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Perez A, Fernandez Bargiela A, Lombardi T. Immediate Implant Placement with Immediate Restorations after Dental Avulsions Due to Endotracheal Intubation in a Patient with Severe Chronic Periodontal Disease. Diagnostics (Basel) 2024; 14:966. [PMID: 38732381 PMCID: PMC11082940 DOI: 10.3390/diagnostics14090966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/18/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024] Open
Abstract
We report the case of a 61-year-old woman who was referred to the Oral Surgery and Implantology Unit of the University Hospitals of Geneva to take care of edentulous sites after the dental avulsions of teeth 11 and 21 following traumatic shock due to endotracheal intubation under general anesthesia. The dental history revealed that the patient had a history of generalized chronic periodontitis that had been treated several years earlier. The treatment consisted, for the first time to our knowledge, of the immediate insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure and immediate restorations.
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Affiliation(s)
- Alexandre Perez
- Unit of Oral Surgery and Implantology, Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland;
| | - Adriana Fernandez Bargiela
- Unit of Oral Surgery and Implantology, Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland;
| | - Tommaso Lombardi
- Unit of Oral Medicine and Oral Maxillofacial Pathology, Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland;
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Aellos F, Grauer JA, Harder KG, Dworan JS, Fabbri G, Cuevas PL, Yuan X, Liu B, Brunski JB, Helms JA. Dynamic analyses of a soft tissue-implant interface: Biological responses to immediate versus delayed dental implants. J Clin Periodontol 2024. [PMID: 38708491 DOI: 10.1111/jcpe.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/16/2024] [Accepted: 03/10/2024] [Indexed: 05/07/2024]
Abstract
AIM To qualitatively and quantitatively evaluate the formation and maturation of peri-implant soft tissues around 'immediate' and 'delayed' implants. MATERIALS AND METHODS Miniaturized titanium implants were placed in either maxillary first molar (mxM1) fresh extraction sockets or healed mxM1 sites in mice. Peri-implant soft tissues were evaluated at multiple timepoints to assess the molecular mechanisms of attachment and the efficacy of the soft tissue as a barrier. A healthy junctional epithelium (JE) served as positive control. RESULTS No differences were observed in the rate of soft-tissue integration of immediate versus delayed implants; however, overall, mucosal integration took at least twice as long as osseointegration in this model. Qualitative assessment of Vimentin expression over the time course of soft-tissue integration indicated an initially disorganized peri-implant connective tissue envelope that gradually matured with time. Quantitative analyses showed significantly less total collagen in peri-implant connective tissues compared to connective tissue around teeth around implants. Quantitative analyses also showed a gradual increase in expression of hemidesmosomal attachment proteins in the peri-implant epithelium (PIE), which was accompanied by a significant inflammatory marker reduction. CONCLUSIONS Within the timeframe examined, quantitative analyses showed that connective tissue maturation never reached that observed around teeth. Hemidesmosomal attachment protein expression levels were also significantly reduced compared to those in an intact JE, although quantitative analyses indicated that macrophage density in the peri-implant environment was reduced over time, suggesting an improvement in PIE barrier functions. Perhaps most unexpectedly, maturation of the peri-implant soft tissues was a significantly slower process than osseointegration.
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Affiliation(s)
- Fabiana Aellos
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Joseph A Grauer
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kasidy G Harder
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julia S Dworan
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Department of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Giacomo Fabbri
- Private Practice, Ban Mancini Fabbri Dental Clinic, Cattolica, Italy
| | - Pedro L Cuevas
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Xue Yuan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Bo Liu
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - John B Brunski
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jill A Helms
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
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Fettouh AIA, Ghallab NA, Mina NA, Abdelmalak MS, Abdelrahman AAG, Shalaby AF, Shemais N. Hard and soft tissue alterations using dual-zone concept versus connective tissue graft at maxillary immediate implant placement: A 1-year randomized clinical and volumetric trial. Clin Oral Implants Res 2024; 35:510-525. [PMID: 38372450 DOI: 10.1111/clr.14247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES To evaluate the esthetic outcome, as well as clinical, radiographic, and volumetric tissue alterations 1 year after immediate implant placement (IIP) with connective tissue grafting (CTG) versus dual-zone concept (DZ) at sites with thin labial bone in the esthetic zone. MATERIALS AND METHODS This randomized clinical trial included 30 patients treated with IIP simultaneous with either CTG or DZ (n = 15 each). Pink esthetic score (PES) was assessed 6 months after crown placement as the primary outcome. Amount of bone labial to the implant, labio-palatal ridge reduction, and crestal bone changes were measured via CBCT after 1 year. Volumetric analysis of linear labial soft tissue contour, interdental, and mid-facial soft tissue level changes, and total volume loss (mm3) were measured after 1 year. RESULTS Similar PES was observed in the CTG (12.53 ± 1.13) and DZ (12.13 ± 1.55) groups, with no significant difference (p = 0.42). Likewise, there were no statistically significant differences found between the two groups in labio-palatal bone reduction (mm&%), interdental papillae, and mid-facial gingival levels (p > 0.05). However, the mean vertical crestal bone changes in the CTG and DZ groups were -1.1 ± 0.6 mm and 0.2 ± 1.0 mm, respectively, with a statistically significant difference (p = 0.0002). Moreover, CTG revealed less linear and total volume (mm3) loss in the labial soft tissue which was statistically significant compared to DZ (p = 0.007). CONCLUSION Both groups demonstrated the same PES, nevertheless, volumetric analysis revealed twice total labial volume loss in DZ compared to CTG. It might be concluded that the use of CTG with IIP caused less horizontal reduction in the supra-implant complex compared to the DZ.
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Affiliation(s)
| | - Noha A Ghallab
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Nael Adel Mina
- International Dental Continuing Education Center, Cairo, Egypt
| | | | | | | | - Nesma Shemais
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
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Sabri H, Manouchehri N, Tavelli L, Kan JYK, Wang HL, Barootchi S. Five decades of research on immediate implant therapy: A modern bibliometric network analysis via Altmetric and level of evidence mapping. Clin Oral Implants Res 2024. [PMID: 38587219 DOI: 10.1111/clr.14269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/10/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
AIM To conduct a bibliometric network analysis to explore the research landscape of immediate implant placement (IIP) and provide insights into its trends and contributors. MATERIALS AND METHODS The Scopus database was utilized as the bibliographic source, and a search strategy was implemented to identify relevant research articles. Various bibliometric parameters were extracted, including publication year, journal, authors, citations, and funding. The analysis involved examining authorship patterns, international collaborations, level of evidence, Altmetric data, and funding analysis. RESULTS We identified a steady annual growth rate of 6.49% in IIP research. The top three countries contributing to research output were the USA, Italy, and China. Prolific authors were identified based on publication and citation metrics. International collaborations among different countries were observed. The level of evidence analysis revealed that over 30% of the articles fell into higher levels of evidence (levels 1 and 2). Altmetric data analysis indicated no significant correlations between citation counts and Altmetric Attention Score (AAS), and conversely a significant association with Mendeley readers count. Funding and open access did not significantly impact the bibliometric indices of the papers. CONCLUSIONS The focus of research on IIP has been evolving as indicated by an exponential growth rate in this study. Only approximately 16% of the articles fit into level 1 evidence, therefore, emphasizing on higher quality level research study shortage in this field. Modern indices can be used as new bibliometric indicators as they also cover social media and online attention scores.
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Affiliation(s)
- Hamoun Sabri
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
| | - Neshatafarin Manouchehri
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Joseph Y K Kan
- Department of Restorative Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
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Shanmugam M, Balaji A, Valiathan M, Kannan R, Jeyaraj Samuel AF. Preserving Peri-Implant Soft Tissue Health: A Case Report on Immediate Implant Placement Using the Socket Shield Technique. Cureus 2024; 16:e57940. [PMID: 38738015 PMCID: PMC11082481 DOI: 10.7759/cureus.57940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Abstract
Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as socket preservation, atraumatic extraction, and immediate implant placement are employed to reduce the dimensional changes associated with extraction. The socket shield technique (SST) is effective in preserving the alveolar ridge's contour, enhancing the aesthetic results of rehabilitation by maintaining the integrity of the bundle bone complex even when the buccal bone is less than 1mm. This case report presents a 23-year-old female patient with a fractured upper central incisor. The socket shield technique was chosen based on the clinical findings from the cone beam computed tomography (CBCT) scan. Immediate temporization was provided to preserve soft tissue integration. A comparison of the initial and subsequent cone beam computed tomography (CBCT) scans, along with clinical observations, suggests that the socket shield technique is a viable method for preserving both hard and soft tissue structures in the anterior dental region, thereby improving aesthetic outcomes.
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Affiliation(s)
| | - Anitha Balaji
- Periodontics, Sree Balaji Dental College and Hospital, Chennai, IND
| | - Mohan Valiathan
- Periodontics, Sree Balaji Dental College and Hospital, Chennai, IND
| | - Rudhra Kannan
- Periodontics, Sree Balaji Dental College and Hospital, Chennai, IND
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Enrile de Rojas FJ, Ventura de la Torre J, Romero Griñolo JM. Long-term outcome of implants exhibiting buccal soft tissue dehiscence in the esthetic zone. J ESTHET RESTOR DENT 2024; 36:539-547. [PMID: 37771295 DOI: 10.1111/jerd.13141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE Increasing aesthetic demands require that the color and contour of the peri-implant soft tissues be in harmony with the neighboring teeth. Recession, migration toward the apical, is a frequent clinical finding. Its presence can lead to inflammation and increased marginal bone loss. These complications, in addition to affecting the aesthetic results of our treatment, are difficult to treat and can threaten the survival of the implant. There are fewer studies showing the outcome of treatment of soft-tissue defects around implants. The aim of this article is to describe the treatment of a soft-tissue defect around an implant-supported prosthesis treatment, performed on two neighboring implants, in the esthetic zone in a patient with a high smile and to evaluate both the coverage achieved and the patient's esthetic satisfaction. CLINICAL CONSIDERATIONS This study showed that a mucogingival approach, using a surgical technique designed for the treatment of alveolar ridge defects, together with tissue management with temporaries and a new restoration, achieved an optimal result. CONCLUSIONS The case has been closely followed up, for 10 years, and the authors have been able to confirm the long-term stability of the result. CLINICAL SIGNIFICANCE The following paper shows the result of an innovative approach. Connective tissue platform technique, usually performed for soft-tissue augmentation, was used for a defect in soft-tissue dehiscence. The authors followed the results for 10 years, and the results achieved were satisfactory in terms of esthetic.
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Yi C, Jiang X, Di P, Ren S, Lin Y. The facial-coronal ridge crest alterations after single immediate implant placement and provisionalization with thin buccal plate phenotype in anterior maxilla: A radiographic case-series study. Clin Implant Dent Relat Res 2024; 26:317-326. [PMID: 37749868 DOI: 10.1111/cid.13280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/26/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
AIM To explore the features of and potential landmarks that predict crestal ridge remodeling after immediate implant placement and provisionalization (IIPP) with thin buccal plate phenotype in the anterior maxilla. MATERIALS AND METHODS Patients requiring IIPP of single maxillary incisor with thin buccal bone plate (<1 mm) were recruited. Cone-beam computed tomography (CBCT), performed before and 6 months after the intervention, were three-dimensionally superimposed. A virtual line connecting the bony emergence points of adjacent teeth was drawn as a reference. The facial-coronal alveolar crest of the extraction socket and healed ridge were located in mesial, middle and distal cross-sectional planes, and linear ridge reductions were measured. The correlation between ridge reduction and local factors was analyzed. RESULTS Fifty patients were included. From the extraction socket to healed ridge, the alveolar crest underwent linear bone reduction of 1.50 ± 0.50, 1.54 ± 0.66 and 1.65 ± 0.73 mm in the mesial, middle, and distal regions in an apical-palatal direction. The middle region had significantly higher horizontal (facial-palatal) but lower vertical (coronal-apical) bone reduction than the mesial and distal areas (P < 0.01). The facial-coronal ridge crest of the healed ridge located close to the reference line. Ridge reduction positively correlated with the distance between the initial facial-coronal crest of the extraction socket and the reference line (P < 0.01). CONCLUSIONS Alveolar crest of the socket lost its curvature and tended to attain a flat profile after IIPP due to inconsistent ridge reduction in middle, mesial and distal areas. The reference line may be a potential landmark for predicting the ridge crest after remodeling.
