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Mancini L, Barootchi S, Thoma DS, Jung RE, Gallucci GO, Wang HL, Tavelli L. The peri-implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance. Clin Implant Dent Relat Res 2023; 25:224-240. [PMID: 36646440 DOI: 10.1111/cid.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Peri-implant mucosa color (PMC) seems to be one of the main parameters affecting the esthetic outcome of implant therapy. However, more emphasis should be given to its assessment and reporting. PURPOSE To describe the available evidence on methods to assess and report the color of the peri-implant mucosa (PMC) and the respective clinical relevance. MATERIAL AND METHODS A comprehensive electronic and manual search was performed to identify clinical studies reporting on PMC. RESULTS A total of 121 studies were included. PMC was evaluated at the time of the follow-up visit (chairside) in 45.5% studies. PMC assessment was performed qualitatively, by comparing PMC with adjacent and/or contralateral gingiva (78.6%) or quantitatively, using spectrophotometry (20.7%) or a software on clinical photographs (0.8%). The most performed method to assess PMC was through esthetic indices (76.9%), either at the time of the follow-up visit (chairside) or at later time point using photographs. Quantitative reporting of PMC included averages of points from esthetic indices or color differences to natural gingiva expressed with the CIELAB color system. PMC assessment allowed describing color discrepancies compared to natural gingiva, evaluating color changes over time, and comparing the outcomes of different treatment modalities. PMC assessment through spectrophotometry was additionally utilized to assess the role of mucosal thickness (MT) on PMC. CONCLUSIONS Various methods for PMC assessment and reporting were described, including visual assessment, mainly through esthetic indices, and spectrophotometry. PMC evaluation has allowed to demonstrate the factors affecting the color of the peri-implant soft tissue, such as the type of abutment/restoration, MT, and soft tissue augmentation.
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Affiliation(s)
- Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Science, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Ribeiro MCDO, Vargas-Moreno VF, Gomes RS, Faot F, Del Bel Cury AA, Marcello-Machado RM. Implant-supported crowns with locking taper implant-abutment connection: A systematic review and meta-analysis. J Prosthet Dent 2022:S0022-3913(22)00379-1. [PMID: 35864024 DOI: 10.1016/j.prosdent.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 10/17/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported single crowns are more prone to screw loosening than splinted prostheses. Therefore, the locking taper system, which has a screwless abutment, may perform better when associated with this type of rehabilitation. However, systematic reviews on this system are lacking. PURPOSE The purpose of this systematic review was to evaluate the clinical performance and complications of single crowns retained by the locking taper system. MATERIAL AND METHODS This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42020189921. An electronic search was made in 5 databases and 3 other sources up to February 2021 to select prospective clinical studies evaluating the performance of single crowns retained by the locking taper system by using the outcomes implant survival, success rate, complications, marginal bone loss (MBL), and prosthesis success rate. Four meta-analyses grouped according to the follow-up intervals were performed. The risk of bias of the selected studies was evaluated by using the RoB 2 checklist for randomized controlled trials (RCTs) and Downs and Black for uncontrolled studies. RESULTS Twelve studies were included: 9 prospective cohort studies and 3 RCTs. A survival rate of 99% (98% to 99%) and a success rate of 97% (92% to 99%) after 5 years were found. Of the total, 2.6% biological and 2.9% prosthetic complications were described. The prosthesis success rate was 97% (96% to 98%) after 5 years. An average of -0.73 mm (-0.93 to -0.52) was found for the MBL after 5 years. The risk-of-bias assessment showed 2 RCTs with high risk and 1 RCT with low risk of bias. Among uncontrolled studies, 2 were classified as poor and 7 as fair. CONCLUSIONS Single crowns retained by locking taper implants can be safely indicated based on the high survival and success rates achieved in the long term, the maintenance of bone level stability over time, and the low incidence of complications.
