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1.
J Clin Periodontol ; 50(7): 1010-1020, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37052357

RESUMEN

AIM: This randomized controlled trial aimed to investigate the efficacy of soft-tissue augmentation (STA) with a subepithelial connective tissue graft (SCTG) or an acellular dermal matrix (ADM) on reducing tissue alterations at an immediate implant site. MATERIALS AND METHODS: This trial had three groups: (i) immediate implant with SCTG (ICT group); (ii) immediate implant with ADM (IAD group); (iii) immediate implant without STA (control group). Forty-six patients were randomly assigned to each group. Implants were placed at the maxillary anterior or premolar areas and restored after the 6-month visit. Clinical outcomes, including buccal soft-tissue contour, peri-implant mucosal level, soft-tissue thickness and keratinized tissue width, were measured at baseline and at 3-, 6- and 12-month follow-up visits. Radiographic bone levels were measured at baseline and at 6- and 12-month follow-up visits. Patient-reported outcomes were also collected. RESULTS: STA procedures increased peri-implant mucosal thickness and maintained buccal soft-tissue contours. Compared to the control group, STA groups did not prevent peri-implant mucosal recession or interproximal bone resorption. Generally, no significant differences in clinical outcomes were detected between the ICT and IAD groups. Most patients were highly satisfied with the immediate implant procedure and outcomes without significant differences between groups. CONCLUSIONS: STA at immediate implant sites enhanced soft-tissue thickness and maintained soft-tissue contours but did not prevent peri-implant mucosal recession or interproximal bone resorption. Long-term follow-up should be performed since these results were reported for only up to 1 year.


Asunto(s)
Resorción Ósea , Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental , Humanos , Tejido Conectivo/trasplante , Resultado del Tratamiento , Maxilar/cirugía , Conservación de Tejido
2.
Surg Radiol Anat ; 42(9): 1025-1031, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32277256

RESUMEN

The anatomical variations of the maxillary sinus septa, greater palatine artery, and posterior superior alveolar arteries might cause unexpected complications when they are damaged. Dentists who know these structures well might hope to learn more practical knowledge to avoid and assess injury preoperatively. Therefore, this review paper aimed to review the reported anatomy and variations of the maxillary sinus septa, greater palatine artery/nerve, and posterior superior alveolar artery, and to discuss what has to be assessed preoperatively to avoid iatrogenic injury. To assess the risk of injury of surgically significant anatomical structures in the maxillary sinus and hard palate, the operator should have preoperative three-dimensional images in their mind based on anatomical knowledge and palpation. Additionally, knowledge of the average measurement results from previous studies is important.


Asunto(s)
Variación Anatómica , Implantación Dental Endoósea/efectos adversos , Complicaciones Intraoperatorias/prevención & control , Seno Maxilar/anomalías , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/métodos , Encía/trasplante , Humanos , Imagenología Tridimensional , Complicaciones Intraoperatorias/etiología , Arteria Maxilar/anatomía & histología , Arteria Maxilar/diagnóstico por imagen , Arteria Maxilar/lesiones , Nervio Maxilar/anatomía & histología , Nervio Maxilar/diagnóstico por imagen , Nervio Maxilar/lesiones , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Osteotomía Le Fort/efectos adversos , Paladar Duro/irrigación sanguínea , Paladar Duro/diagnóstico por imagen , Paladar Duro/inervación , Factores de Riesgo , Elevación del Piso del Seno Maxilar/efectos adversos , Recolección de Tejidos y Órganos/efectos adversos
3.
J Esthet Restor Dent ; 30(6): 572-579, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30367715