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Affiliation(s)
- Chun Yi
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xi Jiang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Shuxin Ren
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
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ElNahass H, Tawfik OK, Naiem SN, Zazou N, Moussa M. Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18-month follow-up prospective cohort study. Clin Implant Dent Relat Res 2024. [PMID: 38380779 DOI: 10.1111/cid.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption. MATERIALS The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score. RESULTS Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results. CONCLUSION Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long-term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes. https://classic. CLINICALTRIALS gov/ct2/results?cond=&term=NCT04731545&cntry=EG&state=&city=&dist=.
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Affiliation(s)
- Hani ElNahass
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Universitätsmedizin Mainz, Mainz, Germany
| | - Omnia K Tawfik
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Suzy N Naiem
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nada Zazou
- Faculty of Dentistry, MSA University, Cairo, Egypt
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Chokaree P, Poovarodom P, Chaijareenont P, Rungsiyakull P. Effect of Customized and Prefabricated Healing Abutments on Peri-Implant Soft Tissue and Bone in Immediate Implant Sites: A Randomized Controlled Trial. J Clin Med 2024; 13:886. [PMID: 38337580 PMCID: PMC10856257 DOI: 10.3390/jcm13030886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
This study aimed to evaluate the effect of customized healing abutments compared to prefabricated healing abutments in immediate implant sites. Twelve patients requiring single immediate implant placement were divided into two groups: a prefabricated group received prefabricated titanium healing abutments, and a customized group received a polyetheretherketone (PEEK) customized healing abutments fabricated based on the individuals' digital impressions. Outcomes, including peri-implant horizontal and vertical soft tissue alteration, bone level change, volume change, pain score, and pink esthetic score (PES) change, were evaluated at the 1-, 4-, and 6-month follow-ups compared to pre-extraction teeth. At the 1- and 4-month follow-ups, the customized group had a significantly lower buccal volume variation (BVv). At the 6-month follow-up, neither group showed any significant difference in the marginal bone change; however, the customized group had a significantly lower PES change and a lower pain score. In the anterior and premolar regions, the customized group showed the preservation of peri-implant buccal horizontal soft tissue and buccal volume, while in the molar regions, the preservation of papilla height and midfacial height was observed. The morphology of the customized healing abutment demonstrated a better trend in preservation of peri-implant soft tissue, esthetic outcomes, and lower patient discomfort in immediate implant sites.
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Affiliation(s)
| | | | | | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (P.C.); (P.P.); (P.C.)
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Liu X, Lv H, Chen M, Chen S, Jia K, Quni S, Zhang L, Zhou Y. Case report and literature review: autonomous robotic system assisted palatal implantation at an anterior teeth site compromised by periapical cyst. Front Med (Lausanne) 2024; 11:1335043. [PMID: 38288274 PMCID: PMC10822917 DOI: 10.3389/fmed.2024.1335043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024] Open
Abstract
Background Immediate implant placement (IIP), which preserves gingival height and papilla shape while simultaneously accelerating the implant treatment period, has become a popular method due to its commendable clinical outcomes. Nonetheless, deploying immediate implants demands specific preconditions concerning the remaining alveolar bone. This poses a challenge to the accuracy of implant surgery. Case presentation In this report, we present the case of a 60-year-old woman with a left upper anterior tooth crown dislodged for over a month. Cone beam computed tomography (CBCT) revealed the absence of a labial bone wall on tooth 22, a remaining 1 mm bone wall on the labial side of the root apex, and a 17.2 mm*8.9 mm*4.7 mm shadow in the periapical region of the root apices of teeth 21 and 22, with the narrowest width on the sagittal plane being approximately 5 mm. After the surgeon removed the cyst, they completed the subsequent implantation surgery using an autonomous robot in a challenging aesthetic area. This method circumvented the potential exposure of the screw thread on the labial implant surface, assured initial implant stability. Conclusion Five months after the operation, the dental crown was restored. The implant remained stable, with yielding notable clinical results. To the best of our knowledge, this clinical case is the first to report the feasibility and precision of immediate implantation in anterior teeth site with periapical cyst removal, performed by an autonomous robotic surgical system. Autonomous robots exhibit exceptional accuracy by accurately controlling axial and angular errors. It can improve the accuracy of implant surgery, which may become a key technology for changing implant surgery. However, further clinical trials are still needed to provide a basis for the rapid development of robotic surgery field.
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Affiliation(s)
- Xiuyu Liu
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Huixin Lv
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Meiqing Chen
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Siyu Chen
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Kewen Jia
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Sezhen Quni
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Lu Zhang
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Yanmin Zhou
- Hospital of Stomatogy, Jilin University, Changchun, China
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Menchini-Fabris G, Toti P, Covani U, Vatteroni E, Marconcini S, Crespi R. Bone Volume Assessment Around Immediate Dental Implant in the Esthetic Area with Immediate Tooth-Like Single Crown Provisionalization: A Laser and Computed Tomography 1-Year Retrospective Study. Int J Oral Maxillofac Implants 2023; 38:933-942. [PMID: 37847835 DOI: 10.11607/jomi.10139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
PURPOSE To examine the remodeling process of both the soft and hard tissue components of the postextraction socket around immediately loaded dental implants after tooth extraction in maxillary esthetic areas. MATERIALS AND METHODS Subjects underwent immediate placement of single implants in postextraction sockets without bone grafting, and their immediate provisionalization with custom tooth-like interim crowns were fabricated using digital diagnostic impressions and a dental milling machine. Intraoperative and 1-year follow-up layered scans of the postextraction sockets after implantation were acquired using a 3D optical system. In the short term, subjects underwent computed tomographic scans. Digital impressions for gingival contours, originally stored as STL (standard tessellation language) files, were converted to DICOM (Digital Imaging and Communications in Medicine) files with the implant shoulder working as a referral point, which were then superimposed to 3D radiologic images. The observed volumetric and linear outcomes were measured using a program known as DentaScan. The width of the alveolar crest at the level of the implant shoulder and marginal bone levels were acquired. Nonparametric tests were applied with a level of significance set at P < .01. RESULTS No failure was reported after a follow-up of 1 year. Little or no inflammation of the treated areas was registered, and there were practically no signs of suppuration. The areas showed a significant reduction in the overall volumes for both soft and bone tissue, with a P value < .0001 from the baseline (0.983 ± 0.172 cm3) to the 1-year survey (0.865 ± 0.156 cm3). If the soft and bone tissue changes were separately evaluated, a significant loss (with a P value < .0001) was registered for only the bone tissues (from 0.434 ± 0.075 to 0.355 ± 0.061 cm3). Moreover, changes in gingival tissue from baseline to the 1-year survey (-0.040 ± 0.067) appeared to be significantly different from the overall volume loss (-0.118 ± 0.083 cm3). A shrinkage in width (-0.5 ± 0.7 mm) was found from baseline (12.6 ± 0.6 mm) to the 1-year follow-up (12.1 ± 0.9 mm). Marginal bone levels were 0.97 ± 0.70 mm and 0.39 ± 0.78 mm, respectively, at the mesial and distal aspects of the implants. CONCLUSIONS The present analysis suggested that immediately customized provisionalization was effective enough to prevent both volume loss and linear shrinkage at the layers of the treated areas. Moreover, the buccal aspects seemed to be the areas most affected by the loss of volume. The mean loss in width, which amounted to roughly 0.5 mm, appeared to be negligible when compared to the overall width measured before surgery.
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Liñares A, Dopico J, Magrin G, Blanco J. Critical review on bone grafting during immediate implant placement. Periodontol 2000 2023; 93:309-326. [PMID: 37658586 DOI: 10.1111/prd.12516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 09/03/2023]
Abstract
In the last 20 years, immediate implant placement has been proposed as a predictable protocol to replace failing teeth. The research conducted in preclinical and clinical studies have focused on soft and hard tissue changes following tooth extraction and immediate implant placement. Different approaches for hard and soft tissue grafting together with provisional restorations have been proposed to compensate tissue alterations. This review analyzed some relevant clinical and preclinical literature focusing on the impact of bone grafting procedures on immediate implant placement in terms of hard and soft tissue changes, aesthetic results, and patient-related outcomes.
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Affiliation(s)
- Antonio Liñares
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Dopico
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Magrin
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Dentistry, Centre for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianopolis, Brazil
| | - Juan Blanco
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Limmeechokchai S, Kan JYK, Rungcharassaeng K, Chen JT, Goodacre B, Lozada J. Facial Contour Preservation of Anterior Immediate Single-Tooth Replacement With the Socket Shield Technique Versus Connective Tissue Graft: A Case Report. J ORAL IMPLANTOL 2023; 49:495-500. [PMID: 37776256 DOI: 10.1563/aaid-joi-d-23-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
The socket shield technique and subepithelial connective tissue graft following immediate implant placement with provisionalization had been advocated for peri-implant facial contour and gingival architecture preservation. This case report used three-dimensional volumetric analysis to longitudinally assess the peri-implant facial contour change before and after these procedures. The results demonstrated comparable and acceptable preservation of peri-implant facial contour between the two procedures after 2 years of function.
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Affiliation(s)
| | - Joseph Y K Kan
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | | | - Joey T Chen
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Brian Goodacre
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Jaime Lozada
- Loma Linda University School of Dentistry, Loma Linda, Calif
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14
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Alasqah M, Alzahrani KS, Gufran K. Interdental Bone Level around Immediately Placed Implants at Maxillary and Mandibular Molar Sites: A Retrospective Radiographic Analysis. Medicina (Kaunas) 2023; 59:1701. [PMID: 37893419 PMCID: PMC10608242 DOI: 10.3390/medicina59101701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: The current study aimed to compare the amount of interdental bone loss between early and immediate implant placements. Materials and Methods: A total of 16 immediate implants and 16 early implants radiographs were included in the current research. The bone level was assessed at two different stages: at the extraction appointment (T1) and after three to six months of implant placement (T2). A line was drawn from the cemento-enamel junction connecting adjacent teeth to the interdental line connecting the interdental alveolar crest at both stages. The difference between measurements in the T1 and T2 stages is the bone loss measurement for the early implant group. For the immediate implant placement sites, the measurements were taken from the interdental bone crest to the implant platform level. Results: A Mann-Whitney U test was performed to evaluate the differences between both groups. The descriptive statistics of the T1 and T2 stages for both groups suggest that the bone loss in the T2 stage was generally higher than T1 stage. The immediate implant group showed higher bone loss compared to the early implant group. Moreover, there was significantly higher bone loss (p = 0.039) in the immediate implant group compared to the early implant group. Conclusions: The results of this study indicate that immediate implant might have disadvantages over early implant in terms of bone loss after the extraction of maxillary and mandibular molar teeth.
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Affiliation(s)
- Mohammed Alasqah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia;
| | - Khalid S. Alzahrani
- Department of Preventive Dental Sciences, College of Dentistry, Riyadh Elm University, Riyadh 12734, Saudi Arabia;
| | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia;
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Aldahlawi S, Nourah DM, Azab RY, Binyaseen JA, Alsehli EA, Zamzami HF, Bukhari OM. Cone-Beam Computed Tomography (CBCT)-Based Assessment of the Alveolar Bone Anatomy of the Maxillary and Mandibular Molars: Implication for Immediate Implant Placement. Cureus 2023; 15:e41608. [PMID: 37565092 PMCID: PMC10409627 DOI: 10.7759/cureus.41608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 08/12/2023] Open
Abstract
Purpose This study aims to examine specific aspects of socket morphology, including buccal and palatal/lingual bone width, interradicular bone (IRB) width, and assessments of root apices and furcation proximity to the vital structures of the maxillary and mandibular first and second molars using cone-beam computed tomography (CBCT). Materials and methods The study involved the analysis of 400 maxillary and mandibular first and second molars. Various measurements were taken to assess socket morphology, including mesiodistal (MD) and buccolingual (BL) width, buccal and lingual bone thickness at 2 mm apical to the alveolar crest, IRB width at 2 mm from the furcation, and the distance between the root apices and furcation to vital structures, such as the floor of the maxillary sinus (FMS) and inferior alveolar nerve (IAN). Results The mesiobuccal (MB) root of the second molar commonly intruded into the sinus, followed by the palatal root of the maxillary first molar. The mean FMS-F distance was 7.17 + 3.98 mm, and it was 7.2 + 2.72 mm for maxillary first and second molars, respectively. The mean IRB width was 2.77 + 0.96 and 2.29 + 0.74 mm for the first and second molars. The mandibular second molar had the shortest distance to the IAN in comparison to the first molar. For maxillary teeth, 7% of the first and 4% of the second molars presented alveolar anatomy adequate for immediate implant placement, compared to 84% and 50% of mandibular first and second molars. Conclusion Understanding the local alveolar bone anatomy of molars and its relationship to vital structures is crucial for the effective planning of implant treatments.
