Use of Artificial Intelligence in Manuscript Preparation-AI as a Co-Author.

The use of Artificial Intelligence (AI) is rapidly expanding. While it comes with some drawbacks, it also offers numerous advantages. One significant application of AI is chatbots, which utilize natural language processing and machine learning to provide information, answer queries, and assist users. AI has various applications and dentistry is no exception. The authors conducted an experiment to assess the application of AI, particularly OpenAI's ChatGPT and Google Apps Script, in various stages of information gathering and manuscript preparation in parallel with conventional human-driven approaches. AI can serve as a valuable instrument in manuscript preparation; however, relying solely or predominantly on AI for manuscript writing is insufficient if the goal is to produce a high-quality article for publication in a peer-reviewed, high-impact journal that can contribute to the advancement of science and society.

Microbiological profile of peri-implantitis: Analyses of peri-implant microbiome.

PURPOSE: To characterize the microbiome composition in peri-implant pocket of peri-implantitis and peri-implant sulcus controls using 16S rRNA gene sequencing. MATERIALS AND METHODS: In this controlled clinical cross-sectional study, 23 subjects with control implants (n = 14) and diseased implants (peri-implantitis, n = 21) were included. The peri-implant pocket/sulcus was sampled and used to extract DNA and amplify the 16S rRNA gene using universal primers targeting the V3-V4 regions. The resulting 16S PCR amplicons were sequenced on Illumina MiSeq, and the sequences were processed using DADA2 and the Human Oral Microbiome Database (HOMD) as references. Alpha and Beta diversity, as well as core microbiome and differential abundance analyses, were performed using the MicrobiomeAnalyst workflow. RESULTS: There were no significant differences in microbial diversity between control implants and implants with peri-implantitis (Shannon p = 0.82). Overall bacterial community structure assessed through beta diversity analysis was also not significantly different between the two groups (p = 0.18). However, high levels of Gram-negative bacteria were detected in peri-implant pockets compared to the control sulcus. Abundant species in peri-implantitis were Capnocytophaga leadbetteri, Treponema maltophilum, Peptostreptococcus, Neisseria, P. gingivalis, and Porphyromonas endodontali, Lactococcus lactis and Filifactor alocis (p < 0.05). Gram-positive bacteria such as Streptococcus salivaris, Prevotella melaninogenica, L. wadei, and Actinomyces spp. serve were more abundant in peri-implant control sulcus. CONCLUSIONS: Peri-implant sulcus in control implants harbors predominantly Gram-positive bacteria, whereas pockets of implants with peri-implantitis harbor predominantly Gram-negative bacteria.

Microbiological profile of peri-implantitis: Analyses of microbiome within dental implants.

PURPOSE: To characterize the microbiome composition within dental implants of peri-implantitis subjects and healthy controls using 16S rRNA gene sequencing. MATERIALS AND METHODS: Twenty-three subjects with healthy (n = 11 implants) and diseased (peri-implantitis, n = 21) implants were included in this controlled clinical cross-sectional study. Samples were obtained from internal surfaces of dental implants using sterile paper points for microbiological analysis. DNA was extracted, and the16S rRNA gene was amplified using universal primers targeting the V3-V4 regions. The resulting 16S polymerize chain reaction amplicons were sequenced on Illumina MiSeq, and the sequences were processed using DADA2 and the Human Oral Microbiome Database (HOMD) as references. Alpha and Beta diversity, as well as core microbiome and differential abundance analyses were then performed using the MicrobiomeAnalyst workflow. RESULTS: A significant increase in microbial diversity was observed in the internal implant surface of healthy implants compared with the internal surfaces of peri-implantitis (Shannon p = 0.02). Bacterial community structure was significantly different among groups (p = 0.012). High levels of Gram-positive bacteria were detected inside implants with peri-implantitis compared to healthy implants, especially Enterococci. CONCLUSIONS: There is a shift in bacterial diversity inside implants with peri-implantitis from the healthy control. The microbial colonization within that space might contribute to the etiology of peri-implant disease.

