Dental connective tissue grafting

A customized treatment plan is important to reach results that will satisfy the patient providing esthetics, function, and long-term stability. This type of oral rehabilitation requires professionals from different dental specialties where communication is a major key point. Digital Smile Design allows the practitioners to plan and discuss the patient's condition to establish the proper treatment plan, which must be driven by the desired zenith position. The ideal gingival position will guide the professionals and determine the need to perform surgical procedures or orthodontic movement before placing the final restorations...

Tooth loss promotes bone and gingival tissue remodeling, thus breaking the harmony between the residual ridge and natural teeth. This is critical in the anterior region of the mouth, and the integration of several dental specialties is often essential to successful rehabilitation with implants. This article describes a multidisciplinary approach to implant-supported oral rehabilitation in the maxillary anterior region, presenting a new technique for optimizing esthetics in implants. A 19-year-old woman was missing her central and lateral incisors and had 2 dental implants in the lateral incisor sites...

BACKGROUND: The soft tissue healing and quality around dental implant is a current debated topic in the recent literature. The free gingival margin and the quantity and quality of the mucosa around teeth and surrounding dental implants still determine the hard and soft tissue healing status. OBJECTIVE: The aim of this study is to assess inter and intra-operative measurement concordance of a method aimed at evaluating the apico-coronal migration of free gingival margin, using intra-oral photography...

AIM: The aim of this study was to determine the treatment outcome of the use of a porcine monolayer collagen matrix (mCM) to augment peri-implant soft tissue in conjunction with immediate implant placement as an alternative to patient's own connective tissue. MATERIALS AND METHODS: A total of 27 implants were placed immediately in 27 patients (14 males and 13 females, with a mean age of 52.2 years) with simultaneous augmentation of the soft tissue by the use of a mCM...

Survival of dental implants depends on several factors; soft tissue (ST) management around dental implants is one of the foremost. Several studies have suggested techniques for ST management around dental implants, but none of them has discussed a suitable timetable for this process. This study aimed to review published articles related to the timing of ST management around dental implants and suggest a customized treatment protocol. A search of the PubMed database was conducted; the search was limited to English-language articles published from January 1995 to July 2015 with available full texts...

OBJECTIVES: To evaluate the volumetric changes and peri-implant health at implant sites with and without previous soft tissue grafting over a 5-year observation period. MATERIAL AND METHODS: In 18 partially edentulous patients, dental implants were placed in the esthetic zone (15-25) with simultaneous guided bone regeneration, followed by submerged healing. During the healing phase, eight patients (test) received a subepithelial connective tissue graft, whereas 10 patients (control) did not receive any soft tissue augmentation...

The treatment of peri-implant disease is one of the most controversial topics in implant dentistry. The multifactorial etiology and the myriad proposed techniques for managing the problem make successful decontamination of an implant surface affected by peri-implantitis one of the more unpredictable challenges dental practitioners have to face. This article presents the first known published case report demonstrating human histologic evidence of reosseointegration using a plastic curette for mechanical debridement and dilute sodium hypochlorite, hydrogen peroxide, and sterile saline for chemical detoxification...

Facial peri-implant mucosal recessions represent an increasing complication in implant dentistry and may negatively affect the esthetic outcome and patient satisfaction. The aim of the present paper is to provide a review on the potential causes of facial peri-implant mucosal recessions and to provide a rationale for treatment along with possible treatment options. The available data indicate that soft tissue augmentation around dental implants is possible, but at present there is no evidence demonstrating that the augmented soft tissues are able to influence the peri-implant bone levels (e...

For ideal implant rehabilitation, an adequate bone volume, optical implant position, and stable and healthy soft tissue are required. The reduction of alveolar bone and changes in its morphology subsequent to tooth extraction will result in insufficient amount of bone and adversely affect the ability to optimally place dental implants in edentulous sites. Preservation of alveolar bone volume through ridge preservation has been demonstrated to reduce the vertical and horizontal contraction of the alveolar bone crest after tooth extraction and reduce the need for additional bone augmentation procedures during implant placement...

OBJECTIVES: The aim was to compile the current knowledge about the efficacy of different soft tissue correction methods around osseointegrated, already uncovered and/or loaded (OU/L) implants with insufficient soft tissue conditions. Procedures to increase peri-implant keratinized mucosa (KM) width and/or soft tissue volume were considered. MATERIALS AND METHODS: Screening of two databases: MEDLINE (PubMed) and EMBASE (OVID), and manual search of articles were performed...

