Comparison of a Novel Ultrasonic Scaler Tip vs. Conventional Design on a Titanium Surface

The aim of this in vitro study was to evaluate the alterations of a titanium surface after treatment with two different types of ultrasonic tips: conventional steel versus an innovative copper alloy silver-plated one. Twenty smooth-surface, grade IV unalloyed titanium discs were divided into two groups. The discs were ultrasonically instrumented and the scaler was connected with a loading machine. The surface morphology was examined using scanning electron microscopy (SEM) and fractal analysis of lacunarity was calculated to highlight the alteration of the surface using the two different tips. The SEM analysis showed different degrees of surface roughness between the two types of scaler tips. Moreover, these observations demonstrated that the new tip showed fewer irregularities on the disc’s surface than the conventional steel tip. The statistical and fractal analysis showed a statistically significant difference between the two groups. Surface alterations of titanium induced by the conventional ultrasonic tips were much greater than those made by copper alloy silver plated tips. The presented results suggest that the use of this new ultrasonic tip may reduce the alterations on the implant surface during its use in dental practice.

Lateral Sinus Floor Elevation Performed with Trapezoidal and Modified Triangular Flap Designs: A Randomized Pilot Study of Post-Operative Pain Using Thermal Infrared Imaging

Purpose: Post-operative pain and swelling are frequently observed after sinus lift procedures. The aim of the present study was the clinical evaluation of swelling and pain of two different sinus flap lift techniques using a visual analogue scale (VAS), verbal rating scale (VRS), and infrared thermal imaging (i.e., thermography). Materials Methods: A randomized controlled trial was conducted with 15 patients (30 sinuses in total) randomly allocated into two groups. For the sinuses of Group I a trapezoidal flap was used, while for Group II a modified triangular flap without anterior release was utilized. Postoperative pain was scored by means of a 100-mm VAS ranging from 0 (no pain) to 100 (worst pain imaginable), and was recorded at 2, 4, 6 and 14 days after surgery. Swelling was recorded by a verbal rating scale (VRS) and was classified into four categories: a score of 1 referred the absence of swelling, patients with intra-oral swelling in the surgical zone scored 2, any extra-oral swelling in the surgical zone scored 3, and intense swelling exhibited by extra-oral swelling extending beyond the surgical zone scored 4. The facial temperature was recorded before and after sinus augmentation, and at 2, 4, 6, and 14 days post-surgery to check the course of healing. Results: In Group I pain intensity was recorded at 2 days after surgery with a mean score of 38.67 ± 6.4 mm. Swelling was greater at 2 and 4 days, and was absent at day 6. The facial temperature difference before and after the procedure was 4.737 &deg;C ± 0.37. In Group II the pain score were lower than in Group I (p < 0.05). The score for swelling was 2 on the first and second days, and was reduced on day 4. After the second day the difference in temperature was significantly reduced as compared to the day of surgery (0.77 &deg;C); at 2 and 4 days no difference was registered. Conclusions: The results of this clinical study show the significant effectiveness of the modified triangular flap in the sinus lift procedure for reducing pain and swelling.

Instant loading with intraoral welding technique and PRAMA implants: a new prosthetic approach

When splinting multiple implants passive fit of the framework should be achieved to avoid excessive force distribution on the implants. Recently, a protocol was suggested for immediate loading of multiple implants by welding a titanium bar to implant abutments directly in the oral cavity so as to create a customized, precise and passive metal-reinforced provisional restoration. The intraoral welding technique subsequently proves to be a successful option in the full-arch immediate restorations of the mandible and maxilla. The aim of this article is to present a case report in which a new prosthetic approach, using trans-mucosal implants, is described. Dental implants are instantly loaded with a provisional prosthesis supported by an intraoral welded titanium framework to obtain a precise passive fit of the immediate loaded prosthesis.

Biomechanical considerations on macromorphology of endosseous dental implants

The aim of the present study is to define the optimal thread form and why the macroscopic shape of the dental intra-osseous implant interacts with the biological environment thus conditioning its lifespan and long-term success.

Static and fatigue resistance of two types of implant/abutment connectors

The aim of this study is to determine in an experimental way through mechanical tests the static, fatigue and torque resistance of two types of implant/abutment connectors with diameters of 3.4–5.2 mm.