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Affiliation(s)
| | - Vanessa Felipe Vargas-Moreno
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Rafael Soares Gomes
- Professor, Department of Prosthodontics, Faculty of Technology and Sciences (UniFTC), Salvador, Bahia, Brazil
| | - Fernanda Faot
- Professor, Department of Restorative Dentistry, Federal University of Pelotas, Pelotas (UFPel), RS, Brazil
| | - Altair Antoninha Del Bel Cury
- Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Raissa Micaella Marcello-Machado
- Postdoctoral Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School (UNICAMP), Piracicaba, São Paulo, Brazil.
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Alqahtani ND. Successful treatment modalities for missing lateral incisors- A systematic review. Saudi Dent J 2021; 33:308-315. [PMID: 34434032 PMCID: PMC8376679 DOI: 10.1016/j.sdentj.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 06/28/2021] [Accepted: 07/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Effective management of Missing lateral incisor has remained a challenge for the clinicians. A multi-disciplinary approach involving orthodontist, restorative dental specialist, pediatric dental specialist, periodontist, oral surgeon and general dentist has proved ideal. Our aim is to review the ultimate esthetic success, and long term survival results between the orthodontic and restorative management of missing lateral incisor. MATERIALS AND METHODS Following the PRISMA guidelines, a systematic review of the published articles pertaining to the topic of interest was done. Searches were carried out in four different databases since February 2021 to April 2021. RESULTS A total of 580 references were found from searches conducted in PubMed, Scopus, Cochrane and Web of Science, and 19 articles were selected and analyzed fully, after screening the title and abstract, 6 articles were included for the study. CONCLUSION An essential orthodontic space closure in combination with modern aesthetic prosthetic tooth replacement techniques has been reported to achieve greater success.
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Affiliation(s)
- Nasser D. Alqahtani
- Pediatric Dentistry and Orthodontics Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Schneider UE, Moser L. Substituting congenitally missing maxillary lateral incisors with implant-borne crowns: A topic still worth a discussion? Semin Orthod 2020. [DOI: 10.1053/j.sodo.2020.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Evaluation of Implant Success in Patients with Dental Aplasia. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1680158. [PMID: 31321229 PMCID: PMC6607699 DOI: 10.1155/2019/1680158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/30/2019] [Accepted: 05/30/2019] [Indexed: 11/17/2022]
Abstract
Introduction Dental aplasia is an anomaly in which the number of teeth is reduced. It is the most commonly occurring dental anomaly during tooth development. Treatment management of patients with dental aplasia is challenging. Objectives The aim of this retrospective clinical study was to analyze the survival and success rates of dental implants placed in hypodontic patients, rated with different criteria. Methods Forty-three patients were diagnosed with dental aplasia and treated with dental implants between November 2000 and February 2016. The variables assessed included the plaque level, bleeding on probing, probing depth, implant mobility, implant stability, and implant loss. To analyze the peri-implant bone level, a panoramic X-ray of each patient was taken. The results were compared with X-rays taken immediately after implantation. Results Thirty-seven patients (16 males; 21 females) participated in this study. In total, 155 implants (86 maxillary; 69 mandibular) were inserted. Two of the 155 implants failed; the in situ survival rate was 98.7%. The success rate according to the criteria of Buser et al. was 96.8%, and that according to the criteria of Albrektsson et al. was 88.4%. Conclusion The survival and success rates of dental implants in patients with congenitally absent teeth were very high and did not differ significantly from results achieved in an unaffected population. Dental implants are a reliable therapy for patients with dental aplasia.
