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Godani A, Iyer J, Nadgere J, Mohite A, Gaikwad A. Impact of immediate interim restoration on peri-implant tissues around immediately placed single dental implants in the esthetic region: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00045-3. [PMID: 38355364 DOI: 10.1016/j.prosdent.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
STATEMENT OF PROBLEM Immediate implant placement with an immediate interim restoration is a well-established protocol. Nevertheless, a consensus regarding the impact of immediate interim restoration on peri-implant tissues around single dental implants is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to address the research question: "Does the placement of an immediate interim restoration influence the mid-facial mucosal (MFM) marginal and interdental papilla (IDP) levels around single dental implants placed in the anterior esthetic region by using an immediate implant placement protocol?" MATERIAL AND METHODS A comprehensive literature search was made in the Medline/PubMed, Scopus, Cochrane, and Science Direct electronic databases for articles published in English evaluating the impact of immediate interim restoration on peri-implant tissues around single dental implants in the anterior esthetic region. The primary outcomes assessed were changes in the MFM marginal and IDP levels. Additional outcomes were marginal bone (MB) loss, esthetic outcomes involving the pink and white esthetic scores (PES and WES), implant survival rates, and patient reported outcome measures (PROMs). The risk of bias assessment was performed by using the RoB 2 tool for randomized trials and the Newcastle-Ottawa scale for nonrandomized studies. Meta-analysis was performed by using random and fixed effects model (α=.05) in the RevMan software program. RESULTS Sixteen studies were included that analyzed 836 single dental implants involving 823 patients. The meta-analysis showed no significant differences in implants with and without interim restoration in terms of MFM marginal level (MD=0.01; 95% CI=-1.23 to 1.25; P=.98), mesial IDP level (MD=0.12; 95% CI=-0.23 to 0.47; P=.50), distal IDP level (MD=0.20; 95% CI=-0.40 to 0.79; P=.52), and MB loss (MD=0.01; 95% CI=-0.42 to 0.43; P=.97). The systematic analysis for survival rates determined no notable difference in implants with or without an interim restoration. However, the esthetic outcomes and PROMs substantially improved with immediate interim restorations. The RoB 2 tool showed a moderate to low risk of bias, and the Newcastle-Ottawa scale indicated high-quality studies. CONCLUSIONS After a 12-month follow-up, immediate interim restoration had no significant impact on peri-implant soft (MFM marginal and IDP levels) and hard tissues (MB loss) around immediately placed single dental implants. Nevertheless, additional well-designed and well-implemented clinical trials with long-term follow-up periods are needed to provide more precise evidence-based recommendations.
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Affiliation(s)
- Aashi Godani
- Postgraduate student, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Janani Iyer
- Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.
| | - Jyoti Nadgere
- Professor and Head, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Anuradha Mohite
- Associate Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Amit Gaikwad
- Associate Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India; Doctoral Researcher, Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany; and Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Hanover Medical School, Hanover, Germany
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Wittneben JG, Molinero-Mourelle P, Hamilton A, Alnasser M, Obermaier B, Morton D, Gallucci GO, Wismeijer D. Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:266-303. [PMID: 37750531 DOI: 10.1111/clr.14172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 08/07/2023] [Accepted: 08/13/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15-25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010. MATERIAL AND METHODS An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A). RESULTS Sixty-three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow-up ranging from 12 to 96 months. One thousand nine hundred sixty-one implants reported survival rates of 99.2 (98.6-99.5) % at 1 year, 97.5 (95.9-98.4) % after 3 years, and 95.8 (93.3-97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8-99.5) % after 1 year, 96.8 (93.6-98.4) % after 2 years, and 94.8 (89.6-97.4) % after 5 years. Comparing baseline to 12-month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of -0.71 (-1.25, -0.1) mm, midfacial recession change of -0.15 (-0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES. CONCLUSIONS Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years.
