The use of the connective tissue graft from the palate for vertical soft tissue augmentation during submerged dental implant placement: A case series.

OBJECTIVES: To evaluate the efficacy of the soft tissue augmentation vertically, using connective tissue graft from the palate, during submerged dental implant placement. MATERIAL AND METHODS: Vertical soft tissue augmentation, using connective tissue graft from the palate, combining with submerged dental implant placement was performed for 50 patients (10 males and 40 females, mean age 57.22 years). Soft tissue thickness vertically was measured in the middle of the alveolar crest with the periodontal probe. After 3 months, healing abutments or multiunits were connected to the dental implants, augmented soft tissue thickness was measured vertically in the middle of the alveolar crest. The vertical soft tissue volume gain was calculated using analysis of variance descriptive analysis, significance set to p = .05. RESULTS: All 50 autogenous connective tissue grafts from the palate healed successfully. The average thickness of the soft tissue grafts from the palate was 1.8 ± 0.41 mm. After 3 months, soft tissue thickness vertically increased from 2.27 ± 0.64 mm to 4.35 ± 0.64 mm. This difference between mean figures, between the groups, before and after soft tissue augmentation was found to be statistically significant F (263;477). The mean increase in soft tissue thickness was 2.08 ± 0.71 mm. CONCLUSION: It can be concluded that soft tissue augmentation vertically, using connective tissue graft from the palate can be successfully used for vertical soft tissue augmentation.

One abutment one time vs. repeatable abutment disconnections in implants, restored with cemented / screw retained fixed partial dentures: Marginal bone level changes. A systematic review and meta-analysis.

PURPOSE: The aim of this systematic review and meta-analysis is to evaluate the impact of abutment disconnections / reconnections on peri-implant marginal bone loss changes in partially edentulous patients. METHODS: Clinical studies were selected via electronic and hand searches in English language journals until January 1, 2020. Only randomized clinical trials (RCGTs) and prospective controlled clinical trials (CCTs) showing direct comparison between the definitive implant abutments and multiple abutment replacements in the same patient or different patient groups in the partially edentulous patients were considered. The outcome measures were (1) the type of the abutment was used, (2) the time the abutment was placed, (3) marginal bone loss changes, (4) biological complications, (5) mechanical complications. RESULTS: After evaluation, 4 controlled clinical studies were included. Majority of the articles reveled protective marginal bone loss preservation for the implants with FAP (final abutment placement) at the time of implant placement compared with the implants with MAP (multiple abutment placements) in connected dental implants, in partially edentulous patients. Meta-analysis of the four studies with 280 implants reviled significantly greater bone loss in cases with multiple abutment disconnections/reconnections. The weighted mean difference in marginal bone loss was 0.4 mm (95% confidence interval, 0.16-0.63 mm), showing bone preservation in the FAP group. CONCLUSION: Within the limitations of this meta-analysis, multiple abutments disconnections significantly affected marginal bone loss changes in partially edentulous patients. The finding suggests to overview current prosthetic and surgical treatment planning protocols to prevent greater marginal bone loss.