The dimension of the horizontal offset would play a minimal role in reducing bone remodeling, whereas the configuration of the transmucosal component would directly influence marginal bone remodeling.
This paper demonstrates the usefulness of endodontic guides for the removal of fibre posts. A 36-year-old man consulted for retreatment of a maxillary first molar presenting a periapical pathology. This tooth revealed a composite reconstruction together with a glass-fibre post in the palatal root canal. To assist removal, use of an endodontic 3D-printed guide was indicated. A cone beam computed tomography examination and an optical impression were made to produce a tooth-supported guide by means of implant planning software (Blue Sky Plan, Blue Sky Bio ® ). The software enabled definition of a drilling pathway, which was transferred clinically using a resin template together with a sleeve and a 0.75-mm drill. The drill was guided as far as the gutta-percha situated in the apical third, limiting any risk of impairment or perforation.
Objectives
The aim of this study was to assess the influence of transgingival compared with submerged healing on peri-implant bone maintenance around a novel, fully tapered implant in a healed crestal ridge in minipigs.
Materials and methods
In each of 12 minipigs, two implants (Straumann® BLX, Roxolid® SLActive®, Ø 3.75 × 8 mm) were placed. Implants were either left for submerged or for transgingival healing for 12 weeks. Measurements performed were bone-to-implant contact (BIC), first bone-to-implant contact (fBIC), bone area to total area (BATA), perpendicular bone crest to implant shoulder (pCIS), bone height change from placement, and bone overgrowth (for submerged implants).
Results
No significant differences were found between transgingival and submerged healing in any of the measured parameters, except for BATA on the buccal aspect in which significantly more bone formation was found for the transgingival healing group. For both groups, there was a gain in crestal bone height during the 12-week healing period.
Conclusions
Loaded compared with unloaded implants displayed comparable levels of osseointegration and equivalent marginal bone levels. This qualifies the implant placement protocol with respect to the osteotomy dimensions and subcrestal placement protocol for immediate loading.
Clinical relevance
The here presented results related to osseointegration and crestal bone maintenance after submerged or transgingival healing have demonstrated a high level of consistency in the used in vivo translational model. The obtained results support the translation of the novel implant type in conjunction with the developed surgical workflow and placement protocol into further clinical investigation and use.
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