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Affiliation(s)
- Julia-Gabriela Wittneben
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Conservative Dentistry and Orofacial Prosthetics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Hamilton A, Gonzaga L, Amorim K, Wittneben JG, Martig L, Morton D, Martin W, Gallucci GO, Wismeijer D. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:304-348. [PMID: 37750515 DOI: 10.1111/clr.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Luiz Gonzaga
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Karina Amorim
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - William Martin
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Groenendijk E, Staas TA, Bronkhorst EM, Raghoebar GM, Meijer GJ. Factors Associated with Esthetic Outcomes of Flapless Immediate Placed and Loaded Implants in the Maxillary Incisor Region—Three-Year Results of a Prospective Case Series. J Clin Med 2023; 12:jcm12072625. [PMID: 37048707 PMCID: PMC10094793 DOI: 10.3390/jcm12072625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Flapless immediate implant placement and provisionalization (FIIPP) is often associated with an increased risk of buccal soft-tissue recession. This study aims to assess the 3-year esthetic outcome. In 100 consecutive patients, one maxillary incisor, with or without a pre-extraction buccal bone defect (≤5 mm), was replaced by an implant installed in a maximal palatal position (buccal gap ≥2 mm). The created gaps were filled with bovine bone substitute. Patient satisfaction (PS), pink esthetic scores (PES/modPES), and white esthetic score (WES) were calculated at different time points. A multilevel regression analysis (MRA) was performed to analyze which factors may be associated with the esthetics. After three years, PS scored 8.9 ± 0.84 on a scale of 10 (n = 83), and the soft-tissue esthetics were high (PES = 12.2; modPES = 8.5), as was the WES (8.2), showing no decrease from one year. Buccal bone defect size and smoking could not be associated with the soft-tissue outcome; however, implant location, gap size, and emergence profiles could. Performing FIIPP, the final crown (WES) scored highest when it was cemented, the soft tissue (PES/modPES) in central-incisor positions, and all (WES/PES/modPES) with concave emergence profiles.
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Lazarov A. Soft-Tissue Augmentation in Periodontally Compromised Patients during Immediate Placement and Immediate Loading Dental Implant Surgery - A Retrospective Study. Ann Maxillofac Surg 2023; 13:37-43. [PMID: 37711524 PMCID: PMC10499271 DOI: 10.4103/ams.ams_207_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/13/2023] [Accepted: 03/15/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction The purpose of this article is to describe a soft-tissue augmentation procedure for multiple tooth extraction sites during immediate placement and immediate loading (IPIL) dental implant surgery in periodontally compromised patients and to present follow-up results of its effectiveness. Methods A retrospective study was conducted on data from patients who underwent IPIL dental implant surgery between 2018 and 2021 at an oral implant centre in Bulgaria. Based on inclusion and exclusion criteria, 103 patients were included, 53 of whom had pre-operative indications for connective tissue grafts (CTGs) and 50 of whom did not. The post-operative incidence of gum recession was evaluated in the two patient groups. Results The majority of the 53 patients (56.60%) had six, seven or eight tooth sites grafted. A significant proportion (87%) needed CTGs at the canine teeth (13 and 23), P < 0.001. The post-operative data showed a low incidence of gum recessions in both the patient groups, with a lower rate in the CTG group at tooth no: 13 (2.20% vs. 18%, P = 0.016) and in the total sum of 10 tooth sites with CTGs (P = 0.001). A reduction in gum problems and increased satisfaction with gum health and aesthetics were reported by 100% of the CTG patients. Discussion Soft-tissue augmentation at multiple tooth extraction sites during IPIL dental implant treatment may benefit periodontally compromised patients through an improved prosthesis-tissue interface in the aesthetic area and a reduction in gum infections, swelling, bleeding and pain.
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Affiliation(s)
- Aleksandar Lazarov
- Department of Research and Evidence, International Implant Foundation, Munich, Germany
- Department of Prosthodontics, Jaipur Dental College, Maharaj Vinayak Global, Jaipur, Rajasthan, India
- Private Oral Implant Center ALDENTAL, Sofia, Bulgaria
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Borgia GS, Pebé P, Barbot R, Haas AN. Immediate implants with buccal defects filled with bone from the tuberosity or a xenograft: 1-year randomized trial. Braz Oral Res 2022; 36:e102. [PMID: 35830145 DOI: 10.1590/1807-3107bor-2022.vol36.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the use of autologous bone from tuberosity (TUBER) and deproteinized bovine bone mineral (DBBM) in immediate implants with buccal bone defects. A total of 31 patients with one single tooth in the upper anterior region indicated for extraction presenting tomographic buccal bone defect were analyzed. Immediate implantation was conducted for all patients. In one group, DBBM and a collagen membrane were inserted into the buccal defect; in the other group, a small block of bone from tuberosity was used. The primary outcome was facial-palatal ridge thickness (FPT) measured in casts 1 year after function. The implant success rate was 100% in both groups. FPT changes were <0.5 mm and did not differ significantly between groups. FPT reductions in the DBBM and TUBER groups were 1% and 0.6%, respectively, at the gingival margin and 5% and 2%, respectively, at 6 mm apical of the gingival margin (p > 0.05). No significant differences were observed between groups for patient's esthetic, satisfaction, pain and quality of life. Pink esthetic scores for the DBBM and TUBER were 11.5±1.7 and 10.8±1.9, respectively (p=0.37). It can be concluded that DBBM and TUBER did not differ in terms of ridge alterations, peri-implant clinical parameters and patient-reported outcomes.
