ABSTRACT
Objective@#To study the postoperative soft and hard tissue changes and aesthetic effect of immediate implantation and provisionalization (IIPP) combined with guided bone regeneration (GBR) for a single anterior maxillary tooth with a thin facial bone phenotype.@*Methods @# A total of 34 patients with thin facial bone (<1 mm) were categorized into two groups: a flapped GBR group and a flapless group. Tooth extraction and IIPP were conducted at the sites in both groups. Implant survival rates, dimensional changes in soft and hard tissues during the six- and twelve-month follow-ups, the pink esthetic score (PES) and patient satisfaction scores at the twelve-month follow-up were measured.@*Results @#The implant survival rates were 100% in both groups, and no complications occurred during the 12 months after surgery. The facial bone thickness remained over 2 mm on all measured sides, and the height of the facial bone crest remained at 1.39 mm at the 12-month follow-up in the flapped GBR group, while the facial bone thickness remained less than 2 mm on all measured sides, and the height of the facial bone crest remained at 1.03 mm at the 12-month follow-up in the flapless group. The absorption of facial bone at all measured sides in the flapped GBR group was greater than that in the flapless group (P<0.05). There was no significant difference between the two groups in the dimensional changes of labial soft tissues during the six- and twelve-month follow-ups (P>0.05). The mean PES scores were 10.29 ± 2.34 for the flap GBR group and 10.12±1.78 for the flapless group (P = 0.807). The mean patient satisfaction scores were 8.65 ± 1.27 in the flapped GBR group and 8.76 ± 1.25 in the flapless group, and the patients in both of the groups were satisfied with the esthetic outcomes (P = 0.787). @*Conclusion @#IIPP combined with GBR might be a prospective treatment strategy for a single anterior maxillary tooth with a thin facial bone phenotype, but the esthetic risks should never be ignored.
ABSTRACT
@#The rapid absorption of labial alveolar bone after tooth extraction not only reduces the aesthetic effect of implant repair but also affects the long-term success rate of implants. The socket shield technique is reported as the latest alveolar preservation technique in the aesthetic zone from both domestic and international case reports and shows a high success rate of short-term osseointegration and excellent aesthetic effects. However, some investigations have shown short- and long-term complications with the socket shield technique, such as failure of osseointegration, loss of crestal bone and buccal bone, inflammation, etc. In this review, the socket shield technique will be reported in detail with its pros and cons. Although the socket shield technique has achieved good clinical effects and short-term success rates in many cases, there are still no conclusions regarding the surgical procedure, such as the thickness, the position of the shield, whether to put the graft material between the shield and implant, etc. Due to the lack of long-term research or a large amount of clinical literature support and technical sensitivity, the socket shield technique should be carefully used in clinical application to reduce unexpected risks.
ABSTRACT
Objective@#To investigate the clinical effect of a titanium-zirconium small-diameter implant in anterior teeth with bone deficiencies in the esthetic area and to provide a basis for clinical application of this implant. @* Methods @# A retrospective analysis was performed using clinical data from 30 patients with a missing alveolar ridge width < 5.5 mm and a titanium-zirconium 3.3 mm diameter implant prosthesis in the anterior esthetic region. A total of 38 titanium-zirconium implants with a diameter of 3.3 mm were implanted in 30 patients. Clinical examination and CBCT were performed 12 and 24 months after implantation to evaluate the success rate and marginal bone resorption of the 3.3 mm small-diameter titanium-zirconium implants. The modified plaque index, improved gingival sulcus bleeding index, exploration depth, pink esthetic score (PES) and prosthetic complications were measured and recorded.@*Results @#The 24-month success rate of the implant was 100%. The average marginal bone resorption height was 0.51 ± 0.20 mm at 12 months after implant placement and 0.59 ± 0.18 mm at 24 months. The edge bone height did not change significantly (t=1.381, P=0.178). No significant differences were found in the modified plaque index around the implant, modified sulcus bleeding index and probing depth between 12 and 24 months (P > 0.05), and the gingival health was good. The PES value was 9.77 ± 1.48 at 12 months and 10.77 ± 1.50 at 24 months (t=0.426, P=0.672). The PES was increased at 24 months versus 12 months, but this difference was not significant (P > 0.05). The overall esthetic effect was good, and no complications occurred after repair.@*Conclusion@# Titanium-zirconium small-diameter implants can achieve good short-term clinical results in the esthetic area of the anterior teeth.
ABSTRACT
A case with horizontal and vertical bone deficiency at the maxillary esthetic area is reported.A titanium disk was applied to maintain the space for guided bone regeneration,and ridge splitting and bone compressing technique were used to prepare the site.Finally,the restoration of implant tooth with favorable esthetic outcome was obtained.