Biomechanical effects of clear aligner with different shape design at extraction space area during anterior teeth retraction.

OBJECTIVE: This study aimed to investigate the biomechanical effects of clear aligner (CA) with different shape designs at extraction space (CAES) area during space closing. MATERIALS AND METHODS: A finite-element method (FEM) model of mandibular dentition, periodontal ligaments, attachments, and corresponding CA was established. The connecting rod design of CAES was modelled for the control group. Eight test groups with different heights of CAES from -4 mm to +4 mm were designed. Tooth displacement tendencies were calculated. The maximum principal stress in PDLs, teeth, and CAs was analysed. Both global coordinate system and local coordinate system were also used to evaluate individual tooth movements. RESULTS: Across all groups, stresses concentrated on the lingual outer surface of CAESs. For the lowered CAES groups, both the stress value and the stress distribution area at CAESs were increased. The lowered CAES groups showed reduced movement in anterior teeth and less tipping tendency of the canines. CONCLUSION: The shape of CAES has a biomechanical impact on anterior teeth movement and should be considered in aligner design. The results suggest that increasing the height of CAES can enhance anterior teeth retraction, while lowered CAES may facilitate controlled root movement. Changes in the shape of CAES represent a potential direction for biomechanical improvement of clear aligner in extraction cases and are worth exploring.

Progressive Strategy for Congenitally Missing Anteriors in Binder Syndrome: A Case Report.

Binder syndrome (maxillonasal dysplasia) is an uncommon congenital craniofacial condition. It is marked by distinctive facial characteristics including a flat, vertically oriented nose, maxillary underdevelopment, malocclusion, and nasal bone irregularities. This case study introduces an inventive strategy for addressing congenitally absent anterior teeth in a patient diagnosed with Binder syndrome. Our treatment approach combined orthodontic interventions and prosthetic restorations to enhance both aesthetics and function. This report explores the diagnostic and therapeutic aspects of the case, underscoring the encountered challenges and the ultimately successful outcome. This approach provides valuable insights into managing dental anomalies linked to Binder syndrome, emphasizing the necessity of a multidisciplinary approach for comprehensive patient care. A suitable strategy for adult patients might be slow maxillary expansion. This case report is about a rare case of maxillonasal dysplasia managed with the esthetic replacement of anterior teeth.

The "HAT-TRICK" technique: A modification of soft tissue grafting using volume stable collagen matrix and cross-linked hyaluronic acid. Part A: The pontic site.

Vertical soft tissue augmentation between implants can be clinically challenging and burdensome for patients when employing conventional techniques. Recently, with the introduction of xenogenic collagen matrices, the principle of single-site surgery has become more common. However, some issues persist regarding graft stability and tissue integration. In the present technical note, the authors introduce the "HAT-TRICK" technique to address these observed difficulties. As the name suggests, this technique is believed to provide improved stability, volumetric gain, and histological integration of the implanted matrix by shaping it appropriately resembling a hat over the crest with apical bevels, stabilized with fixation pins and infused with cross-linked hyaluronic acid (xHya). A two-month observation of a bi-maxillary case is presented with detailed description of the technique and digitalized comparison methods for an easier explanation of the introduced technique.

Evaluation of Load-bearing Capacity of Interim Fixed Partial Dentures Reinforced with Glass Fibers: An In Vitro Study.

AIM: To compare the load-bearing capacity of three and four-unit fixed partial denture (FPD) with two different designs of pontics reinforced with industrial glass fibers at two different positions of the FPD. MATERIALS AND METHODS: A total of 64 samples were made with Bis-acryl composite temporary material and reinforced with industrial glass fibers (E-glass). The specimens were divided into eight groups (groups I-VIII) depending on the number of units, type of pontic design and area of placement of fibers. A universal testing machine was used to evaluate and compare the load-bearing capacity of the specimens. The evaluated data were statistically analyzed using one-way ANOVA and Bonferroni post hoc tests (p ≤ 0.05). RESULTS: Three-unit interim FPD and modified ridge lap pontic design showed greater load-bearing capacity after reinforcement with glass fibers than a four-unit interim FPD and hygienic pontic design, respectively. Fiber placement at the occlusal plus connector area as well as the cervical plus connector area had comparable results. CONCLUSION: Industrial glass fibers (E-glass) could be used as a cheaper alternative but clinical performance and their safety are yet to be evaluated. CLINICAL SIGNIFICANCE: Reinforcement with industrial-grade glass fibers can be a cheaper option for increasing the load-bearing capacity of interim partial dentures, but it needs to be studied in vivo through further studies.

