Socket‐shield technique for implant placement to stabilize the facial gingival and osseous architecture: A systematic review

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.     

Immediate loading after implant placement following tooth extraction up-regulates cellular activity in the dog mandible

Objectives: The aim of this study was to investigate cellular activity of the cervical portion of peri‐implant tissue due to immediate loading after implant placement following tooth extraction from the dog mandible, in terms of morphological, immunohistochemical and molecular characteristics. Material and methods: A sand‐blasted implant was inserted into the root septum bone of each extraction socket and was connected to a superstructure made from resin and then covered with an expanded polytetrafluoroethylene membrane. Implants without the superstructure were used as the non‐loading control group. Animals were sacrificed 1–3 weeks later and specimens were observed using light microscopy and mRNA levels were analyzed by real‐time polymerase chain reaction. Results: The new bone formation ratio in the loading group at 3 weeks was significantly higher than in the non‐loading group. Alkaline phosphatase (ALP)‐positive cells were observed in tissues around the implant surface in both groups at each of the time periods. More osteocalcin (OCN)‐positive cells were observed in the non‐loading group than in the loading group at 2 weeks. The expression of ALP mRNA in the loading group was significantly up‐regulated compared with the non‐loading group (P<0.05). The expression of OCN mRNA in the loading group was significantly up‐regulated compared with the non‐loading group at 2 weeks (P<0.05). Conclusion: These results suggest that immediate loading after implant placement following tooth extraction osteogenic affects cellular activity of cervical portion of peri‐implant tissue. To cite this article:
Sato R, Matsuzaka K, Kokubu E, Inoue T. Immediate loading after implant placement following tooth extraction up‐regulates cellular activity in the dog mandible.
Clin. Oral Impl. Res. xx , 2011; 000–000.
doi: 10.1111/j.1600‐0501.2010.02118.x     

牙片屏障即刻种植术与常规即刻种植临床效果比较的Meta分析

目的:系统评价牙片屏障即刻种植术(socket shield technique,SST)与常规即刻种植在美学及骨组织保存方面的临床效果.方法:检索Pubmed、Embase、Cochrane library、知网、万方、CBM数据库及中国、美国临床试验注册中心2020-09-20日前发表的比较牙片屏障即刻种植术与常规...     

改良盾构术与传统即刻种植术的临床效果对比研究

目的 对比研究美学区改良盾构术与传统即刻种植术的临床效果。方法 选取24例行上颌前牙区单颗牙即刻种植的患者,12例行改良盾构术（试验组）,12例行传统即刻种植术（对照组）,随访1年,比较两组患者的种植成功率、红色美学指数（PES）、唇侧骨板吸收量以及患者满意度。采用SPSS 21.0软件进行统计学分析。结果 术后1年,两组患者的种植成功率均为100%;试验组PES评分以及患者满意度均高于对照组,唇侧骨板吸收量低于对照组,差异均有统计学意义（P<0.05）。结论 改良盾构术有利于维持唇侧骨量,从而获得更好的软组织美学效果。     

改良盾构术与传统即刻种植术的临床效果对比研究

目的 对比研究美学区改良盾构术与传统即刻种植术的临床效果。方法 选取24例行上颌前牙区单颗牙即刻种植的患者,12例行改良盾构术（试验组）,12例行传统即刻种植术（对照组）,随访1年,比较两组患者的种植成功率、红色美学指数（PES）、唇侧骨板吸收量以及患者满意度。采用SPSS 21.0软件进行统计学分析。结果 术后1年,两组患者的种植成功率均为100%;试验组PES评分以及患者满意度均高于对照组,唇侧骨板吸收量低于对照组,差异均有统计学意义（P<0.05）。结论 改良盾构术有利于维持唇侧骨量,从而获得更好的软组织美学效果。     

Comparison of immediate implant placement in infected and non-infected extraction sockets: a systematic review and meta-analysis

Objective: This review aimed to investigate the feasibility of immediate implant placement in infected extraction sockets.

