Secured Anatomy-Driven Flap Extension (SAFE) for Guided Bone Regeneration: A Modified Flap Release Technique Description and Retrospective Study.

Current flap-releasing designs for guided bone regeneration (GBR) emphasize preserving subperiosteal microvasculature by adapting a deep-slit approach, separating the periosteum from the flap. Although biologically sound, a biomechanical disadvantage may be encountered. This study aimed to describe a modified design, the Secured Anatomy-driven Flap Extension (SAFE) technique, for effective facial flap release and to preliminarily evaluate the clinical outcomes of this technique retrospectively.

Comparative Assessment of Flap-Advancing Techniques in an Ex Vivo Cadaverous Porcine Model.

Purpose: Since flap advancement is a prerequisite for tension-free primary closure and successful regenerative procedures, the aim of this study was to test the efficacy of six surgical approaches for flap advancement in an ex vivo porcine model.

Materials And Methods: A total of 60 fresh mandibles from pigs were randomized into one of six groups: (1) trapezoidal full-thickness flap design with two vertical releasing incisions (control), (2) trapezoidal flap with linear periosteal scoring, (3) mucosal detachment technique, (4) mucosal detachment with horizontal extension, (5) mucosal detachment with horizontal and vertical extension, and (6) mucosal detachment with horizontal vertical and cutback extension. Coronal advancement of the flap was recorded as the primary variable; the surface area of exposed mucosa and the tear strength were recorded as secondary variables.

The Buccally Displaced Palatal (BDP) Flap to Increase Quantity and Thickness of Peri-implant Soft Tissue.

Common challenges encountered for atrophic maxilla rehabilitation are the inadequate width and height of attached keratinized mucosa (AKM) and shallow vestibular depth. This study presents a buccally displaced palatal (BDP) flap technique to increase the tissue thickness and AKM width at the second-stage surgery and reestablish the correct fornix depth. The peri-implant pocket depths, modified Plaque Index score, modified sulcus Bleeding Index score, and soft tissue recession were evaluated 6 and 12 months after prostheses loading.

Mucosal Detachment Technique for Flap Advancement in a Thin Tissue Phenotype: Technique Illustration.

Passive-tension flap closure of primary wounds remains the most important factor for achieving predictable bone augmentation outcomes. So far, no specific surgical technique has been proposed for major flap advancement, specifically in the thin tissue phenotype (≤ 1.5 mm thick).

Emergence profile design based on implant position in the esthetic zone.

One of the most challenging tasks in implant dentistry is to fulfill the esthetic expectations of patients. While implant positioning and adequate amounts of soft and hard tissues are essential for achieving an esthetic outcome, the emergence profile of an abutment/restoration also plays an important role in the definitive appearance of implant prostheses. Therefore, the purpose of this paper is to propose a clinical guideline for designing an abutment/prosthesis based on implant position.

Influence of Vertical Soft Tissue Thickness on Crestal Bone Changes Around Implants with Platform Switching: A Comparative Clinical Study.

Background: Numerous studies have shown the superiority of platform-switched implants in preserving crestal bone as compared with platform-matched implants. However, the influence of initial soft tissue thickness on development of crestal bone loss has not been addressed in previous studies; thus, further research is needed.

Purpose: To evaluate crestal bone levels around platform-switched implants placed in thin and thick mucosal tissue.

Impact of implantoplasty on strength of the implant-abutment complex.

Purpose: Implantoplasty, a procedure that is done to smooth contaminated implant surfaces, has been used in the treatment of peri-implantitis. It reduces the implant diameter, which might compromise the implant's strength. This in vitro study was designed to evaluate the effect of implantoplasty on implant strength.

Periosteal pocket flap for horizontal bone regeneration: a case series.

Guided bone regeneration has been shown to be a successful technique to increase the ridge width for dental implant placement. However, in cases of severe or localized horizontal bone deficiencies, achieving sufficient soft tissue mobilization to ensure primary wound closure over the augmented area can be difficult. This article describes a buccal periosteal pocket flap proposed to overcome these challenges.

Clinical and histologic evaluation of a granular bovine bone biomaterial used as an adjunct to GTR with a bioresorbable bovine pericardium collagen membrane in the treatment of intrabony defects.

Background: The aim of the present study is to evaluate the clinical and histologic healing of deep intrabony defects treated with guided tissue regeneration (GTR) with a collagen membrane from bovine pericardium and implantation of granular bovine bone biomaterial.

Methods: Thirty patients with one deep, combined 1- and 2-wall intrabony defect exhibiting a probing depth ≥6 mm and an associated intrabony defect ≥3 mm were treated with GTR with a bioresorbable collagen membrane from bovine pericardium and adjunct implantation of a granular bovine bone biomaterial. The clinical results were evaluated 1 and 3 years after surgery.

Systematic approach for the propagation of postgraduate dental implant education in developing countries.

Purpose: To analyze the outcome of the formative feedback and summative assessment in 2 different groups of dentists after a postgraduate dental implant course. This course was conducted with the hope of developing a systematic approach to implant dentistry training.

