A novel, fully digital approach to quantifying volume gain after soft tissue graft surgery. A pilot study.

OBJECTIVE: Measuring soft tissue thickness after mucogingival surgery has traditionally been performed by means of a calibrated transgingival probe. The main aim of this study was to apply a non-invasive technique based on digital images formatted as Standard Tessellation Language (STL) files to quantify soft tissue volume after connective tissue grafting. CLINICAL INNOVATION REPORT: Ten patients who presented Cairo Class I gingival recession were selected for connective tissue grafting using the tunnel technique. In all patients, the initial position of the gingiva and quantity of keratinized tissue were recorded, and gingival recession was scanned with an intra-oral scanner. Six months after surgery, the same intra-oral parameters were recorded and compared with the initial registers using digital volumetric analysis software. RESULTS: Complete root coverage was obtained in most patients (90%), mean coverage being of 2.70 mm with a mean increase in volume of 115.49 mm3 in the treated areas. No pattern was identified that indicated a statistically significant relation between gingival recession and coverage volume in mm3 . CONCLUSIONS: Digital processing of pre- and post-treatment images makes it possible to measure the volume of tissue gained after tissue graft surgery simply and non-invasively. The technique is an objective and reproducible method for measuring soft tissue thickness.

Influence of Transmucosal Area Morphology on Peri-Implant Bone Loss in Tissue-Level Implants.

PURPOSE: To analyze peri-implant bone loss around two types of tissue-level implants (convergent and divergent transmucosal morphology) placed in the same region of either the maxilla or mandible in a single surgical session. MATERIALS AND METHODS: This prospective study included 21 patients who each received two implants, one with a convergent transmucosal collar (n = 21) the other with a divergent collar (n = 21). Implants were placed in a single surgical session, by the same clinician, in the same clinical setting at the Prosthodontic and Occlusion Unit, University of Valencia (Spain). The implants (n = 42) were restored with splinted crowns screwed directly onto the prosthetic platforms. Bone loss analysis consisted of measurements taken from periapical radiographs 24 months after loading. Statistical analysis evaluated the homogeneity of the groups using Pearson's chisquare test; bone loss was compared with the Wilcoxon test. Statistical significance was set at 5% (α = .05), with a confidence interval of 95% and a power of 57%. RESULTS: Implants with convergent transmucosal morphology presented less mean peri-implant bone loss (0.29 ± 0.34 mm) than those with divergent transmucosal morphology (0.60 ± 0.63 mm), with a statistically significant difference between the two types of implants (P = .031). CONCLUSION: Less peri-implant bone loss occurs around supracrestal implants with convergent transmucosal morphology than divergent transmucosal morphology.

Influence of Implant-Prosthetic Connection on Peri-Implant Bone Loss: A Prospective Clinical Trial with 2-Year Follow-up.

PURPOSE: To analyze peri-implant bone loss around six different types of implant-prosthetic connections over a 2-year follow-up period. MATERIALS AND METHODS: A total of 120 implants were divided into six groups (n = 20), three with crestally and three with supracrestally placed implants, with different internal connections, placed in posterior sectors (molar and premolar), and bearing one-piece CAD/CAM restorations screwed directly to each implant's prosthetic platform. Bone height was measured from parallelized periapical radiographs taken at the moment of loading and 2 years later. RESULTS: The patient sample included 61 subjects, 36 men and 25 women. Significant differences were found in bone loss between groups, the implant with internal hex and convergent transmucosal collar showing the least bone loss (P < .001) in comparison with the other designs. Supracrestally placed implants underwent less bone loss than crestally placed implants (P = .025). CONCLUSION: Peri-implant bone loss is influenced by the level of implant placement in relation to the bone crest (crestal or supracrestal) and by the morphology of the prosthetic platform.

Dental-gingival remodeling with BOPT no-prep veneers.

Recent years have seen increasing demand for treatments aimed at improving dental esthetics. In this context, both patients and dentists prefer to preserve dental structures as far as possible; thanks to technological advances, especially in adhesive dentistry, new materials and minimally invasive techniques such as "no-prep" (no preparation) veneers have made this possible. Nevertheless, no-prep veneers have specific indications and suffer certain disadvantages. OBJECTIVES: This clinical case describes the rehabilitation of the upper anterior region by means of no-prep veneers, with BOPT (Biologically Oriented Preparation Technique) cervical margins. The patient had requested an aesthetic treatment to improve irregularities of the gingival margins associated with the presence of diastemata resulting from microdontia. Key words:BOPT, micro-veneers, hybrid ceramic, ultra-fine veneers, diastemata, without prosthetic finish line, no-prep.

Rehabilitation with implant-supported overdentures in total edentulous patients: A review.

OBJECTIVES: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. MATERIAL AND METHODS: We performed a Medline search and review of pertinent articles on the mentioned subject from 1986 to 2011. As a searching strategy, we used the following words: implant-supported overdentures, attachment systems, Locator attachment, cantilever, fixed prosthesis. RESULTS AND CONCLUSIONS: Implant-supported overdentures constitute an accurate and predictable treatment option and achieve a higher patients' satisfaction. This type of treatment constitutes a cheaper treatment than fixed prostheses and in some patients, with loss of lip support or with an interoclusal space larger than 15 mm, the choice of implant-supported overdentures seems to prevent future aesthetic or phonetic problems. Key words:Overdentures, implant occlusion, implant rehabilitation, total edentulous rehabilitation, fixed prosthesis.