Esthetic Region Research Articles

The impact of collagen membrane fixation protocols on volume stability in horizontal ridge augmentation in the aesthetic area: A retrospective study.

This study aimed to evaluate the impact of different collagen membran fixation protocols on the volume stability in horizontal ridge augmentation in the aesthetic area. A total of 48 patients with 65 augmented sites were included in this study. Implants were placed in the aesthetic region, and simultaneous guided bone regeneration (GBR) surgery was performed for horizontal ridge augmentation. Participants were divided into four groups, each comprising 12 patients, based on different absorbable collagen membrane fixation protocols. Group 1: without fixation; Group 2: fixation with absorbable sutures; Group 3: fixation with titanium pins; Group 4: fixation with titanium pins and absorbable sutures. Cone beam computed tomography (CBCT) was performed immediately after surgery and at 6 months post-surgery, respectively. The horizontal thickness of the augmented region was analyzed for volume stability at the implant shoulder (H0) and 1-5 mm apical to the implant shoulder (H1-H5). Changes in labial thickness during bone healing were calculated as absolute values (mm) and relative values (%). After 6 months of bone healing, horizontal thickness was significantly reduced at all levels (H0-H5) in all groups compared to immediate post-surgery results (p < 0.05). At H1-H5, horizontal bone loss in group 1 was significantly higher than in the other three groups (p < 0.05). Group 4 exhibited significantly less horizontal bone loss compared to group 2 at H0-H2 (p < 0.05) and group 4 compared to group 3 at H0-H1 (p < 0.05). No significant difference in horizontal bone loss between groups 2 and 3 was detected at H0-H5 (p > 0.05). Guided bone regeneration in the aesthetic area with additional membrane fixation demonstrated superior volume stability of the augmented region compared to cases without fixation. There was no significant difference in bone volume stability between membrane fixation with titanium pins and fixation with absorbable sutures. However, the combined use of pins and absorbable sutures yielded superior volume stability.

Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial.

It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation. Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5mm after an extraction were randomly assigned to immediate (Immediate Group, n=20) or delayed (Delayed Group, n=20) implant placement. The second-stage surgery and provisional restoration placement occurred 3months after implant placement in both groups, followed by definitive restorations 3months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded. The mean marginal bone level change was -0.71±0.59mm and -0.36±0.39mm in the Immediate Group and the Delayed Group after 10years (p=0.063), respectively. The secondary outcomes were not significantly different between both groups. Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone. Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.

Effect of Sagittal Root Position, Angle, and Bone Thickness on Peri-implant Tissue Phenotype and Bone Level in Socket Shield Technique: A Retrospective Case Series.

There were only a few studies investigating the effect of sagittal root position (SRP), sagittal root angle (SRA), and buccal bone thickness (BBT) on peri-implant tissues using the socket shield technique (SST). This retrospective case series aimed to evaluate the SRP, SRA, and BBT in socket shield cases and examine the effect of these anatomical factors on the peri-implant tissue phenotype and bone level. Data from 27 patients (14 women, 13 men) treated with SST in the maxillary esthetic region between July 2019 and September 2021 were included. Clinical indices (modified plaque and bleeding indices, probing depth, keratinized mucosa width, mucosal thickness) and periapical radiographic recordings (marginal bone level) taken immediately after permanent prosthesis placement and 1 year later were used. Cone beam computerized tomography images were used to examine BBT, SRP, and SRA before implant placement and horizontal and vertical bone levels before implant placement and 1 year after prosthetic rehabilitation. The data were divided into groups based on BBT (<1 and ≥1 mm) and SRA values (<10° and ≥10°). There were no significant differences in 1-year clinical factors between the SRA <10° and SRA ≥10° groups. However, higher vertical bone loss was found in the SRA ≥10° group (P = .01, d = 0.53). There were no significant differences in clinical or radiographic factors between the BBT <1 mm and BBT ≥1 mm groups. In conclusion, BBT showed no significant effect on tissue phenotype and bone level, but SRA affected bone level in socket shield cases.

