Owing to volumetric changes after tooth extraction, lateral ridge augmentation has become a common procedure prior or simultaneous to implant placement. Nonetheless, little is known with regard to the dimensional remodeling after healing of these lateral ridge augmentation procedures. Hence, the purpose of this systematic review was to assess the stability of bone grafting material between augmentation procedures and final healing, in terms of resorption rate. Materials and Methods: An electronic and hand literature search was conducted in several databases, such as the Cochrane Oral Health Group Trials Register, Embase, and Cochrane Central Register of Controlled Trials, up until February 2017. Only randomized controlled trials (RCTs) with a mean follow-up of at least 6 months after implant placement aiming to evaluate the stability of grafting material for lateral ridge augmentation were included and quantitatively analyzed. Results: A total of 35 articles were evaluated; however, only 17 RCTs met the inclusion criteria. A total of 15 studies reported information on bone resorption, leading to a total sample of 304 implants. The estimated overall mean horizontal bone gain at the time of regeneration was 3.71 ± 0.24 mm, with 4.18 ± 0.56 mm for the block graft technique and 3.61 ± 0.27 mm for guided bone regeneration (GBR). The estimated overall net bone gain at final re-evaluation (11.9 ± 7.8) was 2.86 ± 0.23 mm. The estimated mean (± SD) resorption after 6 months was 1.13 ± 0.25 mm, with 0.75 ± 0.59 mm for the block graft technique and 1.22 ± 0.28 mm for GBR. The implant survival rate was 97% to 100%. Conclusion: Regardless of the material used for regeneration, different degrees of graft resorption should be expected. Given the sample of investigations analyzed in this review, block grafts seemed to maintain the volume of the initial augmentation site more than GBR techniques. During the initial stages of healing, the GBR technique experienced more changes compared with block grafts. The resorption of the xenograft group was inferior compared with the combination of xenograft and autologous bone groups. Consequently, overcorrection of the horizontal defects should be performed to compensate for the resorption of the grafting materials.
Trauma is a worldwide cause of millions of deaths and severe injuries every year, all over the world. Despite the limited extension of the oral region compared to the whole body, dental and oral injuries account for a fairly high percentage of all body traumas. Among head and neck traumas, dental and facial injuries are highly correlated to sport activities, and their management can be a real challenge for practitioners of any specialty. In case of trauma directed to periodontal structures, restorative and endodontic solutions may not be sufficient to achieve a definitive and long-lasting treatment. This article aims to illustrate surgical options and appliances to prevent dental injuries that may be available to the clinicians treating dental trauma involving oral soft and hard tissues.
The surgical techniques available to clinicians to treat peri-implant diseases can be divided into resective and regenerative. Peri-implant diseases are inflammatory conditions affecting the soft and hard tissues around dental implants. Despite the large number of investigations aimed at identifying the best approach to treat these conditions, there is still no universally recognized protocol to solve these complications successfully and predictably. This review will focus on the regenerative treatment of peri-implant osseous defects in order to provide some evidence that can aid clinicians in the approach to peri-implant disease treatment.
Tooth loss after traumatic dental injuries (TDI) often requires rehabilitation with a multidisciplinary treatment plan. In growing patients, the therapeutic approach may be different than in adults; the scientific literature offers alternative solutions even if they involve long, complex and uncomfortable treatments. Among the possible therapeutic options, implant-prosthetic treatment through the use of mini-implants is presented in this complex case report with a 14-year follow-up.
Introduction
A size increase of the gingiva can be a manifestation of gingival disease. While gingival lesions can affect periodontal tissue, only few reports described the association between peripheral giant‐cell granuloma (PGCG) with dental implants and their clinical management. Their clinical relevance is of a great interest since some lesions may lead to extensive bone resorption, esthetic alterations, or even tooth/implant loss. To the author's best knowledge, no specific guidelines for the treatment of PGCG affecting dental implant in the esthetic zone have been reported. The aim of this paper was to report an extensive PGCG associated with a dental implant in the esthetic area and its surgical management.
Case Presentation
A 39‐year‐old suffered from concussive trauma on her anterior maxillary dentition leading to an expanded, purplish soft tissue lesion surrounding the implant provisional crown on right central maxillary incisor. After complete lesion excision, the implant neck was carefully and gently debrided. Histological analysis confirmed the diagnosis of PGCG. The patient was then evaluated weekly for the first 3 weeks then monthly. No episodes of recurrence were identified. After 16 weeks of undisturbed healing, a soft tissue augmentation via tunnel technique was elected as the first treatment option to improve esthetics. Final implant restoration was delivered. Follow up at 22 months from biopsy excluded any recurrence of PGCG with stability of peri‐implant soft tissues.
Conclusion
Excisional biopsy, careful removal of irritating factors, monitoring, and connective tissue grafting can esthetically improve a malpositioned implant and showed no recurrence over a period of 22 months.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.