The purpose of this research was to quantify the visual display (presence) or lack of display (ab... more The purpose of this research was to quantify the visual display (presence) or lack of display (absence) of interdental papillae during maximum smiling in a patient population aged 10 to 89 years. Four hundred twenty digital single-lens reflex photographs of patients were taken and examined for the visual display of interdental papillae between the maxillary anterior teeth during maximum smiling. Three digital photographs were taken per patient from the frontal, right frontal-lateral, and left frontal-lateral views. The data set of photographs was examined by two examiners for the presence or absence of the visual display of papillae. The visual display of interdental papillae during maximum smiling occurred in 380 of the 420 patients examined in this study, equivalent to a 91% occurrence rate. Eighty-seven percent of all patients categorized as having a low gingival smile line (n = 303) were found to display the interdental papillae upon smiling. Differences were noted for individual age groups according to the decade of life as well as a trend toward decreasing papillary display with increasing age. The importance of interdental papillae display during dynamic smiling should not be left undiagnosed since it is visible in over 91% of older patients and in 87% of patients with a low gingival smile line, representing a common and important esthetic element that needs to be assessed during smile analysis of the patient.
Clinical Implant Dentistry and Related Research, Feb 1, 2023
The cover image is based on the Original Article Clinical outcomes of retention of the buccal roo... more The cover image is based on the Original Article Clinical outcomes of retention of the buccal root section combined with immediate implant placement: A systematic review of longitudinal studies by Georgios A. Kotsakis DMD, MS et al., https://doi.org/10.1111/cid.13150. image
A longitudinal study was performed, which measured the soft tissue around implants following surg... more A longitudinal study was performed, which measured the soft tissue around implants following surgery, to determine if a predictable pattern of soft tissue changes could be identified. This study evaluated 63 implants in 11 patients. Baseline measurements were recorded at stage 2 surgery in 2-stage implant systems, and at stage 1 surgery in the 1-stage system. Subsequent measurements were recorded at 1 week, 1 month, 3 months, 6 months, 9 months, and 1 year after baseline measurements. The majority of the recession occurred within the first 3 months, and 80% of all sites exhibited recession on the buccal. It is therefore recommended that one wait 3 months for the tissue to stabilize before either selecting a final abutment or making a final impression. As a general rule, one can anticipate approximately 1 mm of recession from the time of abutment connection surgery. A comparison of this study's results with data recorded in previously reported studies reveals clinically significant trends in the nature of soft tissue healing.
Journal of Esthetic and Restorative Dentistry, 2021
OBJECTIVE One of the most common complications with dental implants placed in the smile zone is t... more OBJECTIVE One of the most common complications with dental implants placed in the smile zone is the development of mid-facial recession, creating an undesirable esthetic result. When deciding how to remediate these clinical scenarios, the question becomes whether it may be feasible to save the problematic implant or if it is more predictable to remove the implant and start all over again. However, patients may be invested emotionally, physically, and financially in the implant and remediation may be a viable option depending on the diagnosis of the specific issues at hand and multi-disciplinary clinical execution. CLINICAL SIGNIFICANCE What is crucial to understand in order to remediate these cases is answering four separate criteria: (1) is the implant in a restorable position, (2) is the implant healthy, (3) is the implant placed at an adequate depth, and (4) are components available to restore the implant. CONCLUSIONS Two different clinical reports are presented that demonstrate various treatment remedies when saving implants in the esthetic zone.
1291 E. Hillsdale Blvd, Suite 123, Foster City, CA 94404, U.S.A. Toll Free: +1 (866) 700-4332 (US... more 1291 E. Hillsdale Blvd, Suite 123, Foster City, CA 94404, U.S.A. Toll Free: +1 (866) 700-4332 (USA, Canada) | T: +1 (650) 578-9495 info@ideausa.net | www.ideausa.net Fouad Khoury D.M.D., Ph.D, Prof. Dr. med. dent. Charles Khoury D.M.D, M.S., D.U. Current Concepts in Bone Grafting and Accelerated Implant Treatment: From Minimally Invasive Augmentation to Advanced Surgical Procedures with Autogenous Bone and Soft Tissue Management May 21 – 24, 2021
Compendium of continuing education in dentistry, 2020
The decision to prescribe an adjunctive antibiotic when placing a dental implant in a systemicall... more The decision to prescribe an adjunctive antibiotic when placing a dental implant in a systemically healthy patient who is not receiving a bone graft remains a controversial issue. In an effort to elucidate this enigma, the authors analyzed, from a statistical and clinical significance perspective, seven current systematic reviews that address this concern. Hypothesis testing often does not provide clear understanding regarding the efficacy of the administration of antibiotics in association with clinical implantations. Therefore, number needed to treat (NNT) calculations may be used to determine the effectiveness of antibiotics to reduce dental implant losses. The NNT indicates how many additional patients need to be treated with antibiotics to avoid an additional implant failure in another patient. This article addresses two questions: Do antibiotics help reduce implant loss, and if they do, what is the best drug dosage to use when placing dental implants? Based on NNT calculations...
