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Objective@#To investigate the effect of the socket-shield technique (SST) concurrent with immediate implant placement and provisionalization (IIPP) in the aesthetic restoration of anterior teeth.@*Methods@#A case of maxillary anterior tooth stumps with a thin labial bone wall was treated with SST for preservation of labial soft and hard tissue fullness, combined with an immediate implant placement and immediate provisional crown for restoring the shape of the tooth and gingival molding@*Results@#Immediate implant placement and provisionalization restored the morphology and function of the affected tooth in the shortest possible time. The patient's labial soft and hard tissue contours in the affected tooth area were well preserved in the 18-month follow-up after the application of the SST, which presented a better aesthetic result. The literature review indicates that the indications for SST are unrestorable maxillary anterior teeth, whose dental, periodontal and periapical tissues are healthy and intact. In the esthetic zone, root shielding is effective in maintaining the soft and hard tissue contour on the labial side of the implant. However, there is no consensus on the technical details of SST, such as the ideal coronal height and thickness of the shield, and the management of the gap between the shield and the implant. Thus, more clinical studies and histologic evidence are needed to provide a reference for clinical decision-making. In addition, digital technology can improve the accuracy of implant placement and shield preparation.@*Conclusion@#The correct application of SST combined with IIPP in the esthetic zone can ensure esthetic results. However, more high-quality evidence-based medical evidence is needed for its long-term efficacy, and indications should be strictly controlled during clinical application.
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OBJECTIVES@#This study aimed to evaluate the long-term clinical efficacy of simple taper retentive implants in the posterior dental area after immediate implantation for 5-7 years.@*METHODS@#Selected from January 2015 to December 2017 in the Fourth Affiliated Hospital of Nanchang University dental clinic line tooth area immediately after the implant prosthesis, a total of 38 patients, 53 implants, were deep into (bone under 2 mm or higher) and the upper structure was repaired. In addition, after the completion of tracking observation of 60-90 months, the implant surrounding bone health was recorded and analyzed.@*RESULTS@#After 5-7 years of follow-up, 1 of the 53 implants failed to fall out, and the implant retention rate was 98.1%. The amount of bone resorption in the proximal and distal margins 5-7 years after implant restoration was (0.16±0.94) mm and (-0.01±1.29) mm, respectively, and the difference in bone height between the proximal and distal margins of the implant and the immediate post-restoration period was not statistically significant (P>0.05). No statistically significant differences were found in the effects of periodontitis, implant site inflammation, and smoking on peri-implant marginal bone resorption (P>0.05).@*CONCLUSIONS@#The single taper-retained implant broadens the indications for immediate implant placement in the posterior region, and its deep sub-osseous placement (≥2 mm below the bone) avoids to a certain extent the disturbance of the implant by external stimuli and the exposure of the cervical abutment of the implant, with the good long-term stability of the marginal bone around the implant.
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Humanos , Implantação Dentária Endóssea , Implantes Dentários , Carga Imediata em Implante Dentário , Seguimentos , Implantes Dentários para Um Único Dente , Perda do Osso Alveolar/cirurgia , Resultado do Tratamento , Prótese Dentária Fixada por Implante , Falha de Restauração DentáriaRESUMO
Background: Dental Implant originally utilized for aesthetic and functional rehabilitation, this treatment option have transformed oral rehabilitation techniques and are now regarded as the gold standard of treatment for replacing single, partial, and full-arch teeth. With improvements in osteotomy technique, implant macro- and micro-geometry, surface treatment, types of implant prosthetic connections, and other aspects, the overall treatment duration has also been greatly shortened.Material & Methods:This study was carried out in two implant centers and is retrospective and descriptive. It was done in the Implant Surgery Centers of Banasree Dental and German Dental, Dhaka, Bangladesh. The research was carried out from January 2010 to June 2022. 63 people made up the entire sample for this study.Results:Most of the patients 21(33.3%) were aged between 51-60 years where most of the patients 36(57%) were female and 27(43%) were male. Maxilla was done in 45(71.4%) patients, mandible was done in 48(76.2%). 69(74.2%) implants were done on the anterior site and 24(25.8%) was done on posterior site. All the patients had a good primary stability of implant with an insertion torque of 30 N/cm or more. There were 100% survival rate after the implants and in good functional condition. All patients were happy with their implant.Conclusion:This approach of osteotomy preparation’s greater primary stability appears to have a minimal detrimental effect on implant success.
