scholarly journals Techniques to preserve keratinized peri-implant mucosa in CT-guided oral implant surgery

2012 ◽  
Vol 2 (1) ◽  
pp. 7 ◽  
Author(s):  
Bernhard Pommer
Keyword(s):  
Soft Tissue ◽  
Virtual Planning ◽  
Ct Guided ◽  
Implant Surgery ◽  
Computed Tomographic ◽  
Implant Placement ◽  
Oral Implant ◽  
Implant Dentistry ◽  
Keratinized Mucosa ◽  
Surgical Templates

Guided implant dentistry using computed tomographic (CT) scans, virtual planning software and mucosa-supported surgical templates is an upcoming technology with the potential for more predictable and less invasive implant placement. While generally associated with a flapless approach, soft tissue punching and removal may not be indicated if available width of keratinized mucosa is limited prior to implant surgery. Two techniques to preserve keratinized peri-implant mucosa (Punch Reposition Technique and Topical Flap Technique) are presented and indications outlined. Appreciation of soft tissue conditions as well as functional and esthetic consequences of mucosal deficiencies (mucosal-driven approach) is recommended to supplement bone- and prosthetic-driven considerations in guided oral implant placement (Trinity Approach).

scholarly journals In-Office Guided Implant Placement for Prosthetically Driven Implant Surgery

2017 ◽  
Vol 10 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Daryoush Karami ◽  
Hamid Reza Alborzinia ◽  
Reza Amid ◽  
Mahdi Kadkhodazadeh ◽  
Navid Yousefi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Direct Observation ◽  
Three Dimensional ◽  
Hard Tissue ◽  
Tissue Thickness ◽  
Computed Tomographic ◽  
Implant Placement ◽  
Soft Tissue Thickness ◽  
Ct Data ◽  
The Cost

Application of surgical stents for implant placement via guided flapless surgery is increasing. However, high cost, need for some professional machines, and not taking into account the soft-tissue parameters have limited their application. We sought to design and introduce a technique named in-office guided implant placement (iGIP) to decrease the cost by using available devices in office and enhance the applicability of surgical stents. A customized surgical stent was fabricated based on prosthetic, soft- and hard-tissue parameters by taking into account the amount of available bone (using the computed tomographic [CT] data), soft-tissue thickness and contour (using a composite-covered radiographic stent), and position of the final crown (by diagnostic cast wax up and marking the final crown position with composite). The efficacy of iGIP, in terms of the accuracy of the three-dimensional position of the implant placed in the study cast and in patient's mouth, was confirmed by direct observation and postoperative CT. The iGIP can enhance implant placement in the prosthetically desired position in various types of edentulism. Using this technique minimizes the risk of unwanted consequences, as the soft-tissue thickness and contour are taken into account when fabricating a surgical stent.

scholarly journals Accuracy of Computer-Assisted Template-Based Implant Placement Using Two Different Surgical Templates Designed with or without Metallic Sleeves: A Randomized Controlled Trial

2019 ◽  
Vol 7 (2) ◽  
pp. 41 ◽  
Author(s):  
Marco Tallarico ◽  
Matteo Martinolli ◽  
Yong-Jin Kim ◽  
Fabio Cocchi ◽  
Silvio Mario Meloni ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Test Group ◽  
Computer Assisted ◽  
Virtual Planning ◽  
Implant Placement ◽  
Surgical Template ◽  
Significant Difference ◽  
Cad Cam ◽  
Open Versus ◽  
Surgical Templates

Purpose: To compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves. Materials and methods: Any partially edentulous patients requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: Surgical template with or without metallic sleeves. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results: No implants failed, and no complications were experienced. Forty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). Conclusion: With the limitations of the present study, surgical templates without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used with caution in the molar region only in case of reduced interarch space. Further research is needed to confirm these preliminary results.

scholarly journals Effect of free gingival graft before implant placement on peri-implant health and soft tissue changes: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chaoling Zheng ◽  
Shimin Wang ◽  
Hongqiang Ye ◽  
Yunsong Liu ◽  
Wenjie Hu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Control Group ◽  
Free Gingival Graft ◽  
Implant Placement ◽  
Soft Tissue Thickness ◽  
Significant Difference ◽  
Tissue Changes ◽  
Implant Restoration ◽  
Soft Tissue Changes ◽  
Keratinized Mucosa

Abstract Background To evaluate the clinical outcome and changes in posterior buccal soft tissue following implant restoration in groups with and without a free gingival graft (FGG) before implant placement. Methods Twenty-six individuals who required implant restoration and displayed lack of keratinized mucosa (KM) were recruited and assigned to the FGG group (with FGG before implant placement) or Control group (without FGG before implant placement) randomly. A screw-retained conventional implant restoration was performed for each patient. Peri-implant soft tissue was captured by an intraoral scanner and analyzed by an image processing software. Clinical parameters (plaque index, gingival index, probing depth, and bleeding on probing) were assessed at baseline and 1, 3, 6, and 12 months. Buccal soft tissue changes (mucosal margin, soft tissue thickness, and width of keratinized mucosa) on the buccal side of implant site were assessed at 1, 3, 6, and 12 months. Two-way ANOVA and Bonferroni test were used to analyze significant difference between groups at each time point (α = 0.05). Results The clinical parameters were lower in the FGG group than that in the Control group, although there were no significant differences between the two groups (P > 0.05). Peri-implant soft tissue collapsed and the changes (mucosal margin and soft tissue thickness) were significantly greater in the Control group than the FGG group (P < 0.05). Width of KM was larger in the FGG group than the Control group, although there was no significant difference between the two groups (P > 0.05). Conclusions Minimal peri-implant soft tissue changes occurred in two groups. Performing FGG before implant placement is a viable procedure to maintain peri-implant soft tissue but might not affect peri-implant health during 12 months follow-up. However, small sample size must be considered. Trial registration This study was retrospectively registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000037954; Date of registration: 6 September 2020).

