Notes

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The purpose of this 12-month randomized, controlled clinical trial was to evaluate the efficacy of a monotherapy protocol with the neodymium-doped yttrium aluminum garnet (NdYAG) laser for treatment of peri-implantitis. Twenty patients with 36 implants exhibiting probing pocket depths (PPDs) > 4 mm and evidence of radiographic bone loss (RBL) were randomly divided into two groups. The test group was treated with the NdYAG laser, and the control group was managed with mechanical debridement only. Peri-implant clinical parameters were recorded at baseline and at 12 months after treatment. PPD, RBL, and bleeding on probing showed improvements after 12 months in the test and control groups. The laser therapy provided additional benefits of greater reduction in PPDs and increased bone level with no adverse outcomes. The results demonstrated that laser therapy could be a valuable modality for the treatment of peri-implantitis.The aim of this study was to analyze horizontal bone augmentation using the tenting screw technique in the posterior mandible. Included subjects had a 3-mm bone width and 9-mm bone height, measured by CBCT. After the surgical approach, two to four screws were inserted, leaving 4 mm of extraosseous space; reconstruction was achieved using allogeneic biomaterial and leukocyte- and platelet-rich fibrin together with an absorbable membrane. After 4 months, a new CBCT scan was obtained to compare the bone gain and implant placement. Early and secondary stability were measured by the implant stability quotient (ISQ); prosthetic load was performed 16 weeks later. Student t test was used to compare bone gains and implant stability, with significance set at P .05). It may be concluded that the tenting screw technique is predictable in terms of bone gain and that it facilitates implant stability.Passive-tension flap closure of primary wounds remains the most important factor for achieving predictable bone augmentation outcomes. So far, no specific surgical technique has been proposed for major flap advancement, specifically in the thin tissue phenotype (≤ 1.5 mm thick). This article illustrates a detailed description of the Mucosal Detachment Technique (MDT), which separates the mucosal tissue from the underneath periosteum and aims to achieve adequate flap flexibility to cover high-volume augmentation in the thin tissue phenotype. Separating the mucosa from the periosteum allows maintenance of vascularization and an even distribution of tension among the advanced flap. The MDT allows bone augmentation procedures in thin tissue phenotype flap. The flap advancement permits tension-free primary closure in all tissue phenotypes (both thin and thick), independent of the degree of volume augmentation.The purpose of this randomized clinical study was to evaluate the efficacy of platform-switching (PS) vs platform-matching (PM) implants when paired with a newly designed marginless abutment (MA) vs a conventional abutment (CA) in maintaining peri-implant tissue stability. Marginal bone level (MBL) and probing depth were measured up to 1 year postloading. Eighty implants were inserted in 42 patients and randomly assigned to one of four groups, each with a different implant/abutment configuration Group 1 (PM+CA), Group 2 (PM+MA), Group 3 (PS+CA), and Group 4 (PS+MA). Data were collected at implant placement (T0), abutment placement (T1), final crown placement (T2), and 1 year postloading (T3). At the 1-year follow-up, MBL was more stable in Groups 3 and 4 compared to Groups 1 and 2. These results suggest that the role played by the implant-abutment connection (PS vs PM) is more important than the type of abutment preparation (MA vs CA).Bone exostosis is defined as a benign overgrowth of bone tissue of unclear origin. Rarely, bone exostosis might develop following soft tissue graft procedures like mucogingival surgical interventions (eg, FGG or subepithelial CTG). This aberration has been mainly associated with surgical trauma or fenestration of the periosteum but is still a matter of debate. The present paper (1) presents a clinical case with clinical, radiographic, and histologic findings at 30 years following application of an FGG to increase the gingival width and (2) provides a short literature review on this particular clinical condition. At the clinical examination, the FGG was firm to palpation, and the 3D images showed an area of increased radiopacity. Histologic analysis revealed localized thickening of the bone with an overlaying connective tissue covered by keratinized epithelium. The bony tissue was vital, had a convex shape, and contained many osteocytes and resting lines, demonstrating some moderate signs of bone remodeling. The connective tissue and keratinized epithelium displayed a regular thickness without any signs of inflammation. Taken together, the histologic findings failed to reveal any pathologic signs except for the presence of vital bone formed outside the bony envelope. It can be concluded that (1) the development of a bone exostosis following a mucogingival procedure is a rare clinical sequela of uncertain etiology, and (2) surgical removal of the exostosis may be indicated accordingly with patient symptoms.Minimally invasive microsurgery performed using an operating microscope (OM) has shown accelerated and improved wound healing for periodontal plastic and regenerative procedures. This case series aims to demonstrate the potential usefulness of OM for maxillary sinus augmentation in a private practice setting. Twelve vertical sinus augmentations (VSAs) and 8 