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Enrile de Rojas FJ, Ventura de la Torre J, Romero Griñolo JM. Long-term outcome of implants exhibiting buccal soft tissue dehiscence in the esthetic zone. J ESTHET RESTOR DENT 2024; 36:539-547. [PMID: 37771295 DOI: 10.1111/jerd.13141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE Increasing aesthetic demands require that the color and contour of the peri-implant soft tissues be in harmony with the neighboring teeth. Recession, migration toward the apical, is a frequent clinical finding. Its presence can lead to inflammation and increased marginal bone loss. These complications, in addition to affecting the aesthetic results of our treatment, are difficult to treat and can threaten the survival of the implant. There are fewer studies showing the outcome of treatment of soft-tissue defects around implants. The aim of this article is to describe the treatment of a soft-tissue defect around an implant-supported prosthesis treatment, performed on two neighboring implants, in the esthetic zone in a patient with a high smile and to evaluate both the coverage achieved and the patient's esthetic satisfaction. CLINICAL CONSIDERATIONS This study showed that a mucogingival approach, using a surgical technique designed for the treatment of alveolar ridge defects, together with tissue management with temporaries and a new restoration, achieved an optimal result. CONCLUSIONS The case has been closely followed up, for 10 years, and the authors have been able to confirm the long-term stability of the result. CLINICAL SIGNIFICANCE The following paper shows the result of an innovative approach. Connective tissue platform technique, usually performed for soft-tissue augmentation, was used for a defect in soft-tissue dehiscence. The authors followed the results for 10 years, and the results achieved were satisfactory in terms of esthetic.
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Pini Prato G, Di Gianfilippo R. Challenges and success in periodontal plastic surgery. J Clin Periodontol 2023; 50:1572-1581. [PMID: 37661329 DOI: 10.1111/jcpe.13869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
To truly understand a field of study, one must delve into its past and examine the challenges and successes that have shaped its current practices. In the case of periodontal plastic surgery, recognizing how challenges induced changes over the last 70 years-from the 1950s to today-is essential to fully comprehend its evolution. This editorial provides a perspective on the field, highlighting the interrelationships between influential surgical techniques and advancements in research methodology. With each event building upon the last, the evolution of periodontal plastic surgery is a story of scientific progress and ongoing research, fostering a sense of community and shared knowledge.
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Affiliation(s)
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Del Castillo R, Ata-Ali J. The clinical use of computer aided designed/computer aided manufactured titanium nitride coated implant abutments: Surgical and prosthetic considerations-A case series. J ESTHET RESTOR DENT 2023; 35:1008-1021. [PMID: 36932837 DOI: 10.1111/jerd.13035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/12/2023] [Accepted: 02/23/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE To describe the clinical use of nitride-coated titanium CAD/CAM implant abutments in the maxillary esthetic zone in two patients with high esthetic and functional demands and, to highlight the advantages of nitride-coated milled titanium abutments when compared to stock/custom titanium, one-piece monolithic zirconia, and hybrid metal-zirconia implant abutments. CLINICAL CONSIDERATIONS Due to the inherent mechanical and esthetic clinical challenges, single implant-supported reconstructions in the maxillary esthetic zone are a complex restorative treatment. While CAD/CAM technology has been suggested to enhance and ease implant abutment design and manufacturing, implant abutment material selection remains as a critical decision affecting restoration's long-term clinical outcomes. To date, considering the esthetic disadvantages of conventional titanium implant abutments, the mechanical limitations of one-piece zirconia abutments and the manufacturing time and costs associated with hybrid metal-zirconia abutments, no abutment material can be considered "ideal" for all clinical scenarios. Due to their biocompatibility, biomechanical characteristics (hardness and wear resistance), optical properties (yellow color), and peri-implant soft tissue esthetic integration, the use of CAD/CAM titanium nitride-coated implant abutments has been suggested as a predictable implant abutment material in mechanically challenging but esthetically demanding clinical situations, as the maxillary esthetic zone. CONCLUSIONS Two patients requiring a combined tooth-implant restorative treatment in the maxillary esthetic zone were treated using CAD/CAM nitride coated titanium implant abutments. The principal advantages of TiN coated abutments include comparable clinical outcomes to stock abutments, optimal biocompatibility, adequate fracture, wear, and corrosion resistance, reduced bacterial adhesion, and excellent esthetic integration with adjacent soft tissues. CLINICAL SIGNIFICANCE Clinical reports and short term mechanical, biological and esthetic clinical outcomes indicate that CAD/CAM nitride coated titanium implant abutments can represent a predictable restorative alternative to stock/custom and metal/zirconia implant abutments and be considered a clinical relevant option in mechanically challenging but esthetically demanding situations, as often found in the maxillary esthetic zone.