A comparative analysis of dual-axis implants placed into maxillary anterior extraction sockets versus virtual planning with uniaxial implants: A simulated cone beam computed tomography study of implant length and diameter.

OBJECTIVE: The biaxial nature of the anterior maxilla poses a surgical and restorative challenge in implant dentistry. The present study sought to investigate the apical socket perforation rate (ASPR) from a simulated uniaxial implant placement and to determine the effect of implant length and diameter on ASPR when a uniaxial implant was placed compared with the orientation of the pre-existing dual-axis implant. MATERIAL AND METHOD: Cone beam computed tomography (CBCT) scans from the database of three private practices were searched for patients who received dual-axis implants within the esthetic zone in immediate tooth replacement therapy. A uniaxial implant was virtually placed using the pre-existing screw access channel of the dual-axis implant as a reference. The closest length and diameter were selected for the simulated implant. ASPR by the uniaxial implant was recorded. In addition, the affordable maximum length of a corresponding uniaxial implant that would avoid apical socket perforation was measured. RESULT: Eighty-one patients with a total of 101 dual-axis dental implants were selected for analysis. A simulated virtual surgical planning with uniaxial implants revealed high ASPR (48.51%). When the length of the uniaxial implant was reduced to 11 and 9 mm, ASPR was decreased to 41.58% and 20.79%, respectively. CONCLUSION: Dual-axis implant design effectively evades anatomical challenges in the anterior maxilla (esthetic zone). Considering the current evidence, efforts should be made to carefully consider the angular disparity between the extraction socket-alveolus complex and the future restorative emergence so that a harmonious biologic-esthetic result may be more predictably and consistently obtained.

Analytical Evaluation of Wet and Dry Mechanochemical Syntheses of Calcium-Deficient Hydroxyapatite Containing Zinc Using X-ray Diffractometry and Near-Infrared Spectroscopy.

Calcium-deficient zinc-containing calcium phosphate (ZnAP), which has sustained zinc release properties that are effective for treating osteoporosis, can be efficiently synthesized as a biomaterial through wet grinding. To elucidate the physicochemical mechanism of these mechanochemical syntheses, ground products were obtained from the starting material powder (S-CP), consisting of calcium hydrogen phosphate dihydrate (CHPD), calcium oxide (CaO), and zinc oxide (ZnO), by wet and dry grinding for 0-3 h in a centrifugal ball mill. The ground S-CP products were analyzed using powder X-ray diffraction (XRD) and near-infrared spectroscopy (NIRS); the crystal transformations and molecular interactions of the ground products were kinetically analyzed. The XRD and second-derivative NIRS results indicate that the S-CP is primarily transformed into ZnAP via amorphous solid formation in wet grinding, and the reaction follows a consecutive reaction model. In contrast, in dry grinding, the ground product of CHPD and CaO is transformed into an amorphous solid following an equilibrium reaction model; however, ZnO is predominantly not transformed and remains crystalline.

Changes in Peri-Implant Soft Tissue Thickness with Bone Grafting and Dermis Allograft. Part III: A Case Series Using a Novel, Hybrid Implant Design with a Subcrestal Angle Correction.

This comparative case series presents 16 consecutively placed and temporized immediate implants in the maxillary esthetic zone. The implants have a novel, inverted body-shift design, intended to achieve high levels of primary stability via the tapered apical portion. The coronal narrow cylinder provides greater space between the implant platform and facial socket wall and adjacent teeth/implants, allowing a greater opportunity for augmentation. The restorative platform also features a subcrestal angle correction, which facilitates screw retention. The wider, facial platform-shift thus creates more room for augmentation via dual-zone bone grafting and the application of a dermal allograft, which yields greater soft tissue thickness after initial healing. This case series aimed to evaluate soft tissue thickness and compare the results to two previously published cohorts where implant design served as the only variable between groups.

