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Torra-Moneny M, Mauri-Obradors E, Egido-Moreno S, Valls-Roca-Umbert J, Marí-Roig A, López-López J. Association of Connective Tissue Grafts in Immediate Implants: Systematic Review and Meta-Analysis. Dent J (Basel) 2024; 12:183. [PMID: 38920885 PMCID: PMC11202705 DOI: 10.3390/dj12060183] [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: 05/03/2024] [Revised: 06/08/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP without CTG. METHODS A systematic review was carried out by two reviewers in Medline-Pubmed, Scopus, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Randomized Clinical Trials (RCTs) that were published between April 2017 and February 2024 were used. Studies that analyzed the performance of a simultaneous or deferred CTG after the placement of an implant in the aesthetic zone, with or without immediate provisionalization, without previous regeneration, with a follow-up of 6 months, and that were performed in humans were included. RESULTS Quantitative analysis was performed using data provided by the RCTs. The five RCTs that were selected analyzed a total "n" of 245 subjects who met the inclusion criteria and focused on the subject of the study. In the quantitative analysis, four RCTs were included. The studies evaluated buccal gingiva levels when placing the IIP with and without CTG, obtaining a mean buccal gingiva level difference of 0.09 mm (95% CI: -0.54 to 0.72, p = 0.05), statistically not significant, but with a favorable trend. CONCLUSIONS The use of CTG associated with the II can maintain the gum level but not increase the volume. CTG is favorable for achieving successful esthetic results when immediate placement of an implant with a provisional prosthesis is planned.
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Affiliation(s)
- Marta Torra-Moneny
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Elisabet Mauri-Obradors
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Sonia Egido-Moreno
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Joan Valls-Roca-Umbert
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Antonio Marí-Roig
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
- Maxillofacial Surgery Service, Bellvitge University Hospital, 08907 Barcelona, Spain
- Oral Health and Masticatory System Group, Institut d’Investigació Biomédica de Bellvitge IDIBELL (Bellvitge Institute of Biomedical Research), 08907 Barcelona, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
- Maxillofacial Surgery Service, Bellvitge University Hospital, 08907 Barcelona, Spain
- Oral Health and Masticatory System Group, Institut d’Investigació Biomédica de Bellvitge IDIBELL (Bellvitge Institute of Biomedical Research), 08907 Barcelona, Spain
- Medical Surgical Area of the Dental Hospital, University of Barcelona (HOUB), 08907 Barcelona, Spain
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Kuebler A, Noelken R. The influence of connective tissue grafting on the reconstruction of a missing facial bone wall using immediate implant placement and simultaneous bone reconstruction: a retrospective long-term cohort study. Int J Implant Dent 2024; 10:25. [PMID: 38760582 PMCID: PMC11101404 DOI: 10.1186/s40729-024-00533-2] [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: 11/20/2023] [Accepted: 03/05/2024] [Indexed: 05/19/2024] Open
Abstract
PURPOSE This retrospective cohort study evaluates the influence of connective tissue grafts (CTG) on bone regeneration at implant sites with total loss of the buccal bone wall treated with flapless immediate implant placement (IIP) and reconstruction with autogenous bone chips (AB) within a follow-up of up to 13 years. METHODS Sixty implants were inserted in 55 patients in sites with total loss of the buccal bone wall between 2008 and 2021. The implants were inserted and the buccal gaps were grafted by AB. A subgroup of 34 sites was grafted additionally with CTG using tunnel technique. Primary outcome was the vertical bone regeneration in height and thickness. Secondary outcome parameters were interproximal marginal bone level, recession, soft tissue esthetics (PES), width of keratinized mucosa (KMW) and probing depths (PPD). RESULTS Mean follow-up period was 60.8 months. In 55 sites a complete vertical bone regeneration was documented. The mean buccal bone level increased by 10.6 mm significantly. The thickness of the buccal bone wall ranged between 1.7 and 1.9 mm, and was significantly thicker in sites without CTG. Interproximal marginal bone level was at implant shoulder level. The mean recession improved significantly by 1.2 mm. In sites with CTG, recessions and PES improved significantly more. CONCLUSIONS Additional CTG in extraction sites with total buccal bone loss followed by IIP with simultaneous AB grafting led to improved PES and recession, but also to a thinner buccal bone wall compared to sites grafted just with AB.
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Affiliation(s)
- Andreas Kuebler
- Private Practice for Oral Surgery, Paradiesplatz 7-13, 88131, Lindau/Lake Constance, Germany.
| | - Robert Noelken
- Private Practice for Oral Surgery, Paradiesplatz 7-13, 88131, Lindau/Lake Constance, Germany
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
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Fettouh AIA, Ghallab NA, Mina NA, Abdelmalak MS, Abdelrahman AAG, Shalaby AF, Shemais N. Hard and soft tissue alterations using dual-zone concept versus connective tissue graft at maxillary immediate implant placement: A 1-year randomized clinical and volumetric trial. Clin Oral Implants Res 2024; 35:510-525. [PMID: 38372450 DOI: 10.1111/clr.14247] [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: 09/30/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES To evaluate the esthetic outcome, as well as clinical, radiographic, and volumetric tissue alterations 1 year after immediate implant placement (IIP) with connective tissue grafting (CTG) versus dual-zone concept (DZ) at sites with thin labial bone in the esthetic zone. MATERIALS AND METHODS This randomized clinical trial included 30 patients treated with IIP simultaneous with either CTG or DZ (n = 15 each). Pink esthetic score (PES) was assessed 6 months after crown placement as the primary outcome. Amount of bone labial to the implant, labio-palatal ridge reduction, and crestal bone changes were measured via CBCT after 1 year. Volumetric analysis of linear labial soft tissue contour, interdental, and mid-facial soft tissue level changes, and total volume loss (mm3) were measured after 1 year. RESULTS Similar PES was observed in the CTG (12.53 ± 1.13) and DZ (12.13 ± 1.55) groups, with no significant difference (p = 0.42). Likewise, there were no statistically significant differences found between the two groups in labio-palatal bone reduction (mm&%), interdental papillae, and mid-facial gingival levels (p > 0.05). However, the mean vertical crestal bone changes in the CTG and DZ groups were -1.1 ± 0.6 mm and 0.2 ± 1.0 mm, respectively, with a statistically significant difference (p = 0.0002). Moreover, CTG revealed less linear and total volume (mm3) loss in the labial soft tissue which was statistically significant compared to DZ (p = 0.007). CONCLUSION Both groups demonstrated the same PES, nevertheless, volumetric analysis revealed twice total labial volume loss in DZ compared to CTG. It might be concluded that the use of CTG with IIP caused less horizontal reduction in the supra-implant complex compared to the DZ.
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Affiliation(s)
| | - Noha A Ghallab
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Nael Adel Mina
- International Dental Continuing Education Center, Cairo, Egypt
| | | | | | | | - Nesma Shemais
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
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Rodrigues DM, Gluckman H, Pontes CC, Januário AL, Petersen RL, de Moraes JR, Barboza EP. Relationship between soft tissue dimensions and tomographic radial root position classification system for immediate implant installation. Odontology 2024:10.1007/s10266-023-00897-8. [PMID: 38324124 DOI: 10.1007/s10266-023-00897-8] [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: 07/25/2023] [Accepted: 12/27/2023] [Indexed: 02/08/2024]
Abstract
The aim of this study was to evaluate the relationship between soft tissue dimensions and radial root position (RRP) classification for immediate implant placement on maxillary anterior teeth. Maxillary anterior teeth (n = 420) were analyzed in the radial plane of cone beam computed tomography (CBCT) scans. Each tooth was classified according to its RRP: class I, (IA, IB); class II (IIA, IIB) class III; class IV, and class V. Soft tissue thickness at different landmarks, supracrestal soft tissue height, and crestal bone thickness were measured in CBCT. Keratinized tissue width was clinically measured. Gingival phenotype (thick or thin) was evaluated by transparency of the periodontal probe and at the landmark 2 mm from the gingival margin in CBCT. Class I tooth position accounted for 31.7%, class II for 45%, class III for 13.3%, class IV for 0.5%, and class V for 9.5%. The gingival phenotype was associated with RRP (χ2 test, p < 0.05). Soft tissue dimensions were significantly different over RRP classes (ANOVA and Tukey tests, p < 0.05). Types IA and IIA presented both thick soft and hard tissues. When planning immediate implants in the anterior maxilla, soft tissue dimensions evaluation should be incorporated into RRP classification to increase the accuracy and predictability of treatment outcomes.
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Affiliation(s)
- Diogo Moreira Rodrigues
- Department of Periodontology, National Institute of Dental Sciences (INCO 25), Niterói, Rio de Janeiro, Brazil.
| | - Howard Gluckman
- Private Practice, Cape Town, South Africa
- Implant and Aesthetic Academy, Cape Town, South Africa
- Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
- Department of Oral Medicine and Periodontology, University of Western Cape School of Dentistry, Cape Town, South Africa
| | - Carla Cruvinel Pontes
- Mouth-Body Research Institute and The Implant and Esthetic Academy, Cape Town, South Africa
| | | | | | - José Rodrigo de Moraes
- Department of Statistics, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Eliane Porto Barboza
- Department of Dental Clinics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
- Lake Erie College of Osteopathic Medicine (LECOM) School of Dental Medicine, Lakewood Ranch, Florida, USA
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Rondone EM, Leitão-Almeida B, Pereira MS, Fernandes GVO, Borges T. The Use of Tissue Grafts Associated with Immediate Implant Placement to Achieve Better Peri-Implant Stability and Efficacy: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:821. [PMID: 38337515 PMCID: PMC10856075 DOI: 10.3390/jcm13030821] [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: 01/04/2024] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Background: The goal of this systematic study and meta-analysis was to evaluate the efficacy of hard and/or soft tissue grafts associated with type-1 implants on healing and treatment outcomes. The primary outcomes studied were implant survival rate, pocket depth, marginal peri-implant recession, bone loss, bone thickness (volumetric change), interproximal bone level, mesial and distal papilla migration, and radiographic evaluation; and the secondary parameters were Pink Esthetic Score (PES), vertical distance from implant shoulder and bone, Visual Analogue Score (VAS), Implant Stability Quotient (ISQ), and biological complications (fistulas, pain, mucositis, and peri-implantitis). Methods: The PICO strategy was used to formulate the hypothesis under study: "For patients who underwent extraction and immediate implant placement, what is the efficacy of using any type of graft (bone or soft tissue) compared to non-grafting regarding the peri-implant parameters?" The electronic search process was performed on the MedLine/PubMed and Cochrane databases. It included randomized controlled trials (RCTs) from the last 11 years (from 2012 to November 2023), which were identified and analyzed. Results: Nine RCTs (κ = 0.98) were selected (403 patients and 425 implants); they were divided into three groups: bone graft (75 patients and 75 implants inserted), bone graft and membrane (213 patients and 235 implants inserted), and without bone graft (115 patients and 115 implants inserted). Three studies calculated the mid-facial mucosa level and two reported better results when a connective tissue graft was combined with the xenograft, whereas another study found better results in the combination of a dual-zone technique with a xenograft. Three studies evaluated the total Pink Esthetic Score (PES) at 12 months, where the authors found no significant difference in using a xenogeneic graft with or without a membrane. In the same period, the facial bone thickness was assessed in two articles; the authors reported better results in graft-treated and flapless groups. The risk-of-bias assessment found four studies with low risk, four with moderate risk, and one with a high risk of bias. The meta-analysis showed a medium level of heterogeneity for the mid-facial mucosa level analysis (I2 = 46%) and an overall effect size of 0.79 (95% CI [0.18; 1.40]), a statistically significant results (p = 0.01), with a tendency to favor the experimental group. Also, there was a medium level of heterogeneity among studies regarding total PES (I2 = 45%), with no significant differences between studies (p = 0.91). Homogeneous results (I2 = 0%) were found among studies analyzing facial bone thickness, favoring the experimental group; the forest plot showed an effect of 0.37 (95% CI [0.25; 0.50]), which was statistically significant (p < 0.00001) for this parameter. Conclusions: Then, it was possible to conclude that using bone and soft tissue grafting techniques associated with immediate implant placement (IIP), even though they are not fundamental, was a valuable resource to prevent significant tissue reduction, reaching greater bone stability and higher levels in the Pink Esthetic Score (PES) and Visual Analogue Score (VAS).
