A novel fully tapered, self-cutting tissue-level implant: non-inferiority study in minipigs
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 Â± 10.63% vs. 54.46 Â± 18.31%) (p=0.99), medium diameter (60.91 Â± 14.42 vs. 54.68 Â± 9.16) (p=0.55), and large diameter (45.60 Â± 14.67 vs. 52.52 Â± 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.
Tissue healing around dental implants with marginal bone defects with and without flap elevation. An experimental study in dogs
Abstract Abstract-The technique of immediate implant placement after extraction has been conceived for preserving the residual bone support and soft tissue morphology. Nowadays this procedure is still not predictable and presents inconveniences both for the patient and the dentist. Therefore, the healing process around a dental implant placed into an extraction socket needs to be deeply investigated in order to increase the predictability of this surgical approach. The aim of the present investigation was to evaluate the healing of bone defects (fresh extraction sockets) following implant installation with flap elevation and primary closure compared to implant installation without flap elevation. This study evaluated by histologic and histomorphometric analyses tissue healing around dental implants with marginal bone defects with and without flap elevation 1 week, 4 weeks and 12 weeks following implantation in the dogs. The main qualitative findings showed that after 1 week of implantation, almost no bone repair was observed and there was no significant difference between the two groups in terms of bone healing performance, inflammatory infiltrates (slight to moderate grade) and bone resorption (moderate to marked grade) limited to the coronal portion of the implanted sites. The two groups with or without flap elevation behaved similarly at this time period of implantation. Under the experimental conditions of this study, it appeared that no biological differences were observed between the two groups with and without flap elevation in terms of crestal bone repair, inflammation, marginal bone loss and soft tissue downgrowth. The qualitative differences observed might be imputable to fortuitous events. The histomorphometric measurements confirmed the qualitative trends observed. The limitations of this study, as of all animal studies, have to be found in their translational aspects. The investigation on the same topic in a human population by setting up a controlled, randomized, prospective trial including a sufficient amount of patients who can be investigated on according to the split-mouth method would be beneficial.
The use of a xenogeneic collagen matrix at the time of implant placement to increase the volume of buccal soft tissue
The purpose of this study was to evaluate the efficacy of Mucograft (MG; a porcine-derived purified collagen membrane) to increase the thickness and height of the buccal soft tissue when placed at the time of implant placement in patients with thin or deficient keratinized tissue (KT). The primary endpoint of the study was the change in thickness and height of the buccal KT. Secondary endpoints included stability of the midbuccal soft tissue level; clinician rating of color, texture, and contour of treatment site; probing pocket depths (PPDs); assessment of satisfaction outcome; and patient assessment of pain/discomfort. Thirty-two patients were enrolled and 31 patients completed the study. There were no statistically significant (SS) differences between the MG and control groups for height measures. There was no SS difference for KT thickness (P = .117) between the groups at the final measurement (3 months postsurgery). However, there was an SS difference (P = .009) in favor of the MG group when comparing the difference in presurgical KT thickness to that 3 months postsurgery. Thus, MG was successful (compared to the control) in increasing the buccal KT. There were no SS differences between the groups for any of the other endpoints, including color, texture, contour, and pain assessment at any visit or successful outcome between the treatment group and the control. More cases and longer follow-up of implants placed with MG are needed to verify the results of this randomized prospective study.
Mucogingival volumetric changes following root coverage with acellular dermal matrix : a case report
[New York NY : NYU College of Dentistry. NYU Academy of Distinguished Educators], 2013
Current status of periodontal risk assessment
Chronic periodontitis is a destructive chronic inflammatory disease of bacterial etiology. Mounting evidence confirms that not all patients are susceptible to inflammatory periodontal disease, and further, that the extent and severity of its clinical manifestation varies as a function of individual risk. Risk assessment models are needed to target treatment effectively. Contemporary risk assessment, as applied to periodontal disease, represents an innovative approach to managing periodontitis. The central intent of this paper is to review the current view of risk assessment as it relates to the diagnosis and management of chronic periodontitis, as well as to consider a number of such applications that can be incorporated into daily practice.
Bone regeneration therapy using low level laser treatment in a rabbit model [Meeting Abstract]
Introduction: Low wattage laser use in periodontal therapy is well documented, but effects on bone repair are not understood. We used a low wattage laser to examine the effects of laser treatment on bone healing in a rabbit cranial defect bone-healing model. Materials and Methods: Bone defects were created in rabbit parietal bones using a trephine in 16 rabbits (5mm in diameter, 1/2 skull thickness defects), and 4 were created in the two parietal bones of each rabbit. One defect was untreated (control), and the remaining three were treated for 15, 30 and 45 seconds using a Navigator 810 nm diode laser (Ivoclar Vivadent, Inc) with non-initiated tip at 1.0 watts in continuous mode. Defects were evaluated using micro computed tomo-graphy (microCT) and hard tissue histomorphometry at 2 and 4 weeks. Results: Treatment was observed to increase levels of coagulation at the wound sites. 2-week analysis was inconclusive, but 4-week results were significant. Histomorphometric analysis of the 15, 30, and 45-second treatment groups versus the control group showed a 21% increase in bone formation, which was significant at a p <= 0.05 level. Treated sites showed higher osteoblastic activity than untreated sites. Increase in bone formation may be related to stabilize coagulation and lower amounts of wound contracture at treated sites. Conclusion: Low wattage laser treatment of craniofacial bone defects suggested significant increases in bone formation versus untreated sites
Dental complications of head and neck cancer radiation
The choice of treatment for head and neck cancer usually depends on the origin and stage. The majority of patients undergo radiation therapy or surgery, or a combination of both, and caring for individuals undergoing radiotherapy involves multifaceted management. Counseling patients before, during, and after head and neck radiotherapy is important to help them become aware of several oral complications that may be severe and may interfere with everyday living. The pharmacist's role is to help lessen oral discomfort and morbidity in this population. The three major types of treatment for managing head and neck cancer are radiation therapy, surgery, and chemotherapy.1 The majority of patients undergo radiation therapy or surgery, or a combination of both. Chemotherapy is usually used as a supplement to the above treatments. Combining chemotherapy and radiotherapy does not improve long-term survival rates over those achieved by radiotherapy and surgery. The choice of treatment usually depends on the origin and stage of the head and neck cancer. Approximately 50,000 new head and neck cancers are diagnosed annually in the United States, and there are about 350,000 deaths yearly worldwide. Most head and neck cancer starts in the squamous cells of the mucosal tissue that lines the head and neck region, such as the tonsils and tongue. Squamous cell carcinoma represents more than 90% of all head and neck cancers. Head and neck cancer can occur anywhere in the head and neck region, and radiation therapy to this area usually results in numerous oral adverse effects that require additional palliative treatment to alleviate these troublesome symptoms