This paper describes a retrospective study in which the gingival and periodontal status was assessed at crowned and natural teeth. 510 crowned teeth and 510 natural teeth in 109 subjects were examined. The time elapsed between active therapy and the clinical examination was: (i) 1 to 3 years for 270 teeth; (ii) 3 to 5 years for 168 teeth; (iii) 6 to 9 years for 72 teeth. 90% of the patients were on a recall schedule that required prophylaxis once every 3 months; 8% returned every 6 months and 2% once a month. Plaque index and gingival index were assessed at 4 sites per tooth and pocket depth at 6 sites per tooth, the highest reading per tooth being used for the statistical analysis. The results indicated that there was no difference in plaque and gingival indices between crowned and natural teeth. In addition, the gingival status of the crowned teeth was good, irrespective of the position of the crown margin (subgingival, at the gingival margin or supragingival).
Computer-guided software and kits have significantly improved the clinical applications of implant surgery. Nonetheless, some technical problems are still in evidence during clinical procedures because of cumbersome surgical tools that can limit access to implant sites, mainly in posterior areas of the mouth in the presence of bulky anatomical structures and in patients with reduced mouth-opening capacity. The present paper aimed to present a novel approach to guided implant surgery, describing the technical characteristics of an innovative guided surgical kit made up of modified sleeves and modular surgical drills. The proposed guided surgical kit is based on a novel patented system of sleeves and modular burs, with an increased length of the metal sleeves and a reduced height of the drills. The innovative design of the proposed system would allow the clinician to position guided fixtures in all clinical situations; the reduced encumbrance would be particularly helpful to gain access to the posterior areas of both maxilla and mandible, which have limited inter-arch space, with an easy and user-friendly approach. The modular system could overcome anatomical limitations, such as reduced mouth-opening capacity, and permit clinicians to maintain the stability and integrity of the surgical templates, even in cases where there is very limited intermaxillary space.
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