Treatment planning 2000: an esthetically oriented revision of the original implant protocol

Efficacy of Nasal Floor Augmentation on the Survival Rate of Dental Implants: A Systematic Review

Aim

To systematically review the existing scientific literature, to summarize and assess the efficacy of the nasal floor augmentation on the survival rate of dental implants by systematically reviewing the available literature.

Methodology

Review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in PROSPERO-CRD42027289143. Electronic databases like PubMed, google scholar and Ebsco Host were searched from 2000 to December 2021 for studies reporting efficacy of nasal floor augmentation and reporting outcomes in terms of survival rates of dental implants. Quality assessment of included comparative follow-up studies was done using the critical checklist put forward by the Joanna Briggs Institute (JBI) was used.

Results

Only nine studies fulfilled the eligibility criteria and were included in the qualitative synthesis. Of those nine studies, five were case reports and four comparative follow-up studies. A total of 14 implants were placed in five patients with a survival rate of 100% in included case reports, while a total of 408 implants were placed in 130 patients with survival rates ranging from 89% to 100% in included comparative follow-up studies. No complications were observed during follow-ups, and the patients were satisfied with the functional and aesthetic results of the treatment. Quality assessment of included studies showed moderate to low risk of bias with overall high quality of studies.

Conclusion

The results of this systematic review indicate that implant placement by nasal floor augmentation techniques can be considered as a predictable treatment modality. However, due to the scarcity of literature, more studies should be carried out on proving the efficacy of nasal floor augmentation on survival rate or success of dental Implants.

Comparison of Two Techniques for Lateral Ridge Augmentation in Mandible With Ramus Block Graft

The purpose of this manuscript was to assess mandibular ramus block grafts used for augmentation of mandibular posterior segments, followed by subsequent implant placement. Twenty-four human subjects in need of lateral ridge mandibular augmentation were included in the current patient series.

INCLUSION CRITERIA

recipient site had at least 10-mm residual height, but less than 4.3-mm bucco-lingual dimension. Autogenous bone blocks were harvested from the mandibular ramus. In the first group ramus block was used in association with platelet-rich fibrin and in the second in association with pericardium membrane. Implant surgery was performed 4 months after bone graft surgery when a total number of 44 implants were placed. Abutments were placed 4 months after implant surgery followed by final restoration. Ramus bone graft was successful in 100% patients for the first group and in 91.67% patients for the second group. Measurement on cone beam computed tomography revealed an average of 5.35 mm of lateral ridge augmentation for group 1 and 5.099 mm for group 2, achieved 4 months after surgery. All implants placed received fixed prosthetic restorations and are in use. Ramus block grafts can be used to allow optimal implant placement, with favor long-term success. Lateral ridge augmentation using mandibular ramus bone graft in association with platelet-rich fibrin is a more predictable and successful technique.

Effect of the implant-abutment interface on peri-implant tissues: a systematic review

OBJECTIVE

The aim of the present systematic review was to determine the peri-implant tissue response to different implant abutment materials and designs available and to assess the impact of tissue biotype.

MATERIALS AND METHODS

Relevant literature published between December 2009 and August 2012 was searched to identify studies dealing with different implant abutment designs and materials, as well as the response of different tissue biotypes. The search terms used, in simple or multiple conjunctions, were 'implant abutment', 'interface', 'material', 'peri-implant', 'soft tissue' and 'esthetic'. Studies were selected according to pre-determined inclusion and exclusion criteria.

RESULTS

The initial search yielded 2449 titles. After a subsequent filtering process, 23 studies were finally selected. The included studies revealed different factors responsible for the stability of peri-implant tissue and the esthetic outcome. These factors include tissue biotype and architecture, implant abutment material and implant abutment design. Several designs were suggested to prevent marginal bone loss and soft tissue recession. These included scalloped implants, platform-switched implants and gingivally converged or concave implant abutments. Due to the limited number of studies and the heterogeneity in their designs, it was not possible to perform a statistical analysis of the data.

CONCLUSIONS

The current literature provides insufficient evidence about the effectiveness of different implant abutment designs and materials in the stability of peri-implant tissues.

Prognosis and evaluation of tooth damage caused by implant fixtures

Damage to adjacent teeth is one of the various complications that may occur during implant placement and is often the result of improper direction during fixture placement or excessive depth of placement. In general, if detrimental symptoms, such as reaction to percussion in damaged teeth, mobility, and pulp necrosis, are not present, osseointegration should be observed at follow-up. In three cases, the possibility of root damage due to an implant fixture placed too close to each adjacent tooth was perceived on radiographs. However, in all of these cases, there were no clinical symptoms or radiographic changes present in the tooth, and the implants did not exhibit decreased stability or peri-implantitis. Therefore, we can carefully predict that the implant fixture close to the adjacent tooth did not invade the cementum of the root, and therefore did not produce the suspected pulpal damage or periradicular symptoms. In this study, we considered both the implant status as well as the adjacent tooth.

