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Moslemi N, Dolatabadi A, Mohseni Salehimonfared S, Goudarzimoghaddam F. Double vertical interrupted suture for optimal adaptation and stabilization of free gingival graft around dental implants: a case report. J Med Case Rep 2024; 18:291. [PMID: 38918876 PMCID: PMC11202392 DOI: 10.1186/s13256-024-04611-2] [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: 10/25/2023] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Free gingival graft is commonly used to augment the keratinized mucosa and vestibular depth around dental implants. The proper suturing technique is fundamental to achieve a successful result following free gingival graft. However, there are limited studies that focus on the details of the suturing methods to optimize graft adaptation. The purpose of this technical note is to describe a new suturing technique for optimal approximation and stabilization of free gingival graft around dental implants. CASE PRESENTATION Here, we present a 53-year-old Persian female with peri-implantitis and lack of keratinized mucosa around mandibular implants who was a candidate for free gingival graft. A new suturing technique, double vertical interrupted suture, was conducted in the interimplant areas. In addition, the suspensory cross-mattress sutures were added to ensure the adaptation of the graft over the implants. The proposed suturing technique is useful for soft tissue augmentation around multiple implants with concave or uneven recipient bed. CONCLUSION The present article describes a novel suturing technique for good adaptation and fixation of free gingival graft around dental implants.
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Affiliation(s)
- Neda Moslemi
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Dental Research Institute, Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Dolatabadi
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Goudarzimoghaddam
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Ćorić A, Kovačić I, Kiršić SP, Čelebić A. Are Mini Dental Implants Suitable for Support of Crowns or Small Bridges in the Mandibular Incisor Region? A 5-year Longitudinal Study. J Oral Maxillofac Surg 2022; 80:1811-1826. [PMID: 36049532 DOI: 10.1016/j.joms.2022.07.145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE It has not been previously studied whether 1-piece category 1 narrow dental implants (≤2.5 mm wide) can successfully support crowns or small bridges. The purpose of this study was to evaluate the long-term benefits of the fixed-type mini dental implants (MDIs) for replacement of mandibular incisors. MATERIALS AND METHODS In a prospective cohort study, fixed-type 1-piece MDIs, replacing single or multiple mandibular incisors, supporting metal-ceramic single crowns (unsplinted group), or splinted crowns/small bridges (splinted group) were observed over the period of 5 years. The primary predictor was the splinting status. The primary outcome variables were peri-implant marginal bone level (MBL) change, success, and survival rates (assessed as per Pisa Consensus Conference). The secondary outcomes were dental patient-reported outcome measures (dPROMs) and oral hygiene assessment. Descriptive statistics, Chi-squared test, t-test, Mann-Whitney and Wilcoxon tests, Kaplan-Meier survival analysis, log-rank (Mantel-Cox) comparison, Cox proportional hazard analyses adjusting for number of implants, Spearman correlation, and repeated measures were used for data analysis. RESULTS From 44 participants (mean age 56.02 ± 5.72 years), 40 completed the 5-year study: 23 in the splinted and 17 in unsplinted group. Three subjects did not respond, while 1 MDI failed (third year) in the unsplinted group. Mean MBL change in both groups was small; however, it increased over time (-0.22 ± 0.38 mm after 1 year; -0.54 ± 0.56 mm after 5 years; P < .05). After 5 years mean MBL change was -0.59 ± 0.71 mm in the unsplinted and -0.50 ± 0.41 mm in the splinted group (P > .05). Survival analysis revealed no significant difference between the unsplinted (85.7% success, 4.8% failures, and 9.5% satisfactory survivals) and splinted group (93.4% success and 6.6% satisfactory survivals) (P > .05). The group affiliation (unsplinted vs splinted) and number of implants were not significant predictors of MDI failure or survival rates (P > .05). Significant improvement in dPROMs after rehabilitation remained unchanged over 5 years (P > .05). Modified plaque index significantly increased over time, correlating with the MBL loss. CONCLUSION MDIs supporting crowns and/or small bridges in the mandibular incisor region showed small rates of marginal bone loss, acceptable success, and survival rates and improved dPROMs over a 5-year observation period.
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Affiliation(s)
- Anka Ćorić
- Health Care Center Mostar, Mostar, Bosnia and Herzegovina & Assistant, Department of Prosthodontics, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Ines Kovačić
- Assistant, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| | - Sanja Peršić Kiršić
- Associate Professor, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Asja Čelebić
- Professor, Department of Prosthodontics, School of Dental Medicine University of Zagreb, Zagreb, Croatia
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Hosseini-Faradonbeh SA, Katoozian HR. Biomechanical evaluations of the long-term stability of dental implant using finite element modeling method: a systematic review. J Adv Prosthodont 2022; 14:182-202. [PMID: 35855319 PMCID: PMC9259347 DOI: 10.4047/jap.2022.14.3.182] [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: 02/09/2022] [Revised: 05/07/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study is to summarize various biomechanical aspects in evaluating the long-term stability of dental implants based on finite element method (FEM). MATERIALS AND METHODS A comprehensive search was performed among published studies over the last 20 years in three databases; PubMed, Scopus, and Google Scholar. The studies are arranged in a comparative table based on their publication date. Also, the variety of modeling is shown in the form of graphs and tables. Various aspects of the studies conducted were discussed here. RESULTS By reviewing the titles and abstracts, 9 main categories were extracted and discussed as follows: implant materials, the focus of the study on bone or implant as well as the interface area, type of loading, element shape, parts of the model, boundary conditions, failure criteria, statistical analysis, and experimental tests performed to validate the results. It was found that most of the studied articles contain a model of the jaw bone (cortical and cancellous bone). The material properties were generally derived from the literature. Approximately 43% of the studies attempted to examine the implant and surrounding bone simultaneously. Almost 42% of the studies performed experimental tests to validate the modeling. CONCLUSION Based on the results of the studies reviewed, there is no "optimal" design guideline, but more reliable design of implant is possible. This review study can be a starting point for more detailed investigations of dental implant longevity.
