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Background: Immediate implant placement (IIP) has shown predictable outcomes when specific requirements are met. The aim of the present study was to radiographically evaluate the dimensions of mandibular incisors and the alveolar bone to further determine the feasibility of IIP in this area., Materials and Methods: A total of 404 intact mandibular incisor CBCT images from 101 patients (42 males, 59 females; mean age 49 ± 16.84 years) were analyzed. The mesiodistal tooth width and the distance between the incisal edge (IE), cementoenamel junction (CEJ), facial bone crest (BC), root apex (RA), and fenestration point (F) were registered, together with the alveolar bone width at 1 and 3 mm below BC. Finally, the angular discrepancy between the dental and the alveolar bone long axis (BLA) was recorded as the tooth torque (TT)., Results: The CEJ to BC distance was 3.23 ± 1.67 mm. The RA to F mean distance was 15.02 ± 3.97 mm. The mean alveolar bone buccolingual widths at 1 and 3 mm below the facial BC were 7.12 ± 0.82 and 6.32 ± 0.71 mm in the lateral and central incisors, respectively (P 0.001). The buccolingual width was less than 6 mm in more than 33% of the central incisors, but only in 3% of the lateral incisors, displaying increased alveolar width. The average was 165.66 ± 7.47 degrees., Conclusions: The results presented in this study point toward the need for careful consideration of the requirements for anterior mandibular IIP for success and predictability purposes.

In oral implantology, surgeons often confront the need to improve alveolar bone quality and volume before implantation in patients with bone defects. Whereas guided bone regeneration with titanium meshes is a clinical gold standard for bone augmentation, mesh removal pre-implantation presents a drawback. This study explores biodegradable scaffolds as an alternative. The research investigates the impact of various compositions of customized bone-grafting scaffolds on proliferation and osteogenic differentiation processes in vitro. Plates (10 × 10 × 0.5 mm) were fabricated from polylactide (PLA), PLA with 15% hydroxyapatite nanoparticles (PLA/HA), and polylactide with glycolic acid copolymers (PLGA 60:40 and 85:15). Gingival fibroblasts assessed the influence of experimental samples on proliferation and osteogenic differentiation in a low-glucose medium. Osteogenic differentiation was induced, and alizarin red staining measured extracellular matrix calcification via spectrophotometry. Active proliferation of gingival fibroblasts occurred along scaffold edges during cultivation. Although cells proliferated with experimental samples, rates were lower than control cells. PLA/HA showed higher alizarin red staining intensity, indicating enhanced matrix calcification. Experimental samples (PLA, PLA/HA, PLGA 85:15, PLGA 60:40) supported cell proliferation at lower rates than control. PLA/HA demonstrated increased matrix calcification. Biodegradable membranes were nontoxic, suggesting potential for bone augmentation.

Introduction: Regeneration of the missing papilla adjacent to single implants in the esthetic zone has always been challenging, despite advances in vertical hard and soft tissue regeneration. Orthodontic tooth extrusion has been shown to effectively gain alveolar bone and gingival tissue. This retrospective study evaluated the effectiveness of orthodontic tooth extrusion on regenerating missing papilla between existing maxillary anterior single implant and its adjacent tooth., Methods: Patients who underwent orthodontic tooth extrusion to regenerate missing papilla adjacent to a single implant in the esthetic zone were included in this study. The gingival phenotype, orthodontic extrusion movement, proximal bone level, dento-implant papilla level, facial gingival level, mucogingival junction level, and keratinized tissue width, of the extruded tooth were recorded at pre-orthodontic extrusion (T 0 ), post-orthodontic extrusion and retention (T 1 ), and latest follow-up (T 2 )., Results: A total of 17 maxillary single tooth had orthodontic tooth extrusion to regenerate missing papilla adjacent to 14 maxillary anterior single implants in 14 patients. After a mean follow-up time of 48.4 months, implant success rate was 100% (14/14), with none of the orthodontically extruded teeth being extracted. After a mean extrusion and retention period of 14.3 months, a mean orthodontic extrusion movement of 4.62 ± 0.78 mm was noted with a mean proximal bone level gain of 3.54 ± 0.61 mm (77.0% efficacy), dento-implant papilla level gain of 3.98 ± 0.81 mm (86.8% efficacy), and facial gingival tissue gain of 4.27 mm ± 0.55 mm (93.4% efficacy). A mean keratinized tissue width gain of 4.17 ± 0.49 mm with minimal mean mucogingival junction level change of 0.10 ± 0.30 mm were observed. The efficacy of orthodontic eruption movement on dento-implant papilla gain was less in the thin (80.5%) phenotype group when compared with that in the thick (91.5%) phenotype group., Conclusions: Within the confines of this study, orthodontic extrusion is an effective, noninvasive method in regenerating mid-term stable proximal bone and papilla adjacent to maxillary anterior single implants., Clinical Significance: This retrospective study presents a mid-term result on orthodontic extrusion as a mean to regenerate dento-implant papilla defect. The extended retention period following orthodontic extrusion showed stable and efficacious proximal bone and papilla gain., (© 2023 The Authors. Journal of Esthetic and Restorative Dentistry published by Wiley Periodicals LLC.)

