Simplifying Implant Planning and Placement in the Fully Edentulous Arch With In-Office Guide Fabrication.

A geometric approach is presented that allows in-office planning with linear and angle corrections and surgical guide fabrication, simplifying the process when treating a fully edentulous arch.

Utilization of Ultrashort Bicon Implants in Clinical Situations: A Retrospective Case Series.

When vertical bone loss results in insufficient crestal height to place standard-length implants without the use of osseous grafting, this poses clinical issues to implant usage. Based on an analysis of the literature and clinical experience, it has been found that it is possible to optimally use the available bone volume of the maxillary and mandibular ridges for implant placement without extensive osseous grafting to increase vertical height. This case report will examine several uses of ultrashort implants utilizing the Bicon system in common clinical situations in the maxillary and mandibular arches without the need for osseous reconstruction to improve the available vertical height of the crest to permit implant placement.

Effectiveness of Oral Rinse as an Adjunct to Toothbrushing: A 6-Week Clinical Trial Management of Plaque and Gingivitis With Daily Oral Rinsing.

A common condition found in many patients, gingival inflammation results from irritation from dental plaque and the bacteria contained in plaque. Although effective management of dental plaque and the resulting gingivitis through daily homecare continues to be heavily emphasized, the high prevalence of oral diseases globally suggests that most individuals do not achieve sufficient plaque removal with their manual toothbrushing routine. To help enhance a patient's homecare regimen, daily oral rinsing has been shown to improve oral hygiene.

A Review of Sinus Floor Elevation Techniques: Lateral Window, Transcrestal, Graft Materials, and Biologics.

Various approaches to implant placement in the atrophic posterior maxilla are currently advocated in the literature. Such strategies range from the use of block bone graft, to short, tilted, and zygomatic implants, to sinus floor elevation (SFE). SFE has shown to be a predictable surgical procedure to increase bone height in the posterior maxilla.

Improving the Prognosis of Periodontally Involved Teeth at the Time of Extraction of Adjacent Teeth With an Amnion-Chorion Barrier and Bioactive Dentin Graft.

With increased awareness, both in the dental literature and by the general public, of peri-implant disease, a growing trend in dentistry is to save teeth with a "questionable" periodontal prognosis. This prospective study involving such patients was designed to evaluate the effects of combining a bioactive barrier and graft, not on the socket but to augment adjacent periodontal conditions on teeth with severe periodontal bone loss at the time of extraction of an adjacent tooth. Fifteen patients were selected; teeth were extracted, ground, prepared with a pH 11 cleanser, partially demineralized, and made into a graft.

Implant Placement When an Impacted Tooth and Supernumerary Teeth Are Present in the Maxilla.

The presence of impacted and/or supernumerary teeth in the maxillary anterior region can cause complications when attempting to perform restorations with implants. Extracting these structures can lead to adverse issues related to the adjacent dentition and require osseous grafting to provide a base to house the planned implant, but such an approach increases treatment time and cost. In this case report, a patient presented with an impacted permanent canine oriented on the horizontal plane with several supernumerary teeth coronal to the impacted canine.

Digital Workflow as an Aid to Complex Multidiscipline Dental Treatment for Improved Esthetics.

Complex treatment frequently requires the often challenging task of cohesively melding multiple disciplines of dentistry. The use of a digital workflow aids in simplifying the flow of treatment from start to finish and can result in faster and better outcomes for the patient as compared to traditional analog methods. Digital workflows allow the clinician to design esthetic outcomes and occlusion first virtually, communicate these esthetic designs to the patient, and then transmit digital files to chairside milling and printing devices as well as to dental laboratories for permanent restoration fabrication.

Treatment of an ossifying fibroma of the mandible with endodontic microsurgery and grafting with a biphasic calcium sulfate material: a case report.

