Comparative outcome of socket shield method and conventional immediate implant implantation with immediate temporization- a 10 years follow-up

Background: Dental implants are now regarded as an effective treatment option for replacing missing teeth. The objective was to evaluate the socket shield approach with immediate temporization to the conventional instantaneous implant with immediate temporization utilizing the parameters of horizontal and vertical dimensional bone loss, crestal bone thickness (CBT) and pink esthetic score (PES). Methods: This prospective study was carried out at Banasree Dental and German Dental implant surgery centers from December 2010 to December 2020 where 74 patients who had non-restorable maxillary teeth in the esthetic region were conducted and evaluated for implant settlement. The allocated individuals were divided into two groups immediate implant with socket shield group (study group, n=22) and the conventional immediate implant placement group (control group, n=52). SPSS version 21.0 was used to analyze all of the data. Results: Mean value of crestal bone thickness (CBT) at the pre-operative time was 1.31±0.2 in both groups but at the 6 months follow-up time it was 1.2±0.22 and 1.07±0.21, at the 24 months follow-up time it was 1.13±0.24 and 0.99±0.20 and at the 60 months follow-up time in was 1.05±0.27 and 0.79±0.15 and at the 120 months follow-up time it was 1.03±0.29 and 0.69±0.17 in the study and control group respectively. In the study group, the mean value of pink esthetic score was 11.45±1.6 at 6 months follow-up time, 12±0.89 at 24 months, 12.5±0.87 at the 60 months and 12.5±0.86 at the 120 months follow-up time whereas in the control group, it was 11±1.32, 10±1.52, 8.9±1.63 and 7.5±1.55, respectively. Conclusions: The SST group revealed minimal reduction in CBT, horizontal and vertical bone loss and a superior PES compared to conventional immediate implant.

Traditional and modified tunnel technique for the treatment of maxillary anterior teeth gingival recession / 口腔疾病防治

Objective @#To compare the clinical effect of the tunnel technique (TUN) and vestibular incision subperiosteal tunnel access (VISTA) combining connective tissue grafts (CTGs) on recovering the exposed root surface in a case of gingival recession over the upper anterior teeth and then to provide clinical evidence for gingival recession treatment. @*Methods@# A case of gingival recession (Miller I type) over teeth 13-14 and 22-23 was treated using different techniques bilaterally. 22-23 were treated by a TUN combined CTG transplantation,while teeth 13-14 were treated by a VISTA technique combined with CTG transplantation. The gingival retraction height (GRH), gingival retraction width (GRW), keratinized gingival width (KW), root coverage aesthetic score (RES) and visual analog scale (VAS) were measured after operation. @*Results @#The effect of post-operation were ideal and complete ginglval recovering were achieved, the postoperative effects of the two methods were stable, GRH and GRW decreased, and KW increased. RES was 10. The VAS score of VISTA combined with CTG transplantation was 6, which was higher than that of TUN+CTG. @*Conclusion@#Gingival recession can be treated by TUN+CTG or VISTA+CTG with ideal prognosis. VISTA with an additional incision facilitates the operative procedure but leads to less comfort.

Patient Satisfaction and Pink Esthetics of PEEK Versus Zirconium Abutments in the Esthetic Zone (A Randomized Controlled Trial) / Satisfação do paciente e estética rosa dos pilares PEEK versus Zircônia na zona estética (um ensaio clínico randomizado)