Evaluating Color Stability of Three Different Provisional Crown Materials: A Short Study

Purpose: To evaluate and compare the colour stability of three different provisional restorations using three different pigmented solutions Material and Methods: Total six samples of each material for each group ( Self-cure PMMA, Revotek LC, and CAD-CAM milled ) with the following specifications 2mm occlusal reduction, 1.5 axial reduction, 1mm round chamfer finish line, 6° convergence angle. This prepared tooth will be used as a guide for the metal die. After immersion in a staining solution of synthetic saliva (control), synthetic saliva and tea, synthetic saliva, and turmeric, on the 1st, 7th and 30th-day color measurement was done using a Spectrophotometer. Results: Mean values were compared using one-way analysis of variance (ANOVA) (statistically significant when P &lt; 0.05). Post hoc test using Tukey’s honestly significant difference was employed to identify significant groups (statistically significant when P &lt; 0.05). Repeated measures of ANOVA were performed to analyze the color stability of the different specimens at different periods of storage. Significant groups were identified using the Bonferroni test. Conclusion: Maximum discoloration was seen in synthetic saliva &amp;turmeric solution for all the two materials. CAD-CAM is the best material out of both if the provisional restoration has to be given for a longer duration in the esthetic region.

Socket-shield Technique and immediate implant placement for ridge preservation in the aesthetic region: a 1-year clinical and tomographic follow-up

Objective: To describe the clinical, radiographic and tomographic aspects, as well as complications, success, aesthetic and functional results of an implant placed using the “socket shield” technique. Case Details: Represents a 46-year-old patient, with increased mobility of the crown in the bucco-palatal direction, with indication for extraction replaced by immediate implant. Atraumatic extraction, socket preservation technique and immediate implant placement were performed. The socket-shield technique was designed for placing implants to protect the oral bone and achieve adequate aesthetics. The buccal fragment of the tooth was kept fixed and the implant was placed in contact with the tooth fragment. Cone Bean computed tomography showed bone formation in the buccal aspect 1 year later, and demonstrated stability of the peri-implant bone tissue and replacement of the root remnant by bone. The clinical appearance demonstrated maintenance of peri-implant soft tissues and good aesthetics without gingival retraction. Final considerations: One-year follow-up shows adequate healing and healthy peri-implant tissue, suggesting that the socket-shield technique with immediate implant placement can be an excellent alternative for preserving the vestibular cortex and implant placement, especially in the aesthetic area.

Horizontal ridge augmentation in the maxillary aesthetic region using the autogenous circular cortical-lamina anchoring technique: A case series study.

This case series aimed to evaluate the effectiveness of the autologous circular cortical lamina-anchoring (CCA) technique for horizontal bone augmentation in the maxillary aesthetic region. A total of 25 patients with 28 implants underwent horizontal bone augmentation using CCA followed by implant placement and crown delivery. The primary outcome measures were alveolar ridge width (ARW) and buccal bone thickness (BBT), whereas the secondary outcome measures included marginal bone loss (MBL), mid-facial mucosal margin loss (MML), clinical assessment of peri-implant and aesthetic parameters, patient-reported outcome measures (PROMs), and implant survival rates. All 25 patients with 28 implants completed the treatment, no dropouts occurred. After CCA, the mean ARW at 1, 2, and 4 mm below the alveolar crest significantly increased from 2.38 ± 0.48, 2.85 ± 0.51, and 3.21 ± 0.53 mm to 6.80 ± 0.48, 6.99 ± 0.50, and 8.08 ± 0.52 mm, respectively. At the 3-year follow-up, the mean BBT0, BBT2, and BBT4 slightly decreased from 2.51 ± 0.26, 2.63 ± 0.31, and 2.75 ± 0.29 mm to 2.43 ± 0.27, 2.51 ± 0.30, and 2.64 ± 0.28 mm, respectively. Although the overall MBL was <0.15 mm, the results were statistically significant. The mean MML at the 3-year follow-up was 0.02 mm. All implant sites showed acceptable peri-implant and aesthetic outcomes. Incisions healed without complications, and no significant differences in PROMs observed at any time point. The 3-year follow-up showed a 100% implant survival rate. The autologous CCA technique is a useful method for increasing ARW and maintaining BBT in the maxillary aesthetic region.