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Affiliation(s)
- Gonzalo Stagnaro Borgia
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Pablo Pebé
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Roberto Barbot
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology and Implantology, Porto Alegre, RS, Brazil
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Puisys A, Auzbikaviciute V, Vindasiute-Narbute E, Pranskunas M, Razukevicus D, Linkevicius T. Immediate implant placement vs. early implant treatment in the esthetic area. A 1-year randomized clinical trial. Clin Oral Implants Res 2022; 33:634-655. [PMID: 35318752 DOI: 10.1111/clr.13924] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 11/08/2021] [Accepted: 01/24/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal bone. MATERIALS AND METHODS Test group patients received an immediate implant with immediate provisional restoration and socket preservation, while patients in the control group received an early implant placement with guided bone regeneration and delayed loading. Patients were followed for 1 year after final prosthetic and pink esthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded. RESULTS Fifty patients received the intended treatment (25 test and 25 control). No implants failed. PES after 1 year was 12.8 ± 1.19 for the test group and 12.5 ± 1.36 for the control group (p = .362). MBML difference between baseline (after final crown delivery) and the 1-year follow-up was gain of 0.2 ± 1.02 mm for the test group (p = .047) and no change in the control group. CBC after 1 year were 0.1 mm ± 0.21 mm (mesial) and 0.2 mm ± 0.22 mm (distal) for the test group and 0.2 mm ± 0.25 mm (mesial) and 0.3 mm ± 0.19 mm (distal) for the control group, p = .540 (mesial) and p = .462 (distal). Test group required half the chair time (127 ± 13 min) when compared to the control group (259 ± 15 min, p < .001). CONCLUSIONS Within the limits of this trial, both treatment protocols resulted in excellent esthetic outcomes with PES >12 after 1-year follow-up.
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Affiliation(s)
- Algirdas Puisys
- Vilnius Research Group, Private Practice VIC Clinic, Vilnius, Lithuania
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Jurado C, Fischer NG, Fu CC, Tsujimoto A. A Multidisciplinary Approach to Congenitally Missing Central Incisors: A Case Report. Cureus 2022; 14:e21911. [PMID: 35273860 PMCID: PMC8901136 DOI: 10.7759/cureus.21911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 11/12/2022] Open
Abstract
Hypodontia is one of the most common developmental problems of human dentition. The treatment of missing maxillary central incisors is always a challenging task, often requiring a multidisciplinary approach. This case report describes such a multidisciplinary approach for a female patient with congenitally missing maxillary central incisors and class II division 1 occlusion. Significant horizontal overlap was present with class II division 1 occlusion in a patient with a history of cleft palate. Implant therapy was thereby not an option. Orthodontic treatment was provided to decrease the horizontal overlap and reposition the teeth. Esthetic crown lengthening was performed and monolithic lithium disilicate crowns were placed. Critical analysis of the treatment plan through cooperation among specialists is required to obtain the ideal result. Orthodontic treatment may be necessary to close or gain more space, followed by implant placement (if acceptable), and restorative treatment. It is important to create the treatment plan through a multidisciplinary approach involving orthodontists, surgeons, and restorative specialists before initiating treatment.