RESUMEN

OBJECTIVE: To examine the correlation between initial site-specific characteristics of patients with multiple gingival recession defects and the outcome of root coverage therapy. MATERIALS AND METHODS: Pretherapy and post-therapy study models of 21 patients (154 teeth) with multiple gingival recession defects, treated with Vestibular Incision Subperiosteal Tunnel Access (VISTA), were optically scanned. Three-dimensional analysis of superimposed preoperative and postoperative images was performed. Linear and surface root coverage were calculated and correlated to various clinical and/or anatomical parameters. A multilevel statistical analysis was conducted, adjusting for the correlation among multiple observations. RESULTS: The mean percentages of linear root coverage were 96.2 ± 13.1% and 84.3 ± 14.4% for Miller Class I/II and Class III recessions, respectively. The mean percentages of root surface area coverage were 92.1 ± 12.0% and 78.6 ± 15.7% for Miller Class I/II and III defects, respectively. Root prominence, initial recession width and posterior tooth type were negatively correlated with linear and root surface area coverage. Initial recession depth was negatively correlated with root surface area coverage. Initial gingival margin thickness was positively associated with both linear and root surface area coverage. CONCLUSION: The results of the present study identified important positive and negative site-specific characteristics that may have utility in predicting the outcome of root coverage. CLINICAL SIGNIFICANCE: This study used sensitive 3-dimensional digital analysis tools to examine the correlation between initial site-specific characteristics of patients with multiple gingival recession defects and the outcome of periodontal root coverage therapy. Results demonstrated that initial root prominence, loss of interdental tissue (Miller Class III), molar tooth type, initial recession depth and width were negatively correlated with the outcome of periodontal root coverage achieved. Conversely, initial gingival margin thickness was associated with increased percentage of root coverage. These site-specific characteristics may serve as important risk indicators to predict the outcome of root coverage procedure.


Asunto(s)
Recesión Gingival , Raíz del Diente , Estudios de Seguimiento , Encía , Humanos , Proyectos Piloto , Estudios Retrospectivos , Colgajos Quirúrgicos , Resultado del Tratamiento
4.
Clin Oral Implants Res ; 28(11): e252-e261, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28422326

RESUMEN

OBJECTIVES: This study sought to investigate the histological changes following tooth extraction, ridge preservation and augmentation, using novel devices designed to obturate the oral orifice of extraction sockets (SocketKAP™) and provide structural support for sockets with defective bony walls (SocketKAGE™) in a non-human primate model. MATERIAL AND METHODS: Six Macaca fascicularis were imaged by cone beam computed tomography to register their preoperative alveolar bone. Three teeth were extracted in each animal, yielding intact socket walls and were divided into three intervention groups: unassisted healing negative control (Group A); SocketKAP™ (Group B); filled with anorganic bovine bone mineral (ABBM) + SocketKAP™ (Group C). Three additional teeth were extracted in each animal, followed by surgical resection of the entire buccal alveolar bone and divided into three groups: negative control (Group D); SocketKAP™ + SocketKAGE™ (Group E); ABBM + SocketKAP™ + SocketKAGE™ (Group F). Animals were euthanized after 12 weeks, and treatment sites were examined by histology and histomorphometric analysis. RESULTS: Control sockets with unassisted healing (Groups A and D) underwent severe loss of bone width, height and total area (approximately 40-60% loss). Application of SocketKAP™ in sites with intact walls, as well as SocketKAP™ plus SocketKAGE™ in sites with defective buccal walls lead to higher preservation of alveolar bone height after 12 weeks post-intervention. Addition of ABBM leads to the highest degree of alveolar bone dimensional preservation. Control sites with unassisted healing (Groups A and D), as well as sites treated with extraction socket devices (Groups B and E) without ABBM yielded higher percentage of vital bone, compared with sites filled with ABBM (Groups C and F). No adverse histological responses were noted to SocketKAP™ or SocketKAGE™ devices. CONCLUSIONS: SocketKAP™ + SocketKAGE™ devices proved effective in reducing post-extraction alveolar bone resorption mediating favorable wound healing within sockets. Addition of ABBM was associated with reduced volumetric loss, although the bone fill was characterized by less mature as well as more woven bone.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/patología , Pérdida de Hueso Alveolar/prevención & control , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/patología , Animales , Tomografía Computarizada de Haz Cónico , Modelos Animales de Enfermedad , Macaca fascicularis , Masculino , Extracción Dental/efectos adversos , Alveolo Dental/patología , Alveolo Dental/cirugía
5.
Clin Oral Implants Res ; 27(7): 859-66, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26498407

