·············································································································································································The study evaluated the efficacy of combining autogenous tooth bone grafts with membranes in surgically created class II furcation defects. Thirty teeth of 10 dogs were assessed. Furcation defects (5 × 4 × 3 mm 3 ) were created in the lower third and fourth premolars. Defects in the control, experimental-1, and experimental-2 groups were treated with non-resorbable membranes only, autogenous tooth bone grafts with non-resorbable membranes, and autogenous tooth bone grafts with resorbable membranes, respectively. Healing patterns were observed 4 to 8 weeks after treatment. Mesio-distal sections were obtained and stained with hematoxylin and eosin, and histological and histomorphometrical analyses were performed. Four weeks after treatment, connective tissue and autogenous tooth bone graft materials with newly formed bone were observed. Partial recovery of periodontal ligament-like tissue and formation of cementum-like tissue at root surfaces also occurred. Eight weeks after treatment, mature bone tissue formation was noted. In addition, regular thickness of cementum-like tissue at root surfaces, and improved periodontal ligament-like tissue were observed. Areas of newly formed tissue were 92.2% ± 13.0%, 97.4% ± 4.4%, and 98.1% ± 2.8% at 4 weeks after treatment, and 96.7% ± 3.7%, 96.8% ± 5.7%, and 99.6% ± 0.8% by 8 weeks post-treatment, in the control, experimental-1, and experimental-2 groups, respectively. Regeneration of defective tissues occurred in the experimental group compared with the control group, but not significantly. This study showed that combining autogenous tooth bone grafts with membranes in class II furcation defects improves healing efficiency.
Stage-two implant surgery, which exposes the implant platform to connect the healing abutment, affects the width of the peri-implant keratinized mucosa thereby affecting the long-term prognosis of the implant. The purpose of this study was to compare the changes in the width of the peri-implant buccal keratinized mucosa between the minimally-invasive crestal incision (MCI) procedure and the apically-positioned full-thickness flap (APFTF) method during stage-two implant surgery. A total of 74 implants were placed in 41 patients. The MCI group included 27 implant cases wherein, healing abutments were connected after stage-two implant surgery using the MCI in 18 patients. The APFTF group comprised 47 implant cases wherein, healing abutments were connected after stage-two implant surgery using the APFTF method in 23 patients. The buccal keratinized mucosa widths (BKMW) of the healing abutment and prosthesis were measured at the mesial, central, and distal aspects after the stage-two surgery and the final restoration. A decrease in the BKMW in both groups after stage-two implant surgery was observed when compared with those after the final restoration; furthermore, the BKMW was significantly lower after stage-two implant surgery in the MCI group (p<0.001). No statistically significant difference in BKMW was noted between the MCI and APFTF groups at any point. These results reveal that the APFTF method was more effective than MCI in terms of preserving the buccal peri-implant keratinized mucosa during stage-two implant surgery.
Implant secondary surgery is an operation that exposes the implant fixture into the oral cavity. Depending on the surgical procedure, keratinized gingiva surrounding the implant may be affected, that may affect long-term prognosis of the implant. The purpose of this case report is to introduce a minimally invasive 2nd stage surgery and to evaluate its clinical features and effect on preservation of keratinized gingiva. Minimally invasive 2nd stage surgery was performed in three patients that had completed first stage implant surgery. The width of keratinized gingiva was measured immediately after surgery and after completion of prosthesis. As a result, the width of keratinized gingiva was preserved, patient's discomfort was reduced, and the operation duration was shortened.
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