Risk indicators for gingival recession in the esthetic zone: A cross-sectional clinical, tomographic, and ultrasonographic study.

To evaluate the risk indicators associated with midfacial gingival recessions (GR) in the natural dentition esthetic regions. Cone-beam computed tomography (CBCT) results of thirty-seven subjects presenting with 268 eligible teeth were included in the cross-sectional study. Clinical measurements included presence/absence of midfacial GR; the depth of the midfacial, mesial, and distal gingival recession; the recession type (RT); keratinized tissue width (KT); and attached gingiva width (AG). Questionnaires were utilized to capture patient-reported esthetics and dental hypersensitivity for each study tooth. Buccal bone dehiscence (cBBD) and buccal bone thickness (cBBT) were measured on the CBCT scans. High-frequency ultrasonography was performed to assess gingival thickness (GT) and buccal bone dehiscence (uBBD). Intraoral optical scanning was obtained to quantify the buccolingual position of each study site (3D profile analysis). Multilevel logistic regression analyses with generalized estimation equations were performed to assess the factors associated with the conditions of interest. The presence of midfacial GR was significantly associated with the history of periodontal treatment for pocket reduction (OR 7.99, p=0.006), KT (OR 0.62, p<0.001), cBBD (OR 2.30, p=0.015), GT 1.5mm from the gingival margin (OR 0.18, p=0.04) and 3D profile 1mm from the gingival margin (OR 1.04, p=0.001). The depth of midfacial GR was significantly correlated to previous history of periodontal treatment (OR 0.96, p=0.001), KT (OR -0.18, p<0.001), presence of bone fenestration (OR 0.24, p=0.044), and cBBD (OR 0.43, p<0.001). The depth of midfacial GR was also the only factor associated with patient-reported esthetics (OR -3.38, p=0.022), while KT (OR 0.77, p=0.018) and AG (OR 0.82, p=0.047) were significantly correlated with patient-reported dental hypersensitivity. Several risk indicators of midfacial and interproximal GR in the esthetic region were identified. The use of imaging technologies allowed for detection of parameters associated with the conditions of interest, and, therefore, their incorporation in future clinical studies is advocated. Ultrasonography could be preferred over CBCT for a noninvasive assessment of periodontal phenotype.

Implant-related plastic and reconstructive surgery

ABSTRACT Dental implant treatment is a common therapy for missing teeth in partial and complete edentulous ridges. Its success depends on the osseointegration of the implant with bone and the presence of abundant soft tissues around it. A peri-implant soft tissue is a major factor for long-term stability with regard to implant restorations. Soft-tissue augmentation procedures often are recommended for gain in keratinized tissue with relation to implant retained prosthesis. In our report, we describe in detail the treatment of mucosal recession associated with crowns placed on implants in the aesthetic region. The long partial edentulous maxillary ridge reconstruction and rehabilitation required several surgical steps for a stable result.

Fratura mandibular em vítima de agressão domiciliar: relato de caso

As a consequence of its prominence on the face, the mandible is one of the bones most susceptible to fractures caused by different etiological agents. Currently, domestic violence has been a considerable factor in the appearance of facial injuries, which are mostly performed by partners of the victims. The aim of this study is to report a case of mandibular fracture caused by domestic violence. Female patient, victim of domestic aggression, attended at the Maxillofacial Service, in Bahia, with extensive submandibular hematoma, facial asymmetry, pain during physical examination and presence of atypical mobility on mandibular manipulation. The Computed Tomography exam evidenced two fracture lines in the mandible. The patient was submitted to surgery for osteosynthesis, uneventfully. Considering that the face is an aesthetic region, manipulation in those structures is an aesthetic and functional challenge, requiring specialized care.

