Implant Site Development Using Titanium Mesh in the Maxilla: A Retrospective Study of 58 Mesh Procedures in 48 Patients.

This article presents a retrospective case series of implant site development using titanium mesh (Ti-mesh) in the maxilla. A total of 58 mesh procedures in combination with several different bone grafts (allograft, cellular allograft, and bovine xenograft) and biologics (including recombinant human platelet-derived growth factor, autogenous platelet-rich growth factor, and recombinant human bone morphogenetic protein-2) were performed in 48 patients. Ti-mesh guided bone regeneration procedures were performed 2 to 3 months after extraction of nonrestorable/hopeless teeth, and the implants were placed 6 to 8 months postaugmentation.

A Prospective Clinical Study on Implant Survival at 1-Year Post-Loading of a Bone-Level Tapered Implant in Private Practice: Multicentered Study.

This non-interventional study evaluated the implant survival and success of a new bone-level tapered implant design in seven private dental practices in the United States. One hundred subjects in need of implant(s) were enrolled according to all cleared indications. After implant surgery, subjects were followed for a period of 1-year post-loading.

Use of Soft-Tissue and Bone Grafting to Treat Complex Recession With Root Prominence and Buccal Plate Deficiencies.

Beyond the traditional monotherapy of connective tissue grafting, the combination of orthodontic therapy, soft-tissue grafting, and bone grafting with biologics may provide ideal treatment for complex recession defects with root prominence, thin tissues, and buccal plate dehiscences. The authors propose the benefits of performing a preoperative evaluation of complex mucogingival defects with cone-beam computed tomography (CBCT) technology and then considering surgical management with modalities like bone grafting and orthodontics in addition to the classic soft-tissue grafting approach. Regeneration of the complete periodontium may result in better long-term soft-tissue stability and tooth retention following treatment of complex recession cases.

Implant Site Development Using Ti-Mesh and Cellular Allograft in the Esthetic Zone for Restorative-Driven Implant Placement: A Case Report.

This article presents a case report of implant site development in a healthy, nonsmoking 62-year-old man using titanium mesh (Ti-mesh) in conjunction with human cellular allograft for ridge augmentation of a type 4 alveolar ridge defect. The patient presented initially with a severely periodontally abscessed maxillary right central incisor probing to the apex. The tooth was extracted, and after 8 weeks a bone reconstructive procedure was completed using a well-stabilized Ti-mesh and cellular allograft that was covered with a quickly resorbing collagen matrix.

Emerging Regenerative Approaches for Periodontal Reconstruction: Practical Applications From the AAP Regeneration Workshop.

Focused Clinical Question: Can emerging technologies for periodontal regeneration become clinical reality? Summary: Emerging technologies are presenting options to hopefully improve the outcomes of regeneration in challenging clinical scenarios. Cellular allografts represent a current technology in which cells and scaffolds are being delivered directly to the periodontal lesion. Recombinant human fibroblast growth factor 2 and teriparatide (parathyroid 1-34) have each been tested in controlled prospective human randomized clinical trials, and both have been shown to have potential for periodontal regeneration.

Emerging regenerative approaches for periodontal reconstruction: a consensus report from the AAP Regeneration Workshop.

Background: Historically, periodontal regeneration has focused predominantly on bone substitutes and/or barrier membrane application to provide for defect fill and/or selected cell repopulation of the lesion. More recently, a number of technologies have evolved that can be viewed as emerging therapeutic approaches for periodontal regeneration, and these technologies were considered in the review paper and by the consensus group. The goal of this consensus report on emerging regenerative approaches for periodontal hard and soft tissue reconstruction was to develop a consensus document based on the accompanying review paper and on additional materials submitted before and at the consensus group session.

Evaluation of a variable-thread tapered implant in extraction sites with immediate temporization: a 3-year multicenter clinical study.

Background: The purpose of this clinical study is to evaluate the radiographic bone remodeling, survival rate, and soft tissue health surrounding a variable-thread tapered implant immediately placed in extraction sites.

Methods: Sixty implants were placed in 55 patients at six centers according to a predetermined protocol. All implants were placed in extraction sockets and were subjected to immediate temporization and function.

Two-year evaluation of a variable-thread tapered implant in extraction sites with immediate temporization: a multicenter clinical trial.

Purpose: The purpose of this clinical trial was to evaluate the survival rate, bone remodeling, and soft tissue health surrounding variable-thread tapered implants placed in fresh extraction sites and loaded immediately.

Materials And Methods: Sixty implants were placed in 55 patients at six centers according to a predetermined protocol. All implants were placed in extraction sockets and were subjected to immediate temporization.

Platelet-derived growth factor promotes periodontal regeneration in localized osseous defects: 36-month extension results from a randomized, controlled, double-masked clinical trial.

