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Terzioglu B, Ayyildiz BG. Effect of Supracrestal Tissue Height on Marginal Bone Level Changes at Platform-Switching Dental Implants Placed Crestally and Subcrestally: A Randomized Clinical-Trial. J Dent 2024:105219. [PMID: 38960001 DOI: 10.1016/j.jdent.2024.105219] [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: 02/03/2024] [Revised: 06/14/2024] [Accepted: 06/28/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVES The presence of insufficient peri-implant supracrestal tissue height (STH) may increase marginal bone resorption. This study aims to evaluate the effect of STH on marginal bone level changes (ΔMBC) in platform-switched posterior implants placed crestally and subcrestally. METHODS A total of 80 implants were included in this study. There were two main groups in the study; STH≤2 mm (A) and STH> 2 mm (B) and four subgroups according to the implant placement level, crestally (I) and subcrestally (II): A-I, A-II, B-I, and B-II. Intraoperatively, STH and placement depths of implants were measured from mesial and distal aspects. The mesial and distal peri-implant marginal bone levels were measured on periapical radiographs at immediately (T0), 6 months (T1), 9 months (T2), and 12 months (T3) after functional loading, and the difference between the marginal bone levels was calculated as the ΔMBC. RESULTS Statistically significantly more mesial ΔMBC was detected in the A-I than in the B-I at the time of T0-T1. In the group with STH greater than 2 mm, the difference in ΔMBC between the crestally and subcrestally placements was not statistically significant. CONCLUSIONS This study was found that STH is effective at protecting the marginal bone in the early period, and in cases where the STH is insufficient, subcrestally placement may increase long-term implant success by preventing marginal bone loss from occurring beyond the implant shoulder. The clinical trial number is NCT05595746. CLINICAL SIGNIFICANCE In this study, it was demonstrated that an STH greater than 2 mm is important for marginal bone stabilization, regardless of crestal and subcrestal levels, and that subcrestally placement is beneficial in cases of insufficient STH.
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Affiliation(s)
- Busra Terzioglu
- Kutahya Health Sciences University, Vocational School of Health Services, Kutahya, Turkey.; Kutahya Health Sciences University, Faculty of Dentistry, Department of Periodontology, Kutahya, Turkey..
| | - Berceste Guler Ayyildiz
- Kutahya Health Sciences University, Faculty of Dentistry, Department of Periodontology, Kutahya, Turkey
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Ruiz Henao PA, Magrin GL, Caneiro-Queija L, Benfatti CAM, Leira Y, Liñares-González A, Blanco-Carrión J. Single-piece zirconia versus single-piece titanium, narrow-diameter dental implants in the anterior maxilla: 5-year post-loading results of a randomized clinical trial. Clin Oral Implants Res 2024. [PMID: 38940623 DOI: 10.1111/clr.14319] [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: 12/01/2023] [Revised: 05/20/2024] [Accepted: 06/02/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single-piece zirconia versus titanium narrow-diameter implants. Additionally, clinical, radiological and patient-reported outcome measures (PROMs) were analyzed. MATERIALS AND METHODS Thirty implants (tissue level implant) were placed in 30 patients in the maxillary esthetic sector. Depending on randomization, a zirconia (test) or titanium implant (control) was placed. Esthetic, clinical, and radiological parameters, including the implant crown esthetic index (ICAI), pink esthetic score (PES), probing pocket depth, bleeding on probing, plaque index, and marginal bone levels, were evaluated at 12, 36 and 60 months after loading. RESULTS Sixty months after crown placement, no significant differences were found between groups. The ICAI values were 5.25 ± 4.21 and 4.50 ± 2.98 for the test and control groups, respectively. The corresponding PES values were 7.44 ± 1.93 and 7.43 ± 1.74 for the test and control groups, respectively. There were no significant intergroup differences for the rest of the parameters evaluated. CONCLUSION It can be suggested that monotype zirconia implants may serve as a potential alternative to titanium implants in selected clinical scenarios. While the results demonstrated comparable esthetic, clinical, and radiological aspects for zirconia implants as compared to titanium implants after a 5-year follow-up period, further research with larger sample sizes and longer-term follow-up is recommended.