RESUMEN

AIM: The aim of this study was to evaluate the efficacy of ridge preservation involving novel devices used for obturation of socket orifice (Socket cap; SocketKAP(™) ) and resorbable cage used for space maintenance in sites with facial wall dehiscence (Socket cage; SocketKAGE(™) ). MATERIAL AND METHODS: Eight teeth were extracted in each of six Macaca fascicularis non-human primates. Six intervention groups consisted of the following: Group A: intact socket negative control. Group B: intact socket: socket cap. Group C: intact socket filled with anorganic bovine bone mineral (ABBM) + socket cap. Group D: dehiscence: negative control. Group E: dehiscence: socket cap + socket cage. Group F: dehiscence: filled with ABBM + socket cap + socket cage. CBCT scans were obtained preoperatively and at 6 and 12 weeks following intervention. The pre- and postoperative scans were superimposed, to quantify 3D volumetric alveolar bone changes. RESULTS: Volumetric bone loss occurred in all sockets, not only within the cretal zone (0-3 mm) to the ridge crest, as has been commonly reported by other investigators, but significant bone loss was also detected in the zone which was 3-6 mm apical to the alveolar crest. For intact sockets, socket cap + ABBM led to significantly greater percentages of remaining bone volume when compared to groups A and B. A significant difference favoring socket cap + socket cage + ABBM treatment was observed for sockets with facial dehiscence defects compared to groups D and E. CONCLUSIONS: Socket cap in conjunction with ABBM appears effective in limiting post-extraction volumetric bone loss in intact sockets, while socket cap + socket cage + ABBM appears effective in limiting post-extraction bone loss in sockets with dehiscence defects.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/prevención & control , Aumento de la Cresta Alveolar/métodos , Prótesis Dental , Alveolo Dental/cirugía , Implantes Absorbibles , Animales , Tomografía Computarizada de Haz Cónico , Imagenología Tridimensional , Modelos Animales , Extracción Dental
6.
Clin Oral Implants Res ; 27(1): 97-105, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25655480

RESUMEN

AIM: This study sought to investigate dimensional changes to the alveolar bone following extraction and application of novel devices used for obturation of socket orifice (socket cap) and space maintenance in sockets with facial dehiscence (socket cage). MATERIAL AND METHODS: Six Macaca fascicularis had six teeth each removed according to the following intervention groups (groups A-C intact alveolar bone; D-E facial dehiscence): negative control (A); socket obturated with cap (B); filled with anorganic bovine bone mineral (ABBM) + socket cap (C); dehiscence negative control (D); socket cap + socket cage (E); ABBM + socket cap + socket cage (F). Serial CBCT scans at preoperatively, 6 and 12 weeks following intervention were compared to quantify linear alveolar bone alterations. RESULTS: Without therapeutic intervention, intact sockets exhibited significant reduction in width at the crestal 2 mm of the ridge crest within 6 weeks. Compared with the negative control sites which lost up to 52% of crestal bone width, sites treated with socket cap + ABBM lost at most 4% of bone width at the crestal 2 mm. Similar results were seen in the dehiscence groups, with the combination of socket cap + socket cage + ABBM maintaining the greatest socket width and height dimensions. CONCLUSIONS: Results from the current non-human primate study suggest that the socket cap and socket cage devices, when used in conjunction with xenograft proved effective in minimizing post-extraction socket width loss and height seen in both intact sockets and sockets with facial dehiscence defects.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Tomografía Computarizada de Haz Cónico , Instrumentos Dentales , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía , Puntos Anatómicos de Referencia , Animales , Sustitutos de Huesos/uso terapéutico , Trasplante Óseo/métodos , Bovinos , Diseño de Equipo , Macaca fascicularis , Masculino , Extracción Dental , Cicatrización de Heridas/fisiología
7.
Clin Oral Implants Res ; 27(9): 1144-51, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26660705