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Albaqawi AH. "All-on-4" and "All-on-6" treatment concept applied using computer-guided surgery in a patient: Case report with a 2-year follow-up. Clin Case Rep 2023; 11:e7101. [PMID: 36937624 PMCID: PMC10014524 DOI: 10.1002/ccr3.7101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/31/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
This case aimed to assess the clinical and radiographic outcomes of the All-on-4 and the All-on-6 concept using three-dimensional computer-assisted treatment planning, and computer-guided surgery. Two years after the treatment, the "All-on-4" and "All-on-6" concepts provided effective treatment for immediate restoration and showed predictable outcomes in a completely edentulous patient.
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Affiliation(s)
- Ahmed Heji Albaqawi
- Department of Restorative Dental ScienceCollege of DentistryUniversity of HaˈilHaˈilKingdom of Saudi Arabia
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17
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Geng N, Ren J, Zhou T, Xia Y, Chen S. Clinical study of dynamic real-time navigation assisted immediate implant without flapping in the esthetic zone. J Stomatol Oral Maxillofac Surg 2023; 124:101278. [PMID: 36064144 DOI: 10.1016/j.jormas.2022.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/16/2022] [Accepted: 08/31/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the clinical effect of Dynamic real-time navigation to assist immediate implant without flapping in the esthetic zone. METHODS Eight patients who underwent immediate implantation in the aesthetic area were included. A total of 11 implants were implanted using dynamic real-time navigation system combined with non-flap technology. Clinical indicators including implant deviation, initial stability, alveolar bone absorption, implant success rate, pink esthetic score (PES), Papilla index score (PIS), and the thickness of labial side bone plate of the implant were recorded. RESULTS The deviation between the actual implant position and the preoperative design was (0.76±0.08) mm at the top, (1.11±0.18) mm at the root, (0.90±0.16) mm at the depth, and (1.48±0.91)°at the Angle. ISO values of all implants were greater than 59. PES was greater than 8. PIS index was 2 or 3. The average alveolar bone absorption was (0.34±0.09) mm and the thickness of bone plate on the lip of implant was greater than 1.6 mm. The success rate of implantation was 100%. CONCLUSION The use of dynamic real-time navigation assisted non-flap implantation in the aesthetic area can effectively reduce implant deviation and improve the aesthetic effect.
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Affiliation(s)
- Ningbo Geng
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Jing Ren
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Tianren Zhou
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yixin Xia
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Songling Chen
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
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Al-Haj Husain A, Stadlinger B, Özcan M, Schönegg D, Winklhofer S, Al-Haj Husain N, Piccirelli M, Valdec S. Buccal bone thickness assessment for immediate anterior dental implant planning: A pilot study comparing cone-beam computed tomography and 3D double-echo steady-state MRI. Clin Implant Dent Relat Res 2023; 25:35-45. [PMID: 36454235 DOI: 10.1111/cid.13160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE To evaluate image quality and diagnostic accuracy of buccal bone thickness assessment in maxillary and mandibular anterior region using cone-beam computed tomography (CBCT) and 3-dimensional double-echo steady-state (DESS) MRI for preoperative planning of immediate dental implants in healthy individuals. METHODS One hundred and twenty teeth in 10 volunteers were retrospectively evaluated for image quality and artifacts using Likert scale (4 = excellent to 0 = decreased). Buccal bone thickness was measured at three measurement points (M1 = 2 mm from the cementoenamel junction, M2 = middle of the root, and M3 = at the root apex) for each tooth in the maxillary (13-23) and the mandibular anterior region (33-43). Descriptive statistics and two-way ANOVA with Tukey's Post-hoc test were performed to evaluate the significant differences (α = 0.05) between both imaging modalities. RESULTS Image quality showed little to no artifacts and enabled confident diagnostic interpretation (CBCT (3.72 ± 0.46); MRI (3.65 ± 0.49)), with no significant differences between both imaging modalities (p > 0.05). Regarding the assessment of buccal bone thickness at M1-M3 for the teeth 13-23 and 33-43, no significant differences were noted (p > 0.05). MRI demonstrated slight, nonsignificant overestimation of thickness with the canines having mainly a thick buccal bone wall, where thin buccal wall was evident for the central incisors. CONCLUSION Black bone MRI sequences, such as 3D-DESS MRI, for immediate implant planning provided confidential diagnostic accuracy in bone thickness assessment without significant disadvantages compared to CBCT. Thus, the implementation of no-dose protocols for dental rehabilitation using an immediate loading approach seems promising and could further improve the treatment strategy for dental rehabilitation.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daphne Schönegg
- Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Soni M, Gugnani S, Pandit N, Bali D, Sharma M. Efficacy of leukocyte-platelet-rich fibrin membrane in immediate postextraction implant placement: A randomized controlled trial. J Indian Soc Periodontol 2023; 27:63-69. [PMID: 36873981 PMCID: PMC9979809 DOI: 10.4103/jisp.jisp_219_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 01/09/2022] [Accepted: 01/15/2022] [Indexed: 03/07/2023] Open
Abstract
Background Leukocyte-platelet-rich fibrin (L-PRF) membrane is an emerging autologous healing biomaterial that promotes angiogenesis and healing in immediate implant sites. The purpose of the study was to evaluate hard and soft tissue outcomes of immediate implant placement with or without L-PRF. Materials and Methods A total of 18 immediate implants were divided randomly into two groups of 9 implants each, i.e., Group 1 and Group 2. All sites received a definitive restoration after 3 months of implant placement and were followed up for a period of 6-months. Results Addition of L-PRF in the extraction sockets when placing immediate implants resulted in statistically nonsignificant benefit in terms of clinical and radiographic parameters when compared to immediate implant placement without L-PRF. Conclusion Immediate implant placement in Group 2 demonstrated marginal but statistically significant benefit as compared to sites in Group 1.
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Affiliation(s)
- Monal Soni
- Department of Periodontology and Oral Implantology, J.N Kapoor DAV (C) Dental College, Yamuna Nagar, Haryana, India
| | - Shalini Gugnani
- Department of Periodontology and Oral Implantology, J.N Kapoor DAV (C) Dental College, Yamuna Nagar, Haryana, India
| | - Nymphea Pandit
- Department of Periodontology and Oral Implantology, J.N Kapoor DAV (C) Dental College, Yamuna Nagar, Haryana, India
| | - Deepika Bali
- Department of Periodontology and Oral Implantology, J.N Kapoor DAV (C) Dental College, Yamuna Nagar, Haryana, India
| | - Monia Sharma
- Department of Periodontology and Oral Implantology, J.N Kapoor DAV (C) Dental College, Yamuna Nagar, Haryana, India
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20
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Aradya A, Chowdhary R, Srinivas S. Immediate flapless implant placement in a smoker patient: A challenge for optimum aesthetics and secondary stability: A case report. Niger J Clin Pract 2022; 25:2067-2072. [PMID: 36537467 DOI: 10.4103/njcp.njcp_106_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The objective of this case report was to restore the young patient with missing teeth and extruded tooth using an immediate implant and synthetic bone graft material for the esthetic and comfort purpose. A 21-year young man reported extrusion of a tooth as well as missing teeth. Clinical examination revealed missing teeth in relation to (irt) 11 and 21, extrusion of tooth in relation to (irt) 12, patient had generalized fluorosis, and localized marginal gingivitis with melanin pigmentation. The patient is a known smoker, and he was advised the cessation of smoking before the treatment. This paper describes a step-by-step approach to different treatment phases, starting with surgical guide fabrication, immediate implant surgical procedures, bone grafting procedure, and later prosthesis fabrication. Follow-up resulted in a satisfactory outcome.
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Affiliation(s)
- A Aradya
- Department of Prosthodontics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - R Chowdhary
- Department of Prosthodontics, RajaRajeswari Dental College and Hospital, Bangalore, Karnataka, India
| | - S Srinivas
- Department of Prosthodontics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
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21
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Fu M, Jiang Z, Ren L, He J, Zhu D, Yang G. Maxillary sinus floor augmentation comparing removing versus retaining antral pseudocyst: A retrospective cohort study. Clin Oral Implants Res 2022; 33:1098-1113. [PMID: 36062937 DOI: 10.1111/clr.13993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To retrospectively compare multilevel volumetric changes in both hard and soft tissues between antral pseudocyst (AP) removal and retainment before maxillary sinus floor augmentation (MSFA) and immediate implant placement. MATERIAL AND METHODS Twenty-six patients with thirty-eight implants placed from 2016 to 2021 were included and divided according to a cohort design as follows: 13 removing the cyst (RC group) and 13 "leaving alone" the cyst (LC group). 3D radiographic parameters (primary outcome), 2D parameters and clinical records (secondary outcome) involving both hard and soft tissues were evaluated for 4 periods (T1: immediate postoperative, T2: 6-month, T3: 12-month, and T4: 2- to 5- year follow-up). Possible confounding factors, including sinus anatomical features and implant distribution, were also analyzed to eliminate their disturbance. RESULTS The 3D volumetric change rate of bone grafts in the RC group (-9.32 ± 10.01%) from T2 to T3 was significantly lower than that in the LC group (-19.8 ± 10.59%) (p < .05). The change rate of apical bone height (ABH), endo-sinus bone gain (ESBG) and other 2D parameters were not significantly different between the two groups. 5.3% implants in RC group and 9.1% implants failed during follow-ups. 0% postoperative complications were observed in RC group. The Schneiderian membrane of RC group was significantly thinner than that of LC group at two measuring points in sinus. CONCLUSION The present study demonstrated that compared to AP retainment, AP removal before MSFA and immediate implant placement can obtain higher bone graft volumetric stability and favorable prognosis. The study protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Stomatology, School of medicine, Zhejiang University, China (Acceptance number: 2021-117(R)).
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Affiliation(s)
- Mengdie Fu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zhiwei Jiang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lingfei Ren
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jin He
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Danji Zhu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Guoli Yang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
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22
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Manekar VS, Shenoi SR, Manekar S, Jhon J. Alveolar ridge split and expansion with simultaneous implant placement in mandibular posterior sites using motorized ridge expanders - modified treatment protocol. Natl J Maxillofac Surg 2022; 13:411-420. [PMID: 36683927 PMCID: PMC9851358 DOI: 10.4103/njms.njms_417_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/31/2021] [Accepted: 09/15/2021] [Indexed: 01/25/2023] Open
Abstract
Purpose "The purpose of the study is to evaluate alveolar ridge split and expansion (ARSE) with simultaneous implant placement in mandibular posterior implant sites using motorized ridge expanders." Background The ARSE is used in the management of horizontally deficient (narrow) alveolar ridge with optimum bone height available. The ARSE procedure in the posterior mandible has limited application as per literature. The successful cases reported are with extensive procedure of the osteo-mobilization with four corticotomies on buccal side. The authors presented the study of mandibular posterior implant sites using motorized ridge expanders. The ARSE performed here was by only crestal osteotomy simple osteo-condensation and immediate implant insertion. Materials and Methods The study was prospective type. The sample size was 15 patients and 31 implant sites. The study population included partially edentulous patients between 18 years and 60 years indicated for implant-supported prosthesis. The outcome variables studied included gain in ridge width, cervical bone loss, success of implant, and survival rate. Successful surgical outcome was evaluated by Buser's criteria. The data collected was evaluated by differential statistics. Conclusion The minimally invasive technique of one-stage ARSE performed with motorized ridge expander and insertion of implant in the same operative procedure decreases the morbidity, treatment time, number of surgical procedures, and the risk of complications, thereby, increasing patient acceptance. In this study, the authors have used this technique in the posterior mandible for narrow ridges (minimum 3 mm) and obtained promising results. The survival rate of the implants was 100% and the gain in ridge width was 3.2 mm. The author has also recommended the protocol according to bone density of mandible.
