The Journal of Implant & Advanced Clinical Dentistry

Cervical Socket Plug Technique

Wednesday, April 8th, 2020

6. Flapless Hard and Soft Tissue Preservation of Posterior Sockets Utilizing the Cervical Socket Plug Technique: Clinical Protocol and Case Report

Different socket grafting techniques have been proposed, utilizing different bone grafting materials, with various degrees of efficacy. A universal problem arising from all of the available techniques is the fact that the soft tissue anatomy present at the time of extraction is lost, resulting in a flat type soft tissue architecture. A novel protocol and case report of a ridge preservation technique that utilizes an anatomically shaped composite resin plug that acts as a graft containment and cervical profile maintenance device is presented.

20. Simplified Three-dimensional Ridge Augmentation using a Deproteinized Porcine-derived Bone Graft: A Case Series

Various osteoinductive and osteoconductive bone grafts have been used for ridge augmentation. Osteoconductive bone grafts such as bovine bone, allografts, and alloplasts have widely been utilized for reconstruction of alveolar defects. However, xenogenic porcine grafts are not frequently used for ridge augmentation. This study investigated the clinical efficacy of porcine-derived xenografts in ridge augmentation.

32. Evaluation of Human Periodontal Ligament and Cell Attachment and Viability on Particulate Bone and Dentin Allografts

Various bone grafting substitutes have been used in the periodontics for bone regeneration which include autografts, allografts, xenografts and alloplasts. Autogenous particulate dentin has been used successfully as a bone grafting substitute. The aim of present study was to evaluate the effect of demineralized and mineralized freeze-dried bone allograft and particulate dentin on osteoblastslike cells and human periodontal fibroblasts.

44. Modified Technique for Root Coverage

Gingival recession and inadequate keratinized tissue are prevalent problems encountered in dental practice and negatively impact prosthodontic and esthetic outcomes. Traditionally, gingival recession has been treated with numerous types of soft tissue procedures, which include coronally positioned flaps, connective tissue grafts, lateral and pedicle grafts, as well as guided tissue regeneration.

Vertical Bone Augmentation

Tuesday, October 15th, 2019

6. Vertical Bone Augmentation and Soft Tissue Management on the Anterior Maxilla, Before and After Implant Placement: A Case Report

Complex bone defects could be challenging and implant placement difficult after a complicated extraction. Treatment planning should include implant placement, bone augmentation and soft tissue grafting in horizontal vertical and transversal relationship. The aim of this study is to evaluate clinically the result of a staged -treatment planning for bone augmentation and soft tissue management before placing the implant and after implantation.

16. Clinical and Radiographic Evaluation of Short Dental Implants in Posterior Atrophic Ridges with a Follow-up Period of 1 year After Loading: A Controlled Clinical Trial

To evaluate clinically and radiographically the performance of short dental implants in the posterior atrophic ridges (maxilla and mandible) with deficient vertical bone height as an alternative treatment modality to other more invasive procedures. Short dental implants seem to be an effective alternative treatment for atrophic ridges with a very high success rate in the mandible. They minimize the need for bone grafting procedures and increase the patients` acceptance, as well as, maximizing dental implant placement possibilities.

26. 2% Lidocaine with Epinephrine Versus 0.75% Ropivacaine for Local Anesthesia

It is common practice during removal of wisdom teeth to administer local anesthetics to the surgical site.Lidocaine is the most commonly used local anesthetic. Ropivacaine is longer-acting,but it is infrequently used in the dental setting. This study aims to compare post-operative pain and patient preference after extraction of mandibular third molars using 2% lidocaine with 1:100,000 epinephrine or 0.75% ropivacaine.

36. A Novel Approach to Repair Severe Damage in the Esthetic Zone for Dental Implant Treatment

The following case reports documents use of platelet rich fibrin (PRF) and titanium mesh for guided bone regeneration (GBR) to facilitate dental implant treatment in the esthetic zone. A 40 year old male patient with a severe hard and soft tissue combination defect in the esthetic zone of the anterior maxilla is treated and photo documentation of the procedure is provided.

