Horizontal Bone Loss Research Articles

Prospective Evaluation of Bone Remodeling in Full-Arch Rehabilitations with Morse Taper Implants: A Case Series Study with One-Year Follow-Up.

This case series study evaluated the survival, success rate and marginal bone remodeling of Morse taper hydrophilic implants placed for full-arch rehabilitations over a 1-year follow-up period. Ten patients in need of maxillary and/or mandibular full-arch rehabilitation were selected. Sixty-six Morse taper implants and sixty-six abutments were inserted. All implants were placed using a surgical flap approach without bone regeneration and were immediately loaded with definitive prostheses according to the passive fitting technique. The patients underwent clinical and radiographic follow-up at different postoperative periods: T0 = immediate (up to 1 month after surgery); T1 = 3-4 months after surgery; T2 = 6-8 months after surgery; and T3 = 1 year after surgery. The survival and success rate of the implants and the marginal bone remodeling were evaluated. Normal distribution of the outcomes was verified by Kolmogorov-Smirnov tests. Therefore, changes in vertical and horizontal marginal bone levels were assessed with paired t-tests. Results were considered significant for P < 0.05. Survival and success rates of 100% and 92.4%, respectively, were observed. Statistically significant vertical bone level changes were shown for all periods. From T0 to T3, there was a mean difference in vertical bone loss of -1.02 mm on the mesial surface and of -0.93 mm on the distal surface, for horizontal bone loss in the same period, it was observed mean changes of -0.14 mm on the mesial surface and -0.09 mm on the distal surface. This 1-year case series follow-up of immediate full-arch rehabilitation, using one-step hybrid passive fitting supported by four to six hydrophilic tapered implants, suggests predictability with high survival and success rates in edentulous patients.

Interdisciplinary orthodontic and prosthodontic approach for esthetic rehabilitation in an adult patient

A 38-year-old female patient reported with a chief complaint of spacing between anterior teeth, and she desire to improve her facial esthetics. The patient was diagnosed with chronic generalized periodontitis with generalized horizontal bone loss on the basis of clinical and radiographic findings. On orthodontic evaluation, she has proclined upper and lower anterior with Class I molar relationship bilaterally and a canine Class I relationship bilaterally. She was treated with an interdisciplinary therapeutic protocol that included nonsurgical periodontal therapy, endodontic treatment, orthodontic therapy, and prosthetic rehabilitation. The orthodontic therapy was performed in generalized horizontal bone loss having loss of bone support in mandibular anterior region. Space closure was done using prosthetic rehabilitation in a healthy periodontium. The interdisciplinary treatment protocol was the key factor in achieving significant improvement in facial and dental esthetics, masticatory function, and quality of life of the patient.

Management of Adult Orthodontics with Periodontal Disease

It is the responsibility of orthodontists to diagnose periodontal issues and address the multidisciplinary therapy of various periodontal issues needing orthodontic therapy. Adults can be quickly and effectively screened for periodontal disorders using the periodontal screening and recording technique. It condenses the information into the basic essential paperwork. An orthopantomograph which is useful for basic scanning, is used by most orthodontists. Plaque, subgingival calculus, and occlusal trauma are some of the etiologic variables that are the focus of preorthodontic periodontal therapy. A customized home-care program is part of the initial phase of periodontal treatment. Before beginning orthodontic therapy, the periodontist should assess sites of minimally attached gingiva. Grafting may be necessary for teeth with gingiva less than 2 mm thick. The conventional techniques for root covering were gingival and pedicle grafting. The type of defect, such as a crater, hemiseptal defect, three-walled defect, and/or furcation lesion, will determine the amount of the osseous repair. The bone level may have moved back several millimeters from the cementoenamel junction in a patient who has experienced extensive horizontal bone loss. To correct the disparities, periodontal surgery might be necessary. The patient must continue on a three-month periodontal maintenance program once orthodontic treatment is finished. After the release of the band, it may take up to six months for appropriate bone remodeling, the termination of mobility, and the constriction of the periodontal ligaments to occur.

