Anterior maxillary single-tooth replacement, using GBR and connective tissue graft according to the concept of immediate implant placement, and non-functional restoration is an accepted treatment modality achieving favorable peri-implant soft tissue condition.

Soft tissue shrinkage during the course of restoring dental implants may result in biological and prosthodontic difficulties. This study was conducted to measure the continuous shrinkage of the mucosal cuff around dental implants following the removal of the healing abutment up to 60 s. Individuals treated with implant-supported fixed partial dentures were included. Implant data--location, type, length, diameter and healing abutments' dimensions--were recorded. Mucosal cuff shrinkage, following removal of the healing abutments, was measured in bucco-lingual direction at four time points--immediately after 20, 40 and 60 s. anova was used to for statistical analysis. Eighty-seven patients (49 women and 38 men) with a total of 311 implants were evaluated (120 maxilla; 191 mandible; 291 posterior segments; 20 anterior segments). Two-hundred and five (66%) implants displayed thick and 106 (34%) thin gingival biotype. Time was the sole statistically significant parameter affecting mucosal cuff shrinkage around dental implants (P < 0.001). From time 0 to 20, 40 and 60 s, the mean diameter changed from 4.1 to 4.07, 3.4 and 2.81 mm, respectively. The shrinkage was 1%, 17% and 31%, respectively. The gingival biotype had no statistically significant influence on mucosal cuff shrinkage (P = 0.672). Time required replacing a healing abutment with a prosthetic element should be minimised (up to 20/40 s), to avoid pain, discomfort and misfit.

Background: Various conditions may lead to bony deficiency in the anterior maxilla. The present study evaluated esthetic (PES—pink esthetic score and WES—white esthetic score) results after augmentation of the anterior atrophic maxilla using cancellous bone-block allograft followed by implant placement and late (conventional) loading. Methods: Cohort study that included 33 patients with missing teeth in the upper anterior region characterized by extensive bone loss. Allogeneic cancellous bone-blocks were used for augmentation. Six months later, a dental implant was inserted. After a waiting time of an additional six-months, implant exposure and reconstruction were performed. The mean follow-up period was 62.93 ± 17.37 months (range 19–82 months). Results: The mean value of PES/WES was 17.8 ± 2.78. All patients had a PES/WES value above 12 (threshold value defined as clinically acceptable esthetics). The mean value of PES was 9.0 ± 1.79 and the mean value of WES was 8.8 ±1.84. Conclusions: Bone augmentation of the anterior atrophic maxilla using cancellous block-allograft and late loading supports achievement of a predictable esthetic result with long-term stability of soft and hard tissues around implant-supported reconstructions.

Impression technique is one of the factors affecting restoration fit accuracy, which is a major aspect influencing its survival. The purpose of this study is to compare, in vivo, the effect of two commonly used Vinyl Polysiloxane (VPS) impression techniques on the metal framework fitting of fixed partial dentures. Ninety-two consecutive patients, diagnosed as partially edentulous, treated by fixed partial denture restorations, participated in the study. Group 1-impressions (n = 44) were subjected to the 1-step technique, while group 2 impressions (n = 48) were subjected the 2-step technique. Three accuracy assessment common methods: probe, tactile sense and radiographic test, were used to validate the clinical fit of the metal framework. Misfit was defined as even one test failure. Twenty-one (22.8%) out of 92 metal frameworks exhibited metal frameworks misfit, whereas the other 71 (77.2%) were found to be accurate. Group 1 presented significantly (p = 0.04) more metal frameworks misfit, 14/44 (31.8%) vs. 7/48 (14.6%). Restoration location (maxilla vs. mandible) had no statistically significant impact on the results (p = 0.461). The use of the VPS putty/wash 2-step impression technique is recommended to improve the clinical fit of fixed partial denture restorations.

Background: Substantial effort is dedicated to finding the most favorable parameters that will ensure low aftercare demands among edentulous patients wearing mandibular implant supported overdentures (MISODs). The purpose of this retrospective cohort study was to compare prosthetic aftercare between MISOD patients with a simultaneous (group A) vs. a three-week settling in period (group B) prior to attachment incorporation. Methods: Forty-five patients enrolled in this study. Two implants per patient were placed using a two-stage implant insertion protocol. Second-stage surgery was performed after three months. All patients received ball attachments using the direct (chairside) incorporation method. Twenty-two patients received their dentures with simultaneous attachment activation and the rest—twenty-three patients—after a three-week settling in period. Patients’ files were scanned for aftercare visits. Outcome parameters included sore spot relief, attachment incorporation, and denture repair. Additionally, gingival index measurements were compared. Confounding factors included age, gender, and implant dimensions. Results: The mean follow-up for the entire cohort was 84 ± 21 months, and the range 39–120 months. The mean number of visits for group A vs. B respectively: pressure sores relieve (3.63 ± 0.84 vs. 3.71 ± 0.61, p = 0.581), liner exchange due to loss of retention (2.09 ± 1.03 vs. 2.31 ± 1.04 p = 0.487), and gingival index (1.3 ± 0.3 vs. 1.03 ± 0.2, p = 0.653) exhibited no statistically significant differences between the tested groups. No statistically significant differences between the groups were also noted for the denture repair aftercare treatments (p = 0.318) and the independent variables including age, gender, and implant length. Conclusions: Prosthetic aftercare in MISOD wearers is similar whether a simultaneous or a three-week settling in period for attachment incorporation is applied.