Convergent implant transmucosal collar and healing abutment: aesthetics influence on soft tissues. A clinical study.

Two conditions are necessary for a correct and functional prosthetic implant rehabilitation: maintaining pre-implant soft tissue health and stability of bone tissue, in terms of implant osseous-integration and maintenance of optimal crestal attachment levels. In addition to these parameters - necessary for the longevity of the restoration - one of the main aspects of therapy is the achievement of a final aesthetic that reproduces as faithfully as possible the natural anatomy of the lost tooth and the associated soft tissues. To achieve this last objective, an implant system was designed and used by our group. This implant is characterized by a convergent trans-mucosal emergence fixture associated with a progressive closing system of trans-mucosa healing pillars (healing abutment). This guarantee, together with the micro and macrostructure of the implant, an immediate and highly aesthetic condition of the peri-implant soft tissues, and in the same time an optimal seal on the convergent neck of the implant itself.

Transgingival implants with a convergent collar (PRAMA); surgical and screwed prosthetic approach. A case report.

This article presents a case report of transmucosal implant with a convergent collar (PRAMA) inserted in the anterior maxillary esthetic area. The purpose of this study is to evaluate soft and hard tissue after 12 months. One implant was placed in the esthetic area. The implant was immediately loaded with a screwed provisional prosthesis. After 3 months the definitive screwed prosthesis was inserted. The patient was reassessed 12 months post-implant placement, and during the examination, the soft-tissue texture, color, and amount of keratinized tissue was checked. No statistically significant horizontal dimensional changes of the alveolar ridge were observed between each time-point. Mean soft tissue levels significantly improved between base-line and 12 months. The reduced buccal width of the transmucosal component gives more space to the gingival thickness and promotes stability and give a better seal. The use of transmucosal implant creates a shift of the inflammatory cell infiltrate away from the crestal bone level.

Implant-abutment connections on single crowns: a systematic review.

Different implant-abutment connections have been developed in the effort of reducing mechanical and biological failure. The most frequent complications are screw loosening, abutment or implant fracture and marginal bone loss due to overload and bacterial micro-leakage. Ideal connection should work as a one-piece implant avoiding the formation of a micro-gap at the implant-abutment interface. Different in vitro and in vivo researches have been published to compare the implant-abutment connections actually available: external hexagon, internal hexagon and conical finding different amount of micro-gap, micro-leakage and marginal bone loss. The aim of this article is to describe, according to the most recent literature, different kind of fixture-abutment connections and their clinical and mechanical advantages or disadvantages.

Esthetic and function rehabilitation of severely worn dentition with prosthetic-restorative approach and VDO increase. Case report.

OBJECTIVE: The aim of this study is to report a case of restorative treatment of severely worn dentition. In this case report, the erosive/abrasive worn dentition have been reconstructed with metal ceramic crown on the posterior teeth and with ceramic veneers on the anterior teeth 1.3 - 2.3 and 3.4 - 4.3. METHODS: A prosthetic treatment was proposed to a male patient of 58 years old having a clinically significant tooth wear. After clinical exam, impressions of maxillary and mandible arches were taken with alginate to obtain preliminary casts for diagnostic waxing to all maxillary and mandibular teeth and fabrication of all provisional crowns in acrylic resin for posterior teeth, and from the diagnostic wax-up were fabricated a silicone guide masks for anterior teeth. An increase in VDO should be determined on the basis of a need to accomplish satisfactory and aesthetically pleasing restorations; it was proposed to increase the incisal lenght of the maxillary anterior incisors, together with alteration of the VDO 3 mm anteriorly. The posterior teeth 1.6 - 1.5 - 1.4 - 2.4 - 2.6 - 3.5 - 3.6 - 3.7 - 4.4 - 4.7, where the amount of tissue lost was greater, were recontructed with metal ceramic crowns. Two implants (Nobel replace 4.3x10) was placed. The implant were located in the area 4.5 - 4.6. The anterior teeth were restored with veneers. DISCUSSION AND RESULTS: The prosthetic challenge with restoring severely worn dentitions is to preserve as much of the already diminished tooth structure as possible for retention while also providing enough interocclusal space for the restorative material.

Maxillo-facial prosthesis (P.M.F): in a case of oral-nasal communication post-surgery and post-radiotherapy.

In patients with oral-nasal communication the absence of alveolar and/or palatal hard and soft tissue, or contraction resulting from previous surgical repair, needed prosthetic rehabilitation. This clinical report describes a treatment of an oral-nasal communication through a mixed prosthetic rehabilitation, fixed and removable, with attachments performed by EDM technique.

