Management of interproximal soft tissue with a resin-bonded prosthesis after immediate implant placement: a clinical report

This report describes immediate implant placement after the extraction of a vertically fractured tooth. During the healing phase, a resin-bonded prosthesis was inserted as a provisional restoration. After the creation of the optimal emergence profile and papillae with the provisional restoration, the definitive metal ceramic crown was fabricated.     

Single-tooth replacement by immediate implant and connective tissue graft: a 1-9-year clinical evaluation

OBJECTIVES: The aim of the present study was to evaluate the long-lasting efficacy of a combined surgical protocol, using immediate implant and subepithelial connective tissue graft for single-tooth replacement. The advantages of this single-center, longitudinal, randomized, blind examiner research were the following: preservation of both keratinized mucosa amount and bone tissue, optimal peri-implant marginal sealing, satisfactory aesthetic results, reduction in treatment time. MATERIALS AND METHODS: In the time period from 1990 to 1998, 116 patients were consecutively admitted for treatment with a total of 116 solid screw ITI-implants supporting single crowns. Ninety-six patients underwent the proposed combined treatment (test group), while 20 received only single immediate implants (control group). The observation time extended from 1 up to 9 years. RESULTS: The 9-year cumulative survival rate was 100% for both test and control groups. Comparative statistical analysis of soft and hard tissue peri-implant parameters demonstrated better results in the test group than in the control during every single 3-year analysis and especially in the last observation interval. The test group also showed very good results in terms of aesthetic parameters, which estimated the keratinized mucosa width, the alignment of crown emergence profile and the patient's satisfaction. CONCLUSION: Single-tooth replacement by immediate solid screw ITI implants in association with connective tissue autograft was demonstrated to be a predictable procedure. Moreover, this treatment can be considered as a sure system to reach an excellent functional and harmonious aesthetic restoration.     

Pocket elimination surgery with simultaneous connective tissue graft. A case report with 3-year follow-up

BACKGROUND, AIMS: The purpose of the present case report was to present 2 ways of treating recession in a periodontal patient combined with regular pocket elimination surgery. The techniques used enabled the operator to reduce the number of surgical sessions and clinically evaluate the 3-year coverage of gingival recessions using a subpedicle connective tissue graft. METHODS: Surgery consisted of pocket elimination procedures to treat adult periodontitis as a way to harvest connective tissue to be placed in the areas of recession. The grafted tissue was covered by the primary flap or left uncovered in a pouch, according to 2 different techniques described in the literature. RESULTS: In this case, we observed that, with this approach, we were successful in reducing the number of surgical session as well as achieving objective and subjective goals of therapy in treated areas.     

Use of HTR synthetic bone as an augmentation material in conjunction with immediate implant placement: a case report

Immediate placement of dental implants (DI) in fresh extraction sockets is associated with remaining voids around the DI and often a partial dehiscence or thin facial alveolar plate. Bioplant HTR synthetic bone (HTR) was used as a ridge preservation/augmentation material in conjunction with this method of DI placement. A 61-year-old white woman requiring extraction of tooth 12 opted for immediate DI placement. HTR was used to fill the remaining socket void and enhance the facial ridge width, and primary closure was attempted with sutures. DI uncovering was performed at about 6 months. Measurements were taken to the nearest 0.5 mm of the internal socket width and total site width at DI placement and uncovering. The internal socket width was essentially maintained (6.8 vs 6.6 mm), and the total ridge width showed a change from 8.7 to 9.1 mm. The results of this case suggest that HTR is a useful adjunct in the placement of immediate DIs for the preservation of ridge width.     

External root resorption following partial-thickness connective tissue graft placement: a case report

We report an unusual case of external root resorption (ERR) that developed in a 37-year-old black male approximately 1 year following routine partial thickness connective tissue graft surgery. The lesion was accessed via flap surgery, thoroughly root planed, and the mucoperiosteal flap replaced. The site healed uneventfully and the patient has been closely observed for over 1 year without symptoms or recurrence of the resorptive lesion and the affected tooth remained vital. Clinicians performing partial-thickness connective tissue grafts should be alert to the possible occurrence of root resorption over extended periods of time. The authors speculate that retention of the donor periosteum with placement on the recipient dentin and root biomodification may limit the resorptive response following connective tissue graft procedures to treat tooth root recession.     

Computer-guided implant placement with immediate provisionalization: a case report.

Placement of dental implants in the esthetic zone is challenging for clinicians because of patients exacting esthetic demands and preexisting anatomy. This article presents an option for highly demanding surgical cases with the use of computer-guided implant placement and immediate provisionalization. This technique optimizes implant placement and soft tissue esthetics while providing the patient with an immediate fixed restoration.     

Bioabsorbable materials for guided bone regeneration prior to implant placement and 7-year follow-up: report of 14 cases

BACKGROUND: The purpose of the present study was to evaluate the efficacy of a guided bone regeneration (GBR) procedure prior to implant placement and the long-term outcome of the inserted implants. METHODS: Prior to dental implant placement, GBR procedure was performed on 14 patients (mean age 48 years) using a synthetic hydroxyapatite (HA) spacer under a collagen membrane. After a mean healing period of 8 months, bone biopsies were obtained during the placement of 14 implants. The specimens were processed for histology without demineralization in order to assess bone quality and quantity of the regenerated bone. RESULTS: Both the bone density and the resorption degree of HA particles were relatively varied between samples. The different phenotypes of osteoclasts and multinucleated giant cells and the individual host response could partially explain the unpredictable results in terms of bone remodeling and biomaterial resorption. However, the presence of HA particles in the regenerated bone had no influence on the osseointegration of implants presenting a success rate of 86% after a 7-year observation period. CONCLUSIONS: These results confirm the possibility of regenerating bone by means of bioabsorbable materials, assuring at the same time the long-term success for implants inserted in regenerated sites.     