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Affiliation(s)
- Rafael Del Castillo
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Javier Ata-Ali
- Department of Dentistry, Faculty of Health Sciences, Universidad Europea de Valencia, Public Dental Health Service, Conselleria de Sanitat Universal i Salut Pública, Valencia, Spain
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Fürhauser R, Fürhauser L, Fürhauser N, Pohl V, Pommer B, Haas R. Bucco‐palatal implant position and its impact on soft tissue level in the maxillary esthetic zone. Clin Oral Implants Res 2022; 33:1125-1134. [DOI: 10.1111/clr.13995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/16/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - V. Pohl
- Academy of Oral Implantology Vienna/ Austria
| | - B. Pommer
- Academy of Oral Implantology Vienna/ Austria
| | - R. Haas
- Academy of Oral Implantology Vienna/ Austria
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Moraschini V, Kischinhevsky ICC, Sartoretto SC, de Almeida Barros Mourão CF, Sculean A, Calasans-Maia MD, Shibli JA. Does implant location influence the risk of peri-implantitis? Periodontol 2000 2022; 90:224-235. [PMID: 35913455 DOI: 10.1111/prd.12459] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Peri-implantitis is characterized by nonreversible and progressive loss of supporting bone and is associated with bleeding and/or suppuration on probing. Peri-implant disease is considered as the main etiologic factor related to implant failure. Peri-implant disease has a pathogenesis similar to that of periodontal disease, both being triggered by an inflammatory response to the biofilm accumulation. Although the prevalence of peri-implantitis has been evaluated by several clinical studies with different follow-ups, there are currently little data on the impact of implant location and the prevalence of peri-implantitis. The aim of this review, therefore, was to summarize the evidence concerning the prevalence of peri-implantitis in relation to implant location and associated risk predictors. Even though most studies evaluating the prevalence of peri-implantitis in relation to implant location are cross-sectional or retrospective, they suggest that the occurrence of peri-implantitis is most prevalent in the anterior regions of the maxilla and mandible. Moreover, it seems that there is a higher prevalence of peri-implantitis in the maxilla than in the mandible.
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Affiliation(s)
- Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil.,Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Suelen Cristina Sartoretto
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Monica Diuana Calasans-Maia
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil
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Thoma DS, Gil A, Hämmerle CHF, Jung RE. Management and prevention of soft tissue complications in implant dentistry. Periodontol 2000 2022; 88:116-129. [PMID: 35103320 PMCID: PMC9306802 DOI: 10.1111/prd.12415] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The management and prevention of soft tissue complications is of key importance in modern implant dentistry and influences biologic and esthetic outcomes. The assessment of the soft tissue conditions from a quantitative and qualitative perspective should, therefore, be part of the overall treatment plan. Such an assessment dictates a potential indication as well as an ideal time point for additional soft tissue management. A proper risk assessment and management of the soft tissues at the planned implant site are of key importance prior to any implant‐related surgery. Cases with peri‐implant soft tissue complications generally involve: (a) a lack of attached and keratinized mucosa; (b) insufficient volume; (c) development of mucosal dehiscences; or (d) a combination of (a), (b), and (c). In case of soft tissue deficiencies, these should be addressed as early as possible to increase the predictability of the surgical interventions. This article reviews the main causes for peri‐implant soft tissue complications and presents different therapeutic options for the management of various clinical scenarios.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Alfonso Gil
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Is there any biomaterial substitute for peri-implant soft tissue phenotype modification? A network meta-analysis of the appraisal literature. Int J Oral Maxillofac Surg 2021; 51:526-534. [PMID: 34373184 DOI: 10.1016/j.ijom.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/13/2021] [Accepted: 07/07/2021] [Indexed: 01/27/2023]
Abstract
Evidence shows that an increased width and thickness of the keratinized mucosa favours peri-implant health. The aim of this network meta-analysis was to compare the clinical effects of alternative biomaterials for peri-implant soft tissue phenotype modification (PSPM) in patients with dental implants when compared to autologous tissue grafts. An electronic search without language or date limitations was performed in four databases and the grey literature for articles published until November 2020. The eligibility criteria included randomized clinical trials (RCTs) evaluating the clinical outcomes of biomaterials for PSPM. A pairwise and network meta-analysis was conducted for each parameter to assess and compare the outcomes between the different treatment arms for the primary and secondary outcomes. A total of 11 RCTs were included in this review. The free gingival graft (FGG) showed the best clinical effect for increasing keratinized mucosa width (KMW). When compared in a network, the FGG demonstrated the best treatment ranking of probability results, followed by connective tissue graft (CTG), acellular dermal matrix (ADM), and xenogeneic collagen matrix (XCM). For the parameters 'mucosa thickness' and 'participant satisfaction with aesthetics', the results were CTG > ADM > XCM and XCM > ADM > CTG, respectively. Autogenous tissue grafts (FGG/CTG) demonstrate the best results in increasing KMW and mucosa thickness when compared to the other biomaterials.
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Saad I, Salem S. Knowledge, awareness, and perception of dental students, interns, and freshly graduated dentists regarding dental implant complications in Saudi Arabia: a web-based anonymous survey. BMC Oral Health 2021; 21:161. [PMID: 33766004 PMCID: PMC7995726 DOI: 10.1186/s12903-021-01506-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is necessary for dental students and freshly graduated dentists to apply their education and practice to different clinical and preclinical procedures. The implant success rate and durability are high. Therefore, this study was designed to assess the level of knowledge, awareness and perception of dental students, interns and freshly graduated students regarding dental implant complications in Saudi Arabia. METHODS A cross-sectional study design using a web-based method was conducted at different dental institutions in Saudi Arabia from December 2019 to March 2020. Data were collected from all (n = 288) undergraduate students, interns and freshly graduated dentists using a pretested standardized self-administered web-based questionnaire that was prepared and circulated using a template provided by Google Forms (Google, Inc., USA). Descriptive statistics and chi-square tests were performed to analyse the data using SPSS (version 20). RESULTS A total of 288 participants completed the questionnaire, with a response rate of 83.4%. Of the total participants, 37.5% showed a good level of knowledge regarding dental implant procedures, and 38.9% showed the same level of knowledge regarding implant complications. The most important cause of complications associated with dental implants was case selection, which accounted for 54.17%. Most participants (58.33%) chose massive bone loss related to implant failure as the most common late dental complication, while 26.39% chose postoperative infection as the most common early dental complication. In addition, 30.56% of the participants selected screw loosening as the most frequent mechanical complication. However, lack of implant primary stability was the most common hard-tissue implant complication. Based on aesthetic and reversible complications, restorations that were too buccal or too palatal and prosthetic-related, respectively, were the least common dental implant complications. CONCLUSIONS The level of knowledge among participants regarding dental implant complications differed among the institutions participating in this study. This difference reflects a significant variation that necessitates reviewing and standardizing dental implant curricula among these institutions.
