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27


Suturing Techniques

Chapter by: Weinberg, Mea A; Segelnick, Stuart L; El Chaar, Edgard
in: Practical techniques in periodontics and implant dentistry by El Chaar, Edgard [Ed]
Hoboken, NJ : Wiley-Blackwell, 2023
pp. 70-76
ISBN: 9781119793557
CID: 5394852

Patient Examination and Initial Therapy

Chapter by: McCarthy, Claire; Engeberston, Steve; El Chaar, Edgard; Weinberg, Mea; Segelnick, Stuart L; Sapanaro, Dena M
in: Practical techniques in periodontics and implant dentistry by El Chaar, Edgard [Ed]
Hoboken, NJ : Wiley-Blackwell, 2023
pp. 50-59
ISBN: 9781119793557
CID: 5394842

Oral Pathology and Oral Medicine

Chapter by: El Chaar, Edgard; Kumar, Arthi M
in: Practical Techniques in Periodontics and Implant Dentistry by El Chaar, Edgard [Ed]
pp. 22-49
ISBN: 978-1-119-79355-7
CID: 5574782

A novel fully tapered, self-cutting tissue-level implant: non-inferiority study in minipigs

El Chaar, Edgard; Puisys, Algirdas; Sabbag, Itai; Bellón, Benjamin; Georgantza, Aikaterini; Kye, Wayne; Pippenger, Benjamin E
OBJECTIVES/OBJECTIVE:To assess the osseointegration and crestal bone level maintenance of a novel fully tapered self-cutting tissue-level implant for immediate placement (test) compared to a clinically established tissue-level implant (control) in moderate bone quality. MATERIALS AND METHODS/METHODS:Test and control implants were compared in 3 groups, i.e., small-, medium-, and large-diameter implants in an edentulous mandibular minipig model with moderate bone quality after 12 weeks of healing. Histometrically derived bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC) were subjected to statistical non-inferiority testing. Maximum insertion torque values in artificial bone were assessed for comparison. RESULTS:BIC values for the tests and control implants for all 3 diameters were comparable and non-inferior: small diameter (61.30 ± 10.63% vs. 54.46 ± 18.31%) (p=0.99), medium diameter (60.91 ± 14.42 vs. 54.68 ± 9.16) (p=0.55), and large diameter (45.60 ± 14.67 vs. 52.52 ± 14.76) (p=0.31). fBIC values for test implants were higher and non-inferior compared to control implants in all three groups. Test implants further showed distinctly higher maximum insertion torque values compared to control implants. CONCLUSION/CONCLUSIONS:The investigated novel tissue-level implant is able to achieve high levels of primary and secondary implant stability under simultaneous preservation of crestal bone levels. This qualifies the studied implant as an attractive candidate for immediate placement in bone of limited quality. CLINICAL RELEVANCE/CONCLUSIONS:This pilot pre-clinical study investigated a novel tissue-level implant for immediate placement. With the aim of translating the studied prototype into clinical application pre-clinical models, procedures and controls have been chosen with the aim of reflecting its future clinical indication and use.
PMID: 33861379
ISSN: 1436-3771
CID: 4846382

Bone Ring Allograft: Digitally Guided Placement in the Anterior Esthetic Area. A Retrospective Case Series

El Chaar, Edgard; Shi, Ye; Engebretson, Steven; Zahedi, Dina; Chang, Edward
This case series demonstrates a surgical technique consisting of a digitally planned and guided placement of a bone ring allograft and implant in the anterior esthetic zone. Eight consecutive patients with horizontal and vertical defects in the anterior maxilla underwent augmentation with a commercially available bone ring allograft and simultaneous implant placement using two digital guides. After 6 to 8 months, implants were uncovered and restored with a screw-retained prosthesis. Follow-up periods ranged from 8 to 24 months. All eight implants met predefined success criteria with no adverse events. Radiographic measurements demonstrated stable peri-implant bone levels 1 year after implantation, with bone loss ranging from 0.0 to 1.4 mm. All patients were satisfied with the total treatment time, postsurgical healing, and final esthetic outcome. This case series describes a one-stage procedure in which a bone ring allograft and implant are simultaneously placed for treatment of a severely defective ridge in the anterior maxilla. The technique appears to be reliable for use in the esthetic zone, with minimal first-year loss of peri-implant bone. In combination with a digital guide, accurate implant and bone ring placement can be achieved, resulting in reduced chair time and fewer surgical procedures for the patient.
PMID: 34818392
ISSN: 1945-3388
CID: 5072242

Clinical Methodology Quantifying the Emergence Profile Contour For Immediate Provisionalization: A Proposed Mathematical Model

El Chaar, Edgard; White, Cecilia; Salama, Toni; Andrawis, Andrew; Shi, Ye
Identifying the ideal position of the final restoration prior to implant surgery is essential for optimal aesthetics. Study of the emergence contour design of implant restorations has been limited. The aim of this report is to compile the factors which affect the final esthetic outcome and integrate those factors into an easy-to-use model. This geometric model includes a linear distance created by the placement of an implant platform in relation to the free gingival margin, and a circle representing the emergence profile to create an Emergence Curve. If this model is evaluated and available, a practitioner can make appropriate decisions based on 3-dimensional immediate implant concepts.
PMID: 33201184
ISSN: 0160-6972
CID: 4702212

A Novel Xenograft Bone Substitute Supports Stable Bone Formation in Circumferential Defects Around Dental Implants in Minipigs