Perserving the Buccal Plate

Thursday, September 19th, 2019

6. Preserving the Buccal Plate with a Novel Bone Graft Material for Immediate Implants in the Esthetic Zone

Implant placement into immediate extraction sockets can present with clinical challenges especially in the esthetic zone. Preservation of the buccal plate is critical to maintaining the position of the gingival tissue so that recession does not compromise esthetics. Position of the implant with respect to the buccal plate is important to allow sufficient thickness of bone, which in the extraction socket will result in a gap between the buccal socket wall and the implant.

14. The One Functional Position, Implant Level, Indirect, Impression Technique: Description of the Technique and a Case Report

Several implant impression techniques have been proposed and evaluated involving conventional and digital protocols. The conventional protocols involve two main methods, the direct and the indirect technique, where the latter is widely used for clinical cases involving less than three implants. One of the most significant problems of the implant level, indirect technique relate to the accuracy of three dimensional impression post installation into the impression along with the stability of the impression post into the latter upon pouring of the stone model.

24. From Single Discolored Tooth to a Full-mouth Reconstruction

A full mouth reconstruction and rehabilitation is a reality. Predictability and success can be achieved if the golden rules of healthy, functional, dynamic occlusion are tested and implemented in a structured, orderly manner to secure the multiple intricate phases of treatment. How do you address healthy, functional occlusion to a person who doesn’t have any pain, discomfort, or concern? This is one of the greatest challenge that facing dentists who try to achieve and provide optimum dental care for all their patients.

32. Complications of the Sinus Lift Procedure

The sinus lift is one of the most common procedures performed to increase the height of posterior maxilla for placement of dental implants. It is a sensitive area which is prone to complications, the most common being sinus membrane tear and bleeding. The most common being sinus membrane tear, placement of implant in deficient bone height and dislodgement of implant in the sinus cavity.

Clinical Effectiveness of Guided Implant Surgery

Tuesday, June 4th, 2019

6. Clinical Effectiveness of Guided Implant Surgery

The present study aimed at investigating the 5-year clinical treatments outcomes of 93 patients with partial and complete edentulism. No intra-operative or immediate postoperative complications were noted. The success rate at 1 year from the final loading was similar in all groups with no implants lost. Guided implant surgery represents a clinically predictable surgical procedure to restore partially and totally edentulous patients.

16. Rehabilitation of Severe Maxillary Noma Defect with Zygomatic Implants: A Case Report

Zygomatic implants have been recently used for prosthetic rehabilitation in patients with large maxillary defects. A 40 year old patient presented to our clinic with Noma treated with free vascularized osteocutaneous fibula flaps. The resultant defect encompassed the total maxilla up to the lower rim of the orbital and maxillary zygomatic arch. Four zygomatic dental implants were placed successfully and a full arch screw-retained fixed prosthesis was later completed. The current Case Report documents treatment of this case.

24. Treatment of a Complex Buccal Dehiscence with an Immediately Placed Dental Implant in an Infected Site: A Case Report

Different procedures to regenerate the bone loss are used with different levels of success to achieve an adequate osseointegration of the immediate implants. The use of platelet-rich fibrin (PRF) with graft materials enhance and accelerate the normal guided bone regeneration (GBR) pathways. This report describes the use of PRF as an enhancer for the stability of an immediate implant with a 1 year follow-up period in infected site

34. Revision Treatment of Failed Iliac Crest Grafts with a Small Diameter Dental Implant: A Case Report

Using dental implants to restore completely edentulous patients is rapidly becoming the top adopted treatment protocol. When restoring completely edentulous patients, there are 2 main options: removable or fixed prosthetics. However, when a patient has limited to no bone, there are fewer options for the patient. The current treatment adding one 3.0 mm diameter implant at the midline does provide stability for the overdenture bar and removable prosthesis. The 1 year follow up shows promising results.

Surgical Planning using 3D Printed Models

Monday, April 22nd, 2019

6. Surgical Planning using 3D Printed Anatomical Models in a Complex Case of Dental Implants

Dental implant therapy in edentulous patient demonstrating significant alveolar bone loss can be challenging and may require augmentation using autogenous block grafts such as that from the mandibular ramus. Harvesting of autogenous grafts entails the possibility of additional morbidity, including the risk of mandibular nerve injury. This case report explores the usefulness of 3D printed anatomic models as an adjunctive tool in pre-surgical planning to minimize the risk of additional morbidity associated with autogenous ramus grafting.