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Pommer B, Danzinger M, Leite Aiquel L, Pitta J, Haas R. Long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading: Systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:56-66. [PMID: 34642986 DOI: 10.1111/clr.13838] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the present systematic literature review was to determine whether long-term treatment results with single-tooth implants may differ depending on the timing of implant placement in relation to tooth extraction (immediate IP/early EP/delayed DP) and the timing of prosthetic loading (immediate IL/early EL/delayed DL). MATERIAL AND METHODS Electronic and manual searches were performed to identify studies reporting on long-term results (survival rate and/or marginal bone resorption after ≥3 years) of maxillary single-tooth implants in the aesthetic zone using defined placement and loading protocols. Comparative trials were subjected to meta-analyses whilst data from single-arm studies were pooled to evaluate differences between timing protocols. RESULTS A total of 7 controlled trials were considered for meta-analyses: immediate loading was compared to delayed loading in 3 studies on immediate placement (IPIL vs. IPDL, p = .306) and in 2 studies on delayed placement (DPIL vs. DPDL, p = 1.000) whilst 2 studies compared early versus delayed placement with delayed loading (EPDL vs. DPDL, p = .600), however, without significant differences. Pooled data analysis of 29 studies (965 implants) did not show differences between timing of placement or loading as well as marginal bone remodelling. No impact of the one abutment - one time concept, flap design and simultaneous bone or soft tissue augmentation could be established. CONCLUSIONS Insufficient data are available for meta-analytic comparison of all combinations of implant placement and loading protocols.
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Affiliation(s)
| | | | - Loise Leite Aiquel
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine & Oral Health, Medical University of Graz, Austria
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Switzerland
| | - Robert Haas
- Academy for Oral Implantology, Vienna, Austria
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Mijiritsky E, Barone A, Cinar IC, Nagy K, Shacham M. 3D Considerations and Outcomes of Immediate Single Implant Insertion and Provisionalization at the Maxillary Esthetic Zone: A Long-Term Retrospective Follow-Up Study of Up to 18 Years. J Clin Med 2021; 10:4138. [PMID: 34575248 PMCID: PMC8472303 DOI: 10.3390/jcm10184138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/04/2021] [Accepted: 09/11/2021] [Indexed: 12/15/2022] Open
Abstract
AIM Long-term studies addressing the outcomes of single immediate implantation and provisionalization at the maxillary esthetic zone are needed. The current study aimed to assess such outcomes along a follow-up period of up to 18 years. MATERIALS AND METHODS The current study is a continuation follow-up of our previously published up to 6-year follow-up study, dated between the years 2002-2008, performed in a private clinical practice in Tel-Aviv, Israel. A total of 15 patients (23 implants) who had been treated for single-tooth replacement at the maxillary esthetic zone since 2002, underwent clinical and radiographic follow-up evaluations. Primary outcomes included mean Marginal Bone Levels (MBL), with Bleeding on Probing (BOP), implant success rate, prosthetic and esthetic complications evaluated as secondary outcomes. RESULTS The implant success rate was at 100%. Bone remodeling processes were observed over the follow-up period, with 0.9 mm mean marginal bone loss observed during the first 6 years of observation, followed by -0.13 ± 0.06 mm mean loss after 6 to 18 years. The last finding suggests bone deposition, as reported by other studies (Donati et al., 2012). At the final radiographic evaluation, a mean MBL of 1.35 mm ± 0.16 was demonstrated. No differences with respect to implant type or site were found. A generalized absence of BOP and esthetic complications occurred in two cases as a result of continuous adjacent teeth eruption versus obvious implant ankylosis. CONCLUSIONS Adhering to careful clinical protocols and 3D bone to implant considerations while immediately placing an anterior implant, this treatment approach offers both stable and esthetically acceptable results for the replacement of missing teeth at the maxillary esthetic zone.