Objective: The purpose of this cone beam computed tomography (CBCT) study was to determine the frequency percentage of screw-retained crown using angulated screw channel (ASC) abutment for single immediate implant placement and provisionalization (IIPP) in the esthetic zone., Methods: The CBCT images of 200 patients without disease and without metal restorations in maxillary anterior teeth were evaluated. The mid-sagittal-sectional CBCT images of maxillary anterior teeth (#6-#11) were created in an implant planning software, screen-captured, and transferred to a presentation program. Template of tapered implants with diameter of 3.5 mm (for central and lateral incisors) and 4.3 mm (for central incisors and canines) and lengths of 13, 15, and 18 mm were applied to the sagittal images to identify the IIPP cases. To qualify for IIPP, the implant must engage >35% bone with at least 1 mm of surrounding bone and no perforations. The IIPP cases were further divided into straight screw channel (IIPPSSC) abutment or 25-degree angulated screw channel abutment (IIPPASC), based upon its restorability. The frequency percentages of possible IIPP, IIPPSSC, and IIPPASC were reported and compared among all maxillary anterior teeth., Results: A total of 1200 maxillary anterior teeth sagittal images from 200 patients (88 male and 112 female) with a mean age of 51.3 years (range 20-83 years) were evaluated in this study. The overall frequency percentages of IIPP, IIPPSSC, and IIPPASC possibility were 84% (74%-92%), 14% (10%-24%), and 75% (66%-87%), respectively., Conclusion: Within the limitations of this CBCT study, 90% of single IIPP in the esthetic zone can be restored with screw-retained crown when utilizing ASC. In addition, the possibility of using a screw-retained restoration following IIPP increases about five times with ASC abutment compared to the SSC abutment., (© 2023 The Authors. Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.)

An intact extraction socket has been considered a prerequisite for an immediate implant placement and provisionalization (IIPP) procedure. Recent studies, however, have shown successful outcomes when IIPP was performed in sockets with a facial bone wall defect. This retrospective study evaluated the facial implant mucosal stability following IIPP in extraction sockets with a facial bone wall defect in the esthetic zone. The study included 16 cases in 16 patients who received maxillary anterior single IIPP with contour bone graft (C-BG) and contour connective tissue graft (C-CTG) in compromised extraction sockets (V- or U-shaped defect). After a mean follow-up of 6 years, the implant success rate was 100% (16/16). Minimal and non-statistically significant changes were noted in the facial implant mucosal and marginal bone level. Statistically significant changes were observed in facial implant mucosal thickness gain (2.5 mm [1.8 mm to 3.5 mm]) and midfacial bone sounding reduction (6 mm). Within the confines of this study, IIPP with simultaneous C-BG and C-CTG in fresh extraction sockets exhibiting a V- or U-shaped facial bone wall defect can lead to long-term successful outcomes in terms of mucosal stability, contour bone gain, and marginal bone level stability.

Purpose: To compare prevalence and type of complications associated with metal resin fixed complete dentures based on implant distribution., Materials and Methods: This retrospective study included data collected for a period of 12 years for patients treated with maxillary and mandibular implant-supported fixed complete dentures at Loma Linda University School of Dentistry. In total, 223 patient's charts were reviewed which included 100 maxillary and 123 mandibular fixed complete dentures. Implant distribution and prevalence of complications associated with each implant-supported fixed complete denture were documented. Tooth delamination, the most common complication associated with fixed complete dentures, was compared between 2 implant distribution groups in each arch. Covariates including age, sex, opposing arch, cantilever occluding units, and number of implants were evaluated to determine their association with tooth delamination. Data and hypotheses were statistically analyzed using descriptive statistics along with logistic regression model. All tests of hypotheses were considered statistically significant at an alpha level of 0.05., Results: In the maxillary arch, some effect of the prevalence of tooth delamination was seen for the group that had implants placed posterior to canine eminence but it was not statistically significant. Denture tooth delamination had the highest prevalence among complications irrespective of implant distribution. Significant denture tooth delamination was seen for patients with opposing fixed complete dentures in comparison to patients with removable opposing arch prostheses., Conclusions: Implant distribution is not a significant factor related to metal resin fixed complete dentures. Opposing fixed complete dentures have a significantly higher association with denture tooth delamination., (© 2022 The Authors. Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.)