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Pedrinaci I, Hamilton A, Lanis A, Sanz M, Gallucci GO. The Bio-Restorative Concept for Implant-Supported Restorations. J ESTHET RESTOR DENT 2024. [PMID: 39210698 DOI: 10.1111/jerd.13306] [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: 06/03/2024] [Revised: 08/07/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE This study aims to present the bio-restorative approach in implant dentistry, which combines biological and restorative concepts through digital planning. This concept combines periodontal, surgical, and prosthetic variables, aiming to reduce patient morbidity while achieving satisfactory esthetic and functional outcomes in implant-supported restorations in the long term. OVERVIEW Implant dentistry evolved from a primarily surgical to a recent prosthetically driven approach. This evolution was partly due to advancements in bone reconstructive techniques and an increased demand for esthetic outcomes. Recently, digital planning has introduced a new paradigm that allows for the full integration of both approaches. The bio-restorative concept considers functional, esthetic, and biological variables in a virtual planning environment. This is achieved through the simultaneous digital assessment of (A) anatomical site characteristics and (B) implant restorative variables. These variables include digital tooth arrangement, soft-hard tissue conditions, implant variables, supra-platform components, and a surgical plan that respects or modifies peri-implant phenotype. CONCLUSIONS The bio-restorative concept is intended to improve contemporary implant dentistry by integrating updated biological and prosthetic notions through digital planning. Adopting this paradigm has the potential to redefine the standards in implant dentistry, fostering a holistic and patient-centered approach. CLINICAL CONSIDERATIONS It enhances patient and clinician satisfaction through more efficient and less invasive procedures. Significantly, it improves predictability, leading to successful implant-supported restorations in the long term.
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Affiliation(s)
- Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Adam Hamilton
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Australia
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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Dolińska E, Węglarz A, Jaroma W, Kornowska G, Zapaśnik Z, Włodarczyk P, Wawryniuk J, Pietruska M. Periodontal Patients' Perceptions and Knowledge of Dental Implants-A Questionnaire Study. J Clin Med 2024; 13:4859. [PMID: 39201001 PMCID: PMC11355290 DOI: 10.3390/jcm13164859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/08/2024] [Accepted: 08/16/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Highly prevalent tooth loss is observed among populations around the world. To restore masticatory function and satisfactory aesthetics, missing teeth must be replaced. Dental implants are increasingly used for this purpose. This study aimed to assess periodontal patients' knowledge and attitudes towards dental implants. Methods: 467 anonymous questionnaires of periodontal patients were analyzed. The population participants were divided according to gender, age, education and place of residence. In the statistical analysis, the chi-squared test of independence was used (p < 0.05). The main questions addressed patients' knowledge about dental implants and the factors influencing their decision to undergo implantation. Results: The majority of periodontal patients were aware of dental implants and the importance of oral hygiene in their maintenance. However, the population studied had many knowledge deficits, especially on the technical and biological aspects of implants. The lack of knowledge about peri-implantitis was surprising in the group seeking professional periodontal care. Patients obtained information mainly from the internet and from family and friends, with their dentists being the third source. Good functional and aesthetic outcomes would encourage them to undergo the implantation procedure, and high cost and the possibility of complications were the most discouraging factors. Conclusions: Given the growing popularity of implant treatment, patients should be provided with evidence-based knowledge about indications and possible contraindications to implants to make informed decisions.
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Affiliation(s)
- Ewa Dolińska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland;
| | - Anna Węglarz
- Student’s Research Group at the Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.W.); (W.J.); (G.K.); (Z.Z.); (P.W.); (J.W.)
| | - Weronika Jaroma
- Student’s Research Group at the Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.W.); (W.J.); (G.K.); (Z.Z.); (P.W.); (J.W.)
| | - Gabriela Kornowska
- Student’s Research Group at the Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.W.); (W.J.); (G.K.); (Z.Z.); (P.W.); (J.W.)
| | - Zuzanna Zapaśnik
- Student’s Research Group at the Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.W.); (W.J.); (G.K.); (Z.Z.); (P.W.); (J.W.)
| | - Patrycja Włodarczyk
- Student’s Research Group at the Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.W.); (W.J.); (G.K.); (Z.Z.); (P.W.); (J.W.)
| | - Jakub Wawryniuk
- Student’s Research Group at the Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.W.); (W.J.); (G.K.); (Z.Z.); (P.W.); (J.W.)
| | - Małgorzata Pietruska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland;
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Park JW, Goodacre CJ, Kan JYK, Lozada J, Al-Ardah A. Proposal regarding horizontal and vertical positioning of single implants placed in healed sites: Effect on cervical crown form and the need for bone grafting. J Prosthet Dent 2024:S0022-3913(24)00381-0. [PMID: 38918155 DOI: 10.1016/j.prosdent.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024]
Abstract
STATEMENT OF PROBLEM When single implants are placed in healed sites, guidelines are lacking on the horizontal and vertical implant positions that optimize cervical crown form and the implant locations that would require bone grafting to develop the optimal crown form. PURPOSE The purpose of this clinical study was to evaluate the cervical contour of wax patterns formed on casts of single implants placed in healed sites and to determine which horizontal and vertical implant positions produced the best cervical crown form and which indicated the need for bone grafting. MATERIAL AND METHODS Fifty-eight wax patterns were fabricated on casts where implants had been placed in healed sites without bone grafting. The wax patterns were subjectively assessed by 5 dental faculty members and 5 graduate students as having good, fair, or poor cervical crown form. Horizontal measurements were made between the facial surface of the implant and a round metal wire connecting the gingival zeniths of the adjacent teeth. Vertical measurements were also made between the wire and implant platform. The subjective assessments along with the horizontal and vertical implant position measurements were used to propose guidelines for optimal implant placement in healed sites. RESULTS Horizontal distances of 2.0 to 3.0 mm produced good cervical crown contours, with distances >3.0 mm and <2.0 mm resulting in fair or poor assessments. Vertical distances of 3.0 to 4.0 mm were judged to have good cervical crown contour, whereas depths of 1.0 mm or less were assessed as poor. CONCLUSIONS Based on the subjective assessment of wax patterns formed on casts of single implants placed in healed sites, a guideline of 2.0 to 3.0 mm is proposed for the horizontal distance between a line connecting the adjacent gingival zeniths and the facial surface of the implant. A vertical distance guideline of 3.0 to 4.0 mm is proposed between the adjacent gingival zeniths and the implant platform.
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Affiliation(s)
- Joon W Park
- Private practice, Fullerton, Calif.; and Former student, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Charles J Goodacre
- Distinguished Professor, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif.
| | - Joseph Y K Kan
- Professor, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Jaime Lozada
- Professor and Program Director, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Aladdin Al-Ardah
- Associate Professor, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
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Vatėnas I, Linkevičius T. The use of the connective tissue graft from the palate for vertical soft tissue augmentation during submerged dental implant placement: A case series. Clin Exp Dent Res 2022; 8:1103-1108. [PMID: 35789972 PMCID: PMC9562572 DOI: 10.1002/cre2.626] [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: 04/05/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives To evaluate the efficacy of the soft tissue augmentation vertically, using connective tissue graft from the palate, during submerged dental implant placement. Material and Methods Vertical soft tissue augmentation, using connective tissue graft from the palate, combining with submerged dental implant placement was performed for 50 patients (10 males and 40 females, mean age 57.22 years). Soft tissue thickness vertically was measured in the middle of the alveolar crest with the periodontal probe. After 3 months, healing abutments or multiunits were connected to the dental implants, augmented soft tissue thickness was measured vertically in the middle of the alveolar crest. The vertical soft tissue volume gain was calculated using analysis of variance descriptive analysis, significance set to p = .05. Results All 50 autogenous connective tissue grafts from the palate healed successfully. The average thickness of the soft tissue grafts from the palate was 1.8 ± 0.41 mm. After 3 months, soft tissue thickness vertically increased from 2.27 ± 0.64 mm to 4.35 ± 0.64 mm. This difference between mean figures, between the groups, before and after soft tissue augmentation was found to be statistically significant F (263;477). The mean increase in soft tissue thickness was 2.08 ± 0.71 mm. Conclusion It can be concluded that soft tissue augmentation vertically, using connective tissue graft from the palate can be successfully used for vertical soft tissue augmentation.
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Affiliation(s)
- Imantas Vatėnas
- Šiaulių Implantologijos Klinika Šiauliai Lithuania
- Institute of Odontology, Faculty of Medicine Vilnius University Vilnius Lithuania
| | - Tomas Linkevičius
- Šiaulių Implantologijos Klinika Šiauliai Lithuania
- Institute of Odontology, Faculty of Medicine Vilnius University Vilnius Lithuania
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A Novel Method for Digital Reconstruction of the Mucogingival Borderline in Optical Scans of Dental Plaster Casts. J Clin Med 2022; 11:jcm11092383. [PMID: 35566508 PMCID: PMC9099921 DOI: 10.3390/jcm11092383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 12/14/2022] Open
Abstract
Adequate soft-tissue dimensions have been shown to be crucial for the long-term success of dental implants. To date, there is evidence that placement of dental implants should only be conducted in an area covered with attached gingiva. Modern implant planning software does not visualize soft-tissue dimensions. This study aims to calculate the course of the mucogingival borderline (MG-BL) using statistical shape models (SSM). Visualization of the MG-BL allows the practitioner to consider the soft tissue supply during implant planning. To deploy an SSM of the MG-BL, healthy individuals were examined and the intra-oral anatomy was captured using an intra-oral scanner (IOS). The empirical anatomical data was superimposed and analyzed by principal component analysis. Using a Leave-One-Out Cross Validation (LOOCV), the prediction of the SSM was compared with the original anatomy extracted from IOS. The median error for MG-BL reconstruction was 1.06 mm (0.49–2.15 mm) and 0.81 mm (0.38–1.54 mm) for the maxilla and mandible, respectively. While this method forgoes any technical work or additional patient examination, it represents an effective and digital method for the depiction of soft-tissue dimensions. To achieve clinical applicability, a higher number of datasets has to be implemented in the SSM.
