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ElNahass H, Tawfik OK, Naiem SN, Zazou N, Moussa M. Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18-month follow-up prospective cohort study. Clin Implant Dent Relat Res 2024; 26:532-544. [PMID: 38380779 DOI: 10.1111/cid.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption. MATERIALS The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score. RESULTS Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results. CONCLUSION Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long-term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes. https://classic. CLINICALTRIALS gov/ct2/results?cond=&term=NCT04731545&cntry=EG&state=&city=&dist=.
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Affiliation(s)
- Hani ElNahass
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Universitätsmedizin Mainz, Mainz, Germany
| | - Omnia K Tawfik
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Suzy N Naiem
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nada Zazou
- Faculty of Dentistry, MSA University, Cairo, Egypt
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Manasa B, Baiju KV, Ambili R. Efficacy of injectable platelet-rich fibrin (i-PRF) for gingival phenotype modification: a split-mouth randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04943-1. [PMID: 36920546 DOI: 10.1007/s00784-023-04943-1] [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: 01/06/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES Gingival phenotype is decisive in periodontal health, aesthetics, and function and is a predictor of treatment outcomes. Injectable platelet-rich fibrin is a recently proposed method of gingival augmentation due to its enhanced regenerative potential. The objective of the present study was to evaluate the efficacy of injectable platelet-rich fibrin for gingival phenotype modification. MATERIALS AND METHODS In this split-mouth study, 30 healthy volunteers with thin gingival biotypes in either maxillary or mandibular incisors were included. iPRF was prepared using 64 g relative centrifugal force for 3 min. i-PRF was injected into the attached gingiva using a 27-gauge disposable needle in relation to the test sites (n = 360), and contralateral sites were kept as control. Re-evaluation was done at the end of 3 and 6 months. Post-operative complications and patient-reported experience measures were also recorded. Statistical analysis was done using paired t-test and analysis of covariance. RESULTS Statistically significant increase in gingival thickness was found in the test group at the individual site and tooth level. An overall increase in gingival thickness of 26.56% after 3 months and 29% after 6 months compared to baseline was noticed in the test group. No significant difference was found in the width of keratinized gingiva in any of the comparisons. CONCLUSION The non-surgical application of i-PRF is promising for enhancing gingival thickness. Future well-controlled studies with long-term follow-up in different patient populations can provide more evidence. CLINICAL RELEVANCE Gingival phenotype modification is a useful therapy to prevent the occurrence of gingival recession in patients with thin phenotypes. TRIAL REGISTRATION Clinical Trial Registration Number: CTRI/2021/04/032650.
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Affiliation(s)
- Budhan Manasa
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - K V Baiju
- Department of Statistics, Government College for Women, Trivandrum, Kerala, India
| | - R Ambili
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India.
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Mancini L, Barootchi S, Thoma DS, Jung RE, Gallucci GO, Wang HL, Tavelli L. The peri-implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance. Clin Implant Dent Relat Res 2023; 25:224-240. [PMID: 36646440 DOI: 10.1111/cid.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Peri-implant mucosa color (PMC) seems to be one of the main parameters affecting the esthetic outcome of implant therapy. However, more emphasis should be given to its assessment and reporting. PURPOSE To describe the available evidence on methods to assess and report the color of the peri-implant mucosa (PMC) and the respective clinical relevance. MATERIAL AND METHODS A comprehensive electronic and manual search was performed to identify clinical studies reporting on PMC. RESULTS A total of 121 studies were included. PMC was evaluated at the time of the follow-up visit (chairside) in 45.5% studies. PMC assessment was performed qualitatively, by comparing PMC with adjacent and/or contralateral gingiva (78.6%) or quantitatively, using spectrophotometry (20.7%) or a software on clinical photographs (0.8%). The most performed method to assess PMC was through esthetic indices (76.9%), either at the time of the follow-up visit (chairside) or at later time point using photographs. Quantitative reporting of PMC included averages of points from esthetic indices or color differences to natural gingiva expressed with the CIELAB color system. PMC assessment allowed describing color discrepancies compared to natural gingiva, evaluating color changes over time, and comparing the outcomes of different treatment modalities. PMC assessment through spectrophotometry was additionally utilized to assess the role of mucosal thickness (MT) on PMC. CONCLUSIONS Various methods for PMC assessment and reporting were described, including visual assessment, mainly through esthetic indices, and spectrophotometry. PMC evaluation has allowed to demonstrate the factors affecting the color of the peri-implant soft tissue, such as the type of abutment/restoration, MT, and soft tissue augmentation.
