Five decades of research on immediate implant therapy: A modern bibliometric network analysis via Altmetric and level of evidence mapping.

AIM: To conduct a bibliometric network analysis to explore the research landscape of immediate implant placement (IIP) and provide insights into its trends and contributors. MATERIALS AND METHODS: The Scopus database was utilized as the bibliographic source, and a search strategy was implemented to identify relevant research articles. Various bibliometric parameters were extracted, including publication year, journal, authors, citations, and funding. The analysis involved examining authorship patterns, international collaborations, level of evidence, Altmetric data, and funding analysis. RESULTS: We identified a steady annual growth rate of 6.49% in IIP research. The top three countries contributing to research output were the USA, Italy, and China. Prolific authors were identified based on publication and citation metrics. International collaborations among different countries were observed. The level of evidence analysis revealed that over 30% of the articles fell into higher levels of evidence (levels 1 and 2). Altmetric data analysis indicated no significant correlations between citation counts and Altmetric Attention Score (AAS), and conversely a significant association with Mendeley readers count. Funding and open access did not significantly impact the bibliometric indices of the papers. CONCLUSIONS: The focus of research on IIP has been evolving as indicated by an exponential growth rate in this study. Only approximately 16% of the articles fit into level 1 evidence, therefore, emphasizing on higher quality level research study shortage in this field. Modern indices can be used as new bibliometric indicators as they also cover social media and online attention scores.

Orthodontic tooth extrusion to regenerate missing papilla adjacent to maxillary anterior single implants: A 2- to 7-year retrospective study.

INTRODUCTION: Regeneration of the missing papilla adjacent to single implants in the esthetic zone has always been challenging, despite advances in vertical hard and soft tissue regeneration. Orthodontic tooth extrusion has been shown to effectively gain alveolar bone and gingival tissue. This retrospective study evaluated the effectiveness of orthodontic tooth extrusion on regenerating missing papilla between existing maxillary anterior single implant and its adjacent tooth. METHODS: Patients who underwent orthodontic tooth extrusion to regenerate missing papilla adjacent to a single implant in the esthetic zone were included in this study. The gingival phenotype, orthodontic extrusion movement, proximal bone level, dento-implant papilla level, facial gingival level, mucogingival junction level, and keratinized tissue width, of the extruded tooth were recorded at pre-orthodontic extrusion (T0 ), post-orthodontic extrusion and retention (T1 ), and latest follow-up (T2 ). RESULTS: A total of 17 maxillary single tooth had orthodontic tooth extrusion to regenerate missing papilla adjacent to 14 maxillary anterior single implants in 14 patients. After a mean follow-up time of 48.4 months, implant success rate was 100% (14/14), with none of the orthodontically extruded teeth being extracted. After a mean extrusion and retention period of 14.3 months, a mean orthodontic extrusion movement of 4.62 ± 0.78 mm was noted with a mean proximal bone level gain of 3.54 ± 0.61 mm (77.0% efficacy), dento-implant papilla level gain of 3.98 ± 0.81 mm (86.8% efficacy), and facial gingival tissue gain of 4.27 mm ± 0.55 mm (93.4% efficacy). A mean keratinized tissue width gain of 4.17 ± 0.49 mm with minimal mean mucogingival junction level change of 0.10 ± 0.30 mm were observed. The efficacy of orthodontic eruption movement on dento-implant papilla gain was less in the thin (80.5%) phenotype group when compared with that in the thick (91.5%) phenotype group. CONCLUSIONS: Within the confines of this study, orthodontic extrusion is an effective, noninvasive method in regenerating mid-term stable proximal bone and papilla adjacent to maxillary anterior single implants. CLINICAL SIGNIFICANCE: This retrospective study presents a mid-term result on orthodontic extrusion as a mean to regenerate dento-implant papilla defect. The extended retention period following orthodontic extrusion showed stable and efficacious proximal bone and papilla gain.

Proposal regarding horizontal and vertical positioning of single implants placed in healed sites: Effect on cervical crown form and the need for bone grafting.