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Affiliation(s)
- Islam Saad
- Department of Periodontology and Oral Medicine, College of Dentistry, Qassim University, King Abdulaziz Road, Mulaidah, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia.
| | - Suzan Salem
- Department of Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Qassim University, King Abdulaziz Road, Mulaidah, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
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Tabanella G. Buccal Pedicle Flap Technique Combined With Porcine Collagen Matrix for Volumetric Augmentation of Peri‐Implant Mucosa. Clin Adv Periodontics 2020; 12:5-11. [DOI: 10.1002/cap.10128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/26/2020] [Indexed: 11/06/2022]
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10
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Moraschini V, Guimarães HB, Cavalcante IC, Calasans-Maia MD. Clinical efficacy of xenogeneic collagen matrix in augmenting keratinized mucosa round dental implants: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:2163-2174. [DOI: 10.1007/s00784-020-03321-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 05/01/2020] [Indexed: 12/13/2022]
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11
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Dixon DR, Yassin A. Sectional Connective Tissue Technique Combined With an Emergence Profile Provisional for Gingival Margin Stabilization During Immediate Implant Placement: A Case Report With a 2-Year Follow-Up. Clin Adv Periodontics 2019; 10:123-129. [PMID: 31854127 DOI: 10.1002/cap.10086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/08/2019] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Little is known regarding maintaining free gingival margin stability after immediate implant placement. Therefore, we present a sequential technique incorporating a sectional connective tissue graft with an emergence tissue provisional to stabilize the free gingival margin position during immediate implant placement in the esthetic zone. CASE PRESENTATION A 57-year-old male was referred for assessment and treatment of a failing maxillary right central incisor. Clinical examination revealed poor retentive features, recurrent caries, and exposed endodontic material rendering a poor prognosis for the remaining tooth root system. After comprehensive evaluation, as well as understanding important patient case expectations, a decision was made to remove the existing tooth and place an immediate implant with a staged-provisional approach. To maintain the free gingival mid-facial height, a sectional-connective tissue graft technique was used concurrently with a custom emergence profile provisional to stabilize the gingiva immediately post-implant placement. CONCLUSION Patients undergoing implant replacement of failing anterior maxillary teeth are at risk of esthetic complications. Marginal stability of the facial gingival is an important component of establishing and maintaining the final esthetic outcome. In cases where the initial hard or soft tissue thickness may put the patient at risk, combining soft and hard tissue augmentation with attention to emergence profile provisionalization appears to aid in the initial stability of the buccal free gingival margin. This report details the steps associated with a sectional connective tissue technique combined with emergence profile provisonalization and characterizes the gingival stability up to 2.5 years obtained with this approach.
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Affiliation(s)
- Douglas R Dixon
- Department of Periodontics, University of Washington, Seattle, WA
| | - Alaa Yassin
- Department of Periodontics, University of Washington, Seattle, WA
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Ratio between Height and Thickness of the Buccal Tissues: A Pilot Study on 32 Single Implants. Dent J (Basel) 2019; 7:dj7020040. [PMID: 30987026 PMCID: PMC6631890 DOI: 10.3390/dj7020040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Previous studies have suggested that mucosal height is related to the bone level and soft tissue thickness. The purpose of this pilot study was to investigate the ratio between the height and width of the tissues around single implants with a conical connection and platform switching. METHODS All patients receiving single implants (Anyridge®, MegaGen, Gyeongbuk, South Korea) and restored with single crowns, in a three-month period, were included in this study. After a provisionalization of 12 months, precision impressions were taken and stone casts were poured for measurements. For each implant, two values were collected at the buccal site: the mucosal height (MH), calculated from the vestibular shoulder of the implant to the upper gingival margin of the supra-implant tissue; and the mucosal thickness (MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. Mean, standard deviation (SD), and confidence intervals (CI 95%) for MH and MT, as well as their ratios, were calculated. Correlation between MH and MT was assessed by Pearson's correlation coefficient, with significance level set at 0.05. RESULTS 32 single Anyridge® implants were eligible for this evaluation. The mean MH was 3.44 mm (±1.28), the mean MT was 3.29 (±1.46). The average of the ratio between MH and MT of the supra-implant mucosa was therefore 1:1.19 (±0.55). The relation between MH and MT was statistically significant at p ≤ 0.01 (Pearson two-tailed 95% CI). CONCLUSIONS Our study found a constant relationship between width and height of the peri-implant mucosa. However, our results are different from those of Nozawa et al., who found a ratio of 1:1.5 between height and thickness of the peri-implant tissues. This may be determined by the different sample and follow-up period, as well as by the implants used in our study.