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Affiliation(s)
- Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Science, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Bienz SP, Pirc M, Papageorgiou SN, Jung RE, Thoma DS. The influence of thin as compared to thick peri-implant soft tissues on aesthetic outcomes: A systematic review and meta-analysis. Clin Oral Implants Res 2022; 33 Suppl 23:56-71. [PMID: 35763024 PMCID: PMC9543651 DOI: 10.1111/clr.13789] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 01/10/2023]
Abstract
Objectives In systematically healthy patients with an implant‐supported fixed restoration (P), what is the influence of thin (E) as compared to thick (C) peri‐implant soft tissues on aesthetic outcomes (O)? Methods Following an a priori protocol, a literature search of six databases was conducted up to August 2020 to identify prospective/retrospective clinical studies on healthy patients with an implant‐supported fixed reconstruction. Measurement of the buccal soft tissue thickness and an aesthetic outcome was a prerequisite, and sites presenting with a buccal soft tissue thickness of <2 mm or shimmering of a periodontal probe were categorized as a thin phenotype. After study selection, data extraction, and risk of bias assessment, random‐effects meta‐analysis of Mean Differences (MD) or Odds Ratios (OR) with their corresponding 95% Confidence Intervals (CI) were conducted, followed by sensitivity analyses and assessment of the quality of evidence. Results Thirty‐four unique studies reporting on 1508 patients with 1606 sites were included (9 randomized controlled trials, one controlled trial, 10 prospective cohort studies, 8 cross‐sectional studies, and 6 retrospective cohort studies). The mean difference of the pink aesthetic score (PES) after the follow‐up was not significantly different between thin (<2.0 mm) or thick soft tissues (≥2.0 mm) or phenotypes (12 studies; MD = 0.15; [95% CI = −0.24, 0.53]; p = .46). PES changes during the follow‐up, however, were significantly in favour of thick soft tissues (≥2.0 mm) or phenotypes (p = .05). An increased mean mucosal thickness was associated with an increased papilla index (5 studies; MD = 0.5; [95% CI = 0.1, 0.3]; p = .002) and an increase in papilla presence (5 studies; OR = 1.6; [95% CI = 1.0, 2.3]; p = .03). Thin soft tissues were associated with more recession, −0.62 mm (4 studies; [95% CI = −1.06, −0.18]; p = .006). Patient‐reported outcome measures (patient satisfaction) were in favour of thick soft tissues −2.33 (6 studies; [95% CI = −4.70, 0.04]; p = .05). However, the quality of evidence was very low in all instances due to the inclusion of non‐randomized studies, high risk of bias and residual confounding. Conclusion Within the limitations of the present study (weak study designs and various soft tissue measurements or time‐points), it can be concluded that increased soft tissue thickness at implant sites was associated with more favourable aesthetic outcomes.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Miha Pirc
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
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Aldhohrah T, Qin G, Liang D, Song W, Ge L, Mashrah MA, Wang L. Does simultaneous soft tissue augmentation around immediate or delayed dental implant placement using sub-epithelial connective tissue graft provide better outcomes compared to other treatment options? A systematic review and meta-analysis. PLoS One 2022; 17:e0261513. [PMID: 35143503 PMCID: PMC8830641 DOI: 10.1371/journal.pone.0261513] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 12/03/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The clinical benefits of simultaneous implant placement and soft tissue augmentation using different treatment modalities are unclear. The current meta-analysis aimed to compare the effect of simultaneous soft tissue augmentation using subepithelial connective tissue graft (SCTG) around immediate or delayed dental implant placement with other treatment modalities on the peri-implant tissue health and esthetic. METHODS Up to May 2021, four databases (PubMed, EMBASE, Cochrane Central, and Google Scholar) were searched. Randomized control trials with follow-up >3 months, evaluating simultaneous implant placement (immediate or delayed) and soft tissue augmentation using SCTG compared with other treatment modalities were included. The predictor variables were SCTG versus no augmentation with/without guided bone regeneration (GBR) or other augmentation techniques (Acellular dermal matrix (ADM), Xenogeneic collagen matrix (XCM). The outcome variables were buccal tissue thickness (BTT), mid-buccal gingival level (MGL), marginal bone loss (MBL), and pink