Biologically Oriented Preparation Technique Research Articles

Rehabilitation of anterior maxilla with a novel hyperbolic profile transmucosal implant in elderly patients.

This study aims to evaluate soft and hard tissues response of a two-piece implant placed nonsubmerged in elderly patients' anterior maxilla. Marginal bone level and Pink Esthetic Score (PES) were evaluated up to 24 months. Twelve healthy consecutive patients (mean age 65.8±5 years; 65.5 median) were included in the study. Implants were inserted with flapless technique after 3 months or immediately after extraction. The smooth machined neck of the implant was characterized by a hyperbolic neck which follows biologically oriented preparation technique (BOPT) principles. A customized abutment and a provisional resin crown was positioned with care to avoid excessive soft tissue compression after 3 months, according with BOPT technique. A definitive ceramic crown was positioned after approx. 4 months. After 24 months all implants were stable and osseointegrated. PES improved at 6 and 12 months recalls, remaining stable at 24 months, indicating a healthy soft and hard tissue response. No complications were observed. Impression procedures and provisional/definitive crown cementation resulted simple and free from complications. The hyperbolic profile allowed the preparation of prosthetic crown free from any gingival tissue pressure to create the adequate soft tissue contour. The use of hyperbolic profile implant associated with the transmucosal (not-submerged) technique is a safe procedure that allow the preservation of soft and hard tissue also in elderly patients.

Digital protocol for creating a virtual gingiva adjacent to teeth with subgingival dental preparations

PurposeThis article describes a digital technique used to record gingival emergence profiles modeled for the prosthetic restoration of teeth prepared using biologically oriented preparation technique (BOPT). Materials and methodsThe description of the technique of intraoral recording, manipulation of digital files, and chairside protocol of prosthetic restorations is developed in the present manuscript on two anterior teeth treated with vertical and subgingival dental preparations for restoration with ceramic crowns. The manipulation of the digital files registered with an intraoral scanner with software that allows its alignment (best-fit) and the performance boolean of operation manages to create a virtual gingival emergency like the one it presents when it is adapted on the cervical part of the interim prosthesis. ConclusionsThe technique allows the dentist and laboratory technician to obtain a digital reproduction of the subgingival soft tissues around the prosthetic crown, unaffected by the collapse of the gingival sulcus when the provisional crown is removed, as well as an exact copy of the provisional restoration, making it possible to fabricate a definitive prosthesis that ensures precise anatomy, and so good compatibility with periodontal tissues.

Analogical and Digital Workflow in the Design and Preparation of the Emergence Profile of Biologically Oriented Preparation Technique (BOPT) Crowns over Implants in the Working Model.

The Biologically Oriented Preparation Technique (BOPT), developed by Ignacio Loi and published in 2008, is a consolidated concept in the modeling and preservation of pericoronal soft tissues. The present study describes the analogical and digital methods allowing adequate design and preparation of the emergence profile of BOPT crowns in the working model, with a view to comparing the workflow and advantages of each method. At present, not all the digital procedures have been fully optimized to completely replace the traditional analogical methods. Nevertheless, it is only a matter of time until dental digitalization technology totally replaces the analogical clinical methods. The digital workflow for this procedure is quickly implemented and optimized, and represents the most realistic option, with possibilities for further development in the immediate future.

Periodontal and prosthetic outcomes on teeth prepared with biologically oriented preparation technique: a 4-year follow-up prospective clinical study

PurposeTo evaluate the clinicaland biological behavior of full coverage restorations on teeth prepared without finish line during a 4-year follow-up. MethodsThis prospective study included 149 teeth treated using biologically oriented preparation technique (BOPT). The sample (149 teeth) was divided into two groups: Seventy four teeth restored with crowns, and 75 teeth supporting fixed partial dentures (FPD). Restorations were fabricated with zirconium oxide cores and ceramic coverings. Patients attended regular annual check-ups when probe depth, presence of inflammation with bleeding on probing, presence of plaque, gingival thickness, marginal stability, biological or mechanical complications, and the patient’s level of satisfaction were registered over a 4-year follow-up. ResultsAfter the 4-year follow-up, 2.1% of teeth underwent increases in probing depth; 12% of the sample presented inflammation and bleeding on probing; 20% of the restored teeth presented plaque; gingival thickening increased a 32.5%; 98.6% of teeth presented marginal stability; the restoration survival rate was 96.6%, with 2% of biological complications and 1.4% of mechanical complications. General satisfaction score was 80.73. ConclusionsRestorations placed on teeth prepared using BOPT present good periodontal behavior, increase of gingival thickening, and marginal stability over a 4-year follow-up. High survival rates after 4 years show that the technique produces predictable outcomes. Clinical significanceThe BOPT technique is a good treatment option in cases where replacement of an old restoration is required; presenting good periodontal behavior, gingival thickening, and marginal stability.