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Affiliation(s)
- Paula Andrea Ruiz Henao
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Leonardo Magrin
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Leticia Caneiro-Queija
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cesar Augusto Magalhães Benfatti
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Yago Leira
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Liñares-González
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Blanco-Carrión
- Unit of Periodontology, Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Monje A, Salvi GE. Diagnostic methods/parameters to monitor peri-implant conditions. Periodontol 2000 2024. [PMID: 38923148 DOI: 10.1111/prd.12584] [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: 02/06/2024] [Revised: 05/18/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
The diagnostic accuracy of clinical parameters, including visual inspection and probing to monitor peri-implant conditions, has been regarded with skepticism. Scientific evidence pointed out that primary diagnostic tools (chairside) seem to be highly specific, while their sensitivity is lower compared with their use in monitoring periodontal stability. Nonetheless, given the association between pocket depth at teeth and implant sites and the aerobic/anaerobic nature of the microbiome, it seems plausible for pocket probing depth to be indicative of disease progression or tissue stability. In addition, understanding the inflammatory nature of peri-implant diseases, it seems reasonable to advocate that bleeding, erythema, ulceration, and suppuration might be reliable indicators of pathology. Nevertheless, single spots of bleeding on probing may not reflect peri-implant disease, since implants are prone to exhibit bleeding related to probing force. On the other side, bleeding in smokers lacks sensitivity owing to the decreased angiogenic activity. Hence, the use of dichotomous scales on bleeding in the general population, in contrast to indices that feature profuseness and time after probing, might lead to false positive diagnoses. The definitive distinction between peri-implant mucositis and peri-implantitis, though, relies upon the radiographic evidence of progressive bone loss that can be assessed by means of two- and three-dimensional methods. Accordingly, the objective of this review is to evaluate the existing clinical and radiographic parameters/methods to monitor peri-implant conditions.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
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Azangookhiavi H, Habibzadeh S, Zahmatkesh H, Mellati E, Mosaddad SA, Dadpour Y. The effect of platelet-rich fibrin (PRF) versus freeze-dried bone allograft (FDBA) used in alveolar ridge preservation on the peri-implant soft and hard tissues: a randomized clinical trial. BMC Oral Health 2024; 24:693. [PMID: 38877446 PMCID: PMC11179368 DOI: 10.1186/s12903-024-04478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/12/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND The effectiveness of alveolar ridge preservation on bone regeneration and tissue healing has been thoroughly documented in the literature. This study aimed to evaluate the peri-implant soft and hard tissue changes after alveolar ridge preservation using either platelet-rich fibrin (PRF) or freeze-dried bone allograft (FDBA) over a 12-month period following the prosthetic loading of implants. METHODS In this randomized clinical trial, 40 individuals were recruited for alveolar ridge preservation using (1) FDBA or (2) PRF in incisal/premolar areas. At two follow-up sessions (six- and 12-months post-implant insertion), radiographic imaging and clinical examinations assessed marginal bone loss and soft tissue factors, including gingival recession and bleeding on probing. The differences between study groups were analyzed using Generalized estimating Equations, the Binary logistic regression model, and Cochran's Q test. RESULTS There was a statistically significant difference regarding gingival recession at both follow-up evaluations; values in the PRF group were considerably lower compared to the FDBA group (p < 0.05). The mean values for vertical marginal bone loss and bleeding on probing showed no significant differences between the two study groups (p > 0.05). CONCLUSIONS Except for gingival recession, applying PRF yielded comparable clinical results to FDBA after one year of implant loading and could be recommended as a potential biomaterial for alveolar ridge preservation following tooth extractions. CLINICAL TRIAL REGISTRATION The research protocol was registered in the Protocol Registration and Results System on 13/08/2021, available at https://clinicaltrials.gov/ (NCT05005377).
