Alveolar bone loss

The role of prosthetic restorations in the final appearance of the surrounding soft tissues has long been recognized. Innovative prosthodontic concepts as described should be used to enhance the biologic as well as the esthetic data of the supporting tissues, in natural teeth and implants alike. Combined dental treatment modalities of different kinds (i.e., orthodontics, periodontal treatment) are often required for optimal results. Meticulous care and attention to the delicate soft tissues should be given throughout all phases of the treatment, with a view to achieving a functional, healthy, and esthetic oral environment.

PURPOSE The aim of this study was to obtain histometric measurements of bone and peri-implant mucosal tissue contact with implants of 2 sintered porous-surfaced designs. The "short-collar" design had a collar height (smooth coronal region) of 0.75 mm, while the "long-collar" model had a smooth coronal region of 1.8 mm. MATERIALS AND METHODS Implants (2 per side) were placed in healed mandibular extraction sites of 4 beagle dogs using a submerged technique. After 4 weeks of healing, they were uncovered and used to support fixed partial dentures for a 9-month period. After sacrifice, specimens were retrieved and nondemineralized sections were examined histometrically to determine the most coronal bone-to-implant contact (first BIC) using the microgap as a reference and standard mucosal parameters of "biologic width." RESULTS Significant (P = .001) differences in first BIC were found between designs (1.97 mm for long-collar versus 1.16 mm for short-collar ...

In the last decade, several investigators have reported that standard length implants (SLIs) have achieved excellent results but no report regarding SLIs (i.e. SLI, length=13 mm) inserted into alveolar bone sites previously augmented with frozen bone (FB) is available. The aim of this study was to evaluate the clinical outcome of SLIs inserted into alveolar bone sites previously augmented with FB. The survival and success rate of standard dental implants was evaluated after surgical placement into alveolar bone sites previously augmented with FB. The distance between Implant Abutment Junction and crestal bone level (i.e. delta IAJ) was measured to evaluate the peri-implant bone loss over time. Kaplan-Meier algorithm and Cox regression were used. The implant survival rate was 97.6% and no differences were detected among the studied variables by using implant loss. On the contrary, the Cox regression showed that implant surface (i.e. sandblasted and acid-etched-SLA- and CaPO(4)ceramic...

This study evaluated the clinical, radiographic, and histologic response to Bio-Oss Collagen when used alone or in combination with Bio-Gide bilayer collagen membrane for the treatment of four intrabony defects (5 to 7 mm) around single-rooted teeth. After reflecting a full-thickness flap, thorough degranulation and root planing were accomplished. In all cases, Bio-Oss Collagen was then used to fill the defects, and in two cases, a Bio-Gide membrane was placed over the filled defect. Radiographs, clinical probing depths, and attachment levels were obtained before treatment and immediately preceding en bloc resection of teeth and surrounding tissues 9 months later. Reduction in pocket depth and gain in clinical attachment level were observed for both treatment protocols. The histologic evaluation demonstrated the formation of a complete new attachment apparatus, evidencing periodontal regeneration that varied with defect morphology. This human histologic study demonstrated that Bio-O...

Although many studies have appeared about diabetes mellitus-associated periodontitis, few have compared periodontitis inflammatory markers between type 1 (T1DM) and type 2 diabetes mellitus (T2DM), and information regarding this issue is scarce and contradictory. We evaluated the levels of plasma C-reactive protein and of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in gingival crevicular fluid in two groups of subjects affected by T1DM and T2DM, in order to identify possible differences between the two classes in the inflammatory mechanisms of diabetes mellitus-associated periodontitis.

The aim of this clinical trial was to evaluate the influence of gingival tissue thickness on crestal bone loss around dental implants after a 1-year follow-up. Forty-six implants (23 test and 23 control) were placed in 19 patients. The test implants were placed about 2 mm supracrestally, whereas the control implants were positioned at the bone level. Before implant placement, the tissue thickness at implant sites was measured with a periodontal probe. After healing, metal-ceramic cement-retained prostheses were constructed. According to tissue thickness, the test implants were divided into A (thin) and B (thick) groups. Intraoral radiographs were performed and crestal bone changes were measured at implant placement and after 1 year. Mean bone loss around the test implants in group A (thin mucosa) was 1.61 +/- 0.24 mm (SE; range, 0.9 to 3.3 mm) on the mesial and 1.28 +/- 0.167 mm (range, 0.8 to 2.1 mm) on the distal. Mean bone loss in test group B (thick mucosa) implants was 0.26 +/-...

