If appropriate clinical conditions exist, immediate dentoalveolar restoration may be the most conservative means of reconstructing the buccal bone wall after immediate implant placement followed by immediate provisionalization with predictable healing and lower treatment time.

The objective of this study was to evaluate the primary stability of short and conventional dental implants with different platform types at different site densities in vitro. One hundred twenty implants were placed in polyurethane blocks that simulate different bone densities (bone types I and IV). The implants were divided into 10 groups, with 12 implants each according to the type of prosthetic connections (external hexagon, EH; morse taper, MT) and size of the implants (conventional: 4 × 10 mm; short: 5 × 5, 5.5 × 5, 5 × 6, and 5.5 × 6 mm). Insertion torque and resonance frequency analyses were performed to evaluate the primary stability. The Kruskal-Wallis test complemented by Dunn's test and the Mann-Whitney test were used for statistical analysis. These tests were applied at the confidence level of 95% (P < .05). The implants installed in blocks with density type IV exhibited reduced insertion torque compared with implants placed in blocks with density type I. Short implants with EH exhibited increased insertion torque compared with short implants with MT in blocks with bone density type I. In general, implants installed in blocks with density type I exhibited greater primary stability. The short implants with EH with a 5.5-mm diameter and the short implants with MT with a 5-mm diameter exhibited reduced primary stability. No differences between short and conventional implants were noted. Short implants have primary stability and insertion torque at least equivalent to conventional implants irrespective of the platform type and density of the site.

When dental implants are malpositioned in relation to the adjacent teeth and alveolar bone or in an excessive buccal or lingual position, the final prosthesis rehabilitation impairs the peri-implant health of the gingival tissues and the aesthetics of the patient. Thus, the purpose of this case was to report and discuss a multidisciplinary protocol for the treatment of a compromised maxillary tooth in a patient with an abscess in his right central incisor due to an excessive buccal implant position. The patient presented with an implant-supported provisional restoration on his right maxillary central incisor and a traumatic injury in his left central incisor. The treatment protocol consisted in (i) abutment substitution to compensate the incorrect angulation of the implant, (ii) clinical crown lengthening, (iii) atraumatic extraction of the left central incisor, and (iv) immediate implant placement. Finally, (v) a custom abutment was fabricated to obtain a harmonious gingival contour around the prosthetic crown. In conclusion, when implants are incorrectly positioned in relation to the adjacent teeth, associated with soft-tissue defects, the challenge to create a harmonious mucogingival contours may be achieved with an interdisciplinary approach and with the placement of an appropriate custom abutment.

Background The aim of this in vitro study was to evaluate the influence of the cortical thickness on the primary stability of short and conventional-sized implants with two types of prosthetic connection. Material and Methods Seventy-two implants were used. These implants were placed in polyurethane blocks that simulated low-density bone tissue (type IV bone), with two bone cortical heights (type I bone): 1mm and 3mm. The implants were divided into 6 groups with 12 implants each according to the type of prosthetic connections (external-hexagon -EH and morse taper- MT) and implant sizes (conventional- 4x10mm and short 5x5mm; 5.5x5mm; 5x6mm; 5.5x6mm). Insertion torque (IT) and resonance frequency analyzes (RFA) were performed to evaluate the primary stability of the implants. Results All implants installed in blocks with 3mm of cortical thickness showed greater IT than those installed in 1mm. The short-sized MT implants had a higher IT than conventional implants of the same connection. Short-sized EH implants showed less IT than short-sized MT implants in blocks with 3mm of cortical. In blocks with 1mm of cortical, conventional EH implants had a higher IT compared to short-sized EH implants. The conventional sized implants presented higher RFA values despite the thickness of the cortical in the blocks. Conclusions The greater bone cortical thickness and implants size provides greater primary stability of the implants regardless the prosthetic connection. Key words: Implants connection, implants macrostructure, primary stability.