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Duong HY, Roccuzzo A, Stähli A, Salvi GE, Lang NP, Sculean A. Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses. Periodontol 2000 2022; 88:201-237. [PMID: 35103325 PMCID: PMC9304161 DOI: 10.1111/prd.12419] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dental implants have become a mainstream treatment approach in daily practice, and because of their high survival rates over time, they have become the preferred treatment option for prosthetic rehabilitation in many situations. Despite the relatively high predictability of implant therapy and high costs to patients, patient perceptions of success and patient-reported outcome measures have become increasingly significant in implant dentistry. Increasing numbers of publications deal with oral health-related quality of life and/or patient-reported outcome measures. The aim of this paper was to provide an overview of the available evidence on oral health-related quality of life of fully and partially dentate patients rehabilitated with fixed and removable implant-supported dental prostheses. A comprehensive electronic search was performed on publications in English up to 2021. A selection of standardized questionnaires and scales used for the evaluation of oral health-related quality of life were analyzed and explained. The analysis encompassed three aspects: a functional evaluation of oral health-related quality of life, an esthetic assessment of oral health-related quality of life, and a cost-related evaluation of oral health-related quality of life for rehabilitation with dental implants. The data demonstrated that the preoperative expectations of patients markedly affected the outcomes perceived by the patients. As expected, reconstructions supported by implants substantially improved the stability of conventional dentures and allowed improved function and patient satisfaction. However, from a patient's perspective, oral health-related quality of life was not significantly greater for dental implants compared with conventional tooth-supported prostheses. The connection of the implants to the prostheses with locators or balls indicated high oral health-related quality of life. The data also suggest that patient expectation is not a good predictor of treatment outcome. In terms of esthetic outcomes, the data clearly indicate that patients' perceptions and clinicians' assessments differed, with those of clinicians yielding higher standards. There were no significant differences found between the esthetic oral health-related quality of life ratings for soft tissue-level implants compared with those for bone-level implants. Comparison of all-ceramic and metal-ceramic restorations showed no significant differences in patients' perceptions in terms of esthetic outcomes. Depending on the choice of outcome measure and financial marginal value, supporting a conventional removable partial denture with implants is cost-effective when the patient is willing to invest more to achieve a higher oral health-related quality of life. In conclusion, the oral health-related quality of life of patients rehabilitated with implant-supported dental prostheses did not show overall superiority over conventional prosthetics. Clinicians' and patients' evaluations, especially of esthetic outcomes, are, in the majority of cases, incongruent. Nevertheless, patient-reported outcomes are important in the evaluation of function, esthetics, and the cost-effectiveness of treatment with implant-supported dental prostheses, and should be taken into consideration in daily practice.
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Affiliation(s)
- Ho-Yan Duong
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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7
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Winitsky N, Naimi-Akbar A, Nedelcu R, Jemt T, Smedberg JI. 3-D tooth movement adjacent to single anterior implants and esthetic outcome. A 14- to 20-year follow-up study. Clin Oral Implants Res 2021; 32:1328-1340. [PMID: 34403160 DOI: 10.1111/clr.13833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To report three-dimensional (3-D) movement of teeth adjacent to single-implant crowns (SICs) in the anterior maxilla and to relate the findings to patient characteristics and esthetic outcome. MATERIALS AND METHODS 3-D movements of teeth adjacent to anterior maxillary SICs were measured in 30 patients with original SICs in function after 14-20 years. The movements were related to facial type, lower anterior facial height (LAFH), age at crown delivery, sex, the position of the implant, implant occlusion, cause of tooth loss, follow-up period, orthodontic treatment prior to implant placement, and marginal bone-level changes. The esthetic outcome and quality were assessed using Visual Analog scale (VAS) and California Dental Association (CDA) index. RESULTS 3-D movement of adjacent teeth between 0 and 2.5 mm was observed at follow-up with incisal and palatal movement being most pronounced. Incisal tooth movement of >1 mm was observed in 30% of the patients and was significantly associated with LAFH ≥70 mm. VAS rating associated poorly between patients and clinicians with scores of >80% in 63% and 20%, respectively. The CDA rating was assessed as satisfactory in 87% of the patients. CONCLUSIONS Significantly more extensive infraposition was observed in patients with SICs without occlusion, other causes of tooth loss than trauma, implant in lateral incisor and canine position, and a LAFH of ≥70 mm. Although infraposition occurs, patients are highly satisfied with the esthetics of their implants and the esthetic results are valued as higher by patients than dentists.
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Affiliation(s)
- Nicole Winitsky
- Department of Prosthetic Dentistry, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Prosthetic Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden.,Department of Oral and Maxillofacial Surgery, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Robert Nedelcu
- Department of Surgical Sciences, Plastic, Oral, and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Torsten Jemt
- Department of Prosthetic Dentistry/Dental Material Science, Institute of Odontology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.,Brånemark Clinic, Public Dental Health Service, Region of Västra Götaland, Sweden
| | - Jan-Ivan Smedberg
- Department of Prosthetic Dentistry, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Prosthetic Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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8
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Stimmelmayr M, Edelhoff D, Güth JF, Krennmair G, Herklotz I. Second-stage surgery in the posterior maxilla to enhance and thicken the keratinized gingiva - a case report. J ORAL IMPLANTOL 2021; 48:243-250. [PMID: 33945623 DOI: 10.1563/aaid-joi-d-20-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Bone augmentation and implant placement often lead to a coronal shift of the soft tissue. Therefore replacement of the mucogingival border during second-stage surgery is required. Different techniques have been described in the literature. MATERIAL AND METHODS In this case report a new technique for second-stage surgery from a combination of a modified roll flap, an apically repositioned split thickness flap and thick free gingival grafts between the implants will be described for predictable gain of keratinized mucosa around and between dental implants. RESULTS Stable soft tissue conditions between the implants and buccal in the posterior maxilla could be gained showing almost no post-surgical resorption. CONCLUSION With this modified technique for second-stage surgery functional and esthetic results can be achieved.
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Affiliation(s)
- Michael Stimmelmayr
- Ludwig-Maximilians-Universitat Munchen Prosthodontics Goethestr. 70 GERMANY Munich Bavaria 93413 Ludwig-Maximilians-Universitat Munchen
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Hyun YK, Lee CY, Keerthana S, Ramasamy S, Song SY, Shim JS, Ryu JJ. Horizontal alteration of anterior alveolar ridge after immediate implant placement: A retrospective cone beam computed tomography analysis. J Adv Prosthodont 2021; 13:117-125. [PMID: 34025960 PMCID: PMC8110735 DOI: 10.4047/jap.2021.13.2.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the labio-lingual alterations of the alveolar bone where the implant was placed immediately after tooth extraction. MATERIALS AND METHODS Implants were placed immediately after tooth extraction on anterior alveolar ridges in the maxilla and mandible. The pin-guide system was used to help determine the location and path of implants during the surgical process. The horizontal distance from implants to the outer border of alveolar bone was measured at the rim and middle of the implants in the cone beam computed tomography images. The alteration of alveolar bone was evaluated comparing the horizontal distances measured immediately after surgery and 3 months after surgery. RESULTS The results show that more resorption occurred towards the labial bone than the lingual bone in the maxilla. A similar amount of labial and lingual bone resorption was observed in the mandible. CONCLUSION Considering the horizontal alteration of alveolar bone, labio-lingual positioning of the implant towards the lingual bone in the maxilla and at the center of the alveolar ridge in the mandible is recommended when it is placed immediately after tooth extraction.
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Affiliation(s)
| | - Chung Yun Lee
- Korea University Graduate School, Clinical Dentistry, Seoul, Republic of Korea
| | | | | | - So-Yeon Song
- Department of Dentistry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Ji Suk Shim
- Department of Dentistry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jae Jun Ryu
- Department of Dentistry, Korea University Anam Hospital, Seoul, Republic of Korea
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Koyuncuoglu CZ, Kara HB, Akdemir S, Demir B, Husain NAH, Özcan M. Cleaning Efficacy of Poly-ether-ether-ketone Tips in Eliminating Cement Remnants Around Implants With Different Abutment Heights. J ORAL IMPLANTOL 2020; 46:548-554. [PMID: 33494100 DOI: 10.1563/aaid-joi-d-19-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The excess cement not removed after the cementation of fixed implant-supported restorations may cause loss of peri-implant attachment or adjacent bone. The aims of this study were to evaluate the amount of residual cement at different abutment-crown connection levels and to test the cleaning efficacy of poly-ether-ether-ketone (PEEK) ultrasonic tips after cementation. One implant was placed in an anterior central tooth position 5 mm below the gingival margin in an acrylic model, and 32 stone models were obtained with implant analogs. Abutment heights of 1-2 and 2.5-4 mm were used on the vestibular and lingual sides, respectively. Crowns were cemented and cleaned, and half of the samples were cleaned again using PEEK tips. The abutment-crown suprastructure was then disconnected, and cleaning efficacy was evaluated. Varying amounts of excess cement were found on all specimens except for the PEEK group with abutment-crown connections 1 mm below the gingival margin. An increase of undetected cement remnants was observed when the restoration margins were located deeper subgingivally. Various amounts of excess cement associated with margin location were detected on the abutment-restoration complex despite meticulous cleaning efforts. Ultrasonic PEEK tips were effective at cleaning the cement remnants around implants to a certain depth.
