The Rigid-Shield Technique: A New Contour and Clot Stabilizing Method for Ridge Preservation.

Tooth extraction causes vertical and horizontal alveolar bone loss and consequent remodeling. Several methods have been introduced in terms of so-called “ridge preservation” techniques, which mostly resemble guided bone regenerative (GBR) procedures using filler materials and membranes in order to stabilize the respective sites. This conceptual case report describes a novel approach using a degradable polylactic acid membrane covered with a collagen matrix, which aims to reshape the resorbed alveolar wall and thereby to stabilize the soft tissues during matrix formation and socket mineralization. Clinical re-entry, radiographic (CBCT) and histologic evaluation proved adequate for osteoneogenesis despite an unfavorable initial situation: An implant could be ideally placed, which was circumferentially covered by bone. This minimally invasive method could offer a new method to approach socket preservation without using filler materials and coverage of the socket entrance. However, more controlled research on this topic is needed.

Single-tooth implant reconstructions: esthetic factors influencing the decision between titanium and zirconia abutments in anterior regions.

Implant-supported single crowns have become a valid alternative to conventional fixed dental prostheses due to their excellent clinical long-term results. However, along with good survival rates, esthetic factors are important for success in anterior regions. Today, several kinds of implant abutments are offered by implant manufacturers. A choice must be made between standardized and customized abutments; further, different abutment materials such as titanium or various ceramics (alumina, zirconia) are available. Finally, the reconstruction can be cemented on the abutment or screw-retained directly on the implant. When choosing an abutment for an anterior single-unit case, several factors should be considered: visibility of the region (eg, high vs low smile line); biotype of the gingiva; color of the neighboring teeth; and finally, esthetic expectations of the patient. In esthetically demanding situations, customized ceramic abutments are indicated. In patient situations with thin peri-implant soft tissues, zirconia abutments and all-ceramic crowns should be used in combination. In cases with thick mucosa, titanium can be used as the abutment material, combined with metal-ceramic crowns. In order to avoid difficulties removing excess cement, screw-retained reconstructions may be preferred; however, the screw access hole should be positioned palatal to the incisal edge.