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Affiliation(s)
- Hassan Azangookhiavi
- Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Habibzadeh
- Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Mellati
- University of Sydney, Sydney, Australia
- Private Practice, Sydney, Australia
| | - Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Yalda Dadpour
- Department of Periodontics, International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Esquivel J, Gomez Meda R, Villarroel M. Timing implant provisionalization: Decision-making and systematic workflow. J ESTHET RESTOR DENT 2024; 36:858-867. [PMID: 38284429 DOI: 10.1111/jerd.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Provisionalization is an important step to achieve esthetic results in implant cases, and many different techniques for provisional restoration fabrication have been described. However, depending on the clinical scenario, the provisionalization strategy will require different approaches and timing. The clinician should modify the provisional restorations efficiently to reduce the number of disconnections from the implant, as repeated disconnections may have biological consequences. This article aims to schematize different scenarios requiring implant provisionalization and propose strategies to help the clinician condition the peri-implant tissues, respecting perio-prosthodontic fundamentals for soft tissue, biological, and esthetic stability. CLINICAL CONSIDERATIONS The clinical outcomes of modern implant therapy aim to achieve results that emulate natural dentition. Different scenarios may require adjunct therapy, including hard- and soft-tissue grafting, which complicates treatment. The provisionalization strategy will vary depending on the initial condition of the tissues, the need for reconstructive procedures, and the timing of implant placement. Selecting the right strategy based on the case type is necessary to reduce treatment time and complications associated with inadequate prosthetic handling of the soft tissues. CLINICAL SIGNIFICANCE Proper emergence profile conditioning through provisional restorations will allow for biologically sound and esthetically pleasing outcomes in implant restorations.
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Affiliation(s)
- Jonathan Esquivel
- Adjunct Associate Professor, Department of Prosthodontics, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Ramon Gomez Meda
- Adjunct Assistant Professor, Department of Prosthodontics, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
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Corbella S, Radaelli K, Alberti A, Francetti L, Taschieri S. Erythritol powder airflow for the treatment of peri-implant mucositis: A randomized controlled clinical trial. Int J Dent Hyg 2024. [PMID: 38659293 DOI: 10.1111/idh.12814] [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: 04/05/2022] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Peri-implant mucositis is a biofilm-related, reversible inflammatory disease that can evolve into peri-implantitis if not adequately treated. The aim of the present randomized controlled clinical trial was to evaluate the efficacy of air-abrasive powder as compared to chlorhexidine (CHX) for the treatment of peri-implant mucositis, in terms of clinical and patient-reported outcomes (PROMs) and occurrence of peri-implantitis 12 months after treatment. METHODS In the control group, full-mouth calculus and plaque removal was performed with ultrasound and manual devices, and a 1.0% CHX gel was applied; in the test group, supra- and subgingival biofilm removal was performed using erythritol powder with a dedicated nozzle and calculus removal was performed with ultrasonic instruments if needed. Bleeding and plaque indexes, peri-implant probing depth and tissue level were measured at 1 week, and 1, 3, 6 and 12 months after treatment, while PROMs were evaluated up to 7 days after treatment. RESULTS Among 80 included implants, 70 were analysed at 12 months follow-up (30 in the test group, 40 in the control group, and 20 subjects). Success rates (implant-level) in terms of bleeding index were significantly different between the test (96.7%) and control group (92.5%); as for PROMs, only taste sensation was significantly better in the test group. The test group was significantly correlated to the smallest changes in peri-implant probing depth between baseline and 3 months. CONCLUSIONS The study showed that both treatment strategies are effective. This suggests that the use of air-abrasive powders could be used as an alternative biofilm removal method instead of adjunctive treatments with antiseptics.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Katherine Radaelli
