Conventional avulsion versus less traumatic extraction of ankylosed roots with a magnetoelectric device in anterior maxillary areas.

The analysis aimed to compare two different single-tooth extraction surgical approaches in anterior maxillary areas of the ankylosed teeth: less traumatic magneto-electrical (mag) versus conventional tooth extraction (con) in minimizing the adverse effects on post-extractive sockets. Parameters of clinical interest such as intra-surgical fracture of the buccal bone plate, presence of postoperative inflammation, and application of stitches were acquired from medical records. The data were subjected to Pearson's χ2 analysis or to Fisher's exact test with significance at 0.05. Sixty-six hopeless maxillary permanent ankylotic teeth were extracted in the same number of patients. In the mag group 2 incisors suffered a fracture. Two patients out of 40 had signs and symptoms of inflammation that resolved completely within 3 days. In the con group 18 out of 26 patients suffered from buccal alveolar fracture. Six of these patients experienced signs of inflamed tissue. The two groups showed significant differences with p-values ≤0.0009 with regards to fracture (2/38 vs. 18/8) and tissue inflammation variables (2/38 vs. 10/16). A significantly different distribution about the presence of sutures was registered between the mag (4/36) and the con (18/8) group with a p-value <0.0001. Mag group seemed to have reduced frequency of fractured and infected post-extractive sites.

Specific use of the implant stability quotient as a guide to improve healing for patients who had undergone rehabilitation with fixed implant-supported dental prostheses.

PURPOSES: to develop a clinical approach to evaluating osteointegration around bone implants and try to determining which was the correct time of implant loading in different edentulous indications, that is, either properly positioned implants or implants "at risk", generally referred to as implants having increased probability of failure (namely those for which primary stability had been achieved via a time-consuming surgery). MATERIALS: Several implant-supported rehabilitation strategies, with or without bone augmentation procedures, were performed in the upper and lower arches: From 2 to 5 months following implant placement, the prosthetic restorations were performed. A resonance frequency analyzer allowed clinicians to measure intraoperative and postoperative implant stability, then the values of the implant stability quotient, ISQ, ranging from 0 to 100, were registered. ISQs were ranked into 3 levels: Green (ISQ ≥ 70), Yellow (60 ≤ ISQ < 70), and Red (ISQ < 60). Groups were subjected to Pearson's χ2 analysis, with YATES correction when necessary, with a significance level of 0.05. RESULTS: A total of 213 implants had been included. When the distribution of normalized values of ISQ registered for implants inserted in native bone and loaded at 2-3 months (5 Red, 19 Yellow, and 51 Green) was compared to that of native implants loaded after 4-5 months (4 Red, 20 Yellow, and 11 Green), a significative difference was found (p-value = 0.0037). At the time of loading, significance was lost. Significant clinical improvements on the distribution of normalized values of ISQ were apparent for both the implants placed in pristine and those placed in lifted sinuses; no significant differences were registered between the two groups. CONCLUSION: At the loading time, implants considered to be at risk behaved similarly to the native sites for which the overall prosthetic workflow took about few; results confirmed that the mandibular implants appeared to have higher stabilities when compared to maxillary implants at both the intraoperative and the postoperative surveys.

Volume assessment of the external contour around immediate implant with or without immediate tooth-like crown provisionalization: A digital intraoral scans study.

PURPOSES: To examine differences between immediate and delayed dental implant loading in maxillary aesthetic areas. METHODS: In this retrospective controlled analysis, 43 subjects who underwent immediate placement of the dental implant in a post-extraction socket were ranked into either immediate (24 implants loaded with non-occlusal tooth-like profile provisional prostheses fabricated by virtual diagnostic impressions and an in-office dental milling machine) or delayed group (19 implants loaded with conventional cover screws and secondary intention healing). Intraoperatively and then four months later, scans of the external layers were acquired with an optical scanner. The width of the alveolar crest and Jemt papilla index were acquired. Non-parametric tests were applied with a level of significance set at p < 0.01. RESULTS: In both groups, the volumes and areas showed significant reductions from the baseline to the 4-month survey. Reductions in volume appeared to be statistically different between the two groups (-39±31 mm3 for the immediate and 89 ± 30 mm3 for the delayed group). The final Jemt papilla index appeared significantly different between the immediate (mesial, 2.5 and, distal, 3) and delayed groups (2 for both aspects). CONCLUSIONS: Immediate provisionalization significantly reduced volume loss and area shrinkage at the external layer when data were compared to a delayed rehabilitation strategy.

