Implant placement and immediate loading with fixed restorations in augmented sockets. Five-year results. A case report.

In this report, a case is presented in which a patient received eight implants 10 months after tooth extraction and socket preservation. The implants were placed in both arches (maxilla = 4, mandible = 4) and immediately loaded using fixed partial restorations; they remained functional over 5 years. No changes in bleeding on probing or plaque index were observed; however, a 1.5-mm probing attachment level loss was observed during the first 3 years (mean: 0.25 mm/year) with no subsequent changes.

Maintenance of class III trifurcated molars versus implant placement in regenerated extraction sockets: long-term results of 2 cases.

Studies to date have reached differing conclusions regarding the long-term prognosis of teeth with class III furcation involvement. Replacement of such teeth with implants could be an alternative. This report compares the treatment outcomes of 2 cases with similar disease progression: 1 treated by implant therapy and 1 maintained with nonsurgical periodontal treatment. Two patients with advanced chronic periodontitis and class III furcation involvement of all molars were treated. Case 1 received a conservative periodontal and antibiotic treatment, followed by 15 years of maintenance. In case 2, the molars were extracted and replaced with implants, and the implants were observed for 7 years. Clinical attachment level (CAL), probing attachment level (PAL), bleeding on probing, plaque index, and periodontal pathogens were recorded. Despite good compliance of case 1, periodontal pathogens were not eliminated and tissue destruction was not halted. The PAL outcomes of case 2 improved over time; mean PAL loss reached 0.35 mm/y in the first 3 years and then decreased to 0.01 mm/y. While CAL outcomes did not change in case 2, case 1 showed increased CAL loss after 8 years. Based on the limited findings of this case report, extraction of molars with class III furcation involvement and subsequent implant placement may render a better predictability of treatment outcomes than nonsurgical periodontal therapy in the cases of infection with periodontal pathogens.

Single-tooth implant placement and loading in fresh and regenerated extraction sockets. Five-year results: a case series using two different implant designs.

BACKGROUND: Implant-supported restorations are a commonly used treatment modality. However, insufficient data are available that compare treatment outcomes of implant restorations using different protocols. Similarly, data comparing the treatment outcomes of different implant designs are limited. METHODS: This retrospective, non-randomized study evaluates 241 single implants in 241 patients (127 males and 114 females; mean age: 49.3 years; range: 45 to 75 years). Tapered-type (TAP; n = 118) and cylindric screw-type (CYL; n = 123) implants were used. Implants were grouped into the treatment categories of immediate placement, delayed placement, immediate non-occlusal loading, and delayed loading. Clinical parameters, including clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP), were recorded at examinations at baseline (BSL) and 1 (E1), 3 (E3), and 5 years (E5) after loading with the final restoration. RESULTS: Eleven implants were lost (five CYL and six TAP). CAL and PI outcomes were similar for both implant types. No significant influence of implant position was found. A CAL loss of 1.5 mm was observed during the first 3 years. The type of implant and timing of placement showed no significant influence on the survival rate, whereas the failure rate was lower for immediate non-occlusal loaded implants. CONCLUSION: The type of implant, position, and timing of placement and loading did not influence the survival rate of this treatment method.

Treatment of intrabony defects using guided tissue regeneration and autogenous spongiosa alone or combined with hydroxyapatite/beta-tricalcium phosphate bone substitute or bovine-derived xenograft.

BACKGROUND: The aim of this case-control study was to investigate the clinical regeneration of deep intrabony defects using guided tissue regeneration (GTR) with autogenous spongiosa (ASB) alone or using GTR with a mixture of ASB with a bovine-derived xenograft (BDX) or a synthetic composite bone substitute (hydroxyapatite/beta-tricalcium phosphate [HA/beta-TCP]). METHODS: Sixty-four patients with a total of 93 intrabony defects of 2- or 3-wall morphology and an intrabony component (IC)>or=4 mm participated in this study. Defects were treated with a bioabsorbable membrane and ASB alone or ASB mixed with HA/beta-TCP or BDX. Clinical parameters measured at baseline and 12 months after surgery included IC, bleeding on probing (BOP), and plaque accumulation (PLI). Vertical bone gain (VBG) and percentage relative bone gain (RBG) were used as indicators of treatment efficacy. A stringent plaque control regimen was enforced in all patients during the 12-month observation period. RESULTS: At baseline, no statistically significant differences in any of the clinical parameters were observed between the groups. At 12 months, HA/beta-TCP and BDX treatments produced similar improvements in intrabony tissue regeneration as shown by VBG (P=0.616) and RBG (P=0.826) with significantly better outcomes than ASB alone (P<0.0001). Changes in BOP and PLI did not differ significantly between the groups. CONCLUSION: The combined use of ASB with BDX or HA/beta-TCP led to significantly greater gain of clinical attachment and hard tissue formation compared to the use of ASB alone.

Treatment of Intrabony Defects Using Guided Tissue Regeneration and Autogenous Spongiosa Alone or Combined With Hydroxyapatite/ß-Tricalcium Phosphate Bone Substitute or Bovine-Derived Xenograft.

BACKGROUND: The aim of this case-control study was to investigate the clinical regeneration of deep intrabony defects using guided tissue regeneration (GTR) with autogenous spongiosa (ASB) alone or using GTR with a mixture of ASB with a bovine-derived xenograft (BDX) or a synthetic composite bone substitute (hydroxyapatite/ß-tricalcium phosphate [HA/ß-TCP]). METHODS: Sixty-four patients with a total of 93 intrabony defects of 2- or 3-wall morphology and an intrabony component (IC) ≥4 mm participated in this study. Defects were treated with a bioabsorbable membrane and ASB alone or ASB mixed with HA/ß-TCP or BDX. Clinical parameters measured at baseline and 12 months after surgery included IC, bleeding on probing (BOP), and plaque accumulation (PLI). Vertical bone gain (VBG) and percentage relative bone gain (RBG) were used as indicators of treatment efficacy. A stringent plaque control regimen was enforced in all patients during the 12-month observation period. RESULTS: At baseline, no statistically significant differences in any of the clinical parameters were observed between the groups. At 12 months, HA/ß-TCP and BDX treatments produced similar improvements in intrabony tissue regeneration as shown by VBG (P = 0.616) and RBG (P = 0.826) with significantly better outcomes than ASB alone (P <0.0001). Changes in BOP and PLI did not differ significantly between the groups. CONCLUSION: The combined use of ASB with BDX or HA/ß-TCP led to significantly greater gain of clinical attachment and hard tissue formation compared to the use of ASB alone.