The International journal of periodontics & restorative dentistry最新文献

Bone augmentation procedures often leads to coronal displacement of the mucogingival junction, a deficiency of keratinized mucosa, and a reduction in soft tissue height. These challenges complicate the achievement of an ideal peri-implant phenotype. It is known that addressing both the quantity and quality of soft tissue is crucial for the long-term success and aesthetics of implants. This paper introduces a novel technique for peri-implant phenotype modification following bone augmentation, which combines a modified onlay graft (MOG) with an apically positioned flap (APF) performed simultaneously with implant placement. Two clinical cases are presented to demonstrate this approach, highlighting the restoration of the soft tissue environment through a single surgical intervention. The technique resulted in successful outcomes, including increased vestibular depth, keratinized tissue width, and vertical soft tissue volume. The modified onlay graft technique effectively manages soft tissue in post-bone augmentation scenarios, providing an ideal peri-implant phenotype and leading to stable, aesthetic, and functional implant restorations. This method requires fewer surgical interventions than traditional alternatives, minimizing patient discomfort and enhancing overall treatment outcomes.

Implantoplasty involves mechanically modifying the exposed implant surface by removing macro- and micro-structures and is typically considered a resective approach. The potential for bone regeneration with implantoplasty alone has not yet been studied. This research aimed to evaluate long-term changes in peri-implant bone levels without using regenerative materials. 56 patients (70 implants) were included in the study and were followed for up to 10 years, with a mean observation time of 59 months (~5 years). The implants were evaluated retrospectively through a radiographic, as well as clinical (bleeding on probing and suppuration) analysis. Out of the 70 implants, 11 (15.7%) were lost due to disease recurrence and additional bone loss. One implant (1.4%) experienced up to 1.0 mm of bone loss, 15 implants (21.4%) showed no change in marginal bone levels (MBL), and 43 implants (61.5%) gained bone up to 4.8 mm, all without the use of any graft material or membrane. The overall mean MBL change for the remaining 59 implants at the end of the follow-up period (84.3%) was a gain of 1.27 mm. Implantoplasty alone without osseous surgery, flap repositioning, or using graft material or membrane; may be a viable option for managing peri-implantitis defects. However, future randomized clinical trials with larger sample sizes are necessary to validate current findings.

Purpose: This study is designed to explore the effect of Er,Cr:YSGG laser tooth etching versus that of conventional tooth surface treatment on the shear bond strength of ceramic laminate veneers.

Methods: Seventy-six maxillary premolars were assigned to two groups (n = 38) according to the type of enamel surface treatment approach. Group 1: samples treated with the conventional acid-etch protocol. Group 2: samples subjected to Er,Cr:YSGG laser. Light-curing resin cement was used to bond the restoration to the tooth and specimens were thermocycled for 30,000 cycles. Shear bond strength testing was conducted on all the specimens. The samples were observed using a scanning electron microscope to record enamel topography and a stereomicroscope to monitor the mode of failure. P ≤ 0.05 was considered significant.

Results: There were no statistically significant differences between the acidetch and laser enamel surface treatment groups for the shear bond strength values at maximum load (MPa) (p-value = .627). There was a significantly higher proportion of cohesive failure in the acid-etch group compared to the laser treatment group and a significantly lower proportion of mixed failure in group 1 compared to group 2 (p-value = .022).

Conclusions: Concerning the bond strength of the laminate veneer, the effects of laser and traditional acid etching on the enamel surface were the same. Enamel surfaces can be successfully etched using a laser as an alternative to the traditional acid-etch method.

Background: Tooth autotransplantation is a reliable procedure with high long-term success and survival rates, showing many advantages over dental implants, particularly for young patients in craniofacial development. Nonetheless, insufficient bone availability at the recipient site is a key limitation. This study aims to establish the feasibility of tooth autotransplantation combined with staged or simultaneous bone regeneration to address complex cases.

Material & methods: Two young patients with missing teeth due to hypodontia or trauma, deemed unsuitable for dental implants, were treated. Both complex cases were addressed through autologous tooth autotransplantation, either in conjunction with simultaneous guided bone regeneration or into a previously regenerated crest.

Results: Five-year follow-up for the autotransplanted cuspid and more than 20-year follow-up for the premolar revealed satisfactory results for both autotransplanted teeth. These teeth played pivotal roles in restoring both function and aesthetics in young patients. Additionally, tooth vitality was preserved throughout the follow-up period, with no complications noted.

Conclusion: Tooth autotransplantation in combination with previous or simultaneous guided bone regeneration proved to be effective in restoring function and aesthetics in complex situations in young patients.

Objective: To evaluate color masking and relative translucency parameter (RTP) of increasing dentin thicknesses from different resin composites, with or without opacifiers, on a veneer dental preparation and resin disks.

Material and methods: Artificial darkened lateral incisors with 1mm-thick veneers preparations were used to evaluate color masking of different resinous materials, with or without opacifiers: IPS Empress Direct (ED) with or without ED Opaque; and Essentia (ES) with or without ES Masking Liner. For the RTP test; disc-shaped specimens were performed and evaluated with a spectrophotometer (VITA Easyshade) against black and C4 backgrounds. Color differences were calculated using the CIEDE2000 formula (ΔE00).

Results: The dentin layer thickness presented no influence on the ΔE00 (P>.05) of the ED group with opacifier; without opacifier, 0.3mm dentin thickness presented higher ΔE00 than 0.8mm layer (P=0.000). For ES group, with and without opacifier, there was a significant decrease in ΔE00 with the increase of dentin thickness (P<.05). All ED groups presented lower ΔE00 than the ES groups (P<.05). All groups showed perceptible color differences, but some ED groups showed acceptable values. For RTP comparisons, a decrease in the ΔE00 was observed with the increase of dentin thickness (P<.05). ED groups with opacifier presented significant lower ΔE00 than ES groups (P<.05). It was observed a significant decrease in ΔE00 for all groups with an opacifier (P<.05).