esthetic scores (PES). Cumulative mean differences (MD) and 95% confidence interval (CI) were estimated. RESULTS Twelve studies were included. SCTG along with immediate implant placement (IIP) or delayed implant placement (DIP) showed a statistically significant improvement in BTT (Fixed; MD, 0.74; 95% CI, 0.51; 0.97), MGL (Fixed; MD, 0.5; 95% CI, 0.21; 0.80), PES (Fixed; MD, 0.79; 95% CI, 0.29; 1.29), and less MBL (Fixed; MD, -0.11; 95% CI, -0.14; -0.08) compared to no graft (P<0.05). A statistically insignificant differences in BTT (Random; MD, 0.62; 95% CI, -0.41; 1.65), MGL (Fixed; MD, -0.06; 95% CI, -0.23; 0.11), MBL (Fixed; MD, 0.36; 95% CI, -0.05; 0.77) and PES (Fixed; MD, 0.28; 95% CI, -0.10; 0.67) was observed when SCTG along with DIP was compared with no augmentation plus GBR. Similarly, no statistically significant difference was observed when comparing SCTG along with DIP with acellular dermal matrix (ADM) concerning BTT (MD:0.71, P = 0.18) and KMW (MD: 0.6, P = 0.19). CONCLUSION There is a very low quality of evidence to provide recommendations on whether simultaneous dental implant placement (IIP or DIP) and soft tissue augmentation using SCTG is superior to no augmentation or is comparable to the other tissue augmentation materials in improving the quality and quantity of peri-implant tissues. Therefore, further, well-designed RCTs with larger sample sizes and long follow-up times are still needed.
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Affiliation(s)
- Taghrid Aldhohrah
- Department of dental implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Ge Qin
- Department of dental implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Dongliang Liang
- Department of dental implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Wanxing Song
- Department of dental implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Linhu Ge
- Department of dental implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Mubarak Ahmed Mashrah
- Department of dental implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
- * E-mail: (MAM); (LW)
| | - Liping Wang
- Department of dental implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
- * E-mail: (MAM); (LW)
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Lv XL, Qian SJ, Qiao SC, Gu YX, Lai HC, Shi JY. Clinical, radiographic, and immunological evaluation of angulated screw-retained and cemented single-implant crowns in the esthetic region: A 1-year randomized controlled clinical trial. Clin Implant Dent Relat Res 2021; 23:692-702. [PMID: 34390601 DOI: 10.1111/cid.13035] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 05/08/2021] [Accepted: 07/19/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Screw-retained implant crowns are considered more biologically compatible than cemented crowns due to the absence of excess cement. However, traditional screw-retained implant crowns are not viable when the access hole of the screw channel would need to be located in an esthetic area, which would compromise the esthetic outcome of the treatment. PURPOSE To evaluate the clinical, radiographic, and immunological outcomes of angulated screw-retained and cemented single-implant crowns in the esthetic region. MATERIALS AND METHODS The study was a single-center, open-label, randomized controlled clinical trial. Eligible patients were randomly placed in two groups: angulated screw-retained group (AG) and cemented group (CG). Implant survival rate, bleeding on probing rate (BOP%), probing depth (PD), modified plaque index (mPI), marginal bone loss (MBL), concentrations of pro-inflammatory cytokines (TNF-α, IL-6) in peri-implant crevicular fluid (PICF), mechanical complications, and pink esthetic score/white esthetic score (PES/WES) were evaluated. RESULTS Fifty-six patients (AG: 29, CG: 27) attended the 1-year examination. The drop-out rate was 6.67%. No implant failure was found in both groups during the observation period. BOP% was significantly lower in the AG than that in the CG (mean, 21.84% ± 19.97% vs. 37.04% ± 26.28%, p = 0.018). The concentration of TNF-α in PICF was significantly higher in the AG than that in the CG (median, 13.54 vs. 4.62, p = 0.019). No significant difference of PD, mPI, MBL, IL-6, or mechanical complication rates was found between the two groups. Mean scores for PES/WES were 21.71 and 21.64 in the AG and CG, respectively. CONCLUSION Based on the present results, both treatment options showed acceptable clinical outcomes in the short term. Angulated screw-retained crowns might benefit the peri-implant soft tissue. However, studies with long-term follow-up are needed to confirm whether the higher concentration of TNF-α will compromise the long-term outcomes of treatment.
