Correction of Buccal Dehiscence During Immediate Implant Placement Using the Flapless Technique: A Tomographic Evaluation.

BACKGROUND: The aim of this study was to evaluate a new technique for treating dehiscence buccal bone sites (Class II) with immediate implant and collagen-enriched bovine-derived xenograft blocks without a surgical flap or membrane. METHODS: Individuals with at least 5 mm of buccal bone dehiscence were selected for a flapless surgical approach to insert xenograft blocks into buccal dehiscence defects as well as the gap between implant and residual bone wall. No membrane was used. Buccal bone wall height was measured by computed tomography in the preoperative period (T0) and 6 to 12 months after procedure (T1). Likewise, buccal-lingual width of alveolar ridge as well as thickness of buccal wall was compared with the contralateral tooth. RESULTS: Fourteen patients were selected. Buccal wall height at T1 was not significantly different after 6 to 12 months between the treated and contralateral teeth, although both were greater than T0 (P <0.01). The heights ranged from 6.4 to 16.30 mm at T0, 12.8 to 25.6 mm at T1, and 14.8 to 25.29 mm in the contralateral teeth. Significant differences were observed between treated teeth (T1) and their contralateral, both buccal-lingually in the alveolar ridge (P = 0.007) and in buccal wall thickness (P = 0.003). Wall thickness ranged from 0.9 mm to 3.81 mm at T1 and 0.25 mm to 1.60 mm in the contralateral teeth. CONCLUSION: Immediate implant placement at dehiscence buccal bone sites using flapless surgery combined with xenograft blocks provided complete formation of the buccal bone wall up to the implant shoulder.

Orthodontic treatment of a mandibular incisor fenestration resulting from a broken retainer.

This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results.

Computed tomographic evaluation of alterations of the buccolingual width of the alveolar ridge after immediate implant placement associated with the use of a synthetic bone substitute.

PURPOSE: To evaluate the alterations of the buccolingual width of the alveolar ridge after immediate implant placement using a fully synthetic biphasic calcium phosphate (BCP) consisting of a mixture of 60% hydroxyapatite and 40% ?-tricalcium phosphate in esthetic regions. MATERIALS AND METHODS: The buccolingual widths of the alveolar ridge in 20 extraction sites in 20 patients were assessed using computed tomography. Measurements were performed before and 6 months after extractions and immediate implant placement. In group 1 (11 patients), BCP was in the space between the buccal wall of the alveolar ridge and implant. In group 2 (9 patients), the same evaluations and procedures were performed but without using BCP. RESULTS: The buccolingual dimensions of the alveolar ridge in group 1 (BCP) showed no significant preoperative differences (8.49 ± 1.1 mm) during the 6-month period after surgery (8.82 ± 0.9 mm) (P = .14). In group 2, the differences in buccolingual dimensions of the alveolar ridge were statistically significant (P = .01) with reduction in dimensions from 8.12 ± 0.7 mm during the preoperative period to 7.01 ± 0.4 mm 6-months after surgery. CONCLUSION: The use of BCP was effective in preserving buccolingual dimensions of alveolar ridges in immediate implant surgeries.

Short implants with single-unit restorations in posterior regions with reduced height: a retrospective study

Aim: Previous studies have shown excellent prognosis with short implants. However, evidence of short implants rehabilitated with single-unit restorations is scarce. The purpose of this study was to evaluate the percentage of success of short implants in posterior maxillary and mandibular regions with single-unit restorations. Methods: This study comprised a retrospective analysis of data of 41 patients that received 54 short implants between 2004 and 2009. All implants were placed by the same surgeon and all restorations were performed by experienced professionals. All implants were placed in sites with reduced bone volume; 48 implants were evaluated by computed tomography and 6 implants by radiography. Failures and biological complications were analyzed. Results: It was observed a success rate of 96.3% in the osseointegration period and 100% in the load period that ranging from 7 to 38 months. Two complications were observed, which were successfully treated without risk of implant loss. Conclusions: Short implants in posterior regions rehabilitated with single-unit restorations are a treatment option with high success rate and thus may be indicated in posterior regions with reduced bone height.

Alterações dimensionais em cirurgia de aumento de coroa clínica a retalho / The dimensional alterations in clinic crown enlargement

O objetivo do presente estudo foi avaliar clinicamente durante um período de 56 dias, o comportamento da margem gengival posterior à uma cirurgia de aumento de coroa clínica com osteotomia. Imediatamente posterior à osteotomia, uma marca foi colocada 3mm coronária à crista óssea. A margem gengival foi colocada em três níveis referentes à esta marca e seu comportamento em termos de estalibidade dimensional para cada nível foi analisado

Terapia periodontal regenerativa: revisão de literatura / Regenerative periodontal therapy: literature review

Este trabalho discute a possibilidade de se obter nova inserção através de procedimentos regenerativos: enxertos ósseos e regeneração guiada dos tecidos (RGT), bem como, os métodos utilizados para a sua avaliação

Comprometimento das bifurcações e trifurcações / Furcations problems

O autor, utilizando a pesquisa bibliográfica, focalizou os aspectos dos problemas de furcas, apresentando sua classificação, etiologia, morfologia, tratamento e outros pontos de importância relacionados com as furcas