Search

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 (bo, 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. [ABSTRACT FROM AUTHOR]

The present technical article describes a protocol to digitally reproduce the emergence profile of an in-terim implant prosthesis (IP) and to transfer its macro-geometry into the definitive restoration. The purpose of this protocol was to minimize alterations in the gin-gival architecture developed during the interim re-storative phase of a single implant that could poten-tially jeopardize its esthetic outcome. The process included obtaining an intraoral scan with the interim IP in situ, a duplicate of this intraoral scan that was used to capture the exact position of the implant, and an extraoral scan of the prosthesis. These data could then be imported into IOS software to create a model where the patients' soft tissue was incorporated with precision, allowing for the fabrication of a definitive crown with an optimal soft tissue adaptation. As there are few articles in the scientific literature that have re-ported a consistent method to replicate the emer-gence profile of an interim IP, the present technical article aims to highlight the potential of utilizing the emergence profile of an interim IP created by IOS software. (Int J Esthet Dent 2024;19:140-150) [ABSTRACT FROM AUTHOR]

Guided bone regeneration (GBR) requires a stable graft-membrane complex. This article presents a novel technique that uses membrane fixation screws to serve as anchors for membrane stabilization sutures without the need for periosteal dissection and biting of the buccoapical periosteum. This technique may be a viable alternative when there is a preference to avoid the complexities of periosteal suturing and direct membrane fixation using tacks or screws. The technique, which utilizes anchoring screws as mooring lines, can be used at the time of tooth extraction as well as for ridge augmentation of an edentulous site in preparation for future dental implant placement. Two case reports are presented that illustrate the feasibility of the technique, in which the integrity and stability of a resorbable membrane is preserved prior to final closure, suggesting that screws used as anchors for stabilization sutures might be a predictable option when addressing challenging horizontal defects requiring GBR. [ABSTRACT FROM AUTHOR]

Stabilization of the graft–membrane complex during guided bone regeneration is a critically important aspect of implant dentistry. Several articles in the dental literature have introduced the utilization of periosteal biting stabilization sutures, rather than fixation screws and pins, to stabilize a bioabsorbable collagen membrane. This article reviews the concept of stabilization using sutures in periodontal regeneration and describes an alternative method, the Ribroast technique™, to stabilize a bioabsorbable membrane, whereby single periosteal biting horizontal mattress sutures are placed along the length of the defect to achieve sufficient stabilization. Two cases are presented that highlight the utility of this technique. Guidelines and limitations for the use of periosteal biting sutures are also discussed along with considerations and protocols that may be useful for improving treatment outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This cone beam computed tomography study (CBCT) evaluated horizontal and vertical dimensional changes to the facial bone following maxillary anterior single immediate implant placement and provisionalization. Materials and Methods: CBCT scans taken immediately after (T1) and 1 year after surgery (T2) were evaluated. The midsagittal cut of each implant was identified, and measurements were made at predetermined levels. Horizontal facial bone thickness (HFBT) was measured at 0, 1, 2, 4, 6, 9, and 12 mm apical to the implant platform. Vertical facial bone level (VFBL) was the perpendicular distance from the implant platform (0) to the most coronal point of the facial bone. Measurements were recorded and changes between T1 and T2 were calculated. The data were analyzed statistically at a significance level of a = 0.05. Results: CBCT scans of 21 patients were analyzed. At T2, the mean HFBT changes ranged from -1.23 to -0.08 mm at the seven different levels evaluated. The mean VFBL change was -0.82 mm. The HFBT changes at the 1- to 9-mm levels were not significantly different from one another, but they were significantly smaller than the change at the 0-mm level and significantly greater than the change at the 12-mm level. Significant positive correlations were observed only between horizontal and vertical changes and between horizontal change and initial VFBL at the implant platform. While the VFBL of eight implants (38%) was apical to the implant platform at T2, none was noted at T1. Conclusions: Dimensional changes to the peri-implant facial bone following maxillary anterior single immediate implant placement and provisionalization should be expected. The greatest HFBT change was noted at the implant platform level, in part because HFBT change is correlated to the initial VFBL and the change in VFBL at that level. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the maxillary central incisor-incisive canal (CI-IC) relationship by comparing the visibility of the incisive canal on the two-dimensional sagittal images of the central incisors acquired from two cone beam computed tomography (CBCT) reconstruction modalities. A retrospective review of CBCT images from 60 patients (30 men and 30 women) with a mean age of 57.9 years (range: 19 to 83 years) was conducted. The CBCT images were evaluated using the manufacturer's recommended method (MRM) and a modified method (MM). The CI-IC relationship was classified as invisible, partially visible, or completely visible. The frequency distribution of the CI-IC relationships of the 60 samples indicated that the visibility of the incisive canal is significantly greater at all locations when using the MRM compared to the MM and on the right central incisor versus the left central incisor . Evaluation of the CI-IC relationship using the proposed method may allow the clinician to better determine whether additional surgical procedures are necessary when planning immediate implant placement and provisionalization at the maxillary central incisor positions. [ABSTRACT FROM AUTHOR]

Several bioabsorbable membranes have been proposed to exclude soft-tissue ingrowth and to stabilize the bone graft when guided bone regeneration (GBR) is performed. The properties of the various membranes differ slightly due to variances in composition and manufacturing processes affecting their handling and suitability for specific techniques. The aim of this article is to present a technique to perform GBR with the use of a sugar-crosslinked absorbable collagen membrane in conjunction with a dehydrated amnion/chorion membrane (dHACM). This technique can be used to perform GBR at the time of tooth extraction and for ridge augmentation of an edentulous site in preparation for future dental implant placement. The use of a collagen membrane in combination with a dHACM can facilitate stabilization of the bone graft and membrane by providing the benefits of a long-lasting bioabsorbable collagen membrane in addition to the unique benefits of an amnion/chorion membrane, which has been shown to provide growth factors to the surgical site that have potential to enhance regenerative outcomes.