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Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Parodontologie: die Zeitschrift für die Praxis (Berlin, Germany) is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Treatment by means of implant-supported immediately loaded fixed full-arch prostheses is known to be related to biologic and technical complications. The aim of this retrospective study was to investigate the prevalence and moment of occurrence of biologic and technical complications happening in immediately loaded fixed full-arch prostheses. Materials and Methods: This study investigated patients who received treatment with immediately loaded fixed full-arch prostheses using four to six implants from 2007 to 2013. The investigation included biologic and technical complications. Complications were depicted regarding their prevalence and their first time of occurrence. Statistical analysis was performed regarding the differences of the mean complication values between the mandible and the maxilla and between technical and biologic complications. Results: The investigation included 482 immediately loaded fixed full-arch prostheses (380 patients, mean observation period: 23.5 months). In 193 arches (40%), either technical (30.9%), biologic (6.5%), or both (3.1%) types of complications occurred. Technical complications occurred significantly more often than biologic complications (P < .000). The most frequent technical complication was “fracture of veneering material” (24.7%, arch level). The most frequent biologic complication was “marginal bone loss ≥ 2 mm” (16.3%, implant level). The median first advents of technical complications were after 23/26 months (implant-/prosthesis-related) and after 3 months for biologic complications, respectively. There was no significant difference of the mean complication rates between the maxilla and the mandible (P = .409). In 99.0% of the arches with complications, the restorations could be obtained. Conclusion: Within this treatment concept, biologic and technical complications may occur over time. However, the vast majority of complications (99.0%) do not affect the overall prosthesis survival. Technical complications are assumed to occur significantly more often than biologic complications. It is suggested that not only stress and material fatigue but also function is a matter concerning this treatment option and, thus, may be a factor related to complication rates. [ABSTRACT FROM AUTHOR]

The aim of this article is to introduce and illustrate the "Teflon tape technique," which provides good lucidity in combination with excellent isolation of the working field. It is intended to serve as a supplement to the gold standard rubber dam for the adhesive working dental practitioner. Primarily, the Teflon tape technique (Teflon is a registered trademark, and not affiliated with Teflon tape) is particularly suitable for the adhesive cementation of restorations with very thin margins. It allows free access to subgingival areas with variable gingival retraction. Furthermore, this principle can also be applied to other indications, such as Class V restorations or deep core buildups. The technique described is therefore flexible and easy to use. This combination allows a fast integration of the Teflon tape technique into the daily workflow of the dental practitioner. [ABSTRACT FROM AUTHOR]

The aim of this clinical case series was to evaluate the clinical performance of the modified tunnel technique for treatment of multiple gingival recessions in the anterior mandible. A total of 20 patients with 63 Miller Class I and II defects were treated via a modified tunnel technique with subepithelial connective tissue graft. At baseline and 6 months postoperative, recession depth, probing pocket depth, width of keratinized tissue, and gingival tissue thickness were assessed. At 6 months, the results revealed a mean recession coverage of 93.87%. Complete recession coverage was achieved in 74.60%. The mean reduction of recession depth was 2.79 ± 0.12 mm. The modified tunnel technique showed successful mean root coverage in the delicate anterior mandible and was able to increase the amount of keratinized tissue. [ABSTRACT FROM AUTHOR]

The article presents a study on the use of the extended sinus elevation technique to preserve the integrity of the sinus membrane and to regenerate bone around zygomatic implants. It mentions the examinations that patients underwent during the study, implant and prosthesis complications and survival, and results of radiographic observations.

The goal of this case series is to present a novel treatment approach for lateral ridge augmentation. Four systemically healthy patients (aged 48 to 59 years) with inadequate dental alveolar ridge widths were selected for inclusion. All ridge defects were augmented using a xenogeneic cortical bone shield in combination with particulated bone substitutes and a thin collagen barrier. At baseline and after 6 months, digital cone beam computed tomography scans were performed. Biopsy specimens were harvested at reentry surgery and processed for histologic analysis. The results revealed a sufficient amount of bone structure for implant placement without additional augmentation procedures. The histologic analysis demonstrated that new bone formation had taken place and the bone shield had resorbed entirely. This case series indicates that the bone lamina technique has the biologic and mechanical properties to succesfully achieve hard tissue augmentation of deficient ridges. [ABSTRACT FROM AUTHOR]

