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Dental implants are commonly used to replace missing single teeth. However, esthetic rehabilitation of an adjacent tooth may also be required due to diastemas, crowding, or existing large direct restorations to improve the final esthetic outcome. With the advancements in ceramics and bonding techniques, minimally invasive esthetic approaches have become viable for compromised spacing issues. This case report describes a dental technique for the esthetic rehabilitation of compromised anterior spacing with a customized zirconia implant abutment at a maxillary central incisor site and a partial ceramic veneer bonded to the adjacent central incisor. [ABSTRACT FROM AUTHOR]

This case report describes a novel approach combining orthodontic and implant digital treatment planning workflows to enable prosthetically driven implant placement before orthodontic treatment is performed or completed. The computer-assisted implant placement is performed using a static surgical guide based on the future positions of the teeth after completion of orthodontic treatment. This innovative approach allows for select partially edentulous patients to undergo fixed prosthetic rehabilitation before orthodontic treatment is completed. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the effect of implant placement and loading protocols (protocol types) on the survival of single implant tooth replacements in different locations. Materials and Methods: An electronic search was conducted to identify clinical trials regarding outcomes of single implants subjected to different treatment protocols. A weighted mean survival rate for each protocol type in the anterior maxilla, anterior mandible, posterior maxilla, and posterior mandible was calculated. Study design, sample size, and outcome homogeneity were used to evaluate the validation of each protocol type in different locations. Results: A total of 45 publications (13 RCTs, 21 prospective studies, and 11 retrospective studies) were included. The anterior maxilla was the most reported site (35 studies, 1,391 implants, weighted survival rate: 97.5% to 99.6%). Immediate placement + conventional loading (Type 1C) and late placement + immediate restoration/loading (Type 4A) were scientifically and clinically validated (SCV). For the posterior maxilla (19 studies, 567 implants, weighted survival rate: 85.7% to 100%), Type 1C was SCV. The anterior mandible was the least-reported site (three studies, 42 implants, weighted survival rate: 98.5% to 100%). For the posterior mandible (13 studies, 447 implants, weighted survival rate: 95.0% to 100%), late placement + conventional loading (Type 4C) was SCV. It was not possible to perform a metaanalysis due to the limited number of controlled studies that had the same comparison and considerable heterogeneity in study design. Conclusion: Differences were found in the level of scientific evidence between the anterior and posterior and the maxilla and mandible, indicating that location is a consideration when selecting treatment protocol for a single implant. [ABSTRACT FROM AUTHOR]

Bone augmentation procedures are frequent today in implant patients, since an implant should be circumferentially anchored in bone at completion of bone healing to have a good long‐term stability. The best documented surgical technique to achieve this goal is guided bone regeneration (GBR) utilizing barrier membranes in combination with bone fillers. This clinical review paper reflects 35 years of development and progress with GBR. In the 1990s, GBR was developed by defining the indications for GBR, examining various barrier membranes, bone grafts, and bone substitutes. Complications were identified and reduced by modifications of the surgical technique. Today, the selection criteria for various surgical approaches are much better understood, in particular, in post‐extraction implant placement. In the majority of patients, biodegradable collagen membranes are used, mainly for horizontal bone augmentation, whereas bioinert PTFE membranes are preferred for vertical ridge augmentation. The leading surgeons are using a composite graft with autogenous bone chips to accelerate bone formation, in combination with a low‐substitution bone filer to better maintain the augmented bone volume over time. In addition, major efforts have been made since the millenium change to reduce surgical trauma and patient morbidity as much as possible. At the end, some open questions related to GBR are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The hydrophilic implant surface (INICELL) is a chemical alteration of a sandblasted and thermally acid-etched surface that should lead to long-term osseointegration. This study investigated 3-year results after early loading of implants with a hydrophilic, moderately rough surface in occlusal contact. Materials and Methods: This prospective case series study was conducted in subjects with partially edentulous mandibles. Implants were placed on day 21 and loaded with a provisional reconstruction after at least 21 days of healing (baseline, day 0) if their implant stability quotient (ISQ) was ≥ 70 (mean of three measurements) and were replaced by definitive porcelain-fused-to-metal prostheses at the 6-month follow-up visit. Follow-up examinations were planned 1, 3, 6, 12, and 36 months after baseline. Results: A total of 20 implants were placed in 15 patients (mean age: 51 years, range: 32 to 67 years). After 36 months, all implants were osseointegrated, and no suppuration was recorded. Small changes of bone level were observed between 3 months and 36 months. At 36 months, the median values of the 20 implants were 0.25 (range: 0 to 0.5, SD: 0.17), 0.25 (range: 0 to 1, SD: 0.27), and 4 (range: 2 to 7.25, SD: 1.17) for the mean modified Plaque Index (mPI), mean modified Sulcus Bleeding Index (mSBI), and mean probing pocket depth, respectively. The pairwise analysis between 3 and 36 months showed an improvement in the mean mPI (P = .0126) and mean mSBI (P = .0059). After 36 months, all patients (n = 15) were fully satisfied with a mean of 9.43 (range: 8 to 10, SD: 0.678) at the visual analog scale. Conclusion: Early functional loading of implants with a hydrophilic, moderately rough outer surface in occlusal contact 21 days after healing appears to be a safe and feasible treatment option when placed in the posterior mandible of partially edentulous patients. [ABSTRACT FROM AUTHOR]