STATEMENT OF PROBLEM: When single implants are placed in healed sites, guidelines are lacking on the horizontal and vertical implant positions that optimize cervical crown form and the implant locations that would require bone grafting to develop the optimal crown form. PURPOSE: The purpose of this clinical study was to evaluate the cervical contour of wax patterns formed on casts of single implants placed in healed sites and to determine which horizontal and vertical implant positions produced the best cervical crown form and which indicated the need for bone grafting. MATERIAL AND METHODS: Fifty-eight wax patterns were fabricated on casts where implants had been placed in healed sites without bone grafting. The wax patterns were subjectively assessed by 5 dental faculty members and 5 graduate students as having good, fair, or poor cervical crown form. Horizontal measurements were made between the facial surface of the implant and a round metal wire connecting the gingival zeniths of the adjacent teeth. Vertical measurements were also made between the wire and implant platform. The subjective assessments along with the horizontal and vertical implant position measurements were used to propose guidelines for optimal implant placement in healed sites. RESULTS: Horizontal distances of 2.0 to 3.0 mm produced good cervical crown contours, with distances >3.0 mm and <2.0 mm resulting in fair or poor assessments. Vertical distances of 3.0 to 4.0 mm were judged to have good cervical crown contour, whereas depths of 1.0 mm or less were assessed as poor. CONCLUSIONS: Based on the subjective assessment of wax patterns formed on casts of single implants placed in healed sites, a guideline of 2.0 to 3.0 mm is proposed for the horizontal distance between a line connecting the adjacent gingival zeniths and the facial surface of the implant. A vertical distance guideline of 3.0 to 4.0 mm is proposed between the adjacent gingival zeniths and the implant platform.

Facial implant gingival level and thickness changes following maxillary anterior immediate tooth replacement with scarf-connective tissue graft: A 4-13-year retrospective study.

OBJECTIVE: A scarf-shaped connective tissue graft can be placed at the facial and proximal aspect of the peri-implant soft tissue zone during immediate implant placement and provisionalization (IIPP) procedures in the esthetic zone to optimize implant esthetics without the need of flap reflection. This retrospective study evaluated soft tissue stability after scarf-connective tissue graft (S-CTG) in conjunction with IIPP procedures in the esthetic zone. MATERIALS AND METHODS: Patients who received IIPP with S-CTG with a minimum 1-year follow-up were evaluated. Mid-facial gingival level (MFGL) change and mid-facial gingival thickness (MFGT) change were measured and compared at the pre-op (T0), IIPP + S-CTG surgery (T1), follow up appointment with MFGT measurement (T2), and latest follow-up appointment (T3). Implant success rate and graft necrosis were also recorded. RESULTS: A total of 22 IIPP and S-CTG procedures in 20 patients were evaluated in the study. After a mean follow-up of 8.2 years (3.9-13.4) (T3), all implants remained osseointegrated (22/22 [100%]), with statistically insignificant mean midfacial gingival level change of -0.19 mm (-1.5 to 0.8). Statistically significant difference in midfacial gingival thickness (MFGT) was noted (2.5 mm [1.8-3.5 mm]) after a mean follow-up time (T2) of 2.3 years (1-8.6) when compared with MFGT at baseline (1.1 mm [0.6-1.3 mm]) (T1). Necrosis of S-CTG during initial healing phase was noted in 9% (2/22) of the sites. CONCLUSIONS: Within the confines of this study, scarf-connective tissue graft at time of immediate implant placement and provisionalization can thicken the gingiva and maintain the gingival level at the critical soft tissue zone. CLINICAL SIGNIFICANCE: Managing the soft tissue zone is as important as that of the hard tissue zone for peri-implant esthetics. Connective tissue graft is one of the methods that can enhance the final esthetic outcomes. This retrospective study has demonstrated that Scarf-CTG technique is an effective treatment modality to maintain soft tissue stability.

A decision-making tree for evaluating an esthetically compromised single dental implant.

