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Dental Clinics of North America Jan 2024As the field of implant dentistry continues to evolve, new techniques and technologies arise that can provide great benefits to the partial or completely edentulous... (Review)
Review
As the field of implant dentistry continues to evolve, new techniques and technologies arise that can provide great benefits to the partial or completely edentulous patient. The purpose of this article is to review the history, definition, and rationale of immediate loading of dental implants with the goal of providing evidence-based recommendations for implementation into clinical practice. Relevant literature is summarized and includes discussion regarding prerequisites for immediate loading/restoration of an endosseous implant. Surgical techniques and methodologies to prevent implant failure in immediate-load cases are discussed as well. The greatest success has been demonstrated with 4 or more mandibular implants. Although there is support in the literature demonstrating successful outcomes in immediate functional loading of single implants, the opinion of the author is to opt for a nonfunctional load that does not have any occlusal contacts when considering immediate loading of a single dental implant.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Dental Implantation, Endosseous; Mouth, Edentulous; Immediate Dental Implant Loading; Treatment Outcome; Follow-Up Studies
PubMed: 37951633
DOI: 10.1016/j.cden.2023.08.002 -
Journal of Oral Biosciences Jun 2024Regenerative dentistry aims to enhance the structure and function of oral tissues and organs. Modern tissue engineering harnesses cell and gene-based therapies to... (Review)
Review
BACKGROUND
Regenerative dentistry aims to enhance the structure and function of oral tissues and organs. Modern tissue engineering harnesses cell and gene-based therapies to advance traditional treatment approaches. Studies have demonstrated the potential of mesenchymal stem cells (MSCs) in regenerative dentistry, with some progressing to clinical trials. This review comprehensively examines animal studies that have utilized MSCs for various therapeutic applications. Additionally, it seeks to bridge the gap between related findings and the practical implementation of MSC therapies, offering insights into the challenges and translational aspects involved in transitioning from preclinical research to clinical applications.
HIGHLIGHTS
To achieve this objective, we have focused on the protocols and achievements related to pulp-dentin, alveolar bone, and periodontal regeneration using dental-derived MSCs in both animal and clinical studies. Various types of MSCs, including dental-derived cells, bone-marrow stem cells, and umbilical cord stem cells, have been employed in root canals, periodontal defects, socket preservation, and sinus lift procedures. Results of such include significant hard tissue reconstruction, functional pulp regeneration, root elongation, periodontal ligament formation, and cementum deposition. However, cell-based treatments for tooth and periodontium regeneration are still in early stages. The increasing demand for stem cell therapies in personalized medicine underscores the need for scientists and responsible organizations to develop standardized treatment protocols that adhere to good manufacturing practices, ensuring high reproducibility, safety, and cost-efficiency.
CONCLUSION
Cell therapy in regenerative dentistry represents a growing industry with substantial benefits and unique challenges as it strives to establish sustainable, long-term, and effective oral tissue regeneration solutions.
Topics: Humans; Animals; Tissue Engineering; Regeneration; Regenerative Medicine; Mesenchymal Stem Cells; Mesenchymal Stem Cell Transplantation; Dental Pulp; Dentistry
PubMed: 38403241
DOI: 10.1016/j.job.2024.02.006 -
Journal of Prosthodontics : Official... Dec 2023To report the means to maximize the predictability and accuracy of intraoral digital implant scans through the evaluation of operator and patient-related factors. (Review)
Review
PURPOSE
To report the means to maximize the predictability and accuracy of intraoral digital implant scans through the evaluation of operator and patient-related factors.
MATERIALS AND METHODS
A search of published articles related to factors that can decrease the scanning accuracy of intraoral digital implant scans was completed in four data sources:MEDLINE, EMBASE, EBSCO, and Web of Science. All studies related to variables that can influence the accuracy of intraoral digital implant scans obtained by using intraoral scanners (IOSs) were considered. These variables included ambient lighting, scanning pattern, implant scan body (ISB) design, techniques for splinting ISBs, arch location, implant position, and inter-implant distance.