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Affiliation(s)
- Eitan Mijiritsky
- Tel-Aviv Sourasky Medical Center, Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel Aviv-Yafo 6139001, Israel
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv-Yafo 6139001, Israel
| | - Antonio Barone
- Unit of Oral Surgery, Department of Surgical, Medical, Molecular Pathologies, and Critical Needs, School of Dental Medicine, University of Pisa, 56128 Pisa, Italy;
| | - Ihsan Caglar Cinar
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, 34093 Istanbul, Turkey;
| | - Katalin Nagy
- Department of Oral Surgery, University of Szeged, Tisza L. krt 64, 6720 Szeged, Hungary;
| | - Maayan Shacham
- School of Social Work, Ariel University, Ariel 40700, Israel;
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Hattingh A, De Bruyn H, Van Weehaeghe M, Hommez G, Vandeweghe S. Contour Changes Following Immediate Placement of Ultra-Wide Implants in Molar Extraction Sockets without Bone Grafting. J Clin Med 2020; 9:jcm9082504. [PMID: 32759638 PMCID: PMC7464762 DOI: 10.3390/jcm9082504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 01/18/2023] Open
Abstract
The aim was to evaluate ridge reduction and mucosal recession following immediate placement of ultra-wide implants in molar sockets, without bone grafting. Impressions were taken prior to tooth extraction, 4 months and 1 year after implant placement. The casts were digitized and compared. Mucosal recessions and horizontal ridge reduction were measured. A total of 16 implants were in the maxilla and 11 in the mandible. At the buccal aspect, there was a mean reduction of 0.94 mm after 4 months and 0.89 mm after one year (p = 0.933). At the palatal/lingual aspect, this was 1.09 mm after 4 months and 0.69 mm after 1 year (p = 0.001). After 1 year, a recession of 0.59 mm was measured at the zenith, 1.04 mm at the mesial and 0.98 mm at the distal papilla. The mean midfacial horizontal ridge reduction was 1.23 mm after 4 months and 1.45 mm after 1 year. At the midpalatal/midlingual aspect, the mean horizontal reduction was 1.43 mm after 4 months and 1.16 mm after 1 year. Immediate implant placement without bone grafting in the posterior jaw yields a significant horizontal ridge reduction and minor mucosal recession. Clinicians should anticipate the amount of ridge reduction and consider augmentation at the time of implant placement.
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Affiliation(s)
- André Hattingh
- Private Practice for Periodontology and Oral Implantology, Sevenoaks, Kent TN15 8BQ, UK;
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Hugo De Bruyn
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
- Dental Faculty, Radboud University Medical Hospital, 6525EX Nijmegen, The Netherlands
| | - Manù Van Weehaeghe
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Geert Hommez
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Stefan Vandeweghe
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
- Correspondence: ; Tel.: +32-9-332-59-22
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Ruales‐Carrera E, Pauletto P, Apaza‐Bedoya K, Volpato CAM, Özcan M, Benfatti CAM. Peri‐implant tissue management after immediate implant placement using a customized healing abutment. J ESTHET RESTOR DENT 2019; 31:533-541. [DOI: 10.1111/jerd.12512] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/21/2019] [Accepted: 06/14/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Edwin Ruales‐Carrera
- Department of Dentistry Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Patrícia Pauletto
- Department of Dentistry Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC) Florianópolis Brazil
- Department of Dentistry Brazilian Centre for Evidence‐Based Research, Federal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - Karin Apaza‐Bedoya
- Department of Dentistry Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Claudia A. M. Volpato
- Department of Dentistry Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Mutlu Özcan
- Department of Dentistry Brazilian Centre for Evidence‐Based Research, Federal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
- Dental Materials Unit Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, University of Zurich Zurich Switzerland
| | - César A. M. Benfatti
- Department of Dentistry Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC) Florianópolis Brazil
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Oh KC, Paik J, Kim JH. Esthetic Rehabilitation of Maxillary Anterior Teeth, Including an Immediate Provisionalization with an Implant-Supported Fixed Dental Prosthesis. J Clin Med 2019; 8:jcm8040428. [PMID: 30925756 PMCID: PMC6518017 DOI: 10.3390/jcm8040428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/21/2019] [Accepted: 03/25/2019] [Indexed: 01/22/2023] Open
Abstract
This report describes the case of a patient who required rehabilitation of their maxillary anterior teeth following a traumatic injury through a physical altercation. The decision was made to extract the maxillary central incisors and maxillary right lateral incisor, perform immediate implantation on the maxillary right lateral incisor and left central incisor areas, and place a three-unit immediate provisional restoration. Predesigned virtual teeth enabled efficient fabrication of the immediate provisional restoration following the implant placement. After a sufficient healing period with periodic check-ups, final impressions were made using a digital approach, with meticulous care taken to preserve the gingival architecture around the sites of rehabilitation. Thus, the custom abutments and definitive restoration were placed without eliciting an uncomfortable feeling in the patient. Both esthetic and functional outcomes were satisfactory. Reduced soft tissue volume around the implant restoration was observed, primarily within the two months post-extraction/implantation, based on superimposition of the serial scan data. Soft tissue volume changes in the present case suggest the need for controlled clinical studies of three-dimensional changes of gingival contours after extraction and/or implantation.
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Affiliation(s)
- Kyung Chul Oh
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul 03722, Korea.
| | - Jeongwon Paik
- Department of Periodontics, Yonsei University College of Dentistry, Seoul 03722, Korea.
| | - Jee-Hwan Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul 03722, Korea.