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Mazzotti C, Stefanini M, Felice P, Bentivogli V, Mounssif I, Zucchelli G. Soft-tissue dehiscence coverage at peri-implant sites. Periodontol 2000 2018; 77:256-272. [DOI: 10.1111/prd.12220] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Rokn A, Bassir SH, Rasouli Ghahroudi AA, Kharazifard MJ, Manesheof R. Long-term Stability of Soft Tissue Esthetic Outcomes Following Conventional Single Implant Treatment in the Anterior Maxilla: 10-12 Year Results. Open Dent J 2016; 10:602-609. [PMID: 27990185 PMCID: PMC5123127 DOI: 10.2174/1874210601610010602] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 07/28/2016] [Accepted: 09/26/2016] [Indexed: 11/22/2022] Open
Abstract
Purpose: The present study aimed to evaluate the long-term stability of esthetic outcomes of soft tissue around maxillary anterior single-tooth implants after 10-to-12 years of loading. Methods: Patients who had been treated for single-tooth implants in the anterior maxilla between February 2000 and July 2002 were invited to participate in the study. All implants had been placed according to delayed implant placement and conventional loading protocols without any connective tissue graft or papilla preservation flaps. Pink Esthetic Score (PES) was rated using standardized clinical photographs to assess the esthetic outcomes of the implant treatment at the time of crown placement and at time of follow-up examination which was at least 10 years after the crown placement. Results: A total of 19 patients were included. The mean score of PES was 11.63 (SD 1.61; range 7-14) at baseline. After 10-to-12 years of function, a mean PES score of 11.05 (SD 2.09; range 6–14) was recorded. No significant differences were found in the esthetic outcomes, categorized based on clinically relevant levels, between the baseline and follow-up session (p>0.05). Conclusion: Within limitation of the present study, it can be concluded that the esthetic outcomes of soft tissue around the maxillary anterior single-tooth implants placed using conventional implant placement technique remained stable in the long-term.
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Affiliation(s)
- A Rokn
- Dental Implant Research Center and Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - S H Bassir
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - A A Rasouli Ghahroudi
- Dental Implant Research Center and Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M J Kharazifard
- Dental Implant Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - R Manesheof
- Dental Implant Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Bach L, Borzabadi-Farahani A. Treatment of Labial Mucosal Recession Around Maxillary Anterior Implants With Tenting Screws, Particulate Allograft, and Xenogenic Membrane: A Case Report. J ORAL IMPLANTOL 2016; 42:427-431. [DOI: 10.1563/aaid-joi-d-16-00019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Le Bach
- Department of Oral & Maxillofacial Surgery, The Herman Ostrow School of Dentistry of USC, Los Angeles County/USC Medical Center, Los Angeles, Calif
- Private practice, Whittier, Calif
| | - Ali Borzabadi-Farahani
- Warwick Medical School, University of Warwick, Coventry, UK
- Orthodontics, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Sousa V, Mardas N, Farias B, Petrie A, Needleman I, Spratt D, Donos N. A systematic review of implant outcomes in treated periodontitis patients. Clin Oral Implants Res 2015; 27:787-844. [DOI: 10.1111/clr.12684] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Vanessa Sousa
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Centre for Adult Oral Health, Periodontology Unit; QMUL Bart's and The London School of Dentistry and Hospital; London UK
| | - Bruna Farias
- Federal University of Pernambuco; Recife-Pernambuco Brazil
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Ian Needleman
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
- International Centre for Evidence-Based Oral Health; UCL Eastman Dental Institute; London UK
| | - David Spratt
- Department of Microbial Diseases; UCL Eastman Dental Institute; London UK
| | - Nikolaos Donos
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
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Esquivel-Upshaw J, Mehler A, Clark A, Neal D, Gonzaga L, Anusavice K. Peri-implant complications for posterior endosteal implants. Clin Oral Implants Res 2014; 26:1390-6. [PMID: 25263400 DOI: 10.1111/clr.12484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES (1) To assess whether there is evidence of an association between the number of peri-implant tissue complications and patient characteristics such as gender, diabetes status, smoking status, and bite force; (2) To assess whether there is evidence of an association between the number of peri-implant tissue complications and location of the implant, surgical technique used, bone graft status and sinus lift status. MATERIALS AND METHODS This randomized, controlled clinical trial included a total of 176 implants (OsseoSpeed, DENTSPLY) in 67 participants with 88 fixed dental prostheses. Information was obtained from health histories, a baseline exam, surgical notes, and post-operative exams. The data were analyzed using Fisher's exact and Mann-Whitney tests and generalized estimating equations using logistic regression with a significance level set at 0.05. RESULTS All 176 implants survived within a recall period of 3 years, but 11 implants demonstrated peri-implant tissue complications. Ten sites showed dehiscence and one case exhibited vertical bone loss. There was a statistically significant association between surgical technique used (1-stage or 2-stage) and the presence of soft tissue complications (P = 0.005), where 2-stage surgery was associated with a higher frequency of peri-implant soft tissue complications. A correlation, although not statistically significant (P = 0.077), was noted, between peri-implant tissue complications and bone grafting, suggesting a possible role for this factor as well. CONCLUSIONS Participants who did not require any second-stage surgery at the implant sites experienced fewer complications. Therefore, additional surgical procedures should be performed judiciously considering their possible effects on peri-implant tissue health. CLINICAL SIGNIFICANCE The clinical implication of this research study is that secondary surgery should be considered with caution during implant placement and it should be performed only when other options have been exhausted, as it has been shown to have a direct adverse effect on the long-term peri-implant tissue health.
