Success rate of immediately loaded implants in the posterior zone.

Dental implants are considered an ideal treatment for a missing single tooth. Immediate loading of implants can hasten the procedure, providing comfort to the patients. Recently, immediate loading of implants has gained much importance as it helps hasten the procedure and provides more comfort to patients. A previous systematic review published 5 years ago compared the success rates between immediate and conventional loading. There are several factors that influence the success rate of implants that were not discussed in detail in the previous review. Hence, the present systematic review is done to report differences in the outcomes from single implant restorations of missing teeth in the posterior region in patients who were subjected to immediate loading and conventional loading. A follow up for 1 year was done. Electronic databases of Medline, Scopus, and Web of Science were searched for publications in the English Language during May 2021. The search results yielded 306 articles, out of which 225 were excluded based on title and abstract screening. Screening of the remaining 81 full text articles yielded 14 original research articles that satisfied the predefined inclusion criteria. Meta analysis was not possible due to the heterogeneity of the data. The overall success rate of the immediate loading of a single implant is 94.31%. Implants in the maxillary region had a higher survival rate than those in the mandibular region. The age range between 18 and 80 years showed good prognosis and outcomes in older individuals. Good oral hygiene was emphasized for all patients to prevent any secondary conditions or delays in healing.

Long-term stability of infrabony defects treated with enamel matrix derivative alone: A retrospective two-centre cohort study.

AIM: To assess the long-term stability of attachment gain in infrabony defects (IBDs) 10 years after regenerative treatment with an enamel matrix derivative (EMD) alone. MATERIALS AND METHODS: Two centres (Frankfurt [F] and Heidelberg [HD]) invited patients for re-examination 120 ± 12 months after regenerative therapy. Re-examination included clinical examination (periodontal probing depths (PPD), vertical clinical attachment level (CAL), plaque index (PlI), gingival index (GI), plaque control record, gingival bleeding index and periodontal risk assessment) and review of patient charts (number of supportive periodontal care [SPC] visits). RESULTS: Both centres included 52 patients (29 female; median baseline age: 52.0 years; lower/upper quartile: 45.0/58.8 years; eight smokers), each contributing one IBD. Nine teeth were lost. For the remaining 43 teeth, regenerative therapy showed significant CAL gain after 1 year (3.0; 2.0/4.4 mm; p < .001) and 10 years (3.0; 1.5/4.1 mm; p < .001) during which CAL remained stable (-0.5; -1.0/1.0 mm; p = 1.000) after an average SPC of 9 years. Mixed-model regression analyses revealed a positive association of CAL gain from 1 to 10 years with CAL 12 months post operation (logistic: p = .01) as well as a higher probability for CAL loss with an increasing vertical extent of a three-walled defect component (linear: p = .008). Cox proportional hazard analysis showed a positive association between PlI after 12 months and tooth loss (p = .046). CONCLUSION: Regenerative therapy of IBDs showed stable results over 9 years. CAL gain is associated with CAL after 12 months and decreasing initial defect depth in a three-walled defect morphology. Tooth loss is associated with PlI 12 months post operation. CLINICAL TRIAL NUMBER: DRKS00021148 (URL: https://drks.de).

Henri Léger-Dorez: The First Expandable Implant (1912).

In the early 1900s, various authors worked on "artificial roots" to replace missing teeth. E. J. Greenfield's pioneering works (1910-1913) are among the best-known today and are often cited in publications reviewing the history of oral implantology. Shortly after Greenfield's first communications in the scientific literature, a French dental surgeon, Henri Léger-Dorez, designed the first expanding dental implant, which he indicated was used successfully in cases of single tooth edentulism. Its aim was to obtain the best primary stability and thus avoid the use of dental splint during osseous healing process. Léger-Dorez's works give us a new angle on the research in oral implantology by the pioneers of the early 20th century.

Influence of different incision designs on bone increment of guided bone regeneration (Bio-Gide collagen membrane +Bio-OSS bone powder) during the same period of maxillary anterior tooth implantation.