Background: Recombinant human platelet-derived growth factor (rhPDGF) is safe and effective for the treatment of periodontal defects in short-term studies up to 6 months in duration. We now provide results from a 36-month extension study of a multicenter, randomized, controlled clinical trial evaluating the effect and long-term stability of PDGF-BB treatment in patients with localized severe periodontal osseous defects.

Methods: A total of 135 participants were enrolled from six clinical centers for an extension trial.

Stem cell-containing allograft matrix enhances periodontal regeneration: case presentations.

Periodontal defects involving either interproximal horizontal bone loss or furcations continue to challenge the regenerative capabilities of the oral cavity. The following case presentations show the successful treatment of these challenging periodontal defects with a novel cellular allograft that contains native mesenchymal stem cells and osteoprogenitor cells.

Histologic and histomorphometric evaluation of an allograft stem cell-based matrix sinus augmentation procedure.

Purpose: Long-term success of dental implants has been demonstrated when placed simultaneously with or after a sinus augmentation procedure. However, optimal bone formation can be from 6 to 9 months or longer with grafting materials other than autogenous bone. For this reason, there is interest in any surgical technique that does not require autogenous bone harvesting, yet results in sufficient bone formation within a relatively short time frame.

Histologic evaluation of recombinant human platelet-derived growth factor-BB after use in extraction socket defects: a case series.

Recent advancements in the arena of therapeutic molecular enhancement have shown favorable clinical findings for periodontics. However, further studies to optimize clinical outcomes using this technology are warranted. Twelve premolar extraction sockets were assigned randomly for treatment with 0.

Human histologic evaluation of anorganic bovine bone mineral combined with recombinant human platelet-derived growth factor BB in maxillary sinus augmentation: case series study.

The objective of this proof-of-principle study was to examine the potential for improved bone regenerative outcomes in maxillary sinus augmentation procedures when recombinant human platelet-derived growth factor BB (0.3 mg/mL) is combined with particulate anorganic bovine bone mineral. The surgical outcomes in all treated sites were uneventful at 6 to 8 months, with sufficient regenerated bone present to allow successful placement of maxillary posterior implants.

Histologic evaluation of a stem cell-based sinus-augmentation procedure.

Background: Predictability has been demonstrated for the long-term success of dental implants placed simultaneously with or after a sinus-augmentation procedure. However, the time required to obtain optimal bone formation can be from 6 to 9 months or longer with grafting materials other than autogenous bone. For this reason, there is interest in a surgical technique that does not require the harvest of autogenous bone but still results in sufficient bone formation within a relatively short time frame.

Scalloped implant designs enhance interproximal bone levels.

Consecutively restored scalloped dental implants were evaluated radiographically and clinically. Radiographic evaluation of 16 two-piece scalloped implants and 9 one-piece scalloped implants revealed enhanced interproximal bone levels versus a nonscalloped conventional flat-top implant design. Based on the Jemt system for interproximal soft tissue level evaluation, 78% of the two-piece implants scored a 3 and 22% scored a 2, and 89% of the one-piece implants scored a 3 and 11% scored a 2.

Bone augmentation techniques.

Background: The advent of osseointegration and advances in biomaterials and techniques have contributed to increased application of dental implants in the restoration of partial and completely edentulous patients. Often, in these patients, soft and hard tissue defects result from a variety of causes, such as infection, trauma, and tooth loss. These create an anatomically less favorable foundation for ideal implant placement.

Effect of rhPDGF-BB on bone turnover during periodontal repair.

Purpose: Growth factors such as platelet-derived growth factor (PDGF) exert potent effects on wound healing including the regeneration of periodontia. Pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP) is a well-known biomarker of bone turnover, and as such is a potential indicator of osseous metabolic activity. The objective of this study was to evaluate the release of the ICTP into the periodontal wound fluid (WF) following periodontal reconstructive surgery using local delivery of highly purified recombinant human PDGF (rhPDGF)-BB.

Platelet-derived growth factor stimulates bone fill and rate of attachment level gain: results of a large multicenter randomized controlled trial.

Background: Growth factors are generally accepted to be essential mediators of tissue repair via well-established mechanisms of action that include stimulatory effects on angiogenesis and cellular proliferation, ingrowth, differentiation, and matrix biosynthesis. The aim of this study was to evaluate in a large-scale, prospective, blinded, and randomized controlled clinical trial the safety and effectiveness of purified recombinant human platelet-derived growth factor (rhPDGF-BB) mixed with a synthetic beta-tricalcium phosphate (beta-TCP) matrix for the treatment of advanced periodontal osseous defects at 6 months of healing.

Methods: Eleven clinical centers enrolled 180 subjects, each requiring surgical treatment of a 4 mm or greater intrabony periodontal defect and meeting all inclusion and exclusion criteria.