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Affiliation(s)
- Cenker Zeki Koyuncuoglu
- Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey
| | - Haluk Baris Kara
- Department of Proshtetic Dentistry, Faculty of Dentistry, Medipol University, Istanbul, Turkey
| | - Sinan Akdemir
- Dental Prosthetics Technology Program, Health Sciences High School, Medipol University, Istanbul, Turkey
| | | | - Nadin Al-Haj Husain
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mutlu Özcan
- Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey.,Division of Dental Biomaterials, Center for Dental and Oral Medicine, Clinic for Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Morelli T, Zhang S, Monaghan E, Moss KL, Lopez B, Marchesan J. Three-Dimensional Volumetric Changes After Socket Augmentation with Deproteinized Bovine Bone and Collagen Matrix. Int J Oral Maxillofac Implants 2020; 35:566-575. [PMID: 32406655 DOI: 10.11607/jomi.7961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE Socket augmentation decreases the magnitude of alveolar ridge resorption, but the literature is limited in respect to quantifying soft tissue remodeling. The aim of this study was to determine the volumetric and linear dimensional changes at the buccal surface for both hard and soft tissues after socket augmentation treated with a xenogeneic collagen matrix in combination with bone grafting. MATERIALS AND METHODS Twenty-four individuals indicated for tooth extraction were enrolled in this investigation. Each participant was randomly assigned to one of two groups: (1) deproteinized bovine bone + collagen plug, or (2) deproteinized bovine bone + xenogeneic collagen matrix. A cone beam computed tomography scan was taken prior to extraction and at 6 months postextraction. Intraoral scanning images were taken at baseline, 3 months, and 6 months postextraction. Hard and soft tissue analyses were performed to compare linear ridge remodeling and volumetric changes by noncontact reverse-engineering software. RESULTS Both groups showed bone and soft tissue remodeling. For hard tissue remodeling, there was no significant difference between the collagen plug and collagen matrix groups. For soft tissue remodeling, the collagen matrix group showed a reduced soft tissue loss compared with the collagen plug group. The volumetric analysis demonstrated that the mean buccal soft tissue volume loss for the collagen matrix group was 68.6 mm3 compared with 87.6 mm3 found in the collagen plug group (P = .009) over a 6-month period. CONCLUSION This clinical investigation provides early evidence of using the total tissue volume to compare soft and hard tissue remodeling after socket augmentation. The results of this study demonstrated that the use of a xenogeneic collagen matrix reduced the buccal soft tissue loss after tooth extraction, but additional studies are necessary to evaluate the clinical significance of soft tissue augmentation after tooth extraction.
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12
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S Brum R, Galarraga ME, Magrin G, Ruales-Carrera E, Escobar-Ramos M, Rodriguez-Ivich J, Cardoso AC, Volpato C. Employment of U-Shape Technique at Re-Entry Surgery for Papillae Coronal Migration on the Rehabilitation of Anterior Single Implant: 3-Year Follow-Up Case Report. Clin Adv Periodontics 2020; 11:208-212. [PMID: 32391642 DOI: 10.1002/cap.10110] [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: 11/14/2019] [Accepted: 04/20/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The rehabilitation of a maxillary single dental implant represents a great challenge at clinical practice. Harmony among the implant-supported crown and adjacent teeth is required in which concerns pink and white esthetics. The aim of the present case report is to depict a multidisciplinary treatment in which the U-shape flap technique for papillae preservation at second stage surgery was used. CASE PRESENTATION One female patient presenting an un-rehabilitated dental implant at the left central incisor position sought treatment at the Centre of Education and Research on Dental Implants (CEPID). Alterations of color, shape, and position were observed on the anterior maxillary teeth. For proper treatment planning, radiograph, wax-up, and mock-up were performed. Second stage surgery was performed by the U-shape flap technique. A trunnion abutment was installed at the implant and a provisional subcontoured cemented crown was manufactured. Dental bleaching, feldspathic veneers, and a ceramic crown were performed. Oral hygiene instructions were recommended. Follow-up appointments were set at 1.5 and 3 years after restoration placement. After 3-year follow-up, soft tissue stability and health were preserved and papillae coronal migration around the single dental implant was observed. A complication-free treatment was reached, and patient demonstrated satisfaction towards esthetic and function. CONCLUSIONS The use of U-shape technique at second stage surgery associated to adequate prosthetic contour improved soft tissue esthetic outcomes, while the multidisciplinary treatment planning provided adequate solutions, refining harmony between dental and implant-supported components.
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Affiliation(s)
- Renata S Brum
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Maria Elisa Galarraga
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Gabriel Magrin
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Edwin Ruales-Carrera
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Mario Escobar-Ramos
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Jair Rodriguez-Ivich
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Antônio Carlos Cardoso
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Claudia Volpato
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
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Walker-Finch K, Ucer C. Five-year survival rates for implants placed using digitally-designed static surgical guides: a systematic review. Br J Oral Maxillofac Surg 2020; 58:268-276. [PMID: 31917014 DOI: 10.1016/j.bjoms.2019.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 12/13/2019] [Indexed: 01/10/2023]
Abstract
Digitally-designed static surgical guides provide an acceptable level of accuracy and predictability for the placement of dental implants. However, to our knowledge, few published studies have compared the long-term survival of implants placed in this way with those placed using other methods. A systematic search of electronic databases using a population, intervention, comparison, and outcome (PICO) framework was conducted of Medline and EMBASE, as well as grey literature and hand searches, to obtain all relevant work pertaining to the survival of dental implants placed by guided surgery. The studies were required to have at least 10 patients with a follow up of at least five years. A total of 621 titles were screened. Four studies met the inclusion criteria for quantitative analysis, and they all reported the exclusive use of Nobel Biocare implants and the NobelGuide system (Nobel Biocare Services). Cumulative survival rates ranged from 94.5% to 100% over five years. The survival rates of implants placed using digitally-designed static surgical guides are comparable to the estimated overall survival rate (95.6% over five years), despite the complex nature of the treatments done with guided surgery. Clinicians who do these operations should, however, have the experience and ability to revert to conventional freehand techniques if complications arise.
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Affiliation(s)
- K Walker-Finch
- Lindley Dental Centre, Huddersfield, West Yorkshire, UK.
| | - C Ucer
- Department of Dental Implantology, Salford University, Manchester, Greater Manchester, UK
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Kolte AP, Kolte RA, Pakhmode RAV. Assessment of buccal and lingual alveolar bone width in the posterior region at dentate and edentulous sites: A cone-beam computed tomography study. J Indian Soc Periodontol 2020; 24:26-31. [PMID: 31983841 PMCID: PMC6961451 DOI: 10.4103/jisp.jisp_122_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/23/2019] [Accepted: 09/01/2019] [Indexed: 11/04/2022] Open
Abstract
Background Alveolar bone dimensions form an important prognostic factor in determining the success of implant treatment outcome. The present study evaluated the buccal and lingual bone width in posterior dentate and edentulous sites using cone-beam computed tomography (CBCT). Materials and Methods The study included 100 patients, divided equally into two groups, Group A (males) and Group B (females) indicated for implant therapy. CBCT scans were evaluated for the assessment of the thickness of buccal and lingual bone width at four levels, i.e., crestal bone width (CBW), mid root bone width, middle of alveolar bone housing bone width , and most apical portion bone width (APBW). Bone width was measured at three levels in the edentulous region as CBW, bone width 5 mm from crest (CBW-1), and 10 mm from crest (CBW-2). Results Gradual increase in bone width was observed from crestal bone at buccal and lingual level (CBW-B and CBW-L) from 1.10 ± 0.29 mm and 1.21 ± 0.34 mm to APBW at buccal and APBW lingual side from 2.82 ± 0.51 mm and 3.43 ± 0.42 mm, respectively. For both the groups, the differences in bone width at three levels were statistically significant, with CBW being significantly higher for Group A than Group B. Conclusion At edentulous sites, CBW was lesser as compared to the apical levels. The bone width on buccal and lingual sides of dentate sites at the coronal level is minimal compared to the apical level, which has definite implications for implant therapeutics.
