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Zhang S, Sun Y, Huang C, He D. Correlation between differences in intraoperative jumping gaps and soft tissue changes around immediate implant placement and provisionalization in the maxillary anterior region. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2023; 41:678-685. [PMID: 38597033 PMCID: PMC10722462 DOI: 10.7518/hxkq.2023.2023153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 10/04/2023] [Indexed: 04/11/2024]
Abstract
OBJECTIVES This study aims to evaluate the correlation between differences in intraoperative jumping gaps and soft tissue changes around immediate implant placement and provisionalization (IIPP) in the maxillary anterior region. Results will provide a basis for clinical evaluation of the change trend and long-term stability of the labial soft tissue contours of patients with different jumping gaps. METHODS Thirty-two patients with single tooth loss in the maxillary aesthetic area were enrolled, and they all received immediate implant placement and restoration. All patients were divided into three groups: A, B, and C according to the size of the jumping gap, group A: horizontal defect dimension (HDD) ≤2 mm; group B: 2 mm3 mm. Geomagic studio 2013 was used to quantitatively analyze the contour volume of the soft tissue around the implant and the level of the labial gingival margin. The pink esthetic score (PSE) was used for the final aesthetic evaluation. RESULTS All implants had osseointegration within 6 months after the surgery. The average thickness of soft tissue contour volume changed by 0.62 mm±0.15 mm, and the average PES was 11.09±0.99. The changes in the gingival mucosa levels in the three groups at 6 months after operation were 0.45 mm±0.11 mm, 0.40 mm±0.12 mm, and 0.35 mm± 0.11 mm, respectively. The changes in the average thickness of the soft tissue contour volume in the three groups at 6 months after the operation were 0.77 mm±0.16 mm, 0.63 mm±0.17 mm, and 0.54 mm±0.11 mm. A moderate negative correlation was found between the jumping gap size and the gingival mucosa level, and the average thickness changed. No significant correlation was found between size of jumping gap and PES. CONCLUSIONS Although the contour volume of the labial soft tissue continuously decreased within 6 months after IIPP in the maxillary anterior region, the surgical procedure can achieve a satisfactory aesthetic effect, and the level of soft tissue around the implant can be well maintained.
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Affiliation(s)
- Sui Zhang
- Dept. of Implantology, Xiangyang Stomatological Hospital, Affiliated Stomatological Hospital of Hubei University of Arts and Science, Xiangyang 441000, China
| | - Yi Sun
- Dept. of Implantology, Xiangyang Stomatological Hospital, Affiliated Stomatological Hospital of Hubei University of Arts and Science, Xiangyang 441000, China
| | - Changbo Huang
- Dept. of Implantology, Xiangyang Stomatological Hospital, Affiliated Stomatological Hospital of Hubei University of Arts and Science, Xiangyang 441000, China
| | - Dongning He
- Dept. of Implantology, Shanxi Medical University School and Hospital of Stomatology, Key Laboratory of Oral Diseases Prevention and New Materials in Shanxi Province, Taiyuan 030001, China
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Wu XY, Shi JY, Buti J, Lai HC, Tonetti MS. Buccal bone thickness and mid-facial soft tissue recession after various surgical approaches for immediate implant placement: A systematic review and network meta-analysis of controlled trials. J Clin Periodontol 2023; 50:533-546. [PMID: 36632002 DOI: 10.1111/jcpe.13771] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/03/2023] [Accepted: 01/07/2023] [Indexed: 01/13/2023]
Abstract
AIM To evaluate the relative efficacy and confidence in the precision of the results of different surgical interventions for immediate implant placement in the anterior area. MATERIALS AND METHODS Electronic searches were performed in PubMed, Embase, and Cochrane CENTRAL. Randomized controlled trials comparing different surgical techniques in anterior jaws for type 1 implant placement were included. Outcome measures included implant survival (primary outcome), buccal bone thickness (BBT) reduction, and mid-facial soft tissue recession (MSTR). Risks of bias assessment, network meta-analysis (NMA), sensitivity analysis, and quality-of-evidence assessment were performed. RESULTS Twenty-two studies reporting on 948 subjects and 5 surgical interventions were included. Fourteen early failures were reported. Compared with open-flap surgery without tissue augmentation (F-N) and looking at BBT preservation, NMA showed that there was moderate confidence that flapless surgery with hard tissue augmentation (FL-HTA) was better than flapless surgery without tissue augmentation (FL-N) or open-flap surgery with hard tissue augmentation (F-HTA) (mean difference -0.8 mm, 95% confidence interval: -1.1 to -0.5 mm; -0.6 mm, -0.9 to -0.4 mm; and -0.5 mm, -0.7 to -0.3 mm, respectively). There was moderate confidence that flapless surgery with hard and soft tissue augmentation (FL-HTA&STA) could significantly prevent MSTR compared with FL-HTA (-0.5 mm, -0.7 to -0.3 mm) and FL-N (-0.6 mm, -1.2 to -0.04 mm). However, there was no significant additional benefit in BBT with the FL-HTA&STA approach compared to the FL-HTA approach (-0.30 mm, -0.81 to 0.21 mm). CONCLUSIONS For immediate implant placement in the anterior areas, the FL-HTA approach better preserves BBT (moderate confidence); adding STA improves the stability of the mid-facial soft tissue level (moderate confidence) but at the expense of BBT (low confidence).
