Autogenous graft versus collagen matrices for peri-implant soft tissue augmentation. A systematic review and network meta-analysis*

Clinical Oral Investigations, Год журнала: 2024, Номер 28(5)

Опубликована: Май 5, 2024

Язык: Английский

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Impact of keratinized mucosa on implant‐health related parameters: A 10‐year prospective re‐analysis study

Clinical Implant Dentistry and Related Research, Год журнала: 2024, Номер 26(3), С. 554 - 563

Опубликована: Фев. 28, 2024

Abstract Aim To investigate whether the lack of keratinized mucosa (KM) affects peri‐implant health after 10 years loading. Materials and Methods Data from 74 patients with 148 implants two randomized controlled studies comparing different implant systems were included analyzed. Clinical parameters including bleeding on probing (BOP), depth (PD), plaque index, marginal bone loss (MBL), KM width (KMW) at buccal sites collected baseline (time final prosthesis insertion), 5‐year postloading. Multivariable logistic linear regression models by means a generalized estimated equation (GEE) used to evaluate influence clinical parameters; BOP, MBL, PD, adjusted for type (one‐piece or two‐piece) compliance. Results A total 35 (24.8%) healthy, 67 (47.5%) had mucositis 39 (27.6%) affected peri‐implantitis. In absence (KM = 0 mm), 75% exhibited mucositis, while in presence (KMW >0 mm) 41.2% mucositis. Regarding peri‐implantitis, corresponding percentages 20% 26.7% mm). Unadjusted showed that tended reduce odds showing BOP (OR: 0.28 [95% CI, 0.07 1.09], p 0.06). The model revealed having 0.21 0.05 0.85], 0.02) using two‐piece 0.34 0.15 0.75], 0.008) significantly reduced BOP. Adjusted GEE associated MBL changes ( < 0.05). Conclusion appears be linked such as but association is weak. design one‐piece may account their increased exhibiting

Язык: Английский

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Reproducibility and Reliability of Intraoral Scanners for Evaluating Peri‐Implant Tissues and Implant‐Supported Prostheses: A Cross‐Sectional Study

Journal of Esthetic and Restorative Dentistry, Год журнала: 2025, Номер unknown

Опубликована: Янв. 9, 2025

ABSTRACT Objective To assess the reproducibility and reliability of pink (PES) white esthetic scores (WES) using digital images intra‐ inter‐examiner agreement among different clinical backgrounds assessment methods. Material Methods Standardized intraoral were obtained from adult subjects with an implant‐supported single‐tooth fixed dental prosthesis located in maxillary zone a camera true‐color scanner. According to PES WES criteria, evaluated by 20 calibrated evaluators, 5 prosthodontists, periodontists, undergraduates, oral surgeons. Results The total number individual was 12600 9000, respectively. Similar values scanner compared camera. Intra‐ inter‐rater variations observed between within evaluators' backgrounds, periodontists showing consistently lower mean WES. intraclass correlation coefficient ranges 0.41 0.61 for 0.42 0.69 WES, resulting fair good both Conclusion peri‐implant tissues prostheses utilizing provided offers reproducible reliable method comparable Clinical Significance This study highlights scanners evaluating prostheses. findings suggest that are viable alternative traditional imaging these assessments. However, scores, according background emphasize need caution when interpreting decision‐making research.

Язык: Английский

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The peri‐implant phenotype and implant esthetic complications. Contemporary overview

Journal of Esthetic and Restorative Dentistry, Год журнала: 2021, Номер 33(1), С. 212 - 223

Опубликована: Янв. 1, 2021

Abstract Objective To provide a contemporary and comprehensive overview of the hard soft tissue biological structures surrounding an osseointegrated dental implant (peri‐implant referred to as peri‐implant phenotype), in context esthetic complications. Overview The individual components phenotype (keratinized mucosa width, mucosal thickness, supracrestal height, buccal bone) have been linked different aspects esthetics, well health‐related aspects. At time therapy, respecting biology tissues, anticipating their remodeling patterns can alleviate future Conclusions While current literature may not allow for point‐by‐point evidence based‐recommendation required amount each structure, bearing mind proposed values phenotype, at prior therapy lead more predictable treatment outcomes, avoidance Clinical Significance Knowledge implant, underlying process is crucial carrying out successful alleviating possible challenges.

