Implant Articles |
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A Decade of the Socket-Shield Technique: A Step-by-Step Partial Extraction Therapy Protocol
Ten years have passed since Hürzeler and coworkers
first introduced the socket-shield technique. Much has
developed and evolved with regard to partial extraction
therapy, a collective concept of utilizing the
patient’s own tooth root to preserve the periodontium
and peri-implant tissue. The specifications, steps, instrumentation,
and procedures discussed in this article
are the result of extensive experience in refining the
socket-shield technique as we know it today. A repeatable,
predictable protocol is requisite to providing
tooth replacement in esthetic dentistry. Moreover, a
standardized protocol provides a better framework for
clinicians to report data relating to the technique with
procedural consistency. This article aims to illustrate a
reproducible, step-by-step protocol for the socket-
shield technique at immediate implant placement
and provisionalization for single-rooted teeth.
Author(s): |
Howard Gluckman, BDS, MChD, PhD;Jonathan Du Toit, BChD, Dip Oral Surg, Dipl Implantol, MSc, MChD (OMP), FCD(SA) OMP, PhD;Maurice Salama, DMD;Katalin Nagy, DDS, DSc, PhD;Michel Dard, DDS, MS, PhD |
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Modified IVAN Technique: Long-Term Follow-Up of 20 Cases Over 2 to 11 Years
When natural teeth fail, frequently there is a loss of hard and soft tissue. This may complicate subsequent dental implant placement by
creating insufficient bone to house the implant. This also occurs when the tooth has been missing for an extended period, especially in the
premaxilla, where the bone is less dense and often lacks sufficient volume of facial bone. Site reconstruction to accommodate implant
placement often requires both hard and soft tissue augmentation. The modified interpositional vascularized augmentation neogenesis
(mIVAN) technique achieves the desired treatment goals in both delayed and immediate placement scenarios. The technique will be
discussed as well as the long-term follow-up on 20 cases.
Author(s): |
Snježana Pohl, MD, DMD;Gregori M. Kurtzman, DDS |
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The Modified IVAN Technique: Hard and Soft Tissue Augmentation at Extraction for Delayed Implant Placement
Failure of a natural tooth may not permit placement of
an implant at the time of extraction due to insufficiency
in available bone to house the implant. Reconstruction
of the extraction socket frequently involves both hard
and soft tissue augmentation to provide a site that can house
the implant and ridge contours that mimic the adjacent natural
anatomy. This situation becomes more problematic in the
maxillary anterior due to the anatomy and the lower density of
the bone of the premaxilla.
The solution is the interpositional vascularized augmentation
neogenesis (IVAN), which consists of hard tissue grafts, various
barrier membranes, and closure with the pediculated connective
tissue graft (PCTG). The modified IVAN (mIVAN) technique
achieves the necessary goals and may be used in both delayed
and immediate placement situations.
Author(s): |
Snježana Pohl, MD, DMD;Gregori M. Kurtzman, DDS |
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Bone Grafting Articles |
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Fibrinogen-Induced Regeneration Sealing Technique (F.I.R.S.T.). An Improvement and Modification of Traditional GBR: A Report of Two Cases
Guided bone regeneration is a technique widely known, clinicians know very well indications and
limitations of this technique. One of the principles to achieve bone augmentation and formation resides
in the stability of the blood clot forming under a barrier membrane. The technique proposed in this article
has the goal of providing stabilization to the bone graft by adding fibrin sealant (FS) to the bone graft and
also using the fibrin sealant to attach a bone membrane (cortical lamina) to the recipient site. This simple
modification of the technique of guided bone regeneration is presented in two successful cases.
