Immediate single-tooth replacement with acellular dermal matrix allogeneic bone on sloped platform-switching implants: A case series.

Achieving predictable success with implants in the aesthetic zone is essential for clinicians. Promoting marginal bone and stability of the gingival environment is key to obtaining a predictable aesthetic outcome. The present study aimed to describe a technique that combines a flapless approach to immediate extraction and placement of sloped implants, using an acellular dermal matrix to contain the coronal aspect of a deproteinised bovine bone mineral graft. This minimally invasive technique results in stable augmentation of soft tissue thickness to ensure predictable aesthetic results. A collection of case reports with a follow-up period of up to 45 months is presented to demonstrate the surgical technique. Clinical presentation showed relative stability of the soft tissue margins during the evaluation period.

The Importance of Interdisciplinary Treatment in an Esthetically Challenging Case.

A single missing tooth is a common occurrence among young patients and impacts esthetics and long-term oral health in terms of compromised bone, gum tissue, and, if warranted, an implant and final prosthesis. In this case report, after years of poorly executed orthodontic therapy, the patient's dental growth complicated the development of an esthetically pleasing smile. An interdisciplinary approach was utilized comprising periodontal surgery, a second course of orthodontics, and prosthodontics to provide comprehensive patient care that included evaluation of occlusion and esthetics. Orthodontic treatment was performed to position the teeth in the most esthetic, functionally optimal position. An implant crown in the maxillary left central incisor position and direct bonding on the maxillary right central incisor were indicated to treat a large edentulous area. Final orthodontic treatment achieved a substantial reduction of incisor protrusion and proper mesial-distal distance between the future implant and adjacent teeth. An ideal emergence profile, appealing esthetics, and a provisional restoration were created before the final crown. Optimal alignment of teeth relative to the arch was achieved, and adequate tissue dimensions were created by combining surgical augmentations with provisional restorative therapy.

Simultaneous Crestal Sinus Elevation and Implant Placement Using a Ribose Cross- Linked, Collagen Bone Graft Material: Case Series of 28 Consecutive Patients.

The anatomic proximity of the maxillary sinus to the apices of molar and premolar teeth is a significant factor when considering implant therapy to replace maxillary posterior teeth. An emerging field within tissue engineering is the application of xenografts capable of stimulating de novo bone regeneration. This article presents a technique using a crestal approach to sinus grafting utilizing a novel bone graft material composed of porcine, ribose cross-linked collagen seeded with a nanocrystalline hydroxyapatite mineral. This highly cohesive biomaterial is able to minimize graft migration, which is particularly important in case of undetected Schneiderian membrane perforations. The material also has been demonstrated in animal studies to be capable of osteoconduction, resulting in increased bone volume in ridge augmentation procedures.

Prosthetic and Surgical Management of Atypical Space When Teeth Are Missing.

When a patient presents with congenitally missing teeth, early diagnosis and comprehensive treatment planning are critical to effective restorative management. Interdental space allocation must be identified to accommodate proper clinical crown proportion(s) through a surgical-prosthetic solution. This article, which presents two case reports describing situations that clinicians may commonly face, demonstrates the management of atypical tooth spacing caused by congenitally missing teeth. The implementation of interdisciplinary therapy resulted in successful outcomes from both functional and esthetic perspectives.

Surgical and Prosthetic Management of Implants: Single and Full-Arch Reconstruction.

Whether it's a single tooth or multiple teeth, tooth loss has esthetic, functional, and health implications. Replacing multiple teeth can be especially complicated due to the loss of surrounding structures, often making it necessary to use additional procedures--eg, bone grafting--to solve the problems that arise. Fortunately, modern techniques and materials in dentistry enable clinicians to replace and mimic lost teeth in a realistic, healthy, and functional way like no other field in medicine. This report discusses two cases that involve multiple subspecialties working synergistically to accomplish ideal tooth replacement and emphasizes the importance of proper diagnosis, treatment planning, and execution of surgical and restorative therapy to achieve optimal results.

Advanced Esthetic Management of Dental Implants: Surgical and Restorative Considerations to Improve Outcomes.

OBJECTIVE: Successful dental implant therapy in the maxillary anterior dentition requires meticulous attention to surgical and prosthodontic measures. CLINICAL CONSIDERATIONS: Proper diagnosis, extraction technique, implant selection, and placement significantly impact outcomes. Respect of hard and soft tissue physiology following tooth loss and implant placement requires specific steps be taken. Management tissue contours properly, via regenerative therapy, results in successful framing of the restoration. Provisionalization and definitive restorative therapy also impacts the level of esthetic success. The contours of the temporary abutment and crown develop soft tissue contours for the final restoration. Overcontouring can lead to soft tissue recession and mucosal asymmetry. Design of the definitive crown(s) is crucial for long-term maintenance of esthetically acceptable results. CONCLUSION: Visualizing the outcome of treatment prior to its inception, following specific surgical and restorative guidelines, increases the likelihood of success. CLINICAL SIGNIFICANCE: This article demonstrates the importance of proper surgical and prosthetic principles in achieving esthetic implant results.

The art and science of the direct posterior restoration: recreating form, color, and translucency.

In the past two decades the major advances bonding has experienced are directly related to material improvements and significant advances in adhesive technology. It is because of the superior physical properties of the posterior composite that we can provide patients with a long-lasting restoration if a meticulous bonding protocol was followed. It is possible simultaneously to preserve healthy tooth structure; reproduce its original shape, color, and translucency; and strengthen the affected tooth. Although the main focus in the past was on improving the bonding adhesive properties and the development of strength and polishability of the restorative materials, the current objective is to simplify the bonding technique and to create a shrinkage-free composite while simultaneously improving its optical properties.