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Quispe-López N, Gómez-Polo C, Zubizarreta-Macho Á, Montero J. How do the dimensions of peri-implant mucosa affect marginal bone loss in equicrestal and subcrestal position of implants? A 1-year clinical trial. Clin Implant Dent Relat Res 2024; 26:442-456. [PMID: 38282266 DOI: 10.1111/cid.13306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION There is evidence that the apico-coronal implant position and the mucosal phenotype can affect the extent of peri-implant bone loss. This clinical trial analyzes the bone remodeling and marginal bone loss that occur around conical-connection implants placed equicrestally and subcrestally, assessing the effect of the peri-implant soft-tissue phenotype. METHODS Fifty-one patients received 56 implants of distinct diameters (3.5 mm Ø n = 6; 4.3 mm Ø n = 41; 5 mm Ø n = 9) in the posterior part of the maxilla or mandible. The implants were placed equicrestally, 1 mm subcrestally and >1 mm subcrestally, depending on the initial supracrestal tissue height (STH). After 3 months of non-submerged healing, single metal-ceramic screw-retained implant-supported crowns were placed. Longitudinal measurements of STH, mucosal thickness and keratinized mucosa width (KMW) were made at the time of implant placement (T0), crown placement (T1), and after 3 (T2) and 6 months (T3) of prosthetic loading. At each of these points, a radiographic evaluation of bone remodeling and marginal bone loss was also performed. RESULTS STH was significantly greater for implants placed >1 mm subcrestally than for those placed 1 mm subcrestally. After 12 months of follow-up, a very significant (p < 0.001) loss of KMW was observed, in addition to a marginal bone loss of 0.08 ± 0.1, 0.15 ± 0.2, and 0.14 ± 0.2 mm in the groups placed equicrestally, 1 mm subcrestally and >1 mm subcrestally, respectively. After the multiple linear regression, marginal bone loss was found to depend primarily on KMW (β = -0.43), while also being affected by STH (β = 0.32) and implant diameter (β = -0.28). CONCLUSIONS Marginal bone loss may be influenced by the position with respect to the bone crest, as well as the KMW, STH, and implant diameter. However, more well-controlled studies are needed to verify these above-mentioned findings with different implant designs and connections.
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Affiliation(s)
- Norberto Quispe-López
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
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Tang C, Zhang P, Zhang X, Peng L. A modified geometric technique to increase peri-implant keratinized mucosa. J ESTHET RESTOR DENT 2024. [PMID: 38308489 DOI: 10.1111/jerd.13202] [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: 11/13/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE The free gingival graft (FGG) has been identified as the most effective method for increasing keratinized mucosa width (KMW). However, the challenge emerges in cases of extensive keratinized mucosa deficiency, where efficient utilization of the patient's limited keratinized tissue to achieve optimal results is crucial. This article introduces a modified geometric technique to address this clinical issue. CLINICAL CONSIDERATIONS Utilizing geometric principles, the modified technique involves dividing the rectangular graft into two triangular or trapezoidal sections, which are then reassembled to form an approximate diamond shape. Through strategic cut and splice, the graft is reshaped to suit the recipient site. CONCLUSION Preliminary observations in cases employing the modified geometric technique have increased the KMW around implants. This method enhances graft utilization and offers a viable clinical option for surgical plans aimed at widening keratinized mucosa in instances of large-area KMW deficiency. CLINICAL SIGNIFICANCE This article proposed a modified method to increase KMW, which may be an optimal choice for patients with insufficient KMW in large area, avoiding the waste of limited graft, decreasing patient morbidity, and effectively widening keratinized mucosa.
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Affiliation(s)
- Chenxi Tang
- Department of Implantology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peng Zhang
- Department of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaohan Zhang
- Department of Implantology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Peng
- Department of Implantology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Pohl S. Effects of socket-shield therapy on inter-implant papilla preservation between upper central and lateral incisors: A case series with 3-5 year follow-up. J ESTHET RESTOR DENT 2024; 36:144-152. [PMID: 37850392 DOI: 10.1111/jerd.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Despite significant progress within implant prosthetic therapy, preserving the papilla between two adjacent implants in the esthetic zone, particularly between central and lateral incisors, remains challenging. This case series aims to report a papilla preservation approach between adjacent upper central-lateral incisor implants using the socket-shield technique. CLINICAL CONSIDERATIONS Six patients with natural dentition received unilateral adjacent central-lateral incisor implants with different socket shield configurations. The esthetic outcomes were clinically assessed after 3-5 years of follow-up. Post-operative papilla fill was evaluated on intraoral images compared to baseline characteristics and the contralateral papilla. Papilla height was preserved in all cases, with minimal alterations observed. CONCLUSIONS Within the limitations of the present case series, the socket-shield technique demonstrated favorable outcomes in preserving the papilla between adjacent upper central-lateral incisor implants in the midterm follow-up. Clinical studies are warranted to validate these results. CLINICAL SIGNIFICANCE The socket-shield technique seems promising in preserving the inter-implant papilla between adjacent central-lateral incisor implants.