OBJECTIVE: To develop a comprehensive decision-making tree for evaluating mid-facial peri-implant soft tissue dehiscence in the esthetic zone and provide a systematic approach for assessing various clinical case scenarios, determining appropriate treatment strategies, and considering factors such as the need for soft tissue augmentation, prosthetic changes, or implant removal. CLINICAL CONSIDERATIONS: This clinical decision tree illustrates numerous case scenarios with various esthetic complications around an esthetically compromised, but clinically healthy single implant and provides clinicians with possible solutions as a predictable map for horizontal and vertical soft tissue augmentation in order to manage different clinical circumstances. According to current evidence, the key to treating such esthetic complications is the use of an adequate pre-surgical prosthetic interdisciplinary approach with proper surgical techniques in order to optimize soft tissue dimensions and create better esthetic results. This may be accomplished through a purely surgical, combination of surgical and prosthetic, or purely prosthetic approaches. CONCLUSIONS: The present report describes a series of successfully treated peri-implant esthetic complication cases in accordance with the decision-making tree that the authors recommend in order to achieve better long-term esthetic outcomes. CLINICAL SIGNIFICANCE: The combination of adequate pre-surgical prosthetic interdisciplinary collaboration and proper surgical technique is critical in the optimization of sufficient soft tissue dimensions and contributes to a more highly esthetic result. This study demonstrates a clinical decision-making tree to provide comprehensive, effective therapy of an esthetically compromised dental implant by using one of the following approaches: purely prosthetic, purely surgical, or a combination of surgical and prosthetic with or without abutment removal.

Artificial intelligence models for diagnosing gingivitis and periodontal disease: A systematic review.

STATEMENT OF PROBLEM: Artificial intelligence (AI) models have been developed for periodontal applications, including diagnosing gingivitis and periodontal disease, but their accuracy and maturity of the technology remain unclear. PURPOSE: The purpose of this systematic review was to evaluate the performance of the AI models for detecting dental plaque and diagnosing gingivitis and periodontal disease. MATERIAL AND METHODS: A review was performed in 4 databases: MEDLINE/PubMed, World of Science, Cochrane, and Scopus. A manual search was also conducted. Studies were classified into 4 groups: detecting dental plaque, diagnosis of gingivitis, diagnosis of periodontal disease from intraoral images, and diagnosis of alveolar bone loss from periapical, bitewing, and panoramic radiographs. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. RESULTS: Twenty-four articles were included: 2 studies developed AI models for detecting plaque, resulting in accuracy ranging from 73.6% to 99%; 7 studies assessed the ability to diagnose gingivitis from intraoral photographs reporting an accuracy between 74% and 78.20%; 1 study used fluorescent intraoral images to diagnose gingivitis reporting 67.7% to 73.72% accuracy; 3 studies assessed the ability to diagnose periodontal disease from intraoral photographs with an accuracy between 47% and 81%, and 11 studies evaluated the performance of AI models for detecting alveolar bone loss from radiographic images reporting an accuracy between 73.4% and 99%. CONCLUSIONS: AI models for periodontology applications are still in development but might provide a powerful diagnostic tool.

Effects of cyclic loading on loss of abutment screw torque of angled screw channel single implant crowns on narrow diameter implants.