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Affiliation(s)
- Abhay Pandurang Kolte
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Rajashri Abhay Kolte
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Resham Aparna Vivek Pakhmode
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
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de Oliveira Limírio JPJ, Lemos CAA, de Luna Gomes JM, Minatel L, Alves Rezende MCR, Pellizzer EP. A clinical comparison of 1-piece versus 2-piece implants: A systematic review and meta-analysis. J Prosthet Dent 2019; 124:439-445. [PMID: 31862146 DOI: 10.1016/j.prosdent.2019.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 07/18/2019] [Accepted: 08/07/2019] [Indexed: 12/21/2022]
Abstract
STATEMENT OF PROBLEM One-step dental implant surgery with a 1-piece implant has been introduced with the aim of simplifying and increasing the effectiveness of treatment and providing greater comfort for the patient. Whether these goals have been met compared with conventional 2-piece implants remains unclear. PURPOSE The purpose of this systematic review and meta-analysis was to compare the use of 1-piece versus 2-piece implants in terms of marginal bone loss and implant survival rate. MATERIAL AND METHODS This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was recorded in the International prospective register of systematic reviews (PROSPERO) database (CRD 42018095721). A literature search was conducted in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases for articles published up to May 2018. The population, intervention, comparison, outcome (PICO) question was, "Do patients who received 1-piece implants show similar marginal bone loss, survival rates, and complications as those who receive 2-piece implants?" RESULTS The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. Implant survival rate was analyzed by using a dichotomous outcome, measured according to risk ratio (RR) and marginal bone loss by continuously evaluating the outcomes according to the mean difference (MD), both with a corresponding 95% confidence interval (CI). Five studies, including 270 participants with a mean age of 54.70 years and receiving 434 dental implants, were included. The mean follow-up period was 4 years. Meta-analysis did not reveal a significant difference in relation to implant survival rate (P=.85; RR: -0.89; CI: -0.27 to 2.98), as well as to marginal bone loss (P=.85; MD: -0.43; CI: -0.43 to -0.52). CONCLUSIONS One- and 2-piece implants demonstrated effectiveness in the rehabilitation of patients requiring dental implants.
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Affiliation(s)
| | - Cleidiel Aparecido Araújo Lemos
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Jéssica Marcela de Luna Gomes
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Lurian Minatel
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | | | - Eduardo Piza Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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Chackartchi T, Romanos GE, Sculean A. Soft tissue‐related complications and management around dental implants. Periodontol 2000 2019; 81:124-138. [DOI: 10.1111/prd.12287] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Tali Chackartchi
- Department of Periodontology Faculty of Dental Medicine Hadassah & Hebrew University Jerusalem Israel
| | - Georgios E. Romanos
- Department of Periodontology School of Dental Medicine Stony Brook University Stony Brook New York USA
| | - Anton Sculean
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
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17
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Wang L, Wang T, Lu Y, Fan Z. A digital approach for 1-step formation of the supraimplant emergence profile at the time of immediate implant placement. J Prosthet Dent 2019; 122:104-107. [DOI: 10.1016/j.prosdent.2018.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 11/17/2022]
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18
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Brouwers JEIG, Buis S, Haumann R, de Groot PPG, de Laat B, Remijn JA. Successful soft and hard tissue augmentation with platelet-rich fibrin in combination with bovine bone space maintainer in a delayed implant placement protocol in the esthetic zone: A case report. Clin Case Rep 2019; 7:1185-1190. [PMID: 31183091 PMCID: PMC6552957 DOI: 10.1002/ccr3.2177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/03/2019] [Accepted: 04/08/2019] [Indexed: 12/29/2022] Open
Abstract
Replacement in the esthetic zone can be very unpredictable and difficult to manage in cases with extreme bone and soft tissue loss. In this case report (2.5-year follow-up), we demonstrate that the use of platelet-rich fibrin in combination with bovine bone can result in a stable, esthetic outcome.
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Affiliation(s)
| | - Sharon Buis
- Institute for Dental ImplantologyAmersfoortThe Netherlands
- Department of Clinical Chemistry and HematologyGelre HospitalsApeldoornThe Netherlands
| | - Rianne Haumann
- Department of Clinical Chemistry and HematologyGelre HospitalsApeldoornThe Netherlands
| | | | - Bas de Laat
- Synapse Research InstituteMaastrichtThe Netherlands
| | - Jasper A. Remijn
- Department of Clinical Chemistry and HematologyGelre HospitalsApeldoornThe Netherlands
- Synapse Research InstituteMaastrichtThe Netherlands
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Guarnieri R, Di Nardo D, Gaimari G, Miccoli G, Testarelli L. Influence of restorative margins position on one-stage laser-microgrooved implants-supported single screwed crowns: A clinical, biochemical, and microbiological analysis. Clin Implant Dent Relat Res 2018; 21:52-59. [PMID: 30475431 DOI: 10.1111/cid.12693] [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: 06/23/2018] [Accepted: 10/05/2018] [Indexed: 11/27/2022]
Abstract
AIM To clinically, biochemically, and microbiologically evaluate the influence of crown margins position on one-stage laser-microgrooved implants. MATERIALS AND METHODS Twenty-one-stage titanium implants with a laser-microgrooved collar surface, supporting screwed, single crown restorations, were placed in 20 partially edentulous patients and evaluated. Clinical parameters included modified plaque index, modified gingival index, peri-implant probing pocket depth, bleeding on probing, and distance between implant shoulder and mucosal margin. The parameters were recorded at baseline (crowns delivery) and at every 6-month recall visit, until the end of the 3 years follow-up period. At the same time intervals, radiographic marginal bone levels were assessed at the mesial and distal aspect of the implant sites. For biochemical analysis, the volume of the peri-implant sulcus fluid, and its levels of interleukin-1beta (IL-1β), interleukin-6 (IL-6), and of tumor necrosis factor-α, were utilized to evaluate the peri-implant health conditions at the end of the 3-year follow-up period. At the same time, microbiological analysis, including the concentration of five putative periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythensis), were assessed. The crown margins positions were classified into four groups (A = intracrevicular position >2 mm, B = intracrevicular position ≤2 mm/<1 mm, C = intracrevicular position ≤1 mm/<0 mm, and D = extracrevicular position), and the biochemical, and microbiological parameters were evaluated at 3 years. RESULTS No statistical differences of clinical and biochemical parameters were found between the four groups. In group A, compared to groups B, C, and D, a statistically significant higher concentration of putative periodontal pathogens was found. CONCLUSIONS Results showed that the intracrevicular deeper position of the restoration margin does not influence the clinical and biochemical peri-implant parameters. The deeper position of the crown margin is associated with a greater amount of putative periodontal pathogenic microflora colonization.
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Affiliation(s)
- Renzo Guarnieri
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Dario Di Nardo
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gianfranco Gaimari
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gabriele Miccoli
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Luca Testarelli
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
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20
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Saulacic N, Schaller B, Muñoz F, Fujioka-Kobayashi M, Kobayashi E, Lang NP, Miron RJ. Recombinant human BMP9 (RhBMP9) in comparison with rhBMP2 for ridge augmentation following tooth extraction: An experimental study in the Beagle dog. Clin Oral Implants Res 2018; 29:1050-1059. [PMID: 30281171 DOI: 10.1111/clr.13371] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The purpose of this study was to compare the effects of rhBMP2 with rhBMP9 on ridge augmentation following healing of extraction sockets in dogs. MATERIAL AND METHODS Five male Beagle dogs, approximately 12 months of age, were used. The mesial roots of the four maxillary premolars were endodontically treated. The distal roots were extracted, and the buccal bony walls removed. All extraction sockets were filled with deproteinized bovine bone mineral (DBBM). A collagen membrane was soaked with 4 μg or 20 μg of rhBMP9, 20 μg of rhBMP2 or sterile saline and placed over the augmented sites. All animals were euthanized after 8 weeks of healing and investigated by micro-CT and histologic analysis. A one-way ANOVA with Tukey's HSD post hoc test was used to compare the differences between the four groups. RESULTS New bone apposition in all defects was observed from the original bone. RhBMP samples showed an increase in bone formation in the buccal area and better integration of DBBM particles when compared to control sites. Both rhBMP9 defects showed higher values of bone (p = 0.024), bone marrow (p = 0.044), and total augmentation volume (p = 0.033) than the rhBMP2 (20 μg) or control sites. Highest bone area was found in rhBMP9 defects (p = 0.895). CONCLUSIONS Within the limitations of the present study, rhBMP9 sites demonstrated higher bone-inducing potential in combination with DBBM than rhBMP2. While rhBMP9s failed to demonstrate a clear dose-response relationship to the outcomes, future studies are necessary to evaluate the appropriate dose and carrier systems.
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Affiliation(s)
- Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Berne, Berne, Switzerland
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Berne, Berne, Switzerland
| | - Fernando Muñoz
- Veterinary Faculty Lugo, University of Santiago de Compostela, Lugo, España
| | - Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Berne, Berne, Switzerland
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Niklaus P Lang
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Berne, Berne, Switzerland
| | - Richard J Miron
- Department of Periodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
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Heydecke G, Mirzakhanian C, Behneke A, Behneke N, Fügl A, Zechner W, Baer RA, Nölken R, Gottesman E, Colic S, Ottria L, Pozzi A. A prospective multicenter evaluation of immediately functionalized tapered conical connection implants for single restorations in maxillary anterior and premolar sites: 3-year results. Clin Oral Investig 2018; 23:1877-1885. [PMID: 30225678 DOI: 10.1007/s00784-018-2614-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This multicenter prospective clinical trial investigated immediately provisionalized, anodized, conical connection, tapered implants with platform shifting in maxillary anterior and premolar sites. MATERIALS AND METHODS Patients requiring single-tooth implant-supported restorations in maxillary anterior and premolar sites were enrolled. Implants were immediately provisionalized and evaluated at insertion, 6 months, and annually thereafter. Outcome measures were marginal bone level change (ΔMBL), cumulative survival rate (CSR), and success rate, soft-tissue parameters, and oral health impact profile (OHIP). ΔMBL and Pink Esthetic Score were analyzed using Wilcoxon signed-rank tests. CSR was calculated using life table analysis. Other soft-tissue parameters were analyzed using sign tests. RESULTS Of 94 enrolled patients (99 implants), 84 (88 implants) attended the 3-year follow-up. After an initial bone loss between implant insertion and 6 months (- 0.92 ± 1.23 mm), bone levels stabilized from 6 months to 3 years (0.13 ± 0.94 mm) with no significant change. The 3-year CSR was 98.9%, and the cumulative success rate was 96.9%. Papilla index scores of 2 or 3 were observed at 88.6% of sites at the 3-year visit compared with 32.8% at implant insertion. Improvements were observed for all other outcomes, including bleeding on probing, esthetics, plaque, and OHIP. CONCLUSIONS This restorative protocol was associated with high primary stability, patient satisfaction, stable bone levels, and an overall improvement of the soft tissue outcomes over a 3-year period. CLINICAL RELEVANCE The presented treatment is a viable option for single-tooth restorations of maxillary anterior teeth and premolars with successful short- to mid-long-term clinical outcomes.