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Affiliation(s)
- Enrico Maria Rondone
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Bruno Leitão-Almeida
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Miguel Silva Pereira
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Gustavo Vicentis Oliveira Fernandes
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- A. T. Still University—Missouri School of Dentistry & Oral Health, St. Louis, MO 63104, USA
| | - Tiago Borges
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
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Limmeechokchai S, Kan JYK, Rungcharassaeng K, Chen JT, Goodacre B, Lozada J. Facial Contour Preservation of Anterior Immediate Single-Tooth Replacement With the Socket Shield Technique Versus Connective Tissue Graft: A Case Report. J ORAL IMPLANTOL 2023; 49:495-500. [PMID: 37776256 DOI: 10.1563/aaid-joi-d-23-00009] [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] [Indexed: 10/02/2023]
Abstract
The socket shield technique and subepithelial connective tissue graft following immediate implant placement with provisionalization had been advocated for peri-implant facial contour and gingival architecture preservation. This case report used three-dimensional volumetric analysis to longitudinally assess the peri-implant facial contour change before and after these procedures. The results demonstrated comparable and acceptable preservation of peri-implant facial contour between the two procedures after 2 years of function.
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Affiliation(s)
| | - Joseph Y K Kan
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | | | - Joey T Chen
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Brian Goodacre
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Jaime Lozada
- Loma Linda University School of Dentistry, Loma Linda, Calif
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Fernandes D, Marques T, Borges T, Montero J. Volumetric analysis on the use of customized healing abutments with or without connective tissue graft at flapless maxillary immediate implant placement: A randomized clinical trial. Clin Oral Implants Res 2023; 34:934-946. [PMID: 37386752 DOI: 10.1111/clr.14119] [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: 11/23/2022] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES To evaluate buccal volume change after using a customized healing abutment with or without connective tissue grafts (CTG) in flapless maxillary immediate implant placement (IIP). MATERIALS AND METHODS The present study was designed as a randomized clinical trial (RCT). Patients treated with flapless maxillary IIP were allocated into two groups, both receiving a customized healing abutment, and additionally, the test group received a CTG. A cone-beam computerized tomography (CBCT) allowed to access the initial buccal bone thickness (BT). Digital impressions were taken prior to extractions (T0), 1 month (T1), 4 months (T2), and 12 months (T3) after implant insertion and superimposed with computer software allowing to compute variables related to buccal volume variation (BVv) and total volume variation (TVv) (ClinicalTrials.gov: NCT05060055). RESULTS Thirty-two patients (mean age 48 ± 11 years), sixteen in each group, were evaluated after a 12-month period. After 1 year of treatment, no significant differences were found between groups, although in participants with BT ≤1 mm, control and test groups showed a BVv of -14.18 ± 3.49% and -8.30 ± 3.78%, respectively (p = .033). Regarding mucosa height variation variables, the control group showed approximately the triple vertical recession in both papillae. CONCLUSIONS The placement of a CTG was not capable of completely maintaining the initial peri-implant tissue architecture, although in thin-bone phenotypes, less dimensional changes are expected when a CTG was used.
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Affiliation(s)
- Danilo Fernandes
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Tiago Marques
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Tiago Borges
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
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Wittneben JG, Molinero-Mourelle P, Hamilton A, Alnasser M, Obermaier B, Morton D, Gallucci GO, Wismeijer D. Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:266-303. [PMID: 37750531 DOI: 10.1111/clr.14172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 08/07/2023] [Accepted: 08/13/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15-25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010. MATERIAL AND METHODS An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A). RESULTS Sixty-three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow-up ranging from 12 to 96 months. One thousand nine hundred sixty-one implants reported survival rates of 99.2 (98.6-99.5) % at 1 year, 97.5 (95.9-98.4) % after 3 years, and 95.8 (93.3-97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8-99.5) % after 1 year, 96.8 (93.6-98.4) % after 2 years, and 94.8 (89.6-97.4) % after 5 years. Comparing baseline to 12-month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of -0.71 (-1.25, -0.1) mm, midfacial recession change of -0.15 (-0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES. CONCLUSIONS Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years.
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Affiliation(s)
- Julia-Gabriela Wittneben
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Conservative Dentistry and Orofacial Prosthetics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Hamilton A, Gonzaga L, Amorim K, Wittneben JG, Martig L, Morton D, Martin W, Gallucci GO, Wismeijer D. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:304-348. [PMID: 37750515 DOI: 10.1111/clr.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Luiz Gonzaga
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Karina Amorim
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - William Martin
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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10
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Strasding M, Jeong Y, Marchand L, Hicklin SP, Sailer I, Sun M, Lee H. Three-Dimensional Peri-Implant Tissue Changes in Immediately vs. Early Placed Tapered Implants Restored with Two Different Ceramic Materials-1 Year Results. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5636. [PMID: 37629928 PMCID: PMC10456968 DOI: 10.3390/ma16165636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND A prospective multi-center randomized controlled clinical trial was performed to digitally analyze tissue volume changes in immediately and early placed implants with simultaneous bone augmentation restored with two different all-ceramic materials. METHODS A total of 60 patients received 60 bone-level tapered implants (BLT, Straumann AG) immediately (n = 30) or early placed, 8-10 weeks after tooth extraction, (n = 30). Implants were restored with all-ceramic single crowns fabricated out of zirconia (Lava Plus, 3M), or lithium disilicate (E.max CAD, Ivoclar Vivadent AG) bonded to titanium base abutments (Variobase for Cerec, Straumann AG). Impressions were taken at baseline (BL), 6 and 12 months, and STL data were used to define an area of interest (AOI) to analyze peri-implant volume changes and midfacial recessions. RESULTS For immediate placement, a mean volume loss of -5.56 mm3 (±5.83 mm3) was found at 6 months, and of -6.62 mm3 (±6.56 mm3) at 12 months. For early placement, a mean volume loss of -1.99 mm3 (±5.82 mm3) at 6 months, and of -3.7 mm3 (±5.62 mm3) at 12 months was found. The differences in volume loss at 12 months between the two implant placement protocols were significant (p = 0.005). In both groups, mean midfacial recessions of 0.48 mm (±0.52) occurred. CONCLUSIONS A more pronounced peri-implant volume loss can be expected 12 months after immediate implant placement compared with early placement.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Yuwon Jeong
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Laurent Marchand
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland;
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Minji Sun
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
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11
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Lee CT, Tran D, Tsukiboshi Y, Min S, Kim SK, Ayilavarapu S, Weltman R. Clinical efficacy of soft-tissue augmentation on tissue preservation at immediate implant sites: A randomized controlled trial. J Clin Periodontol 2023; 50:1010-1020. [PMID: 37052357 DOI: 10.1111/jcpe.13816] [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: 12/27/2022] [Revised: 03/01/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023]
Abstract
AIM This randomized controlled trial aimed to investigate the efficacy of soft-tissue augmentation (STA) with a subepithelial connective tissue graft (SCTG) or an acellular dermal matrix (ADM) on reducing tissue alterations at an immediate implant site. MATERIALS AND METHODS This trial had three groups: (i) immediate implant with SCTG (ICT group); (ii) immediate implant with ADM (IAD group); (iii) immediate implant without STA (control group). Forty-six patients were randomly assigned to each group. Implants were placed at the maxillary anterior or premolar areas and restored after the 6-month visit. Clinical outcomes, including buccal soft-tissue contour, peri-implant mucosal level, soft-tissue thickness and keratinized tissue width, were measured at baseline and at 3-, 6- and 12-month follow-up visits. Radiographic bone levels were measured at baseline and at 6- and 12-month follow-up visits. Patient-reported outcomes were also collected. RESULTS STA procedures increased peri-implant mucosal thickness and maintained buccal soft-tissue contours. Compared to the control group, STA groups did not prevent peri-implant mucosal recession or interproximal bone resorption. Generally, no significant differences in clinical outcomes were detected between the ICT and IAD groups. Most patients were highly satisfied with the immediate implant procedure and outcomes without significant differences between groups. CONCLUSIONS STA at immediate implant sites enhanced soft-tissue thickness and maintained soft-tissue contours but did not prevent peri-implant mucosal recession or interproximal bone resorption. Long-term follow-up should be performed since these results were reported for only up to 1 year.