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Recombinant Human Platelet– Derived Growth Factor: A Systematic Review of Clinical Findings in Oral Regenerative Procedures
The use of
recombinant human plateletderived
growth factor–BB (rhPDGF)
has received Food and Drug
Administration approval for the
treatment of periodontal and
orthopedic bone defects and dermal
wound healing. Many studies
have investigated its regenerative
potential in a variety of other oral
clinical indications. The aim of this
systematic review was to assess the
efficacy, safety, and clinical benefit
of recombinant human plateletderived
growth factor (rhPDGF) use
for alveolar bone and/or soft tissue
regeneration. Based on the
clinical evidence, rhPDGF is safe and
provides clinical benefits when used
in combination with bone allografts,
xenograft, or β-TCP for the treatment
of intrabony and furcation periodontal
defects and gingival recession or
when used with allografts or xenograft
for GBR and ARP.
Author(s): |
L. Tavelli, A. Ravidà, S. Barootchi, L. Chambrone, W.V. Giannobile |
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Modified IVAN Technique: Long-Term Follow-Up of 20 Cases Over 2 to 11 Years
When natural teeth fail, frequently there is a loss of hard and soft tissue. This may complicate subsequent dental implant placement by
creating insufficient bone to house the implant. This also occurs when the tooth has been missing for an extended period, especially in the
premaxilla, where the bone is less dense and often lacks sufficient volume of facial bone. Site reconstruction to accommodate implant
placement often requires both hard and soft tissue augmentation. The modified interpositional vascularized augmentation neogenesis
(mIVAN) technique achieves the desired treatment goals in both delayed and immediate placement scenarios. The technique will be
discussed as well as the long-term follow-up on 20 cases.
Author(s): |
Snježana Pohl, MD, DMD;Gregori M. Kurtzman, DDS |
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View Article>>
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The Modified IVAN Technique: Hard and Soft Tissue Augmentation at Extraction for Delayed Implant Placement
Failure of a natural tooth may not permit placement of
an implant at the time of extraction due to insufficiency
in available bone to house the implant. Reconstruction
of the extraction socket frequently involves both hard
and soft tissue augmentation to provide a site that can house
the implant and ridge contours that mimic the adjacent natural
anatomy. This situation becomes more problematic in the
maxillary anterior due to the anatomy and the lower density of
the bone of the premaxilla.
The solution is the interpositional vascularized augmentation
neogenesis (IVAN), which consists of hard tissue grafts, various
barrier membranes, and closure with the pediculated connective
tissue graft (PCTG). The modified IVAN (mIVAN) technique
achieves the necessary goals and may be used in both delayed
and immediate placement situations.
Author(s): |
Snježana Pohl, MD, DMD;Gregori M. Kurtzman, DDS |
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View Article>>
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Sinus Lift Articles |
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Survival of Implants after Indirect Maxillary Sinus Elevation Procedure: A Two Years Longitudinal Study
The aim of the study was to evaluate the survival rate of two diverse implant systems with different implant surfaces with the same geometrical design. In the present study, we achieved clinical success with both kinds of implant surfaces however Bioetched implant surface showed promising results comparable to Tiunite surface of Nobel BioCare Implants. In the future, more case-controlled studies with longer follow-up are needed to validate the results of the present findings.
Author(s): |
Lanka Mahesh, BDS, MBA;Ashutosh Agarwal; Jose C Guirado; Praful Bali; Nitika Poonia |
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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.
Author(s): |
Monish Bhola, DDS, MSD;Shilpa Kolhatkar; Tamika N. Thompson-Sloan |
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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.
Author(s): |
George A. Mandelaris, DDS, MS;Alan L. Rosenfeld, DDS, FACD |
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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.
Author(s): |
Lanka Mahesh, BDS, MBA;Dr. Manesh Lahori; Dr. Sagrika Shukla; Dr. Prerna Kaushik |
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Soft Tissue Articles |
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The Root Submergence Technique at Single Tooth Sites to Short-Span Edentulous Sites: A Step-By-Step Partial Extraction Therapy Protocol
Submerging roots for ridge preservation was the earliest partial extraction therapy and has been described since the 1970s. Despite the approximately 47 animal and human studies published since, an updated and contemporary step-by-step protocol has not yet been provided. This technique report describes in detail how to manage submerged roots at single tooth sites and at short-span edentulous areas.