Язык: Английский

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Regenerative Medicine Technologies to Treat Dental, Oral, and Craniofacial Defects

Frontiers in Bioengineering and Biotechnology, Год журнала: 2021, Номер 9

Опубликована: Авг. 6, 2021

Additive manufacturing (AM) is the automated production of three-dimensional (3D) structures through successive layer-by-layer deposition materials directed by computer-aided-design (CAD) software. While current clinical procedures that aim to reconstruct hard and soft tissue defects resulting from periodontal disease, congenital or acquired pathology, maxillofacial trauma often utilize mass-produced biomaterials created for a variety surgical indications, AM represents paradigm shift in at individual patient level. Computer-aided systems employ algorithms design customized, image-based scaffolds with high external shape complexity spatial patterning internal architecture guided topology optimization. 3D bioprinting surface modification techniques further enhance scaffold functionalization osteogenic potential incorporation viable cells, bioactive molecules, biomimetic vectors transgene expression within layered architecture. These computational features enable fabrication engineering constructs highly tailored mechanical, structural, biochemical properties bone. This review examines key design, bioresorbable bone produced processes, applications these regenerative technologies. transforming field personalized dental medicine has great improve outcomes care.

Язык: Английский

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Prevalence and risk indicators of midfacial peri‐implant soft tissue dehiscence at single site in the esthetic zone: A cross‐sectional clinical and ultrasonographic study

Journal of Periodontology, Год журнала: 2021, Номер 93(6), С. 857 - 866

Опубликована: Ноя. 17, 2021

Esthetic complications of dental implants in the esthetic zone can have a major negative impact on patients' quality life and perception implant therapy. The aim present study was to evaluate prevalence peri-implant soft tissue dehiscence (PSTD) clinical ultrasonographic risk indicators for this condition.Subjects with ≥1 healthy single area were identified recruited. Clinical measurements, including PSTD class subclass, probing depth, keratinized mucosa width (KMW), mucosal thickness (MT) at 1 mm 3 mm, buccal bone distance (BBD) thickness, evaluated PSTD.A total 153 subjects 176 included. 54.2% 56.8% patient level, respectively. most frequent type one characterized by having both an implant-supported crown longer than homologous tooth visible abutment/implant fixture exposed oral cavity. multivariate analysis showed that presence adjacent implant, time function, limited MT, reduced KMW, increased BBD significantly associated PSTD.PSTDs are common findings region. Several condition, such as function higher BBD, lower MT identified.

Язык: Английский

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Efficacy of biologics for the treatment of periodontal infrabony defects: An American Academy of Periodontology best evidence systematic review and network meta‐analysis

Journal of Periodontology, Год журнала: 2022, Номер 93(12), С. 1803 - 1826

Опубликована: Окт. 24, 2022

Abstract Background A large variety of biomaterials, biologics and membranes have been utilized in the past 40 years for regenerative treatment periodontal infrabony defects. Biologic agents progressively gained popularity among clinicians are routinely used regeneration. In alignment with goals American Academy Periodontology (AAP) Best Evidence Consensus (BEC) on use biologic mediators contemporary clinical practice, aim this sytematic review was to evaluate effect agents, specifically autogenous blood‐dervied products (ABPs), enamel matrix derivative (EMD) recombinant human platelet‐derived growth factor‐BB (rhPDGF‐BB), outcomes Methods detailed systematic search conducted identify eligible randomized control trials (RCTs) reporting therapy using frequentist mixed‐modeling approach network meta‐analysis (NMA), characterized by assessment three individual components an defect (the bone graft material [BG], agent, application a barrier membrane) performed compare relative efficacy different components, therapeutic modalities Results total 153 RCTs were included, 150 studies contributing NMA. The quantitative analysis showed that addition significantly improves radiographic outcomes, as compared BG flap procedures alone. Barrier enhanced but did not provide further benefits combination biologics. type (autogenous, allogeneic, xenogeneic or alloplastic) agent (EMD, platelet‐rich fibrin [PRF], plasma [PRP] rhPDGF‐BB) played significant role final Allogeneic BGs exhibited statistically superior gain than synthetic (p < 0.05 all comparisons), while rhPDGF‐BB PRF demonstrated higher stability gingival margin 0.01) fill/gain 0.05), together greater, although significant, attachment level pocket depth reduction, EMD PRP. Overall, largest size most parameters, including gain, less recession linear gain. Considering relatively high number presenting unclear risk bias, strength recommendation supporting PRP judged weak, EMD, deemed favor. Conclusions Biologics enhance therapy. Combination therapies involving + membrane be monotherapies. choice seems impact

Язык: Английский

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Alveolar ridge preservation reduces the need for ancillary bone augmentation in the context of implant therapy