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Affiliation(s)
- Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Duong Tran
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Yosuke Tsukiboshi
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
- Private office, Aichi, Japan
| | - Seiko Min
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Sung K Kim
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
- Department of Clinical Sciences, University of Nevada School of Dental Medicine, Las Vegas, Nevada, USA
| | - Srinivas Ayilavarapu
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Robin Weltman
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
- Department of Clinical Sciences, University of Nevada School of Dental Medicine, Las Vegas, Nevada, USA
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12
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Wu XY, Shi JY, Buti J, Lai HC, Tonetti MS. Buccal bone thickness and mid-facial soft tissue recession after various surgical approaches for immediate implant placement: A systematic review and network meta-analysis of controlled trials. J Clin Periodontol 2023; 50:533-546. [PMID: 36632002 DOI: 10.1111/jcpe.13771] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/03/2023] [Accepted: 01/07/2023] [Indexed: 01/13/2023]
Abstract
AIM To evaluate the relative efficacy and confidence in the precision of the results of different surgical interventions for immediate implant placement in the anterior area. MATERIALS AND METHODS Electronic searches were performed in PubMed, Embase, and Cochrane CENTRAL. Randomized controlled trials comparing different surgical techniques in anterior jaws for type 1 implant placement were included. Outcome measures included implant survival (primary outcome), buccal bone thickness (BBT) reduction, and mid-facial soft tissue recession (MSTR). Risks of bias assessment, network meta-analysis (NMA), sensitivity analysis, and quality-of-evidence assessment were performed. RESULTS Twenty-two studies reporting on 948 subjects and 5 surgical interventions were included. Fourteen early failures were reported. Compared with open-flap surgery without tissue augmentation (F-N) and looking at BBT preservation, NMA showed that there was moderate confidence that flapless surgery with hard tissue augmentation (FL-HTA) was better than flapless surgery without tissue augmentation (FL-N) or open-flap surgery with hard tissue augmentation (F-HTA) (mean difference -0.8 mm, 95% confidence interval: -1.1 to -0.5 mm; -0.6 mm, -0.9 to -0.4 mm; and -0.5 mm, -0.7 to -0.3 mm, respectively). There was moderate confidence that flapless surgery with hard and soft tissue augmentation (FL-HTA&STA) could significantly prevent MSTR compared with FL-HTA (-0.5 mm, -0.7 to -0.3 mm) and FL-N (-0.6 mm, -1.2 to -0.04 mm). However, there was no significant additional benefit in BBT with the FL-HTA&STA approach compared to the FL-HTA approach (-0.30 mm, -0.81 to 0.21 mm). CONCLUSIONS For immediate implant placement in the anterior areas, the FL-HTA approach better preserves BBT (moderate confidence); adding STA improves the stability of the mid-facial soft tissue level (moderate confidence) but at the expense of BBT (low confidence).
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Affiliation(s)
- Xin-Yu Wu
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun-Yu Shi
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jacopo Buti
- Unit of Periodontology, University College London, Eastman Dental Institute, London, UK
| | - Hong-Chang Lai
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- European Research Group on Periodontology, Genoa, Italy
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13
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Abdelwahab D, Ezz AlArab A, El Nahass H. Soft tissue esthetics around immediately provisionalized delayed implants with and without connective tissue graft: A randomized clinical trial pilot study. Clin Implant Dent Relat Res 2023; 25:11-22. [PMID: 36579756 DOI: 10.1111/cid.13168] [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: 06/03/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Evaluate the peri-implant soft tissue esthetics following a single, immediately provisionalized, delayed implant with/-out subepithelial connective tissue graft (SCTG). MATERIAL AND METHODS The eligible patients were randomized into two groups. Immediate provisionalization was performed with (test group: SCTGG) or without SCTG (control group: NGG). The soft tissue esthetics was assessed by Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI), at 6 and 12 months, following final implant restoration. RESULTS The SCTGG, compared to NGG, yielded a 0.2 increased PES at 12 months (95% confidence interval (CI): -1, 1.4) and a 0.2 decreased MSI score (95% CI -0.9, 0.5) with no statistically significant differences in PES and MSI between both groups (p > 0.05). CONCLUSION Soft tissue grafting around immediately provisionalized delayed implants could exhibit comparable results to immediate provisionalization alone in terms of peri-implant soft tissue esthetics using PES and MSI (ClinicalTrials.gov Identifier: NCT03770975).
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Affiliation(s)
- Dina Abdelwahab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Azza Ezz AlArab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hani El Nahass
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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14
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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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15
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YU XINBO, TENG FEI, ZHAO ANDA, WU YIQUN, YU DEDONG. EFFECTS OF POST-EXTRACTION ALVEOLAR RIDGE PRESERVATION VERSUS IMMEDIATE IMPLANT PLACEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101734. [DOI: 10.1016/j.jebdp.2022.101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 04/02/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
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16
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Araújo MG, Hürzeler MB, Dias DR, Matarazzo F. Minimal invasiveness in the alveolar ridge preservation, with or without concomitant implant placement. Periodontol 2000 2022; 91:65-88. [PMID: 35913046 DOI: 10.1111/prd.12441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
The aim of this systematic review was to evaluate the benefit of ridge preservation (RP) with minimally invasive (MI) approaches with or without concomitant implant placement on morbidity, esthetics, and patient-related outcomes. Three Internet sources were used to search for appropriate papers. The search strategy was designed to include any clinical study published on RP with MI approaches such as flapless surgery, socket shield and socket sealing techniques and, use of biological agents. Characteristics of the individual studies, regarding methodological aspects, quantitative and qualitative data were extracted. The potential risk of bias was estimated, and the acquired evidence was graded. Independent screening of 860 reports resulted in 26 included original articles. Nine publications evaluated MI approaches for RP without concomitant implant placement. Eleven studies evaluated interventions for RP with immediate implant placement (IIP). Six studies compared RP with IIP vs RP without IIP. This systematic review found that MI approaches in most of the studies failed to improve clinical variables regarding morbidity, esthetics, and patient-related outcomes. Based on the limited number of studies analyzed and the methodological discrepancies observed, it is not possible to confirm that MI approaches promote a significant benefit when applied to RP procedures.
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Affiliation(s)
- Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Markus B Hürzeler
- Private Practice Hürzeler/Zuhr, Munich, Germany.,Department of Operative Dentistry and Periodontology, Albert Ludwigs University, Freiburg, Germany
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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17
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Sanz-Martín I, Regidor E, Cosyn J, Wiedemeier DB, Thoma DS. Buccal soft tissue dehiscence defects at dental implants-associated factors and frequency of occurrence: A systematic review and meta-analysis. Clin Oral Implants Res 2022; 33 Suppl 23:109-124. [PMID: 35763025 DOI: 10.1111/clr.13888] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/02/2021] [Accepted: 05/03/2021] [Indexed: 01/10/2023]
Abstract
AIM To identify the factors associated with buccal peri-implant soft tissue dehiscences (BSTDs) and their frequency of occurrence. MATERIALS AND METHODS Randomized controlled trials, controlled clinical trials, cohort studies, and case series assessing the frequency of occurrence of BSTD were included. BSTD was defined as an apical migration of the peri-implant soft tissues of ≥1 mm from the baseline examination (final restoration) or in comparison with the adjacent or contralateral natural tooth. Frequency distributions of BSTD related to the presence or absence of any surgical, prosthetic, or anatomic factor that may have contributed to the development of BSTD were recorded. Random-effects meta-analyses using odds ratios (OR) were performed to investigate the association of certain factors with the development of BSTD. RESULTS Twenty-four articles were finally included belonging to 22 clinical investigations. Patients at higher risk of developing BSTD were associated with thin biotype (OR = 2.85 [1.40, 5.8], n = 5, p = .003) and with buccally placed implants (OR = 14.37 [4.58, 45.14], n = 3, p ≤ .001). Patients without connective tissue grafting (CTG) had greater odds of developing BSTD (OR = 9.00 [3.11, 26.02], n = 5, p ≤ .001), while buccal bone plate thickness of <1 mm and immediately placed implants were not associated with greater BSTD (OR = 1.29 [0.35, 4.77], n = 2, p = .704 and OR = 1.56 [0.46, 5.26], n = 4, p = .477, respectively). The frequency of occurrence of BSTD varied across the included studies with a range from 0% to 61%. CONCLUSIONS Thin tissue biotype and buccally placed implants were associated with BSTD, whereas CTG seemed to have a protective effect. Thin buccal plates and immediately placed implants did not demonstrate a higher risk of BSTD.
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Affiliation(s)
| | - Erik Regidor
- Thinking Perio Research, Periocentrum Bilbao, Private Practice, Bilbao, Spain
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Daniel B Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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18
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Valles C, Vilarrasa J, Barallat L, Pascual A, Nart J. Efficacy of soft tissue augmentation procedures on tissue thickening around dental implants: A systematic review and meta-analysis. Clin Oral Implants Res 2022; 33 Suppl 23:72-99. [PMID: 35763023 DOI: 10.1111/clr.13920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The first focused question (FQ1) was: What is the efficacy of connective tissue graft (CTG), as compared to the absence of soft tissue grafting procedure, in terms of gain in peri-implant soft tissue thickness (STT) reported by randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs)? The second focused question (FQ2) was: What is the efficacy of CTG, as compared to soft tissue substitutes, in terms of gain in peri-implant STT reported by RCTs or CCTs? MATERIALS AND METHODS A manual and electronic search was performed for each question to identify RCTs and CCTs published up to July 2020. The primary outcome variable was changes in peri-implant STT and secondary outcomes were marginal bone level (MBL), clinical parameters for the diagnosis of peri-implant health, changes in the position of peri-implant soft tissues, esthetic outcomes, and patient-related outcome measures (PROMs). For primary and secondary outcomes, data reporting mean values and standard deviations for each study were extracted. Weighted mean differences (WMDs) or standardized mean differences as well as 95% confidence intervals (CIs) and prediction intervals (PIs) were calculated. RESULTS Eight trials were included to answer the first focused question and eight to answer the second one, providing data for 254 and 192 patients, respectively. For the first focused question, a statistically significant difference of 0.64 mm in STT was found in favor of the grafted group (n = 8; 95% CI [0.16; 1.13]; 95% PI [-1.06; 2.35]; p = .01). Moreover, sites treated with CTG exhibited statistically significant less recession than implants without a graft (n = 4; WMD = 0.50 mm; 95% CI [0.19; 0.80]; 95% PI [-0.70; 1.69]; p < .001). For the second focused question, the meta-analysis showed a statistically significant gain of STT in the CTG group when compared to soft tissue substitutes (n = 8; WMD = 0.51 mm; 95% CI [0.28; 0.75]; 95% PI [-0.09; 1.12]; p < .001). Furthermore, the use of CTG resulted in significantly higher pink esthetic score values (n = 3; WMD = 1.02; 95% CI [0.29; 1.74]; 95% PI [-3.67; 5.70]; p = .01) and less recession (n = 2; WMD = 0.50 mm; 95% CI [0.10; 0.89]; 95% PI [not estimable]; p = .014) when compared to soft tissue substitutes. No statistically significant differences between groups were observed for any of the following secondary variables: MBL, clinical parameters for the diagnosis of peri-implant health, position of the interproximal tissues, keratinized mucosa or PROMS (p > 0.05), except for medication intake, which was significantly higher when using CTG as compared to soft tissue substitutes (n = 2; WMD = 1.68; 95% CI [1.30; 2.07]; 95% PI [not estimable]; p < .001). CONCLUSIONS Soft tissue augmentation procedures are efficacious on soft tissue thickening and, in particular, CTG demonstrated a significant STT gain when compared to no graft or soft tissue substitutes.