Purpose: There is a lack of knowledge concerning the critical buccal bone thickness required for securing favorable functional and esthetic outcomes, conditioned to the dimensional changes after implant placement. A preclinical study was therefore carried out to identify the critical buccal bone wall thickness for minimizing bone resorption during physiologic and pathologic bone remodeling. Materials and Methods: A randomized, two-arm in vivo study in healthy beagle dogs was carried out. The first group of dogs was sacrificed 8 weeks after implant placement for histomorphometric examination of postsurgical resorption of the buccal bone wall. The second group of dogs was monitored during three ligature-induced peri-implantitis episodes and a spontaneous progression episode. Morphometric and clinical variables were defined for the study of physiologic and pathologic buccal and lingual bone loss. Results: Seventy-two implants were placed in healed mandibular ridges of 12 beagle dogs. Two groups were defined: 36 implants were placed in sites with a thin buccal bone wall (< 1.5 mm), and 36 were placed in sites with a thick buccal bone wall (≥ 1.5 mm). No implants failed during the study period. For the great majority of the histomorphometric parameters, a critical buccal bone wall thickness of at least 1.5 mm seemed to be essential for maintaining the buccal bone wall during physiologic and pathologic bone resorption. Suppuration (+) and mucosal recession (-) were more often associated with implants placed in sites with a thin buccal bone wall. Conclusion: A critical buccal bone wall thickness of 1.5 mm at implant placement is advised, since a thicker peri-implant buccal bone wall (≥ 1.5 mm) is exposed to significantly less physiologic and pathologic bone loss compared with a thinner buccal bone wall (< 1.5 mm). [ABSTRACT FROM AUTHOR]

Aim: To histologically evaluate the influence of (1) loading and (2) grafting on osseointegration and peri‐implant soft‐tissue healing at immediately placed, self‐cutting progressive tissue‐level implants (TLX) in a minipig model. Materials and Methods: TLX implants (n = 56) were immediately placed following the extraction of the mandibular first and second premolars, bilaterally, in a total of n = 14 minipigs. In each animal, the implant sites were allocated to the following four groups: (1) unloaded with simultaneous grafting using a bovine bone mineral; (2) unloaded without grafting; (3) loaded with simultaneous grafting; and (4) loaded without grafting. Histomorphometric assessments at 4 and 12 weeks (n = 7 animals each) included primary (i.e., bone‐to‐implant contact [BIC]) and secondary outcome measures (e.g., first BIC [fBIC], junctional epithelium length [JE], connective tissue contact length [CTC], biological width [BW = JE + CTC]). Results: At 4 weeks, mean BIC values ranged from 74.5 ± 11.6% in Group 2 to 83.8 ± 13.3% in Group 1, and, at 12 weeks, from 75.5% ± 7.9% in Group 2 to 79.9 ± 8.6% in Group 1. Multivariate linear mixed regression did not reveal any associations between BIC and implant loading or grafting at 4 and 12 weeks. At 12 weeks, significantly higher fBIC values were noted in Group 2 when compared with Group 1. All groups showed comparable JE, CTC, and BW values. Conclusions: Implant loading and grafting had no major effects on osseointegration and peri‐implant soft tissue healing at TLX implants. [ABSTRACT FROM AUTHOR]