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Affiliation(s)
| | - Hamid Reza Katoozian
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
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Tavelli L, Barootchi S, Vera Rodriguez M, Mancini L, Meneghetti PC, Mendonça G, Wang HL. Early soft tissue changes following implant placement with or without soft tissue augmentation using a xenogeneic cross-link collagen scaffold: A volumetric comparative study. J ESTHET RESTOR DENT 2021; 34:181-187. [PMID: 34936177 DOI: 10.1111/jerd.12856] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/06/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Soft tissue augmentation (STA) at implant sites has the potential of improving peri-implant health, esthetics, and marginal bone level stability. The present study aimed at evaluating the volumetric changes occurring following implant placement in sites that received STA compared to non-augmented sites. METHODS A total of 26 subjects received a dental implant in a posterior edentulous site. Simultaneous STA with a xenogeneic cross-linked collagen scaffold was performed for the first 13 patients, while the remaining subjects served as the negative control. An intraoral optical scanner was used at baseline and at 12 weeks to generate digital models. RESULTS The mean volume (Vol) gain of the test group was 38.43 mm3 , while a mean Vol of -16.82 mm3 was observed for the control group (p < 0.05). The mean thickness of the reconstructed volume (ΔD) was 0.61 and -0.24 mm, for the test and control group, respectively (p < 0.05). Higher linear dimensional changes were observed for the test group (p < 0.05), while no significant differences were observed in terms of keratinized mucosa width and pocket depth changes between the two groups. CONCLUSIONS Simultaneous STA with xenogeneic collagen scaffold obtained statistically significant higher volumetric outcomes compared to the non-augmented group. CLINICAL SIGNIFICANCE STA at the time of implant placement using a xenogeneic cross-linked collagen scaffold can prevent remodeling of the ridge during the first 12 weeks, as compared to non-grafted implant sites.
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Affiliation(s)
- Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Center for Clinical Research and Evidence Synthesis In oral TissuE RegeneratION (CRITERION), Ann Arbor-Boston, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Center for Clinical Research and Evidence Synthesis In oral TissuE RegeneratION (CRITERION), Ann Arbor-Boston, USA
| | - Maria Vera Rodriguez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Priscila Ceolin Meneghetti
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Escola de Ciencias de Saúde e da Vida, Ponitificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Hüfner M, Rauch N, Schwarz-Herzke B, Knorr IJ, Sager M, Drescher D, Becker K. Micro-angiogenic patterns around orthodontic implants migrating in bone: A micro-CT study in the rat tail model. J Clin Periodontol 2021; 49:188-197. [PMID: 34818684 DOI: 10.1111/jcpe.13577] [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: 08/31/2021] [Revised: 10/13/2021] [Accepted: 11/05/2021] [Indexed: 11/27/2022]
Abstract
AIM Recent studies revealed that implants can migrate in bone when subjected to continuous loading. Since this process is suspected to be accompanied by bone remodelling, which requires blood vessel formation, the present work aimed at assessing the micro-angiogenic patterns around migrating implants. MATERIALS AND METHODS In 16 rats, two customized implants were placed in a single tail vertebra and connected with contraction springs (forces: 0 N, 0.5 N, 1.0 N, 1.5 N). After 2 or 8 weeks of loading, the animals were scanned by micro-CT before and after vasculature perfusion with a silicone rubber. Vessels were segmented by subtraction of the two micro-CT scans. Vessel thickness (V.Th), vessel volume per total volume (VV/TV), and vascular spacing (V.Sp) were assessed in a peri-implant volume of interest (VOI) around each implant. RESULTS At 2 weeks of loading, force magnitude was significantly associated with VV/TV and V.Th values (χ2 = 10.942, p < .001 and χ2 = 6.028, p = .010, respectively). No significant differences were observed after 8 weeks of loading. CONCLUSIONS Within the limitations of an animal study, peri-implant vessel thickness and density were associated with force magnitude in the early loading phase, whereas effects diminished after 8 weeks of loading.
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Affiliation(s)
- Mira Hüfner
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - Ivonne Jeanette Knorr
- Central Unit for Animal Research and Scientific Animal Welfare Affairs, University of Düsseldorf, Düsseldorf, Germany
| | - Martin Sager
- Central Unit for Animal Research and Scientific Animal Welfare Affairs, University of Düsseldorf, Düsseldorf, Germany
| | - Dieter Drescher
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Abstract
Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated with mini implants. Mini implants have less percutaneous exposure and displacement that may reduce complications. Nonetheless, mini implants transmit about twice the load to the supporting bone, and thus, control of occlusal loading is important. In fixed prosthetics, rounded flat cusps, splinting, implant protective occlusal schemes, and placement only in dense bone sites are features of successful mini implant treatment. With removable prosthetics, multiple mini implants may be needed for appropriate retention and load resistance. Maxillary lateral incisor and mandibular incisor sites may be best suited for mini implant treatment. However, past research on dental implants has been directed at standard sized implants. While mini implants are indeed dental implants, they behave somewhat differently under functional load, and the clinician should be circumspect and very judicious in their use. This article is a mini review and not a systematic review. The topics covered are not pervasive because each would require a monograph or textbook for a complete discussion.
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