Tooth extraction will be followed by marked alterations to the tissue volume, in particular in the anterior zone, which may jeopardize the esthetic outcome of any dental treatment involving tooth extraction. If, however, ridge collapse can be prevented or minimized after tooth extraction, more predictable outcomes with superior esthetics can be accomplished along with fewer surgical procedures. Therefore, it was proposed that stabilizing the soft tissue architecture with a free gingival graft could minimize the soft tissue shrinkage. The following case report describes some surgical modifications and refinements in order to enhance the predictability of the socket- seal surgery. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this prospective clinical trial was to evaluate over a 5-year period the treatment outcomes for immediately loaded full-arch fixed prostheses supported by two axially inclined and two tilted implants used to rehabilitate edentulous arches. This report presents preliminary 1-year results. Materials and Methods: Thirty-seven patients were recruited for treatment with either mandibular or maxillary full-arch fixed prostheses supported by four implants. Within 24 hours, the implants were immediately loaded with screw-retained full-arch acrylic resin provisional restorations. Definitive reconstructions were delivered 6 months later. Complete full-arch prostheses were supported by metal frameworks combined with high-density acrylic resin. Follow-up visits were scheduled for 6 and 12 months after initial prosthetic loading and then annually for up to 5 years. Digital radiographs were obtained immediately, 6 months after surgery, and at each annual follow-up visit. Marginal periimplant bone levels were assessed using digital image analysis. Results: The 1-year implant survival rates were 96.0% for axially positioned implants and 94.6% for tilted implants. The survival rates were 96.6% for maxillary implants and 98.7% for mandibular implants. The prosthetic survival rate was 100%. No significant differences were found in the results for tilted versus axially positioned implants. One year after loading, the mean marginal bone loss was 0.82 ± 0.31 mm around the axially oriented implants and 0.76 ± 0.49 mm around the tilted implants (P ≤ .05). Conclusions: Preliminary data from this clinical trial show high implant survival rates for immediately loaded full-arch prostheses supported by four implants. Immediate loading of tilted implants may be considered a viable treatment option for the rehabilitation of edentulous patients. [ABSTRACT FROM AUTHOR]

The current literature suggests that the bone-condensing approach while performing internal sinus floor elevation may not be beneficial for the future implant site. Furthermore, even with refined procedures, a predictable and controlled infraction of the sinus floor prior to graft placement still seems to be technique sensitive. In this context, the present article presents a modified technique along with the use of parallel osteotomes devoid of any contact to the lateral osteotomy wall. Therefore, compression of the adjacent bone will be avoided and the tactility of the site for the surgeon will be preserved as the osteotome is solely in contact with the subsinus cortex. [ABSTRACT FROM AUTHOR]

Long-term periodontal stability is one of the major issues of periodontal therapy. Besides a successful active therapy and a meticulous periodontal maintenance phase, the initial risk assessment for each single tooth is of utmost importance. However, the literature contains only limited guidelines and recommendations concerning periodontal risk assessment. In particular, when teeth are to be used as abutments for a new prosthetic reconstruction, long-term periodontal stability should be expected. This clinical report discusses the clinical considerations concerning periodontal risk assessment, and factors that aid in the decision-making process. [ABSTRACT FROM AUTHOR]

Recent advances in periodontal plastic surgery have encouraged reassessment of the envelope technique and its modified version, the tunnel technique, for root coverage. This article describes alterations in the technique-sensitive tunnel approach, which include an undermining split flap preparation of the buccal tissues with newly developed instruments to minimize trauma and ensure a better blood supply for the connective tissue graft. The use of a microsurgical concept, including microsurgical blades and suture material, improves wound healing and establishes a better esthetic result. Because these modifications simplify the tunnel approach, the spectrum of indications for the tunnel technique may be expanded and a broader application achieved. [ABSTRACT FROM AUTHOR]

The attainment of primary wound closure is one of the major determining factors of success in oral surgery. Especially when dealing with regenerative or augmentative procedures, healing in a submerged environment is crucial to achieving the desired treatment result. In this context, the use of a microsurgical approach and layered suturing techniques is of utmost importance for precise and meticulous wound closure. However, microsurgical wound closure using both mattress sutures and interrupted sutures is very time consuming and may be detrimental to wound healing because of trauma and extended surgical time. The double-sling suture, a modified suture technique that combines two interrupted sutures that have different bite sizes and engage different tissue layers, is able to predictably and efficiently close the surgical site for improved wound healing. This article describes this new technique and presents two case examples. [ABSTRACT FROM AUTHOR]