STATEMENT OF PROBLEM: Screw access channels that emerge on the facial aspect of anterior screw-retained implant crowns can compromise esthetics. Recently, angled screw channels (ASCs) have been developed that can alter screw access channel angulations to improve esthetics. While ASCs can be used on narrow-diameter implants, information is limited on the loss of abutment screw torque on narrow-diameter implants with ASCs. PURPOSE: The purpose of this in vitro study was to compare the loss of abutment screw torque after thermocycling and the cyclic loading of ASCs from 3 different companies connected to narrow-diameter implants. MATERIAL AND METHODS: A total of 40 narrow-diameter implants (NobelReplace Conical Connection 3.5×11.5 mm) were mounted individually in acrylic resin blocks and divided equally into 4 groups. The first group, NB-0 (Control), consisted of screw-retained zirconia crowns fabricated on ASCs at 0-degree angulation (n=10). The other 3 groups consisted of a total of 30 screw-retained zirconia crowns fabricated on ASCs at 20-degree angulation: NB-20 (Angulated Screw Channel Solutions), ATL-20 (Atlantis Custom Base Solution with angulated screw access), and DA-20 (Dynamic TiBase). Each crown was secured on the mounted implant with its corresponding titanium base insert and screw and then tightened to the manufacturer's recommended torque with a digital torque gauge. The initial reverse torque value (RTVI) was obtained and recorded at baseline. Subsequently, a new set of screws were tightened to recommended values, and each specimen underwent thermocycling and then cyclic loading at 0 to 100 N at 10 Hz for 1 million cycles to simulate 1year of functional loading. After cyclic loading, the final reverse torque values (RTVF) were recorded and compared with the RTVI to evaluate the percentage torque loss (PTLF). Statistical analysis was performed using the Kruskal-Wallis analysis, Rank base analysis of covariance (ANCOVA), and the Tukey HSD post hoc comparisons (α=.05). RESULTS: Significant differences were found for the PTLF among all groups after cyclic loading (P<.001). The PTLF in ATL-20 (51.4%) was significantly higher than in NB-0 (22.2%) (P<.001) and NB-20 (29.2%) (P=.010). No significant difference was found in the PTLF among other groups (P>.05). CONCLUSIONS: The abutment screw torque loss after cyclic loading of the ASCs on narrow diameter implants among the 4 groups did not perform comparably. The largest percentage torque loss was recorded for the ATL-20 group. The NB-20 group demonstrated the lowest percentage torque loss. DA-20 showed percentage torque loss less than ATL-20; however, its RTVF was the lowest.

Guided Lateral Window Osteotomy Using Dynamic Navigation for Maxillary Sinus Augmentation: A Novel Technique.

The size and the position of the sinus antrostomy play a key role in making sinus grafting surgery more predictable and effective with less complications. A cone beam computed tomography and intraoral scan of the maxilla were taken for a patient who is missing maxillary first molar tooth with limited residual bone. Data were exported to the dynamic navigation (DN) system software. Sinus lateral window osteotomy position and dimensions were determined and planned using four 1.5 mm diameter implants placed on the maxillary sinus lateral wall. The osteotomy was initiated following the planned four 1.5 mm implants in a parallel motion to the bone surface using dynamic navigation guidance; thus, creating an outline for the lateral sinus window. Afterword's, the lateral sinus window was greenstick fractured and the membrane was lifted; first molar implant osteotomy done, implant placed, and bone graft material was placed. The flap was sutured, and post-operative instructions and medications were given. No post-operative complications noticed. The outline of the lateral window osteotomy along with implant osteotomy can be accurately planned and executed using DN technology, which may potentially reduce complications and insure accurate placement of the implant and the graft.

Facial Contour Preservation of Anterior Immediate Single-Tooth Replacement With the Socket Shield Technique Versus Connective Tissue Graft: A Case Report.

The socket shield technique and subepithelial connective tissue graft following immediate implant placement with provisionalization had been advocated for peri-implant facial contour and gingival architecture preservation. This case report used three-dimensional volumetric analysis to longitudinally assess the peri-implant facial contour change before and after these procedures. The results demonstrated comparable and acceptable preservation of peri-implant facial contour between the two procedures after 2 years of function.

Navigation guided socket-shield technique for implant and pontic sites in the esthetic zone: A proof-of-concept 1-year prospective study with immediate implant placement and loading.