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Affiliation(s)
- Xin-Yu Wu
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun-Yu Shi
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jacopo Buti
- Unit of Periodontology, University College London, Eastman Dental Institute, London, UK
| | - Hong-Chang Lai
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- European Research Group on Periodontology, Genoa, Italy
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Fettouh AIA, Ghallab NA, Ghaffar KA, Mina NA, Abdelmalak MS, Abdelrahman AAG, Shemais NM. Bone dimensional changes after flapless immediate implant placement with and without bone grafting: Randomized clinical trial. Clin Implant Dent Relat Res 2023; 25:271-283. [PMID: 36596471 DOI: 10.1111/cid.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Immediate implant in postextraction sockets requires managing the postextraction alveolar resorption. This randomized clinical trial examined vertical and horizontal changes 1-year following flapless immediate implant with and without xenograft at sites with thin labial plate. METHODS Forty patients with hopeless teeth in maxillary esthetic zone were randomly assigned to receiving either one immediate implant without bone graft (control) or with bone graft (intervention). Cone beam computed tomography (CBCT) scans were obtained pre-extraction and 1-year postoperatively to measure thickness and dimensional changes of the labial bone. RESULTS Cone beam computed tomography measurements revealed that a xenograft, when compared to no xenograft, led to 0.2 mm increased fill of the horizontal gap (95% confidence interval (CI): -1.1, 0.7). In both groups, there was a significant reduction in the labio-palatal bone width after 1 year compared to baseline (P ≤ 0.05). There was no significant difference (P > 0.05) between the xenograft when compared to no xenograft regarding the labio-palatal bone collapse % at 0 mm (-0.2, 95% CI: -4.8, 4.5) and 2 mm apical to the labial crest (1.9, 95% CI: -1.8, 5.6). While at 5 mm the ridge was significantly reduced (P ≤ 0.05) in the no xenograft when compared to xenograft (4.5, 95% CI: 0.7, 8.2). The xenograft when compared to no xenograft, led to 1.1 mm less vertical bone changes (95% CI: 0.4, 1.9). Both groups revealed significant positive correlation between labio-palatal socket dimension and bone formed labial to the implant (P ≤ 0.05). [Correction added on 7 February 2023, after first online publication: In the 8th line of this section, the word "collapse" was changed to "ridge" in this version.] CONCLUSION: This investigation suggested that immediate implants with or without grafting the labial gap preserved alveolar bone dimension and that bone formation labial to the implant was related to initial labio-palatal socket dimension.
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Affiliation(s)
- Ahmed Ibrahim Aboul Fettouh
- Implant Specialty Program, Continuing Education Center, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | - Noha A Ghallab
- Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Khaled Abdel Ghaffar
- Oral Medicine and Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Nael Adel Mina
- Private Practice, BDS Misr International University, Cairo, Egypt
| | | | | | - Nesma Mohamed Shemais
- Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Giza, Egypt
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Zigmantavičius J, Kilinskaitė G, Leketas M. Dimensional Changes of Buccal Bone after Immediate Implantation Using Different Grafting Materials: A Systematic Review. ANNALS OF DENTAL SPECIALTY 2023. [DOI: 10.51847/vykvdvpn8e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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MeshkatAlsadat M, Hassani A, Bitaraf T, Salmasi SC. Dimensional changes of peri-implant tissue following immediate flapless implant placement and provisionalization with or without xenograft in the anterior maxilla: a study protocol for a randomized controlled trial. Trials 2022; 23:960. [DOI: 10.1186/s13063-022-06918-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/11/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Background
Dental implant therapy requires the preservation of peri-implant tissue in the cosmetic zone. Various surgical procedures have been presented, including ridge preservation, flapless method, and quick provisionalization. The goal of this research was to assess the buccal bone dimensional changes following immediate flapless implant implantation in the front maxilla, with or without xenografting.
Method and design
Thirty patients who meet the inclusion criteria and have maxillary teeth (numbers 14 to 24) are candidates for the immediate implant with immediate provisionalization. Participants will be assigned randomly to one of two groups: (1) an immediate implant with xenograft and (2) an immediate implant without bone grafting. For 3 months, the temporary prosthesis will be installed shortly before the final restoration. Following temporary prosthesis insertion and 6 months after surgery, a CBCT radiograph will be used to examine bone tissue. Soft tissue will be assessed at three points: baseline, 3 months, and 6 months following implant therapy. Patients’ satisfaction, implant failure, prosthesis failure, and complications will be assessed as secondary outcomes after 6 months.
Discussion
The outcomes of this randomized clinical research will show if buccal bone augmentation with xenograft reduces vertical bone and gingiva recession. The findings and patient-reported outcomes will aid in the selection of therapy alternatives for implant treatment patients.
