Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement
Contemporary implant therapy aims to provide highly
esthetic and predictable treatment outcomes while decreasing
treatment duration and complexity. The clinician
must therefore be cognizant of circumstances with a predisposition
toward esthetic outcomes and treatment plan
accordingly. Preservation of the surrounding hard and
soft tissues associated with an immediate postextraction
socket implant to replace a nonrestorable tooth in the
esthetic zone is one of the greatest challenges facing the
dental team. A case report of a hopeless maxillary left central incisor in a patient with a thin periodontal phenotype illustrates this new surgical and prosthetic approach. Clinical, radiological,
and esthetic parameters were recorded to evaluate primary
Reconstruction of a Single-Tooth Traumatic Defect in the Anterior Maxilla Using the Khoury Bone Plate Graft
Trauma to teeth and the dentoalveolar process may result in a ridge defect that precludes straightforward implant
therapy of the patient. Typically bone and soft tissue augmentation of the area would first be needed to adequately
prepare the tissues for the implant and its restoration..Grafting of the site is substantially more difficult in cases where
the ridge also lacks adequate height, and techniques to recreate a bony envelope to apply guided bone regeneration
may be required. Moreover, defects in the anterior aesthetic zone that require both bone and soft tissue grafting and
a restoration that harmonizes the adjacent pink and white aesthetics may be an even more significant challenge to
the restorative team. Hereafter a case of trauma to an anterior maxillary tooth that saw destruction of the ridge is
presented, with the defect reconstructed to accommodate a functional and aesthetically pleasing implant supported
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.
Immediate Implant Placement into Extraction Sockets with Labial Plate Dehiscence Defects: A Clinical Case Series
To measure the buccal plate reconstruction of extraction sockets with labial plate dehiscence defects using a bone
allograft in combination with an absorbable collagen membrane and a custom-healing abutment at the time of tooth
removal. Implants placed into sockets with labial plate dehiscence defects demonstrated radiographic reformation of the labial plate dehiscence defect at 6 to 9 months post-treatment. The net gain in labial plate on CBCT in L1 and L2 was 3.0 mm, where 0 mm existed at pre-treatment. The minimum amount of labial plate thickness of 2.0 mm was achieved in all treated sites, evaluated radiographically at 6-9 months post-operatively, in a single
procedure, without flap elevation and maintaining the gingival architecture and satisfactory esthetics.
Subclassification and Clinical Management of Extraction Sockets with Labial Dentoalveolar Dehiscence Defects
Immediate implant therapy involving implants placed into intact Type 1 extraction sockets has become a consistent clinical technique. The classification of Type 2 extraction sockets, where the mucosal tissues are present but there is a midfacial osseous dehiscence defect, has been described according to the extent of the buccal bone plate absence. The literature has offered different techniques in the treatment of Type 2 sockets; however, the extent of the defect has never been defined or delineated.
Manejo Integral de Maloclusion Clase III en Adulto, con Requerimientos Periodontales y Protesicos; Reporte de un caso clinico
En nuestra clinica observamos un aumento de pacientes adultos con problemas esqueletales, compromiso periodontal y necesidades protesicas. Debemos recurrir a la interconsulta con el periodoncista, protesista y cirujano maxilofacial, para la correccion del caso, prestando especial atencion al componente dentario, esqueletal y los tejidos blandos faciales del paciente. La cirugia ortognatica, que generalmente la realizamos luego de una preparacion ortodoncica, permite corregir discrepancias en el adulto y restaurar la funcion y estetica en los tres planos del espacio. Realizada la correccion oclusal, procedemos a sustituir dientes ausentes, mediante implantes y protesis fijas. El Periodoncista, mantiene un control constante de la salud de los tejidos de soporte, durante todas las fases de la terapia multidisciplinaria.
Sinus Floor Elevation Via the Maxillary Premolar Extraction Socket With Immediate Implant Placement: A Case Series
When immediate implant placement is considered
for teeth with close proximity to the sinus floor, apical
extension of the osteotomy is significantly limited, and often
a staged approach is used. Implant placement into fresh extraction sockets and sinus floor manipulation using bone-added osteotome sinus floor elevation with implant placement
are techniques most often used independently or sequentially.
In this care report, immediate implant placement with simultaneous osteotome sinus floor elevation is an advantageous
combination of two successfully used techniques. This combined
approach can significantly reduce the treatment time
for implant therapy in teeth with close sinus proximity and provide the operator with the ability to place implants of desired length.
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.
Antimicrobial Effect of a Single Dose of Amoxicillin on the Oral Microbiota
Amoxicillin is commonly used in oral surgery for antimicrobial prophylaxis against surgical-site infection and
bacteremia because of its effect on oral streptococci. The aim of this study was to determine whether amoxicillin reaches
the break-point concentrations in saliva and has any effect on the salivary microbiota, colonizing bacteria on mucosal
membranes and on the gingival crevice after a single dose of amoxicillin. A single dose given as prophylaxis to prevent a surgical-site infection results in a significant reducing effect on
the oral streptococcal microflora in the gingival crevice and may have an impact on bacteria spreading into tissues and the
bacteria of streptococci.
Developing Optimal Peri-Implant Papillae within the Esthetic Zone: Guided Soft Tissue Augmentation
Osseointegrated dental implants have enjoyed long-term success in the rehabilitation of totally edentulous patients. Every aspect of traditional treatment planning protocols continues to be re-evaluated and updated to better incorporate the benefits of osseointegration into clinical practice. This is particularly evident as dentistry has committed to fully integrating this approach into the more varied and demanding environment of the partially edentulous patient. Along with the many benefits of added predictability and enhanced options, the ever-evolving role of osseointegrated implants in the treatment pf the partially edentulous jaw has also created new challenged. Unlike the fully edentulous individual who maintains the implant-restorative interface beyond the lip perimeter, many partially edentulous patients undergo the transition within the esthetic zone.
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.
The Socket-Shield Technique: First Histological, Clinical, and Volumetrical Observations after Separation of the Buccal Tooth Segment – A Pilot Study
The “socket-shield technique” has shown its potential in preserving buccal tissues. However, front teeth often
have to be extracted due to vertical fractures in buccolingual direction. It has not yet been investigated if the socket-shield
technique can only be used with intact roots or also works with a modified shield design referring to vertical fracture lines.
The aim of this study was to assess histologically, clinically, and volumetrically the effect of separating the
remaining buccal root segment in two pieces before immediate implant placement.
Mucosal Coronally Positioned Flap for the Management of Excessive Gingival Display in the Presence of Hypermobility of the Upper Lip and Vertical Maxillary Excess: A Case Report
Excessive gingival display is a frequent
finding that can occur because of various
intraoral or extraoral etiologies. This report describes
the use of a mucosal coronally positioned flap for the
management of a gummy smile associated with vertical
maxillary excess and hypermobility of the upper
lip. For patients desiring a less invasive
alternative to orthognathic surgery, the mucosal coronally
positioned flap is a viable alternative. We demonstrate
short-term successful use of this technique
for the management of excessive gingival display in
the presence of slight vertical maxillary excess and
hypermobility of the upper lip. Long-term follow-up
studies are needed to determine stability of the results.
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.
Crowns and Bridges