A Comprehensive Analysis on Nutritional and Antioxidant Characteristics of a Traditional Roasted Maize Flour (Furniko) of Pontic Greeks: Comparative Study to Related Flour Products.

Furniko flour (FF) is a traditional roasted flour derived from a maize landrace, commonly consumed by Greeks of Pontic origin in the northern regions of Greece. Despite its perceived nutritional benefits, there is a lack of scientific data to support and highlight its value. This study aimed to compare the nutritional, physicochemical, anti-nutritional, functional, and antioxidant characteristics of FF with those of traditional and non-traditional types of maize flour. Furniko flour (FF) presented the highest values for protein (10.86 ± 0.36 g/100 g), fat (5.05 ± 0.08 g/100 g), K (539.93 mg/100 g), Mg (126.38 mg/100 g), P (296.4 mg/100 g), Zn (2.44 mg/100 g), and total phenolic content (TPC) (156 mg GAE/100 g). However, FF exhibited lower levels of Fe (3.83 mg/100 g), carbohydrates (70.55 ± 0.24 g/100 g), and antioxidant activity (0.27 ± 0.02 µmol of TE/g) than other types of flour examined. Furniko's functional properties make it an excellent source for porridges, while its low content of antinutrients reduces the possibility of low bioavailability of Fe, Zn, Mg, and Ca. Due to its significant and functional characteristics, Furniko flour could be considered an important material in the food industry, especially in bakery goods and health-oriented foods like energy bars, breakfast cereals, and gluten-free pasta. More research is needed, however, to thoroughly investigate its dietary potential and compatibility with other components.

Single-retainer all-ceramic resin-bonded fixed dental prostheses: Long-term outcomes in the esthetic zone.

OBJECTIVES: To present an update on the concept of cantilevered single-retainer all-ceramic resin-bonded fixed dental prostheses (RBFDPs) first presented 25 years ago in the Journal of Esthetic Dentistry. OVERVIEW: The initially presented case of the concept was followed clinically over 26 years and is presented along with two additional clinical long-term cases using varying methods to obtain an esthetic and hygienic ovate pontic design. Veneered alumina and zirconia ceramic (3 mol% yttria-tetragonal zirconia polycrystalline ceramic; 3Y-TZP) was used and bonded with a phosphate monomer containing luting resin after 50 µm alumina particle air-abrasion at 0.25 MPa pressure. The restorations replacing incisors did not debond and soft tissues in the pontic area were maintained over 26 years. CONCLUSIONS: Cantilevered single-retainer all-ceramic RBFDPs today made from veneered 3Y-TZP zirconia ceramic can be considered a standard of care for the replacement of single incisors and provide an excellent esthetic outcome with a long-term preservation of soft tissues in the pontic area. CLINICAL SIGNIFICANCE: Bonding nonretentive oxides ceramics such as alumina and zirconia ceramic with phosphate monomer containing luting resins after alumina particle air-abrasion is durable over decades. This proves that bonding to zirconia ceramic is not of any problem when adequate methods are used. Single-retainer zirconia ceramic RBFDPs maintain soft tissues in the edentulous area of single missing incisors and often deem implants unessential for this indication.

An in vitro trial on the effect of arch form on connector size requirements in long span anterior zirconia fixed dental prostheses.