The Use of Cortical Heterologous Sheets for Sinus Lift Bone Grafting: A Modification of Tulasne's Technique with 7-Year Follow-up

In this article, the authors describe their experience with using cortical deantigenated equine bone sheets in sinus lift grafting procedures performed on 23 patients. The technique employed resembles that described by Tulasne but avoids the need for using harvested calvaria bone and introduces some additional operating variants. The use of heterologous cortical bone sheets effectively managed even large lacerations of the Schneiderian membrane and allowed for immediate stabilization of the heterologous bone granules. Average histomorphometric values for bone cores collected six months after grafting, at the time of implant placement, were: newly formed bone tissue 43.9±4.2%, residual bone substitute 7.4±1.4%, medullary spaces 48.7±4.0%. At seven year follow-up, clinical and radiographic examination indicated that the use of the bone sheets preserved the regenerated bone volume. In conclusion, the use of heterologous cortical bone sheets in association with granular bone graft material enabled long-term stabilization of the graft material and effective management of intra-surgical complications.

Microbiologic evaluation of crevicular fluid in patients treated with platform switching and traditional implants

BACKGROUND

The purpose of this study was to compare the microbiota around natural teeth and dental implants with different restorative platforms. Attention was focused on whether the microbiological environment could change according to the implant platform used i.e. traditional or Platform Switching implants. As the latter show less signs of bone resorption, a correlation with the presence of certain periodontal bacteria was suggested.

METHODS

Seven partially edentulous patients with dental implants, either traditional or Platform Switching, were included in this study. All the implants were in function at least for 1 year. Gingival crevicular fluid samples were obtained before any periodontal probing from natural teeth and different implant platforms and assayed using DNA extraction and PCR sequences in order to determine quality and quantity of microbiota. Statistical analysis included chi square test were used to establish differences in the microbiological distribution between the two implant platforms.

RESULTS

There were not statistical differences neither regarding the distribution of microbiota around natural teeth and implants nor between the two implant platforms. The presence of B.forsythus was revealed in the majority of the samples (from 90 to 100 percent) while A.actinomycetemcomitans was rarely found (from 0 o 25 percent). As for the other periodontal microbiota, their presence or absence showed a variation according to different sites or patients, without a predictable pattern.

CONCLUSIONS

It was not possible to find a link between the colonization of certain types of bacteria and the reduction of bone loss which occurs around Platform Switching implants. Therefore the preservation of bone crest is only due to biomechanical aspects, which are related to the reposition of the implant-abutment interface away from the outer edge of the implant platform and from the bone.

Vertical ridge augmentation using a flexible heterologous cortical bone sheet: three-year follow-up

Rehabilitation of the atrophic alveolar ridge is often problematic. Bone augmentation surgery may be hindered by a lack of surfaces from which blood vessels can spread during the initial stages of bone regeneration. If heterologous biomaterials are used as an alternative to autologous bone grafts, the standard delivery formats-blocks or granules-both have significant limitations. The present study was designed to evaluate the effectiveness of an alternative material, a flexible equine bone sheet, for vertical ridge augmentation. Forty-nine implants were placed in 18 patients whose vertically atrophic maxillary or mandibular ridges were simultaneously augmented with flexible cortical bone sheets derived from equine femurs. After 4 months, the ridge volume for all patients was completely restored, all implants had successfully osseointegrated, and definitive prostheses were placed. These parameters remained unchanged throughout 3 years of follow-up.

The abutment duplication technique: a novel protocol for cementable implant-supported restorations

The purpose of this study was to present a new laboratory technique for cementable implant-supported restorations and to evaluate its efficacy in reducing chair time for both patients and clinicians, while maintaining the precision of an indirect procedure for crown fabrication. The technique consisted of the duplication of the implant portion of a working cast prepared using double-pour or plastic base die systems for single or multiple crowns. For this purpose, a flask previously intended for the production of ceramic inlays and onlays was used. Duplication was obtained using a high-precision addition silicon material and a low-shrinkage polyurethane resin. The duplicated implant abutment was used to finalize the fixed partial denture restorations after the originals were delivered to the patients. Fifty abutments were tested consecutively. The castings (19 single crowns, 31 fixed partial dentures) produced on the original abutments were seated on the duplicate abutments and evaluated by two prosthodontists and two dental technicians using a visual inspection method (laboratory microscope at 163 magnification). Forty-eight restorations were "good" (completely seated, no marginal opening) and 2 were "acceptable" (incomplete seating but amendable), with a 98% success rate. The technique presented demonstrates efficacy and predictability in reducing the number of clinical sessions for delivering precisely fitting cementable implant-supported restorations.