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Affiliation(s)
- Snjezana Pohl
- Department of Oral Medicine and Periodontology, University of Rijeka, Rijeka, Croatia
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Lee WP, You JS, Oh JS. Technical Note on Simplified Free Gingival Graft Using Tack Fixation (sFGG). MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2062. [PMID: 38138164 PMCID: PMC10745066 DOI: 10.3390/medicina59122062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023]
Abstract
Free gingival graft (FGG) is the gold standard procedure for the reliable augmentation of lost keratinized mucosa (KM) around dental implants. This conventional surgical approach has its drawbacks, including limitations in manipulation, the requirement for suturing, postoperative discomfort, and pain. This case report aimed to evaluate the efficacy of a simplified free gingival graft (sFGG) in addressing the issue of inadequate keratinized mucosa around dental implants. Fixation tacks were used to perform the sFGG procedure. Initially, a partial-thickness flap was created and apically repositioned. The gingival graft was harvested from the palate with a narrow profile and securely affixed to the recipient site using 5 mm long fixation tacks. Significant gains in keratinized mucosa were achieved and successfully maintained within 1 year. Consequently, the sFGG technique emerges as a simple and reliable treatment approach for managing inadequate keratinized mucosa around dental implants.
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Affiliation(s)
- Won-Pyo Lee
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju 61452, Republic of Korea
| | - Jae-Seek You
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju 61452, Republic of Korea; (J.-S.Y.); (J.-S.O.)
| | - Ji-Su Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju 61452, Republic of Korea; (J.-S.Y.); (J.-S.O.)
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Chen D, Li Z, Li Z, Sun Y, Liu Q, Yang J, Song J, Cai H, Feng Z, Chen Z, Huang B. Transcriptome analysis of human peri-implant soft tissue and periodontal gingiva: a paired design study. Clin Oral Investig 2023:10.1007/s00784-023-05017-y. [PMID: 37060358 DOI: 10.1007/s00784-023-05017-y] [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: 08/09/2022] [Accepted: 04/02/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES Limited information is available about the biological characterization of peri-implant soft tissue at the transcriptional level. The aim of this study was to investigate the effect of dental implant on the soft tissue in vivo by using paired samples and compare the differences between peri-implant soft tissue and periodontal gingiva at the transcriptional level. METHODS Paired peri-implant soft tissue and periodontal gingiva tissue from 6 patients were obtained, and the pooled RNAs were analyzed by deep sequencing. Venn diagram was used to further screen out differentially expressed genes in every pair of samples. Annotation and enrichment analysis was performed. Further verification was done by quantitative real-time PCR. RESULTS Totally 3549 differentially expressed genes (DEGs) were found between peri-implant and periodontal groups. The Venn diagram further identified 185 DEGs in every pair of samples, of which the enrichment analysis identified significant enrichment for cellular component was associated with external side of plasma membrane, for molecular function was protein binding, for biological process was immune system process, and for KEGG pathway was cytokine-cytokine receptor interaction. Among the DEGs, CST1, SPP1, AQP9, and SFRP2 were verified to be upregulated in peri-implant soft tissue. CONCLUSIONS Peri-implant soft tissue showed altered expressions of several genes related to the cell-ECM interaction compared to periodontal gingiva. CLINICAL RELEVANCE Compared to periodontal gingiva, altered cell-ECM interactions in peri-implant may contribute to the susceptibility of peri-implant diseases. At the transcriptional level, periodontal gingiva is generally considered the appropriate control for peri-implantitis, except regarding the cell-ECM interactions.
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Affiliation(s)
- Danying Chen
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Zhixin Li
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Zhipeng Li
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yue Sun
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Qifan Liu
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Jieting Yang
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Jiaying Song
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Huaxiong Cai
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Zhicai Feng
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Zhuofan Chen
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.
| | - Baoxin Huang
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.
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