PURPOSE: To test the fracture resistance of maxillary canine to canine fixed partial denture with four missing incisors, with increasing anterior-cantilevers of the pontics and varying connector sizes. MATERIALS AND METHODS: Two 3D-printed titanium alloy (Ti6Al4V) models mimicking a maxillary canine to canine fixed partial denture (FPD) with four pontics replacing the incisors were used as master models. Zirconia FPDs were digitally designed and milled with two different connector sizes (9 and 12 mm2 ) each with three different anterior cantilevers (7, 10, and 13 mm) accounting for 6 test groups. Seven samples were milled for each group generating a total of 42 samples. The zirconia FPDs were cemented on the titanium model using resin modified glass ionomer cement and the model fixated to a variable angle vice. A sinusoidal cyclic waveform load from 50 to 280N was applied using a universal testing machine at a frequency of 30 cycles per second and a total of 5 million cycles. RESULTS: The results of Fisher's exact tests showed that the difference in the proportion of fractured versus nonfractured fixed partial dentures was not statistically significant when comparing the 9 with the 12 mm2 connector size (p = 1.00), as well as when comparing the six test groups (p = 0.2338); on the other hand, it proved to be statistically significant when comparing the 7 mm cantilever with the 10 and 13 mm cantilevers combined (p = 0.0407) indicating that a 7 mm anterior spread of the pontics showed a significantly greater proportion of fixed partial dentures that fractured. CONCLUSIONS: Fracture susceptibility was not a function of cantilever length in this testing configuration for anterior FPDs. Retainer crown thickness seems to be a more important parameter than connector size thickness. Based on the results, a smaller connector size (9 mm2 ) can be used to improve the esthetics of pontics in long span anterior FPDs.

Efeito da dimensão do conector nas propriedades mecânicas de infraestrutura de PPF em uma nova fibra de vidro para CAD/CAM: estudo in vitro e in silico / Effect of connector dimension on the mechanical properties of FPD in a new glass fiber for CAD/CAM: in vitro and in silico study

Compósitos reforçados por fibras (CRF) são utilizados como biomateriais na odontologia e medicina. O desenvolvimento da tecnologia CAD-CAM tem permitido o uso de CRF como alternativa a ligas metálicas, zircônia e plásticos de alta performance na produção de infraestruturas e barras de protocolos de próteses implantossuportadas. O objetivo do estudo foi de avaliar, in vitro e in silico, o efeito da dimensão do conector na resistência à flexão, distribuição de tensões e deformações em uma infraestrutura para prótese parcial fixa (PPF) de 3 elementos obtida em CRF. Um manequim com preparos padronizados para coroa total nos dentes 35 e 37, tendo espaço protético do dente 36, foi escaneado para obtenção do modelo virtual, sobre o qual foram desenhados os espécimes para fresagem. Sete geometrias diferentes de infraestrutura para PPF foram produzidas para a análise de elementos finitos (FEA) sendo que os resultados desta análise mostraram que a concentração de tensões de todas as geometrias ocorreu nas regiões de conexão entre os dentes. Com base nos resultados de FEA, 3 grupos foram selecionados para a realização dos testes mecânicos. Os grupos apresentam dimensão do conector entre os dentes 35-36 e 36-37: 5,60 e 6,81mm², 8,89 e 9,00mm² e 10,46 e 11,92mm². O material (Fiber Cad ­ Implant & Bridge) foi utilizado para a fresagem das infraestruturas para PPF em fresadora odontológica de 5 eixos, sendo os espécimes cimentados em dentes de NEMA G10 e fixados em uma base construída em resina poliuretana. Quarenta e oito horas após cimentação, foi realizado teste de resistência à flexão do tipo load bearing (n = 6), em máquina de teste universal. Os dados de força de ruptura (N) foram tabulados e submetidos à análise de variância e teste de Tukey, ambos com  = 0,05. Adicionalmente, foi realizada análise de micrografia ótica, com aumentos entre 50 e 500. Os resultados de flexão mostraram que a força de ruptura variou entre 859,4 N e 1.157 N. As análises de ANOVA e Tukey mostraram que não houve relação entre os grupos. Todos os grupos apresentaram o mesmo padrão de falha, com trincas que se propagaram de maneira paralela as camadas de tecido de fibra de vidro utilizados como reforço mecânico. Os resultados demonstraram a direta correlação entre a força de ruptura com a área dos conectores e a capacidade do material de fibra de absorvera carga e evitar fraturas frágeis.(AU)