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Affiliation(s)
- Xiao-Lei Lv
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shu-Jiao Qian
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ying-Xin Gu
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Dini C, Borges GA, Costa RC, Magno MB, Maia LC, Barão VAR. Peri-implant and esthetic outcomes of cemented and screw-retained crowns using zirconia abutments in single implant-supported restorations-A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32:1143-1158. [PMID: 34352144 DOI: 10.1111/clr.13824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/23/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the peri-implant tissue changes and esthetic outcomes of cemented and screw-retained crowns of single-tooth implants in the esthetic zone using zirconia abutments. MATERIAL AND METHODS An electronic search was performed on nine databases. The risk-of-bias was assessed by the revised Cochrane risk-of-bias tool for randomized (RoB 2) and non-randomized (ROBINS-I) clinical trials. Marginal bone level change, soft tissue thickness, bleeding on probing, probing depth, survival rates of implants and crowns, complications, plaque and papilla indexes, and pink esthetic score data were extracted and analyzed. The certainty of evidence was accessed through the GRADE approach. RESULTS Nine records were included and 7 were used in the meta-analyses. Screw-retained crowns presented greater marginal bone level change (MD -0.04 [-0.08, -0.00] p = 0.04, I2 = 0%) compared to cemented crowns up to 1-year. At 3 and 4 years no significant differences (p > 0.05) were observed. Soft tissue thickness did not differ between groups (p > 0.05). The bleeding on probing was higher in cemented group than in screw-retained crowns at 1-year (MD 0.17 [0.08, 0.27] p = 0.0005, I2 = 0%), at medium-term periods (3 and 4 years) no statistically significant differences (p > 0.05) were observed for this outcome. Probing depth, survival rates of implants and crowns, complications, and plaque index, as well as esthetic analysis using the papilla index and pink esthetic score did not differ statistically (p > 0.05) between both retention systems at short and medium-term periods. CONCLUSION The connection system considering zirconia abutments presented no influence on peri-implant parameters and esthetics evaluation for medium-term periods (3 and 4 years).
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Affiliation(s)
- Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Guilherme Almeida Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rua Rodolpho Paulo Rocco - Cidade Universitária, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rua Rodolpho Paulo Rocco - Cidade Universitária, Rio de Janeiro, Brazil
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
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Esthetic Outcome and Oral Health-Related Quality of Life after Restoration with Single Anterior Maxillary Implants. BALKAN JOURNAL OF DENTAL MEDICINE 2021. [DOI: 10.2478/bjdm-2021-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Background/Aim: To evaluate the esthetic outcome of single implant restorations and the correlation of these esthetic results between patient satisfaction and oral health-related quality of life (OHRQoL).
Material and Methods: 15 patients with single-tooth implants in the anterior maxilla region were included in this study. Patients were clinically followed to evaluate the esthetic outcomes of implant prostheses and photographs of the implant site were obtained using a digital camera. A researcher evaluated the photographs according to the pink esthetic score/white esthetic score (PES/WES) index. Patients were asked to complete a questionnaire including 13 questions to evaluate their satisfaction with the overall implant and restoration treatments using by visual analogue scale (VAS). OHRQoL was evaluated by patients with the questionnaire Oral Health Impact Profile-14 (OHIP-14).
Results: The mean PES/WES was 13.6. In Ohip-14 questionnaire, the questions were answered ‘never’ generally. The mean VAS score was 9.01±0.9 and ranged from 7.6 to 9.7. There was no correlation between VAS and PES/WES (p= 0.484), similarly, there was no correlation between OHIP-14 and PES/WES (p= 0.763).
Conclusions: All of the implant restorations’ PES/WES scores were clinically acceptable. Professionals evaluated the esthetic outcome more suspicious than patients. Patients were satisfied with the esthetic results.