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Affiliation(s)
- Josephine Esquivel-Upshaw
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Alex Mehler
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Arthur Clark
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Dan Neal
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Luiz Gonzaga
- Department of Oral Surgery, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Kenneth Anusavice
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
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Burkhardt R, Lang NP. Fundamental principles in periodontal plastic surgery and mucosal augmentation - a narrative review. J Clin Periodontol 2014; 41 Suppl 15:S98-107. [DOI: 10.1111/jcpe.12193] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Rino Burkhardt
- The University of Hong Kong; Prince Philip Dental Hospital; Hong Kong SAR and University of Zurich; Zurich Switzerland
| | - Niklaus P. Lang
- The University of Hong Kong; Prince Philip Dental Hospital; Hong Kong SAR and University of Zurich; Zurich Switzerland
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20
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Use of prefabricated titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone. J Prosthet Dent 2014; 111:181-5. [DOI: 10.1016/j.prosdent.2013.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/19/2013] [Accepted: 07/30/2013] [Indexed: 11/20/2022]
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21
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Barbisan A, Dias CS, Bavia PF, Sapata VM, César-Neto JB, Silva CO. Soft Tissues Changes After Immediate and Delayed Single Implant Placement in Esthetic Area: A Systematic Review. J ORAL IMPLANTOL 2014; 41:612-9. [PMID: 24475930 DOI: 10.1563/aaid-joi-d-13-00095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of the present study was to conduct a systematic review of the literature to compare soft tissue aspects of immediate and delayed implant placement in esthetic areas. This review of literature was conducted in the following databases: MEDLINE (PubMed), Lilacs, Scielo, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). For those studies that met the inclusion/exclusion criteria, the results were analyzed and summarized according to the treatment protocol used for implant placement. The primary parameters taken into consideration were papilla level (PL) and marginal mucosa level (MML) around implants. Four randomized controlled trials (RCT) were selected for analysis, but all were deemed as being of poor quality according to quality assessment. No studies reported any statistically significant differences concerning the soft tissue esthetic parameters analyzed around immediate or delayed implants at any follow-up periods reported. However, PL results seemed to be more reliable than were MML results, due to the PL standardization of the method of analysis, which showed a tendency for poorer results around immediately placed implants. In conclusion, although the results are based on only a few poor quality RCTs, both treatment options for implant placement demonstrated similar outcomes in the esthetic area, especially when PL was considered.
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Affiliation(s)
- André Barbisan
- 1 Department of Dentistry, State University of Maringá, Brazil
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22
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Riabilitazioni implantoprotesiche nelle aree esteticamente rilevanti: il condizionamento dei tessuti molli. DENTAL CADMOS 2013. [DOI: 10.1016/s0011-8524(13)70051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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de Jesus Tavarez RR, Malheiros AS, Benatti BB, Tonetto MR, Bandéca MC. Preoperative gingival conditioning as a guide for implant installation and to achieve proper dentogingival contours. J Contemp Dent Pract 2013; 14:560-6. [PMID: 24172008 DOI: 10.5005/jp-journals-10024-1363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A successful esthetic outcome for implant-supported dentures depends on the careful manipulation of peri-implant tissue as well as the precise placement of the implant. In addition, careful surgical and prosthetic planning is essential for esthetically important areas, especially in partially edentulous cases. This study describes a clinical case that presented absent maxillary central incisors in which prior prosthetic planning was used to perform provisional restorations, that was used to condition the gingival tissues and guide implant installation. These procedures made it possible to achieve a dentogingival contour, interdental papillae, and an emergence profile in the edentulous area. The techniques outlined here proved to be sufficient and support the peri-implant tissues to create a more esthetic final prosthesis.
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Roccuzzo M, Gaudioso L, Bunino M, Dalmasso P. Surgical treatment of buccal soft tissue recessions around single implants: 1-year results from a prospective pilot study. Clin Oral Implants Res 2013; 25:641-6. [DOI: 10.1111/clr.12149] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Mario Roccuzzo
- Private Practice; Torino Italy
- Department of Maxillofacial Surgery; University of Torino; Torino Italy
| | | | | | - Paola Dalmasso
- Department of Public Health and Microbiology; University of Torino; Torino Italy
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25
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Man Y, Wang Y, Qu Y, Wang P, Gong P. A palatal roll envelope technique for peri-implant mucosa reconstruction: a prospective case series study. Int J Oral Maxillofac Surg 2013; 42:660-5. [PMID: 23428896 DOI: 10.1016/j.ijom.2013.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 12/10/2012] [Accepted: 01/14/2013] [Indexed: 02/05/2023]
Abstract
The aim of this study was to evaluate peri-implant soft tissue changes after performing a palatal roll envelope technique. Twelve patients, presenting a labial flat or concave profile before second-stage surgery, underwent soft tissue augmentation using the palatal roll envelope technique with papilla reservation design. The convex profile on the facial aspect, Jemt papilla index, facial mucosal level, marginal bone level, proximal bone levels of the adjacent teeth, and surgical/prosthetic complications were evaluated before surgery as the baseline, and then reevaluated at 1 week, 3 months, and 6 months after surgery. Data were analyzed using the Friedman test and Wilcoxon signed-rank test. Results indicated that the convex profile and the average papilla index score were improved, while the facial mucosal level was adjusted to a level similar to that of the contralateral tooth at 3 months and then remained stable for the follow-up visit. With the limitations identified in this report, the palatal roll envelope technique can be considered an alternative method to augment the soft tissue during second-stage surgery. This technique obviates the need for another surgical site and papillae area, and also reduces the risks of graft shrinkage and scarring on the labial site.
