ABSTRACT
Replacing both missing maxillary anterior teeth is particularly challenging, especially in compromised sockets. This case report describes the management of an 18-year-old female patient, who suffered avulsion of both maxillary central incisors at 7 years of age. This multidisciplinary implant technique, called Immediate Dentoalveolar Restoration (IDR), included extraction of the injured teeth and a single procedure for immediate implant placement and restoration of the compromised sockets after root fracture and periapical lesion development were detected during orthodontic treatment. Successful esthetic and functional outcomes and reestablishment of the alveolar process after bone reconstruction were observed during the 3-year follow-up period. The predictable esthetic outcomes and soft- and hard-tissue stability that can be achieved following IDR are demonstrated.
Subject(s)
Immediate Dental Implant Loading , Incisor/injuries , Tooth Fractures/surgery , Adolescent , Bone Transplantation/methods , Crowns , Dental Abutments , Female , Humans , Maxilla , Orthodontics, Corrective , Tomography, X-Ray Computed , Tooth Extraction , Tooth Root/injuriesABSTRACT
Immediate implant placement into compromised sockets is challenging for clinicians. The 3-dimensional implant position, status of the buccal bone wall, and regeneration of the soft tissue contours all affect adequate esthetic and functional results. This clinical report presents a treatment protocol (a variation of the immediate dentoalveolar restoration concept) consisting of immediate implantation and the reconstruction of the buccal bone wall and gingival recession in a single procedure with a triple graft (cancellous and cortical bone and soft tissue graft).
Subject(s)
Alveolar Bone Loss/surgery , Autografts/transplantation , Bone Transplantation/methods , Dental Implantation, Endosseous/methods , Gingiva/transplantation , Gingival Recession/surgery , Plastic Surgery Procedures/methods , Tooth Socket/surgery , Clinical Protocols , Connective Tissue/transplantation , Crowns , Curettage/methods , Dental Implant-Abutment Design , Dental Implants, Single-Tooth , Dental Prosthesis, Implant-Supported , Esthetics, Dental , Humans , Maxilla/surgery , Surgical Flaps/transplantation , Tooth Extraction/methods , Transplant Donor Site/surgeryABSTRACT
A instalação de implantes em alvéolos de extração pode ser considerado um procedimento desafiador, devido ao risco de remodelação óssea e às consequentes alterações gengivais. Objetivo: o presente estudo tem como objetivo propor um protocolo de seleção do diâmetro de implantes osseointegráveis em alvéolos pós-extração na região anterossuperior, baseado na medida vestibulopalatina do alvéolo, permitindo a formação de um espaço entre o implante e a porção externa da parede óssea vestibular, de 3mm, que deverá ser preenchido com biomaterial ou com ósseo autógeno, aumentando a previsibilidade de resultados em longo prazo...
Implant placement in extraction sockets is a challenging procedure, since it offers risks of bone remodeling and, as a consequent, gingival alterations. Objective: This study aims at proposing a protocol for selecting the diameter of osseointegrated implants placed in extraction sockets in the anterosuperior region. This protocol is based on the buccal palatal dimension of the socket and allows a 3-mm gap to form between the implant and the outer surface of the buccal bone wall.Such gap must be filled with biomaterial or autograft so as to increase the predictability of long-term results...
Subject(s)
Humans , Tooth Socket/surgery , Clinical Protocols , /trends , Biocompatible Materials , Bone Remodeling , Bone Transplantation , Brazil , Tooth ExtractionABSTRACT
The aim of this prospective case series was to evaluate the stability of esthetic treatment after single tooth replacement in compromised sockets using the immediate dentoalveolar restoration (IDR) concept. Eighteen patients underwent immediate implant placement and IDR of bone defects. Clinical photographs were used to evaluate the gingival contour and papillae. The mean soft tissue dimensions at baseline and final follow-up were 12.85 ± 2.33 mm and 12.79 ± 2.48 mm, respectively, revealing no recession. The mean mesial and distal papillary heights increased slightly over time. Stable periimplant soft tissues and satisfactory esthetic outcomes were achieved.
