Peri-Implant Cystic Lesion With Unusual Cellular Changes: A Case Report.

INTRODUCTION: This report describes the history and management of a cyst developing in anatomic contact with an immediately placed dental implant. CASE PRESENTATION: The lesion presented clinically as a facial swelling of the gingiva adjacent to an osseointegrated and restored maxillary right lateral incisor implant. Radiographs showed a well-circumscribed radiolucency, which was contiguous with the implant surface. After reflection of a mucoperiosteal flap, the lesion was enucleated in toto, and the defect was curetted. The bony defect was grafted, and the lesional tissues were sent for histologic analysis. The results demonstrated the presence of a cyst of unknown origin with some unusual cellular changes in localized areas of the cyst lining resembling ameloblasts. Healing occurred uneventfully, and the patient was monitored for recurrence. At the 2-year follow-up appointment, the patient presented no clinical or radiographic signs of recurrence of the lesion. The etiology of this lesion is unknown. CONCLUSION: This case emphasizes the need for histologic diagnosis of peri-implantitis lesions and suggests a need for expansion of the current classification system for peri-implantitis lesions.

Hard and soft tissue augmentation in a postorthodontic patient: a case report.

A combination of hard and soft tissue grafting is used to augment a thin biotype. A 26-year-old woman with mandibular anterior flaring and Miller Class I and III recessions requested interceptive treatment. Surgery included a full-thickness buccal flap, intramarrow penetrations, bone graft placement, and primary flap closure. Postoperative visits were at 2 and 4 weeks and 2, 3, and 6 months. Stage-two surgery consisted of submerged connective tissue graft placement. Postoperative visits were completed at 2, 4, 6, and 8 weeks and 1 year. Follow-up was completed 3 years after the initial surgery. Interradicular concavities were resolved and gingival biotype was augmented. Soft tissue recession remained at 6 months. Reentry revealed clinical labial plate augmentation; 2 mm was achieved at the lateral incisors and the left central incisor and 3 mm was achieved at the right canine. No bone augmentation was achieved on the left canine and right central incisor. The dehiscence at the right central incisor appeared narrower. Overall, a 2- to 3-mm gain in alveolar bone thickness/height was observed. Two months after stage-two surgery, near complete root coverage was achieved; 1 mm of recession remained on the left central incisor. There was a soft tissue thickness gain of 2 mm without any visual difference in keratinized tissue height. Interradicular concavities were eliminated; the soft tissue was augmented and the gingival biotype was altered. Interdental soft tissue craters remained. One year after connective tissue graft placement, there was near complete root coverage at the left central incisor, which at 2 months experienced residual recession. Interradicular concavities and interdental soft tissue craters were eliminated with soft tissue augmentation, including clinical reestablishment of the mucogingival junction. Clinical stability remained 3 years after the initial surgery, with the patient noting comfort during mastication and routine oral hygiene. A clinical increase in labial plate thickness, in conjunction with soft tissue augmentation, appears to provide for continued stability and decreased potential for future clinical attachment loss.

Intraosseous anchorage of dental prostheses: an early 20th century contribution.

A thorough literature review of root form implants yielded a paucity of information regarding the true pioneers of this discipline. Numerous articles have been written on the history of endosseous implants, although little information is available describing the individuals to whom we attribute the major developments in implant dentistry. This article will present information regarding significant contributors to modern-day implant dentistry. Initially, articles and textbooks printed early in the 20th century were reviewed, and the relevance of implant-related information was ranked based on current concepts. This article highlights four major contributors in implant dentistry: E.J. Greenfield (1913), who developed many of the surgical techniques and principles used today; Alvin Edward Strock (1939), who introduced the first biocompatible material; Per-Ingvar Brånemark (1969), who proved the long-term success of titanium implants; and André Schroeder (1976), who introduced the roughened implant surface.