Adjacent Implant Influence on Tooth Restoration in a Gastro-Esophageal Reflux Disease (GERD) Patient Using Monoblock Post-Fused Crown: A Case Report.

This case report explores how the presence of an adjacent implant influenced the restoration of a tooth with pulpitis in a gastro-esophageal reflux disease (GERD) patient. A patient with GERD requires a tooth-colored crown not only for aesthetics but also to address potential galvanic concerns arising from an adjacent implant. GERD, a condition causing non-cavity erosion, weakens tooth structure over time, presenting significant challenges in treatment. It resulted in bite relapse and insufficient occlusal clarity over time. A comprehensive treatment approach was needed to restore both function and appearance. This involved managing galvanism using non-metallic materials to ensure optimal occlusal clarity, as well as meticulously reinforcing and restoring tooth structure. Monoblock post-fused crowns were chosen for their superior durability, stability, and comfort. The ceramic layering not only effectively prevented galvanic issues by insulating the tooth structure but also significantly improved the natural appearance of teeth, thereby promoting long-term oral health and successfully managing complex dental concerns. The dental team successfully restored the damaged tooth by considering specific factors that influenced the treatment plan, including achieving optimal aesthetic outcomes.

Risk Factors for Early Implant Failure and Selection of Bone Grafting Materials for Various Bone Augmentation Procedures: A Narrative Review.

Implant therapy is now an established treatment with high long-term success and survival rates. However, early implant failure, which occurs within one year of superstructure placement, occurs at a higher rate than late failure, which is represented by peri-implantitis caused by bacterial infection. Furthermore, various risk factors for early failure have been reported, including patient-related factors, such as systemic diseases, smoking, and bone quality and quantity, as well as surgery-related factors, such as surgeons' skill, osteogenesis technique, and selection of graft material, and implant-related factors, such as initial implant fixation and implant length diameter. Due to the wide variety of relevant factors reported, it is difficult to identify the cause of the problem. The purpose of this review is to discuss the risk factors associated with various types of bone augmentation which have a close causal relationship with early implant failure, and to determine the optimal bone grafting material for bone augmentation procedures to avoid early implant failure.

Retrospective study on the effect of adipose stem cell transplantation on jaw bone regeneration.

PURPOSE: In patients with jaw bone atrophy, dental implant therapy requires bone augmentation on the alveolar ridge. Common methods are autologous bone transplantation or bone substitutes. The latter technique is less surgically invasive because it does not require bone harvesting; however, blood supply from the surrounding tissues and local differentiation of osteoblasts are not guaranteed, so adequate bone regeneration for dental implant therapy is often not achieved. Therefore, at our hospital we introduced a bone regenerative medicine technique that uses adipose stem cells (ASCs) from adipose tissue. The new approach is less surgically invasive and appears to have a better effect on bone regeneration. The current retrospective study aimed to demonstrate the efficacy of ASC transplantation in patients who underwent alveolar ridge bone augmentation at our hospital. METHODS: We compared medical records, postoperative radiographic findings, and histological results from patients treated between January 2018 and March 2022 by augmentation of the jaw bone with bone substitutes (carbonate apatite) mixed with ASCs (ASCs+ group) and those treated with bone substitutes (carbonate apatite) alone (ASCs- group). RESULTS: After 6 months, the survival rate of augmented bone and the gray scale value in dental cone beam computed tomography (a bone density index) were significantly higher in the ASCs+ group than in the ASCs- group. Histological analysis at 6 months showed more adequate bone tissue regeneration in the ASCs+ group. CONCLUSIONS: The findings suggest the effectiveness of using ASCs in bone augmentation on the alveolar ridge in patients with jaw bone atrophy.

Esthetics and bone changes of immediate implants with or without vascularized interpositional periosteal connective tissue grafting: A 2-year randomized controlled trial.

