Triangular implants showed similar percentage of osseointegration, buccal bone volume and soft tissue contours, although attaining greater buccal crestal bone width. No differences were found in regard to soft tissue dimensions and the position of the first bone-to-implant contact.
Objectives
To study the early and late bone healing around implants placed according to a flapless immediate (test) or flapped delayed (control) implant surgical protocol.
Materials and methods
In eight beagle dogs, immediate and delayed implants were placed. Test and control implants were randomly assigned, and horizontal and vertical bone remodelling, as well as bone‐to‐implant contact (BIC), were assessed with histology at 2 and 8 weeks. Teeth were used as negative controls.
Results
Similar results were attained in the two groups when the vertical resorption of the buccal bone crest was evaluated (approximately 0.5 mm). On the other hand, a marked horizontal buccal bone resorption was observed. Immediate implants attained a thinner buccal bone crest as compared to the delayed implant and the tooth. De novo bone formation on the implant surface appeared to be more pronounced at delayed sites at 2 weeks, whereas at 8 weeks, no difference in BIC was observed.
Conclusions
Ridge alterations occurred at both implant placement protocols, with similar limited amounts of vertical buccal bone reduction and a pronounced horizontal bone reduction. The process of horizontal bone remodelling differed between the two surgical protocols.
Objectives
To evaluate new lateral bone formation and lateral volume augmentation by guided bone regeneration (GBR) in chronic non‐contained bone defects with the use of a non‐resorbable TiO2‐block.
Materials and methods
Three buccal bone defects were created in each hemimandible of eight beagle dogs and allowed to heal for 8 weeks before treatment by GBR. Each hemimandible was randomly allocated to 4‐ or 12‐week healing time after GBR, and three intervention groups were assigned by block randomization: TiO2 block: TiO2‐scaffold and a collagen membrane, DBBM particles: Deproteinized bovine bone mineral (DBBM) and a collagen membrane, Empty control: Collagen membrane only.
Microcomputed tomography (microCT) was used to measure the lateral bone formation and width augmentation. Histological outcomes included descriptive analysis and histomorphometric measurements.
Results
MicroCT analysis demonstrated increasing new bone formation from 4 to 12 weeks of healing. The greatest width of mineralized bone was seen in the empty controls, and the largest lateral volume augmentation was observed in the TiO2 block sites. The DBBM particles demonstrated more mineralized bone in the grafted area than the TiO2 blocks, but small amounts and less than the empty control sites.
Conclusion
The TiO2 blocks rendered the largest lateral volume augmentation but also less new bone formation compared with the DBBM particles. The most new lateral bone formation outward from the bone defect margins was observed in the empty controls, indicating that the presence of either graft material leads to slow appositional bone growth.
Root coverage in the anterior mandible is challenging due to a thin gingiva, shallow vestibule, and/or high frenulum. This case series reports on the flattening of the root surface to create a new emergence profile conceived with a two-step surgical approach aimed at providing more space for the graft, increasing the thickness of the gingival margin, and getting extra soft tissue in the open area of the recession. A total of 10 patients with recessions affecting the mandibular incisors were treated to evaluate this two-step approach, which included odontoplasty of the root followed by a connective tissue graft. At 1 year, the mean coverage was 100% in Class II recessions, and 80.5% in Class III. The mean keratinized tissue increase was 5.80 ± 1.75 mm. This surgical approach could be proposed as an alternative when treating mandibular anterior teeth with root prominence or with a buccally tilted position.
Dental implants have shown to be a safe and reliable treatment approach for the rehabilitation of partial and full edentulous patients, demonstrating high long-term survival rates (Papaspyridakos et al., 2018). However, dental implants are not free from complications, and peri-implant diseases (peri-implant mucositis and peri-implantitis) are a frequent finding (Jung et al., 2012;Pjetursson et al., 2012).
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