Clinical Safety of a New Synthetic Resorbable Dental Membrane: A Case Series Study.

Dental membranes are commonly used in oral and maxillofacial surgery for the regeneration of small osseous defects. A new synthetic resorbable membrane has recently demonstrated its biocompatibility and bone regeneration capacity in preclinical studies. This membrane is made of poly(D,L-lactic/glycolic acid 85/15), has a bi-layered structure with a dense film to prevent gingival epithelial cell invasion, and a microfibrous layer to support osteogenic cells and bone healing. This membrane completely degrades by hydrolysis in 4 to 6 months without signs of inflammation. Based on this research, a clinical study was conducted to evaluate the safety of the new membrane in guided tissue regeneration (GTR). In total, 26 patients (age: 50.5 ± 12.4, min-max 31-72 years; male/female 42/58%) were operated on at 7 independent private dental practices. Dental surgeons used the membrane together with various bone fillers in GTR for immediate and delayed implant placement (23 cases, 88%) and, to a lesser extent, socket preservation (2 cases, 8%) and alveolar crest augmentation (1 case, 4%). Surgeons reported an easy placement of the membrane (satisfaction index: 3.8/5). Fourteen days postsurgery, 15 patients had no pain while the others declared minimal pain (verbal rating scale: 2.2/10), and none had minor or serious complications related to the membrane. Exposure of the membrane without loosening the biomaterial granules was observed in 3 cases while mucosa healed normally over time. At 4 months postimplantation, no infection or mucosal inflammation was reported, and the overall dentist satisfaction with the clinical performance of the membrane was 4.5/5 on average. This clinical study demonstrated that the new synthetic resorbable membrane is safe for guided bone tissue regeneration in various dental surgery indications.

The relationship of oral health with general health and NCDs: a brief review.

Oral health is closely related to systemic health. Periodontitis, a chronic inflammatory disease which is highly prevalent worldwide, interacts with a variety of noncommunicable diseases (NCDs). It is a risk factor in the complex pathogenesis of diabetes mellitus and cardiovascular disease and plays a role in the development of endocarditis and recurrent pneumonia in elderly people. However, the available data may be interpreted in different ways, and more and better-designed studies are still needed to answer relevant questions about the causal role of periodontitis in NCDs. What is clear is that periodontitis contributes to the systemic inflammatory burden. As periodontitis shares many common risk factors with NCDs, close collaboration between physicians and dentists is needed to increase the chance of early detection and improve the prevention and control of these conditions.

Guided flapless surgery with immediate loading for the high narrow ridge without grafting.

Computer guided implant treatment allows implants and associated restorations to be precisely placed during the same procedure directly through the gingiva with reduced postoperative complications and surgical time. When bone height is adequate but very narrow, the virtual guided sleeve is often placed too deeply into the ridge crest interfering with the seating of the surgical template. This case report of a patient exhibiting very narrow residual ridges due to severe resorption describes a new computer guided procedure using a single surgical template maintaining bone height and immediate restoration without a mucoperiosteal flap. The success of this technique is the result of innovative modifications in the software as well as instrumentation. Modifications include planning a different implant length virtually to raise the position of guide sleeves, alteration of drilling sequences, modifications of the start drill, incorporation of osteotomes, and use of an alternative implant seating mount. The combination of these methods allows for deeper site preparation and implant seating beyond the default settings, without any crestal bone reduction. These modifications not only make the guided concept possible for the entire preparation and seating procedures, but also allow for the slight removal of bone that would interfere with the implant seating through the surgical template without a mucoperiosteal flap. This new approach to computer guided surgery maintains prosthetic precision in the fabrication of a provisional restoration prior to implantation with minimal delivery adjustments using prefabricated conical abutments when placing implants at differing levels into the high narrow ridge.