RESUMEN

INTRODUCTION: The aim of this pilot study was to examine the kinetics of alterations in alveolar ridge width and height following tooth extraction with and without ridge preservation, using anorganic bovine bone mineral (ABBM) and a novel device (SocketKAP(™) ) designed for obturation of socket orifice. MATERIALS AND METHODS: Maxillary left and right PM1 and mandibular right PM2 and PM4 were extracted on six beagle dogs and treated as follows: Group A: negative control; Group B: SocketKAP(™) alone; Group C: ABBM + SocketKAP(™) . Serial cone-beam computed tomography (CBCT) was taken at 0-, 1-, 2-, 4-, 8- and 12-week intervals to calculate the rate of alveolar bone loss, followed by histologic and histomorphometric analyses at 12 weeks. Across group outcomes were compared. RESULTS: Without additional intervention, the crestal-most 3 mm of alveolar bone width lost approximately 0.21-0.28 mm per week. The rate of alveolar buccal bone height loss was 0.19 mm per week. Comparatively, in group C, the alveolar bone was relatively stable, with loss of only 0.003-0.13 mm of width and 0.12 mm of height per week. These differences were statistically significant. The alveolar bone in sites treated by SocketKAP(™) alone was significantly different from control only at select time points and locations of the ridge, presumably due to small sample size. CONCLUSION: Without additional intervention, tooth extraction was accompanied by rapid loss of alveolar ridge width and height. Applications of SocketKAP(™) and ABBM were effective in reducing alveolar crestal width and height loss following tooth extraction.


Asunto(s)
Proceso Alveolar/cirugía , Extracción Dental/efectos adversos , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/prevención & control , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/patología , Animales , Densidad Ósea , Tomografía Computarizada de Haz Cónico/métodos , Perros , Extracción Dental/métodos
8.
Artículo en Inglés | MEDLINE | ID: mdl-38646865

RESUMEN

BACKGROUND: The socket-shield (SS) technique results in long-term functional osseo- and dento-integration, preserving the dimensional stability of hard and soft tissues over time. This study aimed to describe the successful implementation of a surgical technique to facilitate "SS" cases. METHODS: The cases included males and females aged 32-81 years consecutively treated between 2020 and 2023 (longest follow-up, 3.5 years). For each case, pre- and post-operative cone-beam computed tomography (Digital Imaging and Communications in Medicine files) and intraoral optical scans (IOS; STL files) were performed. Digital immediate implant placement and simultaneous tooth extraction and SS production were planned using an implant planning software. Implants were planned considering sagittal-ridge and tooth-root angular-configuration. Surgical guides were used to perform the digitally-supported SS technique. All cases were planned and surgically performed by one operator (Pedro M. Trejo). Preoperative digital IOS-models were superimposed to post-operative models to assess soft-tissue changes. Pre and post sagittal views were used to assess the radiographic buccal-plate thickness at various healing times. An investigator not involved with case planning or treatment performed measurements. RESULTS: Results reflected soft-tissue stability with minimal mean thickness change at 0-, 1-, 2-, and 3-mm measurement levels of 0.03, -0.2, 0.14, -0.07, and 0.04 mm, respectively, with a mean gingival-margin change of 0.04 mm. The free gingival-margin change ranged from a 0.58-mm gain in height to a -0.57-mm loss. The mean radiographic buccal-plate thickness post-operatively was 2.04 mm (range, 0.7-2.9 mm). CONCLUSION: The digitally-supported guided SS technique enables predictable immediate implant-placement positions and stable buccal peri-implant soft and hard tissues over time. KEY POINTS: Why are these cases new information? The uniqueness of the surgical technique described herein is that it results in favorable positions of immediate, socket-shielded (SSed), implant placements, with soft- and hard-tissue stability as the byproduct. What are the keys to successful management of these cases? Digitally, plan for the best possible implant position within the alveolar housing to satisfy prosthetic requirements, and then adjust this position to accommodate the socket shield dimensions. Digitally, provide a space/gap between the future dentinal shield and the implant. Clinically, allow for time to carve the final position and dimensions of the shield. Plan ahead the extent of the apical third of the SS, and the removal of the apex, if dealing with a long root. What are the primary limitations to success in these cases? Inadequate use of digital technology; case-sensitive technique requires proper execution of each digital and technical clinical step.