Long-Term Outcomes of Implants Placed in Maxillary Sinus Floor Augmentation with Porous Fluorohydroxyapatite (Algipore® FRIOS®) in Comparison with Anorganic Bovine Bone (Bio-Oss®) and Platelet Rich Plasma (PRP): A Retrospective Study.

PURPOSE: The objective of this retrospective study was to evaluate the long-term clinical outcomes of bone regeneration procedures using algae-derived plant hydroxyapatite (Algipore® FRIOS®) compared with demineralized anorganic bovine bone (Bio-Oss®), in combination with autologous blood-derived PRP. MATERIALS AND METHODS: Partially edentulous patients with severe atrophy of posterior maxillary treated by means of the split bone technique in a two-stage grafting procedures were observed for up to seven years after implants placement. After surgeries, the natural porous fluorohydroxyapatite (FHA) (Algipore® FRIOS®; Group, n = 29) or anorganic bovine bone (Bio-Oss® Group, n = 28) with autogenous bone in a 50:50 composite ratio with PRP, were administered in a 2.8-mm critical-size defect (CSD). Four months later, implants were placed at second-stage surgery. RESULTS: A sample of fifty-seven consecutive patients who required sinus augmentation was included in the study, and 57 implants were placed. There was no drop out or loss of follow-up of any case. Clinical and radiographic examinations revealed a comparable pattern of newly formed bone in both groups after seven years of functional loading for implants placed after sinus augmentation using porous fluorohydroxyapatite and anorganic bovine bone. No significant difference in marginal bone loss was found around implants in both groups. CONCLUSIONS: The favorable implant outcomes suggest both biomaterials are suitable for sinus grafting in severely atrophic maxillae.

Interpositional bone grafts in the posterior mandibular region: a report on six patients.

The purpose of this study was to evaluate treatment of resorbed posterior mandibles with interpositional bone grafts (the "sandwich" technique) and implant-supported prostheses. Six consecutive patients with resorbed posterior mandibles (seven sites) were 4reated by the sandwich osteotomy technique with an interpositional bone graft harvested from the iliac crest. Vertical bone height was measured before surgery and 3 to 4 months later, prior to implant placement, on computed tomography scans to evaluate the augmentation obtained. In all the treated sites it was possible to place implants. None of the 21 implants placed failed, and minimal bone resorption was present 14 to 16 months after the prosthetic loading. If confirmed by long-term follow-up studies and more cases, these findings suggest that interpositional bone grafting in the posterior mandible could be a viable alternative to other surgical techniques.

Impact of implant surface and grafting protocol on clinical outcomes of endosseous implants.

PURPOSE: The objectives of this study were to (1) evaluate the survival of implants placed in maxillary sinuses augmented with a 70:30 mixture of autogenous bone and anorganic bovine hydroxyapatite (Bio-Oss) at 1 and 5 years, (2) observe the difference in survival rate between 1-stage and 2-stage procedures, and (3) compare the survival rate of rough-surfaced implants with that of machined implants. MATERIALS AND METHODS: A total of 30 consecutively patients (48 sinuses) with Cawood and Howell Class V and VI atrophy were evaluated. Lateral osteotomy techniques were used in all cases. Implants were placed either simultaneous with grafting (1-stage procedure) or after a delay (2-stage procedure), depending on the amount of residual bone. A 70:30 mixture of autogenous bone and anorganic bovine hydroxyapatite was used as the graft material. All patients were followed up at 1 year after prosthetic loading, while a limited group of these patients was followed up to 5 years. RESULTS: In 8 patients where the residual crestal bone under the sinus floor assessed by computed tomography was at least 4.5 mm (mean, 5.3 mm), the 1-stage procedure was used for 11 sinus elevations and 32 implants. In 22 patients where the residual crestal bone was less than 4.5 mm (mean, 2.5 mm), the 2-stage procedure was used for 37 sinus elevations and 108 implants. For the 140 implants placed, the overall survival rate was 95.7% at the healing abutment surgery, and the cumulative survival rate was 94.9% at 1 and 5 years. The type of surgical technique was significantly associated with implant failure (P < .05); implants placed using the 1-stage procedure showed a failure rate of 12.5%, while implants placed with the 2-stage procedure had a failure rate of 2.8%. No significant difference in survival rate was observed with respect to implant surface. CONCLUSIONS: A high survival rate was achieved when sinus elevation was performed with a combination of autogenous bone and anorganic bovine hydroxyapatite, even where a minimal amount of residual crestal bone was present. The survival rate was improved when implants were placed after a healing period.