Revisiting the Papilla in 2016 - Part 2 of 2
In dental esthetics the regeneration of a compromised papilla , remains the most complex aspect of any reconstructive endeavor. The original 5mm Rule was found to exist only for a papilla bordered by 2 teeth and was expanded into a classification of 6 Types dependent on alternative adjacent support.e. implants or pontics.
Titanium Mesh and rhBMP-2 in Ridge Augmentation: Options and Limitations
Titanium mesh has been used in reconstructive surgery and ridge augmentation for several years. The traditional technique involves using cancellous autogenous bone under the mesh scaffold. More recently growth factors and bone substitutes have been utilized as autograft replacements. There are several advantages to using titanium mesh for space maintenance including strength, ease of use, low cost and biocompatibility. However, the difficulty in removing the mesh has led to a search for other space maintenance scaffolds including tenting screws, dense preshaped collagen and porous high-density polyethylene. This webinar will discuss the use of rhBMP-2 for managing horizontal and vertical bone deficiencies with various scaffolds.
Osseodensification: A Paradigm Shift in Implant Dentistry
This course aims to present Osseodensification techniques designed to maximize implant primary stability, implant insertion torque, and early loading of dental implants. Atraumatic Osseodensification techniques may also be used for alveolar ridge expansion, hydraulic maxillary sinus floor elevation with autografting.
Single Incision Technique to Harvest Free and Vascularised Subepithelial Connective Tissue Graft From The Palate
In this short lecture a harvesting of free and pediculated connective tissue graft from the palate in one incision technique is presented. One incision technique as described by Huerzeler and Allen is a minimal invasive technique that results in wound healing by primary intention and therefore causes minimal postoperative discomfort. Through pictures and animations this technique is shown step by step. This presentation also deals with a wound healing and possible complications.
The ABC Protocol in the Esthetic Zone: A Comprehensive Surgical & Prosthetic Approach
the purpose of this article is to present a surgical and restorative protocol for the replacement of missing teeth in the esthetic zone. The ABC protocol consists of digitally guided implantation, autogenous bone graft, followed by bovine bone xenograft and connective tissue graft. Autogenous bone is placed in contact with the implant surface to induce osseointegration; bovine bone xenograft is then applied to augment the ridge dimension and provide long-term stability. Connective tissue is used to provide additional volume. The ABC biomaterial sequence offers favorable hard and soft tissue dimensions and immediate provisional restoration predictably leads to an esthetically pleasing definitive prosthesis.
Palatal Augmentation Technique: A Predictable Method to Increase the Palatal Connective Tissue at Donor Sites - A Consecutive Case Series
The palatal masticatory mucosa between the canine and first molar is the main source of connective tissue graft (CTG) for use in periodontal plastic surgery. The purpose of this study was to evaluate the palatal augmentation technique (PAT) to increase the palatal connective tissue donor area using a collagen sponge inserted between the palatal flap and bone. The 26 patients enrolled in this study were referred for root coverage and ridge augmentation procedures. All patients lacked adequate donor palatal tissue thickness. The PAT uses a full thickness flap and bone. The palatal thickness was clinically assessed before and after collagen sponge insertion. A Manual probe was inserted in the mucosal surface perpendicular to the long axis of each tooth approximately 6mm from the gingival margin. Probing depth and recession were also recorded. Treatment with PAT resulted in a statistically significant increase in the palatal thickness.
Flapless Postextraction Socket Implant Placement, Part 2. The Effects of Bone Grafting and Provisional Restoration on Peri-implant Soft Tissue Height & Thickness - A Retrospective Study
This article presents the results of evaluating the changes in peri-implant soft tissue dimensions associated with immediate implant placement into anterior post-extraction sockets for four treatment groups: no BGPR(bone graft, no provisional restoration), PR (no bone graft, provisional restoration), BG (bone graft, no provisional restoration), and BGPR (bone graft, provisional restoration). The vertical distance of the peri-implant soft tissue was greater for grafted sites than for non-grafted ones. The facial soft tissue thickness at the gingival third was greater for grafted than for non-grafted sites and for sites with provisional restorations compared to sites without them, respectively. The net gain in soft tissue height and thickness was about 1mm. The increases in vertical and horizontal dimensions for grafted sites were between 0.5 and 1.0mm, as compared to sites with no bone graft and no provisional restoration.
Crestal Bone Stability around Implants with Horizontally Matching Connection after Soft Tissue Thickening: A Prospective Clinical Trial
It has been shown that thin mucosal tissues may be an important factor in crestal bone loss etiology. Thus,
it is possible that mucosal tissue thickening with allogenic membrane might reduce crestal bone loss.
Purpose: The purpose of this study was to evaluate how implants with traditional connection maintain crestal bone level
after soft tissue thickening with allogenic membrane.
After 1-year follow-up, implants in group A had 1.65 1 0.08-mm bone loss mesially and 1.81 1 0.06 mm distally.
Group B had 0.31 1 0.05 mm mesially and 0.34 1 0.05 mm distally. C group implants experienced bone loss of 0.44 1
0.06 mm mesially and 0.47 1 0.07 mm distally. Differences between A and B, and A and C were significant both
mesially and distally, whereas differences between B and C were not significant mesially and distally
Prevention and Treatment of Post-Operative Infections After Sinus Elevation Surgery
Maxillary sinus surgery is a reliable and predictable treatment option for the prosthetic rehabilitation of the atrophic maxilla. Nevertheless, these interventions are not risk-less of postoperative complications with respect to implant positioning in pristine bone. The aim of this lecture is to report the results of a clinical consensus of experts (periodontists, implantologists, maxillofacial surgeons, ENT, and microbiology specialists) on several clinical questions and to give clinical recommendations on how to prevent, diagnose, and treat postoperative infections.
Revisiting the Papilla in 2016 - Part 2 of 2
While different surgical techniques can restore most aspects of a ridge deficiency,as part of the soft tissue restorative frame, the regeneration of lost proximal papilla form is surgically limited to those papillae bordered on each side by a pontic The Classification of 6 types of papilla defects is based on the specifics of the restorative support on either side of the individual site,and can therefore be a tooth, implant or pontic, or combinations of the 3.
Crowns and Bridges