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Barber S, Bekker HL, Meads D, Pavitt S, Khambay B. Identification and appraisal of outcome measures used to evaluate hypodontia care: A systematic review. Am J Orthod Dentofacial Orthop 2018; 153:184-194.e18. [PMID: 29407495 DOI: 10.1016/j.ajodo.2017.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 10/01/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Identification and appraisal of the outcome measures that have been used to evaluate hypodontia treatment and deliver services are essential for improving care. A lack of alignment between outcomes and patient values can limit the scope for patient-centered care. Our objectives were to identify and appraise the outcomes selected to evaluate hypodontia care. METHODS Data sources included 10 electronic databases and grey literature, searched using terms for hypodontia and its treatment methods. Study eligibility included mixed study designs to ensure comprehensive identification of outcomes, excluding case reports and case series with fewer than 10 participants and nonsystematic reviews. Participants and interventions involved people with hypodontia receiving any dental treatment to manage their hypodontia. Simulated treatment, purely laboratory-based interventions, and future treatments still in development were excluded. Research outcomes were identified and synthesised into 4 categories: clinical indicators, and patient-reported, clinician-reported, and lay-reported outcomes. No synthesis of efficacy data was planned, and consequently no methodologic quality appraisal of the studies was undertaken. RESULTS The search identified 497 abstracts, from which 106 eligible articles were retrieved in full. Fifty-six studies and 8 quality-improvement reports were included. Clinical indicators were reported in 49 studies (88%) including appearance, function, dental health, treatment longevity, treatment success and service delivery. Patient-reported outcomes were given in 22 studies (39%) including oral health-related quality of life, appearance, function, symptoms of temporomandibular dysfunction, and patient experience. Clinician-reported outcomes were limited to appearance. Variability was seen in the tools used for measuring outcomes. CONCLUSIONS There is a lack of rationale and consistency in the selection of outcome measures used to evaluate hypodontia care. Outcomes are largely clinician and researcher-driven with little evidence of their relevance to patients. There was a paucity of outcomes measuring access to care, quality of care, and cost. Evidence from hypodontia research is clinician-focused and likely to have limited value to support patients during decision making. Attempts to synthesise the evidence base for translation into practice will be challenging. There is a need for a core outcomes set with a patient-centric approach to drive improvements in health services.
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Affiliation(s)
- Sophy Barber
- Department of Orthodontics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
| | - Hilary L Bekker
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Sue Pavitt
- Department of School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Balvinder Khambay
- Department of Orthodontics, University of Birmingham, Birmingham, United Kingdom
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Meros GC, Shoji A, Suzuki S, Paranhos LR, Manfroi R, Claus J, Garcez A. An Alternative Approach for Space Opening in a Bilateral Maxillary Lateral Incisor Agenesis Patient using Miniplates. J Contemp Dent Pract 2017; 18:1198-1205. [PMID: 29208799 DOI: 10.5005/jp-journals-10024-2200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM This case report aimed to present an orthodontic mechanic alternative for space opening in a patient missing maxillary lateral incisors, using miniplates as anchorage, associated with self-ligating brackets. BACKGROUND Dental agenesis affects the population causing esthetic and functional damages. The prevalence of missing maxillary lateral incisors should be considered for its significant rate and negative impact on smile esthetics. CASE REPORT This treatment was chosen based on the presence of balanced facial pattern, large canine anatomy, the need to improve dental occlusion to prevent further wear, and patient's esthetic complaint. To obtain the results, upper third molars were extracted, and two miniplates were installed to distalize the upper arch with no need for patient compliance or auxiliary devices. Self-ligating brackets were used to reduce friction on posterior teeth, thus facilitating movement with light force application. At the end of 19 months, the patient presented with class I good overbite and overjet, and adequate space for implant and prosthetics; also, good facial esthetic was maintained. CONCLUSION When indicated, space opening may provide excellent esthetics and functional results, and even more predictable results when skeletal anchorage miniplates are used to distalize all posterior teeth. CLINICAL SIGNIFICANCE Considering the high level of esthetic and functional compromise caused by dental agenesis, the technique hereby described represents a viable mechanic alternative within orthodontic possibilities.
