ABSTRACT
Objective @# To investigate the application of digital immediate implant and angle screw channel abutment in the aesthetic area and the related influencing factors by reviewing the data of one case of immediate implant repair of the upper anterior teeth and related literature. @*Methods@#One case of refractory chronic apicitis of the upper anterior teeth involved immediate implantation after extraction. The digital information of the patient was obtained by CBCT and intraoral scanning. According to the information from the patients, a preoperative evaluation was performed; a treatment scheme was formulated; a minimally invasive extraction was performed; implants were placed under a digital guide plate; and temporary restoration was immediately performed. Six months after the operation, the patients underwent individualized mold removal, and angle screw channel fixation was completed. We observed the cosmetic effects and soft and hard tissue and gingival contour maintenance effects after restoration and reexamined the patients 6 months after restoration. In addition, the relevant literature was reviewed. @*Results @#The height of the gingival margin and gingival papilla and gingival contour of this patient were well maintained. The red and white aesthetic effect was good. There was no redness or swelling of the gingiva nor obvious changes in the soft and hard tissues around the implant 6 months after restoration, and the patient was satisfied. The results in the literature review show that a preoperative design based on CBCT and intraoral scanning data combined with digital software and a whole digital guide plate make the procedure more accurate and safer. These factors can not only avoid important anatomical structures and serious surgical complications but can also result in implantation in the best three-dimensional position. In addition, the application of digital impression technology and CAD/CAM increases the efficiency, speed, accuracy, simplicity, and comfort of oral impressions and the construction of temporary and final prostheses more precise and faster, greatly improving clinical efficiency. @*Conclusion@#Digital immediate implant and angle screw channel abutment is a good method to restore the aesthetics and function of missing teeth and to avoid the complications caused by adhesive residue.
ABSTRACT
Periodontal tissue, especially the alveolar bone, are closely associated with the progress and efficacy of orthodontic treatment. Prior to and during orthodontic treatment, dentists should fully evaluate the status of periodontal hard tissues to prevent clinical problems. This article aims to discuss bone issues associated with orthodontic treatment, including gingival papilla absence, alveolar bone insufficiency, excessive cortical resistance, and altered passive eruption, etc. The mechanism and prevention methods of these problems are also described.
Subject(s)
Gingiva , PeriodontiumABSTRACT
@#The morphology of the gingival papilla plays an important role in the aesthetics of oral soft tissue. Gingival papilla recession forms a visible black triangle, causing a series of problems such as aesthetic defects, pronunciation disorders and food impaction and even endangering the health of periodontal tissue. Gingival papilla reconstruction is an effective way to eliminate the black triangle. However, the treatment of lost or collapsed gingival papilla is unsuccessful. Reconstruction of the interdental papilla for aesthetics zone is the most difficult and challenging periodontal treatment. In this article, we review the past literature and summarize the factors affecting the appearance of gingival papilla, including the distance between the contact point and the alveolar crest, the distance between roots, divergent roots, interdental width, embrasure morphology, crown shape, and gingival biotype. The classification of the gingival papilla based on the loss of papillary height and the nonsurgical and surgical methods for the reconstruction of gingival papilla are reviewed to provide a reference for doctors to reconstruct the gingival papilla.
ABSTRACT
Black triangle caused by gingival papilla loss is an ordinary clinical problem. Gingival recession and alveolar bone absorption in the area of gingival papilla lead to the increase of the vertical distance from the adjacent contact point to the alveolar ridge. Periodontal soft tissue grafts play a certain role in the gingival papilla reconstruction. This paper reviewed the effects of soft tissue grafts on the reconstruction of gingival papilla loss through following several aspects, summary of gingival papilla loss, gum soft tissue reconstruction, biological and chemical factors influencing gingival papilla reconstruction. The role of coronally advanced flap surgery, semilunar coronal repositioned flap surgery, subepithelial connective tissue graft, pedicle flap graft, envelop flap graft and tunnel technique were evaluated.
ABSTRACT
The presence of gingival papillae in the anterior maxilla is essential to the aesthetics of the smile. The aim of this study was to evaluate alterations in the height of the upper central incisive papilla, before and after orthodontic movement, using study casts and cone beam computed tomography (CBCT). Sixteen patients between the ages of 13 and 18 years underwent orthodontic treatment. The height of the papillae was calculated in both initial and final study casts by drawing a horizontal line tangent to the zenith of the central incisors and inscribing a vertical line perpendicular to the horizontal line. Papilla height was defi ned as the distance from the tip of the papilla to the point of intersection between the two lines. Initial and final (after orthodontic treatment) CBCT images were analyzed, and the height of interproximal papillae was calculated by measuring the distance from the tip of the papilla to the alveolar bone crest. This measurement was performed in both sagittal and coronal plane views. Data were statistically analyzed using the Student t test. The level of significance was 5%. Initial mean papilla height was 4.6 ± 0.8 mm, and the final value in study casts was 4.3 ± 1.2 mm; there was not a statistically significant difference between initial and final values (p = 0.309). In the CBCT coronal sections, initial mean papilla height was 3.5 ± 1.2 mm vs. 3.1 ± 0.7 mm after treatment (p = 0.094); again, no statistically significant differences were observed. In the sagittal plane, there was a significant difference (p = 0.05) between initial (3.7 ± 1.1 mm) and final (3.1 ± 0.6 mm) mean papilla height. According to our findings, and to the different measuring techniques employed, the height of the papilla changed little as a result of orthodontic therapy.
A presença de papila gengival na região anterior da maxila é essencial para a estética do sorriso. O objetivo deste estudo foi avaliar as alterações na altura papilar dos incisivos centrais superiores, antes e após movimentação ortodôntica, utilizando modelos de estudo e tomografia computadorizada de feixe cônico (TCFC). Dezesseis pacientes, com idades entre 13 e 18 anos, foram submetidos a tratamento ortodôntico. A altura da papila foi calculada nos modelos de estudo iniciais e finais. Para isso, uma linha horizontal foi traçada tangente ao zênite dos incisivos centrais e uma linha vertical foi inscrita perpendicularmente à linha horizontal. A altura papilar foi definida como a distância entre a ponta da papila até o ponto de intersecção entre as duas linhas . Nas imagens TCFC inicial e final de cada paciente, a altura da papila foi caldulada com base na distância do ponto de contato interproximal até a crista do osso alveolar. Esta medida foi realizada em cortes sagitais e coronais. Os dados foram analisados estatisticamente utilizando teste t de Student. O nível de significância foi de 5%. A altura média inicial papilar foi de 4,6± 0,8 mm, e a final, de 4,3 ± 1,2 mm; não houve diferença estatisticamente significativa entre as medidas (p = 0,309). No corte coronal da TCFC, a altura média inicial papilar foi de 3,5 ± 1,2 mm, e a final, de 3,1 ± 0,7 mm final (p = 0,094); novamente, não houve diferença estatisticamente significativa. No corte sagital, houve uma diferença significativa (p = 0,05) entre as alturas inicial (3,7 ± 1,1 mm) e final (3,1 ± 0,6 mm) média papilar. De acordo com nossos resultados e com os diferentes métodos de medição empregados, a altura da papila sofreu pouca alteração após terapia ortodôntica.