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Affiliation(s)
- Guido Heydecke
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | - Alexandra Behneke
- University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nikolaus Behneke
- University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander Fügl
- School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Werner Zechner
- School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Russell A Baer
- University Associates in Dentistry, Chicago, IL, 60601, USA
| | - Robert Nölken
- University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany.,Private Practice, Lindau, Germany
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Chappuis V, Araújo MG, Buser D. Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites. Periodontol 2000 2018; 73:73-83. [PMID: 28000281 DOI: 10.1111/prd.12167] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The key to achieving pleasing esthetics in implant dentistry is a thorough understanding of the biological processes driving dimensional bone and soft tissue alterations post-extraction. The aim of the present report is first to characterize the extent of bone and soft tissue changes post-extraction and second to identify potential factors influencing tissue preservation in order to facilitate successful treatment outcomes. The facial bone wall thickness has been identified as the most critical factor influencing bone resorption and can be used as a prognostic tool in order to identify sites at risk for future facial bone loss subsequent to tooth extraction. Clinical studies indicated that thin bone wall phenotypes exhibiting a facial bone wall thickness of 1 mm or less revealed progressive bone resorption with a vertical loss of 7.5 mm, whereas thick bone wall phenotypes showed only minor bone resorption with a vertical loss of 1.1 mm. This is in contrast to the dimensional soft tissue alterations. Thin bone wall phenotypes revealed a spontaneous soft tissue thickening after flapless extraction by a factor of seven, whereas thick bone wall phenotypes showed no significant changes in the soft tissue dimensions after 8 weeks of healing. In sites exhibiting a limited bone resorption rate, immediate implant placement may be considered. If such ideal conditions are not present, other timing protocols are recommended to achieve predictable and pleasing esthetics. Socket preservation techniques for ridge preservation utilizing different biomaterials and/or barrier membranes often result in a better maintenance of tissue volumes, although the inevitable biological process of post-extraction bone resorption and bone modeling cannot be arrested. In summary, the knowledge of the biological events driving dimensional tissue alterations post-extraction should be integrated into the comprehensive treatment plan in order to limit tissue loss and to maximize esthetic outcomes.
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Saleh MHA, Ravidà A, Suárez-López del Amo F, Lin GH, Asa'ad F, Wang HL. The effect of implant-abutment junction position on crestal bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:617-633. [DOI: 10.1111/cid.12600] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/27/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Muhammad H. A. Saleh
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | | | - Guo-Hao Lin
- Department of Orofacial Sciences; University of California; San Francisco California
| | - Farah Asa'ad
- Department of Biomedical, Surgical & Dental Sciences; University of Milan; Milan Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
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Marvin JC, Gallegos SI, Parsaei S, Rodrigues DC. In Vitro Evaluation of Cell Compatibility of Dental Cements Used with Titanium Implant Components. J Prosthodont 2018. [DOI: 10.1111/jopr.12784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Jason C. Marvin
- Department of Bioengineering; University of Texas at Dallas; Richardson TX
| | - Silvia I. Gallegos
- Department of Bioengineering; University of Texas at Dallas; Richardson TX
| | - Shaida Parsaei
- Department of Biological Sciences; University of Texas at Dallas; Richardson TX
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25
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Wright SP, Hayden J, Lynd JA, Walker-Finch K, Willett J, Ucer C, Speechley SD. Factors affecting the complexity of dental implant restoration - what is the current evidence and guidance? Br Dent J 2018; 221:615-622. [PMID: 27857100 DOI: 10.1038/sj.bdj.2016.855] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2016] [Indexed: 11/09/2022]
Abstract
Objectives The aim of this paper is to identify the factors that affect the complexity of implant restoration and to explore the indices that help us to assess it. With this knowledge the growing number of clinicians restoring dental implants will have a better understanding of the available guidance and evidence base, and the differing levels of competence required.Study design A literature review was conducted. The selection of publications reporting on complexity was based on predetermined criteria and was agreed upon by the authors. After title and abstract screening 17 articles were reviewed. The articles that were utilised to form the ITI SAC tool and Cologne Risk Assessment we also included.Assessing complexity Two key guides are available: International Team for Implantology's Straight-forward Advanced Complex tool and the Cologne ABC risk score. While these guides help identify treatment complexity they do not provide a strong enough evidence base from which to solely base clinical decisions. The key patient factors are expectation, communication, the oral environment, aesthetic outcome, occlusion, soft tissue profile and the intra-arch distance, whereas the key technical factors are impression taking, type of retention, loading protocol and the need for provisional restorations. Human factors also have a significant effect on complexity, specifically, the experience and training of the clinician, team communication and the work environment.Conclusions There are many interconnecting factors that affect the complexity of dental implant restoration. Furthermore the two widely used indices for the assessment of complexity have been investigated, and although these offer a good guideline as to the level of complexity, there is a lack evidence to support their use. The development of evidence-based treatment and protocols is necessary to develop the current indices further, and these need to be expanded to include other critical areas, such as human factors. A practical guide to aid practitioners in reducing complexity has been proposed.
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Affiliation(s)
- S P Wright
- Edge Hill University, Faculty of Health and Social Care, St Helens Rd, Ormskirk, L39 4QP
| | - J Hayden
- Edge Hill University, Faculty of Health and Social Care, St Helens Rd, Ormskirk, L39 4QP
| | - J A Lynd
- Edge Hill University, Faculty of Health and Social Care, St Helens Rd, Ormskirk, L39 4QP
| | - K Walker-Finch
- Edge Hill University, Faculty of Health and Social Care, St Helens Rd, Ormskirk, L39 4QP
| | - J Willett
- Edge Hill University, Faculty of Health and Social Care, St Helens Rd, Ormskirk, L39 4QP
| | - C Ucer
- Edge Hill University, Faculty of Health and Social Care, St Helens Rd, Ormskirk, L39 4QP
| | - S D Speechley
- Edge Hill University, Faculty of Health and Social Care, St Helens Rd, Ormskirk, L39 4QP
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Stefanini M, Felice P, Mazzotti C, Mounssif I, Marzadori M, Zucchelli G. Esthetic evaluation and patient-centered outcomes in single-tooth implant rehabilitation in the esthetic area. Periodontol 2000 2018; 77:150-164. [DOI: 10.1111/prd.12215] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Evaluation of Impacting Factors on Facial Bone Thickness in the Anterior Maxillary Region. J Craniofac Surg 2018; 28:700-705. [PMID: 28403135 DOI: 10.1097/scs.0000000000003643] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The goal of the current study was to measure the width of the labial alveolar bone of the overlying maxillary anterior teeth, based on cone-beam computed tomography (CBCT) images, and the distance between cementoenamel junction (CEJ) and bone crest in adult patients. METHODS A cross-sectional study was performed using a sample of 132 tomographic scans. Intact maxillary anterior with healthy periodontium and teeth was randomly selected and afterwards assessed by 2 calibrated and independent reviewers. RESULT The average bone thickness at 2 mm from the CEJ of the maxillary right central incisors was 0.63 ± 0.69 mm and over the maxillary left central incisors was 0.59 ± 0.71 mm. Moreover on the right and left lateral maxillary incisors, the crestal bone width averaged 0.64 ± 0.81 and 0.61 ± 0.7 mm, respectively. Concerning the maxillary canine region on both sides, the crestal bone thickness averaged 0.72 ± 0.9 and 0.66 ± 0.69 mm, in the maxillary right and left the canine regions, respectively. Furthermore, according to the gender and systemic disease, there were some recognizable differences in the facial bone thickness between the left and the right side. CONCLUSIONS The current study has advocated the outcome of a mostly thin buccal bone overlying the maxillary anterior teeth; hence, clinicians should always consider the thickness of the facial cortical plate of the extraction site and the positioning of the implant placement in the socket.
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Gao E, Hei WH, Park JC, Pang K, Kim SK, Kim B, Kim SM, Lee JH. Bone-level implants placed in the anterior maxilla: an open-label, single-arm observational study. J Periodontal Implant Sci 2017; 47:312-327. [PMID: 29093988 PMCID: PMC5663668 DOI: 10.5051/jpis.2017.47.5.312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/18/2017] [Indexed: 11/08/2022] Open
Abstract
Purpose This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14–24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean 0.07±0.48 mm), while the crestal bone level decreased significantly, from 2.34±0.93 mm at baseline to 1.70±1.10 mm at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable.