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14
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Implant treatment of two failing or missing central incisors in the aesthetic region: a treatment protocol and 1-year prospective study. Int J Oral Maxillofac Surg 2019; 48:1115-1121. [PMID: 30712987 DOI: 10.1016/j.ijom.2019.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/11/2019] [Indexed: 11/23/2022]
Abstract
Implant treatment for two central incisors in the maxillary aesthetic region is complex due to concerns regarding inter-implant hard and soft tissue stability. A treatment protocol was therefore developed and implemented in a 1-year prospective case series study involving 16 patients with two failing or missing central incisors in the maxillary aesthetic region. The protocol consists of five options depending on whether teeth are still present (options 1-3) or not (options 4 and 5) and on the amount of bone available at the start of treatment: (1) extraction followed by immediate implant placement and provisionalization, (2) extraction followed by immediate implant placement and delayed provisionalization, (3) extraction followed by ridge preservation, delayed implant placement and immediate provisionalization, (4) delayed implant placement and guided bone regeneration with delayed provisionalization, (5) guided bone regeneration (extensive bone augmentation of the alveolar ridge), delayed implant placement, and delayed provisionalization. The patients were assessed regarding peri-implant hard and soft tissue parameters, aesthetic index score, and patient satisfaction. All treatment options showed good clinical and radiographic results and high patient satisfaction.
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Ruales-Carrera E, Engler MLPD, Vaz P, Özcan M, Volpato CAM. Esthetic and functional rehabilitation of bilateral congenital absence of maxillary lateral incisors: Minimally invasive surgical and prosthetic approach. J ESTHET RESTOR DENT 2018; 31:5-12. [PMID: 30499164 DOI: 10.1111/jerd.12448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/22/2018] [Accepted: 10/24/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an esthetic and functional restorative treatment. Noninvasive treatments, that are in accordance with the patients' expectations, should be the first therapeutic alternative. If the deciduous tooth is present, minimally invasive dental extraction followed by immediate dental implant placement and provisional restoration is indicated. In this restorative treatment, an adequate emergency profile can be achieved by peri-implant soft-tissue-conditioning techniques. Moreover, the association of restorative materials, such as composite resins and dental ceramics, provides more predictable esthetic results. CLINICAL CONSIDERATIONS The present case report presents a rehabilitation of bilateral congenital absence of maxillary lateral incisors through a multidisciplinary approach. Dental implants, long-term provisional restoration, tooth bleaching, minimally veneered high-translucent monolithic zirconia crowns, feldspathic veneers, and composite restorations were used by the dental team to achieve the expected functional and esthetic outcomes. CONCLUSIONS Different treatment modalities are available for the rehabilitation of congenital absence of teeth. However, it is important that a dental team consider performing minimally invasive treatments, as many of these treatments are done on young patients. CLINICAL SIGNIFICANCE Patient-centered treatments involving minimally invasive approaches in a multidisciplinary environment would be appropriate in order to achieve predictable results.
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Affiliation(s)
- Edwin Ruales-Carrera
- Department of Dentistry, Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianópolis, Brazil
| | - Madalena Lucia Pinheiro Dias Engler
- Department of Dentistry, Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianópolis, Brazil
| | - Paula Vaz
- Department of Orofacial Genetics, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Mutlu Özcan
- Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, University of Zurich, Zurich, Switzerland
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Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: A systematic review. Clin Oral Implants Res 2018; 29 Suppl 16:106-134. [PMID: 30328194 DOI: 10.1111/clr.13276] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To systematically review the evidence for the clinical outcome of fixed implant prostheses treated with different combinations of implant placement and loading protocols in partially edentulous patients. MATERIALS AND METHODS An electronic search was performed in Medline, Embase, and Central to identify studies investigating the outcome of implants subjected to immediate placement + immediate restoration/loading (Type 1A), immediate placement + early loading (Type 1B), immediate placement + conventional loading (Type 1C), early placement + immediate restoration/loading (Type 2-3A), early placement + early loading (Type 2-3B), early placement + conventional loading (Type 2-3C), late placement + immediate restoration/loading (Type 4A), late placement + early loading (Type 4B), late placement + conventional loading (Type 4C) with implant-supported fixed dental prostheses (IFDPs) in partially edentulous patients. Only human studies with at least 10 cases and a minimum follow-up time of 12 months, reporting on solid-screw-type implants with rough surfaces and an intra-osseous diameter between 3 and 6 mm, were included. A cumulative survival rate for each type of the implant placement and loading protocols was weighted by the duration of follow-up and number of implants. RESULTS The search provided 5,248 titles from which 2,362 abstracts and 449 full-text articles were screened. A total of 69 publications that comprised 23 comparative studies (15 randomized controlled trials, 7 controlled clinical trials) and 47 noncomparative studies (34 prospective cohort studies, 13 retrospective cohort studies) were included for analysis. Considerable heterogeneity in study design was found, and therefore, a meta-analysis of controlled studies was not possible. The weighted cumulative survival rate of each type of placement and loading protocol was 98.4% (Type 1A), 98.2% (Type 1B), 96.0% (Type 1C), 100% (Type 2-3B), 96.3% (Type 2-3C), 97.9% (Type 4A), 98.3% (Type 4B), and 97.7% (Type 4C). Type 1C, Type 2-3C, Type 4B, and Type 4C were scientifically and clinically validated (SCV). Type 1A, Type 1B, and Type 4A were clinically documented (CD), and Type 2-3A and Type 2-3B were clinically insufficiently documented (CID). CONCLUSIONS Evaluating outcomes in oral implantology by combining the placement and loading protocols are paramount. The selected loading protocol appears to influence the outcome of immediate implant placement.
