International Journal of Periodontics & Restorative Dentistry, 4/2021
Seiten: 511-519, Sprache: Englisch
The aim of this classification is to diagnose and grade four different types of soft tissue deficiency around loaded, osseointegrated implants according to increasing severity. The suggested soft tissue augmentation to increase the width of the peri-implant keratinized mucosa will improve the long-term stability of peri-implant tissues.
International Journal of Periodontics & Restorative Dentistry, 1/2021
Seiten: 23-30, Sprache: Englisch
MAPA-cision, named after those who first introduced the method, is a novel simplified regenerative technique for periodontal-orthodontic cases that can be used in all circumstances where bone thickening is required. It is an innovative, minimally invasive piezoelectric surgical procedure designed to facilitate orthodontic tooth movement while simultaneously increasing bone thickness with guided bone regeneration principles. A new regenerative device consisting of a resorbable collagen membrane with filling materials (a “bone bundle” or “small sausage”) is inserted through a tunneling procedure to increase the bone envelope width by allowing the teeth to move within an enhanced periodontal support.
International Journal of Periodontics & Restorative Dentistry, 4/2020
DOI: 10.11607/prd.4647, PubMed-ID: 32559030Seiten: 487-496b, Sprache: Englisch
The aim of this retrospective study was to evaluate long-term clinical and radiologic outcomes of submerged and nonsubmerged guided bone regenerative treatments for peri-implantitis lesions. Strict methods of implant-surface decontamination and detoxification were performed. Data on clinical probing depth, soft tissue measures, and marginal bone level that were documented by comparative radiographs were obtained from 45 patients, for a total of 57 implants prior to treatment and at the latest follow-up. The average followup period was 6.9 years (range: 2 to 21 years). Analysis of implant-based data revealed a success rate of 70.2% for a total of 40 implants. Recurrence of periimplantitis was observed on 9 implants, and 8 implants were removed. The regenerative procedures, under a strict periodontal control, were effective in the treatment of moderate to advanced peri-implantitis lesions.
International Journal of Periodontics & Restorative Dentistry, 2/2020
DOI: 10.11607/prd.4616, PubMed-ID: 32032403Seiten: 203-210d, Sprache: Englisch
This investigation was designed to evaluate the healing response of 9.3-μm CO2 laser–assisted periodontal therapy. Five patients presenting with moderate to severe periodontitis, with an initial pocket depth (PD) ≥ 5 mm and with teeth predetermined to be surgically extracted, were enrolled and consented to treatment with full-mouth CO2 laser–assisted therapy. The laser treatment was carried out in the Ultraguide Mode at a setting of 0.25-mm spot size, with an average power of 0.65 to 1.15 watts and 20% mist. The laser tip was passed from the gingival margin and down apically to the base of the pocket with a sweeping L motion. The teeth were intensely scaled with piezoultrasonic instrumentation afterwards. A second pass of the laser tip was performed for the study teeth. At 9 months, all patients were clinically reevaluated. For sites with an initial pocket depth of ≥ 7 mm, a mean PD reduction of 3.97 ± 1.36 mm and a mean clinical attachment level gain of 3.54 ± 1.54 mm were achieved, resulting in a mean PD of 3.91 ± 0.77 mm. En bloc biopsy samples of four teeth were obtained and analyzed; two demonstrated histologic evidence of new bone formation while the other two healed with a long junctional epithelium with minimal inflammatory infiltrate. Further long-term clinical studies are needed to investigate the treatment stability obtained with a 9.3-μm CO2 laser compared to conventional surgical therapy. Nevertheless, the encouraging clinical results indicated that adjunctive use of the 9.3-μm CO2 laser–assisted periodontal therapy can be beneficial for treatment of periodontally compromised patients.
