The Journal of Implant & Advanced Clinical Dentistry

The MIMS Technique for Gingival Grafting

Thursday, June 22nd, 2017

6. The MIMS Technique – A Case Report: A First Look at a New Method for Optimizing Esthetic Gingival Grafting

Suturing in the esthetic zone can be unsightly and difficult for patients post-operatively. Moreover, when clinically presented with a very thin tissue biotype needing soft tissue grafting to repair a mucogingival defect, approaches may be far and wide. Therefore, this article shows a new method of suturing that was created to address both lack of tissue resiliencyand esthetics when working the smile zone. When presented with thin tissue biotypes and/or mucogingival defects in the esthetic zone, utilizing the Modified Internal Mattress Sling technique can greatly aid in securing and concealing soft tissue grafting for patients.

12. Socket Preservation Using a Small Particulate Xenograft: A Case Report

Soon after tooth extraction a cascade of bone remodeling starts which result in bone resorption. Procedures such Socket Seal Surgery can be employed to preserve future implant site. There are various grafts which can used for the same purpose. The best method to observe a graft’s healing is surgical re-entry and or histopathology. The aim of this Case Report is to document the use of Smartbone ® xenograft for socket preservation. After 5 months of healing, histopathological core sampling revealed good osteoconduction of the graft.

18. Crestal Bone Loss: A Comparative Study Among Men And Women In One Stage Dental Implants

Dental implantology is the state of the art technique to replace missing teeth. Crestal bone loss along implant surface jeopardizes its longevity and success of treatment. The present study was performed to evaluate and compare the crestal bone loss along the implant surface between men and women six months after the implant placement. Six months after the implant placement, radiographic evaluation on digital IOPA showed a mean crestal bone loss of 0.66 mm on the mesial side of implant and 0.46 mm on distal side of implant. Gender had significant difference in bone loss

30. Maxillary Split-Crest Technique with Immediate Implant Placement in a 13-year old Patient with Two Years Follow up: A Case Report

This case report presented a divergent approach in which a modified split-crest technique using the piezoelectric tip, one drill and tapered implants was applied. The split-crest surgery was performed with immediate placement of two tapered self-tapping dental implants in the anterior maxilla of a young 13-year old female patient. The patient lost four of her maxillary anterior teeth as a result of an accident at the age of 9 years with subsequent severe alveolar ridge resorption.

Custom Made Auricular Prosthesis

Monday, May 1st, 2017

6. A Custom Made Implant Supported Auricular Prosthesis Designed by Rapid Prototyping for Compromised Bone Support: A Case Report

Implant supported auricular prosthesis requires a minimum of 6mm bone depth in the temporal bone area behind external auditory meatus. Extra oral implants are available from 4mm to 7mm length with 5 to 6mm diameter flange. When the bone height is compromised and when only few regions have favorable positions which are not part of the slot area all the existing extra oral systems cannot be used. In cases with compromised bone condition, a custom made implant is the best choice that can offer good prognosis.

12. Guided Bone Regeneration in Peri-Implantitis Bone Defect After Free Gingival Graft: A Case Report

Peri-implantitis is among the most common pathological conditions encountered in the field of implant dentistry, where regenerative therapy, when possible to perform, is needed. One of the reasons why bone regeneration in peri-implantitis defects is difficult: due to prosthetic reasons, submerged healing is often not possible to perform. Another difficulty arises particularly in cases of insufficient attached keratinized mucosa (KM), where the mobility of alveolar mucosa can increase leakage of grafting materials from the treated defect.  After a healing period of 5 months, an implant was placed in position #30 with further bone augmentation.

20. Computer Based Textural Evaluation of Concentrated Growth Factors (CGF) in Osseointegration of Oral Implants in Dental Panoramic Radiography

Concentrated growth factors (CGF) have positive impact in the field of regenerative medicine. The osseointegration properties of CGF around loaded oral implants were evaluated in this study by means of computerized textural analysis in Panoramic Radiographs.  All selected features achieved Area- Under-Curve (AUC) values within 0.77–0.81 range in the group with CGF employment and manage to capture the significant temporal textural differentiation that can be attributed to CGF properties.