Immediate Loading of Bicortically Engaged Long Implants in Maxillary and Mandibular Esthetic Region – A Clinicoradiographic Evaluation

Abstract Background: Bicortical engagement is the engagement of nasal cortical plate and basal cortical plate in maxillary and mandibular esthetic zone, respectively. These are longer implants which offer osseointegration along with high osseofixation. Increased length of implant provides increased bone–implant contact offering primary stability which permits immediate loading. Aim: The aim of the study was to clinicoradiographically evaluate immediate loading in bicortically engaged long implants in maxillary and mandibular esthetic region. Materials and Methods: Thirty patients with missing teeth in esthetic region were selected for the study. Implants were placed in both arches engaging nasal cortex and basal bone wherever required. One-time definitive abutment was placed and immediate loading was done. Results: No failure was observed in the study period of 9 months. The mean insertion and reverse torque was 66.67 ± 6.794 and 41.67 ± 3.101, respectively, indicating high primary stability. No pain, discomfort, infection, or implant mobility was observed. The mean crestal bone loss changes were statistically insignificant. Conclusion: Hundred percent implant survival was observed.

Efficacy of alveolar ridge preservation with xenografts and resorbable socket sealing materials in the esthetic region: A systematic review with meta-analyses.

The present systematic review aimed to identify and summarize the clinical, radiographic, and histological outcomes of alveolar ridge preservation using bone xenografts and absorbable sealing materials compared with spontaneous healing in the esthetic zone. Randomized clinical trials (RCTs) fulfilling specific eligibility criteria were included. Two review authors independently searched for eligible studies, extracted data from the published reports and performed the risk of bias assessment (RoB 2 tool). Study results were summarized using random effects meta-analyses. Thirteen articles concerning 10 RCTs were included, involving a total of 357 participants. Most of studies were considered as "low" risk of bias. Meta-analyses indicated less horizontal (difference in means-MD = 1.88 mm; p < 0.001), vertical mid-buccal (MD = 1.84 mm; p < 0.001) and vertical mid-lingual (MD = 2.27 mm; p < 0.001) bone resorption in alveolar ridge preservation compared to spontaneous healing as assessed clinically. Bone changes assessed radiographically showed consistent results in terms of horizontal (at 1 mm: MD = 1.84 mm, p < 0.001), vertical mid-buccal (MD = 0.95 mm; p < 0.001) and mid-lingual (MD = 0.62 mm; p = 0.05) resorption. Part of the bone resorption in the spontaneous healing group was compensated by soft-tissues, since the observed differences between groups in linear ridge reduction evaluated through cast models superimposition were smaller (MD = 0.52 mm; p < 0.001). Alveolar ridge preservation with xenogeneic bone substitutes and non-autogenous resorbable socket sealing materials is efficacious in reducing post-extraction bone and ridge changes in the esthetic region.

Two adjacent implant-supported restorations in the aesthetic region: A 10-year prospective case series.

The treatment outcome of two adjacent implant-supported restorations in the maxillary aesthetic region was assessed regarding peri-implant soft and hard tissues, and satisfaction during a 10-year follow-up period. Twenty patients missing two adjacent teeth in the maxillary aesthetic region and treated with two implant-supported restorations were followed prospectively. The patients' clinical and radiographic parameters, as well as their satisfaction, were scored for a 10-year follow-up period. Seventeen patients' data were available for the 10-year follow-up. The survival rate of the implants and restorations was 100%. The 10-year mean peri-implant bone change at the side facing the adjacent tooth was +0.11 ± 0.57 mm and at the side facing the adjacent implant was -0.08 ± 0.50 mm. The peri-implant soft tissues were healthy and the patients' satisfaction was high, but the papilla-index showed compromised inter-implant papillae and low Pink Esthetic Scores. These figures were of the same magnitude at all time points. While it is difficult to obtain sufficient inter-implant papillae and satisfactory Pink Esthetic Scores, the initial treatment results remained stable and the patients were satisfied with the final result throughout the 10-year follow-up period.