Immediate transmucosal implant placement: a report of 2 cases

Immediate placement of implants into fresh extraction sockets has the advantages of decreasing the recommended period of healing, reducing the resorption of the alveolar bone, and achieving optimal esthetic results. A high rate of success with immediately placed implants has been reported in the literature. Conventional intervention involves 2 or 3 surgical visits, and this may not be accepted by the patient or may be of some inconvenience. The technique described involves only one surgical visit at which a transmucosal endosseous root-form implant is inserted, followed by application of a resorbable membrane.     

Particulate inlay nasal graft with immediate dental implant placement in a patient with repaired alveolar cleft: case report

Primary bone grafts in congenital cleft alveolus do not always provide sufficient bulk or height of bone for ideal placement of endosseous implants. Thus, maxillary sinus or nasal floor elevation and inlay bone grafts in previously grafted areas are not exceptions in the daily routine. This case report stresses the need of a detailed treatment plan and careful surgical management of nasal floor elevation with particulate autogenous bone graft to successfully provide the patient with osseointegrated prostheses.     

单个种植体即刻种植即刻负重骨结合情况的动物实验研究

目的本实验设计了单个种植体即刻种植即刻负重的动物模型,目的在于研究种植体周围硬组织的变化.方法选取8只成年狗,体重10～15 kg.分别拔除每只狗的双侧下颌第二前磨牙;同时,各植入一枚ITI种植体,分别以20Ncm及30Ncm的扭矩旋入.实验侧即刻以树脂冠行上部结构修复,对照侧无负荷.每只狗在植入种植体后和处死后拍X线片,观察其影像学的改变.动物分别于1个月和3个月处死后取标本,观察其组织学的改变.结果16枚种植体中14枚种植体获得良好的骨结合,种植体周围包绕着致密的骨组织,未观察到任何间隙和结缔组织长入.实验侧1枚种植体脱落,对照侧1枚种植体松动.结论单个种植体的即刻种植即刻负重是一个可行的选择.     

Gingival/soft tissue abscess following subepithelial connective tissue graft for root coverage: report of three cases

BACKGROUND: The subepithelial connective tissue graft (SCTG) is a predictable technique for root coverage. The small number of potential postoperative problems make SCTG the current treatment of choice for reversing gingival recession. METHODS: The purpose of this article is to report three cases of complications after the use of an SCTG where an abscess occurred following the initial healing phase. The surgical technique that was used and the treatment that was provided for the abscesses are reported, and the possible causes of these complications are discussed. RESULTS: The abscesses were treated conservatively, and no recurrence has been observed after treatment. CONCLUSIONS: Possible causes of the abscesses include "stitch abscess" or reaction to the suture material used for the submerged sutures, or a possible role of epithelium implanted during the procedure. The clinical outcome of the root coverage procedure was not affected.     

Peri-implant mucosal level in patients treated with implant-supported fixed prostheses: a 1-year follow-up study

PURPOSE: The purpose of this follow-up study was to quantify the change in the peri-implant mucosal level after treatment of edentulous patients with fixed prostheses on osseointegrated endosseous implants. MATERIALS AND METHODS: Twenty patients were included in the study: 10 were treated in the maxilla, and 10 were treated in the mandible. Both groups had fixed prostheses on osseointegrated Br?nemark implants. Peri-implant mucosal level was measured with a calibrated probe after removal of the prostheses at the 1-year follow-up. These measurements were compared to those made on the original master casts. RESULTS: A larger mean retraction (-) was observed in the mandible (-1.6 mm) compared to the maxilla (-0.8 mm), but there was great variation. The individual values varied from -4.5 to +1.0 mm in the mandible and from -6.0 to +6.0 mm in the maxilla. CONCLUSION: Peri-implant soft tissue recession occurs during the first year in edentulous jaws after treatment with implant-supported fixed prostheses and more so in the maxilla than the mandible.     

The use of a connective tissue graft for closure over an immediate implant covered with an occlusive membrane

Complete wound closure over an immediate implant is considered to be a desirable goal. This case report describes for the first time the use of a connective tissue autograft placed under the existing flap margins of an extraction socket to successfully achieve closure over an immediate implant covered with an occlusive membrane. The rationale of the method is described. Healing was uneventful and epithelization of the graft surface from surrounding tissues was achieved. This technique created an increased width of keratinized tissue and avoided the need to disrupt the normal anatomical relationships of the surrounding buccal tissues, in contrast to current techniques. The advantages of the technique, together with factors that may influence healing and predictability, are discussed.     

Mandibular connective tissue pedicle flaps in implant dentistry: report of three cases

An increase in soft tissues and alveolar bone in the anterior mandibular area between the canines is necessary to achieve a good esthetic result. The present article describes a technique for gaining bone volume and soft tissue to cover bone defects that would otherwise compromise the final result of prosthetic implant restoration in the anterior mandible. Three patients with anterior mandibular atrophy caused by loss of the mandibular incisors are presented. Particulate autologous bone grafting, the raising of a pediculate connective tissue flap to increase soft tissue, and implant placement were carried out simultaneously. After 2 years of follow-up, the implants were in good clinical and radiologic condition. The problem of atrophy and the lack of soft tissue were thus solved, and an acceptable esthetic outcome was achieved in a single surgical intervention.     

Achieving immediate function with provisional prostheses after implant placement: a clinical report

When using a conventional implant treatment protocol in edentulous patients, reduced function and comfort for up to 6 months after implant surgery is inevitable until bone healing is complete and a prosthesis is securely attached to the implants. The following report highlights 2 treatment modalities that enable immediate function by inserting provisional prostheses immediately after implant placement.