14. Tilted Implant Placement for Rehabilitation of Severe Atrophic Maxilla Supported by Finite Element Analysis

Tilted implants have been used for rehabilitation of maxillary edentulous arches. The purpose of this article is to evaluate the clinical outcome of tilted implants where 6 implants are placed in maxilla and restored with screw retained prosthesis. The difference in the 3 year post loading marginal peri-implant bone loss between delayed and immediate loading groups was found to be insignificant using 6 tilted implants design.

28. A Novel Procedure of Regaining Aesthetics with Implants and Autogenous Dentin Graft: A Report of Three Cases with One Year of Follow Up

Generally, extracted teeth have been discarded as infective medical dusts in the world. While human bone autograft was done in 19th century, human dentin autograft for bone augmentation was reported in 2003. Dentin matrix like bone has the inborn chemical and physical properties to attract progenitor cells and induce them to generate new bone. This series of clinical cases describes a novel procedure of prosthodontic management of the fractured maxillary central incisors using two stage implants reinforced with autogenous dentin graft obtained by immediate transformation of extracted teeth

Immediately Loaded Pterygoid Implants

Thursday, January 3rd, 2019

6. Pterygoid Fixated Arch Stabilization Technique (PFAST): A Retrospective Study of Pterygoid Dental Implants used for Immediately Loaded Full Arch Prosthetics

The pterygomaxillary complex is a known anchorage location for dental implants that is typically reserved for use in compromised situations. The dense bone in this area provides excellent insertion torque for dental implants and has been associated with high survival rates in delayed loading scenarios. To date, no known studies have specifically evaluated pterygoid anchored dental implants for immediately loaded full arch restorations.

18. All on 4 Immediate Loading Technique Using Laser Narrow Made Implants in Severely Reabsorbed Jaws: A 3 Year Prospective Study

The objective of the present prospective study was to observe the behavior of an immediate loading protocol on 4 narrow laser made implants distributed polygonally in severely reabsorbed edentulous mandibles. Preliminary data suggest that the immediate loading through a rigid prosthetic structure associated with narrow posterior tilted implants in combination with narrow medial axial implants could be considered as a viable modality treatment and present a good clinical outcome in the severely reabsorbed mandible.

28. Dental Abscess Affecting Facial Skin: A Case Series

Dental abscesses are frequently found in the oral cavity and are often related to badly decayed teeth and poor oral hygiene. Dental caries and pulpal necrosis often end in extending infections to alveolar bone and sometimes involving the outer layer of the face. The origins of these facial sinus orifices cannot be distinguished easily, often confusing the medical team attempting diagnosis. The following case series documents treatment of dental abscesses that affected facial skin.

36. Immediate Healing Abutment Placement Associated with Connective Tissue Graft and Coronally Positioned Flap on Laser-Microgrooved Implants to Improve Peri-Implant Soft Tissue Conditions: A Case Report

Soft tissue recession is one of the most important problems of implants, when thin buccal bone thickness, and inadequate width and thickness of keratinized gingiva are presents. To prevent such defects and to increase width and thickness of keratinized tissue around implants, connective tissue graft (CTG) is one of the most used surgical techniques. in case of an inadequate vestibular bone thickness (< 1.5/2mm), additional bone grafting is not needed around a lasermicrotextured implant/abutment, if an adequate soft tissue width and thickness is obtained with an immediate CTG, a coronally positioned flap, and immediate healing abutment placement.

CZRAM for Implant Site Development

Thursday, September 27th, 2018

6. Custom Zirconia Ridge Augmentation Matrix (CZRAM) for Implant Site Development: A Report of Two Cases

This is a report of two cases describing the use of custom zirconia ridge augmentation matrices (CZRAM) to effectively augment deficient alveolar ridges prior to dental implant placement. 3D computer-aided design (CAD) of customized zirconia rigid space maintenance devices was carried out using a baseline cone beam CT (CBCT) scan of the deficient ridges, and the devices were milled from partially-sintered zirconia blocks using a five-axis dental mill.