One-piece versus two-piece zirconia abutment supported single implant crown in the esthetic region: 3-Year results from a split-mouth randomized controlled clinical trial.

To compare the clinical, radiographic, and immunological outcomes between one-piece versus two-piece zirconia abutments supported single implant crowns in the esthetic region. The study followed a split-mouth, double-blind, and randomized controlled clinical design for a duration of 3 years. Twenty-two eligible patients with 44 implants were randomly assigned to two groups: Group 1 (one-piece zirconia abutment with zirconia base, n = 22) and Group 2 (two-piece zirconia abutment with titanium base, n = 22). The primary outcome was the technical complication rate. Additionally, survival rates, cytokines concentrations in peri-implant crevicular fluid (PICF), peri-implant conditions, marginal bone loss, and pink/white esthetics score (PES/WES) were assessed as secondary outcomes. Twelve of 22 patients attended the 1-year follow-up (due to the COVID pandemic), and 19 patients attended the 3-year examination. Two abutments in Group 1 were fractured after 10 and 12 months in function. Additionally, one screw loosening occurred in Group 1 at 1-year follow-up. The 3-year technical complication rate was significantly higher in Group 1 than that in Group 2 (15.79% vs. 0%, p < .001). The 3-year implant survival rate was 100% in both groups. The concentration of IFN-γ in PICF was significantly upregulated in Group 2 (p = .018). Furthermore, the IL-6 concentration was positively correlated with BOP% (p = .020). Two-piece zirconia abutments exhibited superior technical performance compared to one-piece designs during a 3-year follow-up in the anterior region. However, further long-term research is necessary to verify the immunological stability of two-piece zirconia abutments.

Reconstructive Options for Basal Cell Carcinoma Defects in the Head and Neck Region: An Institutional Experience.

Basal cell carcinoma (BCC) is the most common skin cancer with more than 80% occurring on the face occurring mainly due to exposure to ultraviolet rays in the elderly due to cumulative exposure of the UV rays during their lifetime. Though various treatment modalities are available for the treatment of basal cell carcinomas, wide local excision is the standard line of management. However, reconstruction of facial BCC poses a challenge to the reconstructive surgeon. Over a 4-year-old period from 2017 to 2021, a total of 30 patients of head and neck basal cell carcinoma were surgically excised in our institution. We have explored all modes of reconstruction from small to large BCC defects in terms of cosmesis, form and function. Four patients underwent primary closure, 8 patients underwent skin grafting, 13 patients underwent closure by local and advancement flaps and 5 patients with large defects underwent free flap reconstruction. No flap loss was reported. None reported any functional deficit. To achieve adequate aesthetic surgical outcomes after reconstruction, knowledge of facial aesthetic regions is of utmost importance. The size and location of the defect and the presence of vital structures adjacent to the defect should be assessed to determine the kind of reconstruction that should be carried out without adversely affecting adjacent structures. For greater patient satisfaction, the method of reconstruction should be tailor made, where donor tissue resembles native tissue with good contour and texture match, suture line scars are camouflaged, and complications are nil.

Immediate placement and loading of implants with laser-microgrooved collar in combination with an anorganic porcine bone mineral matrix in the esthetic zone. Twelve-month results of a prospective multicenter cohort study.