A randomized controlled trial evaluating hyaluronic acid gel as wound healing agent in alveolar ridge preservation.

To compare the results of administration of hyaluronic acid (HA) gel to no gel administration following alveolar ridge preservation (ARP) in terms of changes in wound dimensions over time. Systemically healthy patients scheduled for ARP at one or two sites in the incisor, cuspid, or premolar area with at least one neighbouring tooth and >50% buccal bone present following extraction were included. ARP consisted of socket grafting with collagen-enriched, deproteinized bovine bone mineral and socket sealing by means of a collagen matrix. Following surgical therapy, sites were randomly allocated to the control group (no gel application) or the test group (0.8% HA gel applied onto the collagen matrix three times per day for 7 days). Bucco-lingual and mesio-distal wound dimensions were registered at T0 (immediately post operation), T1 (1 week), and T2 (3 weeks). Patient-reported outcomes, clinical outcomes, and hard and soft tissue changes were recorded up to 4 months (T3). In the control group, 20 patients (7 males, 13 females; mean age 53.30) with 23 sites, and in the test group 18 patients (9 males, 9 females; mean age 52.56) with 23 sites, were included. There were no significant differences between the groups in the changes in wound dimensions from T0 to T2 (bucco-lingual aspect: p=.340; mesio-distal aspect: p=.883). Three sites (13%) in the control group and six (26%) in the test group demonstrated complete wound resolution at T2 (p= .259). HA failed to show any effect on the number of analgesics taken (p= .175), patient-reported outcomes (p ≥ .263), alveolitis (p= .136), socket healing (p ≥ .424), soft tissue changes (p ≥ .064), or mucosal scarring (p=.548). However, significantly more horizontal bone loss at the coronal aspect was found in the test group (p ≤ .025). HA failed to promote wound resolution on a collagen matrix. This study was registered in ClinicalTrials.gov (NCT04467736).

Comparison of cone-beam computed tomography, clinical and surgical analysis for detection of maxillary molar furcation.

The aim of this study was to compare the performance of conebeam computed tomography (CBCT), clinical and surgical probing in assessing maxillary molar furcation involvement (FI). Furcation defects (n= 120) were assessed through CBCT, clinical and intra-surgical evaluation (ISE). Furcation Involvement, vertical and horizontal bone loss were assessed through clinical probing, CBCT and probing during ISE. Three trained radiologists evaluated CBCT images and intra- and interobserver agreement were calculated by Kappa test and Intraclass Correlation Coefficient (ICC). McNemar and Wilcoxon tests were used to compare clinical probing, ISE and CBCT. Accuracy, sensitivity, specificity, positive and negative predictive values were calculated to detect FI. Clinical findings showed 28 sites with Degree I, 25 sites with Degree II, and 8 sites with Degree III. Good intra- (k=1.00) and interobserver agreement (k=0.773) were observed. Intraobserver and interobserver agreement for horizontal bone loss were moderate, k=0.485 and k=0.549, respectively. Intra-surgical findings showed Degree I at 21 sites, and Degree II and Degree III FI at fifteen sites each. Clinical evaluation showed 75% agreement with ISE and 78% with CBCT. Accuracy for clinical detection of FI was 75%, while for CBCT evaluation ranged from 72.5% to 77.5%, considering the 3 observers. Significant differences were found at distal sites using CBCT (p<0.05). Clinical evaluation and CBCT showed similar results for the presence or absence of FI. Concerning horizontal and vertical bone loss, CBCT was not considered a precise examination method for incipient bone defects.