The effect of implant macrogeometry in immediate tooth replacement therapy: A case series.

The concept of immediate tooth replacement therapy (ITRT) in the esthetic zone has become a viable treatment modality and widely accepted in clinical practice. However, achieving adequate primary stability that enables immediate provisional restoration and desirable space for bone-grafting with conventional tapered body implant designs is challenging. The macro-hybrid implant design with a prosthetic angle correction and body-shift feature in a singular form provides not only greater primary stability of a wider diameter implant but also circumferential gap distance both facially and interproximally preserve the labial bone plate and interdental attachment apparatus of the adjacent natural teeth thereby maintaining the interdental papilla. The present clinical series exemplifies the clinical advantages of this inverted body-shift implant design in ITRT in various clinical scenarios in (1) single tooth replacement in a Type 1 intact socket with a thin periodontal phenotype, (2) single tooth replacement in a Type 2 socket with a dentoalveolar dehiscence of the labial bone plate, and (3) multiple adjacent teeth replacement of two maxillary central incisor. CLINICAL SIGNIFICANCE: The macro-hybrid design implant with a prosthetic angle correction and body-shift feature in a singular form provides greater midfacial gap distance as well as tooth-to-implant distance to preserve the interdental attachment of the adjacent natural teeth thereby leaving the interdental papilla undisturbed, without sacrificing higher primary stability afforded by larger diameter implants.

Characterization of the effect of dry-heat treatment on the gelation of alkaline dried egg whites using dynamic viscoelastic measurement and ultrasound spectroscopy.

In the present study, the mechanism for gelation of dried egg whites (DEWs) samples, which were differentially pretreated with dry-heat treatment and alkaline pH, were investigated using dynamic viscoelastic measurements and ultrasound spectroscopy for gels formed with at high protein concentrations. Rheological measurements showed that DEW gels with dry-heat treatments have a higher dynamic complex modulus than DEW gels without dry-heat treatments. Furthermore, ultrasonic attenuation analyses showed that subjecting DEWs to dry-heat treatment and alkaline pH induced the formation of an increased number of DEW protein "soluble aggregates" compared with unheated and neutral DEWs. Our data suggests that pretreatment of DEW samples led to partially unfolded DEW proteins with more "soluble aggregates", which were strongly correlated with the formation of gels with a more homogeneous and rigid texture. Understanding their structural properties at a molecular detail would enable desirable textural modifications for the development of new food products.

Outcomes of a 1-Year Prospective Single-Arm Cohort Study Using a Novel Macro-Hybrid Implant Design in Extraction Sockets: Part 1.

A novel macro-hybrid implant design was introduced to afford high apical primary stability and more coronal space to preserve the circumferential extraction socket architecture. This study presents 1-year data from a prospective single-arm cohort study. The data was distilled based on the following criteria: (1) single-tooth immediate tooth replacement therapy (ITRT) in the maxillary anterior and premolar regions in intact (Type 1) extraction sockets that were (2) treated with the dual-zone grafting technique. The clinical and radiographic outcomes of 48 ITRT implants were evaluated. The mean ± SD labial plate dimension changes were 0.33 ± 0.41 mm at the implant abutment interface (L1) and 0.34 ± 0.40 mm at 5.0 mm below (L2). The mean labial plate dimension (thickness) at the 1-year recall was 2.27 ± 0.88 mm (L1) and 1.95 ± 0.95 mm (L2). At ITRT, the ridge contour at the free gingival margin and 3.0 mm below it were 7.54 ± 0.93 mm and 9.44 ± 2.36 mm, respectively; after final restoration delivery, the corresponding values were 7.45 ± 0.95 mm and 10.23 ± 2.30 mm, respectively. The peri-implant soft tissue thickness (PISTT) at the time of implant-level impression-making was 3.29 ± 0.73 mm, with an average Pink Esthetic Score of 12.79. A macro-hybrid implant design showed high levels of primary stability (~60 Ncm), stable ridge contour at 1 year, a labial plate dimension between 1.5 and 2.0 mm, and PISTT > 3.0 mm, which may be a critical factor in providing stable, long-term esthetic outcomes.