16. Repair of Dental Implant Induced Inferior Alveolar Nerve Injuries with Dehydrated Human Amnion-Chorion Membranes: A Case Series

Dental implant treatment has become a common treatment modality for the replacement of missing teeth. As the number of implants placed annually continues to increase, so too has the incidence of iatrogenic nerve damage secondary to implant placement. Over the past decade, a handful of conservative protocols have been proposed for the treatment of neural maladies following the placement of dental implants with varying degrees of success. Recent advances in biologic growth factor technology have introduced products that may serve as adjuncts in the treatment of neural injury.

30. Full Mouth Rehabilitation with Immediate Implants and Fixed Prosthetics: A Surgeons’ Prospect and Critical Review

Dental implants have become the preferable choice of restoring the missing teeth for the patient, which made the dental professionals look for the best implant systems, advanced research, and techniques for constant improve in the quality of patients life. Dental implants can be placed immediately after the extraction – “Immediate implants” or can be placed after complete healing of the extraction site – Delayed Implants. This article is about the author’s experience with full mouth immediate implants and explained the critical factors that influenced the outcome.

36. Extra-Short Implants for Rehabilitation of Atrophic Ridges: A Retrospective Study with up to 5 Years of Follow-Up

The bone augmentation techniques suggested by literature including onlay bone grafts, guided bone regeneration (GBR), maxillary sinus elevation and distraction osteogenesis (DO) have been proved effective in regaining bone volume. However these approach techniques can present multiple complications and morbidity after surgery, with prolonged treatment duration and extra costs. Short implants could be a simpler, cheaper and faster alternative than augmentation procedures, if they can be shown to result in similar success rates. Recently the use of extra-short implants (6 mm) has been reported with good outcomes 5-8 and promising results have been published in comparison with alveolar bone augmentation techniques.

48. Leveraging the Dental Hygienist to Promote the Periodontal Practice

Periodontal referral is declining, and a dental office must market itself to alert potential patients to its existence. Offering a free cleaning to new patients is a marketing tool that pays long-term dividends in return visits for dental hygiene or periodontal surgery. The number of active dental hygiene patients is a measure of the practice’s financial health, as this service accounts for 40-60% of the office’s income.

Fibrous Dysplasia

Thursday, August 2nd, 2018

6. Fibrous Dysplasia of the Mandible: A Case Report

Fibrous dysplasia is a skeletal developmental disorder of the bone forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. Fibrous dysplasia represents about 2.5% of all bone tumours and over 7% of all benign tumours. The aim of this article is to present a rare case report of monostotic fibrous dysplasia of posterior mandible in a forty seven year old asymptomatic Indian female and its interdisciplinary management.

12. Florid Cemento-Osseous Dysplasia of the Jaws: Report of a Rare Case

Florid Cemento-Osseous Dysplasia (FCOD) is a rare “fibro-osseous” lesion that characteristically affects the jaw bones in middle aged individuals. The condition is usually asymptomatic and needs no treatment. The diagnosis of FCOD is made typically on the basis of clinical and radiological features and biopsy is generally not recommended due to the risk of post operative secondary infection. This article reports a rare case of FCOD affecting the maxilla and mandible as an incidental finding in a sixty three year old asymptomatic Indian female patient.

20. Analysis of the Mechanical Behavior of Components of Osseointegrated Implants Submitted to Maximum Compression

Adell et al. presented a longitudinal clinical study of the protocols proposed by Brånemark, where the clinical behavior of osseointegrated implants was evaluated over 15 years. In this study, the authors confirmed the predictability and high success rate of this new modality of treatment, as well as analyzed its complications and failures

26. Developing a Long-Term Relationship with Patients: The Role of the Dental Hygienist

Dental insurance policies typically include two free cleanings per year, a service performed by dental hygienists; these professionals, therefore, bring new patients to the dental practice. Since most patients desire and can probably afford a teethcleaning session, they are likely to schedule one ( The patients’ self-driven motivation is a valuable opportunity for an office to invest in a strong dental hygiene program, and proper planning and staffing will make such a program an investment yielding high returns.