Exploring the influence of different incision designs on bone increment of guided bone regeneration [Bio-Gide collagen membrane +Bio-OSS bone powder (carbonate apatite crystal extracted from bovine bones), Bio-OSS bone meal was placed on the surface of the bone defect and then covered with a Bio-Gide membrane to close the wound] during the same period of maxillary anterior tooth implantation. The 99 patients from the stomatology department were divided into 3 groups: small incision (N = 30, group A), wide incision (N = 39, group B), internal gingival sulcus incision (N = 30, group C). At the different time (immediately after surgery, 6 months, 12 months and 24 months), the width and height of labial bone at different implant margin (2 mm, 4 mm, 6 mm) has no significant difference in comparison of any two of the three groups (p > 0.05). The score of esthetic feeling in group A was significant higher than group C (P < 0.05). The PPD, the incidence of SH, BOP in group A were all significant higher than group B (P < 0.05). The PISm, PISd, PPD, the incidence of SH and BOP in group A were all significant higher than group C (P < 0.05). The PISm, PISd, PPD, the incidence of SH and BOP in group B were all significant higher than group C (P < 0.05). The three groups has no significant different on the influence bone increment. The soft tissue condition around the implant after surgery was better in internal gingival crevicular incision than others two incisions, large-scale incision better than small incisions.

Surgical treatment with dental implants in a patient with secondary loss of teeth and osteoporosis caused by an imbalance of vitamin D.

In recent years, the success of long-term dental implants has remained problematic, especially because of the increasing rate of mineral balance changes in patients with partial loss of teeth, regardless of their age, race and sex. This article describes the experience of 6 years of treatment with dental implants in a patient with secondary loss of tooth and mineral imbalance (osteopenia) due to vitamin D deficiency, in collaboration with endocrinologist. Along with basic dental care, special medicine was prescribed for this pathology. The bone system was monitored through regular blood tests, skeletal bone densitometry and X-ray of the maxillofacial region. This management plan allowed dental implants to be maintained in good condition for 7 years.

Surgical solutions to orofacial problems.

BACKGROUND: Orofacial problems present frequently to primary care providers. Many of these problems have a surgical solution. Some may require minor procedures, while others require major maxillofacial surgery. OBJECTIVE: The purpose of this article is to illustrate how some common orofacial presentations can be investigated and solutions found in conjunction with oral and maxillofacial surgeons. DISCUSSION: This article outlines a method of approach for some of the issues with which patients present to their primary healthcare provider that may be resolved using skills and techniques of maxillofacial surgery.

Implant stability in patients treated with platelet-rich fibrin and bovine bone substitute for alveolar ridge preservation is associated with peripheral blood cells and coagulation factors.

AIMS: The aim of the present study was to assess the association between dental implant stability and peripheral blood cell composition and levels of coagulation factors in patients treated with alveolar ridge preservation with platelet-rich fibrin (PRF) and bovine bone substitute. MATERIALS AND METHODS: Fifty patients were included between 2015 and 2017. PRF was prepared from autologous blood, in which blood cells and coagulation factor levels were measured. PRF and bovine bone were placed in the socket, followed by closure with PRF membrane. Implants were placed 14 (±2.5) weeks postextraction. The implant stability quotient was measured at t = 0, t = 10 days, t = 7 weeks, and t = 17 weeks by resonance frequency analysis. RESULTS: Erythrocyte count was inversely associated with PRF membrane length, but not with implant stability. Conversely, platelet count did not correlate with membrane size but inversely correlated with implant stability at 7 and 17 weeks. In addition, implant stability was directly correlated with levels FXIII (t = 0, p < .01), active von Willebrand factor (VWF; t = 0 and 7 weeks, p < .05), and total VWF (t = 7 weeks, p = .012). CONCLUSION: Implant stability following alveolar ridge preservation with PRF and bovine bone substitute is associated with circulating blood cells and coagulation factors. In particular, fibrin structure, VWF, and FXIII may be important modulators of implant stability.

Single anterior tooth replacement with direct fiber-reinforced composite bridges: A report of three cases.