Fiber-reinforced composites (FRC) are used as biomaterials in dentistry and medicine. The development of CAD-CAM technology has allowed the use of FRC as an alternative to metal alloys, zirconia, and high-performance plastics in the production of infrastructures and bars for implant-supported prosthesis protocols. The objective of the study was to evaluate, in vitro and in silico, the effect of the connector dimension on flexural strength, stress distribution, and deformations in a framework for a 3- element fixed partial denture (FPD) obtained in FRC. A mannequin with standardized preparations for full crowns on teeth 35 and 37, with prosthetic space for tooth 36, was scanned to obtain the virtual model, on which specimens were designed for milling. Seven different infrastructural geometries for FPD were produced for finite element analysis (FEA), and the results of this analysis showed that stress concentration in all geometries occurred in the connection regions between the teeth. Based on the FEA results, three groups were selected for mechanical tests. The groups had connector dimensions between teeth 35-36 and 36-37: 5.60 and 6.81 mm², 8.89 and 9.00 mm², and 10.46 and 11.92 mm². The material (Fiber Cad ­ Implant & Bridge) was used for milling the FPD infrastructures on a 5-axis dental milling machine, and the specimens were cemented on NEMA G10 teeth and fixed on a polyurethane resin-built base. Forty-eight hours after cementation, a load-bearing flexural strength test (n = 6) was performed on a universal testing machine. The rupture force data (N) were tabulated and subjected to analysis of variance and Tukey's test, both with α = 0.05. Additionally, optical micrography analysis was conducted, with magnifications between 50× and 500×. The flexural results showed that the rupture force varied between 859.4 N and 1,157 N. ANOVA and Tukey's analyses showed no relationship between the groups. All groups exhibited the same failure pattern, with cracks propagating parallel to the layers of fiberglass tissue used as mechanical reinforcement. The results demonstrated a direct correlation between rupture force, connector area, and the material's ability to absorb load and prevent brittle fractures.(AU)

Partial Extraction Therapy for Implant Placement: A Newer Approach in Implantology Practice.

One of the most popular treatment modalities in routine implantology practice is extraction followed by immediate or delayed implant insertion. Teeth removal alone is insufficient, particularly in the maxillary anterior region of the jaw. Patients may experience several issues after tooth extractions. Due to trauma and the loss of periodontal ligaments, post-extraction alveolar ridge resorption cannot be prevented. Atraumatic extraction, socket preservation, grafting, and implant placement immediately after the extraction are some of the procedures that are carried out to minimize or prevent the resorption of alveolar bone. Osseointegration is essential for keeping the clinical effectiveness of dental implants. If the supporting tissues at an implant site resorb and are worsened by risk factors for recession, there may be considerable esthetic and functional failure. Implant placement at the retained root structure preserves the buccal bone resulting in an excellent emergence profile. Resorption in the posterior alveolar ridge may result in a decrease in attached keratinized tissue and a decrease in vestibular depth. This might have a negative impact on the stability of the implant and leads to peri-implantitis resulting in the failure of the implant. Without papilla loss or arch collapse, partial extraction therapy has resulted in effective esthetic outcomes. The socket shield technique is a minimally invasive surgical procedure that helps to maintain both soft and hard tissues by preserving a small section of the root. It lessens the necessity for surgeries on bone and mucogingival grafts, cutting the length of the overall recovery process and reducing the treatment time. When soft and hard tissue grafts are used to fill the socket before applying pressure with pontics, it is known as the pontic shield procedure. However, there is no published study that explains partial extraction therapy in a straightforward and clear manner that can guide a practitioner in determining a shield design with a proven track record of success. This review article focuses on the partial extraction procedure which is very helpful for preserving soft and hard tissues in cases involving immediate implant insertion post-extraction. It has long-term therapeutic success with implant and pontic therapy. This review article will also be helpful for clinicians to understand shield design in different case scenarios and help to learn step-wise procedures carried out in partial extraction therapy.

A retrospective comparison of clinical outcomes of implant restorations for posterior edentulous area: 3-unit bridge supported by 2 implants vs 3 splinted implant-supported crowns.

PURPOSE: To compare the clinical outcomes of two types of implant restoration for posterior edentulous area, 3-unit bridge supported by 2 implants and 3 implant-supported splinted crowns. MATERIALS AND METHODS: The data included 127 implant-supported fixed restorations in 85 patients: 37 restorations of 3-unit bridge supported by 2 implants (2-IB), 37 restorations of 3 implant-supported splinted crowns (3-IC), and 53 single restorations (S) as controls. Peri-implantitis and mechanical complications that occurred for 14 years were analyzed by multivariable Cox regression model. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success and survival of implants. RESULTS: Peri-implantitis occurred in 28.4% of 2-IB group, 37.8% of 3-IC group, and 28.3% of S control group with no significant difference. According to the implant position, middle implants (P2) of the 3-IC group had the highest risk of peri-implantitis. The 3-IC group showed a lower mechanical complication rate (7.2%) than the 2-IB (16.2%) and S control group (20.8%). The cumulative success rate was 52.8% in S (control) group, 62.2% in 2-IB group, and 60.4% in 3-IC group. The cumulative survival rate was 98.1% in S (control) group, 98.6% in 2-IB group, and 95.5% in 3-IC group. There was no significant difference in the success and survival rate according to the restoration type. CONCLUSION: The restoration type was not associated with the success and survival of implants. The risk of mechanical complications was reduced in 3 implant-supported splinted crowns. However, the middle implants of the 3 implant-supported splinted crowns had a higher risk of peri-implantitis.