A Novel Implant Design for Immediate Extraction Sites: Determining Primary Stability.

Achieving primary stability is a critical challenge presented by immediate implant therapy. Surgeons often utilize wider, tapered implants for this purpose, or they use longer implants to achieve primary stability. Both strategies are associated with negative ramifications. Prosthetically guided implant placement must respect biologic principles, such as tooth-implant and implant-implant distance, gap space between the implant and the facial cortex, and, when possible, screw-retention of the prosthesis. A novel implant design geared toward achieving a predictable level of primary stability while adhering to the aforementioned physiologic principles was recently introduced. Both primary and secondary implant stability, along with hard and soft tissue stability, are demonstrated in this study of 107 consecutively placed implants. Rotational and axial stability can be produced with this newly designed implant, along with predictable osseointegration and tissue preservation.

Use of a Novel Implant with an Inverted Body-Shift and Prosthetic Angle Correction Design for Immediate Tooth Replacement in the Esthetic Zone: A Clinical Case Series.

A clinical case series of three patients is presented using a novel implant design to not only address primary stability but also to prevent damage to the labial bone plate and improve the interdental space for papillae preservation with immediate tooth replacement therapy. This unique implant design features an apicocoronal inverted body-shift in diameter (wide to narrow), shape (tapered to cylindrical), thread depth (deep to shallow), and thread pattern (V-shaped to square) to achieve uncompromised primary stability and esthetics, particularly in extraction sockets, in a singular body form. In addition, the implant possesses a prosthetic angle correction within the implant body to facilitate screw-retention of the restoration and avoid the risk of apical socket perforation.

Evaluation of poly lactic-co-glycolic acid-coated ß-tricalcium phosphate for alveolar ridge preservation: A multicenter randomized controlled trial.

BACKGROUND: Alveolar ridge preservation via socket grafting (ARP-SG) is indicated to attenuate physiologic alveolar bone resorption as a consequence of tooth extraction. However, a specific bone grafting material that is patently superior has not been identified yet. The aim of this randomized controlled trial was to evaluate the efficacy of a moldable alloplastic graft, Poly Lactic-Co-Glycolic Acid-Coated ß-Tricalcium Phosphate (PLGA-ß-TCP), for ARP purposes [Group A] compared to freeze-dried bone allograft (FDBA) particles covered with a rapidly absorbable collagen dressing (RACD) (Group B) in function of a panel of radiographic, histomorphometric, and implant-related outcomes. METHODS: Patients in need of extraction of a single posterior tooth (premolar or molar) and subsequent replacement with a dental implant were recruited and randomly allocated into one of the two treatment groups. Follow-up visits took place at 1, 2, 4, 8, and 16 weeks. Cone-beam Computed Tomography (CBCT) scans were obtained at baseline and at 16 weeks. Sites were re-entered at 20 weeks for bone core biopsy harvesting and subsequent implant placement. After delivery of the final implant-supported restoration, follow-up visits were scheduled at 6 and 12 months to monitor peri-implant tissue health and marginal bone levels using standardized intraoral periapical radiographs. RESULTS: A total of 45 patients were initially enrolled in the study, of whom 43 received an implant and 32 completed the study. Healing was uneventful in all sites after ARP-SG and implant placement. No site required bone augmentation to allow for implant placement. CBCT scan analyses showed no statistically significant differences between groups in terms of reduction of horizontal width, midbuccal / midlingual height and ridge volume. Histomorphometric assessments revealed a statistically significant difference between both groups in terms of mineralized tissue formation (Group A = 27.0% ± 22.1% versus Group B = 38.2% ± 12.5%; P < 0.05). On the contrary, no significant differences were observed regarding percent of remaining bone grafting material and non-mineralized tissue. No implant failed throughout the study period and marginal bone level change was negligible in both groups. CONCLUSIONS: Although a higher proportion of mineralized tissue was associated with the use of FDBA+RACD compared to PLGA-ß-TCP alone, both ARP-SG approaches rendered comparable outcomes in terms of maintenance of alveolar bone dimensions, feasibility of implant placement, implant survival, and peri-implant bone level stability up to 12 months post-loading.

