCLUSIONS

This work showed the possibility of using the patient's extracted teeth as provisional teeth during the period of osseointegration, preserving aesthetics and favoring gingival tissue healing with a correct emergence profile and maintenance of the gingival papillae.