OBJECTIVE: To evaluate volumetric changes of soft tissues at pontic sites in patients treated with or without soft tissue grafting over an observation period of 10 years. MATERIALS AND METHODS: A total of 17 patients receiving a tooth-borne fixed dental prosthesis (FDP) were enrolled in this study. Nine patients received a subepithelial connective tissue graft (SCTG) at the pontic site (test). Eight patients continued without soft tissue grafting (control). Baseline impressions were taken after delivery of the final FDP and at 10 years...

Soft tissue dehiscence around dental implant has frequently been observed and it may lead to poor oral hygiene, especially around crowns that exhibit contours with prominent convexity. The present case demonstrates a peri-implant mucosal dehiscence coverage with modified semilunar coronary positioned flap (CPF) in #15 and 16. A semilunar partial-thickness incision was performed 7-10 mm apical from the facial gingival margin. Then, intrasulcular partial-thickness incision was tunneled to the semilunar incision...

The success of dental implant therapy in the esthetic zone requires not only functional osseointegration but also favorable esthetic results. The greatest challenge in the esthetic zone is to establish harmony, balance, and continuity of gingival form between implant restorations and the adjacent natural teeth. In the esthetic zone, a localized ridge defect or loss of a peri-implant papilla is common and can be corrected via soft tissue augmentation. This case report describes a novel surgical technique using connective tissue grafts via an apical pouch to increase soft tissue volume over an alveolar ridge defect or around natural teeth or implants in the maxillary anterior area...

Reducing the need for a connective tissue graft by using an efficacious biomaterial is an important task for dental professionals and patients. This experimental study aimed to test the soft tissue response to a volume-stable new collagen matrix. The device demonstrated good stability during six different time points ranging from 0 to 90 days of healing with no alteration of the wound-healing processes. The 90-day histologic specimen demonstrates eventual replacement of most of the matrix with new connective tissue fibers...

AIM: The aim of this study was to test whether or not soft tissue augmentation with a collagen matrix (VCMX) leads to a similar increase in ridge width around dental implants compared to the use of an autogenous subepithelial connective tissue graft (SCTG). MATERIALS AND METHODS: In 12 dogs, immediate dental implants were placed with simultaneous guided bone regeneration. Three months later, soft tissue volume augmentation was performed by randomly allocating three treatment modalities to these sites [VCMX, SCTG, sham-operated group (control)]...

OBJECTIVE: To document the profile of periodontists in private practice in Canada in terms of services provided and referral patterns. METHODS: An online survey consisted on 45 questions in 3 categories: demographics, referral patterns and periodontal procedures performed. The sampling frame consisted of all active members of the Canadian Academy of Periodontology (n= 280). Letters and email containing links to the online survey were used to invite participants and to send reminders to non-respondents on days 7, 21 and 49...

Long-term success rate of implants inserted in atrophic maxilla is ensured through sufficient bone volume in edentulous sites. Reconstructive surgery is necessary before implant placement to regenerate bone defects caused by atrophy, dental trauma, extractions or periodontal disease. Success rate of implants is related to the correct position and angulation of implants in residual crest, so that height and thickness of bone augmentation can allow predictable results. The most popular surgical procedures to obtain bone augmentation are: bone grafts, guided bone regeneration, maxillary sinus floor elevation, and bone osteogenesis distraction...

OBJECTIVES: Attached peri-implant gingiva has proven to have an influence on the long-term stability of dental implants. In patients with head and neck cancer, a functional peri-implant gingiva is even more of critical importance. The aim of the presented prospective study was to investigate a three-dimensional xenogeneic collagen matrix for augmentation around dental implants in patients with former head and neck cancer. MATERIAL AND METHODS: Eight patients presenting with insufficient peri-implant gingiva underwent vestibuloplasty on 51 implants using a xenogeneic collagen matrix...

PURPOSE: Soft tissue augmentation procedures are often performed to correct gingival recession on the facial aspects of implants in the esthetic zone. This retrospective clinical case series reports on the use of guided bone regeneration (GBR) and a coronal advancement flap with a resorbable membrane and allograft. MATERIALS AND METHODS: We analyzed the records of 14 patients (7 men and 7 women) with a mean age of 36.78 years (SD, 13.9 years) who were treated for soft tissue recessions around implant-supported restorations in the maxillary central or lateral incisor location...

BACKGROUND: Clinicians and patients continually search for procedures to decrease time from tooth extraction to restoration. Evidence to date is limited concerning timing of ridge preservation healing and reentry for implant placement. The first objective of this study is to histologically evaluate new bone formation 8 to 10 weeks versus 18 to 20 weeks after extraction of non-molar teeth and ridge preservation using demineralized freeze-dried bone allograft (DFDBA). The second objective is to compare dimensional changes including ridge width and height at the two healing time points...