Soft and Hard Tissue Management in Implant Therapy-Part II: Prosthetic Concepts

The ongoing pursuit of aesthetic excellence in the field of implant therapy has incorporated prosthetic concepts in the early treatment-planning phase, as well as the previously discussed surgical concepts. The literature has addressed these prosthetic and laboratory approaches required to enhance and perfect the soft and hard tissue management (SHTM). After surgically providing an acceptable hard tissue architecture and adequate timing of loading of the implant, the prosthetic phase is responsible for the soft tissue modeling, through correctly planned and executed procedures, which induce a satisfactory soft tissue profile by considering the microvasculature, the abutment connection and positioning, and the implementation of an adequate provisional phase. The objectives are the modeling of the soft tissues through the use of a conforming periorestorative interface which will produce desired and stable results.

Nasal floor elevation combined with dental implant placement

OBJECTIVES

The aim of the present study was to report on the survival of dental implants placed in conjunction with nasal floor elevation.

METHODS

A retrospective cohort of 32 consecutive patients from two private practices was evaluated. All patients presented with alveolar bone height deficiency in the anterior region, which was not sufficient to place a dental implant according to a computed tomography (CT) scan preformed prior to implantation. Elevation and augmentation of the nasal mucosa was performed simultaneously with dental implant placement. Data collection included demographic information, as well as records of the pre-operative available bone height, implant dimensions, bone addition following nasal floor augmentation, and survival of the implants at last follow-up.

RESULTS

Overall, 32 patients received 100 implants that were performed in conjunction with nasal floor elevation. The average pre-operative available bone height according to a CT scan that was preformed prior to implantation was 9.1 ± 0.9 mm and ranged from 7.3 to 11.2 mm. Bone addition following nasal floor augmentation was 3.4 ± 0.9 mm and ranged between 1.1 and 5.7 mm. The mean follow-up time was 27.8 ± 12.4 months, and during that follow-up period, no implant failure was recorded, resulting in 100% implant survival.

CONCLUSION

Nasal floor elevation might serve as a predictable procedure, which allows implant placement in areas with significant atrophy together with increased implant stability due to the bicortical support.

Failures in implant dentistry

This article describes the many failures and complications that can occur when using implants to support restorations. Most of these failures can be prevented with proper patient selection and treatment planning. Implant failures can be largely classified into four main categories: 1) loss of integration, 2) positional failures 3) soft tissue defects, and 4) biomechanical failures. Each of these will be discussed with examples to illustrate the problem.

Screw versus cemented implant supported restorations

Implant supported restorations can be attached to implants with screws or can be cemented to abutments which are secured to implants with screws. Screw retained implant restorations are the authors' preferred method of securing restorations to implants. This article will be written from this perspective and the advantages and disadvantages of each method of retention will be discussed under the following headings: Aesthetics, Retrievability, Retention, Implant placement, Passivity, Provisionals, Occlusion, Immediate loading, Impression procedures, Long term treatment planning.

A simplified approach to implant-supported metal-ceramic reconstruction

Restoring the edentulous patient with an implant-supported fixed complete denture prosthesis is a challenging procedure. The patient's occlusal vertical dimension, centric relation position, esthetics, and phonetics should be maintained throughout the restorative process, while the patient is traditionally wearing a removable prosthesis. This article presents an alternative treatment philosophy that addresses these concerns and guides the restorative process using a fixed provisional restoration made from the patient's removable complete dentures.

Nobel Perfect esthetic scalloped implant: rationale for a new design

BACKGROUND

Over the past 20 years, there have been relatively few changes in implant designs. Most systems are manufactured from commercially pure titanium with turned threads, are sprayed with plasma, are coated with hydroxyapatite, or have an oxide surface. The majority of dental implants have not been designed for differing bone morphologies. Today patients have high esthetic demands that require modifications of implant designs to fulfill their expectations.

PURPOSE

This article evaluates the problems encountered when trying to achieve an optimum esthetic outcome with dental implants. Implants and abutment designs, biologic width, ridge anatomy, and timing of implant placement all affect esthetic results. Each of these factors is discussed and is related to the introduction of a new scalloped implant design. The purpose of the scalloped design is to keep or create interdental bony peaks that support the soft tissue, thereby maintaining or creating interimplant papillae.

METHODS

Clinical documentation of patients treated with the scalloped implant is presented. The esthetic outcome can be determined by comparing clinical documentation prior to and after treatment.

CONCLUSIONS

The scalloped implant provides clinicians and patients with the option of improving esthetic outcomes. Placement and restoration of this implant are important when planning implant treatment in the esthetic zone.

Fifty years of interdisciplinary site development: lessons and guidelines from periodontal prosthesis

Just as "osseointegration" became synonymous with successful restoration of function in the fully edentulous patient during the 1980s, the term "implant site development" has become intricately associated in the 1990s with the techniques used to achieve esthetic results with implants in the partially edentulous patient. This article explores the roots of the concept of site development within the philosophy and principles of periodontal prosthesis. In addition, the myriad of techniques that are presently collectively referred to as site development are systematically classified into a sequential four-tiered approach that optimizes their efficient application as well as overall success.