Cirugía plástica periodontal para aumento de tejido blando alrededor de implantes
En la actualidad, los objetivos de la odontología han ido evolucionado a partir de las necesidades y las demandas de los procesos quirúrgicos, así como por los defectos o lesiones del periodonto, sobretodo cuando intervienen factores estéticos, donde se requieren restauraciones prostodónticas con aspectos naturales, que busquen un equilibrio armónico entre la arquitectura gingival y el rostro en sí del paciente, aún más en los casos donde se presenta sonrisa gingival.
Es por esto que se han estudiado varias técnicas mucogingivales para recubrimientos de recesiones, cambios de color por biótopo muy fino, aumento de volumen por pérdida del contorno gingival y colapso de los tejidos duros y blandos; siendo la más estudiada el injerto de tejido conectivo, como mecanismo de compensación y estabilidad para contribuir a una sonrisa más armónica y bella a la hora de la rehabilitación con implantes en el área anterior.
Periodontal-Prosthesis in Modern Dentistry – Part 2 of 2
Clinicians must be aware of patient expectations when planning dental treatment. When full mouth reconstruction is planned, it is very important to satisfy such expectations in order to provide successful treatment. Patients are often concerned about the cost and duration of treatment, and the pain, esthetics, comfort, and function after treatment. However, we cannot assure longevity unless the treatment has a scientific basis.
Socket Shield; What Do We Know, What´s New?
The Socket Shield technique is a “new” procedure with 10 years of documented successful cases worldwide. Lately we have done some new proposals like the way we extract the lingual slice, the relation of the shield level to the bone, the use of miniflaps, the distance between implant and shield just to mention some.
On the other hand, the only minor “problem” with this technique is the “external shield exposure” and here I propose the method of successful treatment.
We will see the convenience of applying SS to molars also on the light of the paper of Dr. Mataraso from 2009. The molar SS is a viable alternative rather than ridge preservation techniques.
Surgical Concepts to Treat Esthetic Implant Disaster Cases - Part 2 of 2
The utilization of dental implants in the esthetic zone is a challenge for involved clinicians. With the increasing application of dental implants by non-experienced colleagues, the occurrence of esthetic failures with implant supported restorations is raising. This lecture will address the causes for such esthetic failures and the surgical approach for therapy. In most cases, implant removal is necessary, which must be done with a low-trauma technique to avoid additional bone loss. Today, this is done with special implant removal instruments using the Reverse Torque Technique. In addition, these failures are often characterized by a lack of keratinized mucosa.
The current strategies for the reestablishment of keratinized mucosa and for the augmentation of missing bone, mainly on the facial aspects are presented and documented with case reports. This includes aspects of timing, surgical techniques, and the selection of appropriate biomaterials.
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.
The Socket-Shield Technique to Support the Buccofacial Tissues at Immediate Implant Placement
Tooth loss and subsequent ridge collapse continue to burden restorative implant treatment. Careful management
of the post-extraction tissues is needed to preserve the alveolar ridge. In-lieu of surgical augmentation to correct a
ridge defect, the socket-shield technique offers a promising solution. As the root submergence technique retains the
periodontal attachment and maintains the alveolar ridge for pontic site development, this case report demonstrates
the hypothesis that retention of a prepared tooth root section as a socket-shield prevents the recession of tissues
buccofacial to an immediately placed implant.
The socket-shield technique
is a highly promising addition to clinical implant dentistry and this case report is among the first to demonstrate the
procedure in clinical practice with a 1-year follow up.
Ridge Preservation with Modified “Socket-Shield” Technique: A Methodological Case Series
After tooth extraction, the alveolar bone undergoes a remodeling process, which leads to horizontal and vertical bone loss. These resorption processes complicate dental rehabilitation, particularly in connection with implants. Various methods of guided bone regeneration (GBR) have been described to retain the original dimension of the bone after extraction. Most procedures use filler materials and membranes to support the buccal plate and soft tissue, to stabilize the coagulum and to prevent epithelial ingrowth.
Post-Traumatic Treatment of Maxillary Incisors by Immediate Dentoalveolar Restoration with Long-Term Follow-Up
Replacing both missing maxillary interior teeth is particularly challenging, especially in compromised sockets. The case report describes the management of an 18-year-old female patient, who suffered avulsion of both maxillary central incisors at 7 years of age. The multidisciplinary implant technique, called Immediate Dentoalveolar Restoration (IDR), included extraction of the injured teeth and a single procedure for immediate implant placement and restoration of the compromised sockets after root fracture and peri-apical lesion development were detected during orthodontic treatment. Successful esthetic and functional outcomes and reestablishment of the alveolar process after bone reconstruction were observed during the 3-year follow-up period. The predictable esthetic outcomes and soft and hard tissue stability that can be achieved following IDR are demonstrated.
Managing Esthetic Implant Complications
Dental implant success today is judged not only by osseointegration but also by bone, tissue stability and of course long term esthetic results. Cosmetic predictability can often be difficult to attain, and esthetic implant failures can be multifactorial and patient management issues. Once esthetic implant failures occur, many cannot be fully corrected. Some complications must be addressed by an interdisciplinary dental team. In this summary of case reports, surgical considerations are provided, including cases of facial asymmetry/recession due to facial implant placement or bone loss resulting from technique/treatment failures, as well as papillary deficiencies. Restorative considerations for correcting failures are also discussed.
The Diagnosis and Treatment of Inflammatory Peri-implant Disease: We Have a Problem
This detailed presentation will discuss the etiology, microbiology, histopathology and clinical manifestations of peri-implant disease, and will present evidence based in-office and at-home treatment regimens to stop mucositis from progressing to peri-implantitis. Additionally, "COAP", a new minimally invasive surgical technique for the treatment of peri-implantitis will be introduced.
Modern Crown Lengthening: Classification and Clinical Application
Crown lengthening procedures are indicated to provide adequate tooth structure in case of subgingival tooth fracture or caries, uneven gingival level, un-esthetic short crowns due to the tooth wear, inadequate axial height, altered passive eruption ,forced eruption of a single or multiple teeth and finally in case of gingival smile.
The treatment modality for esthetic crown lengthening procedure should be based on detail diagnosis in each case because of the multifactorial etiology and because of the type of therapy selected by the clinician, will have a direct implication for the esthetic result.
Crown Lengthening in Comprehensive Esthetic Therapy: The Complete Surgical Video A to Z
In this complete surgical video, Dr. David Wong performs an esthetic crown lengthening procedure to address a "gummy smile" as part of comprehensive therapy and smile enhancement. Dr. Wong will outline the indications for crown lengthening surgery as opposed to orthognathic correction. The surgical video will demonstrate the complete crown lengthening surgery, including incision design, flap management and instrumentation. In addition, suturing and post-operative care will also be outlined in detail.
Crowns and Bridges