Pontic site development for fixed dental prostheses with and without soft tissue grafting: 1-year results of a cohort study.

AIM: To describe and compare the pontic site development for fixed-dental prostheses (FDPs) with and without soft tissue grafting up to one-year post insertion of FDPs. MATERIALS AND METHODS: A convenience sample of 24 patients participating in an ongoing RCT was provided with three-unit tooth-borne FDPs. Six patients received a subepithelial connective tissue graft (SCTG) at the pontic site, whereas 18 patients were treated without any soft tissue graft (CONTROL). Digital impressions were taken prior to tooth preparation, after tooth preparation, after insertion of the final FDP, and at the 1 year of follow-up. The obtained stereolithography files (STL) were superimposed and profilometric as well as linear changes of the soft tissue profile were assessed at the pontic regions. Profilometric outcomes included changes of the ridge contour, the alveolar ridge width, and the crown height of the pontic. Further outcomes assessed included: the papilla index, the pink esthetic score (PES), probing depth (PD), bleeding on probing (BOP), and plaque control record (PCR). Descriptive and nonparametric statistics were applied for all outcome measures. RESULTS: The median profilometric contour between tooth preparation and 1 year after the insertion of the final FDP decreased by - 0.25 mm [Q1, Q3: - 0.36, 0.14] in the CONTROL group and increased by 0.61 mm [Q1, Q3: - 0.18, 1.06] in the SCTG group (intergroup p = 0.038). The alveolar ridge width between prior to tooth preparation and the one-year follow-up amounted to - 0.12 mm [Q1, Q3: - 0.74, 0.70] (= loss) in the CONTROL group and to 2.23 mm [Q1, Q3: 0.62, 3.86] (= gain) in the SCTG group (intergroup p = 0.032). At one year, the median crown height of the pontic tended to decrease by - 1.24 mm [Q1, Q3: - 2.05, - 1.05] in the SCTG group (intragroup p = 0.094) and by - 0.22 mm [Q1, Q3: - 0.58, 0.66] in the CONTROL group (intragroup p = 0.831), with significant differences between the groups (intergroup p = 0.022). The papilla index between prior to tooth preparation and one year of follow-up improved significantly in both groups (p < 0.05). Between FDP delivery and one year of follow-up, the PES values decreased significantly in the CONTROL group (intragroup p = 0.007), while in the SCTG group the change was not significant (intragroup p = 0.875). Clinical parameters (PD, BOP, and PCR) remained stable over time and did not differ between the groups at any time point (intergroup p > 0.05). CONCLUSION: Within the limitations of the present study, soft tissue grafting tends to limit contour changes at pontic sites, thus maintaining the esthetic outcomes over time. The lack of soft tissue grafting results in stable clinical outcomes; however, it may lead to a decrease in aesthetic outcomes over time. CLINICAL RELEVANCE: Autogenous soft tissue grafting seems to be a valid therapeutic option for the development of the pontic site to restore ridge defects prior to the delivery of fixed dental prostheses and to limit dimensional changes over time.

Oral Rehabilitation of a Patient With Generalized Inflammatory Gingival Overgrowth Exacerbated by Felodipine: A Case Report.

Gingival enlargement may manifest as a side effect of medications (calcium channel blockers, anticonvulsants, or immunosuppressants) and may be associated with inflammation, malignancy, or genetic inheritance. This condition has a significant impact on a patient's quality of life and affects their oral health status. This case report describes the management of a 68-year-old gentleman who presented with generalized gingival enlargement and chronic periapical abscess originating from tooth 34, which served as an abutment for a fixed partial prosthesis. The patient's medical history revealed that felodipine, an antihypertensive medication, was prescribed to him. A comprehensive treatment plan was developed to improve the patient's quality of life.

