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Human Palatal and Tuberosity Mucosa as Donor Sites for Ridge Augmentation
Since different clinical outcomes of periodontal bilaminar surgeries using the
palate or the maxillary tuberosity as connective tissue (CT) donor sites have
been observed, tissues grafted with CT from the palate or the tuberosity 1
year after surgical procedures for ridge augmentation were compared with
nongrafted tissues by using morphologic and molecular methods. Collagen
content and matrix metalloproteinases 1 and 2 expression were similar in
tissues and cultured fibroblasts from the palate and tuberosity, although with
interindividual differences. In contrast, differences in collagen cross-linking
and maturation in the tuberosity fibroblasts were observed, suggesting a
possible role in determining hyperplastic responses in some patients.
New Surgical Protocol to Create Interimplant Papilla: The Preliminary Results of a Case Series
The aim of this study was to introduce a new surgical technique to regenerate the papilla adjacent to multiple or single implants using a novel instrument and a new incision design. A total of 10 consecutively treated patients with maxillary anterior implant-supported provisional restorations and missing interproximal papillae received a subepithelial connective tissue graft. The receipient site was prepared with a buccal incision apical to the mucoginigival unction and to the defective papilla, and a palatal incision, followed by buccolingual tunneling performed with a translingual curette. An average improvement in papilla index score from 0.8 to 2.4 was found after an average follow-up period of 16.3 months. This case series demonstrated that interimplant papilla regeneration can be successful over a period of 11-30 months postloading. Long-term prospective studies on tissue stability and esthetic outcomes are needed to corroborate the finding in this study.
Vertical Ridge Augmentation and Soft Tissue Reconstruction of the Anterior Atrophic Maxillae: A Case Series
Severe vertical ridge deficiency in the anterior maxilla represents one of the most challenging clinical scenarios in the bone regeneration arena. As such, a combination of vertical bone augmentation using various biomaterials and soft tissue manipulation is needed to obtain successful outcomes. The present case series described a novel approach to overcome vertical deficiencies in the anterior atrophied maxillae by using a mixture of autologous and anorganic bovine bone. Soft tissue manipulation including, but not limited to, free soft tissue graft was used to overcome the drawbacks of vertical bone augmentation (eg, loss of vestibular depth and keratinized mucosa). By combining soft and hard tissue grafts, optimum esthetic and long-term implant prosthesis stability can be achieved and sustained.
Retrospective Analysis of 26 Complete-Arch Implant-Supported Monolithic Zirconia Prostheses with Feldspathic Porcelain Veneering Limited to the Facial Surface
The purpose of this retrospective study was to evaluate the clinical performances of 26 implant-supported, complete-arch, monolithic zirconia restorations with facial feldspathic porcelain veneers for the rehabilitation of completely edentulous patients.
Eighteen patients were treated with a total of 26 complete-arch fixed prostheses. The mean follow-up time was 20.9 months. In total, 154 implants were placed supporting 309 retainers and pontics.
The results of this retrospective evaluation showed that monolithic zirconia restorations
with facial porcelain veneer provided satisfactory clinical performance and suggest that these
rehabilitations are a viable treatment option for completely edentulous patients.
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.
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