In today's dentistry, with the development of adhesive techniques and the improvement of resin-based materials, invasive restorative treatments have been replaced by minimally invasive or noninvasive restorative procedures. Fiber-reinforced adhesive bridges are minimal-invasive or noninvasive restorations that can be applied for definitive restoration in single tooth loss or short spans, where teeth or implant-supported fixed partial prosthesis cannot be applied. This case series describes the rehabilitation of three patients with anterior single tooth loss using the direct fiber-reinforced adhesive bridge. In all patients, esthetic and functional deficiencies in the missing tooth regions were solved with this minimally invasive technique, which is both cost-effective and conservative of tooth structures. During the three-year follow-up of these cases, there was neither fracture nor decementation in the restorations. Also, no caries or sensitivity was noted in the support teeth.

Periprosthetic biomechanical response towards dental implants, with functional gradation, for single/multiple dental loss.

The differences in shape and stiffness of the dental implants with respect to the natural teeth (especially, dental roots) cause a significant alteration of the periprosthetic biomechanical response, which typically leads to bone resorption and ultimately implant loosening. In order to avoid such clinical complications, the implant stiffness needs to be appropriately adapted. In this study, hollow channels were virtually introduced within the designed implant screws for reduction of the overall stiffness of the prototype. In particular, two opposing radial gradients of increasing hollow channel diameters, i.e., outside to inside (Channel 1) and inside to outside (Channel 2) were considered. Two clinical situations of edentulism were addressed in this finite element-based study, and these include a) loss of the first molar, and b) loss of all the three molars. Consequently, two implantation approaches were simulated for multiple teeth loss - individual implantation and implant supported dental bridge. The effects of implant length, approach and channel distribution on the biomechanical response were evaluated in terms of the von Mises stress within the interfacial periprosthetic bone, under normal masticatory loading. The results of our FE analysis clearly reveal significant variation in periprosthetic bone stress between the different implant designs and approaches. An implant screw length of 11 mm with the Channel 2 configuration was found to provide the best biomechanical response. This study also revealed that the implant supported dental bridge approach, which requires lower bone invasion, results in favorable biomechanical response in case of consecutive multiple dental loss.

Dental Implant Therapy on a Patient With von Willebrand Disease: A Case Study.

BACKGROUND: Von Willebrand disease (vWD) is the most common hereditary disorder affecting coagulation. Patients with this disorder are at a higher risk of postoperative complications after dental surgery. This article discusses the successful treatment for a patient with vWD undergoing implant therapy. CASE DESCRIPTION: A young 21-year-old patient with vWD lost tooth #30 because of caries and required implant therapy. Through collaboration with a hematologist administering prophylactic desmopressin (DDAVP), the implant surgery was performed without any postoperative complications. The implant successfully integrated and was restored into function. The successful outcome met expectations after careful planning and execution. PRACTICAL IMPLICATIONS: Collaboration with the appropriate medical providers, as well as treatment modifications for surgical procedures during implant therapy, is necessary for successful treatment of a patient with von Willebrand disorder.

Retrieval of a periodontally compromised tooth by allogeneic grafting of mesenchymal stem cells from dental pulp: A case report.

Objective To report a case of successful allogeneic grafting of mesenchymal dental pulp stem cells (DPSCs) as preliminary findings in a patient with periodontal disease enrolled into clinical trial ISRCTN12831118. Methods Mesenchymal stem cells from the dental pulp of a deciduous tooth from a 7-year-old donor were separated from the pulp chamber and processed via enzymatic digestion and centrifugation. DPSCs were passaged and cultured on a 35 × 13 mm culture dish in minimum essential medium-alpha, without supplementation. After reaching 80% confluency, 5 x 106 allogeneic DPSCs in 250 µl phosphate buffered saline were seeded onto a dry scaffold of lyophilized collagen-polyvinylpyrrolidone sponge placed in the left lower premolar area of a 61-year-old patient with periodontal disease. Surgical access to the lower premolar area was achieved using the flap technique. Results At 3 and 6 months following allogeneic graft, the patient showed no sign of rejection and exhibited decreases in tooth mobility, periodontal pocket depth and bone defect area. Bone mineral density had increased at the graft site. Conclusions Regenerative periodontal therapy using DPSCs of allogeneic origin may be a promising treatment for periodontal disease-induced bone defects.

Prosthetically Driven Computer-Guided Implant Placement and Restoration Using CEREC: A Case Report.