Subject(s)
Dental Implantation, Endosseous/methods , Dental Implants, Single-Tooth , Dental Prosthesis, Implant-Supported , Esthetics, Dental , Immediate Dental Implant Loading , Adult , Aged , Dental Marginal Adaptation , Dental Restoration Failure , Female , Humans , Male , Middle Aged , Prospective Studies , Tooth Socket/surgery , Treatment OutcomeABSTRACT
o prognóstico de fratura radicular, insucesso endodôntico ou de doença periodontal avançada não é favorável. O procedimento escolhido para tratar essas condições inclui extração do dente e instalação de implantes. A fratura radicular, em especial, geralmente está associada à perda óssea da parede vestibular e, consequentemente, ao aumento do risco estético do tratamento. Esse artigo descreve a técnica de Restauração Dentoalveolar Imediata, empregada para restauração óssea de alvéolo comprometido, simultaneamente à instalação do implante, com função imediata, em paciente com fratura coronorradicular na região do incisivo central superior. O paciente foi clinicamente e tomograficamente monitorado por um período de três anos...
The prognoses of root fracture, endodontic failure or advanced periodontal disease are not favorable. The treatment of choice for such patients includes removal of the tooth and implant therapy. Root fracture is commonly associated with bone loss, especially in the buccal wall, and the aesthetic risk is increased. This article describes the use of the Immediate Dentoalveolar Restoration technique to restore a compromised socket through bone graft, implant placement and immediate function in a patient with a complicated crown-root fracture in the maxillary central incisor. The patient was followed up clinically and tomographically for 3 years...
Subject(s)
Humans , Female , Middle Aged , Alveolar Bone Loss , Esthetics, Dental , Tooth Fractures/therapy , Bone Transplantation , Brazil , Immediate Dental Implant Loading , IncisorABSTRACT
Este artigo descreve o procedimento de restauração imediata pós-exodontia em alvéolo comprometido na região do incisivo central superior. Foi realizada a instalação de um implante associada ao enxerto de lâmina óssea da tuberosidade da maxila para a recuperação do defeito ósseo. O posicionamento adequado do implante, a inserção da lâmina óssea no defeito alveolar até o nível da plataforma do implante, a plataforma switching e o perfil de emergência da coroa provisória, promovendo um espaço para permitir a acomodação do tecido mole, foram os critérios utilizados que permitiram o sucesso deste caso clínico. Este procedimento promoveu a recuperação da estrutura anatômica dentoalveolar perdida em um único procedimento, sem retalho, com a manutenção do contorno da margem gengival e estética satisfatória.
This paper describes the procedure of immediate restoration in a compromised fresh extraction socket in the region of upper central incisors. An implant was inserted, together with a bone sliver graft from the maxillary tuberosity, in order to restore the bone defect. The criteria that enabled success in this clinical case were the adequacy of implant positioning; the insertion of a bone sliver into the socket defect, to the level of the implant platform; the platform switching; and the emergence profile of the provisional crown, which promoted space for the soft tissue to be accommodated. This procedure promoted recovery of the lost dentoalveolar anatomical structure in a single procedure, without a flap, while maintaining the gingival profile and satisfactory esthetics.
Subject(s)
Humans , Female , Adult , Bone Transplantation , Surgery, Oral , Tooth Socket , TransplantationABSTRACT
O avanço técnico-científico da implantodontia permite que procedimentos de instalação de implantes com carga imediata, em alvéolos frescos, íntegros ou comprometidos pelos agentes causadores da perda do elemento dental, tenham prognósticos cada vez mais favoráveis. Este artigo apresenta dois procedimentos clínicos de carga imediata em unitários. No primeiro, o implante é instalado em alvéolo com integridade das paredes ósseas e, no segundo, o implante é instalado em alvéolo com comprometimento de uma parede óssea, combinado com o procedimento de enxerto autógeno de lâmina óssea removida da tuberosidade da maxila. A instalação imediata de implante, combinada com a técnica de enxerto ósseo autógeno em alvéolo comprometido, apresentou o mesmo resultado clínico e radiográfico quando comparada ao implante imediato instalado em alvéolo íntegro.
