Foreign Body Gingivitis.

Foreign body gingivitis (FBG) is a non-plaque induced chronic inflammatory process involving the marginal and/or attached gingiva. It results from the introduction of foreign particulate material, primarily dental prophylaxis paste and restorative dental materials, into the gingival tissues. Clinical presentation varies from an erythematous to vesiculoerosive-like process that may mimic a localized form of desquamative gingivitis or an erosive lichenoid process. Rarely, it may also present with a granular appearance. We describe the clinical presentation, differential diagnosis and clinical management of a 52-year-old Woman who presented with localized chronic inflammation of the maxillary anterior and left posterior gingiva secondary to the presence of foreign material.

Hard and soft tissue changes after crestal and subcrestal immediate implant placement.

BACKGROUND: The purpose of this study is to assess the influence of the placement level of implants with a laser-microtextured collar design on the outcomes of crestal bone and soft tissue levels. In addition, we assessed the vertical and horizontal defect fill and identified factors that influenced clinical outcomes of immediate implant placement. METHODS: Twenty-four patients, each with a hopeless tooth (anterior or premolar region), were recruited to receive dental implants. Patients were randomly assigned to have the implant placed at the palatal crest or 1 mm subcrestally. Clinical parameters including the keratinized gingival (KG) width, KG thickness, horizontal defect depth (HDD), facial and interproximal marginal bone levels (MBLs), facial threads exposed, tissue-implant horizontal distance, gingival index (GI), and plaque index (PI) were assessed at baseline and 4 months after surgery. In addition, soft tissue profile measurements including the papilla index, papilla height (PH), and gingival level (GL) were assessed after crown placement at 6 and 12 months post-surgery. RESULTS: The overall 4-month implant success rate was 95.8% (one implant failed). A total of 20 of 24 patients completed the study. At baseline, there were no significant differences between crestal and subcrestal groups in all clinical parameters except for the facial MBL (P = 0.035). At 4 months, the subcrestal group had significantly more tissue thickness gain (keratinized tissue) than the crestal group compared to baseline. Other clinical parameters (papilla index, PH, GL, PI, and GI) showed no significant differences between groups at any time. A facial plate thickness ≤1.5 mm and HDD ≥2 mm were strongly correlated with the facial marginal bone loss. A facial plate thickness ≤2 mm and HDD ≥3 were strongly correlated with horizontal dimensional changes. CONCLUSIONS: The use of immediate implants was a predictable surgical approach (96% survival rate), and the level of placement did not influence horizontal and vertical bone and soft tissue changes. This study suggests that a thick facial plate, small gaps, and premolar sites were more favorable for successful implant clinical outcomes in immediate implant placement.

Immediate implant placement: positives and negatives.

BACKGROUND: An immediate implant approach based on the International Congress of Oral Implantologists Glossary of Implant Dentistry is defined as an implant placement immediately after tooth extraction. This allows clinicians to reduce the number of surgical procedures, resulting in shorter treatment times. However, immediate implant placement may also lead to a higher implant failure rate, inability to predict future soft and hard tissue level, and difficulty in achieving implant primary stability. Hence, the purpose of this review article was to discuss the pros and cons associated with this approach. MATERIALS AND METHODS: Literature published in the English language related to this topic was searched using PubMed. Articles were then reviewed carefully with an attempt to offer suggestions that clinicians could use as guidelines. RESULTS: Careful case selection was determined to be the most important factor to avoid treatment failures and esthetic complications when deciding between immediate and delayed implant placement. Indications, contraindications, and limitations of immediate implant placement are presented and presented. A case treated with this approach is demonstrated. The concept of how to make a proper case selection for immediate implant placement was also provided with scientific evidence. CONCLUSION: The immediate implant placement approach has been studied extensively since being introduced. Evidence available indicates that it is a successful procedure that may benefit patients. However, careful planning and case selection are needed to ensure implant success and final esthetic outcomes.

Finishing systems on the final surface roughness of composites.

AIM: This study evaluated differences in surface roughness of a microhybrid (Gradia Direct, GC America) and a nanofil (Filtek Supreme, 3M ESPE) composite using four polishing systems: PoGo/Enhance (DENTSPLY/Caulk), Sof-Lex (3M ESPE), Astropol (Ivoclar Vivadent), and Optidisc (KerrHawe). METHODS AND MATERIALS: An aluminum mold was used to prepare 2 X 60 composite disks (10 mm X 2 mm). Composite was packed into the mold, placed between two glass slabs, and polymerized for 40 seconds from the top and bottom surfaces. Specimens were finished to a standard rough surface using Moore's disks with six brushing strokes. Specimens were rinsed and stored in artificial saliva in individual plastic bags at 36 degrees C for 24 hours prior to testing. Specimens were randomly assigned to one of the four polishing systems and were polished for 30 seconds (10 seconds per grit) with brushing strokes according to the manufacturer's instructions. Mean surface roughness (Ra) was recorded with a surface-analyzer 24 hours after storage in artificial saliva, both before and after polishing. Means were analyzed using two-way and one-way analysis of variance (ANOVA) and Tukey multiple comparison tests at p < 0.05. RESULTS: There was a statistically significant difference for baseline measures between Filtek and Gradia (p=0.0338). For Filtek, Sof-Lex provided a significantly smoother surface (Ra=0.80 +/- 0.21) than Optidisc (Ra=0.93 +/- 0.28), Astropol (Ra=1.15 +/- 0.24), and Pogo/Enhance (Ra=1.39 +/- 0.39). For Gradia, Sof-Lex provided a significantly smoother surface (Ra=0.47 +/- 0.09) and Astropol provided a significantly rougher surface (Ra=1.39 +/- 0.19) than Pogo/Enhance (Ra=1.11 +/- 0.20) and Optidisc (Ra=1.15 +/- 0.18). There was no significant difference in roughness between composites for individual polishing systems (p=0.3991). CONCLUSION: Filtek specimens were smoother than Gradia specimens after baseline roughening. Sof-Lex provided the smoothest final surface when used with either composite. Astropol provided a rough surface for Gradia specimens.