Evaluation of hard tissue response around wider platform-switched implants

The use of a narrower-diameter abutment over a larger-diameter implant platform has been shown to decrease peri-implant bone resorption. This technique, known as platform switching, shifts the implant-abutment microgap inward. The aim of this study was to examine whether shifting the microgap further inward by increasing the discrepancy between the implant platform and abutment diameter would result in a decrease in crestal bone loss. Ten patients requiring mandibular or maxillary implant restorations were included in this study. The inclusion criteria called for an alveolar crest thickness of at least 8.0 mm at the implant placement site. Fifteen Certain PREVAIL implants with a body diameter of 5.0 mm, an expanded platform feature with a maximum diameter of 5.8 mm at the collar, and a prosthetic seating surface of 5.0 mm were used in lengths of 8.5, 10.0, 11.5, or 13.0 mm. The implants were connected to 4.1-mm healing abutments in a single-stage protocol. Periapical radiographs taken before and immediately after surgery, 8 weeks after implant placement, immediately after definitive prosthesis insertion, and at 12 and 18 months after loading revealed an average peri-implant bone loss of 0.30 mm. Increasing the discrepancy between the diameter of the implant platform and the restorative abutment may lead to a decrease in the amount of subsequent coronal bone loss.

The use of piezosurgery to mobilize the mandibular alveolar nerve followed immediately by implant insertion: a case series evaluating neurosensory disturbance

One of the therapeutic options proposed for reconstruction of the atrophic posterior mandible is inferior alveolar nerve (IAN) mobilization with simultaneous implant placement. However, studies on the functionality of this neurovascular bundle after its mobilization have shown mixed results. This variability can be attributed both to the test methodology, which typically requires subjective answers from patients, and to the surgical procedure itself, which is highly dependent on operator technique. This article reports on a series of 10 cases of IAN mobilization using a device specifically engineered to simplify bone surgery. This device enables the oral surgeon to avoid overstretching the nerve by creating a smaller bone window and using an apicocoronal inclination of instruments to capture the neurovascular bundle. Evaluation by means of neurosurgery function tests over a 36-month period found that all patients had a return to normal sensation after a brief period of neurosensory disturbance. Subjective responses to a patient questionnaire confirmed these findings. The implant success rate was 100%.

Alveolar ridge augmentation using membranes

Successful augmentation of compromised ridges using membranes requires correct diagnosis and careful case selection. The goals of the reconstruction should be identified before surgery. The timing and application of membranes and selecting the type of bone graft specific for each site are important. The technique requires clinical experience in flap design and mobilization, trimming, shaping and stabilizing the membrane, and suturing. Careful postoperative management of forces on the alveolar ridge from removable appliances is required.

Hard and soft tissue responses to the platform-switching technique

Platform switching is a concept recently introduced in implant dentistry. It is intended to reduce the crestal bone loss that is commonly found around implants exposed to the oral environment. The aim of this study was to examine biopsy specimens to help explain the biologic processes occurring around a platform-switched implant. A mandibular implant was removed 2 months after placement because of prosthetic rehabilitation difficulties. The implant was then sectioned and subjected to histologic and histomorphometric analysis. An inflammatory connective tissue infiltrate was localized over the entire surface of the implant platform and approximately 0.35 mm coronal to the implant-abutment junction, along the healing abutment. A possible reason for bone preservation around a platform-switched implant may lie in the inward shift of the inflammatory connective tissue zone at the implant-abutment junction, which reduces its injurious effect on the alveolar bone.

α-Defensin Levels in Whole Saliva of Totally Edentulous Subjects

Salivary levels of α-defensins 1–4 and histatins 1, 3 and 5 were determined in 11 totally edentulous patients, 11 younger healthy adults with normal gingival mucosa (Control group I) and 8 subjects, age-matched with edentulous patients, having a minimum of 25 teeth (Control group II). Whole saliva was treated with trifluoroacetic acid and the acidic soluble fraction analyzed by High Performance Liquid Chromatography-Mass Spectrometry. The area of the extracted ion current peaks was used for peptide quantification. Levels of α-defensinsl-4, but not of histatins, were significantly lower in totally edentulous patients with respect to both Control group I and Control group II. The two control groups did not show significant differences. The reduced level of oral α-defensins, which are mainly of crevicular origin, is most likely due to the absence of the gingival sulcus in the edentulous subjects. The near absence of α-defensins might be in part responsible for the higher vulnerability of the oral cavity to oral pathogen infections observed in totally edentulous patients.