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Ghahroudi AAR, Rokn AR, Shamshiri AR, Samiei N. Does timing of implant placement affect esthetic results in single-tooth implants? A cohort evaluation based on mPES. J ESTHET RESTOR DENT 2020; 32:715-725. [PMID: 32860471 DOI: 10.1111/jerd.12631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study sought to use the mPES to assess various maxillary implant surgical results and placement timing in the esthetic zone. MATERIALS AND METHODS This cohort study was conducted on 146 patients undergoing immediate, early, and late implantation. They received maxillary single-tooth implants in the anterior region during the past 5 years. Patients were clinically examined to determine their mPES and patient-/implant-related parameters. Simple and multiple nominal regression analyses were applied to show how such parameters correlated with mPES. RESULTS The results were found to be in three categories namely the most clinically excellent, acceptable, and unacceptable. Although the most frequent clinically excellent results were noted in the late implantation (late 49.0%, early 25.6%, immediate 24.1%); early implantation was the group with the least frequent clinically unacceptable results (late 16.3%, early 4.7%, immediate 14.8%). The mean width of keratinized tissue was significantly more in patients with clinically excellent results (P-value = 0.01). CONCLUSION Within the limitations of this study, the author(s) drew the following conclusions: (a) the late implant placement was more likely to be reliable and esthetically acceptable, (b) early implant placement remained the safest method to prevent unaesthetic appearance, and (c) Width of keratinized gingiva (≥3 mm) was a significant factor to achieve implant esthetic results. CLINICAL SIGNIFICANCE Maxillary single-tooth implants in the anterior region often have optimal osseointegration and functional performance, but esthetic plays a significant role in the success of these implants. So the aim of the present study was to employ mPES to assess the effect of placement timing and other patient and implant-related variables on esthetic outcomes.
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Affiliation(s)
- Amir A R Ghahroudi
- Department of Periodontics, Tehran University of Medical Sciences, Tehran, Iran.,Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir R Rokn
- Department of Periodontics, Tehran University of Medical Sciences, Tehran, Iran.,Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad R Shamshiri
- Department of Community Oral Health, Tehran University of Medical Sciences, Tehran, Iran.,Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Samiei
- Department of Periodontics, Tehran University of Medical Sciences, Tehran, Iran
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Li Y, Qiao SC, Gu YX, Zhang XM, Shi JY, Lai HC. A novel semiautomatic segmentation protocol to evaluate guided bone regeneration outcomes: A pilot randomized, controlled clinical trial. Clin Oral Implants Res 2019; 30:344-352. [PMID: 30854705 DOI: 10.1111/clr.13420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/28/2019] [Accepted: 03/05/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The aims of this study were to (a) present a novel morphological contour interpolation (MCI) algorithm based method to evaluate grafted bone alterations following guided bone regeneration (GBR), (b) compare clinical and radiological outcomes of GBR with two different collagen membranes. MATERIALS AND METHODS The data were retrieved from an ongoing randomized controlled trial. Patients were randomly allocated into two groups: (a) control group (CG): Bio-Gide (b) test group (TG): bovine dermis-derived collagen membrane. Cone beam computed tomography examinations were performed 1 week (T0) and 6 months after surgery (T1). PES/WES at T1, grafted bone volume and density changes from T0 to T1 were recorded. RESULTS Thirty-six patients (16/20 in test/control group, respectively) were enrolled in the present study. Excellent inter-observer reliability (ICC ≥ 0.97) was revealed for repeated measurements using this method. Significant volumetric reduction of grafted bone were found in both groups (test group: from 0.60 to 0.39 cm3 , p < 0.01; control group: from 0.54 to 0.31 cm3 , p < 0.01). Mean bone density (gray-scale values) significantly increased from 305.12 to 456.69 in CG (p < 0.01). In TG, it slightly increased from 304.75 to 393.27 (p = 0.25). The mean PES/WES values were 13.84 (6.62/7.22) and 13.90 (6.70/7.20) for TG and CG, respectively. As for inter-group comparison, no significant differences of grafted bone volume change, density change and PES/WES were found between two groups. CONCLUSION Within the limitations of this study, the novel MCI-based method is a reproducible tool to segment and visualize changes of grafted bone in 3D. Furthermore, both collagen membranes could be used as a barrier membrane for GBR in humans.