Odontogenic Keratocyst Marsupialization and Decompression

Wednesday, June 13th, 2018

6. Odontogenic Keratocyst Treatment with Marsupialization and Decompression: A Case Series

Odontogenic cysts such as the odontogenic keratocyst are benign lesions that have the potential for aggressive infiltrative behavior and undesirable comorbidities. Treatment of these lesions with conservative techniques such as marsupialization and decompression have proven and lasting benefits. The following series presents two cases in which conservative treatment of odontogenic keratocysts resulted in lesion elimination, spontaneous bone fill, and stability lasting at least 5 years.

12. 3-D Printing of a Customized Bone Scaffold using Beta- Tricalcium-Phosphate, Alginate, and Cellulose Nanofibers: A Novel Test

Three-dimensional bio printing of tissues and biological structures has been proposed to enable precise manufacture of various biomaterials with complex 3D architectures, while being compatible with multiple cell sources and being customizable to patient-specific needs. The construct developed presented with mechanical stiffness that can be transported to an intra-oral bone defect and secured to the recipient site.

16. The Role of Antimicrobials in the Success Rate of Dental Implants

Single tooth replacement implants were placed following two-staged implant placement protocol under aseptic conditions. In the test group, 430 patients were randomly prescribed with an antibiotic, whereas in the control group 430 patients were randomly prescribed with a non-steroidal anti-inflammatory drug after implant procedure. Patients were scheduled for a regular check-up every 6 months. At the end of three years, 8 implants were lost from test group and 11 implants from the control group.

24. Periodontal Perspectives of Autologous Blood Preparations

Periodontitis is an infectious disease of the dental attachment apparatus. Untreated periodontitis leads to bone loss and attachment loss. Though several periodontal treatments are available, only some of them are regarded as true regeneration. Regeneration is reconstitution of both hard and soft tissues in both structure and function. Various modalities such as bone grafts and substitutes, guided tissue regeneration (GTR) membranes and polypeptide growth factors (PGFs) are used for periodontal regeneration. Platelet concentrates are the richest source for polypeptide growth factors. This review highlights various platelet concentrates, and their clinical applications in the treatment of periodontal diseases.


Rebuilding Buccal Plate Deficiency During Immediate Implant Placement

Wednesday, May 2nd, 2018

6. A New Technique for Rebuilding the Buccal Plate during Placement of Immediate Dental Implants in an Extraction Site with Buccal Defects

The final decision when placing a dental implant in an extraction site must be done looking at the integrity of the socket walls. When the buccal plate is partially or totally lost, the primary treatment goal is to preserve the socket until it matures for good implant stability and good esthetic results. What this technique proposes is to allow an immediate implant placement without the problems, esthetic and functional issues of the future final restoration.

16. The Bernotti V-Y Flap: An Alternative to Manage Soft Tissue Esthetic Issues with Implants

Mucosal issues such as inflammation, swelling, fistulas, lack of sufficient keratinized tissue, deficient buccal contour volume, recession and thin biotype became treatment challenges with implant and natural tooth restorations, especially when less than ideal 3D position implant placement has resulted. Management of the soft tissue with an inadequate flap incision may complicate surgical results instead of improving the clinical situation, leading to apical mucosal recession and the resulting aesthetic complications that may ensue. The “Bernotti V-Y Flap” eliminates the complications reported with other approaches to correct these clinical issues.

28. Soft Tissue Augmentation to Increase Width of Keratinized Tissue Around Dental Implants Using Tissue Fixation Screws: A Novel Technique for Graft Tissue Stabilization

Presence of adequate width of attached gingiva for longevity of implants has long been debated upon. The implant-mucosa interface differs from the interface between the mucosa and natural teeth, and these differences are important to the understanding of the susceptibility of implants to infection. Few studies have examined the relationship between the width of keratinized mucosa and the health of peri-implant tissues. The results of these studies are contradictory.

34. The Waya Technique: A Novel Approach Using a Palatal Flap of Apical Repositioning for Primary Tension-Free Closure in Maxillary Bone Augmentation

The success of the processes of horizontal bone augmentation requires that the procedure has a tension-free closure. The greatest challenge in these regenerative techniques is to establish a flap design that covers an increased dimension after the bone graft had been applied to the defect; for this objective there are frequently using alternatives, but they cause loss of vestibular depth and keratinized mucosa, that cause functional and aesthetic discomfort.


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