Evaluation of peri-implant bone loss around platform-switched implants

This clinical and radiographic prospective study evaluated bone loss around two-piece implants that were restored according to the platform-switching protocol. One hundred thirty-one implants were consecutively placed in 45 patients following a nonsubmerged surgical protocol. On 75 implants, a healing abutment 1 mm narrower than the implant platform was placed at the time of surgery. On the remaining implants, a healing abutment of the same diameter as the implant was inserted. All implants were positioned at the crestal level. Clinical and radiographic examinations were performed prior to surgery, at the end of surgery, 8 weeks after implant placement, at the time of provisional prosthesis insertion, at the time of definitive prosthesis insertion, and 12 months after loading. The data collected showed that vertical bone loss for the test cases varied between 0.6 mm and 1.2 mm (mean: 0.95 +/- 0.32 mm), while for the control cases, bone loss was between 1.3 mm and 2.1 mm (mean: 1.67 +/- 0.37 mm). These data confirm the important role of the microgap between the implant and abutment in the remodeling of the peri-implant crestal bone. Platform switching seems to reduce peri-implant crestal bone resorption and increase the long-term predictability of implant therapy.

Bone contact around osseointegrated implants: histologic analysis of a dual-acid-etched surface implant in a diabetic patient

The clinical applicability and predictability of osseointegrated implants in healthy patients have been studied extensively. Although successful treatment of patients with medical conditions including diabetes, arthritis, and cardiovascular disease has been described, insufficient information is available to determine the effects of diabetes on the process of osseointegration. An implant placed and intended to support an overdenture in a 65-year-old diabetic woman was prosthetically unfavorable and was retrieved after 2 months. It was then analyzed histologically. No symptoms of implant failure were detected, and histomorphometric evaluation showed the bone-to-implant contact percentage to be 80%. Osseointegration can be obtained when implants with a dual-acid-etched surface are placed in properly selected diabetic patients.

Bone Contact Around Osseointegrated Implants: A Histologic Study of Acid-Etched and Machined Surfaces

Current literature reports that surface acid etching can improve bone--implant contact (BIC). The aim of this study was to evaluate the differences of BIC between acid-etched (Osseotite) and machined surface implants. Six white New Zealand mature rabbits were used in the present investigation. Each rabbit received two implants, specially made with two surfaces on it (one acid-etched and one machined) into each tibia. A total of 24 implants were inserted. Two animals each were killed at 15, 30, and 60 days after implant placement. Histomorphometry of BIC was statistically evaluated. The acid-etched surfaces showed a greater bone contact percentage than the machined ones during the early phase of healing (15 days), which was not statistically significant. On the other hand, after 30 and 60 days, the differences of BIC between acid-etched and machined surfaces were statistically significant. The acid-etched surface appears to improve BIC at a later stage of healing.

Sandblasted and acid-etched dental implants: a histologic study in rats

PURPOSE

Current literature has revealed that surface etching of endosseous implants can improve bone-implant contact. The aim of this study was to evaluate the differences in bone-implant contact (BIC) between sandblasted/acid-etched and machined-surface implants.

MATERIALS AND METHODS

Thirty-two Sprague-Dawley rats were used in this study. Two implant surfaces, Ecotek (sandblasted/ acid-etched) and machined, were used with 1 implant placed in each tibia of the animals. A total of 64 implants were placed. BIC was evaluated at 5, 15, 30, and 60 days. Histomorphometry of the BIC was evaluated statistically.

RESULTS

The sandblasted/acid-etched surface demonstrated a greater BIC percentage than the machined surface. This difference was statistically significant only at 30 and 60 days after healing.

DISCUSSION AND CONCLUSION

The sandblasted/acid-etched surface demonstrated a stronger bone response than the machined one at a later period of healing.

Three-stage approach to aesthetic implant restoration: emergence profile concept

Proper treatment planning and precise evaluation of various parameters (e.g., bone volume, soft tissues, dental anatomy, surgical and prosthetic components) are crucial for an aesthetic implant restoration. The three-stage approach of the emergence profile concept guides the selection of implant, healing abutment, and provisional prosthesis. Adaptation of the implant, provisional prosthesis, and crown restoration stages and their harmonious integration with the soft tissues enable the development of an optimal aesthetic result. This article demonstrates the incorporation of the emergence profile concept for aesthetic implant placement.