9.
Int J Implant Dent ; 10(1): 1, 2024 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-38270674

RESUMEN

PURPOSE: Guided bone regeneration (GBR) is an accepted method in dental practice that can successfully increase the bone volume of the host at sites chosen for implant placement; however, existing GBR membranes exhibit rapid absorption and lack of adequate space maintenance capabilities. We aimed to compare the effectiveness of a newly developed resorbable bilayer membrane composed of poly (L-lactic acid) and poly (-caprolactone) (PLACL) with that of a collagen membrane in a rat GBR model. METHODS: The rat calvaria was used as an experimental model, in which a plastic cylinder was placed. We operated on 40 male Fisher rats and subsequently performed micro-computed tomography and histomorphometric analyses to assess bone regeneration. RESULTS: Significant bone regeneration was observed, which was and similar across all the experimental groups. However, after 24 weeks, the PLACL membrane demonstrated significant resilience, and sporadic partial degradation. This extended preservation of the barrier effect has great potential to facilitate optimal bone regeneration. CONCLUSIONS: The PLACL membrane is a promising alternative to GBR. By providing a durable barrier and supporting bone regeneration over an extended period, this resorbable bilayer membrane could address the limitations of the current membranes. Nevertheless, further studies and clinical trials are warranted to validate the efficacy and safety of The PLACL membrane in humans.


Asunto(s)
Caproatos , Dioxanos , Lactonas , Mustelidae , Proyectos de Investigación , Humanos , Masculino , Animales , Ratas , Microtomografía por Rayos X , Regeneración Ósea
10.
Artículo en Inglés | MEDLINE | ID: mdl-37655970

RESUMEN

Mucogingival deformities around implants are frequent findings in clinical practice and often present as inadequate keratinized tissue and insufficient mucosal thickness. Phenotype modification therapy can increase peri-implant mucosal thickness and the amount of keratinized mucosa, improving the long-term clinical outcomes of implants. Free gingival graft (FGG) is considered the gold standard to increase keratinized mucosa; however, FGGs on lingual aspects of implants are less predictable due to technique sensitivity and often present with insufficient gain in tissue thickness ue to limited blood supply. The Semilunar Lingualized Apically Positioned Flap (SLAP) with subperiosteal tunnel connective tissue graft (CTG) can increase both peri-implant mucosal thickness and keratinized mucosal width circumferentially. SLAP consists of one full-thickness, semilunar incision within keratinized mucosa on the buccal, and two vertical releasing incisions mesial and distal of the implant, extending lingually into the alveolar mucosa. The tissue is apically positioned lingual to the implant, and sutured in place creating buccal space for CTG via buccal subperiosteal tunneling. SLAP is a minimally invasive and predictable approach in improving peri-implant mucosal phenotype. This case reports demonstrates gain in peri-implant mucosal thickness and the amount of keratinized mucosa over a 10-month period utilizing SLAP with subepithelial CTG.