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Affiliation(s)
- Varsha S Manekar
- Department of Oral and Maxillofacial Surgery (OMFS), Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - S. R. Shenoi
- Department of OMFS, VSPM, Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Sunil Manekar
- Private Practice and Dental Laboratory, Manekar's Multispeciality Dental Clinic, Sidheshwar Dental and Ceramic Laboratory, Nagpur, Maharashtra, India
| | - Janice Jhon
- Department of OMFS, Yogita Dental College and Hospital, Ratnagiri, Maharashtra, India
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23
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Deng TG, Liu P, Zhou HZ, Xue Y, Zheng XN, Ji ZH, Wang L, Hu KJ, Ding YX. Effect on implant drills and postoperative reactions for pre-extraction interradicular implant bed preparation during the COVID-19 pandemic and beyond. Medicine (Baltimore) 2022; 101:e29249. [PMID: 35984133 PMCID: PMC9387664 DOI: 10.1097/md.0000000000029249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The aim of the present study was to observe the abrasion of implant drills and postoperative reactions for the preparation of the interradicular immediate implant bed during the COVID-19 pandemic and beyond. Thirty-two implant drills were included in four groups: blank, improved surgery, traditional surgery, and control. In the improved surgery group, a dental handpiece with a surgical bur was used to decoronate the first molar and create a hole in the middle of the retained root complex, followed by the pilot drilling protocol through the hole. The remaining root complex was separated using a surgical bur and then extracted. Subsequently, the implant bed was prepared. Implant drills were used in the traditional surgery group to complete the decoronation, hole creation, and implant-drilling processes. The tooth remained intact until the implant bed was prepared. The surface roughness of the pilot drill was observed and measured. Surgery time, postoperative reactions (swelling, pain, and trismus), and fear of coronavirus disease 2019 scale (FCV-19S) were measured and recorded, respectively. Statistical analysis revealed significant difference with surface roughness among blank group (0.41 ± 0.05 μm), improved surgery group (0.37 ± 0.06 μm), traditional surgery group (0.16 ± 0.06 μm), and control group (0.26 ± 0.04 μm) (P < .001). Significant differences were revealed with surgery time between improved surgery group (5.63 ± 1.77 min) and traditional surgery group (33.63 ± 2.13 min) (P < .001). Swelling, pain, and trismus (improved group: r ≥ 0.864, P ≤ .006; traditional group: r ≥ 0.741, P ≤ .035) were positively correlated with the FCV-19S. This study proved that a new pilot drill could only be used once in traditional surgery but could be used regularly in improved surgery. Improved surgery was more effective, efficient, and economical than the traditional surgery. The higher FCV-19S, the more severe swelling, pain, and trismus.
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Affiliation(s)
- Tian-Ge Deng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Ping Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Hong-Zhi Zhou
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Yang Xue
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Xue-Ni Zheng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Zhao-Hua Ji
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
| | - Lei Wang
- Department of Female Mental Health, Xi’an Mental Health Center, Xi’an, China
- *Correspondence: Lei Wang, Department of Female Mental Health, Xi’an Mental Health Center, Dong Hangtian Road, Xi’an 710061, China (e-mail: )
| | - Kai-Jin Hu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Yu-Xiang Ding
- Department of Dental Implant, Xi’an Savaid Stomatolgy Hospital, University of Chinese Academy of Sciences, Xi’an, China
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24
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Chatzopoulos GS, Wolff LF. Survival Rates and Factors Affecting the Outcome Following Immediate and Delayed Implant Placement: A Retrospective Study. J Clin Med 2022; 11:jcm11154598. [PMID: 35956213 PMCID: PMC9369675 DOI: 10.3390/jcm11154598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/20/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Immediate implant placement into extraction sockets has become a widely acceptable treatment option to decrease treatment time and enhance esthetics. The objectives of this study were to assess and compare the survival rates of immediate and delayed implant treatment as well as to investigate the effect of patient- and site-related variables on the treatment outcome in a large-scale population-based study. Methods: Dental records of patients who received implant therapy were retrieved from the electronic records of the University of Minnesota School of Dentistry. Demographic characteristics, dental insurance status, socioeconomic status as well as medical history and tobacco use were recorded. The treatment outcome was included as a binary variable (survival/failure). Time to failure (date of procedure to date of visit with failure) was compared between immediate and delayed implant treatment in Cox regression models. Kaplan−Meier plots for the survival of both treatment modalities were created. Patient-sites without failure were censored at the last follow-up visit. Results: A total of 4519 records of implants were included. The sample mean age was 60.27 years and included 50.7% males and 12.9% tobacco users. High socioeconomic status was characterized for 82.3% of the included population and 63.0% of them were self-payers. Immediate implants were significantly more frequently placed in the maxillary arch (p < 0.001) than in the mandible. Tobacco users received more often a delayed rather than an immediate implant placement (p = 0.001). The survival rate analysis revealed there were no significant differences between immediate and delayed implant placements (p = 0.48). The mean follow-up time was 32.27 months during which 1.5% immediate and 1.1% delayed implants were removed. The estimated mean survival time for immediate implants was 68.90 months, while delayed implants placed in healed sockets showed a mean survival time of 75.11 months. A statistically significant association was found between gender (p = 0.03) and osteoporosis (p = 0.001) with treatment outcome. Conclusions: The placement of immediate implants achieved similarly high survival rates when compared to delayed implants placed in healed sites. Males and osteoporotic individuals showed significantly higher implant failure than females and non-osteoporotic patients. This study demonstrated that both immediate and delayed implant placements are sound options with predictable treatment outcome.
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Affiliation(s)
- Georgios S. Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, 515 Delaware St. SE, Minneapolis, MN 55455, USA
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence:
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, 515 Delaware St. SE, Minneapolis, MN 55455, USA
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25
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ElAskary A, Elfana A, Meabed M, Abd-ElWahab Radi I, Akram M, Fawzy El-Sayed K. Immediate implant placement utilizing vestibular socket therapy versus early implant placement with contour augmentation for rehabilitation of compromised extraction sockets in the esthetic zone: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:559-568. [PMID: 35811090 DOI: 10.1111/cid.13120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The present randomized controlled trial compares for the first time the vestibular socket therapy (VST) to the contour augmentation technique in the management of compromised fresh extraction sockets in the maxillary esthetic zone, regarding mid-facial soft tissue changes (primary outcome), mesial and distal papillae dimensions, horizontal soft tissue changes and labial bone plate thickness at apical, middle and coronal levels (secondary outcomes) over 1-year. MATERIALS AND METHODS Forty participants with single nonrestorable maxillary teeth in the esthetic zone were randomized into two groups; VST (test; n = 20) utilizing vestibular access for guided bone regeneration (GBR) with immediate implant placement, or contour augmentation (control; n = 20) undergoing an initial healing period followed by implant placement with GBR through a conventional access flap. RESULTS All implants were successfully osseo-integrated, except for one implant in the test group. VST showed significantly less mid-facial soft tissue changes of -0.53 ± 1.17 mm versus -1.87 ± 0.69 mm in the control group (p < 0.001). Similarly, changes in mesial papilla (test = -0.64 ± 0.95 mm, control = -1.20 ± 0.81 mm), distal papilla (test = -0.56 ± 1.17 mm, control = -1.26 ± 0.63 mm), horizontal soft-tissue (test = -0.82 ± 0.95 mm, control = -1.84 ± 0.88 mm; p < 0.05) were significantly less in VST. Intra-group comparisons demonstrated a significant increase in labial bone thickness, with no differences between groups. Regression analysis revealed a significant correlation between VST as well as increased coronal bone thickness with the reduction in mid-facial soft-tissue changes. CONCLUSION The VST showed less soft-tissue changes and could represent an innovative technique for implant placement in the maxillary esthetic zone. Both techniques showed a high implant survival rate and increased bone thickness after 12 months.
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Affiliation(s)
- Abdelsalam ElAskary
- Elaskary and Associates Educational Center and Institute for Dental Implants, Alexandria, Egypt.,College of Dentistry, University of New York, New York, USA
| | - Ahmed Elfana
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | | | | | - Mahmoud Akram
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Karim Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.,Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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26
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De Pascalis F. Soft tissue integration with a hybrid abutment using the "one abutment-one time" therapeutic protocol: case series. Quintessence Int 2022; 53:590-596. [PMID: 35723484 DOI: 10.3290/j.qi.b3082565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To describe a procedure that uses a definitive BioHPP hybrid abutment (polyether ether ketone [PEEK] reinforced with ceramic nanoparticles), to obtain a hermetic mucous seal with the peri-implant soft tissues. Method and materials: Between July 2017 and December 2019, seven patients aged between 40 and 60 years, who needed prosthetic rehabilitation in the esthetic zone, were treated. Among the various therapeutic solutions offered, patients chose an immediate or conventional implant rehabilitation using the "one abutment-one time" technique with the hybrid SKY elegance implant abutment (bredent medical). Ten implants were placed, five with immediate loading including two postextraction, and five in a conventional/classic loading protocol. The protocol required that the finishing margin of the provisional restoration was positioned approximately 1 to 2 mm from the implant platform, allowing the tissues to heal around the ceramic-reinforced PEEK abutment. After 6 months for the implants with immediate loading, and 3 months for those with conventional loading, the provisional restorations were replaced with definitive zirconia-ceramic prostheses. RESULTS The clinical evaluation on the 10 implants showed that the reinforced PEEK abutments integrated well with the peri-implant tissues, and were healthy, without plaque, and with no bleeding on probing. An average probing depth of 1.0 mm was observed for nine of the ten placed implants, and for the tenth the implant probing depth was 1.5 mm. CONCLUSIONS The ceramic-reinforced PEEK abutments BioHPP SKY elegance associated with the one-time therapeutic protocol is a valid alternative to traditional implant loading procedures, leading to an effective peri-implant hermetic mucous seal. (Quintessence Int 2022;53:590-596; doi: 10.3290/j.qi.b3082565; Originally published (in Italian) in Quintenssenza Internationale 2021;35:48-57).
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Tosta M, Fahl N, Chambrone L, Duarte W. The beyond the gap filling approach: Modeling facial and interproximal tissues and improving esthetics for anterior flapless immediate implant placement. J ESTHET RESTOR DENT 2022; 34:592-603. [PMID: 35261141 DOI: 10.1111/jerd.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Maintenance of adequate interproximal tissue height between an implant and a natural tooth or between adjacent implants represents an esthetic challenge in implant dentistry. The aim of this case report is to describe a modified technique referred to as the beyond the gap filling (BGF) approach designed to improve the horizontal and vertical components of the facial aspect and particularly the height of interproximal bone peaks around immediately placed implants into fresh extraction sockets. CLINICAL CONSIDERATIONS Four patients (five teeth) requiring anterior tooth extraction were treated with the BGF approach that included: (a) minimally traumatic tooth extraction; (b) immediate implant placement without flap elevation; (c) installation of a narrow profile healing abutment to protect the implant during grafting; (d) grafting with a construct with 90% bovine bone granules and 10% porcine collagen packed coronally to the facial and interproximal bone walls above the level of the bone crest; and (e) delivery of an immediate restoration. CONCLUSIONS The current report suggests that the level/height of the interproximal bone crests between an implant and a natural tooth or between two adjacent implants can be improved by the BGF approach and, consequently, papilla height can be maintained in cases with a high risk of papilla height collapse and, consequently, esthetic outcomes can be maximized. CLINICAL SIGNIFICANCE The BGF is a simple technique to be used by clinicians to prevent significant papilla collapse in anterior immediate implants and consequently achieve maximum esthetic outcomes in implant dentistry.