Author(s): |
Jonathan Du Toit, BChD, Dip Oral Surg, Dipl Implantol, MSc, MChD (OMP), FCD(SA) OMP, PhD;Maurice Salama, DMD;Howard Gluckman, BDS, MChD, PhD;Katalin Nagy, DDS, PhD |
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View Article>>
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Fibrinogen-Induced Regeneration Sealing Technique (F.I.R.S.T.). An Improvement and Modification of Traditional GBR: A Report of Two Cases
Guided bone regeneration is a technique widely known, clinicians know very well indications and
limitations of this technique. One of the principles to achieve bone augmentation and formation resides
in the stability of the blood clot forming under a barrier membrane. The technique proposed in this article
has the goal of providing stabilization to the bone graft by adding fibrin sealant (FS) to the bone graft and
also using the fibrin sealant to attach a bone membrane (cortical lamina) to the recipient site. This simple
modification of the technique of guided bone regeneration is presented in two successful cases.
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Buccal Sliding Palatal Pedicle Flap Technique for Wound Closure After Ridge Augmentation
One standard approach for wound closure after ridge augmentation is coronal flap advancement. Coronal flap advancement results in displacement of the mucogingival junction and reduction of the vestibulum. In the maxilla, a buccal sliding palatal flap can be applied for primary wound closure after ridge augmentation. The dissected part of the palatal connective tissue is left exposed, thus eliminating or reducing the amount of the coronal flap advancement respectively and increasing the amount of keratinized gingiva. In combination with guided soft tissue augmentation, this flap design enables a three-dimensional peri-implant soft tissue augmentation.
Author(s): |
Snježana Pohl, MD, DMD;Maurice Salama, DMD;Pantelis Petrakakis, DDS, DPH |
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View Article>>
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A Decade of the Socket-Shield Technique: A Step-by-Step Partial Extraction Therapy Protocol
Ten years have passed since Hürzeler and coworkers
first introduced the socket-shield technique. Much has
developed and evolved with regard to partial extraction
therapy, a collective concept of utilizing the
patient’s own tooth root to preserve the periodontium
and peri-implant tissue. The specifications, steps, instrumentation,
and procedures discussed in this article
are the result of extensive experience in refining the
socket-shield technique as we know it today. A repeatable,
predictable protocol is requisite to providing
tooth replacement in esthetic dentistry. Moreover, a
standardized protocol provides a better framework for
clinicians to report data relating to the technique with
procedural consistency. This article aims to illustrate a
reproducible, step-by-step protocol for the socket-
shield technique at immediate implant placement
and provisionalization for single-rooted teeth.
Author(s): |
Howard Gluckman, BDS, MChD, PhD;Jonathan Du Toit, BChD, Dip Oral Surg, Dipl Implantol, MSc, MChD (OMP), FCD(SA) OMP, PhD;Maurice Salama, DMD;Katalin Nagy, DDS, DSc, PhD;Michel Dard, DDS, MS, PhD |
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Periodontic Surgery Articles |
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The Root Submergence Technique at Single Tooth Sites to Short-Span Edentulous Sites: A Step-By-Step Partial Extraction Therapy Protocol
Submerging roots for ridge preservation was the earliest partial extraction therapy and has been described since the 1970s. Despite the approximately 47 animal and human studies published since, an updated and contemporary step-by-step protocol has not yet been provided. This technique report describes in detail how to manage submerged roots at single tooth sites and at short-span edentulous areas.