Methods: A 6-day mini-residency postgraduate dental implant course which was approved for 75 credit hours by the international congress of oral implantologists and approved for fellowship after a satisfactory grade at the end of course examination was conducted at the Faculty of Dentistry of the University of Ibadan in West Africa.

[Vertical augmentation of the mandible using cortico-spongious xenoblocks. A histomorphometrical study in dogs].

The aim of the present study was to histologically evaluate vertical ridge augmentation of the mandible using partially deproteinized cortico-spongious xenogenous blocks (XB) in dogs. Standardized acute-typed vertical lower jaw defects were surgically created in edentulous ridges of six foxhounds. Two similar bone blocks of 6 mm height were randomly inserted on each mandibular side and fixed with both a titanium implant and an osteosynthetic screw.

Aesthetic flap design for correction of buccal fenestration defects.

Flapless immediate implant surgery has been proposed as a means of reducing the surgical trauma to soft tissue and maintaining natural gingival anatomy. The aesthetic outcome in such cases may, however, be jeopardized when localized horizontal and vertical deficiencies occur. In order to correct such deficiencies, a novel flap design was developed that protected the soft tissue that had the most significant impact on the patient's appearance.

A bovine-bone mineral block for the treatment of severe ridge deficiencies in the anterior region: a clinical case report.

A bovine-bone mineral block was used to treat a severe horizontal and vertical anterior ridge deficiency. Such a block can be shaped to conform to the defect, and it avoids the need for harvesting autogenous bone or fixation of the block with screws. After a 6-month integration period, an implant was placed.

Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference.

The primary function of a dental implant is to act as an abutment for a prosthetic device, similar to a natural tooth root and crown. Any success criteria, therefore, must include first and foremost support of a functional prosthesis. In addition, although clinical criteria for prosthetic success are beyond the scope of this article, patient satisfaction with the esthetic appearance of the implant restoration is necessary in clinical practice.

Use of the natural tooth for soft tissue development: a case series.

The achievement of optimal esthetics around anterior dental implants has been a major challenge for many clinicians. The key to an esthetically pleasing appearance lies in the clinician's ability to properly manage the soft tissue profile around dental implants. Hence, the purpose of this case report is to describe a new technique that uses the patient's own natural tooth for the provisional implant restoration to develop soft tissue architecture that is almost identical to the patient's original immediately after tooth extraction.

Treatment sequencing for the multiunit restoration: hard and soft tissue considerations.

Although the predictability of treating full or partial edentulism with dental implants has long been established, the choice of whether to use a fixed or removable prosthesis to restore such implants remains a complex one. Attention to such factors as the amount of vertical and horizontal bone loss that has occurred, the quality and quantity of the soft tissue, and the patient's restorative history can simplify treatment planning.

Piezosurgery: basics and possibilities.

Useful in a variety of oral surgery procedures, piezosurgery has therapeutic features that include a micrometric cut (precise and secure action to limit tissue damage, especially to osteocytes), a selective cut (affecting mineralized tissues, but not surrounding soft tissues), and a clear surgical site (the result of the cavitation effect created by an irrigation/cooling solution and oscillating tip). Because the instrument's tip vibrates at different ultrasonic frequencies, since hard and soft tissues are cut at different frequencies, a "selective cut" enables the clinician to cut hard tissues while sparing fine anatomical structures (e.g.

Pericardium membrane and xenograft particulate grafting materials for horizontal alveolar ridge defects.

Purpose: The purpose of this study was to evaluate the clinical feasibility of using a native collagen physical resorbable barrier made of bovine pericardium to augment localized alveolar ridge defects for the subsequent placement of dental implants.

Materials & Methods: There were 8 systemically healthy patients with 19 implant sites (aged 35 to 68 years), with inadequate dental alveolar ridge widths, selected for study. All patients completed initial therapy, which included scaling, root planning, and oral hygiene instruction.

Esthetic buccal flap for correction of buccal fenestration defects during flapless immediate implant surgery.

Background: Clinically, it is a tremendous challenge to create natural gingival esthetics after immediate or delayed implant placement. Hence, flapless immediate implant surgery has been proposed to overcome the shortfalls of these techniques. Nonetheless, one of the major limitations for this technique is its inability to correct localized horizontal/vertical deficiency, dehiscence, or fenestration without jeopardizing esthetic outcomes.

A comparative study of bilateral sinus lifts performed with platelet-rich plasma alone versus alloplastic graft material reconstituted with blood.

The objective of this study was to compare the alveolar bone growth in the 2 sides of the maxillary sinus after bilateral sinus lift procedures were performed with the simultaneous placement of dental implants in 20 consecutive patients. After elevation of the Schneiderian membrane, one side had only platelet-rich plasma (PRP) gel applied, while the other had placed only alloplastic graft material reconstituted with blood. Both open window and closed window techniques were used in ridges with > or =9 mm residual crest of bone.

Mini-implants to reconstruct missing teeth in severe ridge deficiency and small interdental space: a 5-year case series.

Two of the major obstacles for dental implant placement to replace missing teeth are the lack of adequate bone width and interdental space. Overcoming these limitations requires bone augmentation procedures that transform the deficient ridge into a ridge that is capable of receiving conventional tooth-form implants. In the case of inadequate interdental space, orthodontic tooth movement is advocated before implantation.