Many techniques have been proposed to address post-extraction ridge resorption, which often represents a concern, especially in the esthetic region. The purpose of the present, prospective, multicenter, single cohort study was to investigate, up to 1 year of function, the effectiveness of a protocol for alveolar ridge preservation involving implants with laser-microgrooved surface immediately placed in fresh extraction sockets. Twenty eight patients candidate to tooth extraction in the esthetic zone (site 15-25 and 35-45) were treated by immediate placement of a single laser-microgrooved implants with the adjunct of a highly porous anorganic porcine bone mineral matrix and a collagen wound dressing. Peri-implant marginal bone level (MBL) was evaluated at time of loading, 3 and 12 months after loading. Gingival index, plaque index, probing depth, and bleeding on probing were measured at 3, 6, and 12 months after loading. Dimensional changes at implant sites were digitally evaluated using the best-fit superimposition of pre-and post-socket preservation models. Implant aesthetic score (IAS) as well as patients' post-operative quality of life were also evaluated at 12 months. Comparisons between data relative to thick and thin gingival phenotypes were made using Student's t-test or Mann-Whitney test, as appropriate. The significance level was set at p = 0.05. No patient dropped out, and 28 implants were evaluated at 12 months post-loading. The overall MBL was found to be 0.92 ± 1.11 mm. Volumetric analysis of superimposed models showed an alveolar bone tissue displacement at the buccal aspect of -0.57 ± 0.52 mm in thin phenotypes and -0.46 ± 0.31 mm in thick phenotypes (p = 0.58, unpaired Student's t-test). No signs of soft tissue recession or esthetically unpleasant buccal gingiva were reported. The clinical protocol herein employed showed benefits in maintaining marginal bone levels and soft tissue contour around post-extraction implants in the esthetic zone.

Basal Cell Carcinoma After High Dose Rate Brachytherapy: Medium-term Dermoscopic Evaluation of Cancer's Response.

Basal cell carcinoma of the facial region remains a challenge for contemporary oncology due to the presence of aesthetic regions and critical organs. Surgery is not always the optimal solution, and high dose rate (HDR) brachytherapy has emerged as an organ-sparing treatment method whose effectiveness has been proven by a growing number of publications. Dermoscopy is a diagnostic tool that bridges clinical and pathological examination of skin lesions. It is routinely used for diagnosis, monitoring of treatment, and post-treatment evaluation; however, the literature lacks data concerning changes in dermoscopic patterns of skin cancers during and after irradiation. Our team conducted a prospective non-randomized trial of 39 patients with high-risk basal cell carcinomas (BCCs), mostly localized within the high-risk zone (H-zone) of the facial region, and who qualified for HDR brachytherapy. HDR contact brachytherapy with custom-made surface molds was introduced, delivering a dose of 45Gy in 9 fractions prescribed to the tumor. Every patient was observed clinically and dermoscopically at three observational points: before treatment, at the end of treatment (3rd week), and 24weeks after the end of therapy. The evolution of clinical and dermoscopic patterns was observed by two independent dermoscopists using current diagnostic criteria. A database of 12,088 photographic observations was evaluated. Univariate logistic regression proved that brachytherapy decreases the number of clinical and dermoscopic patterns typical for basal cell carcinoma, as well as dermoscopic features not related to BCC, presumably due to the formation of scar tissue. In addition, univariate logistic regression with random effects proved a positive correlation between tumor size and presence of various dermoscopic patterns typical for BCC. Dermoscopy is proven to be easy to perform and an adequate monitoring tool for patients with BCCs undergoing HDR brachytherapy.

RAMUS ONLAY BONE GRAFT FOR MAXILLARY ALVEOLAR RIDGE AUGMENTATION-A CASE REPORT

Background: Implant restoration in the anterior esthetic zone is always a clinicians challenge and tooth loss in the anterior region often affects ridge architecture resulting in ridge defects compromising esthetics and implant placement.This case report describes the onlay bone grafting along with PRF application for anterior ridge augmentation and subsequent implant placement. The second stage surgery describes preservation of the keratinised tissue and fabrication of implant restoration of the same. Case description: Block graft was obtained using piezosurgery and onlay bone grafting was done in a 28 year female patient with anterior ridge defect with subsequent implant placement. After 6 months of healing and prosthetic restoration of the implant was done with successful esthetic outcome. Conclusion: Uneventful post-operative healing was observed in the donor site with the use of piezosurgery. There was successful augmentation of the ridge defect with osseointegrated and esthetic implant restoration. Clinical significance: Management of ridge defects in the esthetic region with autogenous Onlay grafting offers the advantage of biologic compatibility and PRF acts as a membrane maintaining soft tissue contours thereby allowing placement of implant in the optimal three dimensional position.