Full-arch maxillary rehabilitation fixed on 6 implants.

OBJECTIVE: The purpose of this study is to report a case of full-arch rehabilitation on six endosseous implants loaded following the standard procedure. METHODS: An implant-prosthetic treatment was proposed to a 53-year-old woman with a total prosthesis in the upper jaw. Six implants on upper maxillary were placed keeping the upper complete denture during the osseointegration period. The implants were left submerged to allow the patient to wear removable prostheses and the prosthesis was rebase with Hydrocast to not compress the sites of healing during the osseointegration period. The impression of implants was made with silicones for addition (VPS) with different viscosities after 8 weeks. The final restoration was carried out taking into account the aesthetic and functional canons. CONCLUSIONS: Correct diagnosis and accurate implant planning are key for success in implant rehabilitation.

Restoration of anterior teeth using an indirect composite technique. Case report.

OBJECTIVE: This article presents a case report of restoration of anterior teeth using an indirect technique with composite veneers in order to restore the dental anatomy and to provide aesthetic and function of anterior teeth. MATERIALS AND METHODS: A treatment of upper anterior teeth with indirect micro-hybrid composite restoration was proposed to a 40-year-old woman with old discolored and fractured ceramic veneers. Upper six anterior teeth were prepared and, after impressions with VPS of maxillary arche, the composite veneers were placed. DISCUSSION AND RESULTS: There are several advantages offered by indirect techniques compared to direct techniques. The increased practice of veneering technique with indirect composites is due to improvement in the properties of composite materials in the last years. The results are very favourable and the patient is satisfied. CONCLUSIONS: The restorations with composite veneers have proved durable and aesthetic, protect tooth structure and aesthetic and function is predictably re-established.

Prosthetic-restorative approach for the restoration of tooth wear. Vdo increase, rehabilitation of anatomy and function and aesthetic restoration of anterior teeth. Case report.

UNLABELLED: Prosthetic-restorative approach for the restoration of tooth wear. Case report OBJECTIVE: This article presents a case report of combined prosthetic-adhesive rehabilitation in a patient with a generalized tooth wear. METHODS: A combined treatment adhesive - prosthetic was proposed to a male patient of 65 years old having a clinically significant tooth wear, with dentine exposure and with a reduction in clinical crown height. The erosive/abrasive worn dentition have been reconstructed with direct resin composite restorations on the posterior teeth and with zirconia crown on the anterior teeth. RESULTS: Direct composite restorations have a number of distinct advantages. These restorations have proved durable and aesthetic, protect tooth structure and posterior occlusal contact is predictably re-established. CONCLUSIONS.: A combinations of direct and indirect restorations, based on the new vertical dimension of occlusion (VDO), can help to reestablish anatomy and function.

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year.

UNLABELLED: Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. OBJECTIVE: The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. METHODS: Forty-three patients were selected from the out patient clinic, Department of Dentistry "Fra G.B. Orsenigo Ospedale San Pietro F.B.F.", Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. DISCUSSION AND RESULT: The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn't difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. CONCLUSIONS: The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven't difficulty in removal and insertion of the denture and in oral hygiene. They haven't in both groups problems related to fractures.

Using laser diodes for the removal of a lesion of the oral mucosa. Case report.

AIM.: Describe a clinical case of a voluminous asymptomatic fibromatosis lesion present on the cheek mucosa and evaluate the healing of the site after removal of the lesion with use of the laser diode. METHODS.: It was decided to use laser diodes to affect the mucous membrane and remove the lesion without the use of local anesthetic infiltration. The protocol used includes a 300-micron fiber and the emission of continuous light of 1.5 Watt with a range of wave of 940 nm. RESULTS.: THE PROVEN BENEFITS OF USING LASER DIODES FOR MINOR SURGERY ARE: drastic reduction of intraoperative bleeding and in the hours after the surgerywill restrict the swellingbetter and faster healing with no scarring and better cosmetic resultdoes not require suturesreducing the operating time thanks to no need for anesthetic infiltrationin most cases totally absent or less post-operative pain on the surgical site. CONCLUSIONS.: The laser diodes give a significant contribution to improving the surgical treatment of tumors of the oral cavity infact during the surgery reduce bleeding and surgical time, while in the process of healing by reduce swelling and post-operative pain and better results appearance without scarring.