Catros, Sylvain; Sandgren, Rebecca; Pippenger, Benjamin E; Fricain, Jean Christophe; Herber, Valentin; El Chaar, Edgard
PURPOSE/OBJECTIVE:The aim of this study was to evaluate and compare bone growth and implant integration in circumferential defects with two commercially available bone substitutes (demineralized bovine bone mineral [DBBM]). MATERIALS AND METHODS/METHODS:Circumferential defects were created in the mandibles of minipigs (n = 10), and Bone Level Tapered implants (Straumann Roxolid with SLActive surface) were placed. The defects (4-mm-deep circumferential defect, 2 mm around each implant) were augmented with either sintered bovine bone mineral (test, cerabone) or natural bovine bone mineral (control, Bio-Oss). Bone formation and tissue composition in augmented sites were histomorphometrically assessed after 8 and 12 weeks of healing time (n = 5 each), respectively, in terms of the percentage of area of newly formed bone to total area, bone-to-implant contact (BIC), and crestal bone height relative to the implant shoulder (first bone-to-implant contact [fBIC]). RESULTS:Bone formation in all defect sites was adequate and equivalent for both groups at individual healing time points. The amount of residual graft material was comparable in both groups after 8 and 12 weeks, with no significant resorption in either group. The mean newly formed bone area in the test group amounted to 46.7% ± 5.1% and 48.7% ± 4.0% after 8 and 12 weeks vs 47.0% ± 4.8% and 47.8% ± 7.3% in the control group, respectively. BIC and fBIC as individually assessed for the lingual and buccal aspects were comparable at both healing time points without any statistically significant differences between the groups. A slightly greater variability of fBIC was observed within the test group. CONCLUSION/CONCLUSIONS:The results of this study indicate that test and control materials both represent viable bovine bone graft material that equivalently support the formation of new and stable bone volume specifically when used for simultaneous augmentation around implants.
PMID: 33270052
ISSN: 1942-4434
CID: 4736792

AAID White Paper: Management of the Dental Implant Patient During the COVID-19 Pandemic and Beyond

Rutkowski, James L; Camm, Daniel P; El Chaar, Edgard
The scientific community's understanding of how the SARS-CoV-2 virus is transmitted and how to best mitigate its spread is improving daily. To help protect patients from acquiring COVID-19 from a dental office nosocomial infection, many state or local governments have classified dental treatments as "nonessential" and have paused routine dental care. Dentists have been instructed to perform only procedures designated as emergencies. Unfortunately, there is not a good understanding of what a dental emergency is among governmental leaders. What a government agency may perceive as an elective procedure may be seen as "essential" by the dental clinician responsible for maintaining the oral health of the patient. Each dental specialty understands the effects delayed care has on a patient's oral and systemic health. Dentistry has made extensive progress in improving oral health through prevention of the dental emergency. The dental profession must work together to prevent the reversal of the progress dentistry and patients have made. This American Academy of Implant Dentistry (AAID) White Paper discusses what COVID-19 is and how it impacts dental treatments, presents guidelines for dentistry in general and for dental implant related treatments, specifically. Recommendations for implant dentistry include the following: (1) what constitutes a dental implant related emergency, (2) how patients should be screened and triaged, (3) what personal protective equipment is necessary, (4) how operatories should be equipped, (5) what equipment should be used, and (6) what, when, and how procedures can be performed. This paper is intended to provide guidance for the dental implant practice so patients and dental health care providers can be safe, and offices can remain open and viable during the pandemic.
PMID: 32882035
ISSN: 0160-6972
CID: 4734392

Treatment of Atrophic Ridges with Titanium Mesh: A Retrospective Study Using 100% Mineralized Allograft and Comparing Dental Stone Versus 3D-Printed Models

El Chaar, Edgard; Urtula, Adolf B; Georgantza, Aiketrini; Cruz, Stephanie; Fallah-Abed, Pooria; Castaño, Alejandro; Abitbol, Thierry; Warner, Michael M
This multicenter study retrospectively evaluated implant survival and bone growth in atrophic ridges that were augmented with titanium mesh and 100% mineralized solvent-dehydrated bone allografts (MSDBA). A secondary objective of this study was to evaluate differences in outcomes by diagnostic model type. Titanium mesh was shaped on a diagnostic wax-up of the patient's jaw: Twenty-three patients (Group 1) had wax-ups on dental stone models, and 16 patients (Group 2) had wax-ups on models fabricated with three-dimensional (3D) printing technology. Clinical and histologic data were analyzed. The average bone gain ranged from 5.94 to 6.91 mm horizontally and 5.76 to 6.99 mm vertically and was not significantly different between the two model groups (P > .05). Implant survival was 100% after 18 to 48 months. Although model type had no significant influence on outcomes, 3D-printed models allowed for faster surgery and served as visual aids for patient education.
PMID: 31226186
ISSN: 1945-3388
CID: 3983442

Crestal Bone and Keratinized Tissue Around 3.0-mm Laser-Microtextured Dental Implants After 1 Year in Function: A Case Series

El Chaar, Edgard; Amin, Shivangi; Cruz, Stephanie; Gil-Fernandez, Natalia; Engebreston, Steven
The purpose of this case series was to evaluate peri-implant tissues in 10 patients at 1 year after placement of a tapered 3.0-mm laser-microtextured dental implant (Laser-Lok, BioHorizons) using a two-stage approach. Clinical and radiographic measurements were assessed. Keratinized tissue at the facial surfaces of each implant had a slight increase of 0.73 mm (95% confidence interval [CI], P = .058), and marginal bone levels had significant increase of 1.85 mm (95% CI, P = .005) at 1 year compared to baseline. These data suggest that 3.0-mm laser-microtextured implants demonstrate stable or improved soft and hard tissue parameters at 1 year postloading.
PMID: 30986282
ISSN: 1945-3388
CID: 4035422