30. Extraction and Immediate Placement of Dental Implants in Mandibular Anterior Site with Delayed Prosthetic Loading Protocol in a Chronic Generalized Periodontitis Patient: A Case Report

In last few decades, implant dentistry has emerged as a fully accepted discipline in dentistry. During this period of development, its concepts, treatment modalities and material science have undergone tremendous changes. The key to successful restorative driven implant therapy is appropriate examination, diagnosis and treatment planning to achieve optimal functional and esthetic results.

Computer Guided Full Arch Immediately Loaded Dental Implants

Monday, February 27th, 2017

6. Computer Guided Full Arch Treatment Modality for the Edentulous Patient: A Case Report

Successful outcomes in the field of implantology often involve an amalgamation of good planning, execution of surgery and finally, accurate prosthetic rehabilitation. In the planning phase, it is possible for the surgeon to interact dynamically with a 3D reconstruction of the actual case scenario. The exact angulations and on the placement of implants can be pre-determined virtually. The virtual plan is then transferred to the clinical setting through the fabrication of a surgical guide. Advances in the prosthetic framework designs especially for a full arch implant reconstruction have led to superior final outcomes for both the patient and the clinician.

16. An Updated Primer on the Utilization of Amnion-Chorion Allografts in Dental Procedures

While placentally derived allografts have been utilized in medical procedures for over 100 years, their use in dental procedures is relatively new with only 10 years of continuous history. As in medical procedures, the initial applications of placental grafts in dental procedures were with amnion products. More recently, however, advanced placental allografts such as laminated amnion-chorion products have displaced the use of amnion-only products. The
addition of a chorion layer to amnion allograft has produced a number of improvements over amnion alone including increased thickness of the membrane and a 20-fold increase in growth factor content.

38. Full Mouth Rehabilitation of Completely Edentulous Patient with Full Arch Screw-Retained Prosthesis: A Case Report with 4 Year Follow Up

In completely edentulous patient’s rehabilitation with screw retained full arch fixed implant supported prosthesis, the achievement passive fit of superstructure to the implants is considered as major challenge to prosthodontist. This passive fit is supposed to be one of the most vital requirements for the maintenance of the osseointegration, otherwise unfavorable complications is expected. In this case report, full mouth rehabilitation of patient with all on-4 implant prosthesis was described.

46. A Review of Photofunctionalization of Dental Implants

UV photofunctionalization of titanium implants has shown promising results of the treatment outcomes. Photofunctionalized implants have shown promising findings in regards to bone implant contact, Osteoblast response & implant stability; hence opening up the avenue to be incorporated in daily implant practice. This article summarizes the findings of all the recent in vivo & in vitro research conducted.

Novel Ridge Augmentation Prior to Implant Treatment

Thursday, February 2nd, 2017

6. A Novel Combination Approach to Ridge Augmentation Procedure in a Severely Infected Alveolus Prior to Implant Supported Restorative Treatment: A Case Report

Acute and chronic odontogenic infections present a significant challenge to effective ridge augmentation procedures prior to dental implant placement. Medical ozone/ oxygen (MOZO) is an anti ineffective therapy that has experienced a resurgence in recent years for treating a variety of medical and dental infections. Recent data has suggested that PRF can be used as a barrier membrane in regeneration procedures. Within the limitation of this study, MOZO has the potential as an adjunct antiinfective therapy combined with the regenerative potential of PRF barrier membrane, providing a novel approach to ridge augmentation in an infected and severely resorbed alveolus.

16. Assessment of Risk Indicators of Peri-implant Diseases Among a Group of Sudanese Subjects Attending Khartoum Dental Teaching Hospital: A Hospital Based Cross-sectional Study

Data indicate that complications of dental implant occur in about 50% of patients after 5 years of function. Peri-implant disease following successful integration of an endosseous implant consider as biological complication of dental implant. Peri-implant diseases may affect the peri-implant mucosa only (peri-implant mucositis) or also involve the supporting bone (peri-implantitis). This study aimed to evaluate the prevalence of peri implant diseases in Khartoum Dental Teaching Hospital (KDTH) and to assess implants/patients characteristics as possible risk indicators for peri-implant diseases.