International Journal of Periodontics & Restorative Dentistry, 3/2019
DOI: 10.11607/prd.3803, PubMed-ID: 30986290Seiten: 409-414, Sprache: Englisch
Thirty-eight patients (aged 25 to 74) requesting extraction-socket and sinus augmentation procedures (27 and 11 patients, respectively) prior to implant placement volunteered to participate in this case series protocol. Surgical sites were grafted with either biphasic calcium phosphate (BCP) + collagen (for extractionsocket augmentation) or BCP with a collagen barrier membrane (for maxillary sinus augmentation). All patients completed the 1-year postloading follow-up, which consisted of clinical and radiographic evaluations. No implants were lost, and both healthy soft tissue support and good radiographic evidence of supporting bone were found around implants. The result of this short-term evaluation of implants placed in areas grafted with alloplasts seemed to be favorable and promising.
International Journal of Periodontics & Restorative Dentistry, 2/2018
DOI: 10.11607/prd.3558, PubMed-ID: 29447307Seiten: 165-170, Sprache: Englisch
The goal of this investigation was to evaluate the bone-to-implant contact (BIC) of dental implants placed into fresh extraction sockets without pre-existing periapical pathology. When the extraction sites exhibited a gap distance of > 2 mm, autogenous bone harvested from surrounding surgical sites was grafted to fill that gap with no barrier membranes. All implants were clinically stable and successful at 6 months postoperative. The histologic examination demonstrated an average of 66.2% BIC for all five immediately placed dental implants. The results of this study provided sufficient histologic and histomorphometric knowledge to support immediate dental implant placement in carefully selected clinical scenarios.
International Journal of Periodontics & Restorative Dentistry, 2/2017
DOI: 10.11607/prd.3131, PubMed-ID: 28196156Seiten: 174-181, Sprache: Englisch
The goal of this investigation was to evaluate the efficacy of dental implants with a surface that was sandblasted with large grit and acid etched in a human model. Eight patients volunteered to allow the biopsy of a small implant in exchange for complete dental rehabilitation at no cost. All biopsy sites received soft and hard tissue reconstruction, and this report provides observation of successful bone-to-implant contact and successful prosthesis construction for the patient. The patients enthusiastically reported improved quality of life as a result of participation in this study. The surgeons' confidence in this implant was reflected by the clinical and histologic result of the study.
International Journal of Periodontics & Restorative Dentistry, 5/2015
DOI: 10.11607/prd.2374, PubMed-ID: 26357692Seiten: 624-636, Sprache: Englisch
This case series presents clinical outcomes on reentry using regenerative submerged and nonsubmerged approaches in peri-implant defects; pre- and posttreatment assessments of nine implants in six patients are presented. A mean bone fill value of 91.3% with a 4.88-mm mean bone gain was obtained. Neither approach led to additional bone loss or required additional bone augmentation procedures. Strict methods of implant surface decontamination and detoxification were used on all patients, regardless of implant surface characteristics. The regenerative procedure was effective in the treatment of moderate to advanced peri-implantitis lesions without compromising the previous fixed implant-supported prostheses. These preliminary results are reasonably encouraging in that all cases showed bone gains. Nevertheless, caution must be exercised when determining reosseointegration, because it is not possible to ascertain it in clinical practice.
International Journal of Periodontics & Restorative Dentistry, 3/2015
PubMed-ID: 25909522Seiten: 354-361, Sprache: Englisch
The coronally advanced flap (CAF) has demonstrated controversial results in the treatment of gingival recession (GRs). The hypothesis of this study was that the CAF can partially reduce GR values over time. Root coverage (RC) in 24 Miller Class I GRs treated with a CAF by one experienced operator is presented with several periodontal parameters and postoperative morbidity. The mean percentage of RC was 80.35% at 3 months and 58.56% at 24 months; these differences were statistically significant. Keratinized gingival width, keratinized papillary gingival height, and gingival thickness were related to RC at 6 months. Postoperative pain was not statistically different over time. The CAF is not a predictable treatment for Miller Class I GRs after a 2-year follow-up period.
International Journal of Periodontics & Restorative Dentistry, 2/2015
DOI: 10.11607/prd.2126, PubMed-ID: 25738336Seiten: 160-167, Sprache: Englisch
This case report shows the combined use of piezosurgical and orthodontic procedures to successfully relocate two severely malpositioned implants in the anterior maxilla by moving them separately, with the objective of attaining functional prosthetic restoration and acceptable esthetics.