OBJECTIVE: To assess clinical, radiological performance of novel navigation guided socket-shield technique (NSS) with immediate implant placement and loading. MATERIALS AND METHODS: Eighteen patients (12 females; age 52.54 ± 4.92; 33-72) treated between January 2018 and June 2019, were investigated, and followed for at least 1 year after definitive prosthesis placement (mean 20.1 months, 18-23). Primary outcomes: implant and prosthetic success rates, surgical, biologic, prosthetic complications. SECONDARY OUTCOMES: marginal bone loss (MBL), implant stability quotient (ISQ), pink esthetic score (PES), plaque and bleeding indexes. RESULTS: Sixty-nine navigation guided socket-shield procedures were performed (27 implant-sites and 42 pontic-sites) and 27 implants (NobelParallel, NobelBiocare AG) positioned and immediately loaded. Mean insertion torque and ISQ at implant positioning were 49 ± 5.34 Ncm (36-74), 73 ± 5.72 (68-81). No implant failure was experienced. Two root-shield exposures with mucositis, ulceration and bleeding were reported at two pontic-sites (2.9%) and successfully treated. No complications were experienced at implant-site leading to an overall NSS success-rate of 100%. No prosthetic complications occurred. Mean MBL was -0.72 ± 0.26 mm (-0.42 to -1.06 mm). PES final at the last follow-up 12.84 ± 0.92. The plaque and bleeding scores were 18.5 ± 6.12 and 3.15 ± 2.21. CONCLUSIONS: Within study limitations, dynamic navigation was effective to streamline execution of socket-shield technique at implant and pontic sites, shortening treatment time and reducing complications. Navigation guided socket-shield technique was reliable to achieve digitally planned shield-to-implant distance, facilitate immediate implant placement and loading and establish the mucosal dimension needed for underlying bone-to-implant protection and esthetic integration. CLINICAL SIGNIFICANCE: The investigated NSS technique overcomes the difficulties related to root preparation at implant and pontic-sites, facilitating immediate implant placement and loading. Dynamic guided surgery contributed to make socket-shield technique less technical-sensitive, shortening time for execution, reducing complication rate.

Exposure of Barriers Used in Guided Bone Regeneration: Rate, Timing, Management, and Effect on Grafted Bone-A Retrospective Analysis.

The purpose of this study is to compare the exposure rate of 3 different barrier types after a guided-bone regeneration procedure as well as to compare the percentage grafted bone dimensional loss with and without exposed barriers. Patient records from September 2007 to May 2015 were reviewed to identify subjects who had received a bone graft followed by implant placement procedure after the graft had completely healed. The subjects were divided into 3 groups: (1) resorbable barrier, (2) nonresorbable barrier, and (3) titanium-mesh barrier. Incidences of barrier exposure were recorded. Cone-beam computerized tomography images before treatment (T0), right after grafting (T1), and after healing (T2) were used to determine the percentage of grafted bone dimensional loss and am quantitative amount of grafted bone remaining (mm2). Three cross-sectioned areas, at 1-mm apart, of preplanned implant positions at the grafted site were measured using cone-beam computerized tomography to calculate the remaining grafted bone and grafted bone dimensional change. The exposure rate of all guided bone regeneration was 36.9%. The exposure rate of the resorbable barrier (23.3%) was significantly lower than titanium mesh (68.9%) and nonresorbable (72.7%; χ2, P < .001). The results of this study revealed that barrier types have a significant effect on the exposure rate. There was also a significant difference in grafted bone dimensional loss between sites with barrier exposure (58.3%) and sites with no barrier exposure (44.1%) during the healing period (Mann-Whitney U test, P = .008).

Heat and Sound Generation During Implant Osteotomy When Using Different Types of Drills in Artificial and Bovine Bone Blocks.

The purpose of this study was to compare heat and sound generated during implant osteotomy when different types of drill were used in artificial bone and bovine bone blocks. A total of 80 implant osteotomies were formed using 4 implant drilling systems: N1 (OsseoShaper) (Nobel), NobelActive (Nobel), V3 (MIS), and BLX (Straumann) in both artificial bone and bovine bone blocks. Thermocouple probes were used to record temperature change at the depths of 5.0 mm and 13.0 mm of each implant osteotomy formed by the final drill. In addition, thermographic images, drilling sound, and drilling time were recorded and evaluated. Statistical analyses were performed at α = 0.05. The mean temperature changes as recorded by thermocouple probes and thermocamera were significantly lower in OsseoShaper than most other drill-bone combinations (P < .05). The mean drilling times and sound generation for OsseoShaper were significantly higher and lower than most other drill-bone combinations (P < .05), respectively. Minimal heat and sound generation can be expected when implant osteotomies are performed using OsseoShaper at a low rotational speed (50 rpm) even without irrigation. However, extended drilling time is required.

Clinical and radiological outcomes of novel digital workflow and dynamic navigation for single-implant immediate loading in aesthetic zone: 1-year prospective case series.