Comparison Between Two Different Design Concepts of 4- Implant Assisted Mandibular Complete Overdenture:- periimplant bone height changes

Abstract:&#x0D; Purpose: This study was accomplished to evaluate the bone height changes radiographically and the reliability of use either two posterior short or inclined implants with two conventional anterior implants retaining mandibular overdenture.&#x0D; &#x0D; Materials and methods: Ten male mandibular completely edentulous patients were divided in two equal groups after delivered complete dentures. For the first group (short implant design- group A) two vertical implants were inserted in the canine areas and two short vertical implants were inserted in the 1st molar area. For the second group (inclined implant design- group B) two vertical implants were inserted in the canine areas and two 30o distally inclined implants were inserted in the second premolar area. Digital standardized periapical radiographic assessment for horizontal and vertical alveolar bone height changes was carried out at T0 (immediately), T6 (6 months), T12 (12 months) and after mandibular complete overdenture insertion.&#x0D; Result: 1. VBL decrease significantly with advance of time in both groups during the time intervals. The highest VBL around the implants was noted in the 1st six months followed by the 2nd six months, the highest amount of total VBL observed with the interval T0-T12, followed by the interval (T0-T6) and the inclined implant group showed significant higher total VBL than short implant group at the intervals T0-T6 and T0-12.&#x0D; 2- HBL decreased significantly with advance of time in both groups. For short and inclined implant group, the highest amount of total HBL observed with the interval T0-T12, followed by the interval (T0-T6). Short implant group showed significant higher total HBL than inclined group at the interval T0-T6 and T0-T12.&#x0D; &#x0D; Conclusion: Within the limitations of this clinical radiographic study it can be concluded that (1) The 30o distally inclined implants inserted in the posterior areas for assisting mandibular complete overdenture induce vertical bone loss more than the axially inserted implants (short or conventional implants). (2) The short implants inserted in the posterior areas for assisting mandibular complete overdenture induce horizontal bone loss more than the axially inserted implants.&#x0D; Keywords: Short implants, O-ring ball attachment, VBL, HBL.&#x0D;

THE EFFECT OF PANORAMIC RADIOGRAPHY ON THE NUMBER OF MICRONUCLUES IN PERIODONTITIS

Background: Periodontitis is a periodontal disease that can cause an increase in Reactive Oxygen Species (ROS). The increase in ROS concentration will cause oxidative stress which has a role in DNA damage. In the case of periodontitis, panoramic radiography plays an important role in showing generalized horizontal bone loss. Radiation on panoramic radiography may cause DNA damage. DNA damage that occurs due to periodontitis or panoramic radiographic radiation exposure is characterized by the formation of micronuclei in gingival epithelial cells. Objective: To determine the effect of panoramic radiography on the number of micronuclei in Wistar rats with periodontitis. Method: This study was true experimental with post-test only and control group design. This study used 15 male Wistar rats which divided into 5 groups. Result: The average number of micronuclei in the normal group and 1 time exposures was 4 compared to the periodontitis group without exposure was 1.67, periodontitis and 1 time exposures was 8, periodontitis and 2 times the exposure was 15.67, and in the periodontitis and 3 times the exposure was 42.67. Result of One-Way Annova test and Post Hoc Bonferroni test indicated that signigicant changes in the number of micronuclei was seen between the normal group with 1 time exposure to the periodontitis group with 2 times and 3 times exposure and int the periodontitis group without exposure to the periodontitis group with 2 times and 3 times exposure. Conclusion: Panoramic radiograph X ray radiation and periodontitis can cause changes in the number of micronuclei in wistar rats. Keywords: , Micronucleus, Panoramic Radiography, Periodontitis.

Immediate Implant Placement in Maxillary Esthetic Zone without Augmenting the Jumping Gap versus the Use of Autogenous Bone Particulates or Demineralized Bovine Bone Graft (Randomized Clinical Trial)