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Affiliation(s)
- Gladistone C Meros
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil, Phone: +554699117799 e-mail:
| | - Aline Shoji
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Selly Suzuki
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Luiz R Paranhos
- Department of Dentistry, Federal University of Sergipe, Lagarto Sergipe, Brazil
| | - Rodrigo Manfroi
- Department of Prosthesis, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Jonathas Claus
- Department of Oral Surgery, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Aguinaldo Garcez
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
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Soft Tissue Stability around Single Implants Inserted to Replace Maxillary Lateral Incisors: A 3D Evaluation. Int J Dent 2016; 2016:9393219. [PMID: 27298621 PMCID: PMC4889829 DOI: 10.1155/2016/9393219] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/27/2016] [Accepted: 04/24/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate the soft tissue stability around single implants inserted to replace maxillary lateral incisors, using an innovative 3D method. Methods. We have used reverse-engineering software for the superimposition of 3D surface models of the dentogingival structures, obtained from intraoral scans of the same patients taken at the delivery of the final crown (S1) and 2 years later (S2). The assessment of soft tissues changes was performed via calculation of the Euclidean surface distances between the 3D models, after the superimposition of S2 on S1; colour maps were used for quantification of changes. Results. Twenty patients (8 males, 12 females) were selected, 10 with a failing/nonrestorable lateral incisor (test group: immediate placement in postextraction socket) and 10 with a missing lateral incisor (control group: conventional placement in healed ridge). Each patient received one immediately loaded implant (Anyridge®, Megagen, Gyeongbuk, South Korea). The superimposition of the 3D surface models taken at different times (S2 over S1) revealed a mean (±SD) reduction of 0.057 mm (±0.025) and 0.037 mm (±0.020) for test and control patients, respectively. This difference was not statistically significant (p = 0.069). Conclusions. The superimposition of the 3D surface models revealed an excellent peri-implant soft tissue stability in both groups of patients, with minimal changes registered along time.
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Mangano FG, Mastrangelo P, Luongo F, Blay A, Tunchel S, Mangano C. Aesthetic outcome of immediately restored single implants placed in extraction sockets and healed sites of the anterior maxilla: a retrospective study on 103 patients with 3 years of follow-up. Clin Oral Implants Res 2016; 28:272-282. [PMID: 26913807 DOI: 10.1111/clr.12795] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to compare the aesthetic outcome of single implants in extraction sockets and healed ridges of the anterior maxilla by means of the pink aesthetic score/white aesthetic score (PES/WES) index. MATERIALS AND METHODS This retrospective study was based on data from 103 patients (43 males, 60 females) aged 24-65 years (mean age 41.4 ± 13.8 years) who had been successfully treated with a single implant in the anterior maxilla, in four different clinical centres. Forty-two patients (mean age 46.5 ± 15.1 years) were treated with a single implant in a fresh post-extraction socket (immediate implant treatment, IIT), while 61 patients (mean age 38.0 ± 11.8 years) were treated with a single implant in a healed site (conventional implant treatment, CIT). Two independent calibrated examiners applied the PES/WES index to the 103 single-tooth restorations, respectively 3 months and 3 years after implant placement. RESULTS A few biological (4.8%) and prosthetic (8.7%) complications were reported. Both IIT and CIT yielded satisfactory aesthetic outcomes. At the delivery of the final restoration, a PES/WES score of 16.6 ± 2.6 and 15.7 ± 3.0 was reported for IIT and CIT, respectively: this difference was not statistically significant. A higher decrease in the PES/WES score was observed with CIT over time. At 3 years, a PES/WES score of 16.4 ± 2.8 and 15.2 ± 3.3 was reported for IIT and CIT, respectively: this difference was statistically significant. IIT seemed to yield better aesthetic outcomes in young patients (≤30 years), with implants placed in central incisor/cuspid areas, in the presence of bone contouring. CONCLUSIONS Both immediate and conventional single-implant treatment in the anterior maxilla can yield satisfactory aesthetic outcomes, when performed by experienced clinicians in well-selected cases. Further studies are needed to confirm these results.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Surgical and Morphological Sciences, Dental School, University of Varese, Varese, Italy
| | | | | | | | | | - Carlo Mangano
- Department of Medical, Oral and Biotechnological Sciences, Dental School, University of Chieti-Pescara, Chieti, Italy