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Affiliation(s)
- Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Lucía Barallat
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Andrés Pascual
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jose Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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19
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Jung RE, Becker K, Bienz SP, Dahlin C, Donos N, Hammächer C, Iglhaut G, Liñares A, Ortiz-Vigón A, Sanchez N, Sanz-Sánchez I, Thoma DS, Valles C, Weng D, Nart J. Effect of peri-implant mucosal thickness on esthetic outcomes and the efficacy of soft tissue augmentation procedures: Consensus report of group 2 of the SEPA/DGI/OF workshop. Clin Oral Implants Res 2022; 33 Suppl 23:100-108. [PMID: 35763020 PMCID: PMC9543632 DOI: 10.1111/clr.13955] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to comprehensively assess the literature in terms of the effect of peri-implant mucosal thickness on esthetic outcomes and the efficacy of soft tissue augmentation procedures to increase the mucosal thickness with autogenous grafts or soft tissue substitutes. MATERIAL AND METHODS Two systematic reviews (SR) were performed prior to the consensus meeting to assess the following questions. Review 1, focused question: In systemically healthy patients with an implant-supported fixed prosthesis, what is the influence of thin as compared to thick peri-implant mucosa on esthetic outcomes? Review 2, focused question 1: In systemically healthy humans with at least one dental implant (immediate or staged implant), what is the efficacy of connective tissue graft (CTG), as compared to absence of a soft tissue grafting procedure, in terms of gain in peri-implant soft tissue thickness (STT) reported by randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs)? Review 2, focused question 2: In systemically healthy humans with at least one dental implant (immediate or staged implant), what is the efficacy of CTG, as compared to soft tissue substitutes, in terms of gain in peri-implant STT reported by RCTs or CCTs? The outcomes of the two SRs, the consensus statements, the clinical implications, and the research recommendations were discussed and subsequently approved at the consensus meeting during the group and plenary sessions. CONCLUSIONS There was a tendency of superior esthetic outcomes in the presence of a thick mucosa. The connective tissue graft remains the standard of care in terms of increasing mucosa thickness.
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Affiliation(s)
- Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Stefan P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christer Dahlin
- Department of Biomaterials, Institute for Surgical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nikos Donos
- Centre for Oral Clinical Research, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | | | - Gerhard Iglhaut
- Department of Oral and Craniomaxillofacial Surgery, Translational Implantology, Center for Dental Medicine, University Medical Center of Freiburg, Freiburg, Germany.,Private Center of Oral Surgery, Memmingen, Germany
| | - Antonio Liñares
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Nerea Sanchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, Madrid, Spain
| | - Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, Madrid, Spain
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Dietmar Weng
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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20
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Wanis RW, Hosny MM, ElNahass H. Clinical evaluation of the buccal aspect around immediate implant using dual zone therapeutic concept versus buccal gap fill to bone level: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:307-319. [PMID: 35507735 DOI: 10.1111/cid.13091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Soft tissue esthetics for immediate implant is considered challenging when restoring a tooth in an esthetic zone. This study aimed to evaluate the buccal aspect after immediate implant using the dual-zone therapeutic concept compared to grafting the buccal gap to the bone crest. MATERIALS AND METHODS Twenty-four patients were randomly assigned into either immediate implant with the dual-zone therapeutic concept (DZ, test group) or with bone grafting till buccal bone crest with immediate temporization (BCG, control group). Pink esthetic score (PES), buccal bone loss (BBL), mid-facial recession (MFR), soft tissue thickness (STT), keratinized tissue width (KTW), post-operative swelling (POS), and patient satisfaction (PS) were evaluated for 1 year. RESULTS At 12 months the PES in the test group was 11.36 ± 1.69, and 10.80 ± 1.55 in the control group, with no statistically significant difference (p = 0.45). MFR in the DZ and BCG groups was 0.27 ± 0.34 and 0.45 ± 0.44 after 12 months with no statistical significance difference (p = 0.195). The STT assessment showed a statistically significant increase in both groups, however the intergroup comparison was statistically not significant (p = 0.23). The mean KTW in the DZ and BCG groups was 4.55 ± 1.08 and 4.20 ± 0.82 mm, respectively with no statistical significance (p = 0.42). There was no statistical significant difference in patient satisfaction between the two groups except in question number 10 concerning the post-operative swelling which was higher in the DZ group (p = 0.009). CONCLUSIONS Both treatment modalities are considered reliable methods to achieve good soft tissue esthetics. However, both treatment modalities were not effective in preventing facial bone resorption despite the use of bone graft.
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Affiliation(s)
- Remon Wahid Wanis
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
| | - Manal Mohamed Hosny
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
| | - Hani ElNahass
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
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21
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A Novel Approach to Immediate Implants: The CastleWall Surgical Technique. Dent J (Basel) 2022; 10:dj10040062. [PMID: 35448056 PMCID: PMC9027629 DOI: 10.3390/dj10040062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: The purpose of this study was to investigate the volumetric stability around immediate implants, in which a 360-degree socket-shield was retained using the CastleWall Surgical Technique (CWST). Material and methods: This retrospective study examined the results of the CWST used for 25 consecutive patients, involving 31 immediate implants. Silicone impressions taken prior to extraction, and at a review appointment were converted to STL files and compared. The median follow-up time was 14.2 ± 5.5 months. Volumetric changes and gingival recession on both buccal and lingual sites were measured. Papillary height changes were also evaluated from available photographs taken before and after treatment. Patients in the study completed a Visual Analogue Scale (VAS) for evaluation of post-operative discomfort and overall satisfaction with this procedure. Results: All implants integrated successfully without complications. Mean loss of buccal and lingual tissue was 0.30 ± 0.32 mm and 0.17 ± 0.27 mm, respectively. Mean recession at the mid-buccal and mid-lingual gingival margin was 0.66 ± 0.64 mm and 0.87 ± 0.84 mm, respectively. Mean recession of the mesial and distal papilla was 0.26 ± 0.55 mm and 0.29 ± 0.52 mm, respectively. Patients reported 97.74 ± 5.60% satisfaction with this procedure using the Visual Analogue Scale (VAS), with minimal post-operative discomfort. Conclusions: The results of this study showed excellent soft tissue stability and aesthetics were achieved using the CWST, with minimal postoperative pain. The other main advantage of retaining a 360-degree socket-shield, is there is more available surface area to lock the implant to the shield to prevent shield migration over time.
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22
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Lee KS, Shin SY, Hämmerle CHF, Jung UW, Lim HC, Thoma DS. Dimensional ridge changes in conjunction with four implant timing protocols and two types of soft tissue grafts: A pilot pre-clinical study. J Clin Periodontol 2022; 49:401-411. [PMID: 35066942 DOI: 10.1111/jcpe.13594] [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: 07/15/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 11/25/2022]
Abstract
AIM To determine the effect of (1) implant placement timing and (2) the type of soft tissue graft in terms of ridge profile changes. MATERIALS AND METHODS Four implant treatment modalities were applied in the mesial root areas of the third and fourth mandibular premolars of 10 mongrel dogs alongside connective-tissue graft (CTG) and volume-stable cross-linked collagen matrix (VCMX): immediate, early, and delayed placement (DP), and DP following alveolar ridge preservation (ARP). All dogs were sacrificed 3 months after soft tissue augmentation. Standard Tessellation Language files from designated time points were analysed. RESULTS Compared with the pre-extraction situation, the median width of the ridge demontstrated a linear increase only in group ARP/CTG (0.07 mm at the 2-mm level), whereas all other groups showed a reduction (between -1.87 and -0.09 mm, p > .05). Groups ARP/CTG (0.17 mm) and DP/CTG (0.05 mm) exhibited a profilometric tissue gain in a set region of interest (p > .05). The net effect of CTG and VCMX ranged from 0.14 to 0.79 mm. CONCLUSIONS Dimensional ridge changes varied between treatment protocols. ARP with CTG led to the smallest difference in ridge profile between the pre-extraction and the study end time point. Both CTG and VCMX enhanced the ridge contour.
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Affiliation(s)
- Kwang-Seok Lee
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University, School of Dentistry, Seoul, Republic of Korea
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University, School of Dentistry, Seoul, Republic of Korea
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University, School of Dentistry, Seoul, Republic of Korea.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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23
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Puisys A, Deikuviene J, Vindasiute-Narbute E, Razukevicus D, Zvirblis T, Linkevicius T. Connective tissue graft vs porcine collagen matrix after immediate implant placement in esthetic area: A randomized clinical trial. Clin Implant Dent Relat Res 2022; 24:141-150. [PMID: 35324053 DOI: 10.1111/cid.13058] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of connective tissue graft (CTG) with immediate implant placement and provisionalisation have shown promising results. It is not clear if the same outcome could be achieved using porcine-derived collagen matrix (PDCM) as grafting material. OBJECTIVES This study aimed to assess the esthetic and functional outcomes of immediate temporization of immediately placed fully tapered implants combined with bone and soft tissue augmentation, using either a CTG or a PDCM, in fresh extraction sockets of the anterior sites. MATERIALS AND METHODS Patients with a failing anterior tooth were included in this study. After extraction, they received an immediate implant with simultaneous hard and soft tissue augmentation and immediate provisional restoration. Patients were randomly assigned to one of the group. Soft tissue augmentation in the control group (CTG) consisted of a CTG, whereas PDCM was used in the test group. After 4 months, definitive restorations were delivered, and pink esthetic score (PES) was evaluated at T1, prosthetic delivery, and at 12-month follow-up (T2). In addition, crestal bone change, probing depth, bleeding on probing, plaque index, bleeding on provisional removal, and implant stability quotient were also recorded. RESULTS A total of 45 patients received the intended treatment (22 controls and 23 tests) 45 implants totally, with no implant failures at T2. PES mean ± SD after 1 year was noted to be 12.9 ± 1.2 for the CTG group and 12.1 ± 1.3 for the PDCM group (p = 0.507). CONCLUSION Within the limits of this trial, both treatment protocols resulted in comparable esthetic outcomes, with results showing PES >12 and stable clinical parameters after 1 year of follow-up.
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Affiliation(s)
| | | | | | | | - Tadas Zvirblis
- Department of Mechanical and Material Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
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24
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Puisys A, Auzbikaviciute V, Vindasiute-Narbute E, Pranskunas M, Razukevicus D, Linkevicius T. Immediate implant placement vs. early implant treatment in the esthetic area. A 1-year randomized clinical trial. Clin Oral Implants Res 2022; 33:634-655. [PMID: 35318752 DOI: 10.1111/clr.13924] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 11/08/2021] [Accepted: 01/24/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal bone. MATERIALS AND METHODS Test group patients received an immediate implant with immediate provisional restoration and socket preservation, while patients in the control group received an early implant placement with guided bone regeneration and delayed loading. Patients were followed for 1 year after final prosthetic and pink esthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded. RESULTS Fifty patients received the intended treatment (25 test and 25 control). No implants failed. PES after 1 year was 12.8 ± 1.19 for the test group and 12.5 ± 1.36 for the control group (p = .362). MBML difference between baseline (after final crown delivery) and the 1-year follow-up was gain of 0.2 ± 1.02 mm for the test group (p = .047) and no change in the control group. CBC after 1 year were 0.1 mm ± 0.21 mm (mesial) and 0.2 mm ± 0.22 mm (distal) for the test group and 0.2 mm ± 0.25 mm (mesial) and 0.3 mm ± 0.19 mm (distal) for the control group, p = .540 (mesial) and p = .462 (distal). Test group required half the chair time (127 ± 13 min) when compared to the control group (259 ± 15 min, p < .001). CONCLUSIONS Within the limits of this trial, both treatment protocols resulted in excellent esthetic outcomes with PES >12 after 1-year follow-up.