OBJECTIVES: To evaluate clinical, radiological performance of novel digital workflow integrating dynamic navigation to streamline in one-visit single-implant immediate loading in aesthetic zone. MATERIAL AND METHODS: Consecutive patients requiring one single-implant in aesthetic zone of both jaws were treated between May and September 2017. Primary outcomes were implant and prosthetic success rates, surgical and prosthetic complications, marginal bone loss (MBL), final pink aesthetic score (PES-f), and implant stability quotient (ISQ-f). Secondary outcomes were ISQ-0 and PES-0 at implant positioning and PES-p at definitive prosthesis placement. Potential effect of jaw (maxilla vs mandible), biotype (thin vs thick), type of incision (flap vs flapless), and implant site (healed vs. post-extractive) on the primary outcomes (MBL, PES-f, and ISQ-f) was evaluated through a multivariable analysis. RESULTS: Fifty-two implants were placed (follow-up 18.6, 15-20 months). One post-extractive implant failed. No other surgical, biological complications occurred, accounting for 98.10% cumulative success rate (CSR). No definitive prostheses failed. Mean MBL was -0.63 ± 0.25 mm (-1.69 to -0.06). PES-f was 12.34 ± 1.41 (9-14). ISQ-f was 78.1 ± 3.2 (70-84). Age had significantly negative effect on MBL and PES-f (p = .0058 and p = .0052). No other variables significantly affected primary outcomes. CONCLUSIONS: Within study limitations, investigated digital workflow integrating dynamic navigation was reliable for single-implant immediate loading in aesthetic zone in one visit. No statistically significant difference was found for MBL, PES-f, and ISQ-f, considering type of incision (flap vs. flapless), implant site (healed vs post-extractive), jaw (maxilla vs. mandible), and biotype (thick vs. thin). Live-tracked dynamic navigation may have contributed to improve operator clinical performance regardless of implant site characteristics. Further investigations are needed to confirm positive outcomes.

Abutment screw torque changes with straight and angled screw-access channels.

STATEMENT OF PROBLEM: Angle-correcting options allow the use of screw-retained implant prostheses in situations where an implant has been placed with a facial inclination. However, manufacturers have different recommended torque values, and it is unclear whether the performance of these designs is equivalent to that of the traditional screw-retained crowns (SRCs) when subjected to cyclic loading forces. PURPOSE: The purpose of this in vitro study was to compare torque differences between conventional straight-line screw access and angulated access SRCs before and after simulated functional loading. MATERIAL AND METHODS: Five groups consisting of 10 SRCs and implants were formed: Nobel Biocare zirconia crowns with 20-degree access channels (NB-20); Dynamic Abutment Solution zirconia crowns (DA-20) with 20-degree access channels; Core3dcentre angle correction zirconia crowns with 20-degree access channels (C3D-20); Nobel Biocare zirconia crowns with 0-degree access channels (NB-0); and gold alloy crowns cast to Nobel Biocare Gold-Adapt abutments (GA-0). Each specimen underwent thermocycling before cyclic loading. A preload torque based on the manufacturer's recommendation was applied to each crown placed on an implant. Reverse torque measurements were obtained for each specimen before cyclic loading. Each implant-abutment assembly was then cyclic loaded at 0 to 100 N at 10 Hz for 1 million cycles. Reverse torque measurements were obtained after cyclic loading and the percentage difference calculated. RESULTS: No significant percentage torque loss differences were observed between the 0-degree and 20-degree SRCs after cyclic loading. No significant differences were seen among the angulated access channel crowns. DA-20 and C3D-20 specimens had significantly higher torque loss compared with the NB-0 group. The C3D-20 group reported the largest percentage torque loss (34.5%) among the angulated access screw channel groups. The GA-0 group reported the largest percentage torque loss of all the groups (35.9%). No crown mobility or other complications were observed in any of the groups after cyclic loading. CONCLUSIONS: Angulated access channel crowns performed comparably with conventional straight-line screw access SRCs with regard to percentage torque values after cyclic loading. Angulated access channel crowns with lower manufacturer recommended torque values had higher percentage torque differences.

Facial Gingival Changes With and Without Socket Gap Grafting Following Single Maxillary Anterior Immediate Tooth Replacement: One-Year Results.