Knowledge and awareness regarding uses of extracted natural tooth in clinical practice.

Restoration of aesthetics is one the major patients' concern in dentistry which may be disrupted due to tooth-loss secondary to trauma, or as part of orthodontic treatment or periodontal problem. A number of treatment options are available for the replacement of teeth, but they may be expensive, and time-consuming, involving artificial teeth. For immediate tooth replacement, patient's own intentionally extracted or unintentionally avulsed tooth maybe used. The current narrative review was planned to discuss various techniques for the use of natural tooth pontic, which preserves the original contours, size and colour of the replaced tooth. Before using these teeth in a prosthesis, they need to be thoroughly disinfected and stored in appropriate medium according to the global guidelines. This reversible option would boost patient's confidence, preserve natural tooth anatomy and improve patient's acceptance.

The Aesthetic Contour Graft - Enhancing peri-implant soft tissue contours and pontic sites with guided bone regeneration.

OBJECTIVE: In this article, we will discuss strategies for enhancing peri-implant soft tissue contours and pontic sites with hard tissue augmentation. CLINICAL CONSIDERATION: One of the keys to the esthetic illusion of an implant-supported restoration is to create an ideal emergence profile. A critical part of any emergence profile is based on the height and thickness of the tissue surrounding the restoration and whether there are any defects in this tissue. Even when there is adequate bone in which to place implants, if any irregular ridge anatomy that supports this tissue is not corrected, then an unesthetic appearance of the restoration can result due to the lack of soft tissue with which to develop a proper emergence profile. CONCLUSION: Most peri-implant soft tissue deficiencies represent an underlying bony defect that can be corrected or enhanced through bone augmentation. CLINICAL SIGNIFICANCE: Traditional methods of enhancing soft tissue emergence profiles around implants and pontic sites mostly involve the use of soft tissue augmentation techniques. Although there are few reports of the use of bone augmentation for this purpose, soft tissue contours can be enhanced by augmenting the underlying bone contours and, in many instances, may obviate the need for subsequent soft tissue augmentation.

Partial Extraction Therapy: A Review of Human Clinical Studies.

Partial extraction therapy (PET) is a collective concept encompassing a group of surgical techniques including socket shield, root membrane, proximal shield, pontic shield, and root submergence. PET uses the patient's own root structure to maintain blood supply derived from the periodontal ligament complex to preserve the periodontium and peri-implant tissues during restorative and implant therapy. This review aims to summarize the current knowledge regarding PET techniques and present a comprehensive evaluation of human clinical studies in the literature. Two independent reviewers conducted electronic and manual searches until January 1, 2021, in the following electronic bibliographic databases: PubMed, EMBASE, and Dentistry & Oral Sciences Source. Gray literature was searched to identify additional candidates for potential inclusion. Articles were screened by a group of 4 reviewers using the Covidence software and synthesized. A systematic search of the literature yielded 5714 results. Sixty-four articles were selected for full-text assessment, of which 42 eligible studies were included in the review. Twelve studies were added to the synthesis after a manual search of the reference lists. A total of 54 studies were examined in this review. In sum, PET techniques offer several clinical advantages: (1) preservation of buccal bone postextraction and limitation of alveolar ridge resorption, (2) mitigation of the need for invasive ridge augmentation procedures, and (3) soft-tissue dimensional stability and high esthetic outcomes. Further randomized clinical studies with larger sample sizes are needed to improve the understanding of the long-term clinical outcomes of PET.

Anterior Tooth Replacement of Avulsed Deciduous Tooth: Resin-Reinforced Fiber With Natural Tooth Pontic.

Sudden tooth loss can be a traumatic experience that affects a child psychologically and hampers social skills in today's world, in which appearances seem to matter from a young age. The child becomes afraid to smile freely. Besides appearances, missing anterior teeth can hamper clarity in speech. Many approaches have been described in the past, such as the use of a removable partial denture, functional Nance appliance, Groper's appliance, and resin-reinforced fiber composite/acrylic pontic. We report the case of a child who lost a deciduous tooth as a result of trauma. The restoration was performed using fiber-reinforced resin and a natural avulsed tooth as pontic, which restored esthetics and function.

Accuracy of the Intra- and Extra-Oral Scanning Technique for Transferring the Intaglio Surface of a Pontic of Provisional Restorations to Definitive Restorations.