Osseotite implant: 3-year prospective multicenter evaluation

PURPOSE

This prospective multicenter study evaluates the cumulative success rate of the Osseotite implant after 3 years of prosthetic loading.

MATERIALS AND METHODS

A total of 413 Osseotite implants (Implant Innovations) were placed in 142 patients (completely or partially edentulous) in five dental offices exclusively devoted to implants. The average age of the patients was 58.3 years. Of the 413 implants, 191 were placed in the maxilla and 222 in the mandible; 271 (65.6%) were posterior implants and 142 (34.4%) were anterior implants. Clinical and radiographic evaluations were made after completion of the prosthetic restoration, after 6 months of loading, at 1 year, and at 3 years.

RESULTS

A cumulative success rate of 95.3% was obtained after 3 years of prosthetic loading. The success rate was similar in both arches: 95.1% in the maxilla and 96.8% in the mandible. Early failures (before prosthetic loading) were greater (n = 12) than late failures (n = 2). After 3 years of prosthetic loading, the marginal bone level of 385 (93.2%) implants were evaluated radiographically. Bone level was at the first thread for 91.4% of the implants. A slightly increased loss was observed around 26 implants (6.7%). Including survival implants, the cumulative implant success rate after 3 years was 96%. A success rate of 98.4% was obtained with 187 short implants (8, 5 and 10 mm) reported in this multicenter evaluation.

CONCLUSION

This multicenter evaluation demonstrates excellent predictability for Osseotite implants.

Optimal implant stabilization in low density bone

Initial stability of the implant is one of the fundamental criteria for obtaining osseointegration. An adequate primary anchorage is often difficult to achieve in low density bone (type IV). Various surgical suggestions were advanced in the 1980s which were aimed at achieving optimal osseous integration in poor quality bone. They offered satisfactory short-term results. Recently, as a result of surgical and technological innovations, new therapeutic proposals have shown very interesting results in their initial studies.

Small-diameter implants: indications and contraindications

The choice of implant diameter depends on the type of edentulousness, the volume of the residual bone, the amount of space available for the prosthetic reconstruction, the emergence profile, and the type of occlusion. Small-diameter implants are indicated in specific clinical situations, for example, where there is reduced interradicular bone or a thin alveolar crest, and for the replacement of teeth with small cervical diameter. Before using a small-diameter implant, the biomechanical risk factors must be carefully analyzed. Preliminary reports of this type of implant show good short- and medium-term results.

The self-tapping and ICE 3i implants: a prospective 3-year multicenter evaluation

This multicenter prospective clinical evaluation was undertaken to determine the therapeutic success and marginal bone level stability of 3i's self-tapping and ICE implants after 3 years of prosthetic loading. Between July 1995 and June 1996, 189 completely or partially edentulous patients were treated with 614 machined-surface screw-type commercially pure titanium implants (self-tapping or ICE). Two hundred seventy-seven self-tapping implants were placed in 85 patients (average age of 56 years), and 337 ICE implants were placed in 104 patients (average age of 61 years). A total of 360 implants (58.6%) were placed in posterior segments. Easier placement was reported with the ICE implant in normal or dense bone. For the self-tapping implants, survival rates of 92.9% and 91.6% were noted after 1 and 3 years of prosthetic loading, respectively. Survival rates of 95.4% and 93.8% were obtained with the ICE implant for the same periods. Late failures (after loading) were more common than early failures (before loading) for both types of implants. The marginal bone level of 238 self-tapping implants (85.9%) and of 307 ICE implants (91%) was radiographically evaluated at 3 years. Marginal bone level was at the first thread for 95.1% of implants. A loss of marginal bone level of 2 to 4 threads was noted for 4.9% of the evaluated implants. No implant showed bone loss greater than the fourth thread. Overall survival rates of 94.3% and 92.9% were obtained after 1 and 3 years of prosthetic loading, respectively, for 596 and 588 implants.

To conserve or implant: which choice of therapy?