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Affiliation(s)
- EnFeng Gao
- Department of Stomatology, China-Japan Friendship Hospital, Beijing, China
| | - Wei-Hong Hei
- Key Laboratory for Oral Biomedical Engineering of Ministry of Education, Wuhan University School and Hospital of Stomatology, Wuhan, China.,Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry, Seoul, Korea
| | - Jong-Chul Park
- Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry, Seoul, Korea
| | - KangMi Pang
- Department of Oral and Maxillofacial Surgery, Seoul National University Gwanak Dental Hospital, Seoul, Korea
| | - Sun Kyung Kim
- Department of Oral and Maxillofacial Surgery, Clinical Trial Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Bongju Kim
- Department of Oral and Maxillofacial Surgery, Clinical Trial Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Soung-Min Kim
- Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Clinical Trial Center, Seoul National University Dental Hospital, Seoul, Korea
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Gamper FB, Benic GI, Sanz-Martin I, Asgeirsson AG, Hämmerle CHF, Thoma DS. Randomized controlled clinical trial comparing one-piece and two-piece dental implants supporting fixed and removable dental prostheses: 4- to 6-year observations. Clin Oral Implants Res 2017; 28:1553-1559. [DOI: 10.1111/clr.13025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Felix B. Gamper
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Ignacio Sanz-Martin
- Section of Periodontology; Faculty of Odontology; University Complutense of Madrid; Madrid Spain
| | - Asgeir G. Asgeirsson
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
- Faculty of Odontology; University of Iceland; Reykjavik Iceland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
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Lambodharan R, Sivasaranya B, Balaji VR, Chandrasekaran D. Esthetic Management of Compromised Ridge in the Anterior Maxilla, a Modified Prosthetic Approach. J Pharm Bioallied Sci 2017; 9:S281-S284. [PMID: 29284980 PMCID: PMC5731031 DOI: 10.4103/jpbs.jpbs_102_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Replacing a missing tooth with an implant, especially in the esthetic zone has been increasing demand for the patient. Placing dental implants in the esthetic zone, especially in the compromised ridge with thin gingival thin biotype is considered to be the ultimate challenge for many dentists. This case report illustrates the implant placement in the traumatic anterior maxilla with thin gingival biotype (Class IV) and a modified approach in prosthetic placement.
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Affiliation(s)
- R Lambodharan
- Department of Prosthodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - B Sivasaranya
- Department of Prosthodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - V R Balaji
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Divagar Chandrasekaran
- Department of Prosthodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Janner SFM, Bosshardt DD, Cochran DL, Chappuis V, Huynh-Ba G, Jones AA, Buser D. The influence of collagen membrane and autogenous bone chips on bone augmentation in the anterior maxilla: a preclinical study. Clin Oral Implants Res 2016; 28:1368-1380. [DOI: 10.1111/clr.12996] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Simone F. M. Janner
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Dieter D. Bosshardt
- Robert K. Schenk Laboratory of Oral Histology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - David L. Cochran
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Guy Huynh-Ba
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Archie A. Jones
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Daniel Buser
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
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Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol 2000 2016; 73:7-21. [DOI: 10.1111/prd.12185] [Citation(s) in RCA: 253] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sadeghi R, Babaei M, Miremadi SA, Abbas FM. A randomized controlled evaluation of alveolar ridge preservation following tooth extraction using deproteinized bovine bone mineral and demineralized freeze-dried bone allograft. Dent Res J (Isfahan) 2016; 13:151-9. [PMID: 27076830 PMCID: PMC4810913 DOI: 10.4103/1735-3327.178202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Alveolar ridge preservation could be performed immediately following tooth extraction to limit dimensional changes of alveolar process due to bone resorption. The aim of this study was to compare the clinical and histologic outcomes of socket preservation using two different graft materials; deproteinized bovine bone mineral (DBBM) and demineralized freeze-dried bone allograft (DFDBA) with absorbable collagen membrane. Materials and Methods: Twenty extraction sockets in 20 patients were randomly divided into 2 treatment groups: 10 sockets were augmented with DBBM and collagen membrane whereas 10 sockets were filled with DFDBA and covered by collagen membrane. Primary closure was achieved over extraction sockets by flap advancement. Horizontal and vertical ridge dimensional changes were assessed at baseline and after 4-6 months at the time of implant placement. For histological and histomorphometrical analysis, bone samples were harvested from the augmented sites with trephine during implant surgery. All data were analyzed using SPSS version 18 (α=0.05). Results: Clinical measurements revealed that average horizontal reduction was 2.3 ± 0.64 mm for DFDBA and 2.26 ± 0.51 mm for DBBM. Mean vertical ridge resorption at buccal side was 1.29 ± 0.68 mm for DFDBA and 1.1 ± 0.17 mm for DBBM. Moreover, mean vertical ridge reduction at lingual site was 0.41 ± 0.38 mm and 0.35 ± 0.34 mm for DFDBA and DBBM, respectively. No significant differences were seen between two groups in any of those clinical parameters. Histologic analysis showed statistically significant more new bone deposition for DFDBA compared to DBBM (34.49 ± 3.19 vs. 18.76 ± 3.54) (P < 0.01). Residual graft particles were identified significantly more in DBBM (12.77 ± 1.85) than DFDBA (6.06 ± 1.02). Conclusion: Based on the findings of this study, both materials have positive effect on alveolar ridge preservation after tooth extraction, but there was more new bone formation and less residual graft particles in DFDBA group than in DBBM group.
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Affiliation(s)
- Rokhsareh Sadeghi
- Department of Periodontics, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Maryam Babaei
- Department of Periodontics, Faculty of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - S Asghar Miremadi
- Department of Periodontics, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mashadi Abbas
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bassetti RG, Stähli A, Bassetti MA, Sculean A. Soft tissue augmentation procedures at second-stage surgery: a systematic review. Clin Oral Investig 2016; 20:1369-87. [PMID: 27041111 DOI: 10.1007/s00784-016-1815-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/28/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate the efficacy of different soft tissue augmentation/correction methods in terms of increasing the peri-implant width of keratinized mucosa (KM) and/or gain of soft tissue volume during second-stage surgery. MATERIALS AND METHODS Screening of two databases, MEDLINE (PubMed) and EMBASE (OVID), and hand search of related articles, were performed. Human studies reporting on soft tissue augmentation/correction methods around submucosally osseointegrated implants during second-stage surgery up to July 31, 2015 were considered. Quality assessment of the selected full-text articles was performed according to the Cochrane collaboration's tool to assess the risk of bias. RESULTS Overall, eight prospective studies (risk of bias: high) and two case series (risk of bias: high) were included. Depending on the surgical technique and graft material used, the enlargement of keratinized tissue (KT) ranged between -0.20 and 9.35 mm. An apically positioned partial-thickness flap/vestibuloplasty (APPTF/VP) in combination with a free gingival graft (FGG) or a xenogeneic graft material (XCM) was most effective. Applying a roll envelope flap (REF) or an APPTF in combination with a subepithelial connective tissue graft (SCTG), mean increases in soft tissue volumes of 2.41 and 3.10 mm, respectively, were achieved. Due to the heterogeneity of study designs, no meta-analysis could be performed. CONCLUSIONS Within the limitations of this review, regarding the enlargement of peri-implant KT, the APPTF in the maxilla and the APPTF/VP in combination with FGG or XCM in the lower and upper jaw seem to provide acceptable outcomes. To augment peri-implant soft tissue volume REF in the maxilla or APPTF + SCTG in the lower and upper jaw appear to be reliable treatment options. CLINICAL RELEVANCE The localization in the jaw and the clinical situation are crucial for the decision which second-stage procedure should be applied.
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Affiliation(s)
- Renzo G Bassetti
- Department of Oral and Maxillofacial Surgery, Lucerne Cantonal Hospital, Spitalstrasse, 6000, Lucerne, Switzerland.
| | - Alexandra Stähli
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Mario A Bassetti
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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Lombardo G, Corrocher G, Pighi J, Mascellaro A, Marincola M, Nocini PF. Esthetic Outcomes of Immediately Loaded Locking Taper Implants in the Anterior Maxilla: A Case Series Study. J ORAL IMPLANTOL 2015; 42:258-64. [PMID: 26652169 DOI: 10.1563/aaid-joi-d-14-00282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to evaluate the esthetic outcome of single-tooth locking taper connection implants placed in the anterior maxilla following a postextractive nonfunctional loading protocol. This preliminary clinical study involving 16 patients evaluated the results of 21 implants placed in areas with high esthetic value. For each implant the pink esthetic score, white esthetic score, cumulative survival rate, and health status of peri-implant tissues were evaluated. The cumulative survival rate was 100% 2 years after prosthetic loading, and the mean total pink esthetic score/white esthetic score was 16.9 ± 1.14 on a maximum value of 20. There was excellent plaque control in all patients, and inflammation indices were within the norm. Within the limits of this study, this immediate nonfunctional loading protocol seems to be a successful procedure esthetically and for the maintenance of peri-implant soft tissues.