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Affiliation(s)
- Yuan Li
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ying-Xin Gu
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xiao-Meng Zhang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
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Altay MA, Sindel A, Tezerişener HA, Yıldırımyan N, Özarslan MM. Esthetic evaluation of implant-supported single crowns: a comparison of objective and patient-reported outcomes. Int J Implant Dent 2019; 5:2. [PMID: 30613918 PMCID: PMC6321832 DOI: 10.1186/s40729-018-0153-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/09/2018] [Indexed: 11/27/2022] Open
Abstract
Background This study investigated objective and patient-reported esthetic outcomes and their correlation for single-tooth implant restorations in the maxillary anterior region. Methods Nineteen patients were included. Gingival biotypes and smile lines were evaluated. Esthetic evaluation was performed according to the pink and white esthetic scores (PES and WES). Patients rated their satisfaction regarding the implant treatment using a subjective outcome questionnaire and a 10-cm visual analogue scale (VAS). Results The mean PES and WES were 10.7 (range 5–13, SD ± 2.24) and 8.6 (range 8–10, SD ± 0.60), respectively. The overall mean VAS was 8.54 ± 0.36 (range 3.8–9.8). No significant correlation was found between VAS and PES or WES (p = 0.475, p = 0.984, respectively). PES and WES scores for gingival biotypes failed to show any statistically significant difference (p = 0.701, p = 0.831). There was a significant negative correlation between the smile line and VAS; indicating that patients with lower smile lines expressed higher patient satisfaction (p = .001). Conclusions Professionally reported esthetic outcomes (PES and WES results) may not correlate with patient-reported outcomes. Smile line is a significant factor in patient satisfaction, which should be evaluated thoroughly prior to implant placement in the anterior maxilla.
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Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey.
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
| | - Hüseyin Alican Tezerişener
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
| | - Nelli Yıldırımyan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
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13
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Peri-implant conditions and marginal bone loss around cemented and screw-retained single implant crowns in posterior regions: A retrospective cohort study with up to 4 years follow-up. PLoS One 2018; 13:e0191717. [PMID: 29401469 PMCID: PMC5798777 DOI: 10.1371/journal.pone.0191717] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 12/23/2017] [Indexed: 12/05/2022] Open
Abstract
The aim of the present study was to identify the peri-implant conditions (bleeding on probing (BOP), pocket probing depth (PPD), modified plaque index (mPI)) and marginal bone loss (MBL, marginal bone level change between follow-up and occlusal loading) around cemented and screw-retained posterior single crowns on tissue-level implants. The study was a retrospective cohort study with up to 4 years (mean 2.5 years) follow-up. Patients with either cemented or screw-retained crowns in posterior regions were included. Implant survival, technical complications, BOP, PPD, mPI, MBL, biologic complications (peri-implant mocositis and peri-implantitis) were evaluated. Mann-Whitney U test was used to test the difference between the screw-retained group (SG) and cemented group (CG). 176 patients (SG: 94, CG: 82) were included. The implant survival rates were 100% in SG and 98.8% in CG. Prosthetic screw loosening was found in 8 restorations (8.7%) at follow-up visit. Peri-implant mucositis rate was significantly higher in the SG group (42.1%) than that in the CG group (32.2%) (P = 0.04). Six patients (6.38%) in the screw-retained group and 5 patients (6.10%) in the cemented group were diagnosed with peri-implantitis, the difference did not reach statistical significance (P>0.05). No significant difference of PPD, mPI and MBL were found between two groups (P = 0.11, 0.13 and 0.08, respectively). High implant survival rates were achieved in both groups. Cemented single crowns on tissue-level implants showed comparable peri-implant conditions in comparison with two-piece screw-retained crowns. Well-designed prospective cohort or randomized controlled clinical trials with longer follow-up are needed to confirm the result.