Conclusions: ED combinations with 0.3mm with opacifier and 0.6mm or higher without opacifier were sufficient to mask a C4 background, while ES combinations could not acceptably mask the substrate, according to the acceptability threshold determined. Dentin thicknesses significantly increase at the same pattern as ΔE00 decreases. A black background promoted increased ΔE00 values than a C4 background.

ChatGPT, an artificial intelligence (AI) chatbot, can generate text prompts based on user input. This study investigated the possibility of utilizing this tool to generate adequate and relevant patient educational and management documents in the context of dental implant surgery. A total of 27 periodontists were surveyed on the accuracy and usefulness of AI-generated documents comprising informational handouts for patients on surgical risks and postoperative instruction sheets for dental implant placement in either smokers or patients with diabetes. These periodontists were also asked in a blinded fashion about their preferences between the generic implant placement consent form currently used at Boston University and two AI-generated consent forms, one generic and one tailored to patients with diabetes. A vast majority of participants found that the information in the AI-generated forms was accurate and useful, and they would feel comfortable using them with their own patients. The AI-generated generic consent form performed at least as well as the humanwritten one, while the personalized AI-generated consent form for patients with diabetes performed significantly better (P < .001). Within the limitations of this study, ChatGPT was able to independently generate accurate and useful informational and management documents for patients.

Robotic systems have revolutionized various industries, and dentistry is no exception. Recently, due to the robust advancements in artificial intelligence and technology, there has been a significant evolution of dental robotic systems, ranging from surgeon-controlled and robot-assisted operations to more autonomous processes. The present clinical case report describes a 1-year follow-up of the successful use of an autonomous dental implant robot system with an osseodensification protocol for implant osteotomy preparation, maxillary sinus elevation, and simultaneous implant placement at the maxillary second premolar site. A prefabricated provisional prosthesis was delivered immediately after implant placement, with final prosthesis delivery at 3 months. The findings from this report demonstrate the integration and clinical augmentation of more autonomous protocols in the field of implant dentistry using dental robots.

The interforaminal region is considered more favorable for implant placement than the posterior mandible in edentulous patients, mainly because the inferior alveolar nerve can interfere with implant placement in the severely resorbed posterior mandible. However, complications in the interforaminal region may occur due to the presence of the mandibular incisive nerve. This scoping review aims to describe the mandibular incisive nerve anatomy related to the potential interference in implant therapy. A comprehensive literature search was conducted in the following databases: MEDLINE (via PubMed), Web of Science, and Scopus. This scoping review was structured according to the Joanna Briggs Institute method. Thirteen studies were included in the review. All of the studies were observational cohort anatomical studies, carried out mainly by CBCT and on cadavers. A total of 1,471 patients/cadavers were studied. The mandibular incisive nerve was present in 87% to 100% of cases, with an average length of 9.97 mm and an average diameter of 1.97 mm. The mandibular incisive nerve may be damaged during drilling and implant placement, especially when using implant lengths > 12 mm. Damage to the mandibular incisive nerve due to implant placement could be present, but it is necessary to conduct more studies focusing on assessing mandibular incisive nerve damage to understand the clinical relevance of this nerve and its associated morbidities, such as neurosensorial alterations. Due to the different anatomical characteristics of this nerve, CBCT analysis is recommended for implant therapy in the anterior mandible to prevent the described complications.

Choosing between screw-retained and cement-retained restorations in the esthetic zone may significantly impact the restorative contour. This study analyzes the effect of facial-palatal implant positioning on the facial emergence angle of implant restorations in the anterior maxilla. A total of 133 maxillary anterior implant cases were captured with intraoral scans and used to create digital prosthetic designs. The restoration facial emergence angle and the implant depth were determined using images at the midfacial cross section. Simple logistic and linear regression models were used to analyze the interrelation between the emergence angle, depth, and retention methods. The average facial emergence angle for all restorations in this study was 34.4 degrees. A significant difference in emergence angle was found between screw-retained and cement-retained groups, with averages of 37.3 degrees and 27.9 degrees, respectively. There was no difference in the mean depth between the two groups. A strong negative linear relationship between depth and emergence angle was seen for the screw-retained group. Overall, implant positioning in the anterior maxilla has a significant influence on emergence angle. Facial emergence angle is significantly greater for implants in a screw-retained position. This may be partially alleviated by deeper implant placement.

Tooth extractions can result in alveolar bone dimensional changes, necessitating additional bone grafting for implant placement. Alveolar ridge preservation (ARP) aims to counteract postextraction changes. This case series evaluates the bone regenerative properties of a freeze-dried bone allograft (FDBA) and the clinical outcomes of implants in grafted extraction sites. A total of 33 patients were enrolled, undergoing single/multiple tooth extractions followed by ARP. Biopsy samples were harvested during implant placement for histologic and histomorphometric analysis. Clinical outcomes included marginal bone loss and pink esthetic score (PES). Twenty-five patients completed the study. FDBA-augmented sockets exhibited new bone formation adjacent to graft particles. Implants (n = 25) showed 100% survival and success rates at 1 and 2 years. PES improved significantly over time (P < .001), while marginal bone loss did not significantly differ at 1 and 2 years (P = .096). Specimens showed trabecular bone, residual FDBA particles, and marrow spaces. High magnification revealed immature bone and woven bone bridges around graft particles. No inflammatory cells were observed. This case series provides valuable insights into ARP performed with FDBA (as implants were placed after 3 months of healing without any additional bone augmentation), the histologic outcomes were favorable, and implants were successful after a 2-year follow-up period.