Microbiological Profile and Human Immune Response Associated with Peri-Implantitis: A Systematic Review.

PURPOSE: To evaluate and synthesize the existing evidence on the microbiological and human immune response associated with peri-implantitis in comparison to healthy implants. MATERIALS AND METHODS: Three electronic databases (MEDLINE, Embase, and Cochrane Library) were searched in October 2019 to identify clinical studies evaluating the microbiota and the immune response associated with peri-implantitis. Two reviewers independently screened the studies and used the full text to extract the data. A qualitative synthesis was performed on the extracted data and summary tables were prepared. Due to clinical and methodological heterogeneity among included studies, no meta-analysis was performed. RESULTS: Forty studies were included in this review. Of these, 20 studies compared the microbiological profile of peri-implantitis with healthy implants. Nineteen studies focused on the immune response associated with peri-implantitis in comparison to healthy implants. Three studies focus on gene polymorphism associated with peri-implantitis. The most commonly reported bacteria associated with peri-implantitis were obligate anaerobe Gram-negative bacteria (OAGNB), asaccharolytic anaerobic Gram-positive rods (AAGPRs), and other Gram-positive species. In regard to immune response, the most frequently reported pro-inflammatory mediators associated with peri-implantitis were IL-1ß, IL-6, IL-17, TNF-α. Osteolytic mediator, e.g., RANK, RANKL, Wnt5a and proteinase enzymes, MMP-2, MMP-9, and Cathepsin-K were also expressed at higher level in peri-implantitis sites compared to control. CONCLUSIONS: Peri-implantitis is associated with complex and different microbiota than healthy implants including bacteria, archaea, fungi, and virus. This difference in the microbiota could provoke higher inflammatory response and osteolytic activity. All of this could contribute to the physiopathology of peri-implantitis.

Immediate Tooth Replacement Therapy in Postextraction Sockets: A Comparative Prospective Study on the Effect of Variable Platform-Switched Subcrestal Angle Correction Implants.

Immediate tooth replacement therapy (ITRT), ie, immediate implant placement and provisional restoration in postextraction sockets, has been shown to achieve favorable outcomes in reference to soft tissue stability and esthetics. However, avoiding socket perforation with uniaxial implants in the anterior maxilla can be challenging due to the inherent anatomy. Dual or co-axis subcrestal angle correction (SAC) implants have been developed to change the restorative angle of the clinical crown restoration subcrestally at the implant-abutment interface to enhance the incidence of screw-retained definitive restorations. An additional benefit of this macrodesign implant feature is variable platform switching (VPS) that increases soft tissue gap distance above the implant platform. The purpose of this prospective study on ITRT in maxillary anterior postextraction sockets was to investigate the effect of SAC with VPS (SAC/VPS) compared to conventional platform-switch-design implants (PS) relative to ridge dimension stability and peri-implant soft tissue thickness. A total of 29 patients had undergone ITRT and received either a PS or SAC/VPS implant; previously described measurements were made compared to the contralateral natural tooth sites. When the comparison of buccal soft tissue thickness was made, SAC/VPS showed a greater increase compared to PS (3.12 mm vs 2.39 mm, respectively) with statistical significance (P = .05). The increase was independent from periodontal phenotype. Therefore, SAC/VPS may increase peri-implant soft tissue thickness and help minimize recession following ITRT.

Tapered Versus Inverted Body-Shift Implants Placed Into Anterior Post-extraction Sockets: A Retrospective Comparative Study.

