Long-Term Peri-Implant Health and Papilla Formation at Healed Sites by Chairside Provisionalization of Single-Tooth Implants: A Prospective Case Series.

PURPOSE: Several procedures are performed to achieve optimal esthetic results in single-tooth implants. However, there is discordance regarding the potential benefit and risks of immediate implant loading/provisionalization. The aim of this prospective case series is to investigate the effect of immediate provisionalization of single-tooth implants at healed sites for periimplant soft-tissue conditions, focusing on papilla formation around single implants. MATERIALS AND METHODS: Twelve patients received a total of 12 implants in the incisor, canine or premolar region of the upper and lower jaw at healed sites with immediate chair-side provisionalization. Four months later, the temporary crown was replaced by the permanent crown. After 40±13.1 months, clinical follow-up was conducted, assessing Probing pocket depth (PPD); Bleeding on Probing(BoP); Mucosal recession (MR) and Width of Keratinized Mucosa (KM). Papilla index (PI) was determined immediately after implant placement (baseline), before removing the temporary crown (t1), 4 weeks after insertion of the definitive crown (t2) and at the final follow-up examination (t3) to evaluate papilla formation and its change over time. RESULTS: None of the implants were lost. The mean PPD was 2.5±0.39 mm, BoP of 25% and 3.5 mm of KM were observed at the final follow-up. No implants showed MR. PI increased in all patients from 1.5±0.45 at baseline to 2.4±0.56 at t1, 2.6±0.47 at t2 and 3.02.6±0 at t3. The increase in PI between t0 and each individual timepoint from t1-t3 showed statistical significance. CONCLUSION: The present results indicate the suitability and benefit of immediate provisionalization to achieve favorable peri-implant soft-tissue conditions and papilla formation.

Short implants in the posterior maxilla to avoid sinus augmentation procedure: 5-year results from a retrospective cohort study.

BACKGROUND: Short implants present a promising approach for patients with advanced atrophy to avoid augmentative procedures. However, concerns about increased biological and technical complications due to an unfavorable implant-crown ratio are still present. PURPOSE: The aim of the present retrospective study was to evaluate whether a reduced implant length has any impact on implant success and peri-implant hard and soft tissue health in implants placed in the posterior maxilla to avoid sinus augmentation procedures. MATERIALS AND METHODS: Fourteen patients received a total of 30 implants of 7-mm length in the posterior maxilla. Implants with a mean loading period of 5 years (range 2-7 years) were followed up clinically and radiologically, with a focus on the peri-implant soft tissue parameters probing pocket depth (PPD), bleeding on probing (BoP), and the stability of the marginal peri-implant bone level. RESULTS: None of the implants were lost, and no technical failures occurred. A mean PPD of 2.5 mm, a mean BoP of 13.3%, and a mean marginal bone loss (MBL) of 0.5 mm indicate healthy peri-implant hard and soft tissue conditions without signs of peri-implantitis. DISCUSSION: The present results indicate the suitability of implants of 7-mm length to replace missing teeth in the posterior maxilla. An unfavorable implant-crown ratio or reduced bone-implant contact length seems to have no negative influence on midterm implant success or on peri-implant hard and soft tissue health.

Expansion of the peri-implant attached gingiva with a three-dimensional collagen matrix in head and neck cancer patients-results from a prospective clinical and histological study.

OBJECTIVES: Attached peri-implant gingiva has proven to have an influence on the long-term stability of dental implants. In patients with head and neck cancer, a functional peri-implant gingiva is even more of critical importance. The aim of the presented prospective study was to investigate a three-dimensional xenogeneic collagen matrix for augmentation around dental implants in patients with former head and neck cancer. MATERIAL AND METHODS: Eight patients presenting with insufficient peri-implant gingiva underwent vestibuloplasty on 51 implants using a xenogeneic collagen matrix. The clinical performance and the shrinking tendency of the matrix were analyzed in a cohort study. Furthermore, eight biopsies from the augmented regions were examined histologically to determine the biomaterial-related tissue reaction. RESULTS: Initially after vestibuloplasty, a mean width of attached gingiva of 4.4 ± 0.94 mm could be achieved. At clinical follow up investigation 6 months after vestibuloplasty, a mean width of 3.9 ± 0.65 mm attached peri-implant gingiva with a mean shrinking tendency of 14 % could be detected. Histological analysis of the biopsies revealed a well integrated collagen22 matrix covered with epithelium. Within the compact layer, mononuclear cells were observed only, while the spongious layer was infiltrated with a cell-rich connective tissue. CONCLUSION: Within its limits, the presented study revealed that the investigated collagen matrix is suitable to enlarge the peri-implant attached gingiva in head and neck cancer patients without adverse reactions or a multinucleated giant cell-triggered tissue reaction. CLINICAL RELEVANCE: The application of the investigated three-dimensional collagen matrix in vestibuloplasty achieved a sufficient amount of peri-implant attached gingiva in head and neck cancer patients. The favorable tissue reaction and the low shrinking tendency make the collagen matrix a promising alternative to autologous tissue grafts.

Rapid regression of Kaposi's sarcoma of the hard palate under therapy with boosted elvitegravir-containing fixdose antiretroviral combination therapy.

INTRODUCTION: Kaposi's sarcoma (KS) is a rare vascular tumor that may occur in a severe, rapidly progressive form, namely in HIV/AIDS patients. HIV-associated KS mainly affects the skin and mucous membranes. CASE PRESENTATION: We report about an HIV-positive patient who presented with an exophytic growing tumor in the region of the hard palate and severe problems regarding his dental status. Histological examination revealed evidence of AIDS-related KS. Antiretroviral therapy initiation with elvitegravir/cobicistat/emtricitabine(FTC)/tenofovirdisoproxilfumarat (E/c/F/T-fix dose combination) resulted in rapid complete remission of the KS within 2 months. CONCLUSION: In this case of a treatment-naive HIV-infected patient with coexisting KS, antiretroviral therapy with E/c/FTC/TDF was very well suited to achieve rapid complete remission of KS.

Visualization of localized elastic properties in human tooth and jawbone as revealed by scanning acoustic microscopy.

The elastic properties of human canine and supporting alveolar bone are measured by the distribution of localized speed of sound using scanning acoustic microscopy. Methods for the dynamic, non-destructive diagnostics of dental hard tissues can have a key role in the early detection of demineralization processes and carious lesions, and they are supposed to open the possibility of early dental restorations. The localized distribution of the ultrasound velocity in canine tooth and alveolar bone was obtained using scanning acoustic microscopy with a 5- and 30-MHz transducer. An acoustic material signature curve signifies the interference of the waves and quantitatively maps the localized speed of sound in alveolar bone and the canine tooth. Seven samples, consisting of alveolar jawbone and tooth sliced along the coronally apical axis, were investigated. The average speed of sound was determined along three independent cross sections at enamel, dentin and cortical bone. The average speed of sound in enamel, bone and dentin was SD 3460 ± 193 m/s, 3232 ± 113 m/s and 2928 ± 106 m/s. The distribution of sound wave propagation reveals a decrease in sound speed from the peripheral parts within the enamel and dentin layers toward the proximal zones. These results prove the possibility of linking the elastic properties to different areas within the osseous and dental hard tissues and visualize them in an extremely high local resolution. The results serve as a basis for further study and substantiate the enormous potential of ultrasound based analysis in the field of dento-alveolar diagnosis.