According to the standard protocol, a load-free healing period is one of the most emphasized requirements for implant integration. Recent studies have encouraged a progressive shortening of the healing period for single-tooth implants and immediate loading has been proposed for the aesthetic zone in the maxilla. The present study evaluated clinical outcomes of immediately loaded FRIALIT-2 Synchro implants 12 months after placement in the maxillary incisal region. In the course of our investigation, nine patients have been treated following an immediate loading protocol. The stepped-screw type implants were inserted with an increasing torque up to 45 Ncm, thus measuring the primary stability of the implants. All implants were immediately restored with unsplinted acrylic resin provisional crowns and the patients provided with occlusal splints. Regular controls were performed at monthly intervals, intraoral radiographs were taken directly after implant placement, 6 and 12 months post insertion. The survival rate, clinical stability (Periotest) and radiographic coronal bone defects (CBD) were evaluated at delivery of the definitive superstructures (CBD 6) and 6 months later (CBD 12). Twelve FRIALIT-2 Synchro stepped screws of 3.8, 4.5 and 5.5 mm diameter and 13 and 15 mm length were placed in the incisal maxillary region. The median Periotest value 6 months post insertion was -2 with a minimum of -5 and a maximum of +2. The mean coronal bone level changes (CBD) at 6 and 12 months were 0.45 and 0.75 mm. No implant failed up to 12 months after insertion, resulting in a 100% survival rate. The presented results showed promising data for immediately loaded single-tooth implants in the anterior maxilla. Periotest values were within the range published for submerged implants. The radiographic coronal bone resorption after 6 and 12 months was even less than evaluated for implants placed in a standard two-stage procedure. It is evident that successful immediate loading protocols require a careful and strict patient selection aimed at achieving the best primary stability and avoiding any excessive functional or non-functional loading. Additional research needs to be done to provide data in situations where problems of poor bone quality, multiple implants or augmentation procedures must be overcome.

– Fifty‐eight traumatically intruded and mainly surgically extruded permanent teeth were followed up for 3 years and 4 months (mid‐term results: 29 teeth) and 9 months (short‐term results: 29 teeth) on average. Statistically, the mid‐term results showed more cases of severe crown discoloration (54%) than the short‐term results (9%), but no difference in pulpal and periodontal healing. Three teeth (5%) were lost. Factors which positively influenced pulpal healing were shallow intrusion depth, intact crown and immaturity of the root. Factors which positively influenced periodontal healing were shallow intrusion depth and minimal surgical manipulation. Alveolar bone healing was positively influenced only by shallow intrusion depth.

Since platelet -rich plasma (PRP) has been introduced to the field of oral surgery, it has become a widely accepted additive for bone regeneration treatment. The aim of this study was to evaluate the regenerative capacity of PRP in a sinus graft study on sheep. Twelve adult sheep underwent a bilateral sinus floor elevation procedure with cancellous bone from the iliac crest. Unilaterally, PRP was administrated to the bone graft. After 4 (six sheep) and 12 weeks (six sheep), bone biopsies were obtained from each site. With histomorphometric analysis we evaluated both the percentage of newly formed bone within the grafted site and the percentage of the contact area between the grafted bone and the newly formed bone. After 4 weeks the mean proportion of newly formed bone on the control side was 26.1%, whereas it was 29.2% on the test side. After 12 weeks it was 46.9% on the control side and 51.1% on the test side. The area of contact between the graft and the newly formed bone was 73.0% on the control side and 78.5% on the test side after 4 weeks, and 87.2% on the control side and 90.1% on the test side after 12 weeks. A statistical analysis did not reveal significant differences between the control and the test side. The results of the present experimental study show a regenerative capacity of PRP of quite low potency. Further basic research is needed to investigate more profoundly the possibilities of PRP in bone regeneration.

No abstract

The purpose of this study was to evaluate the benefits of replanting avulsed permanent teeth in different age groups. Of the 112 replanted teeth, 103 could be examined after 2.5 years on average. The teeth were divided into three groups: immature teeth (group A), mature teeth in children and adolescents (group B), and mature teeth in adults (group C). Concomitant injuries did not differ statistically between the groups. Extra-alveolar time with unphysiologic storage was longer than 15 min in 81 teeth. The results were statistically different for pulpal healing (A >> B > C), loss of marginal bone (C > A), amount of replacement resorption (A and B > C), alveolar growth inhibition (A > B >> C), local gingivitis (B > A and C) and buccal gingival retraction (C > A and B). Only 3 of 23 extracted teeth were lost because of replacement resorption alone. Only 2 of the 23 extracted teeth showed revascularization of the pulp. The results suggested that replanting avulsed teeth should be considered a temporary solution in children and adolescents. In these patients, the benefit of tooth replantation is mainly the time gained to establish an optimal treatment plan. Mature teeth with a necrotic periodontal ligament replanted in children before the pubertal growth spurt seemed to have the poorest prognosis.

In 103 posttraumatic splints, later tooth mobility was measured with Periotest immediately before and after the routine splint removal. The splints were made of composite resin and an 0.017 X 0.025" orthodontic steel wire. 481 teeth were measured. A statistic evaluation revealed that the immobilisation effect did not exceed normal tooth firmness. Fixation to one neighbouring tooth had less effect than fixation to two. Adjacent tooth gaps reduced the effect. Splint extensions had no influence. With the use of the Periotest device, more than 50% of all teeth with a true mobility of 20 Periotest-units or more were detectable as mobile in spite of the fixed splint.

The data corroborate the thesis that periodontitis patients with inadequate stress behavior strategies (defensive coping) are at greater risk for severe periodontal disease. However, further investigations are required to confirm the significance of inappropriate coping styles with respect to the advancement of periodontal disease.

Autogenous bone is the gold standard graft for sinus augmentation. The harvest of autogenous bone grafts from intraoral sites does often not provide sufficient bone volume and quality. A modified technique of harvesting a tibial cancellous graft is presented. With a micro-bone saw, a bony lid is prepared at the medial condyle of the tibia. The lid stays attached to the tendinous pes anserinus. Following the harvest, the lid is repositioned accurately. This method offers some distinct advantages. A sufficient amount of biologically highly valuable cancellous bone may be harvested for sinus grafting and possibly other surgeries with bone augmentation. The procedure may be performed under local anaesthesia and does not require hospitalisation. Neither major complications nor serious postoperative morbidity were observed.