A biologically oriented preparation technique (BOPT) for immediate posterior implant placement, immediate provisionalization, and definitive implant crown fabrication: A complete digital workflow.

OBJECTIVE: Immediate implants and immediate alveolar sealing have been a widely utilized treatment with high predictability and biological advantages. The improvement in technology has made it possible to simplify clinical processes. The aim of the present report was to describe the complete digital workflow of the Biologically oriented preparation technique for immediate posterior implant, immediate provisionalization and fabrication of definitive implant crowns. CLINICAL CONSIDERATIONS: The surgical process and prosthetic management to preserve the gingival contours of the extracted natural tooth during immediate implant placement and provisionalization are described. Additionally, during the same clinical intervention, the definitive intraoral digital implant scans for capturing the implant position, peri-implant tissue contours, adjacent and antagonist dentition, and profile emergence of the interim implant crown are captured for the fabrication of the definitive crown. CONCLUSIONS: Based on the technique described, the immediate implant placement and provisionalization in the posterior area provides biological and clinical advantages, reducing the number of abutment-implant disconnections and the number of clinical appointments, as well as increases patient comfort. CLINICAL SIGNIFICANCE: The present article describes a technique for an immediate implant placement and provisionalization in the posterior region for maintaining the gingival architecture of the extracted tooth. During the same appointment, the implant position, peri-implant tissue contours, and adjacent and antagonist dentition, and profile emergence of the interim implant crown are captured by using an intraoral scanner and used for the fabrication of the definitive crown. This technique aims to reduce the number of abutment-implant disconnections and clinical appointments.

Analysis of Peri-Implant Bone Loss with a Convergent Transmucosal Morphology: Retrospective Clinical Study.

OBJECTIVE: The aim of this study was to analyze the peri-implant bone loss of infracrestal, supracrestal, and crestal implants from the day of placement and up to 1 year of prosthetic loading. MATERIAL AND METHODS: A retrospective clinical study was carried out. The sample consisted of 30 implants placed on 30 patients. It was divided into three groups: infracrestal (n = 10), crestal (n = 10), and supracrestal (n = 10) implants. RESULTS: Following the statistical analysis, it was observed that, 4 months after implant placement, the mean values of total peri-implant bone loss were 0.04 mm in infracrestal implants, 0.26 mm in crestal implants, and 0.19 mm in supracrestal implants. At the end of one year of prosthetic loading, the peri-implant bone loss was 0.12 mm in infracrestal implants, 1.04 mm in crestal implants, and 0.27 mm in supracrestal implants. It was determined that peri-implant bone loss in crestal implants was significantly higher than in supracrestal implants, and these in turn were significantly higher than in infracrestal implants. CONCLUSIONS: The implants that obtained a better biological behavior on peri-implant bone tissue were the infracrestal implants with a converging transmucosal abutment.

Evaluation of peri-implant soft and hard tissues behavior in screw-retained crowns by the biologically oriented preparation technique (BOPT): Ambispective longitudinal analytical study.

BACKGROUND: Clinical and radiographic evaluation of soft and hard tissues around convergent collar implants and shoulderless abutments. MATERIAL AND METHODS: Ambispective longitudinal analytical study with a sample size of 32 implants in 21 patients treated in a private dental clinic. Patients were divided into two groups: Prama Implants or group 1 (n=21) and Shelta implants combined with XA abutment or group 2 (n=11). Probing depth, horizontal mucosa thickness, peri-implant bone loss, plaque and bleeding after one-and two-year follow up are analyzed. RESULTS: In group 1, mean probing depth value was 1.67 mm (±0.58) and mean horizontal mucosa thickness value was 2.71 (±0.96). In group 2 mean probing depth was 2.18 (±0.40) and mean horizontal mucosa thickness value was 3.27 mm (±1.19). In group 1 an 85.7% of peri-implant bone level was maintained and a 14.3% increased. In group 2 a 100% of peri-implant bone level was maintained. In group 1 a 19% presented plaque when crowns were removed and in group 2 a 18.2% presented plaque. Neither of two groups presented spontaneous bleeding when crowns were removed. A 52.4% presented probing bleeding in group 1 and a 45.4% in group 2. CONCLUSIONS: Biologically guided crowns design seems to provide peri-implant hard and soft tissue stability. Key words:Biologic width, peri-implant soft tissue, marginal bone loss, transmucosal implant, convergent collar, BOPT (biological oriented preparation technique), BOPT abutment, soft tissue stability.

Soft tissue thickness evaluation in screw-retained crowns by the biologically oriented preparation technique (BOPT).

BACKGROUND: Intraoral scanner evaluation (3Shape, TRIOS®) of soft tissue thickness around convergent collar implants and shoulderless abutments. MATERIAL AND METHODS: Ambispective longitudinal analytical study with a sample size of 26 implants in 17 patients treated in a private dental clinic. Pacients were divided into two groups: Prama Implants or group 1 (n=19) and Shelta implants combined with XA abutment or group 2 (n=7). Thickness changes after one- and two-year follow-up were analyzed. RESULTS: In group 1 baseline mean thickness was 6.53 mm (±1.06) and follow-up mean thickness was 8.06 mm (±0.98), in group 2 initial mean thickness was 7.66 mm (±1.09) and follow-up mean thickness was of 8.42 mm (±1.03). CONCLUSIONS: Biologically guided crowns design seems to significantly increase the soft tissue volumen around convergent morphology implants. Key words:Biologic width, peri-implant soft tissue, marginal bone loss, transmucosal implant, convergent collar, BOPT (biological oriented preparation technique), BOPT abutment, soft tissue stability, intraoral scanner.