Gaining Soft Tissue with a Hydrogel Soft Tissue Expander: A Case Report.

In this case report, we describe the treatment of a patient referred to our clinic with a hopeless tooth 21 with an attached pontic. The aim of this case report was to, first, describe the advantages and disadvantages of gaining soft tissue with a self-inflating soft tissue expander before performing a bone augmentation procedure in implant dentistry in the esthetic zone. Second, we describe how an amalgam tattoo, caused by a previously performed apicoectomy that made the extension of the raised flap to cover the augmented site esthetically undesirable, was removed. Two silicone enveloped Osmed hydrogel self-inflating soft tissue expanders were placed submucosally on the right- and left-hand side of the amalgam tattoo. One of these two perforated the overlaying mucosa after 24 days. Both tissue expanders were removed, the amalgam tattoo was excided, the site augmented, and an implant with a crown and a pontic was placed.

Bone morphogenetic protein-2 incorporated calcium phosphate graft promotes peri-implant bone defect healing in dogs: A pilot study.

OBJECTIVES: The evaluation of three different drug delivery modes of bone morphogenetic protein-2 (BMP-2) in healing peri-implant bone defects in beagle dogs. BMP-2 was incorporated in or onto calcium phosphate (CaP) granules in various ways: (i) directly on the outer layer of granules CaP: as an adsorbed depot; (ii) during the entire precipitation process of CaP: an internally incorporated depot; or (iii) during the biomimetic coating precipitation of BMP-2 on the surface of CaP granules: as a coating incorporated depot. MATERIAL AND METHODS: After extraction of the lower molars and wound healing in 6 male beagle dogs, 36 implants were placed (n = 6 animal per group). Peri-implant bone defects were induced. The following treatment groups were evaluated: no treatment; air abrasive surface cleaning (SC) using hydroxyapatite; SC and the subsequent filling of the defect with CaP without BMP-2; SC plus the subsequent filling of the defect with CaP adsorbed BMP-2; SC plus the subsequent filling of the defect with CaP internally incorporated BMP-2; SC plus the subsequent filling of the defect with CaP coating incorporated BMP-2. Histological and histomorphometric analyses were carried out to quantify and compare the changes in bone tissue surrounding the treated implants. RESULTS: In Group 1 with no treatment, four implants were lost. Group 5 with the SC and the subsequent filling of the defect with internally incorporated BMP-2 biomimetically prepared CaP (BioCaP), whereby the BMP-2 is incorporated in the entire volume of all BioCaP particles, showed overall the best results to regenerate bone around the implants. CONCLUSION: This study concluded that the group treated with SC plus the subsequent filling of the defect with CaP BMP-2 internally incorporated BMP-2, whereby BMP-2 has been incorporated in the entire volume of all CaP particles, showed overall the best results when aiming to regenerate bone around the implants.

Expanding soft tissue with Osmed tissue expanders in the goat maxilla.

OBJECTIVES: soft tissue limitations are encountered in implant dentistry, due to the loss of alveolar bone. The aim of this study is to compare the outcome of soft tissue preparation using Osmed self-inflating soft tissue expanders with different in situ times in two implantation techniques. MATERIAL AND METHODS: Osmed self-inflating soft tissue expanders were implanted in goats using a tunnel approach and a flap approach. The animals were sacrificed after 1h (controls) and 40 days (treated). A tattoo technique for stereographic measurements was used to look for soft tissue surface gain. Histological and histomorphometric analyses were performed to quantify and compare the changes in soft tissue volume and bone volume after 1h and 40 days of implantation. RESULTS: after 40 days, the expansion was visible and none of the goats had shown any inflammation. The space between the soft tissue and the bone was filled by the completely expanded expander and surrounding connective tissue. Between the test groups and the control groups, there was no histological difference in the structure of the soft tissue. CONCLUSIONS: all the tissue expanders expanded to their maximum size (2.8 times) and were a reliable product for creating a space between soft tissue and bone. The overlying soft tissue remained in excellent shape. There was no difference in the soft tissue volume and the bone volume between the tunnel and the flap approach after 40 days.