11.
Int J Esthet Dent ; 18(3): 278-291, 2023 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-37462380

RESUMEN

AIM: The present case report with medium-term follow-up aims to report on the successful outcomes of ridge preservation using anorganic bovine bone mineral (ABBM) combined with the socket-shield technique (SST) in conjunction with immediate ovate pontic provisionalization of the extraction site, followed by delayed flapless implant placement and immediate implant provisionalization in the rehabilitation of the maxillary anterior esthetic region. Clinical protocol: Three consecutive patients with failing maxillary anterior teeth were treated with this protocol. The alveolar ridge dimension was preserved utilizing ABBM, combined with the retention of a partial tooth root segment in the buccal portion of the extraction socket, to minimize ridge resorption following tooth extraction. An immediate fixed provisional restoration with an ovate base in direct contact with the extraction site was fabricated and delivered immediately to maintain the soft tissue contour. At 4 months postextraction, flapless implant placement was performed via a computer-generated surgical guide, along with immediate implant provisionalization. Definitive restorations were delivered 4 months following implant placement. RESULTS: At the 2-year follow-up after loading, prosthetic and implant success was demonstrated, with a favorable esthetic outcome and a high level of patient satisfaction. CONCLUSIONS: The immediate ovate pontic provisionalization in conjunction with ridge preservation combining ABBM and the SST, followed by flapless computer-guided implant placement with an immediate implant provisionalization protocol, as proposed in this article, offers a viable method to minimize alveolar ridge resorption as well as optimize esthetic outcomes.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Humanos , Animales , Bovinos , Carga Inmediata del Implante Dental/métodos , Alveolo Dental/cirugía , Estética Dental , Proceso Alveolar/cirugía , Pérdida de Hueso Alveolar/cirugía , Pérdida de Hueso Alveolar/etiología , Extracción Dental/efectos adversos , Resultado del Tratamiento
12.
Int J Periodontics Restorative Dent ; 43(3): e135-e140, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37141084

RESUMEN

The aim of the present study was to develop a 3D digital image-analysis method to quantitatively assess gingival changes after clear-aligner orthodontic therapy. Using teeth as fixed reference points, 3D image analysis tools have been used to quantify mucosal level changes after specific therapies. This technology has not been applied to orthodontic therapy, primarily because orthodontic tooth movement precludes using teeth as fixed reference points. Rather than superimposing the pre- and posttherapy volumes for the entire dentition, the methodology presented herein superimposed the pre- and post-therapy volumes for individual teeth. The lingual tooth surfaces, which remained unaltered, were used as fixed references. Intraoral scans taken before and after clear-aligner orthodontic therapy were imported for comparison. Volumes were created for each 3D image and were superimposed in a 3D image-analysis software that allowed quantitative measurements. The results demonstrated this technique's ability to measure very small changes in the apicocoronal position of the gingival zenith, as well as alterations of gingival margin thickness, following clear-aligner orthodontic therapy. The present 3D image-analysis method offers a useful tool for investigating the periodontal dimensional and positional changes that accompany orthodontic therapy.


Asunto(s)
Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Humanos , Proyectos Piloto , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/métodos , Técnicas de Movimiento Dental , Encía/diagnóstico por imagen
13.
Artículo en Inglés | MEDLINE | ID: mdl-36520129

RESUMEN

Phenotype modification therapy has emerged as one of the main treatment objectives of periodontal plastic surgery. However, long-term data on the stability of gingival thickness gains are not available. This study examined the kinetics of mucosal thickness gain as a measure of phenotype modification therapy following treatment of multiple gingival recession defects with vestibular incision subperiosteal tunnel access (VISTA). Six patients with 14 recession type (RT) II teeth were treated using VISTA and subepithelial connective tissue grafts (SCTG). Scanned images of study casts at pre- and postoperative periods (6 to 66 months) were digitally superimposed for quantitative evaluation of soft tissue dimensional changes. Mucosal thickness gains ranged from 1.0 ± 0.7 mm (1 mm apical to cement-enamel junction [CEJ]) to 1.4 ± 0.4 mm (5 mm apical to CEJ). The gingival thickness gains remained relatively stable, with thickness gains at 66 months of 0.5 ± 0.8, 0.9 ± 0.6, 1.1 ± 0.6, 1.0 ± 0.4, and 1.2 ± 0.6 mm at 1, 2, 3, 4 and 5 mm apical to the CEJ, respectively. Treatment of multiple gingival recession defects with VISTA and SCTG led to stable gingival thickness gains and shows promise as a strategy for phenotype modification therapy.