Journal of Periodontology, Год журнала: 2022, Номер 93(6), С. 847 - 856

Опубликована: Март 15, 2022

Abstract Background There is limited information on the need for bone augmentation in context of delayed implant placement whether alveolar ridge preservation (ARP) previously performed or not. The primary aim this retrospective cohort study was to evaluate efficacy ARP therapy after tooth extraction compared with unassisted socket healing (USH) reducing ancillary before at time placement. Methods Adult subjects that underwent non‐molar single without simultaneous were included study. Cone beam computed tomography scans obtained and a variable period used record baseline facial thickness virtually plan according standard method. A logistic regression model effect upon (USH ARP) additional augmentation, adjusting several covariates (i.e., age, sex, KMW, type). Results One hundred forty equally distributed between both groups constituted population. Implant deemed feasible all sites. Simultaneous considered necessary 60% 11.4% sites USH group, respectively. Most these (64.2% group 87.5% group) exhibited thin phenotype (<1 mm) baseline. Logistic revealed odds not needing 17.8 times higher received therapy. Furthermore, reduced 7.7 every 1 mm increase thickness, regardless Conclusions Based digital analysis, therapy, USH, thick largely reduce

Язык: Английский

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Minimal invasiveness in soft tissue augmentation at dental implants: A systematic review and meta‐analysis of patient‐reported outcome measures

Periodontology 2000, Год журнала: 2022, Номер 91(1), С. 182 - 198

Опубликована: Авг. 11, 2022

Abstract The aim of this study was to compare patient‐reported outcome measures (PROMs) soft tissue substitutes versus autogenous grafts for augmentation procedures at implant sites. Comprehensive and systematic literature searches were performed until December 2021. A focused question formulated based on the Population, Intervention, Comparison Outcome criteria (PICO): In patients with dental implants undergoing (P), do (I) compared graft (SCTG [subepithelial connective graft]) (C) limit post‐operative morbidity other patient reported‐outcomes (O). Randomized controlled clinical trials, prospective‐, retrospective‐ case‐series studies included. Meta‐analyses whenever possible results expressed as weighted mean differences (WMD). total 29 For mucosal thickness gain, significantly reduced pain perception SCTG (n = 4; WMD 14.91 Visual Analog Scale [VAS] units; 95% confidence interval [CI] 6.42‐23.40; P < .0006) a 0‐100 VAS scale. Based 0‐10 scale, borderline significance reduction found when applied 1.62 CI 0.01‐3.23; .05). keratinized after scale 2; 21.43 12.58‐30.28; .0001). 1.65 0.66‐2.64; .001). Regarding medication, required less painkillers 6; 1.56 tablets; 1.22‐1.91; .00001) augmentation. surgery time used 5; 10.9 minutes; 4.60‐17.19; .00001). There no significant in satisfaction, aesthetics, quality life (OHIP‐14) between following Soft substitutes, grafts, improve PROMs can reduce perception, amounts while achieving similar levels patient´s satisfaction without impairing outcomes. current evidence indicates that they constitute valid reliable alternative minimize invasiveness

Язык: Английский

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Clinical and patient‐reported outcomes of tissue engineering strategies for periodontal and peri‐implant reconstruction

Periodontology 2000, Год журнала: 2022, Номер 91(1), С. 217 - 269

Опубликована: Сен. 27, 2022

Scientific advancements in biomaterials, cellular therapies, and growth factors have brought new therapeutic options for periodontal peri-implant reconstructive procedures. These tissue engineering strategies involve the enrichment of scaffolds with living cells or signaling molecules aim at mimicking cascades wound healing events clinical outcomes conventional autogenous grafts, without need donor tissue. Several been explored over years a variety scenarios, including regeneration, treatment gingival recessions/mucogingival conditions, alveolar ridge preservation, bone augmentation procedures, sinus floor elevation, regeneration therapies. The goal this article was to review that performed reconstruction implant site development, evaluate their safety, invasiveness, efficacy, patient-reported outcomes. A detailed systematic search conducted identify eligible randomized controlled trials reporting utilized aforementioned indications. total 128 were ultimately included qualitative analysis. Commonly involved enriched mesenchymal somatic (cell-based strategies), more often loaded molecules/growth (signaling molecule-based strategies). approaches found be safe when therapies development. Tissue demonstrated either similar superior than infrabony furcation defects, augmentation. can promote higher root coverage, keratinized width, thickness gain alone can, they obtain mean coverage compared grafts. There is some evidence suggesting positive effect on patient morbidity, preference, esthetics, quality life mucogingival deformities. Similarly, reduce invasiveness complications graft-based staged More studies incorporating are needed understand cost-benefits traditional treatments.

Язык: Английский

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