Unlabelled: A significant percentage of lesions of endodontic origin require surgical management due to the possible diagnosis of odontogenic cysts and tumors in the maxilla and mandible. Ossifying fibroma is a benign fibro-osseous lesion that typically presents as a painless, slow-growing, and expansile lesion that appears as a well-demarcated lesion with a variable degree of internal calcification on radiography. Treatment results in a large osseous defect, utilization of a graft to fill the void accelerates healing and prevents complications that may result from failure to fill by the host response.

Case report: utilization of Z-Point fixture "Trans-nasal" implants.

Unlabelled: Severe bone loss in the anterior maxilla poses challenges to implant placement, especially when treating the entire arch. Utilization of zygomatic implants may not allow positioning of the implant platform anterior enough to properly support the full arch prosthesis, leaving an anterior cantilever in some clinical cases.

Importance: Placement of implants into the trans-nasal bone between the pneumatized maxillary sinus and nasal fossa allows utilization of an extralong implant in this residual bone to augment zygomatic implants placed distal to this for better support of a full arch prosthesis.

The severely atrophic maxilla: Decision making with zygomatic and pterygoid dental implants.

The severely atrophic maxilla can present with some challenges during treatment planning with communication between those performing the surgical and prosthetic aspects of the treatment as well as communication with the patient as to what is being suggested for treatment. This article simplifies the communication and understanding of treating the severely atrophic maxilla and based on the Bedrossian classification gives a guideline for the surgical approach to be adapted based on the patient residual anatomy.

Sinus Augmentation for Implant Placement Utilizing a Novel Synthetic Graft Material with Delayed Immediate Socket Grafting: A 2-Year Case Study.

Frequently, sinus augmentation is required when replacing failing or missing molars in the maxilla due to loss of alveolar bone related to periodontal disease, pneumatization of the sinus or a combination of the two factors. Various materials have been advocated and utilized; these fall into the categories of allograft, xenograft and synthetic materials. This article shall discuss a study of 10 cases with a 2-year follow-up utilizing a novel synthetic graft material used for sinus augmentation either simultaneously with implant placement or in preparation for sinus augmentation and implant placement in the posterior maxilla.

Utilization of Low-Magnitude High-Frequency Vibration (LMHFV) as an Aid in Treating Peri-Implantitis: Case Presentations.

Peri-implantitis is an inflammatory process initiating in the soft tissue and then progressing to the hard tissue surrounding dental implants leading to loss of osseous support and potential loss of the implant if not identified early in the process. This process initiates in the soft tissue, which become inflamed spreading to the underlying bone leading to decreases in bone density with subsequent crestal resorption and thread exposure. In the absence of treatment of the peri-implantitis, the bone loss at the osseous implant interface progresses with inflammatory mediated decrease in the bone density that moves apically, eventually leading to mobility of the implant and its failure.

Horizontal Ridge Augmentation Under a Removable Partial Denture and Implant Placement.

Implant planning has moved in recent years to virtual planning with a CBCT scan and fabrication of a surgical guide based on that virtual planning. Unfortunately, positioning based on prosthetics is typically missing from the CBCT scan. Use of a diagnostic guide fabricated in office permits information from ideal prosthetic positioning to improve virtual planning and subsequent fabricated of a corrected surgical guide.

Trans-sinus dental implants, for immediate placement when insufficient alveolar height is present: an alternative to zygomatic implants - surgical case series.

Low maxillary bone density associated with physiological bone remodeling and resorption accelerated by the presence or history of periodontal disease can prevent implant placement without either ridge and/or sinus augmentation in atrophic maxillary edentulous cases. As an alternative to avoid bone grafting and provide immediacy in restorative treatment care for the patient, remote anchorages to the basal bones of the maxilla of the patient are being used with zygomatic or pterygoid implants. The trans-sinus implant, when indicated can offer a reliable alternative to the zygomatic dental implant in that treatment of the severely edentulous maxilla.

Peri-implantitis and the Effect of the Implant Surface at Placement.