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Affiliation(s)
- Algirdas Puisys
- Vilnius Research Group, Private Practice VIC Clinic, Vilnius, Lithuania
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25
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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: 1] [Impact Index Per Article: 0.5] [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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26
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Thanissorn C, Guo J, Jing Ying Chan D, Koyi B, Kujan O, Khzam N, Miranda LA. Success Rates and Complications Associated with Single Immediate Implants: A Systematic Review. Dent J (Basel) 2022; 10:dj10020031. [PMID: 35200256 PMCID: PMC8870981 DOI: 10.3390/dj10020031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/05/2023] Open
Abstract
This study examined the success rates of single immediate implants and their associated biological, hardware and aesthetic complications. Using a developed search strategy, randomized controlled trials (RCTs) on single-unit immediate implants with at least six human participants, a minimum follow-up time of 12 months and published between January 1999 and January 2021 were identified. Data was extracted independently using pre-designed data extraction forms. Information on success rates and associated biological, hardware and aesthetic complications were obtained and assessed. Out of 191 potentially eligible studies, 26 RCTs assessing 1270 patients with a total of 1326 single implants were included and further evaluated. In this review, success rate was reported to be 96.7–100% over a total of 9 studies. However, there was a lack of consensus on a universal success criterion between authors emphasizing the need for agreement. The average follow up was 29 months and most reported complications were aesthetic (63 cases, 4.7%), whilst there were relatively fewer biological, (20 cases, 1.5%), and hardware complications (24 cases, 1.8%). Success rate is an uncommon clinical outcome with 9 out of 26 of the selected RCTs reporting it. In these studies, single immediate implants showed a high success rate with low numbers of biological and hardware complications, and high patient satisfaction with aesthetics were reported in the short-term follow-up of one year.
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Affiliation(s)
- Charn Thanissorn
- UWA Dental School, The University of Western Australia, 17 Monash Ave, Nedlands, WA 6009, Australia; (C.T.); (J.G.); (D.J.Y.C.); (O.K.); (N.K.)
| | - Jason Guo
- UWA Dental School, The University of Western Australia, 17 Monash Ave, Nedlands, WA 6009, Australia; (C.T.); (J.G.); (D.J.Y.C.); (O.K.); (N.K.)
| | - Dianna Jing Ying Chan
- UWA Dental School, The University of Western Australia, 17 Monash Ave, Nedlands, WA 6009, Australia; (C.T.); (J.G.); (D.J.Y.C.); (O.K.); (N.K.)
| | - Bryar Koyi
- Independent Researcher, London W11 3LF, UK;
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, 17 Monash Ave, Nedlands, WA 6009, Australia; (C.T.); (J.G.); (D.J.Y.C.); (O.K.); (N.K.)
| | - Nabil Khzam
- UWA Dental School, The University of Western Australia, 17 Monash Ave, Nedlands, WA 6009, Australia; (C.T.); (J.G.); (D.J.Y.C.); (O.K.); (N.K.)
- Independent Researcher, Como, WA 6152, Australia
| | - Leticia Algarves Miranda
- UWA Dental School, The University of Western Australia, 17 Monash Ave, Nedlands, WA 6009, Australia; (C.T.); (J.G.); (D.J.Y.C.); (O.K.); (N.K.)
- Correspondence: ; Tel.: +61-8-6457-7894
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Abstract
Esthetic complications in implant dentistry have become a significant consideration for patients and practitioners. This review presents an appraisal on the current knowledge of the physiological peri-implant soft-tissue dimensions and factors that may compromise peri-implant tissue esthetics. Factors such as papilla fill adjacent to the implant and midfacial mucosal height are critical parameters that determine the esthetic success of implant-supported restorations. Papilla fill adjacent to a single dental implant appears to depend upon the clinical attachment level of the neighboring tooth. A horizontal inter-implant distance of at least 3 mm is necessary to ensure optimal interproximal mucosal embrasure between two adjacent implants in the anterior maxilla. In cases where implants cannot be placed at least 3 mm apart, a single implant with a cantilever bridge should be considered. Buccolingual implant positioning plays a major role in midfacial mucosal height. Soft-tissue volume grafting following immediate implant placement in the presence of a thin soft-tissue phenotype or simultaneous to surgical peri-implantitis therapy might help to overcome facial mucosa recession.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Madical Center of the Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
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28
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Garcia‐Sanchez R, Dopico J, Kalemaj Z, Buti J, Pardo Zamora G, Mardas N. “Comparison of clinical outcomes of immediate versus delayed placement of dental implants. A systematic review and meta‐analysis”. Clin Oral Implants Res 2022; 33:231-277. [DOI: 10.1111/clr.13892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 12/01/2021] [Accepted: 12/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ruben Garcia‐Sanchez
- King’s College London UK
- Guy's and St Thomas' NHS Foundation Trust London UK
- Universidad de Murcia Murcia Spain
| | - Jose Dopico
- Universidad de Santiago Santiago de Compostela Spain
| | | | | | | | - Nikos Mardas
- QMUL Barts & The London School of Dentistry London UK
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29
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Fickl S, Therese Kröger A, Dietrich T, Kebschull M. Influence of soft tissue augmentation procedures around dental implants on marginal bone level changes-A systematic review. Clin Oral Implants Res 2021; 32 Suppl 21:108-137. [PMID: 34642978 DOI: 10.1111/clr.13829] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This systematic review assessed the influence of soft tissue augmentation procedures on marginal bone level changes in partial or fully edentulous patients. MATERIAL AND METHODS We identified three relevant PICO questions related to soft tissue augmentation procedures and conducted a systematic search of four major electronic databases for clinical studies in systemically healthy patients receiving at least one dental implant and a minimum follow-up of one year after implant placement. The primary outcome was mean difference in marginal bone levels, and secondary outcomes were clinical and patient-related outcomes such as thickness of peri-implant mucosa, bleeding indices, and Pink Esthetic Score. RESULTS We identified 20 publications reporting on 16 relevant comparisons. Studies varied considerably and thus only two meta-analyses could be performed. This systematic review showed that: Soft tissue augmentation either for augmentation of keratinized mucosa or soft tissue volume inconsistently had an effect on marginal bone level changes when compared to no soft tissue augmentation, but consistently improved secondary outcomes. The combination soft and hard tissue augmentation showed no statistically significant difference in terms of marginal bone level changes when compared to hard tissue augmentation alone, but resulted in less marginal soft tissue recession as shown by a meta-analysis. Soft or hard tissue augmentation performed as contour augmentations resulted in comparable marginal bone level changes. CONCLUSIONS Peri-implant soft and hard tissues seem to have a bidirectional relationship: "Bone stands hard, but soft tissue is the guard".
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Affiliation(s)
- Stefan Fickl
- Department of Periodontology, Julius-Maximilians University Würzburg, Würzburg, Germany.,Private practice, Fürth, Germany
| | - Annika Therese Kröger
- Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK.,Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Thomas Dietrich
- Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK.,Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Moritz Kebschull
- Birmingham Community Healthcare NHS Trust, Birmingham, UK.,Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK.,Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, USA
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30
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Raghoebar GM, Korfage A, Meijer HJA, Gareb B, Vissink A, Delli K. Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:138-156. [PMID: 34642988 DOI: 10.1111/clr.13759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/02/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess the outcomes of soft tissue augmentation, in terms of change in level and thickness of mid-buccal mucosa, at implants sites in the zone of the aesthetic priority. MATERIAL AND METHODS MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases were searched (last search on 1 June 2020). Inclusion criteria were studies reporting outcomes of different materials and timing of grafting in patients undergoing soft tissue augmentation at implant sites in the aesthetic zone with a follow-up of ≥1 year after implant placement. Outcome measures assessed included changes in level and thickness of mid-buccal mucosa, implant survival, peri-implant health and patients' satisfaction. RESULTS Eighteen out of 2,185 articles fulfilled the inclusion criteria. Meta-analysis revealed a significant difference in vertical mid-buccal soft tissue change (0.34 mm, 95% CI: 0.13-0.56, p = .002) and mid-buccal mucosa thickness (0.66 mm, 95% CI: 0.35-0.97, p < .001) following immediate implant placement in favour of the use of a graft versus no graft. Mean difference in mid-buccal mucosa level following delayed implant placement (0.17 mm, 95% CI: 0.01-0.34, p = .042) was also in favour of the use of a graft versus no graft. With regard to mucosa thickness, the use of a graft was not in favour compared with no graft following delayed implant placement (0.22 mm, 95% CI: -0.04-0.47, p = .095). Observed changes remained stable in the medium term. CONCLUSION Soft tissue augmentation in the zone of the aesthetic priority results in less recession and a thicker mid-buccal mucosa following immediate implant placement and less recession in mid-buccal mucosa following delayed implant placement compared with no graft.
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Affiliation(s)
- Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anke Korfage
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, University of Groningen, University Medical Center Groningen, Centre for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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31
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Fernandes D, Nunes S, López-Castro G, Marques T, Montero J, Borges T. Effect of customized healing abutments on the peri-implant linear and volumetric tissue changes at maxillary immediate implant sites: A 1-year prospective randomized clinical trial. Clin Implant Dent Relat Res 2021; 23:745-757. [PMID: 34423560 DOI: 10.1111/cid.13044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/07/2021] [Accepted: 08/07/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Immediate implant placement (IIP) associated with the use of bone substitutes and collagen matrices (CM) seems to reduce the amount of resorption at peri-implant areas. Recently, customized healing abutments (CA) appeared as another solution in order to seal the socket and preserve the original soft tissue contour. PURPOSE To evaluate peri-implant tissues dimensional changes after using customized healing abutments compared with the use of xenogeneic collagen matrices as socket sealing options in flapless maxillary immediate implant placement. MATERIAL AND METHODS The present study was designed as a prospective, randomized, controlled clinical trial. Patients were allocated into two groups depending on the socket sealing option: in the CM group a collagen matrix was used and in the CA group a customized abutment. Digital impressions were taken prior to extraction, 1, 4, and 12 months after implant insertion and the digital files allowed to evaluate linear buccal changes (MBC) and the buccal volumetric variation (BVv) between the different time points at peri-implant tissue areas. Additionally, mucosa variation was computed assessing the papilla presence and the midfacial mucosa height. Statistical significance was set at 0.05. RESULTS Twenty-eight patients were observed during a 12-month period. Significant differences between mean values of BVv at the first month were observed at the CM and CA group (-9.75 ± 6.65% and -4.76 ± 5.29%, respectively) (p = 0.043). At the 1-year follow-up, no significant differences were found in terms of BVv between the two groups, although the thin bone phenotype (≤1 mm) significantly influenced the volumetric variations that occurred in each group. No significant differences were noticed in midfacial mucosa and papillae alteration between groups, after 1 year of treatment. CONCLUSION Both treatment options are predictable solutions for socket sealing in IIP, although a higher volumetric variation can be expected in the presence of thin bone phenotypes.