Material and methods: We performed electronic and manual searches up to March 2017 to obtain data from randomized controlled trials (RCTs) and nonrandomized controlled clinical trials (CCTs). Using a fixed-effects model to assess the difference in survival rate (primary outcome), we evaluated the risk difference for immediate implant placement in infected and non-infected sites. We estimated the weighted mean differences (WMDs) of the change in marginal bone loss (MBL), probing depth (PD), modified bleeding index (mBI), marginal gingival level (MGL) and width of keratinized gingiva (WKG) at baseline and latest follow-up.

Results: In total, five studies (0 RCT, five CCTs) were included in the systematic review and three studies were included in the meta-analysis. The risk difference for immediate implant placement in an infected extraction socket compared with that in a non-infected socket was ?0.02. WMDs for MBL, PD, mBI, MGL and WKG between the two groups were 0.32, 0.12, 0.07, ?0.06, 0.20 and 0.51, respectively. No statistical differences were observed between the two groups, except for the change in WKG.

Conclusions: Implants can be placed in infected extraction sockets after thorough socket debridement. For aesthetics, WKG should be considered when performing immediate implant placement in infected sites.     

Immediate Nonfunctional Loading of NobelPerfect Implants in the Anterior Dental Arch in Private Practice – 5‐Year Data

Background: The concept of scalloped implants to maintain the natural contour of the alveolar ridge has been a source of controversy for many years. Purpose: This study examined the long‐term clinical performance of the scalloped NobelPerfect implant in a one‐stage procedure (immediate loading in the esthetic zone). Materials and Methods: In 20 patients, immediate prosthetic restorations were placed on 31 NobelPerfect implants in a private practice and followed for up to 78 months. Twenty‐one implants were placed immediately after extraction, seven implants were placed after osseous consolidation of the extraction sockets, and three implants were placed secondary to extended alveolar ridge augmentation procedures. All implants were provisionalized on the day of implant placement and adjusted to clear all contacts in centric occlusion and during eccentric movements. Outcome variables were success rates, marginal bone levels, and pink esthetic score (PES) assessed per implant. Results: One implant failed after 1.4 months. Five patients with six implants in total were scored in the 5‐year follow‐up as dropouts. Mean follow‐up period of remaining 24 implants was 65 months (range, 55–78 months). Cumulative success rates according to the criteria specified by Smith and Zarb were 96.8%. Marginal bone levels averaged 1.1 mm above the first thread. Mean PES ratings were 10.5 (range, 3–13). Conclusions: Survival rates, marginal bone levels, and esthetic results suggest proof of principle for the preservation of the interproximal bony lamella with a scalloped implant design in long‐term data.     

Evaluation of a Variable‐Thread Tapered Implant in Extraction Sites With Immediate Temporization: A 3‐Year Multicenter Clinical Study

Background: The purpose of this clinical study is to evaluate the radiographic bone remodeling, survival rate, and soft tissue health surrounding a variable‐thread tapered implant immediately placed in extraction sites. Methods: Sixty implants were placed in 55 patients at six centers according to a predetermined protocol. All implants were placed in extraction sockets and were subjected to immediate temporization and function. Definitive prostheses (58 single crowns and one two‐unit fixed bridge) were placed within the first year. Clinical and radiographic examinations were performed at implant placement and after 3, 6, 12, 24, and 36 months. Measurements of implant stability, papilla index, plaque, peri‐implant mucosa, and marginal bone levels were recorded at each visit. Results: Thirty‐five implants were evaluated at both implant insertion and 3‐year follow‐up. Bone levels were observed at 6 months after surgery and yearly intervals thereafter and remained stable throughout the study. There was a slight decrease in mean bone level from ?0.68 mm at implant insertion to ?0.93 mm at the 6‐month recall and then an increase of bone to ?0.53 mm from the reference point at the 2‐year follow‐up (an average increase of 0.15 mm from implant insertion). Bone levels remained steady between the 2‐year recall and the 3‐year recall. Papilla scores increased significantly (P <0.001; Wilcoxon signed‐rank test) from insertion to the 3‐year follow‐up, with most of the increase occurring during the first year. Patient assessments of function, esthetics, feel of implant, speech, and self‐esteem also showed significant improvement over the course of the study. Conclusions: The results, over 36 months, indicate that the variable‐thread tapered implant can be used safely and effectively under demanding conditions as an immediate postextraction tooth replacement. Bone remodeling remained stable with a slight increase, and patients expressed high levels of satisfaction with the restorative results over the course of the study.