When taking the final impression for a three-unit fixed partial denture (FPD), the intaglio surface of the pontic of provisional restoration cannot be transferred accurately to that of definitive restoration. The intra- and extra-oral scanning (IEOS) technique, a method for accurately reproducing the submucosal morphology of the superstructure of an implant, has been reported using an intraoral scanner. In the present study, we evaluated the difference between the conventional impression method using impression material and the IEOS technique in reproducing the morphology of the surface of the pontic of a definitive FPD. There was a significant difference in the trueness of the intaglio surface morphology of the pontic between the conventional method and the IEOS technique; however, no significant difference in precision was observed. As a result, the intaglio surface of the pontic of the three-unit FPD could be transferred to definitive restorations more accurately with the IEOS technique than with the conventional method. These results suggest that the IEOS technique can duplicate the intaglio surface of the pontic more reproducibly to the definitive restorations compared with the conventional method.

Non-conventional method of pontic site preservation with laser-assisted bone regeneration.

This report presents an alternative method to the removal of failing implant and using a bone graft to preserve ridge which needs several months to heal and it is a costly technique. The pontic site was preserved by covering the failing implant with connective tissue and laser-assisted peri-implant defect regeneration.

Free Gingival-Bone Graft in the Anterior Maxilla: A Clinical Case Report.

AIM: To present the healing, development, and long-term clinical results after a combined gingival-bone graft as an alternative treatment for the management of critical extraction sites in the esthetic zone. BACKGROUND: To enhance the knowledge of in vivo soft and hard tissue remodeling, in this case report, we observed the healing, development, and long-term clinical results after a case of a combined gingival-bone graft as an alternative treatment for the management of critical extraction sites. CASE DESCRIPTION: Autogenous grafts of gingival and bone tissue were placed in a 56-year-old female patient, where a hopeless upper left central incisor with an evident loss of both the buccal and the palatal bony plates and with endodontic problems was due for extraction. In order to obtain enough autogenous tissue for filling the defect, a cylindrical free gingival and bone graft was retrieved from the retromolar area with a trephine drill, to obtain hard and soft tissues for grafting the postextraction defect. After 6 months, following soft tissue maturation and once esthetic and natural gingival contours were achieved, the surgical site was prosthetically restored with a porcelain fused to a metal bridge and scheduled for regular follow-up. CONCLUSION: No complications were observed either from the donor site or from the recipient site. The post-treatment result was esthetically pleasing, based upon successful architectural stability of both hard and soft tissues. Although more studies are needed to confirm the beneficial use of this approach, the procedure can be considered a viable option in the management of soft and hard tissue remodeling in esthetically compromised cases. CLINICAL SIGNIFICANCE: The gingival-bone graft may be considered as an alternative treatment for the management of critical extraction sites in the esthetic area. How to cite this article: Signore A, Stepanov M, Angelis ND, et al. Free Gingival-Bone Graft in the Anterior Maxilla: A Clinical Case Report. J Contemp Dent Pract 2021;22(5):568-571.

Life-history studies on infrapopulations of Mazocraes alosae (Monogenea) parasitising Alosa immaculata (Actinopterygii) in the northern Black and Azov Seas.

The life-history of Mazocraes alosae Hermann, 1782 on one of its hosts, the Pontic shad Alosa immaculata Bennett, is described for the first time. This anadromous fish, which occurs off the coast of the Crimea and migrates from the Black Sea to the Sea of Azov and into the River Don for spawning, was studied throughout its migration and during all seasons. It is demonstrated that the period of reproduction of this monogenean is significantly longer than that reported for the population in the Caspian Sea, lasting from April to November with a peak in April-May, and continues both in the sea and the river. Experiments showed that water salinity does not limit the development of the eggs or the hatching of the oncomiracidia. Our data reveal that the abundance of M. alosae is not determined by the size or sex of mature fish and that shad of less than two years old can also be infected with this monogenean, although less frequently than older fish. The direction of the migration of A. immaculata, either from the Black Sea to the Sea of Azov and into the rivers or in the opposite direction, does not influence the number of monogeneans present on the host. The main factor affecting the dynamics of the abundance of this monogenean is season, and, as has been indicated previously in the Caspian Sea basin, there is a synchronisation between the parasite's life-history and both the host's spawning behaviour and the duration of its migration.