Clinicians are often confronted with changes in the anatomy of the local site following tooth extraction. Successful management of the extraction socket can be challenging, particularly in the aesthetic zone. Proper management is necessary to ensure that the implant used to support a prosthesis will remain stable. This article will recommend a classification system for various types of extraction sockets. A simple, noninvasive approach to the grafting and management of sockets when soft tissue is present but the buccal plate is compromised following tooth extraction will also be discussed. This article discusses a classification system for extraction sockets and a noninvasive approach for grafting. Upon reading this article, the reader should: Understand the proposed classification system, which addresses three different types of sockets. Become more familiar with the steps involved in a socket-repair technique for Type II sockets.

Material and Methods: Twelve mongrel dogs were included in the study. In both quadrants of the mandible incisions were made in the crevice region of the 3rd and 4th premolars. Minute buccal and lingual full thickness flaps were elevated. The four premolars were ...

ObjectiveThis systematic review aims to evaluate the scientific evidence on the efficacy in the surgical protocols designed for preserving the alveolar ridge after tooth extraction and to evaluate how these techniques affect the placement of dental implants and the final implant supported restoration.This systematic review aims to evaluate the scientific evidence on the efficacy in the surgical protocols designed for preserving the alveolar ridge after tooth extraction and to evaluate how these techniques affect the placement of dental implants and the final implant supported restoration.Material and methodsA thorough search in MEDLINE-PubMed, Embase and the Cochrane Central Register of controlled trials (CENTRAL) was conducted up to February 2011. Randomized clinical trials and prospective cohort studies with a follow-up of at least 3 months reporting changes on both the hard and soft tissues (height and/or width) of the alveolar process (mm or %) after tooth extraction were considered for inclusion.A thorough search in MEDLINE-PubMed, Embase and the Cochrane Central Register of controlled trials (CENTRAL) was conducted up to February 2011. Randomized clinical trials and prospective cohort studies with a follow-up of at least 3 months reporting changes on both the hard and soft tissues (height and/or width) of the alveolar process (mm or %) after tooth extraction were considered for inclusion.ResultsThe screening of titles and abstracts resulted in 14 publications meeting the eligibility criteria. Data from nine of these 14 studies could be grouped in the meta-analyses. Results from the meta-analyses showed a statistically significant greater ridge reduction in bone height for control groups as compared to test groups (weighted mean differences, WMD = −1.47 mm; 95% CI [−1.982, −0.953]; P < 0.001; heterogeneity: I2 = 13.1%; χ2P-value = 0.314) and a significant greater reduction in bone width for control groups compared to the test groups (WMD = −1.830 mm; 95% CI [−2.947, −0.732]; P = 0.001; heterogeneity: I2 = 0%; χ2P-value = 0.837). Subgroup analysis was based on the surgical protocol used for the socket preservation (flapless/flapped, barrier membrane/no membrane, primary intention healing/no primary healing) and on the measurement method utilized to evaluate morphological changes. Meta-regression analyses demonstrated a statistically significant difference favoring the flapped subgroup in terms of bone width (meta-regression; slope = 2.26; 95% IC [1.01; 3.51]; P = 0.003).The screening of titles and abstracts resulted in 14 publications meeting the eligibility criteria. Data from nine of these 14 studies could be grouped in the meta-analyses. Results from the meta-analyses showed a statistically significant greater ridge reduction in bone height for control groups as compared to test groups (weighted mean differences, WMD = −1.47 mm; 95% CI [−1.982, −0.953]; P < 0.001; heterogeneity: I2 = 13.1%; χ2P-value = 0.314) and a significant greater reduction in bone width for control groups compared to the test groups (WMD = −1.830 mm; 95% CI [−2.947, −0.732]; P = 0.001; heterogeneity: I2 = 0%; χ2P-value = 0.837). Subgroup analysis was based on the surgical protocol used for the socket preservation (flapless/flapped, barrier membrane/no membrane, primary intention healing/no primary healing) and on the measurement method utilized to evaluate morphological changes. Meta-regression analyses demonstrated a statistically significant difference favoring the flapped subgroup in terms of bone width (meta-regression; slope = 2.26; 95% IC [1.01; 3.51]; P = 0.003).ConclusionsThe potential benefit of socket preservation therapies was demonstrated resulting in significantly less vertical and horizontal contraction of the alveolar bone crest. The scientific evidence does not provide clear guidelines in regards to the type of biomaterial, or surgical procedure, although a significant positive effect of the flapped surgery was observed. There are no data available to draw conclusions on the consequences of such benefits on the long-term outcomes of implant therapy.The potential benefit of socket preservation therapies was demonstrated resulting in significantly less vertical and horizontal contraction of the alveolar bone crest. The scientific evidence does not provide clear guidelines in regards to the type of biomaterial, or surgical procedure, although a significant positive effect of the flapped surgery was observed. There are no data available to draw conclusions on the consequences of such benefits on the long-term outcomes of implant therapy.