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Affiliation(s)
- Y Man
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
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26
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Papillae alterations around single-implant restorations in the anterior maxillae: thick versus thin mucosa. Int J Oral Sci 2013; 4:94-100. [PMID: 22627613 PMCID: PMC3412666 DOI: 10.1038/ijos.2012.25] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration. According to the inclusion criteria, 32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included. The patients were assigned to two groups according to the mucosal thickness: (i) group 1, 1.5 mm s mucosal thickness 3 mm; and (ii) group 2, 3 mm<mucosal thickness 4.5 mm.Assessments of interproximal papillae at the time of crown placement (baseline) and at 6-month post loading (follow-up) were made by two prosthodontists using papilla fill index (PFI). The mean mucosal thickness was (2.49±_0.31) mm (group 1) and (3.81±_0.31) mm(group 2) for the two groups respectively. A significant difference in PFI between the groups was detected at the baseline (P<0.001).PFI improvements over time occurred after 6-month follow-up irrespective of the groups. When compared to group 1, the likelihood to obtain papilla fill was significantly higher for group 2 with an odds ratio of 6.05 (P<0.001). The interproximal papilla level around single-implant restorations could improve significantly over time after 6-month restoration according to PFI assessment. The thicker mucosa before implant placement implied a more favorable esthetic outcome in papilla alteration.
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Valutazione multidisciplinare e trattamento delle agenesie degli incisivi laterali mascellari. Revisione della letteratura. DENTAL CADMOS 2011. [DOI: 10.1016/j.cadmos.2011.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Kim YB, Shim JS, Han CH, Kim SJ. The level of buccal gingival margin around single and two adjacent implant restorations: a preliminary result. J Adv Prosthodont 2010; 1:140-4. [PMID: 21165270 PMCID: PMC2994692 DOI: 10.4047/jap.2009.1.3.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 11/10/2009] [Accepted: 11/11/2009] [Indexed: 11/08/2022] Open
Abstract
STATEMENT OF PROBLEM Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.
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Affiliation(s)
- Young-Bum Kim
- Former Graduate Student, Department of Prosthodontics, Yonsei University Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
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Huynh-Ba G, Pjetursson BE, Sanz M, Cecchinato D, Ferrus J, Lindhe J, Lang NP. Analysis of the socket bone wall dimensions in the upper maxilla in relation to immediate implant placement. Clin Oral Implants Res 2010; 21:37-42. [PMID: 20070745 DOI: 10.1111/j.1600-0501.2009.01870.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Animal and human researches have shown that immediate implant placement into extraction sockets failed to prevent socket dimensional changes following tooth extraction. It has been suggested that a minimal width of 1-2 mm of buccal bone is necessary to maintain a stable vertical dimension of the alveolar crest. AIM To determine the dimensions of the bony wall at extraction sites in the esthetic zone (anterior teeth and premolars in the maxilla) and relate it to immediate implant placement. METHODS As part of an ongoing prospective randomized-controlled multicenter clinical study on immediate implant placement, the width of the buccal and palatal bony walls was recorded at 93 extraction sites. RESULTS The mean width of the buccal and palatal bony walls was 1 and 1.2 mm, respectively (P<0.05). For the anterior sites (canine to canine), the mean width of the buccal bony wall was 0.8 mm. For the posterior (premolar) sites, it was 1.1 mm (P<0.05). In the anterior sites, 87% of the buccal bony walls had a width < or = 1 mm and 3% of the walls were 2 mm wide. In the posterior sites, the corresponding values were 59% and 9%, respectively. CONCLUSIONS If the criterion of a minimal buccal bone width of 2 mm to maintain a stable buccal bony wall is valid, only a limited number of sites in the anterior maxilla display such a clinical situation. The data suggested that in the majority of extraction sites in the anterior maxilla, thin (< or = 1 mm) buccal walls were present. This, in turn, means that in most clinical situations encountered, augmentation procedures are needed to achieve adequate bony contours around the implant.
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Affiliation(s)
- Guy Huynh-Ba
- Department of Periodontics, University of Texas Health Science Center at San Antonio (UTHSCA), 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
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30
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Lee DH, Choi BH, Jeong SM, Xuan F, Kim HR. Effects of Flapless Implant Surgery on Soft Tissue Profiles: A Prospective Clinical Study. Clin Implant Dent Relat Res 2009; 13:324-9. [DOI: 10.1111/j.1708-8208.2009.00217.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Dimensional changes of periodontal soft tissues after intrasulcular incision. Clin Oral Investig 2009; 13:401-8. [PMID: 19172314 DOI: 10.1007/s00784-009-0251-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 01/12/2009] [Indexed: 10/21/2022]
Abstract
In maxillofacial surgery, intrasulcular incisions are often used. This prospective case series was established to evaluate the detrimental effects of intrasulcular incisions on periodontal structures. In 35 patients, measurements of probing depth and crown length before and 10 months postoperatively were performed to calculate changes of attachment level and gingival recession. In a subgroup, surgically treated sites were compared with untreated control sites. A nonparametric test was applied for longitudinal and split-mouth comparisons. Overall, intrasulcular incisions did not induce significant attachment loss. The frequency of sites losing > or = 2 mm of attachment was 5.0%, 2.6%, and 4.7% at mesial, buccal, and distal sites, respectively. Intrasulcular incisions caused only a slight increase in gingival recession by 0.4 +/- 0.5, 0.2 +/- 0.3, and 0.3 +/- 0.4 mm at mesial, buccal, and distal sites, respectively. Within the limitations of the study design, it can be concluded that intrasulcular incisions without additional vertical incisions do not impose a serious risk for attachment loss and/or gingival recession.