Aim: to assess Immediate Implant Placement in Maxillary Esthetic Zone without Augmenting the Jumping Gap versus the Use of Autogenous Bone Particulates or Demineralized Bovine Bone Graft. Material and Methods: This was a Randomized parallel controlled clinical trial conducted on 30 implant sites that indicated immediate implant placement in the maxillary esthetic zone divided into 3 groups equally: In group (A): immediate implants were inserted in the esthetic maxillary zone with no graft in the jumping gap. In group (B): immediate implants were inserted in the esthetic maxillary zone with demineralized bovine bone mineral (DBBM) in the jumping gap. In group (C): immediate implants were inserted in the esthetic maxillary zone with autogenous bone graft in the jumping gap. CBCT scans were performed immediately after the surgery and 6 months later for measuring horizontal bone changes at 3 levels (platform, mid implant, and apex level) of the labial plate of the bone and vertical bone changes labial and palatal plate of bone. Results: The mean horizontal bone loss at platform level was 1.57±0.283mm, 0.845±0.167 mm, and 1.226 mm at groups A (graft less group), B (xenograft group), and C (autogenous group) respectively. While at mean mid implant level was 1.155±0.3 mm,0.754±0.185 mm, and 0.829±0.31 mm at group A (graft less group), B (xenograft group) & C (autogenous group) respectively. Conclusion: the use of DBBM as a graft in the jumping gap showed the least bone dimensional changes compared to no graft and autogenous bone graft group in immediate implant placement.

Current approach to bone augmentation with allogeneic cortical graft: A case report

Aim: Today, dental implant applications have become the most preferred option in the treatment of tooth deficiencies. Long-term successful results in dental implant applications depend largely on the volume and quality of the hard and soft tissues in the relevant region. Insufficient soft tissues and alveolar crest resorption complicate implant applications. Grafts and additional surgical procedures are required to compensate for resorption and to provide bone augmentation. Shell technique, one of the augmentation methods used in the treatment of alveolar bone defects, is an important procedure for guided bone regeneration. The purpose of this case report is to describe the treatment of vertical and horizontal bone loss with the Shell technique using allogeneic cortical grafts.&#x0D; Methodology: A 58-year-old female patient without any systemic disease was admitted to our clinic with the complaint of tooth loss in the right posterior mandibular region. In the intraoral and radiological examinations, it was determined that the bone volume in the relevant region was not sufficient for dental implant. Two-stage surgical treatment was planned for the patient. First, vertical and horizontal bone defects were augmented with allogeneic cortical graft application under local anesthesia. After the healing process, dental implants were placed in the sufficient volume of the alveolar bone and the patient's treatment was completed.&#x0D; Conclusion: Allogeneic grafts in the treatment of alveolar crest defects; it is a good alternative to autogenous bone grafts,there is no need for a second surgical field and the resulting reduction in morbidity.&#x0D; &#x0D; How to cite this article: Eriş Derkuş F, Yılmaz UN. Current approach to bone augmentation with allogeneic cortical graft: A case report. Int Dent Res 2021;11(Suppl.1):299-302.&#x0D; https://doi.org/10.5577/intdentres.2021.vol11.suppl1.44&#x0D; &#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Overall stress in periodontal ligament under orthodontic movement during a periodontal breakdown

This research aimed to assess qualitatively and quantitatively the overall stress in the periodontal ligament during gradual periodontal breakdown (0-8 mm) under orthodontic movements. Correlations between the applied forces, the level of bone loss, the decrease of force magnitude, and the increase of stress were also assessed.On the basis of cone-beam computed tomography examinations (voxel size, 0.075 mm), nine 3-dimensional models of a mandibular second premolar with intact periodontium were created and then individually subjected to various levels of horizontal bone loss. Orthodontic forces (intrusion at 0.2 N; extrusion, rotation, and tipping at 0.6 N; translation at 1.2 N) were applied on the brackets. Finite elements analysis was performed, and von Mises (VM) stresses were quantitatively and qualitatively determined.Rotation and translation induced the highest stress apically and cervically, whereas intrusion determined the lowest. Apical stress was lower than cervical stress. In intact periodontium, VM stress was under maximum hydrostatic pressure (MHP) and maximum tolerable stress (MTS). In reduced periodontium, VM stress was lower apically than MHP, whereas cervically, the rotation, translation, and tipping exceeded MHP.A force of 1.2 N seemed safe to be used in the intact periodontium. Forces higher than 0.6 N could produce stresses exceeding MHP and MTS endangering the reduced periodontium. VM stress failure criterion (despite its limited use) seemed to be more adequate for accurate quantitative results. An overall correlation between the applied force, VM stress increase, and periodontal breakdown applicable to all 5 movements could not be established. This was possible only for individual movements.

