A novel methodological approach using superimposed Micro‐CT and STL images to analyze hard and soft tissue volume in immediate and delayed implants with different cervical designs

Sanz‐Martín, Ignacio; Permuy, María; Vignoletti, Fabio; Núñez, Lucía González; Muñoz, Fernando; Sanz, Mariano

doi:10.1111/clr.13365

Cited by 14 publications

(18 citation statements)

References 26 publications

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“…This increase however, did not involve the soft tissue volume above the implant shoulder, hence suggesting the need of soft tissue grafting in the transmucosal area to attain an optimal tissue volume. 23 The observed reduction in tissue contours may be mainly related to the reduction in the width of the osseous ridge, which occurred in spite of having grafted the socket with DDBM-C. These findings are in agreement with those observed in a recent RCT using the same bone replacement graft, compared to non-grafting, which reported that grafting the gap significantly limited horizontal bone resorption, although a certain degree of bone resorption always occurred.…”

Section: Discussionsupporting

confidence: 89%

“…In this study, the buccal bone volume lost after extraction was compensated by an increase in soft tissue volume below the implant shoulder. This increase however, did not involve the soft tissue volume above the implant shoulder, hence suggesting the need of soft tissue grafting in the transmucosal area to attain an optimal tissue volume …”

Section: Discussionmentioning

confidence: 88%

“…Male or female patients, aged 18 or older, that had one nonmaintainable tooth in the anterior region of the maxilla or first premolar area (FDI position [14][15][16][17][18][19][20][21][22][23][24] with adjacent natural teeth were included in the study.…”

Section: Study Populationmentioning

confidence: 99%

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Soft tissue augmentation at immediate implants using a novel xenogeneic collagen matrix in conjunction with immediate provisional restorations: A prospective case series

Sanz‐Martín

Encalada

Sanz‐Sánchez

et al. 2018

Clin Implant Dent Rel Res

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Background Collagen matrices used around immediate implants may reduce morbidity although there is limited evidence on their performance. Purpose To evaluate soft and hard tissue changes when combining immediate implants, hard and soft tissue grafting, and an immediate provisional restoration. Material and Methods In 12 patients, immediate implants were placed in the anterior maxillary and first premolar area together with a xenogeneic bone substitute. Then a xenogeneic collagen matrix was placed under the buccal mucosal margin with an immediate provisional restoration. Study casts and clinical measurements were taken before extraction (Baseline/BS) at 6 months (6M) and 12 months (1Y) after implant placement. Files from the scanned casts were matched to calculate the linear and volumetric changes at the buccal tissues. Cone Bean Computed Tomographies (CBCTs) were taken prior to extraction and at 6M. The superimposed DICOM files allowed for assessing hard tissue changes and the superimposition of DICOM and STL files allowed for evaluating of soft tissue thickness at BS and 6M. Results After 6 months, the horizontal tissue contours decreased 0.66 ± 0.57 mm, concomitant with a horizontal bone loss of 1.31 ± 1.32 mm, measured 1 mm below the most coronal aspect of the ridge. In contrast, the soft tissue thickness, 1 mm below the gingival margin, increased 0.75 ± 1.12 mm. At 1‐year, tissue contours had decreased 1.01 ± 0.67 mm compared to BS reaching statistical significance. The mean volume loss after 1Y was 20.43 ± 11.70 mm3 while the mean mucosal margin recession was 0.86 ± 0.67 mm. These changes had a limited clinical impact as the PES Scores remained stable. Conclusions The tested protocol resulted in a significant reduction of the tissue contours and osseous ridge dimensions that was partially compensated by a non‐significant increase in soft tissue thickness.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 88%

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Soft tissue augmentation at immediate implants using a novel xenogeneic collagen matrix in conjunction with immediate provisional restorations: A prospective case series

Sanz‐Martín

Encalada

Sanz‐Sánchez

et al. 2018

Clin Implant Dent Rel Res

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“…In recent years, the superimposition of DICOM data from CBCT and STL methodology gave insights in experimental and clinical research to better understand the dynamics of tissue healing in a three-dimensional way. Furthermore, this technology allowed to discern the hard and soft tissue inter-play and the reciprocal role that they may have (Sanz-Martin et al, 2017;Sanz-Martin, Encalada, et al 2019;Sanz-Martín, Permuy, et al, 2018). Chappuis et al (2015), evaluating the fate of buccal soft and hard tissues 8 weeks after extraction and before delayed implant placement, observed that soft tissue profile did not follow the pronounced resorption pattern of the underlying bone anatomy.…”

