1,721,401 research outputs found
Topographic Assessment of Calcified Material After Sinus Floor Augmentation
No full textPurpose: This study aimed to topographically examine the healing of mineralized human bone allograft in sinus augmentation. Materials and Methods: Thirty-two patients with crestal bone height <= 2 mm who required sinus augmentation were recruited for the study. A mixture of 80/20 cortical/cancellous mineralized human bone allografts were used to augment the sinus floor using a crestal window approach. A bone core biopsy specimen was taken at the time of implant placement, 6 months after surgery. Microradiographs of methacrylate-embedded sections were split into five longitudinal sectors (crestal to sinusal) to topographically assess the bone, graft, and fibrous tissue amount. Results: All implants were osseointegrated 3 months later without any adverse effects. The polynomial (degree 2) of results (all with great correlation coefficient, P < .01) gave rise to a polynomial curve of graft percentage with a maximum at sector 4 (presinusal), a bone percentage with a minimum between sectors 3 and 4, and a fibrous tissue percentage with a maximum between sectors 3 and 4. Conclusion: Based upon topographic analysis, mineralized human bone allograft is capable of achieving adequate vertical bone height for implant placement. The need for a topographic analysis to assess the outcomes of sinus augmentation is emphasized. Int J Oral Maxillofac Implants 2021;36:1219-1223. doi: 10.11607/jomi.756
Complications and treatment errors in periodontal and implant therapy
No full textThe assortment of periodontal and implant-related treatments has been continuously improved over the last 50 years. Once the decision-making process has been established and the treatment procedure applied, the partial or complete resolution of the problem (eg, periodontal probing depth reduction, clinical attachment level gain, gingival recession reduction, dental hypersensitivity decrease) and a diagnosis change with no or minimal occurrence of adverse events (ie, complications, harms, technical errors, or adverse/side effects) can be expected. The clear identification of the potential types of adverse effects, complications, or even errors is important for contemporary decision-making processes, as they may be related to different local, systemic, and technical aspects. This chapter focused on four core components: (a) providing periodontal definitions for errors, complications, harms, and side effects; (b) defining the types of risk and the clinical impact of adverse effects, errors, and complications in periodontal and peri-implant therapies; (c) evaluating the influence of accidental errors versus the lack of a proper treatment planning; and (d) reporting on the importance of establishing the “net benefit ratio” between the clinical improvements promoted by the therapy and the occurrence of potential adverse events.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/177641/1/prd12442.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/177641/2/prd12442_am.pd
New Biomaterials and Regenerative Medicine Strategies in Periodontology, Oral Surgery, Esthetic and Implant Dentistry 2016
Full text linkComparison of immediate versus delayed implant placement in a failed implant site: A retrospective analysis of early implant survival
No full textPurpose: To compare immediate and delayed implant replacement at failed implant sites to evaluate the factors associated with early failure of second implants after replacement. Materials and methods: Data regarding early implant failure followed by replacement with another fixture in a private practice setting between 2003 and 2019 were analysed retrospectively. Early failure was defined as loss of the dental implant within 6 months of placement. The impact of patient-level (age, sex, diabetes, smoking history) and implant-level (timing of implant replacement, timing of prosthetic loading, bone grafting) variables on the early failure rate of second implants after replacement was evaluated. Due to the hierarchical structure of the data, a multivariate multilevel mixed-effects Poisson regression analysis was performed. Results: A total of 109 patients (63 men and 46 women) diagnosed with early implant failure at 124 implant sites were included in the present study. Fifty-eight implants were immediately replaced at the time of removal of the failed implant (test group), whereas 66 were replaced after a healing period of 2 to 4 months (delayed approach; control group). A total of 15 implants failed after replacement in 11 patients during the first 6 months of follow-up. Of these, nine failures (15.25%) occurred in seven patients (13.21%) after immediate replacement, and six (9.09%) occurred in four patients (7.02%) who underwent delayed replacement. No statistically significant differences were detected between the two groups (P = 0.431). Conclusions: No significant differences in implant survival at sites of previous failure were found according to the timing of implant replacement
Influence of Platform-Switched, Laser-Microtextured Implant on Marginal Bone Level: A 24-Month Case Series Study
No full textThe aim of this case series study was to evaluate clinical and radiographic changes of soft and hard tissues around tapered, platform-switched, laser-microtextured implants 24 months after crown placement
Preliminary outcome in consecutively treated case series with trabecular metal implants
No full textObjective: The aim of this study was to illustrate the successful use of trabecular metal (TM) implants placed in posterior maxilla following maxillary sinus augmentation. Methods and Materials: Twelve TM implants were placed after maxillary sinus augmentation using mineralized human bone allograft (MHBA) in 6 patients. At second stage procedure, 3 months after TM implants installation, the outcome measures evaluated were implant success and removal torque test. Result: At second stage procedure, the implant
success rate was 100%. No evidence of peri-implant marginal bone loss was noted clinically and all implants successfully tolerated a 25 Ncm torque test. Conclusions: The favorable outcome of the treatment described suggests that the rehabilitation of atrophic posterior maxillary region can be achieved by the placement of TM implants in sites augmented with MHBA
Influence of tooth location on coronally advanced flap procedures for root coverage