Modern root-form endosseous dental implants have been used to successfully replace missing teeth for more than four decades. The implant industry has grown substantially during this time, with many hundreds of dental implant manufacturers providing components for clinicians around the globe. Increased acceptance of dental implants has greatly amplified the number of dental implants placed worldwide.

The systemic oral health connection: Biofilms.

Frequently, periodontal health and it's associated oral biofilm has not been addressed in those patients who have systemic health issues, especially those who are not responding to medical treatment via their physician. Oral biofilm may be present in the periodontal sulcus in the absence of clinical disease of periodontal disease (bleeding on probing, gingival inflammation) and periodontal reaction is dependent on the patient's immune response to the associated bacterial and their byproducts. Increasing evidence has been emerging the past decade connecting oral biofilm with systemic conditions, either initiating them or complicating those medical conditions.

A Digital Approach to Immediate-Load, Full-Arch Implant Dentistry: A Case Report.

Conventional approaches to full-arch implant dentistry require a verified master model created by luting together impression jigs. This process involves numerous steps and is sometimes prone to errors that require subsequent correction. A novel approach involving an extraoral scanning technique using an Imetric 4D Imaging system demonstrates an alternative for same-day delivery of printed full-arch prosthetics.

Increasing Lateral Ridge Width for Implant Placement Using Calcium Sulphate Bone Cement Technique.

Dental implant practitioners are often faced with a presentation of a narrow crest, making it difficult or impossible for implant placement and requiring modification of the ridge to allow implants to be utilized. Many different factors need to be considered when choosing the technique to expand the ridge laterally. Ideally, the technique should facilitate the goal of ridge width increase while reducing inflammation and postoperative pain for the patient.

Novel Protocols for the Production of Autologous Blood Concentrates With High Platelet Volume.

Autologous blood concentrates (ABCs), specifically platelet-rich plasma (PRP), were originally discussed in the literature more than 60 years ago. Since then, protocols to fabricate PRP from patient-derived blood have steadily evolved with the aim of creating better products with more effective clinical results. Key to the protocol evolution has been the development of ABCs with higher concentrates of platelets and other blood components that enhance soft- and hard-tissue healing and, hence, regeneration.

Evaluation of the Accuracy of a New Geometric Approach to Implant Guidance.

Purpose: Implant surgical guides are often fabricated using CBCT technology. In this study, an alternative technique is proposed. The aim of this in vitro study was to compare the accuracy of the guide sleeve corrections of a geometric approach to guided surgery to the accuracy of in vitro studies of stereolithographic guides.

Utilization of Biphasic Calcium Sulfate as Socket Preservation Grafting as a Prelude to Implant Placement: A Case Report.

Extraction of the natural tooth may be a prelude to implant placement. This may be done using an immediate placement protocol or require a delayed approach depending on multiple factors that include residual infection related to the failed tooth being extracted, availability of bone to stabilize the implant at placement, or soft tissue issues. Socket preservation is recommended when the delayed approach is selected to create an osseous bed with adequate height and width that can accommodate the implant that is planned.

Socket Preparation for Delayed Implant Placement Using a Mineralized Cancellous Allograft.

Various materials have been used for extraction socket preservation in anticipation of implant placement or to limit resorption of socket walls. Materials have ranged from autogenous bone, allografts, and xenografts to synthetics. Ideally, the graft material being placed into the socket at the time of extraction should fully convert to host bone to yield vital bone that will permit implant osseointegration with as much contact between bone and the implant surface as possible.

Implant Restorations: Establishing a Proper Emergence Profile.

The replacement of missing teeth is more complex than simply placing a dental implant and restoring it, especially when a single implant site is involved. Implants have a round cross-section, whereas natural teeth do not but instead have crestal cross-sections that vary in shape from ovoid to triangular to rectangular depending on which tooth is being replaced. When this factor is combined with the zone between the crestal bone and adjacent proximal contacts, an emergence profile presents that will govern the esthetics of the restoration.