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Affiliation(s)
- German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Wenjie Zhou
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
- Second Dental Clinic, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Stephen Chen
- Melbourne Dental School, The University of Melbourne, Melbourne, Vic., Australia
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Digital workflow to provide an immediate interim restoration after single-implant placement by using a surgical guide and a matrix-positioning device. J Prosthet Dent 2018; 121:17-21. [PMID: 30093118 DOI: 10.1016/j.prosdent.2018.03.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 11/24/2022]
Abstract
This article describes a workflow based on a top-down approach to provide a fixed-type immediate interim restoration after placing a single implant using a digitally driven surgical guide and a matrix-positioning device. A characteristic of the technique is that both the surgical guide and the matrix-positioning device are fabricated from a single diagnostic virtual trial restoration designed on computer-aided design (CAD) software. This workflow may shorten the time required for chairside placement of an interim restoration and enhance esthetics when rehabilitating anterior teeth.
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van Nimwegen WG, Raghoebar GM, Zuiderveld EG, Jung RE, Meijer HJA, Mühlemann S. Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: A 1-year randomized controlled trial and volumetric study. Clin Oral Implants Res 2018; 29:671-678. [PMID: 29806181 PMCID: PMC6099353 DOI: 10.1111/clr.13258] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2018] [Indexed: 11/29/2022]
Abstract
Objective To volumetrically compare peri‐implant mid‐facial soft tissue changes in immediately placed and provisionalized implants in the aesthetic zone, with or without a connective tissue graft. Material and methods Sixty patients were included. All implants were placed immediately after extraction. After randomization, in one group, a connective tissue graft (test group, n = 30) was inserted at the buccal aspect of the implant. The other group (control group, n = 30) received no connective tissue graft. Clinical parameters, digital photographs and conventional impressions were obtained before extraction (Tpre) and at 12 months following definitive crown placement (T12). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between Tpre and T12. Results Twenty‐five patients in each group were available for analysis at T12. Volumetric change, transformed to a mean (±SD) change in thickness, was −0.68 ± 0.59 mm (test) and −0.49 ± 0.54 mm (control) with a non‐significant difference between groups (p = .189). The mid‐facial mucosa level was significantly different between both groups (p = .014), with a mean (±SD) change of +0.20 ± 0.70 mm (test) and −0.48 ± 1.13 mm (control). The Pink Esthetic Score was similar between both groups. Conclusions The use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12 months, leading to the assumption that a CTG cannot fully compensate for the underlying facial bone loss, although a significantly more coronally located mid‐facial mucosa level was found when a CTG was performed.
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Affiliation(s)
- Wouter G van Nimwegen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elise G Zuiderveld
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald E Jung
- Department of Fixed and Removable Prosthodontics and Dental Material Science, School of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sven Mühlemann
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, Zurich, Switzerland
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Stefanini M, Felice P, Mazzotti C, Mounssif I, Marzadori M, Zucchelli G. Esthetic evaluation and patient-centered outcomes in single-tooth implant rehabilitation in the esthetic area. Periodontol 2000 2018; 77:150-164. [DOI: 10.1111/prd.12215] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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