Developments in 3-dimentional (3D) diagnostic technology and advanced digital optical imaging have improved the predictability, safety, and efficiency of restoratively driven implant dentistry. Surgical procedures may now be performed in a single visit utilizing chairside, computer-aided design/computer-aided manufacturing technology and in situations when a two-stage implant protocol is indicated as demonstrated in this case. The CEREC® GALILEOS® integration workflow system was used to prosthetically plan and place an implant in the lower right mandibular first molar site, No. 30, which had been previously grafted following tooth extraction. Preoperative planning was performed, taking into consideration all anatomic landmarks, current tissue status, and restorative needs while incorporating cone-beam computed tomography data to design and mill a stable, tooth-supported surgical guide (CEREC Guide 2.0). After placement and subsequent osseointegration, the implant was restored chairside in a pre-doctoral treatment center. The Sirona TiBase system and VITA ENAMIC® IS block were used to produce an esthetically pleasing and clinically excellent screw-retained implant crown.

Autotransplantation of teeth.

Dental autotransplantation is the surgical transposition of a tooth from its original site to another site to replace a lost or compromised tooth in the same individual.1 It offers a method for replacing missing teeth or avulsed and traumatized teeth, particularly in children and adolescents. This surgical therapy is often overlooked as a treatment option by dentists and oral surgeons, who typically treat space closure by placing dental implants or bridges despite the fact that recent autotransplantation studies show high survival rates and success rates of 91.3%.2 Most tooth losses due to traumatic incidents occur in young patients, and implant placement is contraindicated until the completion of growth. In cases where there is no donor dilemma, and if a suitable graft is available, autotransplantation may be the therapy of choice.

Periodontal prosthesis in contemporary dentistry.

In the last 5 decades, the developments of osseointegrated titanium implants (since 1965) have led to the success of contemporary dentistry. Endosseous implant-supported restorations delivered in accordance with the traditional Branemark protocol have proven to be highly predictable. Today, implants are becoming increasingly common in dental care and provide more therapeutic options, but treatment planning and the sequencing of therapy are critical in implant-assisted and implant-supported cases. Implant prostheses give patients and dentists more options in treatment planning, but also present challenging decisions regarding implant surgery. In essence, the emerging thought is that teeth are expendable, as we now have implants to solve these problems. The fact that peri-implantitis is no simple problem to treat does not seem to affect many who hold that thought. In this article, the authors explain how to properly apply the periodontal prosthesis philosophy, concepts, principles, and techniques in contemporary dentistry. (This article is an update from the article was published in 2005) [1].

Block iliac bone grafting enhances osseous healing of alveolar reconstruction in older cleft patients: A radiological and histological evaluation

Background: Older alveolar cleft patients (>12 years old) often have wide bone defect as well as teeth loss, resulting in poor osseous healing with conventional alveolar bone grafting (ABG). In this study, we investigated a surgical technique of block iliac bone grafting for the alveolar cleft reconstruction and evaluated the clinical and radiological outcomes of these cleft patients. Material and Methods: Fifteen patients were included in this study. All cases received preoperative cone bean computed tomography (CBCT) scans for the alveolar cleft evaluation. Osseous outcomes of block iliac bone grafting were assessed at 1 week, 3- and 6-month postoperatively. Volume changes and bone resorption rates were calculated using the measurement modules of Simplant software. Bone samples from one patient undergoing dental implantation were assessed by micro-CT and histological examination. The morbidities of donor-site were analyzed by clinical examination and questionnaire survey. Results: The average age of the case series was 18.53±2.50 years. The intraoral incision of thirteen cases healed well. However, two cases had oronasal fistula and graft exposure at 1-week postoperatively. The results of follow-up CBCT scans showed significant resistance to radiation on both sides of the bone graft, suggesting a good osseous healing and new bone formation. The mean residual bone volume was 1.68±0.26 cm3 , 1.29±0.23 cm3 and 1.15±0.23 cm3 at 1-week, 3- and 6-month postoperatively. Correspondingly, the mean bone resorption rates in 3- and 6-month postoperative were 21.78±6.88% and 30.66±8.97%, respectively. From micro-CT and HE examinations, the block bone samples exhibited a cancellous structure in which mature bone trabecula and functional blood vessels appeared. The average scores of donor-site morbidities were drastically decreased at 3- and 6-month postoperatively compared with those at 1-week postoperatively. Conclusions: Our results demonstrated that block iliac bone grafting could achieve satisfying osseous outcomes in older alveolar cleft patients, and this technique provided favorable bony condition for further treatments, especially dental implantation (AU)

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Prosthodontic Rehabilitation for a Patient with Down Syndrome: A Clinical Report.