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Affiliation(s)
| | - Newton Fahl
- Private Practice & Clinical and Scientific Director, Fahl Center, Curitiba, Brazil
| | - Leandro Chambrone
- School of Dentistry, Ibirapuera University (UNIB), São Paulo, Brazil.,Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Wagner Duarte
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
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28
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Happe A, Schmidt A, Neugebauer J. Peri-implant soft-tissue esthetic outcome after immediate implant placement in conjunction with xenogeneic acellular dermal matrix or connective tissue graft: A randomized controlled clinical study. J ESTHET RESTOR DENT 2022; 34:215-225. [PMID: 35043553 DOI: 10.1111/jerd.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/31/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This randomized comparative study evaluated the clinical esthetic outcome of the peri-implant mucosa following extraction and immediate implant placement in conjunction with anorganic bovine bone mineral (ABBM) and the use of a porcine acellular dermal matrix (pADM) versus an autogenous connective tissue graft (CTG) in the anterior maxilla. MATERIALS AND METHODS Twenty patients (11 men, 9 women) with a mean age of 48,9 years (range 21-72) were included in the study and randomly assigned to either the test (pADM) or control group (CTG). They underwent extraction and immediate implant placement together with ABBM for socket grafting and either pADM or CTG for soft tissue augmentation. Twelve months after implant placement color measurements of the peri-implant mucosa and a reference tooth were performed using a spectophotometer and the color difference (ΔE) was calculated. The overall esthetic appearance of the peri-implant soft tissue was evaluated using the Pink Esthetic Score (PES). Statistical analysis was performed using Student's T-Test, the alpha was set to 0.05. RESULTS All implants received osseointegration and were restored. The mean color difference of the peri-implant mucosa 1 year after surgery amounted ΔE 4.06 ± 1.6 for the test group (pADM) and ΔE 3.58 ± 1.36 mm for the control group (CTG), showing no statistically significant difference (p = 0.47). The mean PES of the pADM group was 11.4 ± 1.4 and for the CTG group 10.7 ± 1.5, showing no statistically significant difference (p = 0.29). CONCLUSION Twelve months after surgery, a porcine acellular dermal matrix for soft tissue augmentation in conjunction with immediate implant placement showed no difference in the overall esthetic appearance regarding color match and Pink Esthetic Score in comparison to autogenous soft tissue graft. CLINICAL SIGNIFICANCE Connective tissue grafts have become a standard in order to enhance the soft tissue quality and esthetic appearance in immediate implant placement. The use of new biomaterials like porcine acellular dermal matrices may avoid the need to harvest autogenous grafts resulting in simplified treatment and less postoperative morbidity.
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Affiliation(s)
- Arndt Happe
- Dr. Happe & Kollegen, Münster, Germany.,Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Ulm, Germany
| | - Alexander Schmidt
- Department of Oral and Maxillofacial Surgery, University of Münster, Münster, Germany
| | - Jörg Neugebauer
- Department of Oral and Maxillofacial Plastic Surgery, University of Cologne, Köln, Germany
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29
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Durrani F, Nahid R, Pandey S, Painuly H, Shukla A. Soft-tissues stabilization after immediate implant; platform switch with supraperiosteal augmentation. J Indian Soc Periodontol 2021; 25:553-559. [PMID: 34898924 PMCID: PMC8603790 DOI: 10.4103/jisp.jisp_413_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/04/2020] [Accepted: 12/16/2020] [Indexed: 11/15/2022] Open
Abstract
The architecture around an oral implant pushes the clinicians for an equalization of biological and physiological requirements. An esthetic implant-supported restoration needs plethora of knowledge and expertise. Surgeon skills can be of use for correct tridimensional position of implant in the extraction socket, shaped abutment contours, and anatomical final crown. An immediate implant placement for a fresh socket requires existing oral parameters judgment and evidence-based treatment plan. They are hard- and soft-tissue relationship, gingival biotype, and the tooth position. In this article, we describe a case of immediate implant placement, provisional crown, bovine bone contraction, soft-tissue collapse, and its management.
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Affiliation(s)
- Farhan Durrani
- Division of Periodontics, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Rakhshinda Nahid
- Division of Periodontics, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Samidha Pandey
- Division of Periodontics, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Himani Painuly
- Division of Periodontics, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Akanksha Shukla
- Division of Periodontics, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
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30
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Mao Z, Lee CT, He SM, Zhang S, Bao J, Xie ZG. Buccal bone dimensional changes at immediate implant sites in the maxillary esthetic zone within a 4-12-month follow-up period: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2021; 23:883-903. [PMID: 34761503 DOI: 10.1111/cid.13051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/15/2021] [Accepted: 10/09/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the changes in buccal bone dimensions (CBD) following immediate implant placement in the maxillary esthetic zone and to identify the factors influencing the degree of buccal bone resorption for different placement and restoration protocols. MATERIAL AND METHODS An electronic search was conducted using the EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (PubMed) databases, combined with a manual and gray literature search, up to January 2021. Selected clinical studies had to report the changes in horizontal buccal bone dimension in maxillary immediate implantation sites (premolar to premolar) at baseline and at follow-up visits within a year of implantation. A meta-analysis was conducted to calculate the mean value of the changes in horizontal and vertical buccal bone dimensions (CHBD and CVBD) around implants. To further investigate the heterogeneity and identify factors associated with buccal bone loss after immediate implant placement, subgroup analysis and univariate meta-regression were performed. RESULTS From a total of 3498 articles, 4 randomized controlled trials and 12 nonrandomized controlled trials were included for analysis. The mean survival rate of 568 implants was 99.6%. The mean CHBD and CVBD values were 0.71 mm (95% confidence interval: [0.56, 0.86]) and 0.58 mm (95% confidence interval: [0.43, 0.72]), respectively. For possible factors that related to bone resorption, including buccal bone thickness, flap design, bone grafting, horizontal defect dimension, and restoration protocol, bone grafting was the only variable that significantly influenced CHBD. CONCLUSIONS This study demonstrated that immediate implant placement in the esthetic zone does not prevent buccal bone from resorption. Due to data heterogeneity and the small sample size of the studies included in the analysis, further well-conducted, randomized controlled trials with homogeneous samples are required to investigate the correlation of CBD with different variables.
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Affiliation(s)
- Zhen Mao
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Si Meng He
- Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Shu Zhang
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Jibo Bao
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Zhi Gang Xie
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
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31
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De Angelis N, Signore A, Alsayed A, Hai Hock W, Solimei L, Barberis F, Amaroli A. Immediate Implants in the Aesthetic Zone: Is Socket Shield Technique a Predictable Treatment Option? A Narrative Review. J Clin Med 2021; 10:4963. [PMID: 34768483 PMCID: PMC8584280 DOI: 10.3390/jcm10214963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background. Dental implant placement in the anterior region requires extreme precision due to relatively high aesthetic demand. This narrative review aimed to analyse some of the available clinical studies of the socket-shield technique and determine its viability for dental implant survival/success and complication rates. (2) Methods. An electronic search for publications was performed using the Cochrane, PubMed-MEDLINE, Web of Science, and Google Scholar databases. All electronic searches included human clinical and animal studies and were performed by three independent examiners. (3) Results. A total of 1383 records were identified with the initial search strategies, but only 25 full texts + five abstracts clinical studies were kept after the recruitment criteria screening. The technical details, advantages, and limitations of the techniques were illustrated. (4) Conclusion. Within the limitations of the present review, it would be merely justified that immediate dental implant placement in conjunction with the socket-shield technique can be a promising strategy for dental implant therapy.
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Affiliation(s)
- Nicola De Angelis
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
- Department of Dentistry, University Tunku Abdul Raman (UTAR), Sungai Buloh 47000, Malaysia
| | - Antonio Signore
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
- Therapeutic Dentistry Department, Faculty of Dentistry, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Arwa Alsayed
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
| | - Wong Hai Hock
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
| | - Luca Solimei
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
| | - Fabrizio Barberis
- Department of Civil, Chemical and Environmental Engineering, University of Genoa, 16100 Genoa, Italy;
| | - Andrea Amaroli
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
- Department of Orthopedic Dentistry, Faculty of Dentistry, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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32
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Francisco H, Marques D, Pinto C, Aiquel L, Caramês J. Is the timing of implant placement and loading influencing esthetic outcomes in single-tooth implants?-A systematic review. Clin Oral Implants Res 2021; 32 Suppl 21:28-55. [PMID: 34642985 DOI: 10.1111/clr.13811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/20/2021] [Accepted: 07/26/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To address the following question: "Is the timing of implant placement and/or loading influencing the esthetic outcomes of implant-supported single crowns?" MATERIAL AND METHODS A literature screening was performed in four electronic databases until June 2020. Randomized controlled clinical trials with a minimum of 10 patients and 1 year of follow-up and reporting on dimensional changes of the peri-implant mucosa (midfacial recession, papilla level) and esthetic indexes were included. Cochrane Risk of Bias Tool was used, and comparable trials were subjected to meta-analyses. RESULTS Out of 8549 articles, 72 full-text articles were assessed for eligibility and 18 were included. Nine trials evaluated the timing of implant placement, and nine trials evaluated the timing of loading. The included trials comparing immediate implant placement to delayed implant placement evaluating the midfacial recession reported heterogeneous findings. No differences were found at 1 and 2-years, when comparing midfacial recession and papilla level between immediate and early implant placement. In immediate and delayed implant placement, when comparing conventional and immediate loading, the midfacial mucosal margin change was not statistically significant at the 1-year follow-up. When evaluating the timing of implant placement and/or loading the included trials found no differences in the Pink Esthetic score, White Esthetic score, and Papilla Index between groups. CONCLUSIONS Both immediate and early implant placement protocols presented stable treatment results in terms of esthetic outcomes at the 1-, 2-, and 10-years follow-up. Loading protocols did not seem to influence esthetic outcomes in short- and medium-term follow-ups.
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Affiliation(s)
- Helena Francisco
- Departamento de Cirurgia Oral e Implantologia, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Implantology Institute, Lisbon, Portugal
| | - Duarte Marques
- Implantology Institute, Lisbon, Portugal.,Evidence-Based Dentistry Center, Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | | | - Louise Aiquel
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University of Graz, Graz, Austria
| | - João Caramês
- Departamento de Cirurgia Oral e Implantologia, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Implantology Institute, Lisbon, Portugal
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33
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Nazzal SQ, Al-Dubai M, Mounir R, Ali S, Mounir M. Maxillary vertical alveolar ridge augmentation using computer-guided sandwich osteotomy technique with simultaneous implant placement versus conventional technique: A pilot study. Clin Implant Dent Relat Res 2021; 23:842-850. [PMID: 34609058 DOI: 10.1111/cid.13045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sandwich osteotomy technique (Inlay bone grafting) is considered as a highly reliable procedure for vertical bone augmentation in the maxillary anterior esthetic zone. The aim of this study was to compare vertical bone gain and palatal tipping using computer-guided inlay technique versus the conventional technique. MATERIAL AND METHODS This was a randomized clinical trial including 12 patients who were randomly divided into two groups: sandwich osteotomy with simultaneous implant placement at the anterior maxillary esthetic zone (six patients) using patient-specific guides (PSGs) in the study group versus conventional technique (six patients). In the control group, free-hand sandwich osteotomy was done, while in the study group all the procedures were performed with two sequential PSGs with cutting slits, guiding holes, and implant sleeves. Radiographic assessment included measurements of linear changes in the vertical dimensions of the labial plate of bone and palatal tipping on cross-sectional cuts of cone-beam computed tomography using special software. RESULTS All the procedures were uneventful except one case of the study group showed a cracked bony segment that did not affect the final outcome. Radiographic results showed comparable bone gain in both groups with no statistical significance difference (study group 4.4 mm, control group 3.9 mm). To the contrary, the computer-guided approach significantly reduced the palatal tipping to 0.4 mm compared to 2.1 mm in the conventional group, and there was a statistically significant difference between the two groups (p-value <0.001). CONCLUSION Sandwich osteotomy using PSGs appears to be efficient and showed promising results regarding improving the palatal tipping compared to the free-hand technique.