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Affiliation(s)
- Giorgio Lombardo
- 1 Clinic of Dentistry and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Giovanni Corrocher
- 1 Clinic of Dentistry and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Jacopo Pighi
- 1 Clinic of Dentistry and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Anna Mascellaro
- 1 Clinic of Dentistry and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Mauro Marincola
- 2 School of Dentistry, Universidad de Cartagena, Cartagena, Colombia
| | - Per Francesco Nocini
- 1 Clinic of Dentistry and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
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Temple KE, Schoolfield J, Noujeim ME, Huynh-Ba G, Lasho DJ, Mealey BL. A cone beam computed tomography (CBCT) study of buccal plate thickness of the maxillary and mandibular posterior dentition. Clin Oral Implants Res 2015; 27:1072-8. [PMID: 26364803 DOI: 10.1111/clr.12688] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Buccal plate thickness is of clinical importance in treatment planning for implants. The purpose of this study was to evaluate the buccal plate thickness in posterior dentate areas of both the maxilla and mandible using cone beam computed tomography in order to estimate the approximate distributions of this anatomic variable. METHODS Two hundred and sixty-five subjects were included for a total of nine hundred and thirty-four roots assessed by cone beam computed tomography. CBCT scans were taken and evaluated at the ideal buccolingual cross-sections of each root at 1 mm, 3 mm, and 5 mm apical to the alveolar crest to measure buccal plate thickness. Data are reported by geometric means and 95% confidence intervals. RESULTS Both arches demonstrated increasing buccal plate thickness from anterior to posterior. Maxillary teeth had a significant decrease in thickness from coronal to apical along the tooth root (P < 0.001), except at second molars. The first premolar and mesial root of the first molar were significantly thinner than all other roots in the maxilla. Conversely, the mandible demonstrated a significant increase in buccal plate thickness from coronal to apical (P < 0.001). The premolars were significantly thinner than all other roots. Age and sex were found to have limited impact on buccal plate thickness in both arches. CONCLUSIONS Buccal plate thickness is highly dependent upon the arch position, tooth location, and measurement point, but age and sex have limited impact.
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Affiliation(s)
| | - John Schoolfield
- Department of Periodontics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Marcel E Noujeim
- Department of Comprehensive Dentistry, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Guy Huynh-Ba
- Department of Periodontics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - David J Lasho
- Department of Periodontics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Brian L Mealey
- Department of Periodontics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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Veltri M, Ekestubbe A, Abrahamsson I, Wennström JL. Three-Dimensional buccal bone anatomy and aesthetic outcome of single dental implants replacing maxillary incisors. Clin Oral Implants Res 2015; 27:956-63. [DOI: 10.1111/clr.12664] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Mario Veltri
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Göteborg Sweden
| | - Annika Ekestubbe
- Department of Oral and Maxillofacial Radiology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Göteborg Sweden
| | - Ingemar Abrahamsson
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Göteborg Sweden
| | - Jan L. Wennström
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Göteborg Sweden
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Willenbacher M, Al-Nawas B, Berres M, Kämmerer PW, Schiegnitz E. The Effects of Alveolar Ridge Preservation: A Meta-Analysis. Clin Implant Dent Relat Res 2015; 18:1248-1268. [DOI: 10.1111/cid.12364] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Maximillian Willenbacher
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
| | - Manfred Berres
- Department of Mathematics and Technology; University of Applied Sciences Koblenz, RheinAhrCampus Remagen; Remagen Germany
- Institute of Medical Biometry, Epidemiology, and Informatics; Johannes Gutenberg-University; Mainz Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University of Rostock; Rostock Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
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Chappuis V, Engel O, Shahim K, Reyes M, Katsaros C, Buser D. Soft Tissue Alterations in Esthetic Postextraction Sites. J Dent Res 2015; 94:187S-93S. [DOI: 10.1177/0022034515592869] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Dimensional alterations of the facial soft and bone tissues following tooth extraction in the esthetic zone play an essential role to achieve successful outcomes in implant therapy. This prospective study is the first to investigate the interplay between the soft tissue dimensions and the underlying bone anatomy during an 8-wk healing period. The analysis is based on sequential 3-dimensional digital surface model superimpositions of the soft and bone tissues using digital impressions and cone beam computed tomography during an 8-wk healing period. Soft tissue thickness in thin and thick bone phenotypes at extraction was similar, averaging 0.7 mm and 0.8 mm, respectively. Interestingly, thin bone phenotypes revealed a 7-fold increase in soft tissue thickness after an 8-wk healing period, whereas in thick bone phenotypes, the soft tissue dimensions remained unchanged. The observed spontaneous soft tissue thickening in thin bone phenotypes resulted in a vertical soft tissue loss of only 1.6 mm, which concealed the underlying vertical bone resorption of 7.5 mm. Because of spontaneous soft tissue thickening, no significant differences were detected in the total tissue loss between thin and thick bone phenotypes at 2, 4, 6, and 8 wk. More than 51% of these dimensional alterations occurred within 2 wk of healing. Even though the observed spontaneous soft tissue thickening in thin bone phenotypes following tooth extraction conceals the pronounced underlying bone resorption pattern by masking the true bone deficiency, spontaneous soft tissue thickening offers advantages for subsequent bone regeneration and implant therapies in sites with high esthetic demand (Clinicaltrials.gov NCT02403700).
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Affiliation(s)
- V. Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - O. Engel
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - K. Shahim
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - M. Reyes
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - C. Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - D. Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Zhang W, Skrypczak A, Weltman R. Anterior maxilla alveolar ridge dimension and morphology measurement by cone beam computerized tomography (CBCT) for immediate implant treatment planning. BMC Oral Health 2015; 15:65. [PMID: 26059796 PMCID: PMC4460662 DOI: 10.1186/s12903-015-0055-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 06/03/2015] [Indexed: 01/07/2023] Open
Abstract
Background Implants have been widely used to restore missing teeth. Limited information on applied anatomy at the anterior maxilla compromises the clinical outcome for implant placement in this region. In the current study, Cone Beam Computerized Tomography (CBCT) was used to measure alveolar ridge and buccal undercut dimension at the anterior maxilla to help develop treatment planning for immediate implant placement. Methods CBCT scans were screened to include 51 subjects with full dentition at right maxilla. Measurements were taken at the cross sectional views in the middle of the maxillary right central incisor, lateral incisor, and canine regions. Alveolar height was measured from the alveolar crest to floor of nasal fossa. Alveolar width was measured from the buccal to palatal cortical plate at the coronal, middle, and apical third of the distance from the alveolar crest to floor of the nasal fossa. Buccal undercut location was measured from where the buccal cortical plate started dipping to a line extending at the alveolar crest that was perpendicular to the long axis of the alveolar ridge. The buccal undercut depth was measured from the deepest point of the undercut at the buccal plate to a line tangent to the buccal plate paralleling the long axis of ridge. Results Alveolar width increased from coronal to apical direction for each tooth. Mean alveolar widths (mm) were: central incisor, 9.55; lateral incisor, 8.30; canine, 9.62. The lateral incisor had a significantly smaller alveolar width than the other anterior teeth. No significant difference in ridge height was noted among the teeth. Undercut locations from the alveolar crest (mm) were: central incisor, 5.84; lateral incisor, 3.59; canine, 5.11. Undercut depths (mm) were: central incisor, 0.76; lateral incisor, 0.87; canine, 0.73. The percentages of teeth with buccal undercuts were: central incisor, 41 %, lateral incisor, 77 %, and canine 33 %. Male demonstrate significant larger ridge width compared with females for all three teeth. Conclusions At anterior maxilla, the lateral incisor has the thinnest alveolar bone, and most frequently exhibits a buccal undercut which is the closest to alveolar ridge compared with other maxillary anterior teeth.
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Affiliation(s)
- Wenjian Zhang
- Department of Diagnostic and Biomedical Sciences, The University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA.
| | - Adam Skrypczak
- Junior Dental Student, The University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA.
| | - Robin Weltman
- Department of Periodontics and Dental Hygiene, The University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA.
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Mechery R, Thiruvalluvan N, Sreehari AK. Ridge split and implant placement in deficient alveolar ridge: Case report and an update. Contemp Clin Dent 2015; 6:94-7. [PMID: 25684920 PMCID: PMC4319354 DOI: 10.4103/0976-237x.149300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Dr. Hilt Tatum 1970s introduced a method of ridge splitting or bone spreading, which over a period have been used in implant dentistry for esthetic rehabilitation and implant site preparation in cases of deficient alveolar ridges to satisfy the basic ideal need of hard tissue augmentation for functional and esthetic outcome of implant. In this case report, we describe a case of horizontal ridge augmentation using ridge split and simultaneous implant placement in esthetic maxillary premolar zone.