RESULTS
Among operator-related factors, ambient lighting conditions, scanning pattern, and ISB design (material, geometry, and retention design) can impact the accuracy of intraoral digital implant scans. The optimal ISB for maximizing IOS accuracy is unclear; however, polymer ISB can wear with multiple reuse and sterilization methods. Among patient-related factors, additional variables should be considered, namely arch (maxillary vs. mandibular arch), implant position in the arch, inter-implant distance, implant depth, and angulation.
CONCLUSIONS
Ambient lighting conditions should be established based on the IOS selected to optimize the accuracy of intraoral digital implant scans. The optimal scanning pattern may vary based on the IOS, clinical situation, and the number of implants. The optimal ISB design may vary depending on the IOS used. Metallic implant scan bodies are preferred over polymer ISB designs to minimize wear due to multiple use and sterilization distortion. Among patient-related factors, additional variables should be considered namely the arch scanned, implant position in the arch, inter-implant distance, implant depth, and angulation. The impact of these factors may vary depending on the IOS selected.
Topics: Humans; Dental Implants; Imaging, Three-Dimensional; Dental Impression Technique; Computer-Aided Design; Models, Dental; Polymers
PubMed: 37586762
DOI: 10.1111/jopr.13749 -
Evidence-based Dentistry Sep 2023
Topics: Humans; Evidence-Based Dentistry
PubMed: 37737328
DOI: 10.1038/s41432-023-00920-5 -
Compendium of Continuing Education in... 2023The treatment of a peri-implant soft-tissue dehiscence (PSTD) can be quite challenging for many clinicians and leave gravely disappointing esthetic remarks for patients...
The treatment of a peri-implant soft-tissue dehiscence (PSTD) can be quite challenging for many clinicians and leave gravely disappointing esthetic remarks for patients to bear. The present article describes the treatment of two adjacent PSTDs in the forefront of the anterior region, where papilla deficiency also was exhibited. The case was treated with a coronally advanced flap and connective tissue graft (CTG) with submerged healing. The implant-supported crowns and abutments were removed, and soft-tissue augmentation was performed using a CTG that was sutured to the buccal site of the implants. The flap was released and sutured over the implants, which were submerged aiming for a closure by primary intention. After 3 months, a combination of an apically positioned flap and roll flap was performed to increase keratinized mucosa width around the implants and augment the peri-implant papilla. Clinical and esthetic satisfactory outcomes were obtained at 1 year.
Topics: Humans; Dental Implants, Single-Tooth; Treatment Outcome; Esthetics, Dental; Dental Implantation, Endosseous; Gingivoplasty; Dental Implants; Connective Tissue
PubMed: 37450675
DOI: No ID Found -
Compendium of Continuing Education in... Oct 2023Surgical crown lengthening (SCL) is the treatment of choice to ensure healthy tissues when subgingival tooth defects encroach on the biologic width.1 However,...
Surgical crown lengthening (SCL) is the treatment of choice to ensure healthy tissues when subgingival tooth defects encroach on the biologic width.1 However, restorative techniques employing adhesive dentistry may provide viable alternatives to or complement SCL in select cases without the repercussions of surgical bone removal and open interproximal spaces. One such clinical technique, deep margin elevation (DME), employs a direct restoration to relocate the cervical margin of small subgingival defects of posterior teeth supragingivally. The "elevated" margin simplifies impression-making and bonding of indirect restorations, especially inlays and onlays. Recent scientific systematic literature reviews indicate favorable clinical outcomes and suggest that DME restorations made with scrupulous care have high success rates and are compatible with periodontal health. Optimal working field isolation, meticulous placement of matrices, proper bonding and buildup procedure, as well as regular maintenance and follow-up are essential for success. This article provides an overview of this approach.
Topics: Dental Restoration, Permanent; Crown Lengthening; Dental Cements; Inlays; Crowns
PubMed: 37850958
DOI: No ID Found -
The Journal of Prosthetic Dentistry Jun 2024The visual appeal of teeth and smiles significantly influences both how others perceive individuals and their self-image and confidence. The subjective nature of dental...