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Objective @# To investigate the effect of immediate and delayed implant placement on dimensional changes in hard and soft tissues as well as esthetic outcomes. @*Methods @# A total of 40 maxillary single anterior teeth with a dehiscence defect on the labial bone (≤4 mm) were categorized into two groups according to the timing of implant placement: immediate implant placement (n = 20) or delayed implant placement (n = 20). Guided bone regeneration (GBR) was conducted at the sites using a flap approach, and the implants were given immediate provisionalization. Implant survival rates, dimensional changes in hard and soft tissues during the six- and twelve-month follow-ups, and pink esthetic scores (PESs) were measured. @*Results @# The implant survival rates in both groups were 100%, and no complications occurred during the follow-up time. There was no significant difference between the two groups at the measurement sites in the dimensional change of hard and soft tissues during the six- and twelve-month follow-ups. The largest resorption was observed at the implant neck, with a loss of (1.29 ± 0.71) mm in the immediate implant placement group and (1.43 ± 0.19) mm in the delayed implant placement group. The mean PES scores were (10.95 ± 1.51) for the immediate implant placement group and (11.05 ± 1.23) for the delayed implant placement group. @*Conclusion@# Immediate implantation or delayed implantation combined with GBR and immediate provisionalization might both be a prospective treatment strategy for a maxillary single anterior tooth with a dehiscence defect on the labial bone.
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@#The method of placing an implant immediately into the fresh extraction socket at the same time as tooth extraction has the advantages of reducing the number of operations and the overall treatment time, making full use of the existing bone mass, and resulting in ideal aesthetic effects. However, immediate implant placement also has its own inherent shortcomings. Due to the existence of the extraction socket, it is difficult to close the wound; because the size of the implant does not match the size of the extraction socket, it is difficult to achieve good initial stability, and there is a risk of soft tissue recession. This article reviews the success rate, indications and expansion of immediate implant placement, surgical requirements, complications and the prevention and treatment of anterior teeth in the aesthetic area. A literature review showed that the 5-year success rate of immediate implant placement was over 95%. The indications included intact socket walls, a facial bone wall at least 1 mm in thickness, the presence of thick, soft tissue, the absence of acute infection at the site, and the availability of bone apically and lingually to the socket to provide primary stability. In addition, in recent years, with the improvement of surgical implantation technology and the improvement of bone substitute material performance, immediate implant placement can be used as one of the conventional methods for oral implantation treatment, and its indications have shown a trend toward expansion. Immediate implant placement also has complications, including poor placement of implants and gingival receding that results in poor aesthetic outcomes. In addition, immediate restoration and conventional loading protocols after immediate implant appear to have similar outcomes and result in better aesthetic effects. However, the long-term stability and patient satisfaction after immediate implant placement in terms of soft tissue aesthetics require more research.
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OBJECTIVE@#To compare the clinical effects of a modified socket shield technique (SST) and the conventional immediate implant placement in the esthetic zone.@*METHODS@#Twenty-four patients with one hopeless upper incisor were consecutively enrolled in this study. All patients were scheduled for immediate implant placement. Twelve patients underwent a modified SST (experimental group) whereas the others underwent conventional procedures (control group). Radiographic and clinical data were obtained preoperatively, immediately after surgery, and 12 months after surgery. The success rate of the implants, the pink esthetic score (PES) and patient satisfaction were analyzed. Statistical analysis was conducted using SPSS 21.0 software.@*RESULTS@#One year after operation, the success rate of the implants was 100% in both groups. The PES and patient satisfaction of the experimental group were significantly higher than those of the control group (P<0.05). The buccal bone plate resorbed less in the experimental group than in the control group (P<0.05).@*CONCLUSIONS@#The modified SST is advantageous over the conventional immediate implant placement in terms of buccal bone and soft tissue maintenance.
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Humanos , Implantes Dentários para Um Único Dente , Estética Dentária , Carga Imediata em Implante Dentário , Extração Dentária , Alvéolo Dental , Resultado do TratamentoRESUMO
Objective@#To evaluate the clinical effect of a digital whole-process surgical guide for immediate implantation in the molar area. @*Methods @#Twenty-six patients with molar extraction plans were accepted for preoperative CBCT and model construction. Computer software was used to design the ideal three-dimensional position of the implant. The control group of 13 patients underwent immediate implantation with a free hand operation, whereas the experimental group of 13 patients underwent preparation and implant insertion under the guidance of a surgical guide. Bone grafting was performed, and a good initial stability was achieved. After 5 to 6 months, osseointegration was achieved, and the final restoration was delivered. After surgery, the accuracy of the three-dimensional position of the implants was measured, and at the 6 month return visit, the modified Plaque Index (mPLI), modified Sulcular Bleeding Index (mSBI) and probing depth (PD) were measured. @*Results @# In the control group and experimental group, the vertical errors at the top of the implants were 1.246 ± 0.072 mm and 0.628 ± 0.046 mm (t = 26.078, P < 0.001), respectively, and the horizontal errors were 1.563 ± 0.086 mm and 0.546 ± 0.056 mm (t = 35.813, P < 0.001), respectively; and the vertical errors at the root of the implants were 1.352 ± 0.042 mm and 0.532 ± 0.030 mm (t = 57.021, P < 0.001), respectively, and the horizontal errors were 1.645 ± 0.076 mm and 0.625 ± 0.072 mm (t = 35.086, P < 0.001), respectively. For the experimental group, the mPLI value was 0.923 ± 0.760, the mSBI value was 0.846 ± 0.689, and the PD value was 3.460 ± 0.713 mm, which were significantly lower than those of the control group. For the control group, the mPLI value was 1.769 ± 0.927 (t = 2.546, P = 0.018), the mSBI value was 1.692 ± 0.947 (t = 22.605, P = 0.016) and the PD value was (4.579 ± 0.475) mm (t = 4.709, P < 0.001). @*Conclusion@#A digital surgical guide plate can increase the precision of immediate implantation and the peri-implant health in the molar area.