The esthetic outcome of dental implants in the esthetic zone is a major treatment concern in modern dentistry, especially in singlestep procedures, which unite extraction, implantation, and augmentation into one surgical intervention, and are gaining popularity. Although these procedures offer advantages concerning early soft tissue preservation, they also show a high risk of complications when careful patient selection is neglected. Thus, the aim of this article is to illustrate the complexity and limitations of immediate implant procedures using two case reports. The clinical cases and scientific data show that immediate implant placement must be divided into two different groups: single-tooth implants and multiple adjacent implants. While immediate placement of single-tooth implants often shows predictable and superior esthetic results, the immediate placement of multiple adjacent implants is far less predictable. It is important to establish whether the advantages observed in single-tooth applications are also feasible for multiple adjacent implants. [ABSTRACT FROM AUTHOR]

Replacement of two adjacent teeth in an anterior maxilla with deficient hard and soft tissues appears to be the utmost challenge in implant dentistry in the esthetic zone. In this case report, baseline conditions for implant placement were improved by alveolar distraction to enhance hard and soft tissues around the maxillary central incisors. Three months after the active phase of distraction, the roots of the central incisors were extracted and two screw-type dental implants were immediately placed into the extraction sockets. For immediate provisionalization, acrylic resin crowns were fabricated on UCLA abutments, providing the ideal emergence profile to support the periimplant soft tissue. Six months after implant placement, the prosthetic restoration of the case was finished with ceramic crowns cemented to individually fabricated zirconium oxide abutments. The described treatment strategy appears to have a great potential to restore natural esthetics in cases with major tissue deficiencies in the esthetic zone. [ABSTRACT FROM AUTHOR]

The article describes the case of a 30-year-old patient who needed to undergo oral surgery to extract a maxillary left central incisor for endodontic reasons. Esthetic analysis showed that the gingival conditions at the right central incisor were ideal and were eventually selected as reference for the final restoration. A periapical translucency was also found at the left central incisor through radiographic evaluation. The treatment procedure involves extraction of the endodontically affected left central incisor and implant placement.

Objectives: The aim of the present publication was to report on the EAO Workshop group‐4 discussions and consensus statements on the five reviews previously prepared. These reviews provided the scientific evidence on the effect of crown‐to‐implant ratio, on reconstructions with cantilevers in fully and partially edentulous patients, on biological and technical complications of tilted in comparison with straight implants, and on the effects of osseointegrated implants functioning in a residual dentition. Material and Methods: The group discussed, evaluated, corrected where deemed appropriate, and made recommendations to the authors regarding the following five reviews submitted: (a) Is there an effect of crown‐to‐implant ratio on implant treatment outcomes?; (b) Implant‐supported cantilevered fixed dental rehabilitations in fully edentulous patients; (c) and in partially edentulous patients; (d) Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses; (e) What are the adverse effects of osseointegrated implants functioning among natural teeth of a residual dentition? Based on the five manuscripts and the discussion among the group as well as the plenum members, the major findings were summarized, consensus statements were formulated, clinical recommendations were proposed, and areas of future research were identified. Results: Crown‐to‐implant ratios ranging from 0.9 to 2.2 did not influence the occurrence of biological or technical complications also in single‐tooth restorations. Reconstructions with cantilevers for the rehabilitation of fully and partially edentulous jaws showed high implant and reconstruction survival rates. In contrast, the rate of complications—in particular associated with veneering material—was high during the observation period of 5–10 years. The data reported were primarily derived from studies with high risk of bias. The data for single‐implant reconstructions were small. There was no evidence that distally tilted implants were associated with higher failure rates and increased amounts of marginal bone loss. The data supporting these findings, however, were at high risk of bias and frequently incompletely reported. Frequent positional changes occurred between the natural teeth and the implant‐supported restorations. These changes were more pronounced in younger individuals, and even though they were reduced with age, they still occurred in adult patients. Even though these changes were frequent, potential implications for the patient are unclear. Conclusions: The use of single‐tooth restorations with crown‐to‐implant ratio in between 0.9 and 2.2 may be considered a viable treatment option. Multiunit reconstructions with cantilevers are a viable treatment option in fully and partially edentulous patients. Clinicians and patients should be aware, however, that complications are frequent and primarily related to resin material used for veneering. There is some evidence that tilting an implant does affect stability of the implant and the surrounding bone. Treatment options to tilted implants should carefully be considered, as the effect on soft tissues and on prosthesis behavior is poorly reported for tilted implants. Positional changes in the dentition in relation to implant‐supported restorations occur frequently. The patient should be informed about the possible need for a treatment related to these changes in the long term. [ABSTRACT FROM AUTHOR]