Volumetric variation of peri-implant soft tissues in convergent collar implants and crowns using the biologically oriented preparation technique (BOPT)

BackgroundTo evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading.Material and MethodsA pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibular sector. A total of 32 convergent collar implants were placed using a non-submerged protocol. Three months later the provisional cemented crowns were fitted using the BOPT approach with the finish line 1-1.5 mm below the gingival margin, simulating coronal emergence of a natural tooth. The soft tissue changes were measured with an intraoral scanner at two different timepoints: a) on the day of provisionalization, before prosthetic loading; and b) 10 months later without the provisional prosthesis. The STL files were superimposed and the soft tissue changes were recorded using a color scale with measurement of the volumetric changes in mm3.ResultsA mean increase in peri-implant mucosal volume of 64.7 mm3 was observed in 29 implants. The zones with the greatest increase in soft tissue volume were the papillae of implants with adjacent teeth and the peri-implant buccal margin. Three implants showed a mean decrease in soft tissue volume of -25.1 mm3.ConclusionsThe fitting and design of crowns using the biologically oriented preparation technique (BOPT) over convergent collar implants affords a significant increase in peri-implant soft tissue volume both at the level of the papillae and in the buccal margin. Key words:Dental implants, one-piece dental implants, convergent collar implants, soft tissue volume, peri-implant mucosa, BOPT, vertical preparation, shoulderless abutments, emergence profile, intraoral scanner, profilometric analysis.

Prospective Clinical Study of Zirconia Full-coverage Restorations on Teeth Prepared With Biologically Oriented Preparation Technique on Gingival Health: Results After Two-year Follow-up.

To evaluate the clinical behavior of one-piece complete-coverage crowns and fixed partial dentures (FPDs) on teeth with vertical preparation without finish line biologically oriented preparation technique (BOPT). This prospective study included 52 patients requiring treatment with restorations in the esthetic region: 74 crowns and 27 FPDs. The sample included a total of 149 teeth that were prepared vertically without finish line. The sample was divided into two groups: one-piece crowns and FPDs, all with zirconia cores, feldspathic ceramic veneer, and a 0.5-mm prosthetic finish line of zirconia. All procedures were carried out at the University of Valencia from 2013 to 2014. The following parameters were evaluated over a two-year follow-up: oral hygiene, periodontal state, gingival thickening, gingival margin stability, the presence of complications, and restoration survival rate. Patient satisfaction with treatment was assessed by means of a visual analogue scale (VAS). Two years after treatment, 80.5% of treated teeth remained free of gingival inflammation and bleeding. Mean gingival thickening was 0.41 ± 0.28 mm for one-piece crowns and 0.38 ± 0.36 mm for FPDs. Gingival margin stability was 100%, but 2% of the sample presented biological complications. The VAS patient satisfaction scores were eight out of a maximum score of 10. Two years after treatment, vertical preparation without finish line produces gingival thickening, margin stability, and optimal esthetics. Neither crowns nor FPDs presented any mechanical complications.

Prospective clinical study of zirconia full‐coverage restorations on teeth prepared with the biologically oriented preparation technique (BOPT)

Prospective clinical study of zirconia full‐coverage restorations on teeth prepared with the biologically oriented preparation technique (BOPT)

Increase of periimplant soft tissues with biologically oriented preparation technique (BOPT) prosthesis

Increase of periimplant soft tissues with biologically oriented preparation technique (BOPT) prosthesis

Vertical preparation for fixed prosthesis rehabilitation in the anterior sector

This clinical report describes a biologically oriented preparation technique (BOPT) for teeth and an implant for the esthetic rehabilitation of the maxillary anterior sector. The technique was designed to create an anatomic crown with a prosthetic emergence profile that simulated the shape of the natural tooth.

Correzione di parabole gengivali con tecnica di preparazione orientata biologicamente

ObjectivesTwo clinical cases with inappropriate gingival architecture were examined and the dental aesthetics and function were restored with Biologically Oriented Preparation Technique (BOPT). Materials and methodsThe first clinical case was a patient who presented with a prosthetic restoration with a gingival recession. The second clinical case was a patient who presented with asymmetric gingival parables of upper anterior incisors, showing erosive lesions in the cervical area. All teeth were prepared according to a standardized protocol. A vertical preparation was performed and the crown margins were located sub-gingivally. The provisional restorations were appropriately modified during the prosthetic treatment, according to BOPT technique, until an excellent match between gingival architecture and definitive restoration was obtained. ResultsThe mean observation period was 36 months. Patients are recalled for prophylaxis sessions once every six months. None of the fixed crowns gave problems during the observation period. The correction of the gingival architecture was observed and such result kept stable over time. ConclusionsThe asymmetry of gingival parables can be modified with BOPT technique without surgical procedures.