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Affiliation(s)
- Sharif Qassim Nazzal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohammed Al-Dubai
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ragia Mounir
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sherif Ali
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Mounir
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
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34
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Jalaluddin M, Sathe S, Thomas J, Haleem S, Naik S, Shivanna MM. Assessment of Implant Stability in Immediate Implant Placement using Different Bone Grafting materials: A Clinical Study. J Pharm Bioallied Sci 2021; 13:S612-S615. [PMID: 34447164 PMCID: PMC8375779 DOI: 10.4103/jpbs.jpbs_627_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 11/14/2022] Open
Abstract
Aim: The aim of the present study was to assess the implant stability in immediate implant placement using different bone grafting materials. Materials and Methods: Twelve patients (5 males, 7 females, range of 40–58 years) were included in the study. All patients were divided into two groups based on the graft material used. For Group 1, Xenograft bone grafting material was used, and for Group 2, Freeze-dried bone allograft was used. The patients were suggested to rinse with 0.2% chlorhexidine mouth wash for 1 min. Periotome was used for atraumatic tooth extraction, and necessary care was taken to avoid fracture of socket wall. The implant was placed with respective bone grafting materials. An Orthopantomogram (OPG) radiograph is taken at the day of the operation to serve as baseline data for the marginal bone level. Clinical and radiological parameters were evaluated at baseline, 3 months, 6 months, and 12 months to assess the mean marginal bone level changes. Periotest was used for the measurement of implant stability. Results: The mean marginal bone level in Group 1 at baseline (13.58 ± 1.09), 3 months (12.64 ± 0.88), 6 months (12.02 ± 1.42), and 12 months (11.20 ± 1.26), respectively. In Group 2, the marginal bone level was at baseline (14.22 ± 0.26), 3 months (13.52 ± 1.28), 6 months (13.10 ± 0.32), and 12 months (12.12 ± 1.26), respectively. There was a statistically significant difference found in both the groups. Moreover, there was no statistically significant differences found between the groups at all the duration on intergroup comparison of the mean marginal bone level. The mean difference of implant stability in Group 1 the implant stability was 188.6 ± 22.5 and in Group 2 was 191.5 ± 18.2, and there was no statistically significant difference found between the groups. Conclusion: Both bone grafting materials used in the study showed improvement in implant stability and marginal bone levels after immediate placement of implant.
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Affiliation(s)
- Mohammad Jalaluddin
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Saurabh Sathe
- Department of Oral and Maxillofacial Surgery, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Joyce Thomas
- Department of Prosthodontics, Al Azhar Dental College, Thodupuzha, Kerala, India
| | - Shaista Haleem
- Dental Health Care Department, Inaya Medical College, Riyadh, Saudi Arabia
| | - Sachin Naik
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 1143, Saudi Arabia.,Public Health Department, Texila American University, South America, Guyana
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Garcia-Sanchez R, Mardas N, Buti J, Ortiz Ruiz AJ, Pardo Zamora G. Immediate implant placement in fresh alveolar sockets with a minimal split-thickness envelope flap: A randomised controlled clinical trial. Clin Oral Implants Res 2021; 32:1115-1126. [PMID: 34218469 DOI: 10.1111/clr.13806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Comparing PES/WES scores, modified success rate, survival, success, buccal bone thickness and patient-reported outcomes of immediate dental implants placed in fresh alveolar sockets using a flap or a minimal split-thickness envelope flap (MSTEF). MATERIALS AND METHODS Implants following random assignment into a flap or MSTEF group were placed immediately in anterior and premolar areas. Guided bone regeneration and autogenous connective tissue graft were used in all cases. A temporary prosthesis was provided followed by the final prosthesis at 16-18 weeks. Success and survival rates together with radiographic buccal bone thickness and patient satisfaction were evaluated at 12-month post-loading. The aesthetic outcome was evaluated through the Pink (PES) and White (WES) Aesthetic Score by 8 blind clinicians of different training background and incorporated in modified success criteria. RESULTS 28 implants were placed on 28 patients. No statistically significant differences were noted in PES (10.54 control versus 10.80 test), WES scores (6.97 control versus 6.95 test) or success criteria including aesthetic parameters (modified success criteria) for the different specialty groups (Range 69%-92%). In addition, no statistically significant differences were noted in survival (100%), success (100%), buccal wall thickness between control (0.72 ± 0.22) and test group (0.92 ± 0.31) and patients' reported outcomes. CONCLUSIONS Immediate dental implant treatment with flap/ MSTEF provided similar mean PES/WES scores, modified success rate, survival, mean buccal bone levels and patients' satisfaction. However, aesthetic failures were common in both groups.
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Affiliation(s)
- Ruben Garcia-Sanchez
- Universidad de Murcia, Murcia, Spain.,Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Nikos Mardas
- QMUL, The London School of Dentistry, London, UK
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Velasco Bohórquez P, Rucco R, Zubizarreta-Macho Á, Montiel-Company JM, de la Vega Buró S, Madroño EC, Marín LSH, Hernández Montero S. Failure Rate, Marginal Bone Loss, and Pink Esthetic with Socket-Shield Technique for Immediate Dental Implant Placement in the Esthetic Zone. A Systematic Review and Meta-Analysis. Biology (Basel) 2021; 10:biology10060549. [PMID: 34207379 PMCID: PMC8235067 DOI: 10.3390/biology10060549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022]
Abstract
Aim: To compare the failure rate, marginal bone loss, and pink esthetic for the socket-shield technique and the conventional technique for immediate dental implant placement in the esthetic zone. Material and methods: A systematic literature review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the failure rate, marginal bone loss, and pink esthetic with the socket-shield technique for immediate dental implant placement in the esthetic zone was performed. A total of 4 databases were consulted in the literature search: PubMed-MEDLINE, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, 16 articles were selected for the qualitative and quantitative analysis. Results: Four randomized controlled trials, five prospective clinical studies, four retrospective studies, and three case series were included in the meta-analysis. The dental implant failure rate for the socket-shield technique for immediate dental implant placement was 1.37% (95% CI, 0.21-2.54%); however, no statistically significant differences between the conventional and socket-shield technique were found. The estimated mean difference in the marginal bone loss for the socket-shield technique was -0.5 mm (95% CI, -0.82 to -0.18) and statistically significant (p < 0.01), with a high heterogeneity (I2 = 99%). The mean pink esthetic score was 12.27 (Q test = 4.47; p-value = 0.61; I2 = 0%). The difference in pink esthetic between the conventional (n = 55) and socket-shield techniques (n = 55) for immediate dental implant placement was 1.15 (95% CI, 0.73-1.58; Q test = 8.88; p value = 0.11; I2 = 44%). The follow-up time was found to be significant (beta coefficient = 0.023; R2 = 85.6%; QM = 3.82; p = 0.049) for the PES for the socket-shield technique. Conclusions: Within the limitations of this systematic review with meta-analysis, the dental implant failure rate did not differ between the socket-shield technique and conventional technique for immediate implant placement in the esthetic zone. However, a lower marginal bone loss and higher pink esthetic scores were found for the socket-shield technique compared to the conventional technique.
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Affiliation(s)
- Pilar Velasco Bohórquez
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.V.B.); (R.R.); (S.d.l.V.B.); (E.C.M.); (L.S.H.M.); (S.H.M.)
| | - Roberta Rucco
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.V.B.); (R.R.); (S.d.l.V.B.); (E.C.M.); (L.S.H.M.); (S.H.M.)
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.V.B.); (R.R.); (S.d.l.V.B.); (E.C.M.); (L.S.H.M.); (S.H.M.)
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
- Correspondence:
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - Susana de la Vega Buró
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.V.B.); (R.R.); (S.d.l.V.B.); (E.C.M.); (L.S.H.M.); (S.H.M.)
| | - Esther Cáceres Madroño
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.V.B.); (R.R.); (S.d.l.V.B.); (E.C.M.); (L.S.H.M.); (S.H.M.)
| | - Lara San Hipólito Marín
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.V.B.); (R.R.); (S.d.l.V.B.); (E.C.M.); (L.S.H.M.); (S.H.M.)
| | - Sofía Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.V.B.); (R.R.); (S.d.l.V.B.); (E.C.M.); (L.S.H.M.); (S.H.M.)
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Atef M, El Barbary A, Dahrous MSED, Zahran AF. Comparison of the soft and hard peri-implant tissue dimensional changes around single immediate implants in the esthetic zone with socket shield technique versus using xenograft: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2021; 23:456-465. [PMID: 34028974 DOI: 10.1111/cid.13008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/22/2021] [Accepted: 04/26/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Compare the dimensional changes of the peri-implant soft and hard tissues clinically and radiographically around single immediate implants in the esthetic zone with socket shield technique versus filling the buccal gap with xenograft. MATERIALS AND METHODS Forty-two patients with a single non-restorable tooth in the esthetic zone replaced with an immediate implant were randomly assigned either to the socket shield technique (test) or to grafting the buccal gap with xenograft (control). The vertical and horizontal buccal bone resorption were measured 6-months following implant placement. The esthetic outcomes were evaluated by assessing the Pink Esthetic Score (PES) and the amount of midfacial mucosal alteration, in addition to patient satisfaction assessment through a Visual Analogue Scale (VAS) based questionnaire 1-year following implant restoration. RESULTS The present study showed that the socket shield group yielded significantly less vertical and horizontal buccal bone resorption of 0.35 (±0.62) mm and 0.29 (±0.34) mm compared to 1.71 (±1.02) mm and 1.45 (±0.72) mm in the xenograft group respectively. Also, there was a significantly greater midfacial mucosal recession in the xenograft group of 0.466 (±0.58) mm compared to midfacial mucosal coronal migration of 0.45 (±0.75) mm in the socket shield group. However, there was no statistically significant difference regarding the total PES and patient satisfaction in both treatment groups. CONCLUSION The socket shield technique can preserve hard and soft peri-implant tissues following immediate implant placement. (ClinicalTrials.gov Identifier: NCT03684356).
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Affiliation(s)
- Mohamed Atef
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed El Barbary
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mona Salah El-D Dahrous
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amr Fouad Zahran
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Ellis R, Chen S, Davies H, Fitzgerald W, Xu J, Darby I. Primary stability and healing outcomes of apically tapered and straight implants placed into fresh extraction sockets. A pre-clinical in vivo study. Clin Oral Implants Res 2020; 31:705-714. [PMID: 32455469 DOI: 10.1111/clr.13618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/21/2020] [Accepted: 04/25/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare the stability of apically tapered and straight (non-tapered cylindrical) implants at the time of immediate placement and to histologically evaluate the healing outcomes after 6 weeks. MATERIALS AND METHODS The second maxillary incisors were extracted bilaterally in nine dogs. After randomization, apically tapered and straight implants with a 3.3 mm shoulder diameter were inserted into the extraction sockets. The implant stability quotient (ISQ) of the implants was recorded after placement. Peri-implant defects on the buccal aspect were filled with deproteinized bovine bone mineral and covered with resorbable type I/III porcine collagen matrix. After 6 weeks of healing, sections were prepared for histological and morphometric analysis. RESULTS All implant sites healed uneventfully. The apically tapered implants had significantly higher ISQ values compared to straight implants at placement (p = .009). The histomorphometric outcomes 6 weeks following implant placement in both experimental groups were similar, except in the apico-palatal region. Apically tapered implants demonstrated significantly less percentage bone-to-implant contact (p = .035) in the apico-palatal region. At both implant types, substantial corono-apical resorption of the buccal bone wall was noted in the coronal 2 mm of the implant. CONCLUSION Apically tapered implants had significantly higher ISQ values at immediate placement compared to straight implants. The healing outcomes and remodelling of the buccal bone wall were similar for both implant designs. In the apico-palatal region, there was less %BIC at the implant surface at apically tapered implants compared to straight implants.
