Does residual cement around implant-supported restorations cause peri-implant disease? A retrospective case analysis
The purpose of this study was to determine the relationship between patients with a history of periodontitis and development of cement-related peri-implant disease. Seventy-seven patients with 129 implants for this retrospective analysis were selected from completed implant cases that were scheduled for regular maintenance or had experienced mechanical or biological complications between years 2006 and 2011 in private practice. Implants with extracoronal residual cement and implants without cement remnants were analyzed.

The Dual-Zone Therapeutic Concept of Managing Immediate Implant Placement and Provisional Restoration in Anterior Extraction Sockets
Improvements in implant designs have helped advance successful immediate anterior implant placement into fresh extraction sockets. Clinical techniques described in this case enable practitioners to achieve predictable esthetic success using a method that limits the amount of buccal contour change of the extraction site ridge and potentially enhances the thickness of the peri-implant soft tissues coronal to the implant-abutment interface. This approach involves atraumatic tooth removal without flap elevation, and placing a bone graft into the residual gap around an immediate fresh-socket anterior implant with a screw-retained provisional restoration acting as a prosthetic socket seal device.

Clinical Investigation on Axial versus Tilted Implants for Immediate Fixed Rehabilitation of Edentulous Arches: Preliminary Results of a Single Cohort Study
The aims of this study were to evaluate the clinical outcomes and patients’ satisfaction with immediately loaded full-arch fixed prostheses supported solely by axial or by a combination of axial and tilted implants in both jaws and to compare the outcome of tilted versus axial fixtures in the same patients up to 5 years. The null hypothesis was that no difference in survival rate and marginal bone level change would exist between axial and tilted implants and no difference in prosthetic survival between rehabilitation's supported only by axial implants or by a combination of axial and tilted implants.

Immediate Dentoalveolar Restoration - A New Technique for Compromised Extraction Sites
Immediate loading of implant in damaged fresh extraction socket with gingival architecture involvement, using bone sliver graft from maxillary tuberosity: a clinical case. <br> Immediate loading of implants in undamaged sockets following tooth extraction is very well established in the literature. In cases of tooth loss with socket structure loss, the esthetic risk increases, thus contraindicating immediate loading, such that the bone graft procedure needs to be prior to implant insertion. This paper describes an immediate loading procedure in a damaged fresh socket in the region of an upper central incisor that presented unevenness of gingival contour.

Reconstruction of Damaged Fresh Sockets by Connective-Bone Sliver Graft From the Maxillary Tuberosity, to Enable Immediate Dentoalveolar Restoration - A Clinical Case
This paper describes a procedure for immediate loading of an implant following tooth extraction, in a socket presenting severe damage to the vestibular bone plate and gingival recession in the region of the upper central incisors. The procedures of extraction of the tooth, immediate insertion of the implant, connective- bone graft from the maxillary tuberosity and immediate restoration were shown to be a predictable treatment alternative. These procedures led to restoration of the tooth, bone and gingival structures in a single surgical stage and to maintenance of the favorable esthetic and functional result 24 months afterwards.

Retrospective Evaluation of Crestal Bone Changes Around Implants With Reduced Abutment Diameter Placed Non-Submerged and at Subcrestal Positions: The Effect of Bone Grafting at Implant Placement
One method to measure the success of dental implant treatment is to evaluate marginal peri-implant bone-level changes and stability over time. The location of the fixture–abutment interface (FAI) can be of major importance when the goal is to construct esthetic restorations. In these situations the FAI is often placed in a more apical position to create an ideal emergence profile for the prosthetic construction. However, several animal studies have reported that placement of the FAI in a subcrestal position may result in peri-implant marginal bone loss. The aim of the present study is to evaluate the effect of bone grafting of the defect between the bone crest and the coronal aspect of the implant for implants with reduced abutment diameters placed non-submerged and in subcrestal positions.

Immediate Implant Placement with GBR Using Alloplast
Presented here is a case report wherein guided bone regeneration was done simultaneously at the time of immediate implant placement to achieve a desirable outcome.

Long-Term Block Graft Stability in Thin Periodontal Biotype Patients - A Clinical and Tomographic Study
Autogenous block grafting seems to be a predictable treatment modality to reconstruct alveolar ridge defects in the long term. A thin periodontal biotype did not seem to affect the volume of transplanted bone for the population studied.

Alternative Applications of Guided Surgery: Precise Outlining of the Lateral Window in Antral Sinus Bone Grafting
Computed tomography (CT) and the application of CT-based guided implant surgery allow clinicians to provide enhanced precision and accuracy in implant surgery. Because of the difficulty in transferring a patient’s often complex anatomic sinus configurations, as viewed on a preoperative CT scan, into precise osteotomy cuts at antral bone graft surgery, a prototype cutting guide was developed. The surgical guide was developed through the use of CT imaging and the stereolithographic process to precisely position the lateral window, facilitating schneiderian membrane elevation. This report demonstrates the step-by-step method to perform precise guided sinus window preparation using computer software and a stereolithographically generated surgical guide.

Indirect Sinus Lift with CPS Putty
In situations where lack of bone volume is related to an enlarged maxillary sinus, elevation of the sinus floor has been advocated for implant placement.

Schneiderian Membrane Perforation Rate During Sinus Elevation Using Piezosurgery - Clinical Results of 100 Consecutive Cases
This article presents an alternative approach that uses a piezoelectric instrument for the sinus elevation procedure.