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In the anterior tooth zone, the criteria of successful implant restoration is not only to ensure a high survival rate of implant, but also to provide long-lasting and stable aesthetic outcomes. As for the rehabilitation of anterior teeth, immediate implant placement might achieve a survival rate similar to those of delayed implant placement and significantly reduce treatment time, whereas several aesthetic complications such as gingival recession, loss of interdental papilla, exposure of implant margin could also occur. Therefore, an important issue need to be solved is that how to avoid or handle the aesthetic complications of immediate implant placement of anterior teeth. This article mainly discusses the clinical features, possible etiologies and handling methods of aesthetics complications in rehabilitation of anterior teeth using immediate implant placement.
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Objective@#To evaluate the preliminary clinical outcome of socket shield technique in maxillary anterior region.@*Methods@#Nine patients were treated with socket shield technique in Peking University School and Hospital of Stomatology from February 2012 to December 2015 were enrolled in this study. Ten implants were placed and restored immediately. After 12-48 months' follow-up (averaged 32 months), the peri-implant hard and soft tissue were clinically evaluated.@*Results@#No implants were lost during the observation period, resulting a cumulate 32-month survival. The pink esthetic score (PES) was 13.5. Mesial and distal bone loss were 0.17 mm and 0.22 mm respectively.@*Conclusions@#To achieve good esthetic results, socket shield technique may be an option for maxillary anterior region immediate implant placement.
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Objective:To compare the changes of marginal bone resportion between immediate implantation and delayed implantation after 12 to 24 months of definitive prostheses finished.Methods:41 patients were recruited and divided into immediate implant placement group(n =20) and delayed implant placement group(n =21).All implants were evaluated via radiograph after surgery,6 months after implantion,1 year and 2 years after prostheses placement respectively,the height of marginal bone was measured 6 month after implation,1 year and 2 years after prostheses placement.Results:After 6 month,1 year and 2 year the mesial marginal bone attachement (MBA) of immediate implant placement group increased by (1.35 ± 1.12),(2.16 ± 1.73) and (2.53 ± 1.65) mm,the distal by (1.46 ± 1.17),(1.94 ± 1.16) and (2.32 ± 1.68) mm,respectively (among the 3 time points of examination,P ＜ 0.05).As for the delayed implantation group,in the mesial area MBA increased by (-0.52 ± 0.47),(-0.69 ± 0.58) and (-0.97 ± 0.78) mm,in the distal area by (-0.46 ± 0.44),(-0.60 ± 0.45) and (-0.72 ± 0.63) mm (among 3 time points,P ＞ 0.05).Conclusion:Immediate implantation is superior to delayed implantation for marginal bone attachement of dental implant.
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Developing of digital technique, it is possible to fabricate implant prostheses for edentulous area using intraoral 3-dimentional information throughout implant diagnosis and treatment process. It is being changed that from the method using CAD/CAM, producing prostheses by model scanning after conventional impression and model processing, to the method of fabricating implant provisional restorations and customized abutments by digital impression after connecting digital impression copings (scanbody) and implant fixtures without models. But, this digital method has not been actively used for implant prostheses not yet. Specially, it is short of intraoral digital impression cases for immediate provisional restorations of the maxillary anterior implants. The gingival contour impression of maxillary anterior area is very important for esthetic restorations. Accordingly, in this case report, the using a digital impression coping (scanbody) and digital impression by CEREC Omnicam (Sirona, Bensheim, Germany) or Trios (3shape, Copenhagen, Denmark) were introduced for immediate provisional restorations in 3 cases needed a single implant restoration in maxillary anterior area. The clinical results were satisfactory on the convenience and accuracy of digital impression technique and the good esthetics of final restorations.
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Diagnóstico , Estética , Próteses e ImplantesRESUMO
The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.