Clinical and Histologic Evaluation of Using Block Xenograft Combined With Leukocyte-Platelet Rich Fibrin (L-PRF) Versus Intraoral Autogenous Bone Block Graft With L-PRF in Treating Localized Ridge Defects: A Randomized Clinical Trial

Background: Augmentation of vertical bone defects remains the corner stone in periodontal tissue engineering. The amount and quality of alveolar bone available in all dimensions affects the success of dental implants for restoration of edentulous areas. Adequate and healthy bone supports the degree of osseointegration which in turn affects the long-term success of oral implants. The primary aim of the study was to histologically evaluate autogenous block grafts versus synthetic block grafts for the treatment of atrophic vertical and horizontal bony defects (Siebert Class III) in the anterior esthetic zone of the mouth. The secondary aim was to clinically and radiographically evaluate the outcomes of the procedure. Methods: This was a randomized controlled clinical study with a statistically determined sample size of 10 patients per group and a total of 20 patients in both groups. Patients with vertical and horizontal bone loss were enrolled from the Department of Oral Medicine, Periodontology, and Oral Diagnosis of Ain Shams University and Misr International University. Bone augmentation procedures were performed using two techniques: autogenous bone block graft and xenograft bone block graft both with leukocyte-platelet rich fibrin (L-PRF). Results: Both autogenous and xenograft blocks in conjunction with L-PRF had a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region. Conclusion: Both autogenous and xenograft bone blocks in conjunction with L-PRF have a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region.

Clinical efficacy of mineralized collagen (MC) versus anorganic bovine bone (Bio-Oss) for immediate implant placement in esthetic area: a single-center retrospective study

BackgroundThe purpose of this retrospective study was to evaluate the clinical efficacy of mineralized collagen (MC) versus anorganic bovine bone (Bio-Oss) for immediate implant placement in esthetic area.MethodsMedical records of Department of Oral and Maxillofacial Surgery of Shandong Provincial Hospital were screened for patients who had been treated with immediate implant implantation in the esthetic area using either MC (Allgens®, Beijing Allgens Medical Science and Technology Co., Ltd., China) or Bio-Oss (Bio-Oss®, Geistlich Biomaterials, Wolhusen, Switzerland), between January 2018 and December 2019. All patients fulfilling the in-/exclusion criteria and following followed for a minimum period of 1 year after surgery were enrolled into the presented study. Implant survival rate, radiographic, esthetic and patient satisfactory evaluations were performed.ResultsAltogether, 70 patients were included in the study; a total of 80 implants were inserted. All implants had good initial stability. The survival rate of implants was 100% at 1-year follow-up. The differences in horizontal and vertical bone loss between the MC group (0.72 ± 0.26 mm, 1.62 ± 0.84 mm) and the Bio-Oss group (0.70 ± 0.52 mm, 1.57 ± 0.88 mm) were no significant difference statistically no significant 6 months after permanent restoration. Similar results occurred at 12 months after permanent restoration functional loaded. Clinical acceptability defined by pink esthetic score (PES) ≥ 6 (6.07 ± 1.62 vs. 6.13 ± 1.41) was not significantly different between groups. Patient satisfaction estimated by visual analog scale (VAS) was similar (8.56 ± 1.12 vs. 8.27 ± 1.44), and the difference was no significant difference between the two groups.ConclusionsThe biomimetic MC showed a similar behaviour as Bio-Oss not only in its dimensional tissues changes but also in clinical acceptability and patient satisfaction. Within the limitations of this study, these cases show that MC could be considered as an alternative bone graft in IIP