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32
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33
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Lai HC, Zhang ZY, Wang F, Zhuang LF, Liu X, Pu YP. Evaluation of soft-tissue alteration around implant-supported single-tooth restoration in the anterior maxilla: the pink esthetic score. Clin Oral Implants Res 2008; 19:560-4. [DOI: 10.1111/j.1600-0501.2008.01522.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Burkhardt R, Joss A, Lang NP. Soft tissue dehiscence coverage around endosseous implants: a prospective cohort study. Clin Oral Implants Res 2008; 19:451-7. [DOI: 10.1111/j.1600-0501.2007.01497.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Single-rooted teeth deemed not restorable via conventional means may be candidates for implant placement at the time of tooth extraction. Immediate implant placements are believed to preserve soft and hard tissue form and contours, reduce the need for augmentation procedures, minimize surgical exposure of the patient, reduce treatment time and improve esthetic outcomes. METHOD This retrospective review analyzed the esthetic outcomes of 42 non-adjacent single-unit implant restorations completed using an immediate implant surgical placement protocol. RESULTS The mean time in function was 18.9 months (range 6-50 months) and the majority of implants placed had a restorative platform diameter of 4.1 and 4.8 mm. A highly significant change in crown height due to marginal tissue recession of 0.9 +/- 0.78 mm (P=0.000) was recorded for all sites, with no difference seen between implant systems (P=0.837). Thin tissue biotype showed slightly greater recession than thick tissue biotype (1 +/- 0.9 vs. 0.7 +/- 0.57 mm, respectively); however, this difference was not statistically significant (P=0.187). Implants with a buccal shoulder position showed three times more recession than implants with a lingual shoulder position (1.8 +/- 0.83 vs. 0.6 +/- 0.55 mm, respectively) with the difference being highly statistically significant (P=0.000). CONCLUSIONS Immediate implant placement requires very careful case selection and high surgical skill levels if esthetic outcomes are to be achieved. Long-term prospective studies on tissue stability and esthetic outcomes are needed.
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37
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Ishikawa-Nagai S, Da Silva JD, Weber HP, Park SE. Optical phenomenon of peri-implant soft tissue. Part II. preferred implant neck color to improve soft tissue esthetics. Clin Oral Implants Res 2007; 18:575-80. [PMID: 17655714 DOI: 10.1111/j.1600-0501.2007.01390.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate an optical solution to eliminate the undesirable shine-through effect of implants on peri-implant mucosa by selecting an optimized implant neck color based on an objective and quantifiable method. MATERIAL AND METHODS The optical effect of color strips on 15 peri-implant mucosal sites of 14 patients with Straumann single-tooth implant replacements in the maxillary anterior region was analyzed. The color differences between the peri-implant mucosa with insertion of each of eight different color strips (white, black, light pink, pink, light orange, orange, gold, violet) and the gingiva of an adjacent or contralateral tooth without any color strips were compared for the selection of optimal color of implant neck. Spectrophotometric color measurements were performed to compare the color difference index (DeltaE) and color coordinates (DeltaL*, Deltaa*, Deltab* and DeltaC*). RESULTS The colors of the peri-implant mucosa with color strips and the gingiva of natural tooth demonstrated that the test site soft tissue with color strips of light pink, pink, light orange and orange showed a significantly smaller DeltaE value (P<0.05). Moreover, light pink exhibited the lowest mean DeltaE value of 2.6+/-0.6, indicating a clinically indistinguishable color difference. CONCLUSIONS The results suggest that it is possible to improve gingival esthetics by coloring the implant neck, most effectively with light pink, to mask the impact of the underlying titanium implant. The use of implants with optimized neck colors to correct an esthetic deficiency may be a feasible approach to establish improved peri-implant soft tissue esthetics.
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Affiliation(s)
- S Ishikawa-Nagai
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA.
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38
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El Askary AES. Treatment Complications in the Esthetic Zone. FUNDAMENTALS OF ESTHETIC IMPLANT DENTISTRY 2007:301-327. [DOI: 10.1002/9780470376423.ch12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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39
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Rompen E, Raepsaet N, Domken O, Touati B, Van Dooren E. Soft tissue stability at the facial aspect of gingivally converging abutments in the esthetic zone: A pilot clinical study. J Prosthet Dent 2007; 97:S119-25. [PMID: 17618926 DOI: 10.1016/s0022-3913(07)60015-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
STATEMENT OF PROBLEM The literature indicates that 0.5 to 1.5 mm of gingival recession most often occurs within the first months after implant placement or abutment connection. PURPOSE The purpose of this pilot study was to evaluate the effect of a concave transmucosal profile on the vertical stability of soft tissues at the facial aspect of dental implants. MATERIAL AND METHODS Fifty-four implants were placed in esthetically demanding sites in 41 patients (17 women, 24 men; age range of 23 to 62 years, mean 40.3 years; 5 smokers), primarily following a 1-stage approach. Twenty-five implants were placed immediately after extraction. Experimental concave titanium (n=49) and zirconia abutments (n=5) were used, and a provisional crown was placed at the same session. Digital photographs were made perpendicularly to the facial aspect of the teeth at abutment placement, and at 1, 3, 6, 12, 18, and 24 months, and enlarged views were subsequently analyzed by an independent examiner. Vertical changes in soft tissue levels were measured, and the definitive esthetic result was evaluated subjectively (poor to excellent). Data were analyzed with descriptive statistics. RESULTS Twenty-four implants were evaluated at 24 months, 20 at 18 months, and 8 at 12 months. Vertical augmentation or no recession in soft tissue was observed in 87% of the situations, and in no situation was recession greater than 0.5 mm found. The gingival level remained stable at 12, 18, and 24 months. The average esthetic outcome was rated as 4.5 (very good to excellent) on a 0- to 5-point scale. CONCLUSIONS The concave, gingivally converging abutments used in the study allowed for above-average soft tissue outcomes.