Asunto(s)
Recesión Gingival , Humanos , Recesión Gingival/diagnóstico por imagen , Recesión Gingival/cirugía , Resultado del Tratamiento , Estudios Retrospectivos , Raíz del Diente/cirugía , Colgajos Quirúrgicos , Encía/cirugía , Tejido Conectivo/trasplante
14.
Int J Periodontics Restorative Dent ; 41(4): e177-e182, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34328483

RESUMEN

In the maxillary anterior region, augmentation to correct a soft tissue deficiency is often required for an esthetic outcome and long-term implant therapy success. This case series of three patients presents a novel approach for soft tissue augmentation using xenogeneic collagen matrix balls in the esthetic zone around the implants. This technique avoids a secondary donor site compared to autogenous connective tissue graft. With this technique, a horizontal soft tissue volume increase (range: 3 to 5 mm) was observed postsurgically and maintained at later follow-ups. The described ball technique offers a viable method for peri-implant mucosal augmentation in the maxillary anterior region.


Asunto(s)
Implantes Dentales , Colágeno , Tejido Conectivo , Humanos
15.
Biomed Res Int ; 2020: 6153724, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33029518

RESUMEN

INTRODUCTION: The aim of this study was to investigate the ability of anti-bone morphogenetic protein 2 monoclonal antibody (anti-BMP-2 mAb) to functionalize scaffolds to mediate bone regeneration in a canine model. MATERIALS AND METHODS: The mandibular right premolar 4 (PM4) was extracted in eight beagle dogs and grafted with anti-BMP-2 mAb+anorganic bovine bone mineral with 10% collagen (ABBM-C) and porcine bilayer native collagen membrane (CM). The ABBM-C and CM were functionalized with either anti-BMP-2 mAb (test group) or an isotype matched control mAb (control group). Animals were euthanized at 12 weeks for radiographic, histologic, and histomorphometric analyses. Outcomes were compared between groups. RESULTS: 3D imaging using cone beam computed tomography (CBCT) revealed that sites treated with ABBM-C and CM functionalized with anti-BMP-2 mAb exhibited significantly more remaining bone width near the alveolar crest, as well as buccal bone height, compared with control groups. Histologic and histomorphometric analyses demonstrated that in anti-BMP-2 mAb-treated sites, total tissue volume was significantly higher in the coronal part of the alveolar bone crest compared with control sites. In anti-BMP-2 mAb-treated sites, bone formation was observed under the barrier membrane. CONCLUSION: Functionalization of the ABBM-C scaffold and CM appeared to have led to bone formation within healing alveolar bone sockets.


Asunto(s)
Proceso Alveolar/patología , Anticuerpos Monoclonales/farmacología , Proteína Morfogenética Ósea 2/inmunología , Andamios del Tejido/química , Proceso Alveolar/efectos de los fármacos , Puntos Anatómicos de Referencia , Animales , Diente Premolar/diagnóstico por imagen , Diente Premolar/patología , Tomografía Computarizada de Haz Cónico , Modelos Animales de Enfermedad , Perros , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Membranas , Tamaño de los Órganos/efectos de los fármacos
17.
Artículo en Inglés | MEDLINE | ID: mdl-30543734