OBJECTIVES: To compare esthetics at single immediately placed implants with and without soft tissue augmentation. MATERIALS AND METHODS: Patients with non-restorable maxillary teeth in the esthetic zone were assigned into 2 groups: immediately placed implants with simultaneous vascularized interpositional periosteal connective tissue grafting (VIP-CTG) or non-grafted immediately placed implants (NG). The outcomes included: pink esthetic score (PES), gingival thickness, keratinized tissue width, buccal bone changes, marginal bone loss, pain, and satisfaction. RESULTS: Eighteen implants were included. At 2 years the mean value for PES was 12 ± 3.2 for the VIP-CTG and 12.9 ± 1.3 for the NG (p = .855). Mucosal thickness and keratinized tissue width showed no statistically significant difference between the two groups (p = .253) and (p = .931) respectively. Clinically buccal bone showed mean bone loss of 2.03 ± 1.57 mm for VIP-CTG and 1.09 ± 1.3 mm for NG (p = .247) and radiographically showed 1.67 ± 0.84 mm at the VIP-CTG and 1.16 ± 0.47 mm at the NG (p = .118). No statistically significant difference between both groups was demonstrated regarding marginal bone level changes (p = .142), pain (p = .622), or satisfaction (p = .562) at any time point. CONCLUSION: Simultaneous soft tissue grafting with immediate implant placement did not provide a more favorable outcome regarding esthetics or alveolar bone preservation effect. Undisturbed healing with the least surgical intervention seems to provide more favorable outcomes.

Effect of a novel interocclusal recording method on occlusal accuracy of implant-supported fixed prostheses: A randomized clinical trial.

OBJECTIVES: To investigate the effect of a novel interocclusal recording method on the occlusal accuracy of implant-supported fixed prostheses for partially dentate patients with distal extension. MATERIALS AND METHODS: Twenty patients with two or more adjacent teeth missing in the distal extension and scheduled to receive implant-supported fixed prostheses were enrolled. Two interocclusal recording methods were used: placing polyvinyl siloxane (PVS) on the interocclusal recording caps (test), and placing PVS on healing abutments (control). The intraoral occlusal contacts in maximal intercuspal position (MIP) were compared with those in the mounted casts to calculate sensitivity and positive predictive value (PPV). Then, patients were randomly allocated into two groups to determine which interocclusal record would be used. The implant prostheses' evaluations mainly included occlusal adjustment height, volume, and time, occlusal contact score based on articulating paper examination. Paired-samples t-test, Mann-Whitney U test, and least squares regression analyzed the statistic differences. RESULTS: The test method had higher sensitivity to detect intraoral occlusal contacts than the control method (p = .002), but similar PPV (p = .10). During the prostheses' evaluations, the occlusal adjustment height in the test group was significantly lower than that in the control group [99.4 (53.2, 134.2) vs. 159.0 (82.3, 247.8) µm, p = .03], while the occlusal contact score before adjustment was higher (p = .006). The groups had similar occlusal adjustment volume and time. CONCLUSIONS: The novel interocclusal recording method for implant-supported fixed prostheses was more accurate and could reduce the occlusal adjustment.

Mental Nerve Anterior Loop Detection in Panoramic and Cone Beam Computed Tomography Radiograph for Safe Dental Implant Placement.

Background and aim Different imaging modalities have been used as preoperative assessment tools since the emergence of dental implants. This study aimed to compare the detection and presence of mental nerve anterior loop in cone beam computed tomography (CBCT) radiograph and panoramic radiograph. Material and methods A descriptive, retrospective study was done. The optimal sample size was calculated using Epi Info software. According to the study population (795), the sample size was 259 cases which gave 95% power of the study. A previously taken CBCT and digital panoramic radiographs from the database of Taibah University Dental School and Hospital were observed by two trained and calibrated examiners to determine the presence of a mental nerve anterior loop and compare the two modalities. The mean length of the mental nerve anterior loop was also assessed.  Results Mental nerve anterior loops were detected bilaterally in 57.1% and 17.4% using CBCT and panoramic radiographs, respectively. In CBCT, the right side (20.8%) had a higher prevalence of mental nerve anterior loop than the left side (12%). The mental nerve anterior loop was not visible in 49.4% of the cases using a panoramic radiograph, while CBCT gave 10% of cases as not visible. The mental nerve anterior loop average length was 1.8 ± 0.35 mm and the width was 1.7 ± 0.28 mm. The average distance from the mental foramen to the inferior border of the mandible was 12.1 ± 0.87 mm and the average distance from the mental frogmen to the mandibular midline was 25.1 ± 0.68 mm. Conclusion As differences between CBCT and panoramic radiographs were statistically significant, CBCT is more accurate and reliable. CBCT is recommended to be used as a preoperative assessment tool to minimize nerve injury-related surgical complications during implant placement at the mandibular premolar area.