Compendium of continuing education in dentistry, 2019
An innovative macro hybrid implant design is aimed at enhancing labial plate dimension and tooth-... more An innovative macro hybrid implant design is aimed at enhancing labial plate dimension and tooth-implant distance while achieving consistent esthetic outcomes. This unique "body-shift" concept in diameter and shape combines a tapered apical portion with a cylindrical coronal portion in a singular implant body design. The overall configuration of the implant is inverted and "convergent" in form toward the implant-abutment interface where bone is thinnest. Conversely, the tapered apical portion is wider where the bone is greatest in volume and vascularity. By reducing the coronal portion of the implant with the inverted body-shift design, a coronal circumferential chamber is created, thereby allowing larger amounts of graft material to be placed labially and interdentally to create a net increased bone dimension. Use of the implant is demonstrated in a case report.
PurposeTo search the literature and to critically evaluate the findings on the periodontal outcom... more PurposeTo search the literature and to critically evaluate the findings on the periodontal outcomes of restorations and tooth‐supported fixed prostheses.Materials and MethodsPubMed was searched according to a systematic methodology, previously reported, but updated to include a larger database. Filters applied were: Case reports, clinical trial, review, guideline, randomized controlled trial, meta‐analysis, systematic reviews, and English. A narrative review was then synthesized to discuss periodontal outcomes related to restorations and tooth‐supported fixed prostheses. Relevant data was organized into four sections: Direct restorations, indirect restorations, biologic width or supracrestal tissue attachment and tooth preparation/finish line design.ResultsWhile increased gingival index, bleeding on probing, probing depth and clinical attachment loss have been associated with subgingival restorations, intracrevicular margins do not cause periodontal diseases. Inflammation and bone l...
The purpose of this research was to quantify the visual display (presence) or lack of display (ab... more The purpose of this research was to quantify the visual display (presence) or lack of display (absence) of interdental papillae during maximum smiling in a patient population aged 10 to 89 years. Four hundred twenty digital single-lens reflex photographs of patients were taken and examined for the visual display of interdental papillae between the maxillary anterior teeth during maximum smiling. Three digital photographs were taken per patient from the frontal, right frontal-lateral, and left frontal-lateral views. The data set of photographs was examined by two examiners for the presence or absence of the visual display of papillae. The visual display of interdental papillae during maximum smiling occurred in 380 of the 420 patients examined in this study, equivalent to a 91% occurrence rate. Eighty-seven percent of all patients categorized as having a low gingival smile line (n = 303) were found to display the interdental papillae upon smiling. Differences were noted for individual age groups according to the decade of life as well as a trend toward decreasing papillary display with increasing age. The importance of interdental papillae display during dynamic smiling should not be left undiagnosed since it is visible in over 91% of older patients and in 87% of patients with a low gingival smile line, representing a common and important esthetic element that needs to be assessed during smile analysis of the patient.
Clinical Implant Dentistry and Related Research, Feb 1, 2023
The cover image is based on the Original Article Clinical outcomes of retention of the buccal roo... more The cover image is based on the Original Article Clinical outcomes of retention of the buccal root section combined with immediate implant placement: A systematic review of longitudinal studies by Georgios A. Kotsakis DMD, MS et al., https://doi.org/10.1111/cid.13150. image
A longitudinal study was performed, which measured the soft tissue around implants following surg... more A longitudinal study was performed, which measured the soft tissue around implants following surgery, to determine if a predictable pattern of soft tissue changes could be identified. This study evaluated 63 implants in 11 patients. Baseline measurements were recorded at stage 2 surgery in 2-stage implant systems, and at stage 1 surgery in the 1-stage system. Subsequent measurements were recorded at 1 week, 1 month, 3 months, 6 months, 9 months, and 1 year after baseline measurements. The majority of the recession occurred within the first 3 months, and 80% of all sites exhibited recession on the buccal. It is therefore recommended that one wait 3 months for the tissue to stabilize before either selecting a final abutment or making a final impression. As a general rule, one can anticipate approximately 1 mm of recession from the time of abutment connection surgery. A comparison of this study's results with data recorded in previously reported studies reveals clinically significant trends in the nature of soft tissue healing.
Journal of Esthetic and Restorative Dentistry, 2021
OBJECTIVE One of the most common complications with dental implants placed in the smile zone is t... more OBJECTIVE One of the most common complications with dental implants placed in the smile zone is the development of mid-facial recession, creating an undesirable esthetic result. When deciding how to remediate these clinical scenarios, the question becomes whether it may be feasible to save the problematic implant or if it is more predictable to remove the implant and start all over again. However, patients may be invested emotionally, physically, and financially in the implant and remediation may be a viable option depending on the diagnosis of the specific issues at hand and multi-disciplinary clinical execution. CLINICAL SIGNIFICANCE What is crucial to understand in order to remediate these cases is answering four separate criteria: (1) is the implant in a restorable position, (2) is the implant healthy, (3) is the implant placed at an adequate depth, and (4) are components available to restore the implant. CONCLUSIONS Two different clinical reports are presented that demonstrate various treatment remedies when saving implants in the esthetic zone.