BACKGROUND: A retrospective comparative radiographic and clinical studywas performed to evaluate primary stability, bone volume, and esthetic outcomes of tapered (T) implants (control group) versus inverted body-shift (INV) implants (test group). METHODS: A total of 42 platform-switched implants, 21 T and 21 INV, were used to replace nonrestorable teeth in maxillary central incisor post-extraction sockets. Implant primary stability and insertion torque values in addition to radiographic differences in labial plate dimension, tooth-to-implant distance, and marginal bone levels were correlated with clinical outcomes using the pink esthetic score (PES). RESULTS: Statistically significant differences (P ≤ .05) were found between groups, with T implants having not only lower primary stability at immediate implant placement than INV implants but also less circumferential bone volume at recall. Consequently, lower PESs were seen in the T implant group that equated to an increased frequency of midfacial recession, tissue discoloration, and papilla loss. CONCLUSIONS: INV implants, which feature a unique macro hybrid design, may offer advantages over T implants in maxillary anterior post-extraction sockets with regard to achieving both higher primary stability and superior esthetic outcomes.

Clinical Outcomes of Maxillary Anterior Postextraction Socket Implants with Immediate Provisional Restorations Using a Novel Macro-Hybrid Implant Design: An 18- to 24-Month Single-Cohort Prospective Study.

Extraction and immediate implant placement/restoration in the esthetic zone is clinically challenging; benefits include fewer surgical appointments and maintenance of peri-implant soft tissues throughout the treatment period, and limitations include gingival recession and bone dehiscence during surgery. Macro-hybrid implants (large-diameter apical/narrow-diameter occlusal) were placed in 19 patients immediately following the extraction of hopeless maxillary anterior teeth. Immediate restorations were fabricated without occlusal contacts. Pre- and postplacement cone beam computed tomography (CBCT) scans were taken. Nineteen implants were available for recall 13 to 25 months postoperatively. The overall implant cumulative survival rate was 100% (range: 13 to 25 months, mean: 19 months), and mean insertion torque value was 65 Ncm. Mean Pink Esthetic Score was 12.63 at 6 months, and was 13 at the 18- to 24-month follow-up. Mean mesial and distal tooth-to-implant distances immediately after implant placement were 2.55 ± 1.29 mm and 2.29 ± 0.82 mm, respectively. Interproximal bone crest width, distance, and height were maintained at implant platforms, mesially and distally, 18 to 24 months postoperative. The results of this study indicated that the macro-hybrid implant geometry for this immediate surgical/restorative protocol provided excellent and stable 2-year results relative to implant survival (100%), labial plate thickness via CBCT evaluations, tooth-to-implant distances immediately post-implant placement, PES, and interproximal bone crest width, distance, and heights, which were maintained at the implant platforms.

Changes in Peri-implant Soft Tissue Thickness with Bone Grafting and Dermis Allograft. Part II: A Comparative Retrospective Case Series Using a Subcrestal Angle Correction Implant Design.

Immediate tooth replacement therapy (ITRT) in the maxillary anterior sextant is an increasingly frequent treatment option sought by patients and performed by clinicians worldwide. Achieving long-term results that are predictable, stable, esthetic, and healthy is the ultimate goal. This trend also lends itself to minimally invasive surgery as well as defining the procedure to a singular surgical intervention. Preserving and augmenting hard and soft tissues at the time of immediate implant placement provides the best opportunity to achieve these goals. Incorporating an implant with a subcrestal angle correction [SAC] or biaxial feature facilitates screw-retention of both provisional and definitive restorations through the cingulum portion of the crown. Compared to uniaxial implants, these implants also feature an extended or variable platform switch [VPS] facially. Measurements of the peri-implant soft tissue thickness 2.0 mm apical to the facial free gingival margin were compared between two groups of 15 consecutively treated patients with different implant designs to evaluate the effect of SAC/VPS for ITRT. The null hypothesis was that there is no difference between uniaxial and biaxial implants with bone grafting and dermis allograft. These authors contend that using a combined hard and soft tissue grafting approach along with SAC/VPS biaxial implants has a synergistic effect on increasing peri-implant soft tissue thickness compared to uniaxial implants.