This 1-year prospective study evaluated horizontal and vertical facial gingival tissue changes after immediate implant placement and provisionalization (IIPP) with and without bone graft in the implant-socket gap (ISG). During IIPP, 10 patients received bone graft material in the ISG (G group), while the other 10 patients did not (NG group). The implants were evaluated for implant stability quotient (ISQ), modified plaque index (mPI), modified bleeding index (mBI), marginal bone level (MBL), facial gingival level (FGL), and facial gingival profile (FGP) changes. The mean ISQ value at 9-month follow-up was statistically significantly greater than on the day of implant surgery (P < .05). The mPI and mBI scores demonstrated that patients were able to maintain a good level of hygiene. There were no statistically significant differences in the mean MBL changes between the G and NG groups (P > .05). There were statistically significant differences in FGL changes between the G (-0.77 mm) and NG (-1.35 mm) groups (P = .035). There were no statistically significant differences in FGP changes between the G and NG groups (P > .05). However, statistically significant differences were noted in FGP change between the 3-12 and 0-12 month intervals in both groups (P < .05). Within the limitations of this study, although no significant differences were noted in FGP changes between groups, G group experienced significantly less FGL changes than NG group. Bone graft material placement into ISG seems to be advantageous for tissue preservation during IIPP. However, future long-term studies, with larger sample size, are needed to validate the efficacy of such procedure.

Accuracy of 3D Printed Models Created by Two Technologies of Printers with Different Designs of Model Base.

PURPOSE: To evaluate the accuracy of three-dimensional (3D) printed models manufactured using two different printer technologies with different model base designs. MATERIALS AND METHODS: A maxillary typodont was scanned using a desktop scanner to generate the Standard Tessellation Language (STL) file as a reference scan. After the scanning procedure, the STL file was exported to Model Builder™ for designing the following two types of the model bases: a solid base design and a hollow base design with a 2.0 mm thickness of the external shell. Each design was printed to produce 10 models using a Continuous Liquid Interface Production (CLIP) printer and a Digital Light Processing (DLP) printer. The following four groups were tested: CLIP with solid base (CS); CLIP with hollow base (CH); DLP with solid base (DS); and DLP with hollow base (DH). A total of 40 models were scanned using the same desktop scanner to generate the STL files for evaluation of the accuracy by evaluation of trueness and precision. All STL files were superimposed with the control STL file via surface matching software and a comparison was performed using the 3D color mapping function and a 2D comparison of 48 points selected on the tested model. The data were collected by measuring the deviation between the tested model and the reference scan. Trueness was calculated by using the comparison among four tested groups. The Kruskal-Wallis analysis was conducted to assess the overall statistical significance of differences among the tested groups (α = 0.05). For precision measurement, the evaluation was conducted using Intraclass Correlation Coefficient (ICC) value at 95% confident interval to determine the deviation within the same tested groups. RESULTS: The median values for the deviated distance of the four tested groups were 0.045 (CH), 0.035 (CS), 0.077 (DH), and 0.077 mm (DS). There were no statistically significant differences between the trueness of the two groups when using the same printers regardless of the designs of model base (p > 0.05). However, when comparing the two printers using the same model base design and the two different designs of model base, there were statistically significant differences in trueness (p < 0.05). The 3D printed models created using CLIP technology had higher trueness than the DLP technology printer. Precision of the 3D printed model was displayed in ICC value. The ICC values of four tested groups were 0.968 (CH), 0.981 (CS), 0.969 (DH), and 0.983 (DS). All tested groups were classified as exhibiting an excellent level of precision based on 95% confident interval of the ICC estimation. CONCLUSIONS: The accuracy of 3D printed models was affected by the printer technology regardless of whether the model base was solid or hollow. The CLIP technology printer produced significantly less variation from the reference model than the DLP printer. However, all of the 3D printed models were determined to exhibit a clinically acceptable level of accuracy based on the recorded dimensions being less than 100 µm different than the reference model.

Adhesive residue on the CAD-CAM surgical guide sleeve: A technical report.