Using FEM to Assess the Effect of Orthodontic Forces on Affected Periodontium

Orthodontic treatment in patients with no periodontal tissue breakdown vs. horizontal bone loss should be approached with caution even though it can bring significant benefits in terms of periodontal recovery and long-term success. We used the finite element method (FEM) to simulate various clinical scenarios regarding the periodontal involvement: healthy with no horizontal bone loss, moderate periodontal damage (33%) and severe horizontal bone loss (66%). Afterwards, forces of different magnitudes (0.25 N, 1 N, 3 N, and 5 N) were applied in order to observe the behavioral patterns. Through mathematical modeling, we recorded the maximum equivalent stresses (σ ech), the stresses on the direction of force application (σ c) and the displacements produced (f) in the whole tooth–periodontal ligament–alveolar bone complex with various degrees of periodontal damage. The magnitude of lingualization forces in the lower anterior teeth influences primarily the values of equivalent tension, then those of the tensions in the direction in which the force is applied, and lastly those of the displacement of the lower central incisor. However, in the case of the lower lateral incisor, it influences primarily the values of the tensions in the direction in which the force is applied, then those of equivalent tensions, and lastly those of displacement. Anatomical particularities should also be considered since they may contribute to increased periodontal risk in case of lingualization of the LLI compared to that of the LCI, with a potential emergence of the “wedge effect”. To minimize periodontal hazards, the orthodontic force applied on anterior teeth with affected periodontium should not exceed 1 N.

Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design\u2014retrospective analysis after a mean follow-up of 5 years

BackgroundAs a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI.ResultsClinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = − 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs.ConclusionsTreatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.

Evaluation of Mineralized Plasmatic Matrix as a grafting material around immediate dental implant in mandibular posterior teeth

Abstract Objective: the present study was performed to evaluate Mineralized Plasmatic Matrix (MPM) as a grafting material around immediate dental implant in mandibular posterior teeth Material and Methods: eight patients were selected for immediate dental implant in mandibular posterior teeth and use MPM as a grafting material around the implant. After surgery each patient were evaluated clinically at the following interval immediate, one week, two weeks, and three months postoperatively for:: Presence of infection, Edema, Graft exposure and/or loss, Soft tissue dehiscence, Pain, Nerve injury and Implant stability, and radiographically immediate and three months postoperatively interval by CBCT for: Bone density around the dental implant and Horizontal bone loss around the dental implant. Results: All patients hadn’t any infection, nerve injury, Graft exposure and /or loss, soft tissue dehiscence and facial edema throughout the study till three months. Osstel at 3 months (81.0 ± 7.68) was higher than immediately (63.40±4.16). Bone density at 3 months (447.0± 28.64) was higher than immediately (243.0±17.18). Patients experienced mild to moderate pain after surgery, at the surgical sites which decrease gradually during four days postoperatively then disappeared completely at the 7th day. Conclusion: The use of MPM with immediate implant reduces postoperative infection, edema, pain, graft exposure and/or loss and soft tissue dehiscence. Use of MPM with immediate implant enhances the implant stability, improves bone density around it and decrease marginal bone loss around the immediate implant.

A rare case report of focal cement osseous dysplasia associated with recurrent periodontal abscess

Focal cemento-osseous dysplasia (FocCOD) is a fibro-osseous lesion of the jaw, which is usually asymptomatic. We report the case of FocCOD in association with recurrent periodontal abscess. A 58-year-old female reported a chief complaint of swelling of gums for 2 months. Periodontal abscess with respect to 35 and 36 tooth regions was noted with no associated tooth mobility. Panoramic view showed extensive generalized horizontal bone loss suggestive of generalized chronic periodontitis. There was a characteristic radio-opaque lesion in relation to apices of 34 and 35. The periodontal abscess was recurrently formed even after repeated scaling, curettage, and antibiotic coverage. The associated teeth were extracted along with the hard tissue mass, and the histopathological examination of the latter revealed FocCOD. This case report intends to highlight the diagnostic dilemma and management of a rare, symptomatic FocCOD associated with recurrent periodontal abscess.

A Mini Review on Non-augmentative Surgical Therapy of Peri-Implantitis—What Is Known and What Are the Future Challenges?