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Affiliation(s)
- Rebecca Ellis
- Periodontics, Melbourne Dental School, University of Melbourne, Parkville, VIC, Australia
| | - Stephen Chen
- Periodontics, Melbourne Dental School, University of Melbourne, Parkville, VIC, Australia
| | - Helen Davies
- Faculty of Veterinary Science, University of Melbourne, Parkville, VIC, Australia
| | - Wayne Fitzgerald
- Faculty of Veterinary Science, University of Melbourne, Parkville, VIC, Australia
| | - Junhua Xu
- The First Affiliated Hospital of Medicine College, Zhe Jiang University Hangzhou, Hangzhou, China
| | - Ivan Darby
- Periodontics, Melbourne Dental School, University of Melbourne, Parkville, VIC, Australia
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Assery M. A 22-Year Follow Up of Immediate Implant Placement without Bone Augmentation: A Case Series Study. J Prosthodont 2020; 29:101-106. [PMID: 31916642 DOI: 10.1111/jopr.13142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To retrospectively evaluate the treatment outcome of immediate implants placed in fresh extraction sockets without bone augmentation after 22 years of function. MATERIALS AND METHODS The study group received implant therapy in 1997, including surgical placement and prosthodontic rehabilitation. The mean age of the subjects at the time of implant placement was 40 ± 5.54 years. A total of 35 subjects received 36 implants in fresh extraction sockets without bone augmentation. Definitive prostheses were placed 4 to 6 months after implant placement. Implant treatment outcomes were evaluated using clinical and radiographic parameters obtained during follow-up visits at 1, 5, 10, 15, 20, and 22 years after prosthetic loading. RESULTS Among the 35 treated subjects, five patients moved out of the country and could not be evaluated at the follow-up times. A total of 29 subjects were included in the study with a drop-out rate of 14.1%. Of these, one patient lost the implant during the osseointegration period before prosthodontic treatment. No other implant failure or complication during the rest of the follow-up period was reported, thus giving a cumulative survival rate of 97.2% during the 22-year follow-up. The change in marginal bone level was less than 2 mm in most subjects at the 22-year examination. The mean bone loss from baseline to 22-year follow-up was 1.61 mm, and the mean bone level at the 22-year follow-up examination was situated at 2.13 ± 0.023 mm from the implant platform, which was used as the reference point. CONCLUSIONS Immediate implant placement in extraction sockets exhibits excellent prognosis even when bone augmentation is not performed.
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Affiliation(s)
- Mansour Assery
- Department of Prosthodontics, Vice-Rector for Post Graduate and Scientific Research, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
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Durrani F, Painuly H, Shukla A, Pandey S, Nahid R. Socket shield: An esthetic success? J Indian Soc Periodontol 2020; 24:289-294. [PMID: 32773983 PMCID: PMC7307468 DOI: 10.4103/jisp.jisp_557_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/30/2020] [Accepted: 02/16/2020] [Indexed: 11/04/2022] Open
Abstract
Dental implants require adequate bone, three dimensionally, for successful osseointegration. The extraction socket changes in the dimension had been described in several studies. Implant in extraction socket cannot prevent resorption of the surrounding tissues. The bony alterations make oral esthetic implant reconstruction difficult without hard- and soft-tissue augmentation. Placement of bone substitute material and immediate implant were not able to completely establish an esthetic outcome. A novel technique of retaining the buccal aspect of the tooth root during implant placement has shown preservation of esthetics. Hard and soft tissues were preserved in their original form around the replaced tooth. The retained root on the buccal aspect of an oral implant is observed to have formed cementum and to some aspects of osseointegration with the surrounding tissues. It is called socket-shield technique and if completed meticulously can be an alternative for regenerative materials and soft-tissue grafting. In our report, we completed 14 cases of the said technique with 5-year follow-up. The results looked promising as none of the cases required guided bone regeneration procedures. This may become the future noninvasive method for the preservation of hard and soft tissues around an oral implant in esthetic areas.
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Affiliation(s)
- Farhan Durrani
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India,Address for correspondence: Dr. Farhan Durrani, Professor Periodontics, Faculty of Dental Sciences, Banaras Hindu University, Varanasi 221 005, Uttar Pradesh, India. E-mail:
| | - Himani Painuly
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Akanksha Shukla
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Samidha Pandey
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rakhshinda Nahid
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Demircan S. Prosthetically driven immediate implant placement at lower molar area; an anatomical study. Eur Oral Res 2020; 54:25-30. [PMID: 32518907 PMCID: PMC7252531 DOI: 10.26650/eor.20200059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/26/2019] [Accepted: 09/16/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To examine the effectiveness and safety of immediate implant placement (IIP), we evaluated the risk of lingual plate perforation (LPP) and mandibular canal perforation (MCP) associated with posterior mandible anatomy using cone beam computed tomography (CBCT) images. MATERIALS AND METHODS A morphological study of the molar sockets of 135 patients (age: 18-84 y) was done and its relationship to the mandibular canal was investigated. The risk of LPP and MCP was recorded as yes or no. Mandibular cross-sectional morphology was defined as one of three types (U-P-C) using the criteria of Chan et al. RESULTS The risk of LPP was significantly higher for second molars (p = 0.0001), and the risk increased with age (p = 0.039). There was a strong relationship between the risk of LPP and cross-section type U (p = 0.0001). The mean root to alveolar canal (RAC) distance (mm) of males was significantly higher than that of females. The mean RAC value was 5.02 mm for males and 3.49 mm for females. There was no statistically significant relationship between the risk of MCP and sex. There was a significant relationship between the risk of MCP and cross-section type U (p = 0.0001). Although the MCP risk was higher in second molars, there was no statistically meaningful relation between MCP and tooth type. CONCLUSION The results suggest that IIP in the mandibular molar area carries a high risk of MCP and LPP. Based on the elevated level of risk, a delayed implant protocol should be considered.
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Affiliation(s)
- Sabit Demircan
- Beykent University Vocational School Dental Services, Oral Health Program, Istanbul,Turkey
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Dixon DR, Yassin A. Sectional Connective Tissue Technique Combined With an Emergence Profile Provisional for Gingival Margin Stabilization During Immediate Implant Placement: A Case Report With a 2-Year Follow-Up. Clin Adv Periodontics 2019; 10:123-129. [PMID: 31854127 DOI: 10.1002/cap.10086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/08/2019] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Little is known regarding maintaining free gingival margin stability after immediate implant placement. Therefore, we present a sequential technique incorporating a sectional connective tissue graft with an emergence tissue provisional to stabilize the free gingival margin position during immediate implant placement in the esthetic zone. CASE PRESENTATION A 57-year-old male was referred for assessment and treatment of a failing maxillary right central incisor. Clinical examination revealed poor retentive features, recurrent caries, and exposed endodontic material rendering a poor prognosis for the remaining tooth root system. After comprehensive evaluation, as well as understanding important patient case expectations, a decision was made to remove the existing tooth and place an immediate implant with a staged-provisional approach. To maintain the free gingival mid-facial height, a sectional-connective tissue graft technique was used concurrently with a custom emergence profile provisional to stabilize the gingiva immediately post-implant placement. CONCLUSION Patients undergoing implant replacement of failing anterior maxillary teeth are at risk of esthetic complications. Marginal stability of the facial gingival is an important component of establishing and maintaining the final esthetic outcome. In cases where the initial hard or soft tissue thickness may put the patient at risk, combining soft and hard tissue augmentation with attention to emergence profile provisionalization appears to aid in the initial stability of the buccal free gingival margin. This report details the steps associated with a sectional connective tissue technique combined with emergence profile provisonalization and characterizes the gingival stability up to 2.5 years obtained with this approach.
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Affiliation(s)
- Douglas R Dixon
- Department of Periodontics, University of Washington, Seattle, WA
| | - Alaa Yassin
- Department of Periodontics, University of Washington, Seattle, WA
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Yan SJ, Zhou C, Liu J, Xu XN, Yang Y, Chen X, Lan J. [Clinical evaluation of the socket-shield technique for immediate implantation in the maxillary anterior region]. Hua Xi Kou Qiang Yi Xue Za Zhi 2019; 37:615-620. [PMID: 31875439 DOI: 10.7518/hxkq.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the clinical effect of the socket-shield technique in the maxillary anterior region at one year after implant placement. METHODS Ten patients with maxillary anterior teeth that cannot be reserved were enrolled. Implants were installed following the socket-shield technique and restored six months after the surgery. The thickness of the labial maxillary bone of the implant was compared before and one year after the surgery. At one year follow-up, the reten-tion rate of the implants, Jemt classification, and pink and white aesthetic scores were evaluated. Postoperative complications and patient satisfaction were also analyzed. RESULTS One year after installation, the retention rate of the implant was 100%. The thickness of the maxillary bone at the neck, central, and root section of the implant reduced to (0.27±0.21), (0.19±0.20), and (0.28±0.29) mm, respectively, compared with the values immediately after the operation. The thickness of the labial maxillary bone at the three measurement points immediately after and one year after the operation was statistically significant (P<0.05). No significant difference (P>0.05) of the difference thickness between immediate and one year after operation at the three measurement points. The pink esthetic scores of the implant prosthesis was 9.10±0.54, and the white esthetic scores was 9.00±0.63. No complications were observed, and the patients had a high degree of satisfaction. CONCLUSIONS The socket-shield technique could provide acceptable treatment results but cannot completely avoid the reconstruction of the labial maxillary bone of the implants. The technique exhibits favo-rable short-term aesthetic result, but its long-term clinical effect and aesthetic problems need to be further studied.
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Affiliation(s)
- Sheng-Jie Yan
- Shandong Provincial Key Labo-ratory of Oral Tissue Regeneration, Jinan 250012, China;Dept. of Implantology, School & Hospital of Stomatology, Shan-dong University, Jinan 250012, China
| | - Cong Zhou
- Shandong Provincial Key Labo-ratory of Oral Tissue Regeneration, Jinan 250012, China;Dept. of Implantology, School & Hospital of Stomatology, Shan-dong University, Jinan 250012, China
| | - Jin Liu
- Shandong Provincial Key Labo-ratory of Oral Tissue Regeneration, Jinan 250012, China;Dept of Prosthodontics, School & Hospital of Stomatology, Shandong University, Jinan 250012, China
| | - Xiang-Na Xu
- Shandong Provincial Key Labo-ratory of Oral Tissue Regeneration, Jinan 250012, China;Dept. of Implantology, School & Hospital of Stomatology, Shan-dong University, Jinan 250012, China
| | - Yun Yang
- Shandong Provincial Key Labo-ratory of Oral Tissue Regeneration, Jinan 250012, China;Dept. of Implantology, School & Hospital of Stomatology, Shan-dong University, Jinan 250012, China
| | - Xin Chen
- Shandong Provincial Key Labo-ratory of Oral Tissue Regeneration, Jinan 250012, China;Dept. of Implantology, School & Hospital of Stomatology, Shan-dong University, Jinan 250012, China
| | - Jing Lan
- Shandong Provincial Key Labo-ratory of Oral Tissue Regeneration, Jinan 250012, China;Dept. of Implantology, School & Hospital of Stomatology, Shan-dong University, Jinan 250012, China
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Mourya A, Mishra SK, Gaddale R, Chowdhary R. Socket-shield technique for implant placement to stabilize the facial gingival and osseous architecture: A systematic review. ACTA ACUST UNITED AC 2019; 10:e12449. [PMID: 31433130 DOI: 10.1111/jicd.12449] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 06/15/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022]
Abstract
The aim of the present study was to establish the efficacy of the socket-shield technique (SST) for the stabilization of the facial gingival and osseous architecture. An electronic search including the Cochrane databases, EBSCOhost, Medline/PubMed and Web of Science was performed. Articles related to SST for placing dental implants were included. Articles and abstracts not written in English were excluded. The initial literature search resulted in 113 articles related to questions raised. Hand searching of the journals related to implants and cross-referencing related to SST within the selected articles resulted in 1 more paper. Finally, 20 full texts and abstract of 1 article were included in the present systematic review: 11 case reports, 6 case series, 1 human randomized control trial (RCT), 1 technical report and 2 animal RCT. Recent modifications in SST, along with long follow-up studies with increased sample size, provided promising results. This systematic review still recommends that SST should not be used in routine clinical practise until a higher level of evidence established. Further RCT on SST are required to establish the clinical efficacy of this technique.
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Affiliation(s)
- Akanksha Mourya
- Department of Prosthodontics, People's College of Dental Sciences and Research Center, Bhopal, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, People's College of Dental Sciences and Research Center, Bhopal, India
| | - Reetika Gaddale
- Department of Periodontology, AME'S Dental College and Hospital, Raichur, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, India
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Zufía J, Blasi G, Gómez-Meda R, Blasi A. The four-layer graft technique, a hard and soft tissue graft from the tuberosity in one piece. J ESTHET RESTOR DENT 2019; 31:304-310. [PMID: 30946527 DOI: 10.1111/jerd.12480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/28/2019] [Accepted: 03/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Successful immediate implant placement in the maxillary anterior zone continues to be a challenge. There is an uncertainty on whether it should be performed on patients with thin gingival phenotype or incomplete buccal plate. This clinical case report describes a novel technique for immediate implant placement with simultaneous hard and soft tissue augmentation. CLINICAL CONSIDERATIONS This technique employs a combined epithelialized-subepithelialized connective tissue graft and cortical-cancellous autogenous bone graft for the treatment of incomplete buccal plate at an extraction site. Significant horizontal bone regeneration appears to have been achieved as well as soft tissue augmentation for a central incisor in a single surgical step. Following three and a half years, gingival contours and bone augmentation were stable with a pleasant esthetic result. CONCLUSIONS The use of the four-layer tissue graft for immediate implant placement can be suggested to improve hard and soft tissues in a single procedure. CLINICAL SIGNIFICANCE The use of the four-layer graft technique has shown to be successful regarding function and esthetic outcomes in anterior immediate implant placement. It reduces surgical interventions and treatment time and minimizes soft tissue recession and bone resorption.