26. Efficacy of Biograft (β Tricalcium Phosphate) in Alveolar Ridge Preservation: A Randomized Controlled Clinical Study

The purpose of this study is to evaluate the efficacy of biograft (β tricalcium phosphate) in alveolar ridge preservation. Guided Bone Regeneration is a successful method of alveolar ridge preservation and that synthetic bone substitute (β- TCP) with a collagen membrane can be usefully utilized for this purpose.

34. A New Standard Classification System for Dental Implant Drills and Role of Implant Drills in Successful Osseointegration

Implant drills use is so common now a days and clinicians are aware about implant drills of the system which they are using. It is demand of the time that we should formulate a classification system to categories these drills for ease to remember and identification. Attempts have been made through this article to shed some light on various types of implant drills along with a simplified system of their classification. Another aspect included in this article is various factors influencing the drilling process and causing overheating in osteotomy site.

Implant-Supported Milled Bar Overdenture

Wednesday, December 28th, 2016

6. Implant-Supported Milled Bar Overdenture

Edentulism is a common condition affecting a significant portion of the population. A conventional approach to compensate for this condition is the fabrication and placement of dentures; however, traditional denture rehabilitation has its limitations. Implant-retained dentures provide increased retention, while implant-supported dentures provide ideal bracing and resolution of many patient
complaints. The implant-supported milled bar overdenture is an alternative approach to rehabilitation in which the patient can easily remove and clean their denture, maximizing oral hygiene. This approach is technically demanding but provides an accessible, cost-effective option

14. Full Mouth Rehabilitation of Patient with Advanced Chronic Periodontitis: A Case Report

In rehabilitation of patients with advance chronic periodontitis, a great concern to both patient and dentist is the effect of periodontal infection on the implant survival rate. In this case report, full mouth rehabilitation of patient with history of advanced chronic periodontics was described. The treatment performed includes full arch maxillary fixed implant supported prosthesis, mandibular anterior fixed teeth supported prosthesis and mandibular posterior fixed implant supported prosthesis.

22. MMP-8 Levels in Peri-Implant Sulcular Fluid from Platform-Switched and Conventional Implants

Despite clinical implications of the role of MMP-8 in gingival inflammation few studies have examined the correlation of MMP-8 to platform switching in implant dentistry. The objective of this study was to compare MMP-8 concentration in periimplant sulcular fluid associated with non-platform- switched and platform-switched implants. MMPs play central roles in wound healing and inflammatory response. However the current study suggests that MMP-8 levels may not be a consistent diagnostic indicator to assess clinical response post-function where the goal is to compare different implant abutment platform designs.

30. An investigation of the Availability of Consumer Prices for a Single Tooth Implant

This study assessed the availability and costs of replacing a single tooth with an implant and crown in academic and private practices. Prosthodontic departments were more likely to disclose the costs of placing and restoring an implant, and were cheaper. Geographic locations influenced costs. Future research should focus on evaluating the difference in fees between general dentists and specialists.

Reviews of Complications from Lateral and Crestal Sinus Lifts

Wednesday, November 23rd, 2016

6. Sinus Augmentation Complications: Part-I Associated with Lateral Technique (Direct Approach): A Review

Maxillary sinus augmentation procedures using crestal or lateral approach are the predictable treatment modalities for placing the implant in atrophic maxillary posterior area. Like any other dental procedures there is always risk of encountering the intra or postsurgical complications. This review article illustrates the complication, prevention and management associated with the lateral (Direct) technique.

14. Sinus Augmentation Complications: Part-II Associated with Crestal Technique (Indirect Approach): A Review

Treatment of the posterior edentulous maxilla can be complicated by atrophy of the edentulous ridge or by an aging-related increase in the pneumatization of the maxillary sinus. The technique of sinus floor elevation has expanded the prosthetic rehabilitation options for this region through the placement of dental implants. However, this technique can be quite aggressive and often patients would prefer an option that stresses minimalism. A less invasive alternative to the lateral window approach for sinus elevation was introduced by Summers in 1994. This review article illustrates the complications associated with the crestal i.e. indirect sinus lift.