lateral sinus augmentations (LSAs) were performed with the assistance of OM. AG-14361 in vivo Flap reflection, osteotomy, sinus membrane elevation, membrane integrity evaluation, implant placement (if indicated), and wound approximation with sutures were performed under OM. After a minimum healing period of 6 months, radiographic bone height gain was assessed. One sinus membrane perforation was observed during VSA surgery. The mean vertical bone gain was 4.82 ± 1.31 mm and 8.36 ± 1.45 mm for VSA and LSA, respectively, with 100% implant success rate. OM-assisted maxillary sinus augmentation provides favorable clinical visualization, thus facilitating delicate hard and soft tissue manipulation.This multicenter retrospective study assessed clinical and radiographic outcomes of 686 parallel-walled conical-connection implants consecutively placed in 281 partially and fully edentulous patients. Implants were placed in healed and postextraction sites and subjected to immediate, early, or delayed loading. With a mean follow-up of 10 ± 6.7 months, the implant survival rate was 97.7%, while mean marginal bone loss was 0.7 ± 1.5 mm between implant placement and 1 year (n = 290 implants) and 0.1 ± 0.6 mm between 1 and 2 years (n = 72 implants). Advanced patient age and longer implants were associated with fewer implant failures, while different crestal positions at implant placement were not associated with differences in implant survival or changes in marginal bone level over time.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.Inferior alveolar nerve (IAN) damage following implant placement is a severe complication that can compromise a patient's quality of life. Previous studies have suggested that a safety zone of 2 mm, if maintained, might avoid this problem. This retrospective study evaluates implants placed in closer proximity to the IAN without resulting in any postoperative neurologic complications and suggests a new concept of safety distance. A total of 60 consecutive patients receiving 101 mandibular implants less then 2 mm from the IAN were included in this study. All enrolled patients had a CBCT scan done for radiologic assessment before implant placement and following final restoration. Measurements were obtained through cross-sectional views using Simplant software. In patients without neurologic disturbances, a mean distance of +0.75 mm was seen from the closest portion of the implant to the nerve bundle. In cases where a direct transection and/or compression of the nerve was not observed, the patients did not experience neurosensory disturbances.A novel macro-hybrid implant design was introduced to afford high apical primary stability and more coronal space to preserve the circumferential extraction socket architecture. This study presents 1-year data from a prospective single-arm cohort study. The data was distilled based on the following criteria (1) single-tooth immediate tooth replacement therapy (ITRT) in the maxillary anterior and premolar regions in intact (Type 1) extraction sockets that were (2) treated with the dual-zone grafting technique. The clinical and radiographic outcomes of 48 ITRT implants were evaluated. The mean ± SD labial plate dimension changes were 0.33 ± 0.41 mm at the implant abutment interface (L1) and 0.34 ± 0.40 mm at 5.0 mm below (L2). The mean labial plate dimension (thickness) at the 1-year recall was 2.27 ± 0.88 mm (L1) and 1.95 ± 0.95 mm (L2). At ITRT, the ridge contour at the free gingival margin and 3.0 mm below it were 7.54 ± 0.93 mm and 9.44 ± 2.36 mm, respectively; after final restoration delivery, the corresponding values were 7.45 ± 0.95 mm and 10.23 ± 2.30 mm, respectively. The peri-implant soft tissue thickness (PISTT) at the time of implant-level impression-making was 3.29 ± 0.73 mm, with an average Pink Esthetic Score of 12.79. A macro-hybrid implant design showed high levels of primary stability (~60 Ncm), stable ridge contour at 1 year, a labial plate dimension between 1.5 and 2.0 mm, and PISTT > 3.0 mm, which may be a critical factor in providing stable, long-term esthetic outcomes.The correction of transverse malocclusions due to maxillary width deficiency in adults is challenging. Multiple surgical and nonsurgical procedures have been used in conjunction with orthodontics to address this situation, and most common is the surgically assisted rapid maxillary expansion (SA-RME). Although successful, it is quite aggressive. The present investigation assesses the usefulness of Piezocision-assisted orthodontics as a less-invasive option for treatment of transverse maxillary deficiencies in adults. Dental casts were taken before and after Piezocision-assisted palatal expansion in four patients. They were digitized into STL files and superimposed. Differences on cross-arch tooth torque, angulation/tipping, and movement distances between time points were quantified using a digital static and a novel digital 3D-movement evaluation method. For the buccolingual movement per tooth, first premolars averaged 3.33 ± 1.3 mm, second premolars averaged 3.63 ± 0.6 mm, and first and second molars averaged 1.56 ± 1.2 mm and 0.36 ± 1.2 mm, respectively. Bodily movement of the teeth was observed with minimal tipping and no development of gingival recessions. Piezocision-assisted palatal expansion is a safe and reliable procedure that can help patients with maxillary width deficiency. It is a new tool in the orthodontist's armamentarium that can be used as an accelerator of treatment and as a new way to solve orthodontic challenges in selected adult patients.
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