Author(s): |
Jonathan Du Toit, BChD, Dip Oral Surg, Dipl Implantol, MSc, MChD (OMP), FCD(SA) OMP, PhD;Maurice Salama, DMD;Howard Gluckman, BDS, MChD, PhD;Katalin Nagy, DDS, PhD |
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View Article>>
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Buccal Sliding Palatal Pedicle Flap Technique for Wound Closure After Ridge Augmentation
One standard approach for wound closure after ridge augmentation is coronal flap advancement. Coronal flap advancement results in displacement of the mucogingival junction and reduction of the vestibulum. In the maxilla, a buccal sliding palatal flap can be applied for primary wound closure after ridge augmentation. The dissected part of the palatal connective tissue is left exposed, thus eliminating or reducing the amount of the coronal flap advancement respectively and increasing the amount of keratinized gingiva. In combination with guided soft tissue augmentation, this flap design enables a three-dimensional peri-implant soft tissue augmentation.
Author(s): |
Snježana Pohl, MD, DMD;Maurice Salama, DMD;Pantelis Petrakakis, DDS, DPH |
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View Article>>
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A Decade of the Socket-Shield Technique: A Step-by-Step Partial Extraction Therapy Protocol
Ten years have passed since Hürzeler and coworkers
first introduced the socket-shield technique. Much has
developed and evolved with regard to partial extraction
therapy, a collective concept of utilizing the
patient’s own tooth root to preserve the periodontium
and peri-implant tissue. The specifications, steps, instrumentation,
and procedures discussed in this article
are the result of extensive experience in refining the
socket-shield technique as we know it today. A repeatable,
predictable protocol is requisite to providing
tooth replacement in esthetic dentistry. Moreover, a
standardized protocol provides a better framework for
clinicians to report data relating to the technique with
procedural consistency. This article aims to illustrate a
reproducible, step-by-step protocol for the socket-
shield technique at immediate implant placement
and provisionalization for single-rooted teeth.
Author(s): |
Howard Gluckman, BDS, MChD, PhD;Jonathan Du Toit, BChD, Dip Oral Surg, Dipl Implantol, MSc, MChD (OMP), FCD(SA) OMP, PhD;Maurice Salama, DMD;Katalin Nagy, DDS, DSc, PhD;Michel Dard, DDS, MS, PhD |
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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.
Author(s): |
Howard Gluckman, BDS, MChD, PhD;Maurice Salama, DMD;Jonathan Du Toit, BChD, Dipl Implantol, Dipl Oral Surg, MSc Dent |
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Other Surgical Articles |
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Socket Shield Technique - Implantology Today
The socket shield procedure is an effective
surgical technique for implant supported
restorations. It helps in preserving the labial
bone and soft tissue architecture around
osseointegrated implants. The procedure provides
comparable or better outcomes compared
to other conventional alternatives at a
lower cost.
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The “Scalloped Guide”: A Proof-of-Concept Technique for a Digitally Streamlined, Pink-Free Full-Arch Implant Protocol
Inadequate restorative space can result in mechanical, biologic, and esthetic
complications with full-arch fixed implant-supported prosthetics. As such,
clinicians often reduce bone to create clearance. The aim of this paper was
to present a protocol using stacking computer-aided design/computerassisted
manufacturing (CAD/CAM) guides to minimize and accurately
obtain the desired bone reduction, immediately place prosthetically guided
implants, and load a provisional that replicates predetermined tissue contour.
This protocol can help clinicians minimize bone reduction and place the
implants in an ideal position that allows them to emerge from the soft tissue
interface with a natural, pink-free zirconia fixed dental prostheses.
Author(s): |
Maurice Salama, DMD;Prof. Dr. Alessandro Pozzi;Wendy AuClair-Clark, DDS, MS;Marko Tadros, DMD;Lars Hansson, CDT, FICOI;Pinhas Adar, MDT, CDT |
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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.
Author(s): |
Markus B. Hürzeler, DMD, PhD;Daniel Bäumer, DDS; Otto Zuhr, DDS; Stephan Rebele, DDS; David Schneider, DDS, PhD; Peter Schupbach, PhD |
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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.
Author(s): |
Monish Bhola, DDS, MSD;Nomahn Humayun; Shilpa Kolhatkar; Jason Souiyas |
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