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Tettamanti S, Millen C, Gavric J, Buser D, Belser UC, Brägger U, Wittneben JG. Esthetic Evaluation of Implant Crowns and Peri-Implant Soft Tissue in the Anterior Maxilla: Comparison and Reproducibility of Three Different Indices. Clin Implant Dent Relat Res 2015; 18:517-26. [PMID: 25727214 DOI: 10.1111/cid.12306] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND A successful implant reconstruction with optimal esthetics consists of a visually pleasing prosthesis and complete and healthy surrounding soft tissue. In the current literature, numerous indices used to qualitatively assess esthetics have been described. However, studies comparing the indices and their reproducibility are scarce. PURPOSE The aim of this study was to compare three different esthetic indices for the evaluation of single implant-supported crowns. MATERIALS AND METHODS A total of 10 prosthodontists (P), 10 orthodontists (O), 10 general dentists (G), and 10 lay people (L) independently performed the same assessment using 30 photographs and corresponding casts with three different esthetic indices (Peri-Implant and Crown Index [PICI], Implant Crown Aesthetic Index [ICAI], "Pink Esthetic Score/White Esthetic Score [PES/WES]) and repeated the evaluations 4 weeks later. RESULTS The PES/WES and the PICI showed significantly higher esthetic scores (pink, white, total) and clinical acceptance compared with the ICAI in all four groups and in both assessments. The highest intraobserver agreement was achieved using the PES/WES and the least with the ICAI. The mean Kappa per group ranged from 0.18 (group L with ICAI) to 0.63 (group G with PICI). CONCLUSION In comparison with the ICAI, the PES/WES and PICI were more reproducible. Therefore, PES/WES and PICI seem to be more suitable as esthetic indices for single implant crowns.
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Affiliation(s)
- Sandro Tettamanti
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Christopher Millen
- Department of Restorative Dentistry, Edinburgh Dental Institute, Edinburgh, Scotland
| | - Jelena Gavric
- Department of Fixed Prosthodontics and Occlusion, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Urs C Belser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Julia-Gabriela Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
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Single-tooth morse taper connection implant placed in grafted site of the anterior maxilla: clinical and radiographic evaluation. Case Rep Dent 2014; 2014:183872. [PMID: 25431687 PMCID: PMC4238176 DOI: 10.1155/2014/183872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/30/2014] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to achieve aesthetically pleasing soft tissue contours in a severely compromised tooth in the anterior region of the maxilla. For a right-maxillary central incisor with localized advanced chronic periodontitis a tooth extraction followed by reconstructive procedures and delayed implant placement was proposed and accepted by the patient. Guided bone regeneration (GBR) technique was employed, with a biphasic calcium-phosphate (BCP) block graft placed in the extraction socket in conjunction with granules of the same material and a resorbable barrier membrane. After 6 months of healing, an implant was installed. The acrylic provisional restoration remained in situ for 3 months and then was substituted with the definitive crown. This ridge reconstruction technique enabled preserving both hard and soft tissues and counteracting vertical and horizontal bone resorption after tooth extraction and allowed for an ideal three-dimensional implant placement. Localized severe alveolar bone resorption of the anterior maxilla associated with chronic periodontal disease can be successfully treated by means of ridge reconstruction with GBR and delayed implant insertion; the placement of an early-loaded, Morse taper connection implant in the grafted site was effective to create an excellent clinical aesthetic result and to maintain it along time.
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Abstract
The definition of failure for dental implants has evolved from lack of osseointegration to increased concern for other aspects, such as esthetics. However, esthetic failure in implant dentistry has not been well defined. Although multiple esthetic indices have been validated for objectively evaluating clinical outcomes, including failure of an implant-supported crown, only one author has determined a failure threshold. On the basis of objective indices, esthetic failures in implant dentistry can be categorized as pink-tissue failures and white-tissue failures. This article discusses esthetic failures, the factors involved in these failures, and their prevention and treatment.
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Affiliation(s)
- Rodrigo Fuentealba
- Restorative Division, University of Kentucky College of Dentistry, 800 Rose Street, D642, Lexington, KY 40356-0297, USA.
| | - Jorge Jofré
- Center for Advanced Prosthodontics and Implant Dentistry, University of Concepcion, Victoria 232 Barrio Universitario Concepción, Concepcion 4030000, Chile
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