1291 E. Hillsdale Blvd, Suite 123, Foster City, CA 94404, U.S.A. Toll Free: +1 (866) 700-4332 (US... more 1291 E. Hillsdale Blvd, Suite 123, Foster City, CA 94404, U.S.A. Toll Free: +1 (866) 700-4332 (USA, Canada) | T: +1 (650) 578-9495 info@ideausa.net | www.ideausa.net Fouad Khoury D.M.D., Ph.D, Prof. Dr. med. dent. Charles Khoury D.M.D, M.S., D.U. Current Concepts in Bone Grafting and Accelerated Implant Treatment: From Minimally Invasive Augmentation to Advanced Surgical Procedures with Autogenous Bone and Soft Tissue Management May 21 – 24, 2021
Compendium of continuing education in dentistry, 2020
The decision to prescribe an adjunctive antibiotic when placing a dental implant in a systemicall... more The decision to prescribe an adjunctive antibiotic when placing a dental implant in a systemically healthy patient who is not receiving a bone graft remains a controversial issue. In an effort to elucidate this enigma, the authors analyzed, from a statistical and clinical significance perspective, seven current systematic reviews that address this concern. Hypothesis testing often does not provide clear understanding regarding the efficacy of the administration of antibiotics in association with clinical implantations. Therefore, number needed to treat (NNT) calculations may be used to determine the effectiveness of antibiotics to reduce dental implant losses. The NNT indicates how many additional patients need to be treated with antibiotics to avoid an additional implant failure in another patient. This article addresses two questions: Do antibiotics help reduce implant loss, and if they do, what is the best drug dosage to use when placing dental implants? Based on NNT calculations...
Compendium of continuing education in dentistry, 2019
An innovative macro hybrid implant design is aimed at enhancing labial plate dimension and tooth-... more An innovative macro hybrid implant design is aimed at enhancing labial plate dimension and tooth-implant distance while achieving consistent esthetic outcomes. This unique "body-shift" concept in diameter and shape combines a tapered apical portion with a cylindrical coronal portion in a singular implant body design. The overall configuration of the implant is inverted and "convergent" in form toward the implant-abutment interface where bone is thinnest. Conversely, the tapered apical portion is wider where the bone is greatest in volume and vascularity. By reducing the coronal portion of the implant with the inverted body-shift design, a coronal circumferential chamber is created, thereby allowing larger amounts of graft material to be placed labially and interdentally to create a net increased bone dimension. Use of the implant is demonstrated in a case report.
PurposeTo search the literature and to critically evaluate the findings on the periodontal outcom... more PurposeTo search the literature and to critically evaluate the findings on the periodontal outcomes of restorations and tooth‐supported fixed prostheses.Materials and MethodsPubMed was searched according to a systematic methodology, previously reported, but updated to include a larger database. Filters applied were: Case reports, clinical trial, review, guideline, randomized controlled trial, meta‐analysis, systematic reviews, and English. A narrative review was then synthesized to discuss periodontal outcomes related to restorations and tooth‐supported fixed prostheses. Relevant data was organized into four sections: Direct restorations, indirect restorations, biologic width or supracrestal tissue attachment and tooth preparation/finish line design.ResultsWhile increased gingival index, bleeding on probing, probing depth and clinical attachment loss have been associated with subgingival restorations, intracrevicular margins do not cause periodontal diseases. Inflammation and bone l...
The International Journal Of Oral & Maxillofacial Implants
A distance of more than 3 mm between two adjacent standard implants has been shown to preserve th... more A distance of more than 3 mm between two adjacent standard implants has been shown to preserve the interproximal bone peak, resulting in only 0.45 mm of resorption. The purpose of this study was to determine whether use of the platform-switching technique would change the bone resorption patterns between adjacent implants placed less than 3 mm apart. Radiographic studies of bone resorption around 41 pairs of implants placed less than 3 mm apart in 37 patients
were carried out. Mean vertical bone resorption was 0.62 mm, and the mean horizontal component was 0.60 mm. The bone peak that extended coronally beyond an imaginary line connecting the two implant-abutment interfaces was measured, and the mean bone height preservation above this interimplant line was 0.24 mm.
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Papers by Dennis Tarnow
were carried out. Mean vertical bone resorption was 0.62 mm, and the mean horizontal component was 0.60 mm. The bone peak that extended coronally beyond an imaginary line connecting the two implant-abutment interfaces was measured, and the mean bone height preservation above this interimplant line was 0.24 mm.