Guided flapless surgery with immediate loading for the high narrow ridge without grafting

Papilla Formation in Response to Computer-Assisted Implant Surgery and Immediate Restoration

This retrospective analysis was undertaken to evaluate the effect of immediate implant restoration using a computer-assisted technique in partially edentulous sites on interimplant and intertooth bone level stability and papilla formation. Nine partially edentulous patients received a total of 23 implants that supported immediately placed implant restorations. Planning was accomplished using a radiographic guide, which allowed visualization of the emergence profile from the platform of the implant to the cervical of the planned restoration. Guided implants were placed according to the manufacturer's instructions, and restorations were screw retained directly to the implant. Multiple implants were splinted at surgery with autopolymerizing resin. Measurements were made at a mean of 545 days (range 288-958) postoperatively on the basis of radiographs and photographs. Measures were: (1) distance from bone crest to platform, (2) bone crest to contact point, (3) interimplant distance at the outer diameter of the platform, and (4) papilla from highest point to a reference line. At follow-up time, the bone ridge was located higher than the implant platform (mean 0.57 mm) compared to implants whose interimplant distance was less than 3 mm (mean 0.27 mm). Mean increase of the bone level between insertion and approximate 1-year follow-up was 0.047 mm. The mean distance from the contact point to bone was 2.39/3.93 mm postoperatively, resulting in 91/71% papilla fill between implants and between implant and adjacent tooth, respectively. Computer-assisted surgery with the preplanned immediate restoration seems to be an effective method to minimize bone loss at the implant platform resulting in support for papilla.

Laser welded versus resistance spot welded bone implants: analysis of the thermal increase and strength

INTRODUCTION

The first aim of this "ex vivo split mouth" study was to compare the thermal elevation during the welding process of titanium bars to titanium implants inserted in pig jaws by a thermal camera and two thermocouples. The second aim was to compare the strength of the joints by a traction test with a dynamometer.

MATERIALS AND METHODS

Six pigs' jaws were used and three implants were placed on each side of them for a total of 36 fixtures. Twelve bars were connected to the abutments (each bar on three implants) by using, on one side, laser welding and, on the other, resistance spot welding. Temperature variations were recorded by thermocouples and by thermal camera while the strength of the welded joint was analyzed by a traction test.

RESULTS

For increasing temperature, means were 36.83 and 37.06, standard deviations 1.234 and 1.187, and P value 0.5763 (not significant). For traction test, means were 195.5 and 159.4, standard deviations 2.00 and 2.254, and P value 0.0001 (very significant).

CONCLUSION

Laser welding was demonstrated to be able to connect titanium implant abutments without the risk of thermal increase into the bone and with good results in terms of mechanical strength.