Advances in implant therapy in North America: Improved outcomes and application in the compromised dentition.

Advances in dental implant therapy have strengthened our understanding of the management of the implant-soft tissue interface, with site-specific implications ranging from marginal tissue management and esthetics to immediate placement and restoration, and extend to patient-level implications of systemic conditions. The advancements in implant therapy have placed an increased emphasis on patient-centered outcomes. In this paper, the following conclusions can be drawn: improvements in both esthetics and long-term maintenance have been guided by the study of the marginal peri-implant tissues leading to innovations in implant design along the implant-abutment interface. Patient expectations for simple and realistic time intervals for treatment have promoted the use of immediate implant placement and restoration. The expansion of implant therapy offers implant options for patients with medical conditions, with one in particular, diabetes mellitus a focus of this paper. Studies on patients with diabetes are supporting the development of evidence-based treatment considerations with broader application and greater benefits for the use of implant therapy across a larger patient population. This paper is not intended to offer a comprehensive review, but offers a representative review of some of the many contributions of USA and North American clinicians to the global scientific dialogue that has guided the development of dental implant therapy.

Flapless Postextraction Socket Implant Placement: The Effects of a Platform Switch-Designed Implant on Peri-implant Soft Tissue Thickness-A Prospective Study.

This paper presents the results of a prospective study on the clinical effect of grafting the buccal gap with platform switching, following flapless tooth extraction and immediate implant placement and provisional restoration, on (1) alterations in buccolingual ridge dimension and (2) midfacial peri-implant soft tissue thickness. Fifty-six patients were placed in one of four treatment groups: (1) a non-platform-switching implant (Non-PS, n = 14); (2) a non-platform-switching implant and bone graft (BG/Non-PS, n = 14); (3) a platform-switching implant (PS, n = 15); and (4) a platform-switching implant and bone graft (BG/PS, n = 13). Buccolingual ridge dimensional change and peri-implant soft tissue thickness at 2 mm below the free gingival margin were measured. Both PS and BG/PS groups showed an increase in buccolingual dimension compared to the contralateral natural tooth site as well as peri-implant soft tissue thickness of > 2.5 mm, clinically. Platform switching was associated with significantly greater midfacial soft tissue thickness than bone grafting (mean ± standard deviation: 2.17 ± 0.04 for Non-PS and 3.55 ± 0.14 for PS). Using platform-switched implants, in conjunction with immediate implant placement and immediate provisional restoration, was associated with a significantly greater stability of ridge dimension and peri-implant soft tissue thickness than using non-platform-switched implants when measured 12 months after placement of the final restoration. Platform switching may help achieve preservation of ridge dimension and enhance the stability of peri-implant soft tissue following immediate implant placement and provisional restoration without bone grafting. Further research is required to assess the long-term outcome.

Flapless Postextraction Socket Implant Placement, Part 3: The Effects of Bone Grafting and Provisional Restoration on Soft Tissue Color Change-A Retrospective Pilot Study.

This article presents the results of a soft tissue color study on flapless immediate implant therapy from a sample of 23 patients who received either a provisional restoration alone or with bone grafting. The gingival color in clinical photographs was measured for the implant and for the contralateral tooth site at 2.0 and 5.0 mm below the free gingival margin using Photoshop software (Lightroom CC, Adobe). The average color difference (ΔE) values for the two groups were 2.6 and 2.4 at 2.0 mm and 1.9 and 2.5 at 5.0 mm from the free gingival margin, respectively. Approximately 80% of the sites were below the visibly perceptible threshold (ΔE = 3.1 ± 1.5) and not detectable by the human eye. The use of provisional restorations has shown positive outcomes on the stability of peri-implant soft tissue thickness and lower ΔE values. Further research is required to assess esthetic outcomes inclusive of color change relative to the clinical treatment rendered.