The longevity of teeth depends directly on the state of the periodontal tissues. Many etiologic factors can lead to the loss of a tooth. Tooth loss is frequently associated with bone resorption. The diagnosis of a condition and knowledge of its etiology are essential to assess the prognosis of the remaining teeth and to formulate the correct treatment plan. Many parameters must be investigated to ascertain an accurate diagnosis. An understanding of the patient's needs and the length and likely success of treatment guides the decision of whether to preserve teeth or extract them and place implants. Advanced periodontitis poses a major therapeutic dilemma. Judicious, strategic extractions may permit the placement of long implants in ideal positions.

Implant Treatment of Posterior Mandibular Sextants

In mandibular posterior sextants an insufficient bone quality or volume may contraindicate implant placement. Crestal bone resorption, supra-eruption of teeth, and minimal bone coronal to the mandibular canal are the principal reasons for not placing dental implants. The available prosthetic space is also a major factor in determining surgical and prosthetic treatment. Various surgical approaches are used to create adequate bone volume in the posterior mandible, thereby allowing the possibility for implant placement. The therapeutic choice is made depending upon residual bone volume and available prosthetic space. The risks and disadvantages of the various techniques must be seriously evaluated and explained to the patient.

Dental implants in the oral rehabilitation of a teenager with hypohidrotic ectodermal dysplasia: report of a case

This report presents the case of a teenager affected by hypohidrotic ectodermal dysplasia and rehabilitated with a fixed maxillary partial prosthesis and mandibular overdenture supported by osseointegrated implants. Treatment had a major impact on patient's self-esteem, function, and esthetics.

Histologic evaluation of osseointegrated implants restored in nonaxial functional occlusion with preangled abutments

Of concern with the use of preangled abutments on implants is the transmission of masticatory forces and the angle at which they occur. Nineteen endosseous implants were placed in two subhuman primates. After 6 months, to allow for osseointegration, the implants were fitted with preangled abutments of various degrees and restored with type IV alloy castings. Straight abutments were used as control. Histologic evaluation revealed that, after 1 year of service, the implants exhibited complete osseointegration. Implants, whether restored with straight or preangled abutments, had no adverse effect on the surrounding bone. Soft tissue pockets measured, on average, from 2.2 to 2.6 mm; acute and chronic inflammatory cells were present. When crown loss was observed, it was caused by mechanical failure of components, such as gold screws and the screws used to secure the preangled abutments to the implants. Preangled abutments appear to be a valuable adjunct in implant dentistry, although long-term studies are needed for confirmation.

The guided tissue regeneration principle in endodontic surgery: one-year postoperative results of large periapical lesions

Twenty patients with large endodontic lesions, which failed to respond to conventional endodontic therapy, were selected for this study. The lesions had a radiographic diameter of at least 10 mm, were removed by periradicular surgery, before retrofilling the apices with either super EBA or dessicated zinc oxide-eugenol. In 10 test sites large e-PTFE membranes (Gortex) were placed to cover the lesions, while at the control sites the lesions were not covered before resuturing. Radio-graphic analysis of the lesions at 3, 6, 9 and 12 months revealed that lesions covered with the membranes healed quicker than the control lesions, and that the quality and quantity of the regenerated bone was superior when membranes were used. Results of the study indicate that guided tissue regeneration (GTR) principles can be effectively applied to the healing of large periapical lesions, especially in through-and-through lesions.

Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of e-PTFE and a new titanium membrane

To evaluate the efficacy of guided tissue regeneration around exposed implant threads, 16 implants were placed into fresh extraction sockets in beagle dogs. Polytetrafluoroethylene (e-PTFE) membranes and titanium membranes were used to cover the defects around implants. A control group did not receive any membranes. Results were evaluated histologically. The average gain in bone height was 2.1 mm for e-PTFE sites, 0.8 mm for titanium membranes, and 2.9 mm for control sites. The greatest gain in bone levels was seen for two sites that received e-PTFE membranes and remained covered for the entire evaluation interval. Within the limits of this study, clinical and histologic evidence demonstrated that, when primary coverage is maintained, the use of e-PTFE membranes can significantly enhance bone regeneration around implants.

[Bone regeneration in implantology. The use of Gore-Tex membranes: GTAM]

The use of expanded polytetrafluorethylene membranes to attain bone regeneration around dental implants is described. Membranes discourage "non-desirable" cells form colonizing the healing site. These cells are essentially derived from gingival epithelium and gingival connective tissue. It is suggested that this procedure could be employed directly after tooth extraction.