Section: Introductionmentioning

confidence: 99%

The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Soft tissue findings from a randomized controlled clinical trial

Clementini

Castelluzzo

Ciaravino

et al. 2020

J Clinic Periodontology

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Aim: To compare soft tissue dimensional changes and relative differences in soft and hard tissue volumes 4 months after single-tooth extraction and three different treatment modalities: spontaneous healing (SH) and alveolar ridge preservation by means of a deproteinized bovine bone mineral and a collagen matrix, with (IMPL/DBBM/CM) or without (DBBM/CM) immediate implant placement. Materials and Methods: STL files from study casts obtained at baseline and after 4 months were matched to calculate buccal soft tissue linear and volumetric changes. DICOM files from CBCTs were superimposed to STL files allowing the evaluation of soft tissue thickness at baseline and 4 months. Results: Mean horizontal reduction accounted for 1.46 ± 0.20 (SH), 0.85 ± 0.38 (DBBM-CM) and 0.84 ± 0.30 IMPL/DBBM-CM, with no statistical differences. Soft tissue thickness had a significant mean increase of 0.95 for SH group, compared to a non-significant mean decrease for DBBM-CM (0.20) and IMPL/DBBM-CM groups (0.07). Conclusion: A preservation technique with DBBM-CM, with or without immediate implant placement, did not reduce the horizontal linear and volumetric changes at the buccal soft tissue profile significantly at 4 months after tooth extraction when compared to spontaneous healing. This is due to a significant increase in soft tissue thickness in spontaneously healing sites.

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“…There are dentists who have used this superimposed method to obtain the implant position and the emergence contour of prosthesis, and suggested that the aesthetic outcome was satisfactory (Liu, Liu, Mao, & Tan, 2017). Recently, there was an animal experiment in which the optical scan data of the study model were superimposed with the micro-CT, and histological measurements indicated that the digital measurement had high accuracy and repeatability (Sanz-Martin et al, 2018). In clinical studies, researchers also measured the volume change of soft tissue around the implant and natural tooth, which proved the feasibility of this method (Fickl et al, 2009;Schneider, Grunder, Ender, Hammerle, & Jung, 2011;Windisch et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

The two‐dimensional size of peri‐implant soft tissue in the anterior maxilla and some relevance: A 1‐ to 7‐year cross‐sectional study

Wang

Jin

et al. 2020

J Clinic Periodontology

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Aim This study measured the two‐dimensional size of soft and hard tissues and analysed some relevance between them. Material and methods Ninety‐six maxillary anterior implants with a follow‐up time 1–7 years postoperatively were evaluated. We superimposed the CBCT data of 72 patients with the optical scan data, followed by the measurements of the thickness and the height of soft and bone tissues. The shoulder of the implant was the reference point for all vertical measurements. Results At the level of implant shoulder, the mid‐buccal mean thickness of soft tissue was 1.83 ± 0.76 mm, and on the palatal side, it was 4.00 ± 1.22 mm. The mean height of mid‐buccal and mid‐palatal gingiva was 4.16 ± 1.07 mm and 4.27 ± 1.07 mm. The buccal and palatal vertical bone wall peak was 0.41 ± 0.73 mm and 0.22 ± 0.57 mm coronal to the implant shoulder, and the marginal bone loss was −0.28 ± 0.76 mm and −0.84 ± 1.41 mm. Correlation analysis showed that the soft tissue thickness was negatively correlated with the bone thickness at 0 mm on the buccal side and at 0/2/4 mm on the palatal side apical towards from implant shoulder. The gingival height was significantly positively correlated with bone peak height and marginal bone height. Conclusion Soft and hard tissues were basically negatively correlated in the horizontal direction. Sites with little marginal bone loss or high bone peak positively correlated with higher soft tissue levels.

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A novel methodological approach using superimposed Micro‐CT and STL images to analyze hard and soft tissue volume in immediate and delayed implants with different cervical designs

Abstract: Objectives:To study the hard and soft tissue volume after placing immediate (IMI) or delayed implants (DLI) with a triangular coronal macro-design (Test/T) or a conventional cylindrical design (Control/C).

Cited by 14 publications

References 26 publications

Soft tissue augmentation at immediate implants using a novel xenogeneic collagen matrix in conjunction with immediate provisional restorations: A prospective case series

Soft tissue augmentation at immediate implants using a novel xenogeneic collagen matrix in conjunction with immediate provisional restorations: A prospective case series

The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Soft tissue findings from a randomized controlled clinical trial

The two‐dimensional size of peri‐implant soft tissue in the anterior maxilla and some relevance: A 1‐ to 7‐year cross‐sectional study

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