The visual appeal of teeth and smiles significantly influences both how others perceive individuals and their self-image and confidence. The subjective nature of dental esthetics, varying greatly among patients and dental professionals, has made digital smile design tools essential for creating natural and personalized esthetics. Contemporary digital methods and workflows encompass all clinical phases, from diagnosis to the creation of a smile aligned with the patient's facial features, and the completion of the restoratives. Digital technologies not only streamline treatment planning, smile designing, and the creation of restorations but also enable effective and time-efficient collaboration among different dental specialists and dental laboratory technicians, enhancing overall patient care. The use of contemporary digital tools in interdisciplinary esthetic treatments is presented, underscoring the role of high magnification for precision, implant placement, minimal invasiveness, and clinical effectiveness.
Topics: Humans; Esthetics, Dental; Smiling; Dental Prosthesis Design; Computer-Aided Design; Patient Care Planning; Digital Technology; Technology, Dental
PubMed: 38649318
DOI: 10.1016/j.prosdent.2024.03.002 -
Compendium of Continuing Education in... 2023Implant rehabilitation in the esthetic zone is often challenged by vertical bone defects and soft-tissue deformities. This article describes a combined hard- and...
Implant rehabilitation in the esthetic zone is often challenged by vertical bone defects and soft-tissue deformities. This article describes a combined hard- and soft-tissue restorative approach that involves staged guided bone regeneration, implant placement, and two soft-tissue augmentation procedures to achieve optimal esthetic outcomes at multiple implant sites in the anterior zone. The staged bone augmentation procedure, performed with a mixture of autogenous and xenogeneic bone graft and a nonresorbable membrane, allowed for the placement of three implants in ideal positions after 9 months. Further soft-tissue augmentation involved the use of multiple connective tissue grafts (CTGs) stabilized on the occlusal aspect of the implants and between the implants to enhance peri-implant papillae (ie, the "iceberg" CTG approach). Then, a second soft-tissue grafting procedure was executed to reposition the mucogingival junction and re-establish an adequate amount of keratinized mucosa at the implant sites. The article highlights the importance of performing both hard- and soft-tissue augmentation for implant therapy in the esthetic zone.
Topics: Dental Implants; Maxilla; Esthetics, Dental; Dental Implantation, Endosseous; Gingiva; Dental Implants, Single-Tooth; Alveolar Ridge Augmentation; Treatment Outcome
PubMed: 37450676
DOI: No ID Found -
Periodontology 2000 Oct 2023Rehabilitation of the edentulous maxilla with implant-supported fixed dental prostheses can represent a significant clinical challenge due to limited bone availability... (Review)
Review
Rehabilitation of the edentulous maxilla with implant-supported fixed dental prostheses can represent a significant clinical challenge due to limited bone availability and surgical access, among other factors. This review addresses several treatment options to replace missing teeth in posterior maxillary segments, namely the placement of standard implants in conjunction with maxillary sinus floor augmentation, short implants, tilted implants, and distal cantilever extensions. Pertinent technical information and a concise summary of relevant evidence on the reported outcomes of these different therapeutic approaches are presented, along with a set of clinical guidelines to facilitate decision-making processes and optimize the outcomes of therapy.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Sinus Floor Augmentation; Maxilla; Dental Prosthesis Design; Mouth, Edentulous; Dental Prosthesis, Implant-Supported; Jaw, Edentulous; Treatment Outcome
PubMed: 37486029
DOI: 10.1111/prd.12507 -
Compendium of Continuing Education in... 2023Current diagnostic and treatment planning tools support a complete digital workflow that takes the guesswork out of implant dentistry and facilitates asynchronous...
Current diagnostic and treatment planning tools support a complete digital workflow that takes the guesswork out of implant dentistry and facilitates asynchronous collaboration between all involved specialties, from the restorative dentist to the surgeon to the dental laboratory. Long gone are the days of freehanded implant placement as guided as well as navigated surgery and now even robots provide unprecedented precision and predictability in implant placement based on the individual medical, morphologic, and anatomic situation of each patient.
Topics: Humans; Dental Implants; Workflow; Computer-Aided Design; Dental Implantation, Endosseous; Dental Prosthesis, Implant-Supported
PubMed: 37450680
DOI: No ID Found