scholarly journals Immediate Loading of Single Post-Extractive Implants in the Anterior Maxilla: 12-Month Results From a Multicenter Clinical Study

2012 ◽  
Vol 38 (S1) ◽  
pp. 477-484 ◽  
Author(s):  
Tommaso Grandi ◽  
Giovanna Garuti ◽  
Rawad Samarani ◽  
Paolo Guazzi ◽  
Andrea Forabosco
Keyword(s):  
Clinical Study ◽  
Soft Tissue ◽  
Bone Resorption ◽  
Tooth Extraction ◽  
Immediate Loading ◽  
Insertion Torque ◽  
Anterior Maxilla ◽  
Implant Placement ◽  
Implant Size ◽  
Multicenter Clinical Study

The purpose of the study was to evaluate survival and peri-implant bone levels of single, immediately loaded post-extractive implants in the anterior maxilla 12 months after implant placement. Thirty-six consecutive patients from 3 study centers were included in the study. The concerned sites were upper premolars, canines, and incisors. For each patient the following data were recorded: reason for tooth extraction, bone quality, implant size, and final insertion torque. Implants were placed using a flapless technique and immediately loaded with a nonoccluding temporary restoration. Final restorations were provided 4 months later. Peri-implant bone resorption was evaluated radiographically after 6 and 12 months. The average final insertion torque was 70.55 Ncm. One implant inserted in D3 quality bone with a 35-Ncm seating torque was lost. All other implants had a final insertion torque ranging between 50 and 80 Ncm. The average peri-implant bone loss was 0.437 and 0.507 mm at 6 and 12 months, respectively. All the sites maintained excellent papillae and peri-implant soft-tissue conditions. The resulting 1-year success rate was 97.2%. Immediate nonfunctional loading of single post-extractive implants in the anterior maxilla is a predictable treatment. And it seems that achieving high insertion torques by placing self-tapping/self-condensing implants in an underprepared osteotomy is favorable.

scholarly journals A case series of profilometric changes in two implant placement protocols at periodontally compromised non-molar sites

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kwantae Noh ◽  
Daniel S. Thoma ◽  
Jung-Chul Park ◽  
Dong-Woon Lee ◽  
Seung-Yun Shin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tooth Extraction ◽  
Case Series ◽  
Tissue Level ◽  
Ridge Preservation ◽  
Bone Augmentation ◽  
Implant Placement ◽  
Alveolar Ridge Preservation ◽  
Tissue Changes ◽  
Facial Area

AbstractInformation regarding profilometric changes at a soft tissue level following implant placement with different protocols is insufficient. Therefore, this study aimed to comparatively investigate the profilometric tissue changes with respect to late implant placement following alveolar ridge preservation (LP/ARP) and early implantation (EP) in periodontally compromised non-molar extraction sites. Sixteen patients were randomly assigned to the following groups: implant placement 4 months post-ARP (group LP/ARP) and tooth extraction and implant placement 4–8 weeks post-extraction (group EP). Dental impressions were obtained immediately after final prosthesis insertion and at 3, 6, and 12 months. At the time of implant placement, bone augmentation was performed in the majority of the patients. Profilometric changes of the tissue contour were minimal between the final prosthesis insertion and 12 months in the mid-facial area (0.04–0.35 mm in group LP/ARP, 0.04–0.19 mm in group EP). The overall tissue volume increased in both groups (1.70 mm3 in group LP/ARP, 0.96 mm3 in group EP). In conclusion, LP/ARP and EP led to similar stability of the peri-implant tissue contour between the final prosthesis insertion and at 12 months. Moreover, the change of peri-implant tissue on the soft tissue level was minimal in both modalities.

Evaluation of the accuracy of a novel surgical guide for flapless dental implant placement for immediate loading in edentulous jaws

2021 ◽  
Author(s):  
Giovanni de Almeida Prado Di Giacomo ◽  
Patrícia Cury ◽  
Airton Moreira da Silva ◽  
Jorge Vicente Lopes da Silva ◽  
Carlos Eduardo Pompeo Souto ◽  
...  
Keyword(s):  
Dental Implants ◽  
Dental Implant ◽  
Selective Laser Sintering ◽  
Apical Region ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Implant Placement ◽  
Surgical Guides ◽  
Edentulous Jaws ◽  
Edentulous Jaw

This study was designed to evaluate the accuracy of a novel computer-designed and selectively laser sintered surgical guide for flapless dental implant placement in the edentulous jaw. Fifty dental implants were placed in 11 patients with at least one totally edentulous jaw. Initially, cone-beam computed tomography (CBCT) was performed in each patient to define the virtual position of the dental implants based on the assessment of bone availability and the proposed dental prosthesis. After virtual planning, 3D surgical guides were printed using selective laser sintering. CBCT was repeated after the surgery, and the pre-and postoperative images were overlapped in the CAD software to compare the planned and actual positions of the dental implants using a one-sample t-test. The mean ± angular standard deviation between the long axes of the planned and final dental implant positions was 4.58 ±2.85 degrees; The linear deviation in the coronal position was  0.87 ± 0.49 mm and  in the apical region of the dental implants was 1.37 ± 0.69 mm. These differences were statistically significant (p &lt;0.001). The proposed modifications reduced the deviations, resulting in an improvement in the technique. We were able to place implants and temporary prostheses using the present protocol, taking into account the differences between the planned and final positions of the dental implants.

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