Purpose: The zygomatic implant is mainly indicated for the rehabilitation of extremely atrophied maxillae when bone augmentation should be avoided. One drawback of zygomatic implants, which typically pass through the sinus, is initial or late bone resorption around the implant neck, which can result in oroantral communications followed by possible infection of the sinus. To decrease the risk of sinus infection, a modified technique was developed to preserve the integrity of the sinus membrane and to regenerate bone around zygomatic implants using an extended sinus grafting approach. Materials and Methods: Patients with extremely atrophied maxillae were provided with one to four zygomatic implants in conjunction with sinus grafting, plus conventional auxiliary implants, for immediate support of a provisional full-arch maxillary prosthesis. Definitive prostheses were delivered at 6 months after implant placement. All patients underwent clinical and radiographic examinations at 6 months. Results: Twenty-two zygomatic and 23 conventional auxiliary implants were placed in 10 patients. The overall 6-month implant survival rate was 90.9% for zygomatic implants and 100% for auxiliary implants placed in the anterior area. Only two minor technical complications were seen, and clinical indicators (including probing pocket depth, keratinized tissue, and plaque and bleeding indices) were good in all patients. A substantial gain of radiographic bone around the zygomatic implants was observed. Conclusion: The proposed technique led to successful prosthetic function for all patients. With the described technique, exposed implant threads within the maxillary antrum are eliminated and the potential for biologic complications is minimized. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the influence of biomechanical and prosthetic factors in the formation and preservation of peri-implant hard and soft tissue levels and the influence of biologic, implant, and surgical factors.

Objectives: The aim of the present publication was to report on the EAO Workshop group-4 discussions and consensus statements on the five reviews previously prepared. These reviews provided the scientific evidence on the effect of crown-to-implant ratio, on reconstructions with cantilevers in fully and partially edentulous patients, on biological and technical complications of tilted in comparison with straight implants, and on the effects of osseointegrated implants functioning in a residual dentition., Material and Methods: The group discussed, evaluated, corrected where deemed appropriate, and made recommendations to the authors regarding the following five reviews submitted: (a) Is there an effect of crown-to-implant ratio on implant treatment outcomes?; (b) Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients; (c) and in partially edentulous patients; (d) Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses; (e) What are the adverse effects of osseointegrated implants functioning among natural teeth of a residual dentition? Based on the five manuscripts and the discussion among the group as well as the plenum members, the major findings were summarized, consensus statements were formulated, clinical recommendations were proposed, and areas of future research were identified., Results: Crown-to-implant ratios ranging from 0.9 to 2.2 did not influence the occurrence of biological or technical complications also in single-tooth restorations. Reconstructions with cantilevers for the rehabilitation of fully and partially edentulous jaws showed high implant and reconstruction survival rates. In contrast, the rate of complications-in particular associated with veneering material-was high during the observation period of 5-10 years. The data reported were primarily derived from studies with high risk of bias. The data for single-implant reconstructions were small. There was no evidence that distally tilted implants were associated with higher failure rates and increased amounts of marginal bone loss. The data supporting these findings, however, were at high risk of bias and frequently incompletely reported. Frequent positional changes occurred between the natural teeth and the implant-supported restorations. These changes were more pronounced in younger individuals, and even though they were reduced with age, they still occurred in adult patients. Even though these changes were frequent, potential implications for the patient are unclear., Conclusions: The use of single-tooth restorations with crown-to-implant ratio in between 0.9 and 2.2 may be considered a viable treatment option. Multiunit reconstructions with cantilevers are a viable treatment option in fully and partially edentulous patients. Clinicians and patients should be aware, however, that complications are frequent and primarily related to resin material used for veneering. There is some evidence that tilting an implant does affect stability of the implant and the surrounding bone. Treatment options to tilted implants should carefully be considered, as the effect on soft tissues and on prosthesis behavior is poorly reported for tilted implants. Positional changes in the dentition in relation to implant-supported restorations occur frequently. The patient should be informed about the possible need for a treatment related to these changes in the long term., (© 2018 The Authors. Clinical Oral Implants Research Published by John Wiley & Sons Ltd.)