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Affiliation(s)
- Danilo Fernandes
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain.,Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Sílvia Nunes
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Gonzalo López-Castro
- Faculty of Medicine and Dental Medicine, Universidad de Santiago de Compostela, Santiago, Spain
| | - Tiago Marques
- Faculty of Dental Medicine, Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Tiago Borges
- Faculty of Dental Medicine, Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
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Mareque S, Castelo-Baz P, López-Malla J, Blanco J, Nart J, Vallés C. Clinical and esthetic outcomes of immediate implant placement compared to alveolar ridge preservation: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4735-4748. [PMID: 34100157 DOI: 10.1007/s00784-021-03986-6] [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: 02/02/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
AIM The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP) in terms of clinical, esthetic, and patient-reported outcomes. METHODS A manual and electronic search (National Library of Medicine) was performed for controlled clinical trials, with at least 12 months of follow-up. Primary outcome variable was implant survival and secondary outcomes were marginal bone level (MBL) (change), pink esthetic score (PES), mid-facial mucosal level (change), papilla index score, complications, and patient-reported outcomes. RESULTS A total of 10 publications were included (7 randomized clinical trials and 3 controlled clinical trials). The results from the meta-analyses showed that survival rate was significantly lower in the IIP group compared to ARP group [RR = 0.33; 95% CI (0.14; 0.78); p = 0.01]. No significant differences between the two groups were observed regarding radiographic MBL, PES scores, or mid-facial mucosal level (p > 0.05). CONCLUSION The results from this systematic review and meta-analysis showed that IIP had lower survival rates and similar esthetic results when compared to ARP. CLINICAL RELEVANCE Clinicians should weigh the benefits and disadvantages of each intervention to select the optimal timing of implant placement.
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Affiliation(s)
- Santiago Mareque
- School of Medicine and Dentistry, Periodontology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pablo Castelo-Baz
- School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Joaquín López-Malla
- Department of Periodontology, Faculty of Dentistry, University of Alfonso X El Sabio, Madrid, Spain
| | - Juan Blanco
- School of Medicine and Dentistry, Periodontology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain.
| | - Cristina Vallés
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain
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de Siqueira GRC, Tavares JR, Pedrosa RF, de Siqueira RAC, Fernandes GVDO. Immediate implant with provisionalization and soft tissue grafting after 4-year follow-up. Clin Adv Periodontics 2021; 12:32-38. [PMID: 33914411 DOI: 10.1002/cap.10162] [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: 11/07/2020] [Accepted: 04/24/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION This paper presents a case report of immediate implant placement (IIP) with a provisionalization technique to restore function and esthetics with follow-up after 4 years. CASE PRESENTATION Minimally traumatic extraction was performed with IIP, soft-tissue grafting, and immediate provisional crown. Six months after optimal healing, the patient was submitted to an esthetic restorative work through veneers in lithium disilicate. Fourteen-month and 4-year follow-up visits revealed stability of the peri-implant soft-tissues with peri-implant health status, with the evaluation of the pink and white esthetic score, yielding to mean scores, respectively, in 14 months of 11.62 ± 2.07 (pink esthetic score [PES]) and 18.25 ± 1.46 (PES/white esthetic score [WES]) and in 4 years of 11.0 ± 1.32 (PES) and 17.62 ± 0.65 (PES/WES). Intraoral digital radiographs showed minimal crestal bone level changes throughout the follow-up period. Thus, IIP is a sensitive technique procedure, and a 3D implant position is crucial for success. CONCLUSION Immediate implant with grafting to fill the gap and soft tissue augmentation led to less horizontal changes and stable mucosal margin, and immediate provisionalization helped to maintain soft tissue architecture, and proper case selection is key for clinical success.
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Affiliation(s)
| | | | | | | | - Gustavo Vicentis de Oliveira Fernandes
- Faculty of Dental Medicine at the Universidade Católica Portuguesa, Viseu, Portugal.,Interdisciplinary Centre for Investigation in Health (CIIS), Viseu, Portugal
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Huang X, Bai J, Liu X, Meng Z, Shang Y, Jiao T, Chen G, Deng J. Scientometric Analysis of Dental Implant Research over the Past 10 Years and Future Research Trends. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6634055. [PMID: 33954187 PMCID: PMC8057884 DOI: 10.1155/2021/6634055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/28/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND We conducted a bibliometrics analysis to explore the recent trends in dental implant research which could help researchers have a clear grasp of the relevant research hotspots and prospects. Material and Methods. Altogether, 15,770 articles on dental implants, from January 1, 2010, to October 31, 2019, were selected from the Web of Science Core Collection. We used BICOMB software to extract the high-frequency MeSH terms and construct binary and coword matrices. gCLUTO software was used for biclustering and visual analysis, Ucinet 6 software for social network analysis, SCIMAT software for strategic diagram building, Citespace 5.5 software to form timeline visualization, and VOSviewer software, eventually, for bibliometrics cocitation network. RESULTS Altogether, 72 high-frequency keywords were extracted from the selected articles and 4 clusters and 7 subcategories were identified through biclustering analysis in the dental implant research field. The use of the strategic diagram also enabled us to find the research hotspot and development trends. CONCLUSIONS The survival rate of dental implants and subsequent restoration have always been the core focus of research. Sinus floor elevation and guided bone regeneration are worthy of constant exploration owing to their reliability. With continuous improvement in technology, immediate loading could become a future research hot spot.
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Affiliation(s)
- Xin Huang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Jin Bai
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Xu Liu
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Zhaosong Meng
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Yuli Shang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Tiejun Jiao
- Department of Oral Implantology, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Gang Chen
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Jiayin Deng
- Department of Periodontics, Stomatological Hospital of Tianjin Medical University, Tianjin, China
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Ferrantino L, Camurati A, Gambino P, Marzolo M, Trisciuoglio D, Santoro G, Farina V, Fontana F, Asa'ad F, Simion M. Aesthetic outcomes of non-functional immediately restored single post-extraction implants with and without connective tissue graft: A multicentre randomized controlled trial. Clin Oral Implants Res 2021; 32:684-694. [PMID: 33638216 DOI: 10.1111/clr.13733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the 1-year aesthetic results of flapless single implants, placed in fresh extraction sockets with bone replacement and immediate provisional restoration with or without a connective tissue graft (CTG). MATERIAL AND METHODS The present study proposes a partially blinded multicentre parallel randomized controlled trial, where computer-generated tables were used for central randomization to allocate treatments. A total of 59 of the 60 patients screened by eight private practices in Northern Italy fulfilled the inclusion criteria. Immediate implants were placed in a fresh extraction socket with a non-functional immediate provisional restoration with (Test group) or without (Control group) a CTG. The primary outcome variable was the implant Crown Aesthetic Index (ICAI) at the 1-year follow-up. RESULTS ICAI for the 59 randomized patients (Test group = 31, Control group = 28) at the 1-year follow-up was 4.69 (95% CI = 3.16-6.22) for the Test group and 3.45 (95% CI = 1.83-5.08) for the Control group, without statistically significant difference between the two groups (p = .086). One implant failure was recorded in each group, resulting in an implant survival rate of 96.8% [95% CI = 83.3-99.9] for the Test group and 96.4% [95% CI = 81.7-99.9] for the Control group. Other secondary outcome variables and complication rates were comparable across the two groups. CONCLUSIONS Within the limitations of the present clinical trial, the results suggested that the adjunct use of CTG is not mandatory to achieve successful aesthetic outcomes for a well-planned immediate implant placement with immediate non-functional provisional restoration in a fresh extraction socket.
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Affiliation(s)
- Luca Ferrantino
- Department of Esthetic Dentistry, Istituto Stomatologico Italiano, University of Milan, Milan, Italy
| | | | | | | | - Davide Trisciuoglio
- Maxillo-Facial and Odontostomatology Unit, Department of Periodontology, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | | | | | - Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Massimo Simion
- Maxillo-Facial and Odontostomatology Unit, Department of Periodontology, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Obreja K, Ramanauskaite A, Begic A, Galarraga-Vinueza ME, Parvini P, Schwarz F. The influence of soft-tissue volume grafting on the maintenance of peri-implant tissue health and stability. Int J Implant Dent 2021; 7:15. [PMID: 33619644 PMCID: PMC7900372 DOI: 10.1186/s40729-021-00295-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background To investigate the influence of soft-tissue volume grafting employing autogenous connective tissue graft (CTG) simultaneous to implant placement on peri-implant tissue health and stability. Material and methods This cross-sectional observational study enrolled 19 patients (n = 29 implants) having dental implants placed with simultaneous soft-tissue volume grafting using CTG (test), and 36 selected controls (n = 55 implants) matched for age and years in function, who underwent conventional implant therapy (i.e., without soft-tissue volume grafting). Clinical outcomes (i.e., plaque index (PI), bleeding on probing (BOP), probing depth (PD), and mucosal recession (MR)) and frequency of peri-implant diseases were evaluated in both groups after a mean follow-up period of 6.15 ± 4.63 years. Results Significant differences between test and control groups at the patient level were noted for median BOP (0.0 vs. 25.0%; p = 0.023) and PD scores (2.33 vs. 2.83 mm; p = 0.001), respectively. The prevalence of peri-implant mucositis and peri-implantitis amounted to 42.1% and 5.3% in the test and to 52.8% and 13.9% in the control group, respectively. Conclusion Simultaneous soft-tissue grafting using CTG had a beneficial effect on the maintenance of peri-implant health.
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Affiliation(s)
- Karina Obreja
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University Frankfurt, Carolinum, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University Frankfurt, Carolinum, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt, Germany.
| | - Amira Begic
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University Frankfurt, Carolinum, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt, Germany
| | | | - Puria Parvini
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University Frankfurt, Carolinum, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University Frankfurt, Carolinum, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt, Germany
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Efficacy of different surgical techniques for peri-implant tissue preservation in immediate implant placement: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:1655-1675. [PMID: 33515121 DOI: 10.1007/s00784-021-03794-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Preserving peri-implant tissues after immediate implant placement (IIP), especially in aesthetic zones, is a topic of interest. OBJECTIVES This systematic review investigated the effects of currently available surgical procedures for preserving peri-implant tissue or ensuring dimensional stability following immediate implant placement. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement's guidelines were followed, and articles were sought on the PubMed and Cochrane databases with no date restrictions. Only randomised clinical trials that evaluated changes in soft and hard tissues around immediately placed implants were included. Statistical analyses were performed, and the studies´ quality was assessed using the Cochrane Collaboration tool. The agreement between reviewers was assessed based on Cohen's kappa statistics. RESULTS Of the 14 studies that met the inclusion criteria, 11 were analysed in the meta-analysis (kappa = 0.814; almost perfect agreement). The use of connective tissue grafts resulted in a significantly greater improvement of the facial gingival level (MD = -0.51; 95% CI: -0.76 to -0.31; p = < .001), and the placement of bone grafts significantly reduced the horizontal resorption of the buccal bone (MD = -0.59; 95% CI: -0.78 to -0.39; p < .001). CONCLUSION Connective tissue grafts and bone grafts positively influence tissue preservation around immediately placed implants. Neither the flapless technique nor palatal implant positioning resulted in significant improvements to any of the investigated parameters. Additional longitudinal studies are required. CLINICAL RELEVANCE This meta-analysis is useful for discerning the effects of soft tissue augmentation, bone grafting, the flapless technique, and palatal implant positioning on preserving peri-implant tissues after immediate implant placement.
