Application of "10 Keys" Checklist and Partial Extraction Techniques to Optimize Esthetic Outcome for Adjacent Implants in the Esthetic Zone.

Placing immediate implants in the esthetic zone area poses significant challenges. Implants should be placed with consideration to hard and soft tissue management to optimize long term implant and cosmetic success. In this case report, two maxillary central incisors were extracted in two different time points, separated by 5 years because of horizontal root fractures. Implants were placed according to immediate single-tooth guidelines, using two different surgical and loading approaches, as risk assessment factors changed in the time between first immediate placement (#8) and second immediate placement (#9). These techniques included Partial Extraction Therapy (PET), the use of allograft and growth factors, connective tissue graft (CTG), platelet rich fibrin (PRF) and immediate and conventional loading. These were grouped as the "10 keys", a checklist used to pursue long term success. After 6-year and 1-year follow-up, radiographic and clinical results were satisfactory.

Single-Tooth Implant Restorations in Fresh Extraction Sockets of the Maxillary Esthetic Zone: Two-Year Results of a Prospective Cohort Study.

In this prospective study, 15 patients received 15 variable-thread tapered implants placed in fresh extraction sites in the maxillary esthetic zone and immediately were provisionalized out of occlusion. Of the 15 patients, 11 completed their 2-year follow-up. At 2 years, the success and cumulative survival rates were both 100%, and the mean bone level gain was 0.83 mm. Soft tissue assessment showed no zero esthetic scores, improved papilla indices, and low bleeding on probing and plaque accumulation. Overall, the study implants showed excellent hard tissue, soft tissue, and esthetic outcomes, indicating a healthy tissue response in single-tooth extraction sites in the maxillary esthetic zone.

Radiographic appearance of commonly used cements in implant dentistry.

Cement-retained restorations allow for a conventional fixed partial denture approach to restoring dental implants. However, inadequate removal of excess cement at the time of cementation may introduce a severe complication: cement-induced peri-implantitis. Radiopaque cements are more easily detected on radiographs and should improve the recognition of extravasated cement at the time of insertion. The purpose of this study was to evaluate the radiopacity of commercially available cements in vitro. Eighteen different cements commonly used for luting restorations to implants were tested at both 0.5- and 1.0-mm thicknesses. The cements examined were zinc oxide eugenol, zinc oxide, zinc polycarboxylate, zinc phosphate, resin-reinforced glass ionomer, urethane resin, resin, and composite resin. Two samples of each cement thickness underwent standardized radiography next to an aluminum step wedge as a reference. The mean grayscale value of each of the nine 1-mm steps in the step wedge were used as reference values and compared to each of the cement samples. Temp Bond Clear (resin), IMProv (urethane resin), Premier Implant Cement (resin), and Temrex NE (resin) were not radiographically detectable at either sample thickness. Cements containing zinc were the most detectable upon radiographic analysis. There are significant differences in the radiopacity of many commonly used cements. Since cementinduced peri-implantitis can lead to late implant failure, cements that can be visualized radiographically may reduce the incidence of this problem.

Assessing image-guided implant surgery in today's clinical practice.

As implant dentistry has progressed, greater emphasis has been placed on natural-looking tooth replacement, minimally invasive techniques, and better cost efficiencies, with implant positioning being guided by the desired prosthetic outcome. Image-guided surgery is a technique that merges preoperative diagnostic imaging with computer-based planning tools to facilitate surgical and restorative plans and procedures. This article discusses the intricacies of guided implant surgery, including 3-dimensional presurgical planning and the challenges of maintaining guide stability during surgical execution.

Incidental findings from a retrospective study of 318 cone beam computed tomography consultation reports.

PURPOSE: Cone beam computed tomography (CBCT) is a three-dimensional radiographic technique used in planning implant therapy to help clinicians determine the volume and dimension of bone available for implant placement, and CBCT images potentially depict coincident findings. MATERIALS AND METHODS: Three hundred eighteen patients received CBCT scans prior to receiving implants, which were interpreted by blinded board-certified oral and maxillofacial radiologists. All incidental findings were defined as non-tooth-related pathologies or abnormalities. These findings were categorized and analyzed using descriptive statistics. RESULTS: The patients ranged in age from 16 to 91 years (mean age for men, 64.73 ± 15.05 years; for women, 62.47 ± 15.83 years). Controlling for age, men were 2.13 times more likely to have sinus pathology than women. Patients over age 65 were 5.01 times more likely to demonstrate vascular pathology (eg, carotid artery calcification) than patients ages 41 to 65; the likelihood versus patients ages 16 to 40 was 13.39. Women were 2.63 times more likely to display brain pathology (eg, pineal or pituitary calcifications). Controlling for gender, patients ages 41 to 65 were 3.17 times more likely to exhibit condylar pathology (eg, degenerative changes) than patients ages 16 to 40. Similarly, patients above age 65 were 3.53 times more likely to show condylar pathology than patients ages 16 to 40, and women were 1.61 times more likely to have condylar pathology than men. Versus patients ages 16 to 40, patients ages 41 to 65 were 17.69 times more likely to show signs of vertebral pathology (eg, degenerative disc changes) and patients over age 65 were 28.67 times more likely to display vertebral pathology. CONCLUSION: CBCT scans frequently reveal non-tooth-related pathologies and/or abnormalities in the head and neck region. Therefore, comprehensive review of the entire CBCT image set is necessary.

Choice of a dental implant system.

Many dentists are bewildered by the intricacies and complexities of dental implants. They are constantly besieged by product advertisements and can find it difficult to choose which systems to work with. Some dentists are so intimidated by the subject that they choose to avoid getting involved with implants and instead stick to traditional tooth replacement systems. By breaking implants down into 4 main components, the body, collar, connection, and restorative post, it is easier to understand the structure and function of dental implants. Each portion should be designed to achieve certain objectives. Once these structural components are understood, it is easier to compare and contrast differing implant systems.