Full text linkBACKGROUND: The efficacy of Coronally Advance Flap (CAF) has been extensively evaluated and several parameters influencing the results, such as interproximal attachment loss, recession defect size, papilla dimension, flap thickness, have also been identified. However, the influence of tooth location has not been systematically investigated yet. Therefore, the aim of this systematic review was to evaluate the influence of tooth location on the outcomes of CAF. METHODS: A literature search on PubMed, EMBASE, Cochrane libraries and hand-searched journal until September 2017 was performed to identify clinical studies reporting the outcome of CAF for localized gingival recessions (GRs) for each single tooth. RESULTS: Eighteen articles reporting 399 localized GRs treated with CAF were included in the present systematic review. Canines and incisors were related to a higher mRC and CRC than premolars and molars (odds ratio 1.63) (p 0.05). The addition of a graft such as Connective Tissue Graft (CTG) with or without Enamel Matrix Derivative (EMD) was shown to enhance the outcomes compared to CAF alone (p 0.05). CONCLUSIONS: Tooth location plays an important role on mRC and CRC following CAF. The addition of CTG or substitutes, especially with biological agents (EMD), enhance the clinical outcomes compared to CAF alone
Implant placement in the esthetic area: criteria for positioning single and multiple implants
No full textPatient expectations from implant treatment have changed over the years and esthetics plays an important role in defining what is now called success of rehabilitation. Of the many factors that influence the outcome of the rehabilitation, the two main ones are the bone and soft-tissue deficiencies at the intended implant site. Many surgical approaches are described in terms of timing of implant placement and management of regenerative procedures. The aim of this article is to discuss the different implant placement alternatives in the esthetic area, in particular: (i) the timing of implant placement/regenerative procedures/skeletal growth/altered passive eruption; (ii) the correct three-dimensional position of the fixture between the cuspids and in the premolar area; (iii) multiple missing teeth in the esthetic area with single tooth/pontic or cantilevered options/prosthetic compensation; (iv) placement of implants into infected sites; and (v) the influence of abutment and crown morphology on implant position. Combining our long-standing clinical experience and the pertinent literature, the following conclusions can be drawn: Immediate implant placement can be a successful procedure in terms of esthetics but it is technique sensitive and requires an experienced team. Immediate placement is less traumatic to the patient as fewer surgical procedures are involved and patients tend to prefer this clinical approach with regards to quality of life. The diagnostic phase is of utmost importance, with not only bone and soft tissue deficiencies being addressed but also: skeletal growth, dental/implant soft tissue parameters such as altered passive eruption and the morphology of the roots adjacent to the edentulous area. Post-extraction immediate loading is feasible in infected sites. The correct position of the fixture should follow widely accepted guidelines but the abutment morphologies play a role in the vestibular/palatal position of the implant. The long axis of the implant, aiming at the incisal edge of the future restorations, is the most appropriate implant position when a shoulder-less abutment is used and allows a restorative crown morphology with a cervical contour resembling a natural tooth. The use of a shoulder-less abutment gives more space for the tissue to grow compared with the traditional abutment with shoulder finish line
Attendibilità della tomografia computerizzata a fascio conico nella valutazione del tessuto mineralizzato nei rialzi di seno
No full textScopo: l’obiettivo dello studio era l’analisi delle densitometrie della tomografia computerizzata a fascio conico (CBCT) di rialzi di seno mascellari utilizzando osso omologo, utilizzando anche campioni microradiografici ottenuti precedentemente per verificare il potenziale diagnostico della CBCT. Materiali e metodi: è stato utilizzato un protocollo a due fasi in 21 pazienti consecutivi, tutti con un’altezza di osso crestale < 2 mm. Il rialzo di seno è stato effettuato con granuli di osso omologo mineralizzato con accesso laterale. È stata eseguita una serie di scansioni CBCT della mascella prima delle chirurgia, immediatamente dopo il rialzo del seno mascellare e dopo 6, 10 e 18 mesi dal posizionamento implantare. Mediante sonde virtuali, le immagini CBCT acquisite a 6, 8 e 10 mm dalla superficie crestale sono state processate con un software di imaging medicale ed espresse come livelli di grigio
(LG). Risultati: in totale, sono state eseguite 24 procedure di incremento di seno in 21 pazienti. I valori medi di CBCT-LG variavano da 571 a 654, presentando il valore massimo a 8 mm immediatamente dopo il posizionamento implantare e il valore minimo a 6 mm dopo 10 mesi. Inoltre, è stato rilevato che il contenuto minerale dell’innesto diminuiva nel tempo, scomparendo completamente tra 10 e 11 mesi. Conclusione: La CBCT e il software di imaging medicale utilizzati per la visualizzazione e l’analisi delle immagini sono strumenti affidabili per studiare il comportamento dei biomateriali dopo le procedure di rialzo di seno. Inoltre, i risultati di questo studio dimostrano che è possibile un completo riassorbimento dell’alloinnesto di osso umano. A causa della dimensione limitata del campione, sono ecessari ulteriori studi morfometrici e clinici
The Relevance of the Use of Radiographic Planning in Order to Avoid Complications in Mandibular Implantology: A Retrospective Study
Full text linkThe aim of this retrospective radiological study was to evaluate the variability of the mandibular anatomy in the presence and absence of teeth and to consider how it could influence implant planning. 187 mandibular CT DentaScans were selected from our department archive according to the inclusion criteria. The axial height, vertical height, angulation of the bone crest, and the bone available for ideal implant placement were measured. The analysis of the data shows that the mandible contour presents a constant degree of angulation. The variation of angulation in the absence of teeth was statistically significant only in the region between the canine and the first premolar and in that between the second premolar and the first molar. The difference between the crest height and the available distance to place the implant was greater in the region of the second molar while in the other regions the implant planning was made complex by postextraction resorption. Alveolar bone resorption after tooth loss can be considered as a risk factor for lingual cortical perforation during the insertion of an implant. To avoid potential intra/postoperative complications, 3D radiographic examination is recommended in order to study the mandibular anatomy and identify the risk areas
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