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Noh K, Thoma DS, Park JC, Lee DW, Shin SY, Lim HC. A case series of profilometric changes in two implant placement protocols at periodontally compromised non-molar sites. Sci Rep 2021; 11:1714. [PMID: 33462323 PMCID: PMC7813861 DOI: 10.1038/s41598-021-81402-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 01/06/2021] [Indexed: 01/13/2023] Open
Abstract
Information regarding profilometric changes at a soft tissue level following implant placement with different protocols is insufficient. Therefore, this study aimed to comparatively investigate the profilometric tissue changes with respect to late implant placement following alveolar ridge preservation (LP/ARP) and early implantation (EP) in periodontally compromised non-molar extraction sites. Sixteen patients were randomly assigned to the following groups: implant placement 4 months post-ARP (group LP/ARP) and tooth extraction and implant placement 4–8 weeks post-extraction (group EP). Dental impressions were obtained immediately after final prosthesis insertion and at 3, 6, and 12 months. At the time of implant placement, bone augmentation was performed in the majority of the patients. Profilometric changes of the tissue contour were minimal between the final prosthesis insertion and 12 months in the mid-facial area (0.04–0.35 mm in group LP/ARP, 0.04–0.19 mm in group EP). The overall tissue volume increased in both groups (1.70 mm3 in group LP/ARP, 0.96 mm3 in group EP). In conclusion, LP/ARP and EP led to similar stability of the peri-implant tissue contour between the final prosthesis insertion and at 12 months. Moreover, the change of peri-implant tissue on the soft tissue level was minimal in both modalities.
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Affiliation(s)
- Kwantae Noh
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jung-Chul Park
- Department of Periodontology, College of Dentistry, Dankook University, Cheonan-si, Republic of Korea
| | - Dong-Woon Lee
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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Influence of Immediate Implant Placement and Provisionalization with or without Soft Tissue Augmentation on Hard and Soft Tissues in the Esthetic Zone: A One-Year Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8822804. [PMID: 33490278 PMCID: PMC7803424 DOI: 10.1155/2021/8822804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/02/2020] [Accepted: 12/26/2020] [Indexed: 11/25/2022]
Abstract
The purpose of this clinical research was to evaluate peri-implant marginal changes around immediate implants placed either with the application of SCTG or XCM or without soft tissue grafting. A total of 48 patients requiring a single implant-supported restoration in the anterior jaw were selected for inclusion. Three surgical procedures were performed, as follows: type 1 implant with subepithelial connective tissue graft (SCTG), type 1 implant with xenogenic collagen matrix (XCM), and type 1 implant without soft tissue augmentation (NG) (control group). The marginal change of peri-implant soft tissue, facial soft tissue thickness (FSTT), peri-implant health status, esthetics, and patient satisfaction were assessed at one year after surgery. All of the placed implants showed a survival rate of 100%. No significant differences in FSTT were recorded between the SCTG group and the XCM group after treatment (P > 0.05), while the NG group presented a significant difference (P < 0.05). Patients in the NG group lost significantly more in the buccal marginal level than did patients in the SCTG group and those in the XCM group (P < 0.05). The favourable success rate recorded in all groups confirmed immediate tooth replacement as a choice of treatment for a missing anterior single tooth. The NG group presented significant changes of FSTT and buccal marginal level, while XCM constituted a viable alternative to SCTG.
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Lim HC, Paeng KW, Kim MJ, Jung RE, Hämmerle CHF, Jung UW, Thoma DS. Immediate implant placement in conjunction with guided bone regeneration and/or connective tissue grafts: an experimental study in canines. J Periodontal Implant Sci 2021; 52:170-180. [PMID: 35505577 PMCID: PMC9064777 DOI: 10.5051/jpis.2104040202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/29/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose This study was conducted to assess the effect of hard and/or soft tissue grafting on immediate implants in a preclinical model. Methods In 5 mongrel dogs, the distal roots of P2 and P3 were extracted from the maxilla (4 sites in each animal), and immediate implant placement was performed. Each site was randomly assigned to 1 of the following 4 groups: i) gap filling with guided bone regeneration (the GBR group), ii) subepithelial connective tissue grafting (the SCTG group), iii) GBR and SCTG (the GBR/SCTG group), and iv) no further treatment (control). Non-submerged healing was provided for 4 months. Histological and histomorphometric analyses were performed. Results Peri-implant tissue height and thickness favored the SCTG group (height of peri-implant mucosa: 1.14 mm; tissue thickness at the implant shoulder and ±1 mm from the shoulder: 1.14 mm, 0.78 mm, and 1.57 mm, respectively; median value) over the other groups. Bone grafting was not effective at the level of the implant shoulder and on the coronal level of the shoulder. In addition, simultaneous soft and hard tissue augmentation (the GBR/SCTG group) led to a less favorable tissue contour compared to GBR or SCTG alone (height of peri-implant mucosa: 3.06 mm; thickness of peri-implant mucosa at the implant shoulder and ±1 mm from the shoulder: 0.72 mm, 0.3 mm, and 1.09 mm, respectively). Conclusion SCTG tended to have positive effects on the thickness and height of the peri-implant mucosa in immediate implant placement. However, simultaneous soft and hard tissue augmentation might not allow a satisfactory tissue contour in cases where the relationship between implant position and neighboring bone housing is unfavorable.
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Affiliation(s)
- Hyun-Chang Lim
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ronald E. Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph HF. Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Daniel S. Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Seyssens L, De Lat L, Cosyn J. Immediate implant placement with or without connective tissue graft: A systematic review and meta-analysis. J Clin Periodontol 2020; 48:284-301. [PMID: 33125754 DOI: 10.1111/jcpe.13397] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/29/2020] [Accepted: 10/25/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To assess the effect of connective tissue graft (CTG) in terms of vertical mid-facial soft tissue change when applied at the buccal aspect following single immediate implant placement (IIP). MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, EMBASE and Cochrane databases as well as a manual search to identify eligible clinical studies up to January 2020. Randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP with CTG and without CTG over a mean follow-up of at least 12 months were included for a qualitative analysis. Meta-analyses were performed on data provided by RCTs. RESULTS Out of 1814 records, 5 RCTs and 3 NRSs reported on 409 (IIP + CTG: 246, IIP: 163) immediately installed implants with a mean follow-up ranging from 12 to 108 months. Only 1 RCT showed low risk of bias. Meta-analysis revealed a significant difference in terms of vertical mid-facial soft tissue change between IIP + CTG and IIP pointing to 0.41 mm (95% CI [0.21; 0.61], p < .001) in favour of soft tissue grafting. This outcome was clinically relevant since the risk for ≥1 mm asymmetry in mid-facial vertical soft tissue level was 12 times (RR 12.10, 95% CI [2.57; 56.91], p = .002) lower following IIP + CTG. Soft tissue grafting also resulted in a trend towards less bleeding on probing (MD 17%, 95% CI [-35%; 1%], p = .06). Meta-analyses did not reveal significant differences in terms of pink aesthetic score, marginal bone level change and probing depth. Results were inconclusive for horizontal mid-facial soft tissue change and papilla height change. Based on GRADE guidelines, a moderate recommendation for the use of a CTG following IIP can be made. CONCLUSION CTG contributes to mid-facial soft tissue stability following IIP. Therefore, CTG should be considered when elevated risk for mid-facial recession is expected in the aesthetic zone (thin gingival biotype, <0.5 mm buccal bone thickness).
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Affiliation(s)
- Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Liesa De Lat
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Tavelli L, Barootchi S, Majzoub J, Siqueira R, Mendonça G, Wang HL. Volumetric changes at implant sites: A systematic appraisal of traditional methods and optical scanning-based digital technologies. J Clin Periodontol 2020; 48:315-334. [PMID: 33151586 DOI: 10.1111/jcpe.13401] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/06/2020] [Accepted: 10/28/2020] [Indexed: 12/13/2022]
Abstract
AIM To evaluate techniques for assessing soft tissue alterations at implant sites and compare the traditionally utilized methods to the newer three-dimensional technologies emerging in the literature. MATERIALS AND METHODS A comprehensive search was performed to identify interventional studies reporting on volumetric changes at implant sites following different treatments. RESULTS Seventy-five articles were included the following: 30 used transgingival piercing alone, one utilized calliper, six with ultrasonography, six on cone-beam computed tomography, and 32 utilized optical scanning and digital technologies. Optical scanning-based digital technologies were the only approach that provided 'volumetric changes,' reported as volumetric variation in mm3 , or the mean distance between the surfaces/mean thickness of the reconstructed volume. High variability in the digital analysis and definition of the region of interest was observed. All the other methods reported volume variation as linear dimensional changes at different apico-coronal levels. No studies compared volumetric changes with different approaches. CONCLUSIONS Despite the emergence of optical scanning-based digital technologies for evaluating volumetric changes, a high degree of variation exists in the executed workflow, which renders the comparison of study results not feasible. Establishment of universal guidelines could allow for volumetric comparisons among different studies and treatments.