Non-augmentative surgical therapy of peri-implantitis is indicated for cases with primarily horizontal bone loss or wide defects with limited potential for bone regeneration and/or re-osseointegration. This treatment approach includes a variety of different techniques (e.g., open flap debridement, resection of peri-implant mucosa, apically positioned flaps, bone re-contouring, implantoplasty, etc.) and various relevant aspects should be considered during treatment planning. The present mini review provides an overview on what is known for the following components of non-augmentative surgical treatment of peri-implantitis and on potential future research challenges: (1) decontamination of the implant surface, (2) need of implantoplasty, (3) prescription of antibiotics, and (4) extent of resective measures.

IMMEDIATE IMPLANT PLACEMENT WITH PROVISIONALIZATION USING AUTOGENOUS BONE GRAFT PARTICULATES VS DEPROTEINIZED BOVINE BONE VS NANO-HYDROXYAPATITE AS A SPACE FILLING MATERIAL IN THE MAXILLARY ESTHETIC ZONE

Background: Latest dentistry had been reported as fast and growing evolution. Regarding the implant- rehabilitation protocols, they had been altered in order to fulfill patient’s increasing prospects in terms of ease, appealing and smaller treatment period. Aim; evaluate bone and soft tissue changes after tooth extraction and immediate implant insertion with immediate provisionalization in the anterior maxilla, Results: Mean horizontal bone loss for Group I, II and III were (0.671), (0.380) and (0.289) mm respectively. This was statistically not significant as p=0.057. Mean vertical bone loss for Group I, II and III were (0.212), (0.233) and (0.262) mm respectively. This was statistically not significant as p=0.807. Conclusion: Immediate implant with immediate temporization using graft materials to augment jumping gap is a successful treatment modality for rehabilitation of hopeless teeth in the esthetic zone. The type of graft materials doesn’t significantly affect on the outcome (horizontal and vertical bone loss) following implant installation with immediate temporization in the esthetic zone.

Pathological Abnormalities Due to Impaction of Third Molar Mandibular Horizontal and Mesioangular Angulation with Observation of Panoramic Radiography

Background: The lower third molar teeth are the most commonly impacted teeth due to a lack of place for an eruption. Impacted teeth affect the surrounding tissue and can lead to pathological abnormalities. The effect of impacted teeth results in various complaints such as pain, caries, pericoronitis, adjacent tooth root resorption, dentigerous cysts, and odontogenic tumors. The impacted mandibular third molars and associated pathological abnormalities were observed with panoramic radiography. Purpose: To determine the pathological abnormalities that accompany the molar impaction of horizontal and mesioangular angular mandibula with panoramic radiographic observation. Material&Methods: In this study, using the panoramic radiograph, consisting of 53 samples of radiographs were evaluated based on the mesioangular and horizontal angulation of mandibular impacted third molars and pathology abnormalities caused. The data were processed and analyzed by using the Friedman test and Chi-square test. Result: In impaction with mesioangular angulation, bone loss at the interalveolar between third molar and mandibular second molars by 33.3%, caries on the mandibular second molars and mandibular second molar’s root resorption had a similar percentage by 26.7% and caries in mandibular third molar impaction amounted to 13.3%. In impaction with horizontal angulation bone loss at interalveolar third molar and mandibular second molar by 59.1%, mandibular second molars of caries were 22.7%, caries in mandibular third molar impaction and mandibular second molar root resorption by 9.1%. Conclusions: The most common pathological abnormalities in mandibular third molar impaction of mesioangular and horizontal angulation are bone loss in the interalveolar third molar and the mandibular second molar.

Porcine-derived acellular dermal collagen matrix and enamel matrix derivative for the treatment of infrabony defect in the esthetic area

This case report describes a modified connective tissue graft wall technique with enamel matrix derivative proposed to treat vertical bony defects. The surgical procedure consisted of a coronally advanced flap with a porcine-derived acellular dermal matrix placed below, acting as a buccal soft tissue wall of the bony defect. The patient showed a bony defect between #12 and #13 with horizontal bone loss and a deep infrabony component at the mesial area of the canine. At one year after surgery, the position of the interdental papilla and the clinical attachment level gain were improved along with radiographic bone defect fill.