Trial registration
Iranian Registry of Clinical Trials IRCT20211119053106N1. Registered on 6 December 2021 and Open Science Framework (OSF) on May 20, 2022. Registration DOI https://doi.org/10.17605/OSF.IO/VUGFQ.
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Seyssens L, Eeckhout C, Cosyn J. Immediate implant placement with or without socket grafting: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:339-351. [PMID: 35313067 DOI: 10.1111/cid.13079] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/19/2022] [Accepted: 02/18/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP). MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible. RESULTS Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made. CONCLUSION SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
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Affiliation(s)
- Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Célien Eeckhout
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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An MK, Kim HJ, Choi JU, Kim KH, Lee YM, Rhyu IC, Seol YJ. The healing pattern of a 4 mm proximal infrabony defect was not significantly different from a 2 mm defect adjacent to dental implant in a canine mandible. J Periodontal Implant Sci 2022; 52:422-434. [PMID: 36302648 PMCID: PMC9614175 DOI: 10.5051/jpis.2106420321] [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] [Received: 12/16/2021] [Revised: 03/30/2022] [Accepted: 04/20/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose The purpose of this study was to evaluate and compare the healing patterns of 2-mm and 4-mm proximal infrabony defects adjacent to dental implants in canine mandibles. Methods Four male beagles were used. Two groups were created: a 2-mm group (n=4) and a 4-mm group (n=4) depending on the horizontal dimension of proximal infrabony defects adjacent to implants. Bone healing patterns between the 2 groups were evaluated and compared at 8 and 16 weeks using radiographic, histological, histomorphometric, and fluorescent labelling analyses. Results According to microcomputed tomography, the median bone volume fraction, bone mineral density, and the percentage of radiographic distance from the defect bottom to the most coronal bone-to-implant contact (radio-mcBIC) were 32.9%, 0.6 g/cm3, and 73.7% (8 weeks) and 45.7%, 0.7 g/cm3, and 76.0% (16 weeks) in the 2-mm group and 57.7%, 0.8 g/cm3, and 75.7% (8 weeks) and 50.9%, 0.8 g/cm3, and 74.7% (16 weeks) in the 4-mm group, respectively. According to histomorphometry, the median bone area fraction, mcBIC and the percentage of BIC amounted to 36.7%, 3.4 mm, and 58.4% (8 weeks) and 49.2%, 3.4 mm, and 70.2% (16 weeks) in the 2-mm group and 50.0%, 3.0 mm, and 64.8% (8 weeks) and 55.7%, 3.0 mm, and 69.6% (16 weeks) in the 4-mm group, respectively. No statistically significant differences were found between the groups for any variables (P>0.05). Conclusions The proximal defects that measured 2 mm and 4 mm showed similar healing patterns at 8 and 16 weeks, and the top of bone formation in the defects was substantially limited to a maximum of 1.6 mm below the implant shoulder in both groups.
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Affiliation(s)
- Min Kuk An
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun Ju Kim
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
- Department of Periodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Jin Uk Choi
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyoung-Hwa Kim
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - In-Chul Rhyu
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Safi Y, Amid R, Kadkhodazadeh M, Mortazavi H, Sharifi MP, Gandomi S. Bone quality and quantity of the mandibular symphyseal region in autogenous bone grafting using cone-beam computed tomography: a cross-sectional study. Head Face Med 2021; 17:26. [PMID: 34253223 PMCID: PMC8273950 DOI: 10.1186/s13005-021-00282-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bone volume plays a pivotal role in the success of dental implant treatment. Autogenous bone grafts should be harvested from reliable sites in the maxillofacial region. This study sought to assess the quantity and quality of bone in the mandibular symphysis for autogenous bone graft harvesting using cone-beam computed tomography (CBCT). METHODS This cross-sectional study evaluated the CBCT scans of 78 adults presenting to three oral and maxillofacial radiology centers. The vertical (VD) and horizontal (HD) alveolar bone dimensions, cortical thickness (CT), and cancellous to cortical bone ratio (C/C) were measured in the interforaminal region of the mandible at the sites of central incisor to first premolar teeth. The interforaminal distance (ID) and the anterior loop length were also measured. Nonparametric statistical tests were used to analyze the data with respect to sex, age, and tooth position. RESULTS The median VD, HD, and CT of the symphysis were 20.21 (3.26), 4.13 (0.37), and 2.25 (0.23) mm, respectively. The median C/C was 1.51 (0.11). The median ID was 52.24 (8.24) mm, and the median anterior loop length was 1.82 (1.06) mm. Significant differences were observed in all parameters among different teeth. Most of the measured parameters were greater in males compared with females. There were significant differences in ID, VD, and CT between different age groups. CONCLUSIONS The quantity and quality of the available bone in the mandibular symphysis for bone graft harvesting vary by gender, age, and harvesting site, necessitating careful preoperative evaluation.
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Affiliation(s)
- Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shiva Gandomi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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