22. Histologic Analysis of the Outcomes of Split-Mouth Maxillary Sinus Augmentation with Allograft and Xenograft Grafting Mediums

A histomorphometric analysis determined presence of good regenerative results in both groups. Presence of vital bone in the specimens was observed on the average of 97% (by the area of examination). Structural composition of the specimens indicated that on average 45% of the area observed under the microscope was filled with newly formed bone. Clinical analysis of the pre augmentation and post-augmentation measurements established that in all augmented sites a consistent and statistically measurable increase of the bone structure was achieved.

34. Temperature Changes During Implant Osteotomies Utilizing Three Different Implant Systems: A Pilot Study

Bone overheating may lead to failure of dental implant osseointegration. The purpose of this study was to compare three different implant drill designs in order to evaluate the temperature changes over the osteotomy area. The highest temperature was found with D1 initial drills (65.0±6.90C). The lowest temperature was noted with D2 initial drills (47.3±2.90C). For the D1 system, the use of irrigation resulted in statistically significant lower maximum temperature by 8.70C. For the D2 system, irrigation was found to significantly decrease the average maximum temperature by 7.10C.

Xenograft Treatment of Multiple Recession Defects

Wednesday, October 26th, 2016

6. Creeping Attachment After Xenogenic Collagen Matrix Placement for Multiple Recessions Treatment: A Discussion of Two Case Reports

The combination of coronally advanced flap (CAF) with a subepithelial connective tissue graft (SCTG) is the gold standard for root coverage treatment. Xenografts represent a viable alternative to the SCTG. The following cases represent the application of repositioning of the cementoenamel junction (CEJ) where a xenogeneic collagen matrix (CM) was used in combination with a CAF for the treatment of multiple recession defects. The combination of CM, repositioning of the CEJ and strict post-operative protocol showed creeping attachment twelve months post-operatively. The creeping attachment noted, ranged from 0.5-2mm.

16. Effectiveness of a Novel Approach for Soft Tissue Augmentation in a Severe Reabsorbed Alveolar Ridge

Severe deformity of the alveolar ridge occurs frequently after traumatic teeth loss, causing severe bone resorption, esthetic/functional compromises, and represents a challenge for surgeons. This article aims to present the effectiveness of a novel approach for soft tissue augmentation in which a pedicle graft and connective tissue graft are used to rehabilitate severe defects in the aesthetic zone.

24. Histologic Analysis of the Newly Formed Bone after Maxillary Sinus Augmentation witMh Xenograft Material

The objective of this study was to evaluate the vitality of newly formed bone after maxillary sinus augmentation completed with Xenograft (NuOss XC SinusTM) Bone Composite. A histomorphometric analysis determined a clinically evident presence of vital, newly formed bone in the specimens with the average of 97% (by the area of examination). Clinical radiographic analysis of the pre-augmentation and post-augmentation measurements established that in all augmented sites a consistent and statistically measurable increase of the bone structure was achieved.

32. Rehabilitation of Partially Edentulous Patient with Mandibular Teeth Supported Bar Overdenture: A Case Report

The teeth-supported overdenture is one of the best and most comfortable modalities of treatment for the patients with few remaining teeth. The use of attachments can further increase the retention of the overdenture prosthesis, but is usually limited by the insufficient space available and cost factors. The availability of different types of attachments has enabled a wide variety of treatment options. Therefore, the modern clinician must consider use of overdentures whenever possible.

Horizontal Augmentation of the Deficient Alveolar Ridge

Wednesday, September 28th, 2016

6. Horizontal Augmentation of the Deficient Alveolar Ridge Associated with Concurrent Implant Placement: A Retrospective Analysis of Outcomes

The challenges of many clinical cases lie in difficulty of managing severely compromised ridge defects. History of previously sustained alveolar trauma, past surgical procedures and variable pathologic developments cause substantial alteration of normal bone structure requiring osseoregenerative procedures to restore an adequate volume and architecture of alveolar structure needed for implant placement. The objective of this retrospective study was to measure and analyze clinical benefits gained by completion of guided osseous tissue regeneration treatment with utilization of “Tunnel Approach” completed concurrently with dental implant placement.