The present patient report describes a missing mandibular molar rehabilitated by two one piece narrow diameter dental implants. Although the gold standard treatment is to place a regular diameter implant, unfortunately due to horizontal bone resorption, this option is not possible without lateral bone augmentation. In this situation narrow diameter implants are a viable alternative. immediate provisional crown is provided after implant placement and three months latter, replaced with partially transparent monolithic friction frit cement free zirconia crown. Follow up til the end of one year revealed healthy hard and soft tissues around implants.

Improvements in implant designs have helped advance successful immediate anterior implant placement into fresh extraction sockets. Clinical techniques described in this case enable practitioners to achieve predictable esthetic success using a method that limits the amount of buccal contour change of the extraction site ridge and potentially enhances the thickness of the peri-implant soft tissues coronal to the implant-abutment interface. This approach involves atraumatic tooth removal without flap elevation, and placing a bone graft into the residual gap around an immediate fresh-socket anterior implant with a screw-retained provisional restoration acting as a prosthetic socket seal device.

This prospective clinical study evaluated the survival rate and the implant-crown success of 314 Morse taper connection implants, used for single-tooth replacement, after 1 year of functional loading. Over a 4-year period (January 2003 to January 2007), 314 implants (168 maxilla, 146 mandible) were inserted in 302 patients (128 males, 174 females, aged between 23 to 79 years) in six different clinical centres. The sites included anterior (n = 118) and posterior (n = 196) teeth. To evaluate implant-crown success, the following clinical, prosthetic and radiographic parameters were assessed: modified plaque index (mPI), modified sulcus bleeding index (mBI), probing depth (PD), distance from the implant crown margin to the coronal border of the peri-implant mucosa (DIM), width of keratinised mucosa (KM), prosthesis function, and the distance between the implant shoulder and first crestal bone-implant contact (DIB). Success criteria included: absence of suppuration and mobility, PD&lt;5....

The aim of this retrospective study is to investigate the medium- to long-term prognosis of short implants in partially and totally edentulous patients with mandibular bone atrophy. The study involved 109 patients with 280 implants placed in the mandible. The implants were 7 or 8.5 mm long and 3.75 or 4 mm in diameter. The implant surfaces were machined (M; n = 176) or rough (R; n = 104). Patients were asked to attend a radiographic and clinical follow-up, and their previous clinical records and radiographs were assessed. Implant-related and prosthetic failures and complications were recorded. The mean follow-up was 9 years (range of 5 to 16 years). The survival rate (SSR) and success rate (SR) were calculated using life-table analysis for both M and R short implants. The M implants had a 16-year SSR of 95.7% and a corresponding SR of 93.9%, whereas the 16-year SSR and SR for the R implants were 97.2% and 95.2%, respectively. The mean ± SD bone resorption for all implants was 1.37 ± 0.5 mm. For marginal bone loss, there was no statistically significant difference between the two implant lengths (P = 0.38) or diameters (P = 0.34) or between the M and R implant surfaces (P = 0.47). Different implant lengths, diameters, and surface treatments do not appear to influence the prognosis of the implant. Within the limitation that most of the short implants were splinted to longer implants, the reduced length of the fixtures did not worsen the long-term survival of the implant-supported fixed prostheses.

Implants placed in fresh extraction sites and healed sites were restored simultaneously by cross-arch provisional fixed prostheses. Clinical and radiographic parameters were recorded for up to 36 months. Treatment with a full-arch implant prosthesis, either screw-retained or cemented, was assigned to 54 patients. A total of 676 implants were placed in either immediate extraction sites (n = 367) or in healed alveoli (n = 309), followed by placement of a one-piece provisional prosthesis. The definitive restoration was placed 3 to 6 months after implant placement. Clinical parameters were recorded and digital radiographs obtained at 6, 18, and 36 months. The chi-square test, t test, and analysis of variance with repeated measures were used for statistical analysis of the outcomes. Osseointegration failed in 21 (3.1%) implants; 13 of these (62%) had been placed immediately after extraction. All occurred within 2 months of the surgical healing phase. Short (8-mm) and narrow (3.3-mm) impl...

This is a cross-sectional study that aimed to estimate maxillary sinus floor (MSF) pneumatization in single missing tooth of posterior maxilla, by using cone-beam computed tomography (CBCT). CBCT images were analyzed bilaterally and divided into 2 groups: edentulous site (EdS) - edentulous single region of upper second premolar, first or second molars; Tooth site (TS) - contralateral region homologous to the EdS region, with tooth present. Variables evaluated were: sinus height (SH), estimated sinus pneumatization (eSP: ∆ EdS - TS), healed ridge height (HR) and presence of localized sinus pneumatization (LSP) in molars teeth at TS. HR were categorized according to therapeutic option for posterior maxilla. 183 CBCT scans were included and it was observed that EdS presented a higher SH than the TS (p &lt; 0.001) showing an eSP of 0.9 ± 2.93 mm. First molars presented the highest SH for both sides, although significant differences were detected when compared to second molars. First mol...