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Affiliation(s)
- Eric Rompen
- Department of Periodontology, University of Liege, Liege, Belgium.
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40
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Sammartino G, Marenzi G, di Lauro AE, Paolantoni G. Aesthetics in Oral Implantology: Biological, Clinical, Surgical, and Prosthetic Aspects. IMPLANT DENT 2007; 16:54-65. [PMID: 17356372 DOI: 10.1097/id.0b013e3180327821] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to identify a correct clinical, surgical, and prosthetic management of endosseous implants replacing missing teeth in the anterior maxilla, achieving predictable aesthetic outcomes. Placement of immediate post-extraction implants without incisions or flap elevation is one of the surgical treatment options able to improve the healing and regenerative potentials of the fresh socket. MATERIALS Fifty-five patients (33 men, 22 women), ranging in age from 19 to 57 years (mean 29), were selected for this study. All the patients were not smokers, no bruxers, presented stable soft tissue conditions, an acceptable occlusion, and the absence of pathologies that would contraindicate bone healing. Patients were treated with implants made by 2 manufacturers: Institute Straumann, Walderburg, Switzerland and Friadent, Mannheim, Germany. A total of 87 implants were placed immediately after each failing tooth had been removed. The temporary restoration was placed 3 months after implant placement, and the final restoration was placed 4 months from the surgical procedure. The patients were evaluated clinically and radiographically at implant placement, and 2, 4, 18, and 24 months post-insertion. RESULTS At 24 months, only 3 implants were lost (2 in male patients;1 in female patient). All of these failed implants did not achieve osseointegration. The overall success rate was 96.6%, with an implant failure rate of 3.4%, all prior to restoration. CONCLUSIONS The immediate placement in the anterior maxilla fresh extraction sockets without incisions or flaps elevation is a surgical option that can ensure ideal peri-implant tissues healing, preserving the presurgical gingival and bone aspects. For a predictable aesthetic result, the most important aspect seems to be the height and thickness of the buccal bone wall, which remain after immediate placement of the fixture.
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Affiliation(s)
- Gilberto Sammartino
- University of Naples Federico II, Faculty of Medicine, Department of Odontostomatologic and Maxillo-Facial Science, Naples, Italy.
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41
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Myshin HL, Wiens JP. Factors affecting soft tissue around dental implants: a review of the literature. J Prosthet Dent 2006; 94:440-4. [PMID: 16275304 DOI: 10.1016/j.prosdent.2005.08.021] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Much of the focus in the early dental implant literature is on the bone-to-titanium interface because a successful osseointegrated implant requires direct bone contact to the implant surface. The research on soft tissue around dental implants has focused on the partially edentulous patient and, in particular, on the maxillary anterior dentition. Few studies have evaluated soft tissue around dental implants in completely edentulous patients over time. This paper reviews the pertinent literature on soft-tissue healing in both partially and completely edentulous dental implant patients from a Medline search of the English peer-reviewed literature from 1980 to 2004.
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42
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Meijndert L, Meijer HJA, Raghoebar GM, Vissink A. A Technique for Standardized Evaluation of Soft and Hard Peri-Implant Tissues in Partially Edentulous Patients. J Periodontol 2004; 75:646-51. [PMID: 15212345 DOI: 10.1902/jop.2004.75.5.646] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a growing need to evaluate the esthetics of implant-supported crowns and bridges. An important tool for such an evaluation is standardized assessment of the soft and hard peri-implant tissue levels. METHODS A simple acrylic device has been developed for reliable and reproducible assessment of soft and hard peri-implant tissues using standardized color slides and standardized dental x-rays. With this device, changes in both the soft and hard tissues around implant-supported crowns can be evaluated as a function of time. The reproducibility of the technique was tested on color slides as well as on dental x-rays in a series of implant-supported crowns and their neighboring teeth. RESULTS The reproducibility of this technique was excellent. The measuring errors for repeated measurements of the soft and hard tissues were 0.14 +/- 0.02 mm and 0.13 +/- 0.01 mm, respectively. CONCLUSIONS The device is a reliable tool to assess changes in both soft and hard tissues around crowns and implants over time. Likewise, it is suggested that this technique also can be used to objectively assess soft and hard tissue changes around natural teeth with or without prosthetic restorations.
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MESH Headings
- Acrylic Resins
- Alveolar Process/diagnostic imaging
- Alveolar Process/pathology
- Crowns
- Dental Implants
- Dental Prosthesis, Implant-Supported
- Equipment Design
- Esthetics, Dental
- Humans
- Jaw, Edentulous, Partially/diagnostic imaging
- Jaw, Edentulous, Partially/pathology
- Patient Care Planning
- Periodontium/diagnostic imaging
- Periodontium/pathology
- Photography, Dental/instrumentation
- Photography, Dental/standards
- Radiography, Dental/instrumentation
- Radiography, Dental/standards
- Reproducibility of Results
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Affiliation(s)
- Leo Meijndert
- Department of Oral and Maxillofacial Surgery, Groningen University Hospital, Groningen, The Netherlands.
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