Objective: This study was performed to evaluate the use of PEEK abutments versus zirconium abutments with lithium disilicate superstructure on the esthetic acceptance and peri-implant clinical parameters. Zirconium abutments were found to have high surface roughness even after polishing. This causes a remarkable collapse of the soft tissue papilla that is a primary factor in the Pink Esthetic Score(PES), resulting in failed esthetic restoration in the anterior esthetic zone. Material and Methods:Twenty patients who needed a single implant restoration in the esthetic zone were included in this study. Eighteen patients completed screening, baseline, three-month, six-month, and twelve-month follow-up visits. At the screening visit, the patients were randomly allocated into two groups: Zirconia abutments (A) Group, and PEEK abutments (B) Group, both of which were restored with IPS e.max CAD superstructure. Patients Satisfaction was assessed by visual analogue scale (VAS). Pink esthetics score (PES), modified plaque index (mPI) and modified gingval index (mGI) were also assessed. Results: All implants were successfully osseo-integrated with a 100% survival rate over one year. Patient satisfaction was significantly higher for the PEEK group than the zirconium group. The pink esthetic score showed no statistical significance between both groups. The modified plaque index was significantly lower for the PEEK group than the zirconium group. The modified gingival index showed no statistical difference between both groups. Conclusion: PEEK revealed to be a versatile material to replace zirconium for implant abutments, due to its lower plaque affinity and higher patient satisfaction (AU)

Objetivo: Este estudo foi realizado para avaliar o uso de pilares PEEK versus pilares de zircônia com estrutura de dissilicato de lítio quanto a aceitação estética e parâmetros clínicos peri-implantares. Os pilares de zircônia apresentam alta rugosidade superficial, mesmo após o polimento. Isso causa um colapso notável da papila do tecido mole, que é um fator primário no índice estético rosa (Pink Esthetic Score - PES), resultando em falha na restauração estética na zona estética anterior. Materiais e Métodos:Vinte pacientes que precisavam de um implante unitário na zona estética foram incluídos neste estudo. Dezoito pacientes completaram a triagem, a consulta inicial e as visitas de acompanhamento de três, seis e doze meses. Durante a triagem, os pacientes foram aleatoriamente divididos em dois grupos: Grupo Pilares de Zircônia (A) e Grupo de Pilares PEEK (B), ambos foram restaurados com IPS e.max CAD. A satisfação dos pacientes foi avaliada pela escala visual analógica (VAS). O PES, o índice de placa modificado (mPI) e o índice gengival modificado (mGI) também foram avaliados. Resultados: Todos os implantes foram osseointegrados com sucesso, com uma taxa de sobrevivência de 100% ao longo de um ano. A satisfação do paciente foi significativamente maior para o grupo PEEK quando comparado com o grupo de pilares de zircônia. O índice da estética rosa não apresentou significância estatística entre os dois grupos. O índice de placa modificado foi significativamente menor para o grupo PEEK quando comparado com o grupo de pilares de zircônia. Conclusão: O PEEK revelou-se um material versátil para substituir a zircônia em pilares de implante, devido a sua menor afinidade de placa e maior satisfação do paciente. (AU)

Esthetic outcome for maxillary anterior single implants assessed by different dental specialists

PURPOSE: The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients. MATERIALS AND METHODS: Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) for 23 implant-supported single restorations. The satisfactions of the patients on the esthetic outcome of the treatment have been evaluated according to the visual analog scale (VAS). RESULTS: The mean total PES/WES was 12.26 ± 4.76. The mean PES was 6.45 ± 2.78 and mean WES was 5.80 ± 2.82. There was a statistically significant difference among the different specialties for WES (P<.01) and Total PES/WES (P<.01). Prosthodontists were found to have assigned poorer ratings among the other specialties, while oral surgeons gave the higher ratings than periodontists, orthodontists, and prosthodontists. CONCLUSION: Prosthodontists seemed to be stricter when assessing aesthetic outcome among other specialties. Moreover, a clear correlation existed between dentists' and patients' esthetic perception, thereby providing rationales for involving patients in the treatment plan to achieve higher levels of patient satisfaction.

Outcome Evaluation of an Immediately Placed Maxillary Anterior Single-Tooth Implant Using Objective Esthetic Criteria: Case Report

Immediate implant placement is one of the treatment options in postextraction sites in anterior region. This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior maxilla using a flapless approach and modifying a provisional restoration. The case reported illustrates the practical procedure involved in developing natural esthetics with modifying a provisional restoration. The technique provides an accurate impression of the soft tissue through the intraoral use of provisional restoration. The final restoration uses a custom-made titanium abutment and porcelain fused gold crown. The technique is relatively simple and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores and white esthetic scores after 1 year.