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Affiliation(s)
- Reenesh Mechery
- Department of Dental Surgery, Division of Periodontology, Armed Forces Medical College, Pune, Maharashtra, India
| | - N Thiruvalluvan
- Department of Dental Surgery, Division of Periodontology, Armed Forces Medical College, Pune, Maharashtra, India
| | - A K Sreehari
- Department of Dental Surgery, Division of Periodontology, Armed Forces Medical College, Pune, Maharashtra, India
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Jensen SS, Bosshardt DD, Gruber R, Buser D. Long-Term Stability of Contour Augmentation in the Esthetic Zone: Histologic and Histomorphometric Evaluation of 12 Human Biopsies 14 to 80 Months After Augmentation. J Periodontol 2014; 85:1549-56. [DOI: 10.1902/jop.2014.140182] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Puisys A, Vindasiute E, Linkevciene L, Linkevicius T. The use of acellular dermal matrix membrane for vertical soft tissue augmentation during submerged implant placement: a case series. Clin Oral Implants Res 2014; 26:465-470. [DOI: 10.1111/clr.12401] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Algirdas Puisys
- Vilnius Mokslo Grupe; Vilnius Lithuania
- Vilnius Implantology Center; Vilnius Lithuania
| | - Egle Vindasiute
- Vilnius Mokslo Grupe; Vilnius Lithuania
- Vilnius Implantology Center; Vilnius Lithuania
| | - Laura Linkevciene
- Institute of Odontology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
| | - Tomas Linkevicius
- Vilnius Mokslo Grupe; Vilnius Lithuania
- Vilnius Implantology Center; Vilnius Lithuania
- Institute of Odontology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
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Iglhaut G, Schwarz F, Winter RR, Mihatovic I, Stimmelmayr M, Schliephake H. Epithelial Attachment and Downgrowth on Dental Implant Abutments-A Comprehensive Review. J ESTHET RESTOR DENT 2014; 26:324-31. [DOI: 10.1111/jerd.12097] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Gerhard Iglhaut
- Oral Surgery Office; Bahnhofstrasse 20 87700 Memmingen Germany
| | - Frank Schwarz
- Department of Oral Surgery; Heinrich-Heine University; Moorenstrasse 5 40225 Düsseldorf Germany
| | | | - Ilja Mihatovic
- Department of Oral Surgery; Heinrich-Heine University; Moorenstrasse 5 40225 Düsseldorf Germany
| | | | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery; George-Augusta-University Göttingen; Robert-Koch-Strasse 40 37075 Göttingen Germany
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Shi JY, Wang R, Zhuang LF, Gu YX, Qiao SC, Lai HC. Esthetic outcome of single implant crowns following type 1 and type 3 implant placement: a systematic review. Clin Oral Implants Res 2014; 26:768-74. [PMID: 24450873 DOI: 10.1111/clr.12334] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2013] [Indexed: 02/04/2023]
Affiliation(s)
- Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Ren Wang
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Long-Fei Zhuang
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Ying-Xin Gu
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; School of Medicine; Shanghai Jiaotong University; Shanghai China
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Bruno V, O'Sullivan D, Badino M, Catapano S. Preserving soft tissue after placing implants in fresh extraction sockets in the maxillary esthetic zone and a prosthetic template for interim crown fabrication: a prospective study. J Prosthet Dent 2013; 111:195-202. [PMID: 24314570 DOI: 10.1016/j.prosdent.2013.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
STATEMENT OF PROBLEM The technique of immediate implant placement is said to have success rates similar to those of implantation into a healed socket. An implant-supported restoration in an esthetic area must achieve a harmonious balance of functional, esthetic, and biologic imperatives to be considered effective. PURPOSE The purpose of this clinical study was to assess the height of the interproximal gingival papillae adjacent to immediate implants with immediate loading. The hypothesis was that specific positioning of the proximal contact areas of the interim crowns would facilitate the maintenance or regeneration of the interproximal papilla. MATERIAL AND METHODS Twenty-eight participants were provided implants (n=36) in the anterior maxillary area that were loaded with a specifically contoured interim crown immediately after tooth extraction. The proximal contact areas of the interim crowns were positioned 5 to 6 mm incisal to the interproximal bony crest by using a prosthetic template. Papilla height was classified according to a previously described papilla index. A comparison was made between the papilla height before the extraction, at interim crown placement after the implant placement, and at 6 and 12 months postoperatively. Parametric and nonparametric tests were used when appropriate (Kolmogorov-Smirnov). Significance was expressed at the α=.05 level. Cross tables were used to describe the changes in the papilla index score. RESULTS During the 1-year follow-up, the score of the distal and mesial papilla indices increased significantly (repeated-measures Friedman exact test; P=.035 and P=.002). CONCLUSIONS This prospective study indicated that the use of a prosthetic template for positioning an interim crown on immediately placed implants and for ensuring that the proximal contact areas of the crown with adjacent teeth are 5 to 6 mm incisal to the interproximal bony crest does not seem to hinder the maintenance or regeneration of the height of the interproximal papillae.
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Affiliation(s)
- Vincenzo Bruno
- Lecturer, Department of Prosthodontics, Dental School, University of Ferrara, Ferrara, Italy.
| | - Dominic O'Sullivan
- Professor, School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | | | - Santo Catapano
- Chief and Associate Professor, Department of Prosthodontics, Dental School, University of Ferrara, Ferrara, Italy
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Juodzbalys G, Kubilius M. Clinical and radiological classification of the jawbone anatomy in endosseous dental implant treatment. J Oral Maxillofac Res 2013; 4:e2. [PMID: 24422030 PMCID: PMC3886111 DOI: 10.5037/jomr.2013.4202] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 06/12/2013] [Indexed: 11/24/2022]
Abstract
Objectives The purpose of present article was
to review the classifications suggested for assessment of the jawbone anatomy, to
evaluate the diagnostic possibilities of mandibular canal identification and risk
of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone, as
well as to suggest new classification system of the jawbone anatomy in endosseous
dental implant treatment. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic
databases. The keywords used for search were mandible; mandibular canal; alveolar
nerve, inferior; anatomy, cross-sectional; dental implants; classification. The
search was restricted to English language articles, published from 1972 to March
2013. Additionally, a manual search in the major anatomy and oral surgery books
were performed. The publications there selected by including clinical and human
anatomy studies. Results In total
109 literature sources were obtained and reviewed. The classifications suggested
for assessment of the jawbone anatomy, diagnostic possibilities of mandibular canal
identification and risk of inferior alveolar nerve injury, aesthetic considerations
in aesthetic zone were discussed. New classification system of the jawbone anatomy
in endosseous dental implant treatment based on anatomical and radiologic findings
and literature review results was suggested. Conclusions The
classification system proposed here based on anatomical and radiological jawbone
quantity and quality evaluation is a helpful tool for planning of treatment strategy
and collaboration among specialists. Further clinical studies should be conducted
for new classification validation and reliability evaluation.
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Affiliation(s)
- Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Marius Kubilius
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
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Papillae alterations around single-implant restorations in the anterior maxillae: thick versus thin mucosa. Int J Oral Sci 2013; 4:94-100. [PMID: 22627613 PMCID: PMC3412666 DOI: 10.1038/ijos.2012.25] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration. According to the inclusion criteria, 32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included. The patients were assigned to two groups according to the mucosal thickness: (i) group 1, 1.5 mm s mucosal thickness 3 mm; and (ii) group 2, 3 mm<mucosal thickness 4.5 mm.Assessments of interproximal papillae at the time of crown placement (baseline) and at 6-month post loading (follow-up) were made by two prosthodontists using papilla fill index (PFI). The mean mucosal thickness was (2.49±_0.31) mm (group 1) and (3.81±_0.31) mm(group 2) for the two groups respectively. A significant difference in PFI between the groups was detected at the baseline (P<0.001).PFI improvements over time occurred after 6-month follow-up irrespective of the groups. When compared to group 1, the likelihood to obtain papilla fill was significantly higher for group 2 with an odds ratio of 6.05 (P<0.001). The interproximal papilla level around single-implant restorations could improve significantly over time after 6-month restoration according to PFI assessment. The thicker mucosa before implant placement implied a more favorable esthetic outcome in papilla alteration.
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Comut A, Acharya V, Jahangiri L. Use of forced eruption to enhance a pontic site in the anterior maxilla. J Prosthet Dent 2012; 108:273-8. [PMID: 23107234 DOI: 10.1016/s0022-3913(12)00152-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Extraction of teeth leads to bone resorption that can result in asymmetrical hard and soft tissue topography. This article describes a technique to enhance a pontic site in the anterior maxilla by using forced eruption as an alternative to conventional hard and soft tissue augmentation surgeries. Forced eruption is a well-known procedure and its use in developing a pontic site for a fixed dental prosthesis is described in this clinical report.
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Affiliation(s)
- Alper Comut
- Department of Prosthodontics, New York University College of Dentistry, New York, NY 10010, USA.
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50
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Alveolar ridge preservation. A systematic review. Clin Oral Investig 2012; 17:341-63. [PMID: 22814758 DOI: 10.1007/s00784-012-0758-5] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 05/14/2012] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The objective of this paper is to examine the effect of alveolar ridge preservation (ARP) compared to unassisted socket healing. METHODS Systematic review with electronic and hand search was performed. Randomised controlled trials (RCT), controlled clinical trials (CCT) and prospective cohort studies were eligible. RESULTS Eight RCTs and six CCTs were identified. Clinical heterogeneity did not allow for meta-analysis. Average change in clinical alveolar ridge (AR) width varied between -1.0 and -3.5 ± 2.7 mm in ARP groups and between -2.5 and -4.6 ± 0.3 mm in the controls, resulting in statistically significantly smaller reduction in the ARP groups in five out of seven studies. Mean change in clinical AR height varied between +1.3 ± 2.0 and -0.7 ± 1.4 mm in the ARP groups and between -0.8 ± 1.6 and -3.6 ± 1.5 mm in the controls. Height reduction in the ARP groups was statistically significantly less in six out of eight studies. Histological analysis indicated various degrees of new bone formation in both groups. Some graft interfered with the healing. Two out of eight studies reported statistically significantly more trabecular bone formation in the ARP group. No superiority of one technique for ARP could be identified; however, in certain cases guided bone regeneration was most effective. Statistically, significantly less augmentation at implant placement was needed in the ARP group in three out of four studies. The strength of evidence was moderate to low. CONCLUSIONS Post-extraction resorption of the AR might be limited, but cannot be eliminated by ARP, which at histological level does not always promote new bone formation. RCTs with unassisted socket healing and implant placement in the ARP studies are needed to support clinical decision making. CLINICAL RELEVANCE This systematic review reports not only on the clinical and radiographic outcomes, but also evaluates the histological appearance of the socket, along with site specific factors, patient-reported outcomes, feasibility of implant placement and strength of evidence, which will facilitate the decision making process in the clinical practice.
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