Immediate postextraction implantation with provisionalization of two primary canines and related impacted permanent canines: a case report.

This study presents a case of replacing two maxillary primary canines and related impacted permanent canines with two single implants, in conjunction with grafting lost hard tissue. By using immediate postextraction implant placement and provisionalization protocols, the stability of the implant was ensured while bypassing the bony void created by the removal of the primary canines. In this respect, a minimum healing period of 1 year was originally planned to evaluate the gingival esthetics before the final step was carried out. By the time the final restorations were fitted, the graft and tissues were stable. The time involved not only placed biology on the clinician's side, but also helped the patient to spread the cost over time. In modern esthetic dentistry, harmonious results can be achieved relatively quickly when the prerequisites for esthetic success have already been met, but, as this case demonstrates, human biology often requires more time and patience for augmented hard and soft tissues to heal and mature.

Key factors for predictable aesthetics in single tooth immediate implantation with provisionalization.

Early implant placement is one treatment option for implant therapy following a single-tooth extraction in the anterior maxilla. In this article some key factors are presented to analyze and follow in an effort to obtain a predictable and acceptable esthetic result. The creation of predictable peri-implant esthetics requires proper preservation of the osseous and soft tissues around the failing teeth, proper 3-D implant placement and proper understanding of the prosthetic management. The surgical technique presented here is characterized by tooth extraction without flap elevation, implant placement in a correct three-dimensional position, simultaneous contour augmentation on the facial aspect with connective tissue grafting combined with heterologous bone chips filled into the implant bone gap.

Maxillary sinus elevation with an alloplastic material and implants: 11 years of clinical and radiologic follow-up.

PURPOSE: The aim of this retrospective study was to determine the clinical and radiologic results, over an 11-year period, of resorbable hydroxyapatite used as a bone substitute in maxillary sinus elevation. MATERIALS AND METHODS: Between 1996 and 2007, we treated 26 patients with maxillary sinus elevation (27 sinuses) using resorbable hydroxyapatite and simultaneous insertion of 47 titanium implants. Patients were recruited, screened, and accepted or rejected sequentially based on specific inclusion/exclusion criteria. Ten months later, 2-stage surgery and prosthetic rehabilitation were performed. RESULTS: During the 11-year follow-up period (mean, 6 years), all the implants appeared clinically and radiologically integrated. The cumulative survival rate was 100%. During the observation period, the resorption of the graft apically to the implant was 1.8 mm on average. CONCLUSION: The posterior area of the maxilla often represents a challenging clinical situation because of either the lack of alveolar bone or the structural characteristics of the trabeculae in that specific area. The high survival rate of the implants and the stability of the mineralization of the graft confirmed that resorbable hydroxyapatite was a suitable material for sinus grafting.

Soft tissue stability with immediate implants and concave abutments.

Implant therapy success in the anterior maxilla is judged not only by osseointegration, but also by having sound and stable peri-implant tissues that appear identical to the gingiva surrounding the healthy adjacent teeth. The creation of predictable peri-implant esthetics requires proper preservation of the osseous and soft tissues surrounding the failing teeth, proper three-dimensional implant placement, and proper understanding of prosthetic management. It is now possible to place immediate implants and immediate prostheses to improve esthetics and to simplify treatment, but this technique does not seem to have a stable long-term buccal mucosa. To avoid or reduce this negative effect it appears to be important to increase the thickness of the buccal tissues, and to use appropriate implant components. The aim of the present retrospective study was to observe the dimensional alterations of the peri-implant tissues after immediate implants and single-tooth restorations with concave abutments performed on 28 patients, with a mean followup time of 20.4 months.

Five-year follow-up with Procera all-ceramic crowns.

OBJECTIVE: The purpose of this study was to evaluate the clinical performance of Procera AllCeram crowns placed over a 5-year period at three different private dental practices. METHOD AND MATERIALS: Two hundred five Procera AllCeram crowns (50 anterior and 155 posterior) were evaluated in a prospective study from a minimum of 6 months to a maximum of 60 months, with a mean of 23.52 months. RESULTS: A restoration was considered to be a failure when it impaired esthetic quality or function, thus necessitating remake of the crown. The survival rate was determined with the use of the Kaplan-Meier survival rate, which gave an overall survival rate of 96.7% (100% for the anterior crowns and 95.15% for the posterior crowns). CONCLUSION: The Procera AllCeram system seems to have a good prognosis for the posterior teeth and an excellent one for the anterior teeth.

Porcelain laminate veneers: 6- to 12-year clinical evaluation--a retrospective study.

The purpose of this study was to retrospectively evaluate the clinical performance of laminate veneers placed in the anterior segments of the dental arches over a 12-year period at two different private dental practices. Forty-six patients were restored with 182 porcelain laminate veneers. The veneers were studied for a mean observation time of 5.69 years. Color match, porcelain surface, marginal discoloration, and marginal integrity were clinically examined following modified CDA/Ryge criteria. On the basis of the criteria used, most of the veneers rated A. Risk of fracture was determined with a Kaplan-Meier survival analysis. Probability of survival of the 182 veneers was 94.4% at 12 years, with a low clinical failure rate (approximately 5.6%). Porcelain veneers must be bonded with a correct adhesive technique to reach this successful survival rate.

An 11-year clinical evaluation of leucite-reinforced glass-ceramic crowns: a retrospective study.

OBJECTIVE: The purpose of this study was to retrospectively evaluate leucite-reinforced glass-ceramic crowns placed over a 6-year period at two different private dental practices. METHOD AND MATERIALS: One hundred twenty-five Empress crowns were placed in 54 patients. The 93 anterior and 32 posterior crowns were evaluated clinically with a mirror and probe, radiographically, and from clinical photographs, in accordance with a modified California Dental Association and Ryge quality evaluation system. The risk of fracture was determined with the Kaplan-Meier survival analysis. RESULTS: Crowns were studied over periods ranging from 4 to 11 years. The probability of survival of the 125 crowns was 95.2% at 11 years (98.9% in the anterior segment and 84.4% in the posterior segment). Six crowns had to be replaced. Most of the 119 successful crowns were rated excellent; Alfa ratings were assigned to 94.2% for color match, 91.6% for porcelain surface, 86.6% for marginal discoloration, and 94.2% for marginal integrity. CONCLUSION: Leucite-reinforced glass-ceramic crowns showed a low clinical failure rate and excellent esthetics after up to 11 years.