RESUMEN

The objective of this study was to investigate marginal bone level (MBL) changes as the primary outcome of implants placed following healing of extraction sockets treated with ridge preservation, compared to implants placed following unassisted healing. A total of 268 patients (contributing 572 implants) treated from April 2005 to March 2013 were included in this retrospective study. Following estimation of the overall success rate of implants placed in the practice, 129 patients (contributing 222 implants) met the inclusion and exclusion criteria to be further evaluated. Of these, 78 patients (contributing 105 implants) received ridge preservation procedures, which entailed placement of anorganic bovine bone mineral covered with polytetrafluoroethylene membrane. The other 51 patients (contributing 117 implants), with healed sites without history of bone grafting, served as controls. Digital radiographs were taken at the time of implant placement and during follow-up visits. The mean follow-up period for ridge preservation sites was 33.6 months (range: 7.5 to 61.5 months) and for healed sites was 36.3 months (range: 6 to 91.2 months). The survival rate of implants in sites following healing of ridge preservation was 97.3%, compared to 98.5% in the nongrafted healed sites. The mean MBL changes during the observation period were 0.11 and 0.07 mm on the mesial and 0.06 and 0.06 mm on the distal aspects of the ridge preservation and healed sites, respectively (P > .05). The mean crestal bone remodeling during the observation period was 0.63 and 0.45 mm on the mesial and 0.48 and 0.12 mm on the distal aspects in the ridge preservation and healed sites, respectively (P < .05). The results of this study demonstrated stable MBL and survival of implants placed in sites following ridge preservation with xenograft as well as nongrafted healed sites.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Implantación Dental Endoósea/métodos , Implantes Dentales de Diente Único , Minerales/uso terapéutico , Alveolo Dental/cirugía , Animales , Bovinos , Femenino , Humanos , Masculino , Membranas Artificiales , Politetrafluoroetileno , Estudios Retrospectivos , Resultado del Tratamiento
18.
Artículo en Inglés | MEDLINE | ID: mdl-29240211

RESUMEN

A total of 68 extraction sockets were grafted with anorganic bovine bone mineral and covered by dense polytetrafluoroethylene membrane. Quantitative analysis of three-dimensional microcomputed tomography imaging of core samples retrieved after a mean of 21.0 ± 14.2 weeks revealed 40.1% bone volume fraction (bone volume [BV]/total volume [TV]) and 12% residual graft. Evidence of de novo bone formation was observed in the form of discrete islands of newly formed bone in direct apposition to graft particles, separated from parent bone. Anterior sockets exhibited a significantly higher percentage of residual graft compared to premolar sockets (P = .05). The BV/TV and percentage of residual graft correlated well with histomorphometric analysis of the same sites, but not with implant outcomes.


Asunto(s)
Sustitutos de Huesos , Minerales , Herida Quirúrgica/diagnóstico por imagen , Extracción Dental , Alveolo Dental , Microtomografía por Rayos X , Adulto , Anciano , Anciano de 80 o más Años , Animales , Bovinos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Cicatrización de Heridas
19.
Int J Periodontics Restorative Dent ; 38(5): 637­644, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29897354

RESUMEN

The objective of this study was to examine wound healing in extraction sockets following ridge preservation and the outcome of implants placed in those sites. Extraction sockets (N = 31) were grafted with anorganic bovine bone mineral (ABBM) and covered with dense polytetrafluoroethylene membrane. Bone cores obtained during implant placement were examined histologically and histomorphometrically. Percentages of vital bone and residual graft were 37.5% ± 21.3% and 12.5% ± 8.9%, respectively. New vital bone showed a negative correlation with patient age. Percentage of vital bone formation in sockets was correlated with neither postgraft wound healing time nor peri-implant marginal bone level.


Asunto(s)
Proceso Alveolar/patología , Aumento de la Cresta Alveolar/métodos , Matriz Ósea/trasplante , Adulto , Anciano , Pérdida de Hueso Alveolar/cirugía , Proceso Alveolar/cirugía , Animales , Bovinos , Implantación Dental Endoósea/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Alveolo Dental/patología , Cicatrización de Heridas
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