Esthetic outcomes of immediate implants placement following immediate restoration: Controlled clinical trial

The aim of this controlled clinical trial was to evaluate the variation in the thickness of the buccal bone plate and the position of the gingival margin in single implants installed in extraction socket and in healed ridges, both with immediate loading in aesthetic region. Materials and Methods: individuals in group 1 (n=7) were treated with minimally invasive tooth extraction, cone morse implant (Neodent®), xenogene bone “gap” filling (Bio Oss®) and cementation of provisional crown. Individuals in group 2 (n=3), in edentulous unitary ridges, received a cone morse implant (Neodent®) and provisional crown cementation. The coronal (C), mid (M) and apical (A) points of the buccal bone plate (BBP) were measured by means of computed tomography and, with the aid of a probing guide, the measurements of the position of the gingival margin (PGM) were performed at the mesial (M), vestibular (V) and distal (D) points, both analyzes were assessed in the preoperative (T0), immediate postoperative (T1) and six months postoperatively (T2). Results: in the analysis of buccal bone plate (BBP), no statistical differences were observed in the interaction of period and group factors, the same happened when comparing only the different periods. Group 1, when compared to group 2 in T1, presented higher averages in the buccal bone plate (p &lt;0.05), and this statistical difference was significant. In the PGM analysis, there was no significant statistical difference between the groups and periods interaction, the same could be observed when comparing the groups with each other (p&gt; 0.05). A statistical difference between time T0 and T2 was observed, with time T2 having a mean of the measurements greater than the time T0 in both groups. Conclusions: the treatment conferred in group 1 was shown to be a reliable option, with results of vestibular bone thickness and gingival level stable in the observed periods, when compared with group 2 treatment. With similar results between groups, the advantages of immediate implant as reduction of postoperative morbidity, reduction of medication use and maintenance of the perimplant framework become attractive for indication of the technique tested

Immediate Implant Placement Simultaneously with Ridge Augmentation in the Maxillary Esthetic Region Using Allograft versus Autogenous Bone Rings

Immediate Implant Placement Simultaneously with Ridge Augmentation in the Maxillary Esthetic Region Using Allograft versus Autogenous Bone Rings

Evolution of Esthetic Publications in Dentistry, Research Trends, and Global Productivity: A Bibliometric Analysis.

To perform a bibliometric study in the literature about the increasing number of global studies on dental esthetics in recent years. Articles on dental esthetics published between 1980 and 2021 were pulled from the Web of Science (WoS) database. In this comprehensive bibliometric study on dental esthetics, a summary of 2,858 articles published in the last 41 years was shared. Network visualization maps were used to identify citation analyses and trending topics. Spearman correlation coefficient was used for correlation studies. The exponential smoothing estimator was used to estimate the number of articles to be published in the coming years. Of the 3,666 publications, 2,858 (77.9%) were articles. The top three contributing countries to the literature were the USA (816, 28.5%), Brazil (286, 10%), and Italy (246, 8.6%). The most active institution was the University of Bern (n = 55). The journal with the highest number of articles was Journal of Prosthetic Dentistry (n = 178). According to the average number of citations per article, the most influential journal was Journal of Periodontology (citations: 55.6). Keywords of the trending topics related to dental esthetics are perception, bleaching, cleft lip, connective tissue graft, smile esthetics, adolescent, esthetic region, soft tissue augmentation, and clinical studies. In regard to the global output in dental esthetics, this article is a useful resource for clinicians, scientists, and dental students.