18. An Analysis of Negative Online Reviews for Dental Practices in Multiple Metropolitan Markets

Modern consumers are increasingly relying on crowdsourced online reviews to assist with their purchasing decisions. This is especially true when evaluating intangible items such as services which cannot be physically evaluated by the consumer. A variety of factors such as Framing, Primacy Effect, and Valence of online reviews have significant impact on consumer perceptions of evaluated businesses. Negative reviews have been shown to have a dramatic impact on all of the factors that affect online reviews and thus, also impact business performance.

24. Smile Design with Immediate Implant Placement

The esthetic dentist should have a thorough knowledge and appreciation of the artistic principles that can be applied to the dentofacial complex and should combine artistic creativity with scientific discretion to effect an appreciable change in the dentition. The smile we create should be esthetically appealing and functionally sound and requires a comprehensive approach to patient care. Appropriate application of principles of smile designing for any restorative work can drastically improve the esthetics of the patients. Nowadays, patients do not accept even the shortest period of edentulism.

32. Bone Quality Assessment in Routine Dental Implant Treatment among Dental Implant Practitioners in the Kingdom of Saudi Arabia

A questionnaire was created that included shut inquiries about attitude and knowledge and also to assess for symptomatic routines of bone quality evaluation. The questionnaire was web-based and sent to the most of the dental practitioners who practice dental implants in dental schools, hospitals, and private clinics in Saudi Arabia. The questionnaire was designed for four groups: general practitioner, postgraduate resident, specialist, and consultant.

Augmentation of Severe Ridge Defect with rhBMP-2 and Titanium Mesh

Monday, August 1st, 2016

6. Dehydrated Human Amnion-Chorion Barrier used to Assist Mucogingival Coverage of Titanium Mesh and rhBMP-2 Augmentation of Severe Maxillary Alveolar Ridge Defect: A Case Report

Recombinant human bone morphogenetic protein (rhBMP-2) is a potent osteoinductive protein that has proven to be a valuable tool for augmentation of severe alveolar dental defects. Because rhBMP-2 must be combined with a collagen carrier, it lacks space maintenance and must therefore be combined with ridged materials such as Titanium mesh. While effective for space maintenance and a proven aid in bone augmentation procedures, Titanium mesh has a documented history of premature exposure which can reduce final outcome gains.  The current Case Report documents use of an amnion-chorion barrier to assist mucogingival coverage of a Titanium mesh barrier and rh- BMP2 augmentation of a severely atrophic anterior maxillary ridge.

18. Long-Term Retrospective Clinical and Radiographic Follow-up Evaluation of 108 OsteoCare™ Mini and Midi Ball-Type Implants Subjected to Immediate Loading of Mandibular Overdentures

Dental implants have provided major changes in the treatment planning of completely edentulous patients with atrophic ridges Objectives: the present contemplate retrospectively evaluated OsteoCare™ Mini and Midi one-piece ball-type dental implants for immediate loading of mandibular overdentures with an emphasis on long-term survival, implant stability, peri-implant soft and hard tissue conditions, and patient satisfaction.  Follow-up averaged 5.4 years (range between 5-11 years) and the cumulative survival rate (CSR) was 100%.  OsteoCare™ Mini and Midi one-piece ball-type implants have demonstrated excellent long-term survival, marginal bone response, and soft tissue conditions with immediately loaded mandibular overdentures.

30. Long-Term Efficacy of Occlusal Loading on an Implant with Low Stability: A Case Report

Primary stability plays an important role in successful osseointegration. Primary stability is defined as the contact of implant and bone during the surgical implant placement. This contact is crucial for direct bone deposition between the bone/implant interface as well as subsequent mineralization process of osteogenesis. Secondary stability, however, is not purely a mechanical stability of the implant, unlike the primary stability; it is a biological stability which is formed within few weeks after implant placement during bone remodeling. This case report demonstrates that the secondary stability can be controlled by progressive loading and it dictates the percentage of functionally and biologically integrated bone-implant contact which in turn dictates its loading schedule.