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Humanos , Anestesia Geral , Reabsorção Óssea , Atenção à Saúde , Cárie Dentária , Boca , Boca Edêntula , Pacientes Ambulatoriais , Próteses e Implantes , Esquizofrenia , Extração DentáriaRESUMO
The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.
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Humanos , Anestesia Geral , Reabsorção Óssea , Atenção à Saúde , Cárie Dentária , Boca , Boca Edêntula , Pacientes Ambulatoriais , Próteses e Implantes , Esquizofrenia , Extração DentáriaRESUMO
Successful placement of dental implant into fresh extraction socket in single rooted tooth region has been reported. In cases of immediate implant placement in the single rooted tooth, initial primary stability is important to achieve predictable outcome. It is also suggested that the implant should be placed into minimum of 3 mm of solid bone apical to extraction site. The single stage approach preserves site morphology by protecting and supporting existing hard and soft tissues. Clinical success appears to be attributed to several important features of the technique which will be discussed in this case report. In the case presented, clinical and radiographic findings after implant placement confirmed a satisfactory treatment result.
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Conventional implant protocols required a load-free healing period of three to six months between placement and functional loading of the implants. Many efforts have been made to minimize the duration of treatment time. Several literatures have documented immediate function with provisional or definitive prosthesis within a week of the placement in response to these demands. In addition, immediate implant placement has advantages such as shortened treatment time and preservation of soft tissue architectures. This article presents immediate implant placement into fresh extraction sockets followed by functional immediate loading with provisional prosthesis on canine and premolars for a patient having canine protected occlusion.
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Humanos , Dente Pré-Molar , Oclusão Dentária , Prótese Parcial Fixa , Próteses e ImplantesRESUMO
Conventional implant protocols required a load-free healing period of three to six months between placement and functional loading of the implants. Many efforts have been made to minimize the duration of treatment time. Several literatures have documented immediate function with provisional or definitive prosthesis within a week of the placement in response to these demands. In addition, immediate implant placement has advantages such as shortened treatment time and preservation of soft tissue architectures. This article presents immediate implant placement into fresh extraction sockets followed by functional immediate loading with provisional prosthesis on canine and premolars for a patient having canine protected occlusion.
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Humanos , Dente Pré-Molar , Oclusão Dentária , Prótese Parcial Fixa , Próteses e ImplantesRESUMO
The level of bone crest surrounding the implant is of utmost significance to determine osseointegrated implant success, as preservation of marginal bone height is highly important for long-term dental implant survival. Various approaches have been described in the literature to prevent the crestal bone loss, including platform switching, non-submerged approach, scalloped implants, implant design modifications, progressive loading, immediate implant placement, etc. The purpose of this paper is to review all the possible methods to preserve the crestal bone, when each method should be used and their success rates in an attempt to address this complex problem of crestal bone resorption. "PubMed" and "Google Scholar" were used to find out any studies involving platform switching concept from 1990 up to 2009. Twenty-four studies involving methods for preservation of crestal bone were evaluated, which included 26% studies on platform switching, 22% on non-submerged approach, 17% on scalloped implants, 13% on progressive loading and 22% on immediate implant placement. Crestal bone preservation should be thought of starting from the design of the implant to be placed. The technique to be followed in a given case will depend upon the density of bone, force factors by the patient, bone volume and amount of soft tissues, etc. The best possible method or the combination of the methods should be used to preserve the crestal bone for the long-term success of the implants.
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Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/patologia , Densidade Óssea/fisiologia , Projeto do Implante Dentário-Pivô , Implantação Dentária Endóssea/métodos , Implantes Dentários , Planejamento de Prótese Dentária , Humanos , Carga Imediata em Implante Dentário , Osseointegração/fisiologia , Periodonto/patologia , Análise de SobrevidaRESUMO
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.
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Humanos , Coroas , Implantes Dentários para Um Único Dente , Porcelana Dentária , Estética , Maxila , TitânioRESUMO
BACKGROUND: Immediate implant placement has become an acceptable treatment for the edentulous area. The advantages of the immediate implant placement include considerable decrease in time from tooth extraction to placement of the finial prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plans. But the success is dependent on the quantity and quality of the extraction socket. The purpose of this study is to evaluate the success of the immediate implant placement. MATERIALS AND METHODS: Twenty-one sites in 16 patients were selected for the evaluation of the immediate implant placement. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent pain or sign of infection. RESULTS: Of the 21 implants, 13 implants have been succeeded. Of the 13 implants, 10 implants were replaced for the periodontal disease and 3 implants were replaced for the trauma. CONCLUSION: The criteria of the success in immediate implant placement are as follows. 1) Implants placed into fresh extraction sockets have a high rate of survival. 2) Implant should be placed as close as possible to the alveolar crest. 3) Implant placed into available bone beyond the apex have a high success rate.