Computer-aided design and computer-aided manufacturing (CAD-CAM) surgical guides can be used by the clinician and dental technician to create a definitive cast before surgery, thereby allowing an indirect interim restoration to be fabricated. However, the accurate transfer of the interim restoration from the laboratory to the surgical site requires a precise interface between components. This article reports the prosthetic significance of adhesive residue on the intaglio surface of the CAD-CAM surgical guide sleeve, which can create errors in the implant analog position of the definitive cast. A technique for identifying the presence of residue and its careful removal are also introduced.

Immediate implant placement and provisionalization of maxillary anterior single implants.

An inevitable loss of soft and hard tissue after tooth extraction often results in a compromised site for anterior implant esthetics in both vertical and horizontal dimensions. Immediate implant placement and provisionalization has been a viable option for replacing failing maxillary anterior teeth as it preserves the vertical existing osseous and gingival architecture. With the simultaneous addition of soft- and hard-tissue grafts, the peri-implant horizontal tissue topography can also be maintained. The esthetic success of immediate implant placement and provisionalization procedures is influenced by a number of factors that can be identified as patient-dependent or clinician-dependent. This article describes in detail the process of patient selection, indications, contraindications, diagnosis, treatment planning and treatment execution required to achieve functional and esthetic success with immediate implant placement and provisionalization.

Marginal bone response of implants with platform switching and non-platform switching abutments in posterior healed sites: a 1-year prospective study.

OBJECTIVES: This 1-year prospective study evaluated the implant success rate and marginal bone response of non-submerged implants with platform and non-platform switching abutments in posterior healed sites. MATERIAL AND METHODS: Nineteen patients (9 male, 10 female) with posterior partially edentulous spaces, between the ages of 23 and 76 (mean = 55.4 years), were included in this study. A total of 30 implants (15 implants restored with platform switching [PS] abutments [control] and 15 implants restored with non-platform switching [NPS] abutments [test]) were assigned between two groups using a randomization procedure. The definitive abutments with conical connections were placed at the time of surgery, and the definitive restorations were placed at 3 months. All patients were evaluated clinically and radiographically using standardized radiographs at time of implant placement (0), 3, 6 and 12 months after implant placement. Data were analyzed using Friedman test with post hoc pairwise comparisons, Mann-Whitney U-test, and Pearson's chi-square test at the significance level of α = 0.05. RESULTS: At 12 months, all 30 implants remained osseointegrated corresponding to a 100% success rate. The overall mean marginal bone level change at 12 months was -0.04 ± 0.08 mm for PS group and -0.19 ± 0.16 mm for NPS group. Statistically significant difference in the marginal bone level change was observed between groups at 0 to 12 months and 3 to 12 months (P < 0.05). CONCLUSIONS: This 1-year randomized control study suggests that when a conical implant-abutment connection is present, similar peri-implant tissue responses can be achieved with platform switching and non-platform switching abutments.

Accuracy of computer-guided surgery: A comparison of operator experience.

STATEMENT OF PROBLEM: Even though high-precision technologies have been used in computer-guided implant surgery, studies have shown that linear and angular deviations between the planned and placed implants can be expected. PURPOSE: The purpose of this study was to evaluate the effect of operator experience on the accuracy of implant placement with a computer-guided surgery protocol. MATERIAL AND METHODS: Ten surgically experienced and 10 surgically inexperienced operators participated in this study. Each operator placed 1 dental implant (Replace Select) on the partially edentulous mandibular model that had been planned with software by following a computer-guided surgery (NobelGuide) protocol. Three-dimensional information of the planned and placed implants were then superimposed. The horizontal and vertical linear deviations at both the apex and platform levels and the angular deviation were measured and compared between the experienced and inexperienced groups with the independent t test with Bonferroni adjustment (α=.01). The magnitude and direction of the horizontal deviations were also measured and recorded. RESULTS: No significant differences were found in the angular and linear deviations between the 2 groups (P>.01). Although not statistically significant (P>.01), the amount of vertical deviation in the coronal direction of the implants placed by the inexperienced operators was about twice that placed by the experienced operators. Overall, buccal apical deviations were most frequent and of the highest magnitude. CONCLUSIONS: When a computer-guided protocol was used, the accuracy of the vertical dimension (depth of implant placement) was most influenced by the operator's level of experience.