36. A Modified Split-Crest Technique using Piezoelectric Surgery and Immediate Implant Placement in the Atrophic Maxilla

The successful placement of dental implants is limited by the presence of a deficient maxillary alveolar ridge. This study reports a modified approach to the split-crest technique using piezoelectric surgery in combination with immediate implant placement in management of atrophic maxillary ridges.  Results achieved showed a significant increase in the mean maxillary ridge width by 2.93 ± 0.13 mm. The survival rate of the implants was 100%.

Titanium Mesh Ridge Augmentation for Dental Implant Placement

Monday, June 6th, 2016

Titanium Mesh Ridge Augmentation for Dental Implant Placement

11. Localized Ridge Augmentation using Titanium Mesh with Alloplast and Simultaneous Implant Placement:
A Case Report

Implant placement in the atrophic anterior part of the maxilla was once a difficult task. Many procedures have been developed over the years for reconstruction of the alveolar ridge to enable implant placement. Alveolar ridge augmentation along with guided bone regeneration has been introduced in recent years to re-establish an appropriate alveolar ridge width. In guided bone regeneration, the quantity of bone regenerated under the membranes has been demonstrated to be directly related to the amount of the space under the membranes. This space can diminish as a result of membrane collapse. To avoid this problem, a new technique of ridge augmentation, which involves the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments is been used.

21. Treatment of a Central Giant Cell Granuloma of the Mandible

Removal and restoration of oral/dental tumors require multidisciplinary treatment planning and are very challenging for the patient, clinician and dental technician. Today CAD/CAM technology and advances in dental technology frequently allow for a successful and predictable treatment outcome for the patient. A multidisciplinary approach to a patient’s surgical and prosthodontic rehabilitation will be presented. The use of a CAD/CAM designed and milled titanium framework and resultant definitive prosthesis will be discussed.

31. The Effects of Reinforcement on the Fracture Rates of Provisional All-On-4 Restorations: A Retrospective Report of 257 Cases Involving 1182 Dental Implants

Immediately loaded full arch dental implant restorations rely on immediately delivered acrylic provisional restorations for esthetics, masticatory function, and cross arch stabilization. These provisional restorations may be in function from 4-12 months prior to delivery of a definitive final restoration. Fracture of the acrylic provisional restoration during the healing phase has been reported anywhere from 11-40% of cases in dental literature. Recent studies have suggested that reinforcement of the provisional restoration with a variety of materials may improve rigidity and decrease fracture rates. The purpose of this retrospective review is to evaluate if reinforcement of immediately loaded full arch transitional dental implant restorations has any effect on fracture rates during the healing phase.

39. Effect of Root Support versus Implant Support on the Biting Force of Attachment Retained Mandibular Overdentures

An overdenture is a complete or removable partial denture that has one or more tooth roots or implants to provide support.1 A very important advantage in natural teeth is the presence of the periodontal ligament PDL, which is the natural mechanism of attachment of the tooth to its socket in the alveolar bone. One of the main functions of the PDL is to provide sensory feedback in the masticatory cycle during chewing. 20 patients were selected ten of which were completely edentulous patients where two implants were installed in the mandibular
canine area. in both groups there was statistically significant increase in biting force after 3 months follow up period.

47. Comparative Analysis of User Generated Online Yelp Reviews for Periodontal Practices in Multiple Metropolitan Markets

Previously published research for a single metropolitan market found that Periodontists fared poorly on the Yelp website in regards to nearly all metrics including average star ratings, number of reviews, review filtering rate, and evaluations by Elite Yelp users. The purpose of the current study was to confirm or refute these findings by expanding the data sets to additional metropolitan markets of varying sizes and geographic locations.

59. Analysis of Online Review Characteristics and Filtering Rates for User Generated Yelp Evaluations of Periodontal Practices in a Major Metropolitan Market

User generated online reviews of businesses have increased dramatically during the past decade. The ability of these reviews to positively influence business revenues has resulted in occasional fraudulent review manipulation. To combat this, online review websites have begun to employ computer algorithms that identify and remove suspected fraudulent reviews. The purpose of this study was to analyze characteristics and filtering rates for user generated Yelp evaluations of dental practices with a specific focus on periodontal practices.