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Affiliation(s)
- Juan Zufía
- Department of general dentistry, Private Practice, Madrid, Spain
| | - Gonzalo Blasi
- Division of Periodontology, University of Maryland School of Dentistry, Baltimore, Maryland.,Department of Periodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Alvaro Blasi
- Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta, Georgia
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Uner DD, Izol BS, Gorus Z. Correlation between buccal and alveolar bone widths at the central incisors according to cone-beam-computed tomography. Niger J Clin Pract 2019; 22:79-84. [PMID: 30666024 DOI: 10.4103/njcp.njcp_320_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective The aim of this study is to assess whether there is a correlation between buccal bone thickness and mean alveolar bone thickness around the central teeth using CBCT images. Materials and Methods Three points were selected at 3, 6 and 9 mm from the cemento-enamel junction, respectively, perpendicular to the long axis of the measuring points made to determine the width of the alveolar bone ridge. The arithmetic mean of the length measurements was taken as the average alveolar bone thickness. To determine the average buccal alveolar bone thickness, the buccal bone length was measured perpendicular to the long axis of the tooth from these 3 points, and the average of the measurements was taken from these 3 points. Results The mean coronal, mid-root, and apical third root widths of the maxillary, left central incisors were 7.72±0.60, 8.64 ± 0.93, and 9.23±1.45 mm, respectively and the mean widths of the buccal alveolar bone at the coronal, mid-root, and apical third root positions of the left central incisor were 1.18±0.39, 1.15±0.44, and 1.06±0.50 mm, respectively. The Spearman correlation coefficients were 0.194 and 0.191 for the left and right central incisors, respectively. Conclusions There was no statistically significant difference between the alveolar bone thickness averages of the left and right central incisors, but the alveolar bone thickness was found to be thicker in males than females. Although the mean of alveolar and buccal bone thicknesses was positively correlated the statistical analysis demonstrated the correlation between the mean of alveolar and buccal bone thicknesses is not significant.
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Affiliation(s)
- D D Uner
- Department of Periodontology, Faculty of Dentistry, Harran University, Şanlıurfa, Turkey
| | - B S Izol
- Department of Periodontology, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Z Gorus
- Department of Prosthodontics, Faculty of Dentistry, Harran University, Şanlıurfa, Turkey
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Lee J, Park D, Koo KT, Seol YJ, Lee YM. Validity of a regenerative procedure for a minor bone defect with immediate implant placement: a systematic review and meta-analysis. Acta Odontol Scand 2019; 77:99-106. [PMID: 30600736 DOI: 10.1080/00016357.2018.1508743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This systematic review evaluates implant survival and the change in the width of the horizontal ridge following immediate implant placement with or without a regenerative procedure. MATERIALS AND METHODS An electronic search of MEDLINE, EMBASE, and the LILACS database of the Cochrane Central Register of controlled trials was performed, along with a manual search, up to April 2018. Randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials (CCTs) with >10 subjects were eligible for this systematic review. A meta-analysis of the risk difference in implant failure between the regenerative and non-regenerative procedure groups was performed using a fixed-effect model. In addition, a meta-analysis of the change in alveolar bone width was conducted using a fixed-effect model. RESULTS Seven studies (six RCTs and one CCT) were included. A meta-analysis of three studies found no statistically significant risk difference in implant failure between the regenerative procedure and non-regenerative procedure groups. A meta-analysis of four studies showed that horizontal shrinkage of the alveolar ridge in the site of immediate implant placement was statistically significantly lower with the regenerative procedure than without it (<1 year follow up studies: weighted mean difference (WMD) 0.75 mm, 95% confidence interval 0.41-1.09, p < .00001; ≥1 year follow up study: WMD 1.22, 95% confidence interval 0.52-1.91, p = .00006; total: WMD 0.84 mm, 95% confidence interval 0.53-1.14, p < .00001). CONCLUSION Within the study limitations, immediate implant placement with a regenerative procedure showed similar implant survival and less shrinkage of the ridge width than immediate implant placement without a regenerative procedure. Due to the high risk of bias and small sample sizes of the included studies, further clinical studies are warranted to draw definitive conclusions.
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Affiliation(s)
- Jungwon Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Dueun Park
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Kinaia BM, Kazerani S, Korkis S, Masabni OM, Shah M, Neely AL. Effect of guided bone regeneration on immediately placed implants: Meta-analyses with at least 12 months follow up after functional loading. J Periodontol 2019; 92:1749-1760. [PMID: 30702152 DOI: 10.1002/jper.18-0543] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/19/2018] [Accepted: 12/24/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Immediate implant placement (IIP) into fresh extraction socket is a favorable treatment option. If successfully managed, it reduces the overall treatment time, and increases patient's satisfaction. Surgical and restorative factors affect IIP success rates. In this systematic review we evaluate the effect of guided bone regeneration (GBR) at the time of IIP on crestal bone level (CBL) changes after at least 12-months of functional loading. METHODS Reviewers conducted an independent search of the National Center for Biotechnology Information PubMed, Medline, and the Cochrane Collaboration Library from 1966 to January 2017 following the inclusion criteria. A hand search of bibliographies of reviews and clinical trials related to IIP was also performed. This study looked into CBL changes around IIP primarily and further extracted the data to conduct three meta-analysis of "IIP using GBR versus IIP without GBR", "IIP using bone graft alone versus IIP using bone graft with membrane" and "IIP using GBR versus conventional implant placement" which were further subdivided to provide more detailed information for each. Four reviewers independently assessed the study data and methodologic quality using data extraction and assessment forms. RESULTS The electronic search identified 714 potential studies and the hand search retrieved 55 studies. Crestal bone level (CBL) changes were determined in three meta-analyses. The results revealed a mean difference in CBL changes of 0.179 ± 0.174 mm in favor of IIP without GBR when compared with implant with GBR. However, IIP with bone graft and membrane showed better results when compared with IIP with bone graft alone [CBL changes of 0.532 ± 0.572 mm]. CBL preservation was noted in IIP with GBR versus conventional implant placement [CBL changes of - 0.001 ± 0.049 mm]. CONCLUSIONS Meta-analyses showed minimal difference in CBL around IIP with bone graft versus without bone graft and with IIP with GBR compared with conventional implant placement. However, IIP with bone graft and membrane reported better CBL preservation compared with IIP with bone graft alone. Nonetheless, these results should be interpreted with caution because of moderate heterogeneity between studies.
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Affiliation(s)
- Bassam M Kinaia
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI.,Private practice, Sterling Heights, MI
| | - Shahrdad Kazerani
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
| | - Samuel Korkis
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
| | - Omar Mario Masabni
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
| | - Maanas Shah
- Department of Periodontology, Hamdan Bin Mohammed College of Dental Medicine, Dubai, UAE
| | - Anthony L Neely
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
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Sanz-Martín I, Permuy M, Vignoletti F, Nuñez J, Muñoz F, Sanz M. A novel methodological approach using superimposed Micro-CT and STL images to analyze hard and soft tissue volume in immediate and delayed implants with different cervical designs. Clin Oral Implants Res 2018; 29:986-995. [PMID: 30246362 DOI: 10.1111/clr.13365] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/14/2018] [Accepted: 08/09/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the hard and soft tissue volume after placing immediate (IMI) or delayed implants (DLI) with a triangular coronal macro-design (Test/T) or a conventional cylindrical design (Control/C). MATERIAL AND METHODS T/C implants were inserted in healed ridges or in fresh extraction sockets of eight beagle dogs. Biopsies were processed for Micro-CT analysis and dental stone casts were optically scanned to obtain STL files revealing the soft tissue contours at 12 weeks. Image analysis software was utilized to match common landmarks superimposing the two sets of data. Three distinct volumes were calculated; buccal bone volume (B-BV), soft tissue volume below the implant shoulder (EC-STV), and the soft tissue volume above the implant shoulder (SC-STV). Using linear measurements, the soft tissue height (STH), the mucosal thickness (MT-IS), and the distance from the implant shoulder to the bone crest (I-BC) were assessed in the digital images and in conventional histology to assess the concordance, reproducibility, and reliability. RESULTS There were no significant differences between test and control implants regarding the buccal bone volume, although test implants had greater B-BV in all locations except for PM2. The soft tissue volume was similar at T/C implants. The surgical approach influenced the distribution of the total tissue volume. In the IMI, a low position of the bone crest was correlated with low values of B-BV, SC-STV, MT-IS, and STH. Linear measurements showed a high correlation between the histology and digital measurements and high inter and intra examiner agreement. CONCLUSION The superimposition of Micro-CT/STL allowed the analysis of soft and hard tissue volumes. Reduction of the implant buccal aspect resulted in nonsignificant higher bone volume although similar soft tissue volume while the surgical approach influenced soft tissue response.
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Affiliation(s)
- Ignacio Sanz-Martín
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - María Permuy
- Faculty of Veterinary Lugo, University of Santiago de Compostela, Lugo, Spain
| | - Fabio Vignoletti
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Javier Nuñez
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fernando Muñoz
- Faculty of Veterinary Lugo, University of Santiago de Compostela, Lugo, Spain
| | - Mariano Sanz
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Noelken R, Geier J, Kunkel M, Jepsen S, Wagner W. Influence of soft tissue grafting, orofacial implant position, and angulation on facial hard and soft tissue thickness at immediately inserted and provisionalized implants in the anterior maxilla. Clin Implant Dent Relat Res 2018; 20:674-682. [PMID: 30092115 DOI: 10.1111/cid.12643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/09/2018] [Accepted: 05/22/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Resorption of hard and soft tissues following immediate implant insertion is frequently reported. Data regarding the influencing factors on facial tissue thickness are rare. PURPOSE This retrospective study investigated the impact of connective tissue grafting, the orofacial angulation and position of immediately inserted and provisionalized implants on the facial hard and soft tissue thickness in the anterior maxilla within a 1- to 5-year follow-up. MATERIAL AND METHODS Implants with the prerequisite of having preoperative and postoperative cone beam computed tomography (CBCT) and a follow-up of 1 to 5 years were included. Facial bone deficiencies were grafted flaplessly with autogenous bone in all sites. In a subgroup of implants additional connective tissue grafting was performed, whereas the remaining implants were not grafted with soft tissue. The orofacial tooth and implant angulation, the change of horizontal position and the facial bone thickness were measured by CBCT, the facial mucosa thickness by an ultrasonic device. RESULTS In total, 76 implants were placed in 55 patients. Sixty-nine sites showed a facial bone defect. Thirty-eight received a connective tissue graft additionally. All implants were still in function after a mean follow-up of 36 months. The mean thickness of the facial mucosa was 1.72 mm at 1 mm, 1.63 mm at 4 mm, 1.52 mm at 6 mm, and 1.66 mm at 9 mm apically to mucosal margin. The bone thickness was 0.02, 0.25, and 0.36 mm initially and 1.32, 1.26, and 1.11 mm finally at 1, 3, and 6 mm apically to implant shoulder level. Mixed model analysis revealed an impact of the preoperative bone status on the facial bone increase. The facial soft tissue thickness was significantly influenced by the gingival biotype. CONCLUSIONS The results indicate that an initial severe hard tissue defect allows for significant bone regeneration. The facial soft tissue thickness is primarily influenced by the gingival biotype.
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Affiliation(s)
- Robert Noelken
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany.,Private Practice for Oral Surgery, Lindau/Lake Constance, Germany
| | - Jannik Geier
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Martin Kunkel
- Department of Oral and Maxillofacial Surgery, University Hospital of Bochum, Bochum, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
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