Patients with Down syndrome can present with a variety of oral manifestations such as hypodontia, periodontal disease, premature tooth loss, reduced salivary flow, crowding of teeth in both arches, and decreased occlusal vertical dimension. The intellectual ability of people with Down syndrome varies widely. They present with a mild-to-moderate intellectual disability that restricts their ability to communicate and adjust to their environment, which can add complexity in the overall dental treatment. There is little information in the literature regarding the prosthodontic rehabilitation for patients with Down syndrome in combination with dental implant placement. An implant-assisted removable partial dental prosthesis can be a cost-effective treatment alternative for carefully chosen patients with Down syndrome. This article presents the treatment of a 44-year-old male patient with Down syndrome and a moderate intellectual disability who presented with congenital and acquired tooth loss with significant occlusal discrepancies. The treatment included a prosthodontic approach that used a single dental implant, which will be described and illustrated in this article.

Oral rehabilitation with implant-supported fixed dental prostheses of a patient with cleidocranial dysplasia.

This clinical report describes the oral rehabilitation with implant-supported fixed dental prostheses in the maxilla and mandible of a patient with cleidocranial dysplasia. Cone-beam computed tomography and a tilted implant protocol in the mandible helped to establish a conservative approach for bone preservation, prevent surgical complications, enable proper implant positioning to avoid anatomic structures, and support the fixed dental prostheses.

Feline Dental Implants: Long-Term Follow-up of Two Cases.

Dental implants have become an option for replacement of lost canine teeth in cats. Although cats appear to manage well after a canine extraction, complications such as lip entrapment can occur after maxillary canine tooth extraction. Even cats with a complicated crown fracture of the maxillary canine tooth that have had root canal therapy can develop lip entrapment. This can lead to painful lip ulcers and potential need for further dental treatment. Canine tooth replacement with a dental implant and prosthodontic crown is, in the authors' experience, a predictable option that can be offered to clients who would like to replace a lost canine tooth. This report will discuss 2 long-term cases of maxillary canines replaced by dental implants/crowns.

Oral manifestations, dental management, and a rare homozygous mutation of the PRDM12 gene in a boy with hereditary sensory and autonomic neuropathy type VIII: a case report and review of the literature.

BACKGROUND: Hereditary sensory and autonomic neuropathy type VIII is a rare autosomal recessive inherited disorder. Chen et al. recently identified the causative gene and characterized biallelic mutations in the PR domain-containing protein 12 gene, which plays a role in the development of pain-sensing nerve cells. Our patient's family was included in Chen and colleagues' study. We performed a literature review of the PubMed library (January 1985 to December 2016) on hereditary sensory and autonomic neuropathy type I to VIII genetic disorders and their orofacial manifestations. This case report is the first to describe the oral manifestations, and their treatment, of the recently discovered hereditary sensory and autonomic neuropathy type VIII in the medical and dental literature. CASE PRESENTATION: We report on the oral manifestations and dental management of an 8-month-old white boy with hereditary sensory and autonomic neuropathy-VIII over a period of 16 years. Our patient was homozygous for a mutation of PR domain-containing protein 12 gene and was characterized by insensitivity to pain and thermal stimuli, self-mutilation behavior, reduced sweat and tear production, absence of corneal reflexes, and multiple skin and bone infections. Oral manifestations included premature loss of teeth, associated with dental traumata and self-mutilation, severe soft tissue injuries, dental caries and submucosal abscesses, hypomineralization of primary teeth, and mandibular osteomyelitis. CONCLUSIONS: The lack of scientific knowledge on hereditary sensory and autonomic neuropathy due to the rarity of the disease often results in a delay in diagnosis, which is of substantial importance for the prevention of many complications and symptoms. Interdisciplinary work of specialized medical and dental teams and development of a standardized treatment protocols are essential for the management of the disease. There are many knowledge gaps concerning the management of patients with hereditary sensory and autonomic neuropathy-VIII, therefore more research on an international basis is needed.