Controlling Systematic Perioperative Anaerobic Contamination During Sinus-Lift Procedures by Using Metronidazole: An Innovative Approach
Analysis of tomodensitometric controls following sinus grafts clearly demonstrates a quite systematic lack of homogeneity. Sinus contamination by anaerobic bacteria seems almost unavoidable during bone graft surgery, and this problem may jeopardize the healing process.The aim of this study was to characterize in a systematic way the nonhomogeneities observed at 1,2,or 3 months post surgery within allogenous sinus grafts,and to assess the possible influence of a 0.5% sterile solution of metronidazole in corporated in the sinus bonegraft.

Maxillary Anterior Papilla Display During Smiling: A Clinical Study of the Interdental Smile Line
The purpose of this research was to quantify the presence or absence of interdental papillae during maximum smiling in a patient population aged 10 to 89 years. The visual display of interdental papillae during maximum smiling occurred 380 of the 420 patients examined in this study, equivalent to a 91% occurrence rate. Eighty seven percent of all patients categorized as having a low gingival smile line were found to display the interdental papillae upon smiling. Differences were noted for individual age groups according to the decade of life as well as a trend toward decreasing papillary display with increasing age. The importance of interdental papillae display during dynamic smiling should not be left undiagnosed since it is visible in over 91% of older patients and in 87% of patients with a low gingival smile line, representing a common and important esthetic element that needs to be assessed during smile analysis of the patient.

Labial Bone Thickness in Area of Anterior Maxillary Implants Associated with Crestal Labial Soft Tissue Thickness
Soft tissue problems (ie, gingival recessions) are common in implantology and are often associated with thin soft tissue biotypes or buccally placed implants. Goaslind described 2 types of biotypes commonly found in the natural dentition: thick and thin. It has been suggested that thicker soft tissue biotypes are associated with less tissue recession, higher crestal bone levels, and better aesthetics. A thin tissue biotype has been shown to be more prone to tissue recession. Gingival recession is always associated with alveolar bone dehiscences. Furthermore, there is evidence that thick soft tissue may be protective against crestal bone loss (ie, tissue thickness of ,2.5 mm resulted in crestal bone loss of 1.45 mm vs. thicker tissues had 0.26 mm). This protective effect occurred, despite the supracrestal position of the implant-abutment interface.

A Decision Tree for Soft Tissue Grafting
The decision tree proposed serves as a guide for clinicians to select the most appropriate and predictable soft tissue grafting procedure to minimize unnecessary mistakes while providing the ultimate desired treatment outcome.

Subpapillary Continuous Sling Suturing Method for Soft Tissue Grafting with the Tunneling Technique
This paper describes a new suturing method, the subpapillary continuous sling suture, for use with soft tissue grafts in tunnel procedures to treat gingival recession.

Does residual cement around implant-supported restorations cause peri-implant disease? A retrospective case analysis
The purpose of this study was to determine the relationship between patients with a history of periodontitis and development of cement-related peri-implant disease. Seventy-seven patients with 129 implants for this retrospective analysis were selected from completed implant cases that were scheduled for regular maintenance or had experienced mechanical or biological complications between years 2006 and 2011 in private practice. Implants with extracoronal residual cement and implants without cement remnants were analyzed.

A Periodontal-Restorative Approach to Achieving an Esthetic Outcome in Worn Dentition
Esthetic dentistry demands more of clinicians than just simeple knowledge of tooth anatomy and the proper dimensions of teeth. Dentists must also know and understand the proper positions of the teeth in relation to the gingiva, the lips, and entire face. Esthetic measurements are not the only important factors. Other considerations need to include the patient's phonetics and function. A example of a situation where this knowledge and awareness is imperative is in the case of the worn dentition (eg, attrition, abrasion, etc). This article addresses a simple case of how a patients esthetics have been compromised as a result of erosion as well as parafunctional activity (toothbrush abrasion) and how the patient was eventually restored with an interdisciplinary approach between the restorative dentist and the periodontal surgeon.

Combining Perio-Restorative Protocols to Maximize Function
This article describes a team approach for periodontal and restorative treatment intended to produce a predictable, biologically sound outcome that preserves more supporting bone and restores carious and broken down teeth.

Periodontal Photo Essay
Dr. Daniel J. Melker presents a Periodontal Photo Essay. Question: Why do we barrel in furcations?

Cirurgia ortognática: uma alternativa possível e viável para o tratamento de problemas odontológicos interdisciplinares.
Cirurgia ortognática: uma alternativa possível e viável para o tratamento de problemas odontológicos interdisciplinares. Além de curar diversos sintomas dos problemas funcionais que incomodam os pacientes no seu dia-a-dia, proporciona ainda a elevação da autoestima e da autoconfiança, pois os resultados estéticos são surpreendentes

Periodontal Accelerated Osteogenic Orthodontics - A Description of the Surgical Technique
The purpose of this article is to describe the clinical surgical procedures that comprise the PAOO procedure.

Human Histologic Evaluation of Anorganic Bovine Bone Mineral Combined with Recombinant Human Platelet-Derived Growth Factor BB in Maxillary Sinus Augmentation: Case Series Study
The objective of this study was to examine the potential for improved bone regenerative outcomes in maxillary sinus augmentation procedures using platelet-derived growth factor BB and anorganic bovine bone mineral.

Applied Techniques for Predictable Suture Placement Part 3
Standard protocols for suturing have been developed for the positioning and securing of surgical flaps to promote optimal healing. Parts 1 and 2 of this article discussed the indications for a variely of suturing techniques, including the periosteal suture technique, the simple look modification of interrupted suture technique, and several continuous suture techniques. Vertical mattress sutures, coronally repositioned mattress sutures, horizontal mattress sutures, and vertical sling mattress sutures…