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Affiliation(s)
- Lorenzo Tavelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Jad Majzoub
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Rafael Siqueira
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Parvini P, Obreja K, Becker K, Galarraga ME, Schwarz F, Ramanauskaite A. The prevalence of peri-implant disease following immediate implant placement and loading: a cross-sectional analysis after 2 to 10 years. Int J Implant Dent 2020; 6:63. [PMID: 33073302 PMCID: PMC7569077 DOI: 10.1186/s40729-020-00259-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background To evaluate the prevalence of peri-implant disease after immediate implant placement and loading. Material and methods This cross-sectional analysis included a total of 47 patients with 64 implants exhibiting a mean loading time of 2 to 10 years (4.23 ± 1.7 years). The surgical and prosthetic procedures were standardized in all patients. Peri-implant health and disease was assessed based on the established case definitions. Results The prevalence of peri-implant health, peri-implant mucositis, and peri-implantitis amounted to 38.3%, 57.5%, and 4.2% of the patients, respectively. Mucosal recession of 1 mm was present at 4 (6%) implants. No suppuration, pain, or implant failures were reported. Ordinal logistic regression revealed that reduced keratinized mucosa height was significantly associated with the diagnosis of peri-implant mucositis and peri-implantitis (OR = 0.514, P = 0.0125). Conclusion Immediate implant placement and loading was associated with high success rates at 2 to 10 years.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Kathrin Becker
- Department of Orthodontics, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
| | | | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
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44
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Zuiderveld EG, van Nimwegen WG, Meijer HJA, Jung RE, Mühlemann S, Vissink A, Raghoebar GM. Effect of connective tissue grafting on buccal bone changes based on cone beam computed tomography scans in the esthetic zone of single immediate implants: A 1-year randomized controlled trial. J Periodontol 2020; 92:553-561. [PMID: 32918332 PMCID: PMC8246894 DOI: 10.1002/jper.20-0217] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Connective tissue grafting has a beneficial effect on the peri-implant mucosa, but the effect of grafting the buccal mucosa on buccal bone thickness (BBT) has not been investigated, although BBT is proposed to be a key factor for the soft-tissue contour. The aim of this trial was to assess the outcome of a connective tissue graft (CTG) in the esthetic zone of single immediate implants on the change of BBT according to cone beam computed tomography (CBCT) scan analysis. METHODS In a 1-year randomized controlled trial, 60 patients received an immediately placed implant and provisionalization, either combined with CTG (test group) or without CTG (control group). CBCTs were taken preoperatively (Tpre ) and 1 year after definitive restoration (T2 ). Any change in BBT was assessed at different implant levels. Additionally, the change in mid-buccal mucosal level (MBML) and approximal marginal bone level were assessed. RESULTS Fifty-five patients were available for statistical analysis (test group, n = 28; control group, n = 27). At T2 , the average change in BBT was significantly larger in the test group (-0.84 ± 0.61 mm) than in the control group (-0.46 ± 0.54 mm, P = 0.02). A MBML gain of 0.07 ± 0.85 mm in the test and a MBML loss -0.52 ± 1.16 mm in the control group was observed at T2 . Average loss of marginal bone was 0.05 ± 0.33 mm and 0.01 ± 0.38 mm, respectively. CONCLUSIONS The application of CTG in the esthetic zone of immediately placed and provisionalized implants is accompanied with more loss of BBT, but at the same time better maintains the mid-buccal mucosal level.
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Affiliation(s)
- Elise G Zuiderveld
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wouter G van Nimwegen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Sven Mühlemann
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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45
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Seyssens L, Eghbali A, Cosyn J. A 10‐year prospective study on single immediate implants. J Clin Periodontol 2020; 47:1248-1258. [DOI: 10.1111/jcpe.13352] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Lorenz Seyssens
- Faculty of Medicine and Health Sciences Oral Health Sciences Department of Periodontology and Oral Implantology Ghent University Ghent Belgium
| | - Aryan Eghbali
- Faculty of Medicine and Health Sciences Oral Health Sciences Department of Periodontology and Oral Implantology Ghent University Ghent Belgium
- Faculty of Medicine and Pharmacy Oral Health Research Group (ORHE) Vrije Universiteit Brussel (VUB) Brussels Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences Oral Health Sciences Department of Periodontology and Oral Implantology Ghent University Ghent Belgium
- Faculty of Medicine and Pharmacy Oral Health Research Group (ORHE) Vrije Universiteit Brussel (VUB) Brussels Belgium
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46
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De Bruyckere T, Cabeza RG, Eghbali A, Younes F, Cleymaet R, Cosyn J. A randomized controlled study comparing guided bone regeneration with connective tissue graft to reestablish buccal convexity at implant sites: A 1‐year volumetric analysis. Clin Implant Dent Relat Res 2020; 22:468-476. [DOI: 10.1111/cid.12934] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/23/2020] [Accepted: 06/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas De Bruyckere
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE)Vrije Universiteit Brussel (VUB) Brussels Belgium
- Department of Periodontology and Oral ImplantologyFaculty of Medicine and Health Sciences, Dental School, Ghent University Ghent Belgium
| | - Ricardo Garcia Cabeza
- Department of Periodontology and Oral ImplantologyFaculty of Medicine and Health Sciences, Dental School, Ghent University Ghent Belgium
| | - Aryan Eghbali
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE)Vrije Universiteit Brussel (VUB) Brussels Belgium
- Department of Periodontology and Oral ImplantologyFaculty of Medicine and Health Sciences, Dental School, Ghent University Ghent Belgium
| | - Faris Younes
- Department of Periodontology and Oral ImplantologyFaculty of Medicine and Health Sciences, Dental School, Ghent University Ghent Belgium
| | - Roberto Cleymaet
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE)Vrije Universiteit Brussel (VUB) Brussels Belgium
| | - Jan Cosyn
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE)Vrije Universiteit Brussel (VUB) Brussels Belgium
- Department of Periodontology and Oral ImplantologyFaculty of Medicine and Health Sciences, Dental School, Ghent University Ghent Belgium
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47
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Jiang X, Di P, Ren S, Zhang Y, Lin Y. Hard and soft tissue alterations during the healing stage of immediate implant placement and provisionalization with or without connective tissue graft: A randomized clinical trial. J Clin Periodontol 2020; 47:1006-1015. [PMID: 32542725 DOI: 10.1111/jcpe.13331] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/27/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Xi Jiang
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing P.R. China
| | - Ping Di
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing P.R. China
| | - Shuxin Ren
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing P.R. China
| | - Yu Zhang
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing P.R. China
| | - Ye Lin
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing P.R. China
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48
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Borges T, Fernandes D, Almeida B, Pereira M, Martins D, Azevedo L, Marques T. Correlation between alveolar bone morphology and volumetric dimensional changes in immediate maxillary implant placement: A 1‐year prospective cohort study. J Periodontol 2020; 91:1167-1176. [DOI: 10.1002/jper.19-0606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Tiago Borges
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Danilo Fernandes
- Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Bruno Almeida
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Miguel Pereira
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - David Martins
- Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Luís Azevedo
- Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Tiago Marques
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
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49
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Zhou Y, Gao J, Sheng M, Qi W, Jin J, He F. Facial alveolar bone alterations and gray value changes based on cone beam computed tomography around maxillary anterior implants: A clinical retrospective study of 1-3 years. Clin Oral Implants Res 2020; 31:476-487. [PMID: 31990412 DOI: 10.1111/clr.13583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 11/14/2019] [Accepted: 01/08/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The purpose of this cone beam computed tomography (CBCT) study was to describe facial alveolar bone alterations and gray value (GV) changes around implants in aesthetic anterior maxilla with simultaneous guided bone regeneration (GBR) and to investigate potential influence of factors related to vertical alveolar bone stability, such as particle sizes of the deproteinized bovine bone mineral (DBBM) used. MATERIALS AND METHODS A retrospective study design was adopted. Four facio-palatal cross-sectional CBCT images of 166 implants from 124 patients who had maxillary anterior implants were obtained. Measurements of the vertical facial alveolar bone level (VFBL), horizontal facial alveolar bone thickness (HFBT), and GV were identified of 1-3 years. Then, correlation coefficients for those parameters were calculated. Finally, linear mixed models were established to investigate potential factors influencing vertical alveolar bone resorption. RESULTS Facial alveolar bone underwent fast bone modeling and remodeling during the first 6 months, with decreases of 1.00 ± 1.19 and 0.74 ± 0.86 mm in VFBL and HFBT in implant shoulder, respectively, and there was positive and significant correlation between the alterations in VFBL and HFBT1 (rs = .516, p = .000). Linear mixed models identified particle size of DBBM as a critical factor associated with vertical bone resorption (p = .000). The GV gradually increased during the follow-up period. CONCLUSIONS Rapid and unavoidable peri-implant bone resorption usually happened during the first 6 months after implant placement. GBR is a predictable treatment for maxillary anterior implants, since GV has an increasing trend. Large bone particles of DBBM help maintain vertical alveolar bone stability.
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Affiliation(s)
- Yi Zhou
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Jiayu Gao
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Min Sheng
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Wenting Qi
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Jiali Jin
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Fuming He
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
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50
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Sicilia-Felechosa A, Pereira-Fernández A, García-Lareu J, Bernardo-González J, Sicilia-Blanco P, Cuesta-Fernández I. Flapless immediate implant placement and provisionalization in periodontal patients: A retrospective consecutive case-series study of single-tooth sites with dehiscence-type osseous defects. Clin Oral Implants Res 2019; 31:229-238. [PMID: 31755601 DOI: 10.1111/clr.13559] [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: 03/03/2019] [Revised: 10/30/2019] [Accepted: 11/10/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To assess the clinical outcomes of flapless, immediate implant placement with simultaneous augmentation of dehiscence defects and immediate provisional restoration. MATERIALS AND METHODS Retrospective evaluation of 40 periodontal patients who received a flapless immediate implant for single-tooth replacement with simultaneous augmentation of dehiscence defects and immediate provisional restoration, at follow-up periods ranging from 1 year minimum to 7 years maximum. Dehiscence defects were augmented using autogenous bone grafts and/or deproteinized bovine bone mineral, and autogenous or allogeneic connective tissue grafts. The following aspects were evaluated: clinical success (Clinical Oral Implants Research, 8, 1997, 161), crestal bone loss (calibrated digital periapical X-rays) and aesthetics (Pink Esthetic Score, PES). Additionally, a questionnaire was devised to obtain patient's subjective evaluation. RESULTS A 98.3% (95% CI: 91%-99%) success rate was observed. At 8 weeks, mean bone loss was 0.47 mm (n = 39); between 8 weeks and 1 year, this va lue attained 0.24 mm and between years 1 and 5 years 0.06 mm (n = 9). The evaluated PES in 37 single-tooth implants was 12.4, with PES = 7 (aesthetic failures) in two cases, and aesthetic outcomes were excellent (PES ≥ 12) in 29 cases (78.4%). When compared with the contralateral tooth, a recession under 1 mm was observed in 78% of cases. The patient's subjective satisfaction value ranged from 98% to 100%. CONCLUSION This type of minimally invasive treatment of alveoli with buccal plate deficiencies delivers, in the hands of an experienced clinician, a high clinical and aesthetic success percentage being rated by patients as satisfactory. Clinicians should be aware that 1-2 mm comparative recession could be observed.
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Affiliation(s)
- Alberto Sicilia-Felechosa
- Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Dentistry, University of Oviedo, Oviedo, Spain.,Clínica Sicilia, Oviedo, Spain
| | - Adolfo Pereira-Fernández
- Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Dentistry, University of Oviedo, Oviedo, Spain
| | - Javier García-Lareu
- Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Dentistry, University of Oviedo, Oviedo, Spain
| | - Julio Bernardo-González
- Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Dentistry, University of Oviedo, Oviedo, Spain
| | - Pelayo Sicilia-Blanco
- Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Dentistry, University of Oviedo, Oviedo, Spain.,Clínica Sicilia, Oviedo, Spain
| | - Isabel Cuesta-Fernández
- Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Dentistry, University of Oviedo, Oviedo, Spain
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