International Journal of Esthetic Dentistry最新文献

Aim: The present case report with medium-term follow-up aims to report on the successful outcomes of ridge preservation using anorganic bovine bone mineral (ABBM) combined with the socket-shield technique (SST) in conjunction with immediate ovate pontic provisionalization of the extraction site, followed by delayed flapless implant placement and immediate implant provisionalization in the rehabilitation of the maxillary anterior esthetic region. Clinical protocol: Three consecutive patients with failing maxillary anterior teeth were treated with this protocol. The alveolar ridge dimension was preserved utilizing ABBM, combined with the retention of a partial tooth root segment in the buccal portion of the extraction socket, to minimize ridge resorption following tooth extraction. An immediate fixed provisional restoration with an ovate base in direct contact with the extraction site was fabricated and delivered immediately to maintain the soft tissue contour. At 4 months postextraction, flapless implant placement was performed via a computer-generated surgical guide, along with immediate implant provisionalization. Definitive restorations were delivered 4 months following implant placement.

Results: At the 2-year follow-up after loading, prosthetic and implant success was demonstrated, with a favorable esthetic outcome and a high level of patient satisfaction.

Conclusions: The immediate ovate pontic provisionalization in conjunction with ridge preservation combining ABBM and the SST, followed by flapless computer-guided implant placement with an immediate implant provisionalization protocol, as proposed in this article, offers a viable method to minimize alveolar ridge resorption as well as optimize esthetic outcomes.

The goal of this section ist o bring our readers eye-catching and high quality images related to novel techniques, clinical challenges and emerging trends relevant to esthetic dentistry. The section portrays the clinical image, the photographer, the camera and a short caption of the story behind the photograph.

With changing expectations for dental treatment, esthetics have become an essential factor in defining successful rehabilitation with dental implants. The stability of the gingival contours as well as the color and texture of the surrounding tissue are critical for the long-term maintenance of successful implant treatment outcomes. The aim of the present article is to demonstrate the correlation of the 3D implant position and the adjacent tissue management protocol with the long-term maintenance of immediate implant placement results in postextraction sites. A series of 12 cases with a mean follow-up of 21.91 months is presented to introduce the concept of the 'magic square' (MS), denoting the area formed in the cervical implant region when the ideal 3D implant position is achieved. This position is 3-mm coronoapical from the implant platform to the gingival margin, with the maintenance of a 3-mm vestibulopalatine thickness of the buccal bone (ie, hard tissue gap from the buccal implant surface to the outer portion of the buccal bone wall), and a ≥ 3-mm soft tissue gap at the cervical portion of the implant. The achievement of the MS promotes soft tissue growth and the formation of a thicker peri-implant bone ridge, and ensures the stability of treatment outcomes over time.

Objective: The present study was formulated as a gender-based evaluation of the vertical apicocoronal (VAC), horizontal mesiodistal (HMD), and horizontal faciopalatal (HFP) dimensions of the interproximal area and their influence on the presence of interdental papillae and gingival thickness (GT) in maxillary anterior teeth.

Materials and methods: A total of 120 patients in an age range of 20 to 40 years, divided equally into two groups based on gender, were evaluated for interproximal VAC, HMD, and HFP dimensions through radiovisiographic (RVG) images. Additionally, the existence of interdental papillae and GT were assessed clinically in the maxillary anterior sextant.

Results: The overall mean VAC dimensions in between the central incisors were greater in females than in males, with maximum mean values of 5.91 ± 0.33 mm and 5.03 ± 0.23 mm, respectively. The mean values for HMD and HFP showed a reverse trend, being greater in males than in females, with the differences being statistically significant. Similarly, the mean GT was greater in males than in females (P < 0.0001). It was also shown that as the VAC dimension increased, the existence of complete papillae in the interproximal areas reduced.

Conclusions: The gender variability of intraoral characteristics such as VAC and GT dimensions and their influence on the existence of interdental papillae provide valuable guidelines that can be implemented in procedures in the maxillary anterior sextant. The associations between HMD and HFP dimensions and interdental papillae were not clearly evident, and further exploration in participants of different age groups would be useful and informative.

Aim: To describe a technique for performing an adhesive oral rehabilitation based on a digital workflow and focused on the integration between esthetic and occlusal aspects in a young patient with a worn dentition.

Materials and methods: An adhesive oral rehabilitation with severe loss of dental structure in a 40-year-old male patient is described. The treatment was based on a fully digital workflow (including facial scanning), esthetic and occlusal virtual planning, guided implant surgeries, an adhesive resin prototype, and ceramic restorations. The technique integrates both esthetic and occlusal factors, splitting the dental arches into four sectors and following a stepped sequence with specific objectives for each one. The loss of dental structure was initially rebuilt by an adhesive composite resin full-mouth prototype rehabilitation. This step also helped to confirm the esthetic and occlusal digital planning. After 4 months, lithium disilicate restorations were delivered following the same order, sector by sector, to reduce possible errors when transferring the previously approved anatomy to the final ceramic oral rehabilitation. Lastly, an acrylic nightguard was installed and a 6-month recall program established.

Results: An accurate integration between esthetic and occlusal aspects was achieved during digital planning, which was also corroborated by the adhesive resin prototype. The final ceramic restorations fulfilled the patient's esthetic expectations and recovered the occlusal anatomy.

Conclusions: The proposed esthetically guided and occlusally protected (EGOP) technique seems to be a reliable approach to treat patients with worn dentition. Further clinical research and additional proposals are necessary to assess the possible benefits associated with these procedures.