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Abstract
PURPOSE To assess the impact of implant system on color harmonization of periimplant mucosa. MATERIALS AND METHODS In this case series, color of periimplant mucosa was compared with color of natural tooth gingiva. Seventeen intercanine implants were analyzed (11 bone level [BL], 6 tissue level [TL] implants). Colorimetric data, at 2, 4, and 6 mm from gingival margin, were collected through fiber optics reflectance spectroscopy, and color differences calculated as ΔE. Dentists, dental students, and lay people, in blind, performed an additional visual color analysis on clinical images. RESULTS Independently from implant system, the color of periimplant mucosa was significantly different from gingiva (ΔE = 8.2 ± 0.7), resulting darker at L* comparison (P ≤ 0.05). TL periimplant mucosa showed higher ΔE than BL (9.0 ± 1.0 vs 6.6 ± 0.8, respectively; P ≤ 0.05). Observers correctly identified where the implant was placed in about half of the cases, with no significant difference between implant systems. CONCLUSION Within the limitations of this study, the color of periimplant soft tissues appears different from gingiva, at spectroscopic analysis. Color discrepancy results higher in the presence of TL implants than in BL implants, although the difference may not be clinically significant.
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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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Angkaew C, Serichetaphongse P, Krisdapong S, Dart MM, Pimkhaokham A. Oral health-related quality of life and esthetic outcome in single anterior maxillary implants. Clin Oral Implants Res 2016; 28:1089-1096. [DOI: 10.1111/clr.12922] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Chayanuch Angkaew
- Esthetic Restorative and Implant Dentistry Program; Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | - Pravej Serichetaphongse
- Department of Prosthodontics; Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | - Sudaduang Krisdapong
- Department of Community Dentistry; Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | - Michel M. Dart
- Department of Periodontology and Implant Dentistry; College of Dentistry New York University; New York NY USA
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
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17
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Long-term outcomes of the use of allogeneic, radiation-sterilised bone blocks in reconstruction of the atrophied alveolar ridge in the maxilla and mandible. Cell Tissue Bank 2015; 16:631-8. [PMID: 26162810 PMCID: PMC4659845 DOI: 10.1007/s10561-015-9512-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 05/29/2015] [Indexed: 11/16/2022]
Abstract
Increasingly dental surgeons face the challenge of reconstruction of the height and/or thickness of the alveolar ridge as more and more patients wish to have permanent restoration of their dental defects based on intraosseous implants. Evaluation of human allogeneic bone tissue grafts in reconstruction of atrophied alveolar ridge as a pre-implantation procedure. The material comprised 21 patients aged 19–63, treated between 2009 and 2012 by the same surgeon. Restoration of bone tissue defects was performed with allogeneic, frozen, radiation-sterilised, corticocancellous blocks. The study included 26 grafting procedures with 7 procedures consisting in reconstruction of the alveolar ridge in the mandible and 19 in the maxilla. In all the cases the atrophied alveolar ridge was successfully reconstructed, which allowed placement of intraosseous implants in compliance with the initial treatment plan. After the treatment was completed the patients reported for follow-up annually. The average time of follow-up amounted to 39 months (28–50 months). None of the implants was lost during the follow-up period. There was one case of gingival recession causing aesthetics deterioration of the prosthetic restoration. In three cases the connector became unscrewed partially, which was corrected at the same visit. Frozen, radiation-sterilised, allogeneic bone blocks constitute good and durable bone-replacement material allowing effective and long-lasting reconstruction of the atrophied alveolar ridge to support durable, implant-based, prosthetic restoration.
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Zhao X, Qiao SC, Shi JY, Uemura N, Arai K, Lai HC. Evaluation of the clinical and aesthetic outcomes of Straumann®Standard Plus implants supported single crowns placed in non-augmented healed sites in the anterior maxilla: a 5-8 years retrospective study. Clin Oral Implants Res 2014; 27:106-12. [PMID: 25534135 DOI: 10.1111/clr.12540] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Xu Zhao
- Department of Oral and Maxillo-facial Implantology; Shanghai 9th People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology; Shanghai 9th People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology; Shanghai 9th People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Naoya Uemura
- Department of Oral Implantology; Osaka Dental University; Osaka Japan
| | - Korenori Arai
- Department of Oral Implantology; Osaka Dental University; Osaka Japan
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology; Shanghai 9th People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
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Abstract
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.
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Affiliation(s)
- Rodrigo Fuentealba
- Restorative Division, University of Kentucky College of Dentistry, 800 Rose Street, D642, Lexington, KY 40356-0297, USA.
| | - Jorge Jofré
- Center for Advanced Prosthodontics and Implant Dentistry, University of Concepcion, Victoria 232 Barrio Universitario Concepción, Concepcion 4030000, Chile
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