Clinical Realities - Papilla and Free Gingival Margin Preservation in Multiple-Tooth Extraction
Alejandro James, DDS, MsD, FID; Jose L. Castellanos, DDS
Replacing the Natural Tooth System in the Esthetic Zone: Flapless Implant Placement and Simultaneos Restoration to Preserve Tissue Contours and Guarantee Esthetics
Over the last decade, the number of cosmetic dental procedures performed in the general dental practice has increased steadily each year. Likewise, the use of dental implants as a tooth replacement options has become a more routine treatment alternative for patients missing teeth or requiring tooth removal.
Biologic Width Adjacent to Loaded Implant with Machined and Rough Collars in the Dog
Dental implant surface technology has evolved from a relatively smooth machined implant surface for osseointegration to more roughened osteoconductive surfaces. Recent studies suggest that peri-implant soft tissue inflammation with progressive bone loss (ie peri-implantitis) is becoming a prevalent condition. One possibility that could explain sucha a finding is that more bacterial plaque forms on the roughened implant and abutment surfaces, which may result in the peri-implant inflammation if the soft tissues. This study compared 36 tissue-level implants with a machined transmucosal collar to 36 implants with a relatively roughened transmucosal surface in the dog. The results demonstrated that the connective tissue contact was similar between the two implant types but that the junctional epithelium and biologic width dimensions were greater around the implants with the machined collars...
The Pontic-Shield: Partial Extraction Therapy for Implant Dentistry
Augmentive ridge preservation techniques aim to manage the postextraction ridge. The partial extraction of teeth may better preserve the ridge form by maintaining the bundle bone-periodontal tissues and preserve the ridge beneath dentures or fixed prostheses. The socket-shield technique entails preparing a tooth root section simultaneous to immediate implant placement and has demonstrated histologic and clinical results contributory to esthetic implant treatment. A retrospective 10-patient case series treating 14 partial extraction sites demonstrates how a modification of the socket-shield technique can successfully develop pontic sites and preserve the ridge.
Restoration of Optimal Esthetics in Complex Clinical Situations
Patients often neglect or delay dental care for an extended time because of their negative experiences with and fear of dental treatments. This neglect may result in the advance of periodontitis with severe bone loss, a substantial number of missing teeth, and problems with the remaining teeth. Preexisting malocclusion can aggravate this condition. This case report
demonstrates an interdisciplinary strategic approach, in combination with the use of biologically grounded, clinically proven, and viable techniques and technologies to restore optimal esthetics and function in such complex cases. The authors emphasize the importance of carefully planning the timing and sequence of performing periodontal, orthodontic, and implant therapies. The advanced techniques and technologies successfully implemented in this case report include the growth factor and titanium mesh (Ti mesh)-assisted bone augmentation; ovate pontic-mediated, noninvasive soft tissue contouring; and photofunctionalization
Management of Multiple Recession Defects in the Maxillary Arch - Utilization of Acellular Dermis Matrix
Dr. David Wong describes the management and correction of multiple recession defects in the maxillary arch.
"XP Treatment Planning Challenge - Phase II" - Parameters for Integration of Aesthetics and Function in Implant Dentistry
This is Part 2 of Case report. Part 1 featured the diagnostic cascade and ask you to consider different treatment approaches to the case.. This Second Part showcases the actual treatment performed. Please place your comments and treatment suggestions in the comment section.
Managing the Extraction Site - Optimal Preservation and Enhancement Techniques
There is rarely a day that clinicians do not have to deal with an extraction site. If implant therapy is a consideration, then bone and soft tissue quantity and quality must be factored into treatment options. The ideal opportunity for bone preservation exists at the time of tooth extraction. All too often this opportunity is lost. Extraction techniques will be demonstrated that not only preserve but augment the amount of alveolar bone. The importance of piezosurgery, atraumatic surgical technique, the use of bone grafts, resorbable membranes and growth factors will be elucidated along with soft tissue enhancement.
Connective Tissue Graft Harvesting Techniques - Part 1
In this presentation, Prof. Giovanni Zucchelli develops a critical comparison between the different CTG harvesting techniques, and shows the correct management of this kind of graft as well as its use in coronally advanced flap surgical technique for the treatment of gingival recessions.
Tissue Engineering and Platelet Derived Growth Factors: Evidence Based Therapy
Platelet derived growth factors are now routinely utilized in reconstructive therapy. This presentation describes very detailed and evidence based guidelines for clinicians interested in enhancing their abilities in tissue engineering, especially as it relates to bone augmentation. Specifically, while successful bone augmentation requires the standard surgical parameters of space maintenance, low pressure on the grafts and tension-free flap closure, optimization of this goal requires management and enhancement of the local biological conditions with growth factors. Towards that end, platelet concentrates through the constant release of growth factors are able to promote and enhance new vascularization, provide plasma protein, normal lipidemia, as well as increased collagen and fibrin activity.
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