Window Approach for Simultaneous Root Fragment Removal and Implant Placement: Two Case Reports.

INTRODUCTION: Root fracture during extraction is not uncommon due to the presence of multiple and thin roots, which are often divergent and curved. The retained root fragments (RF) are usually radiographic incidental findings and often asymptomatic without associated pathology. However, careful and conservative surgical strategies for the removal of RF must be incorporated to allow for simultaneous implant placement and to avoid potential complications such as compromised osseointegration or retrograde peri-implantitis. Conventional RF removal techniques may lead to a significant amount of bone removal, involving more trauma and a prolonged healing period. CASE PRESENTATION: In these two case reports, the Window Approach for Simultaneous Root Fragment Removal and Implant Placement (WASRIP) technique was used to extract RF in a minimally invasive fashion to preserve both the coronal and apical bone, which are critical components in providing mechanical stability for simultaneously placed implants. All implants presented in both cases showed adequate primary stability and successfully achieved osseointegration at a 3-month follow-up period. CONCLUSION: Through the buccal window, sufficient access was provided to remove RF atraumatically with maximal retention of surrounding bone that led to predictable implant placement.

Management of the exposure of a dense PTFE (d-PTFE) membrane in guided bone regeneration (GBR): a case report.

Guided bone regeneration (GBR) is a well-established and generally predictable method for repairing alveolar ridge defects and preparing edentulous sites for implant placement. Standard GBR involves filling the space underneath a membrane with autogenous bone or a mixture composed of autogenous bone particles and allogeneic bone tissue or heterologous biomaterials. The use of a barrier membrane for GBR has sometimes been associated with complications, however - reportedly involving exposure, infection, and collapse - and the non-resorbable types of membrane seem to be involved more often than the resorbable solutions. Such complications may be severe enough to defeat the object of the GBR procedure. A non-resorbable high-density polytetrafluoroethylene (d-PTFE) membrane has recently been designed specifically for use in bone-augmentation procedures that seems to assure a good bone regeneration process even when the membrane is exposed to the oral cavity. This case report describes an exposure of a d-PTFE membrane occurring after a maxillary GBR procedure and how it was overcome successfully, enabling implants insertion.

Are predoctoral students able to provide single tooth implant restorations in the maxillary esthetic zone?

The objective of this study was to assess the ability of the University of Illinois at Chicago College of Dentistry (UIC-COD) predoctoral students to provide single tooth implant (STI) prostheses in the maxillary esthetic zone. The patient's esthetic satisfaction and the correlation between prosthodontists' and patients' perspectives were examined. Twenty-seven patients were recruited for recall examinations at the UIC-COD predoctoral implant program and underwent clinical and radiographic examination with clinical photographs of the implant sites. The patients completed a semantic differential scale questionnaire. The collected information was formulated into a PowerPoint presentation for two Diplomate of the American Board of Prosthodontists to use the Pink/White Esthetic Score (PES/WES) to evaluate the esthetic outcome. Descriptive analyses, Cohen kappa test, and Spearman rank correlation coefficient test were performed. The average PES/WES were above 6.0 (out of 10). The median for the patient satisfaction and esthetic outcome questionnaires were 10 and 9, respectively, on a scale with 10=highest. There was a medium and positive correlation between prosthodontists' and patients' perspectives in esthetic outcome. This study found that, with strict guidance and proper selection criteria, predoctoral students were able to provide esthetically acceptable STI prostheses in the maxillary esthetic zone and patients were satisfied with the treatment provided.