hom-lay Wang

PurposeTo establish consensus-driven guidelines that could support the clinical decision-making process for implant-supported rehabilitation of the posterior atrophic maxilla and ultimately improve long-term treatment outcomes and patient satisfaction.Materials and methodsA total of 33 participants were enrolled (18 active members of the Italian Academy of Osseointegration and 15 international experts). Based on the available evidence, the development group discussed and proposed an initial list of 20 statements, which were later evalu-ated by all participants. After the forms were completed, the responses were sent for blinded ana-lysis. In most cases, when a consensus was not reached, the statements were rephrased and sent to the participants for another round of evaluation. Three rounds were planned.ResultsAfter the first round of voting, participants came close to reaching a consensus on six statements, but no consensus was achieved for the other fourteen. Following this, nineteen statements were rephrased and sent to participants again for the second round of voting, after which a consensus was reached for six statements and almost reached for three statements, but no consensus was achieved for the other ten. All 13 statements upon which no consensus was reached were rephrased and included in the third round. After this round, a consensus was achieved for an additional nine statements and almost achieved for three statements, but no consensus was reached for the remaining statement.ConclusionThis Delphi consensus highlights the importance of accurate preoperative planning, taking into consideration the …

Background Because little is known about the impact of implant surface modifications on the peri‐implant microbiome, we aimed to examine peri‐implant communities in various surface types in order to better understand the impact of these surfaces on the development of peri‐implantitis (PI). Methods One hundred and six systemically healthy individuals with anodized (AN), hydroxyapatite‐coated (HA), or sandblasted acid‐etched (SLA) implants that were >6 months in function were recruited and categorized into health (H) or PI. Peri‐implant biofilm was analyzed using 16S rRNA gene sequencing and compared between health/disease and HA/SLA/AN using community‐level and taxa‐level metrics. Results Healthy implants did not demonstrate significant differences in clustering, alpha‐ or beta‐diversity based on surface modification. AN and HA surfaces displayed significant differences between health and PI …

Aim This study aimed to characterize the periodontal breakdown during supportive periodontal care (SPC) and to quantify the corresponding cost‐effectiveness of periodontal therapy. Materials and Methods Data were obtained from charts of patients who received active periodontal therapy (APT) with a minimum follow‐up of ≥10 years. Analysis was done to identify factors associated with the incidence of additional sub‐gingival instrumentation (SGI) and/or surgery (SUR) during SPC and mean cumulative cost of recurrence was calculated. All relevant data were collected. Results In all, 442 patients were included. Over the follow‐up period, 62% of Stage I and II patients and 72% of Stage III and IV patients required further treatment following the APT; 56.5% of SGI patients and 78.6% of SUR patients received a second intervention. SUR patients received more SUR during the follow‐up period (p = .035 …

Objective Complete arch implant rehabilitation necessitates meticulous treatment planning and high‐level collaboration between surgical and prosthetic dental teams. Emerging virtual technologies hold considerable promise in streamlining this process. The aim of this article is to extend recommendations to clinicians venturing into the virtual patient‐assisted esthetic implant rehabilitation workflow. Overview This article summarizes recommendations for virtual patient‐assisted esthetic implant rehabilitation in the following five aspects: three‐dimensional data handling and superimposition, occlusion and virtual articulator integration in creating virtual patients, streamlined face‐ and prosthetic‐driven surgical planning, reuse of presurgical data (“Copy & Paste”), and final impression for passive fitting of final restoration. To illustrate these principles, a case with complete‐mouth implant rehabilitation completed within …

Successful rehabilitation of severely atrophic, short-span edentulous ridges in esthetic regions can seldom be done without some form of vertical ridge augmentation (VRA). The best available evidence shows that guided bone regeneration procedures may present a very predictable option with reduced potential for complications compared to alternative options. The present case series presents a novel technique to achieve predictable VRA with a low complication rate using tenting screws and cross-linked resorbable membranes. A total of 10 patients (5 men, 5 women) with severe vertical defects in the esthetic zone participated in this study. Following a mean healing time of 9.3 months, the mean defect resolution was 80%, with a mean vertical bone gain of 6.2±1.61 mm. Only one case presented with reduced defect resolution (50%); however, the bone gain for this case was 6 mm.

Objectives The objective of this study is (1) to compare the accuracy of an open‐sleeved static computer‐assisted implant system (sCAIS) with a closed‐sleeve sCAIS and free‐hand approach in immediate implant placement (IIP) of maxillary molar sites and (2) to investigate the influence of socket morphology on these approaches. Materials and Methods Ninety partially edentulous duplicated maxillary models simulating three different molar sockets (type A, B, and C based on Smith and Tarnow's classification) were investigated. Three modalities, including sCAIS with open‐sleeves, sCAIS with closed‐sleeves, and free‐hand approach, were applied separately to 30 models with 120 sockets. A customized Python script automatically measured the deviations between the virtual and actual implant positions for all 360 implants. Results The 3D deviations of sCAIS were significantly influenced by the socket and …

Purpose: To explore whether extra-short (4-mm) implants could be used to rehabilitate sites where regenerative procedures had failed in order to avoid additional bone grafting. Materials and methods: A retrospective study was conducted among patients who had received extra-short implants after failed regenerative procedures in the posterior atrophic mandible. The research outcomes were complications, implant failure and peri-implant marginal bone loss. Results: The study population was composed of 35 patients with 103 extra-short implants placed after the failure of different reconstructive approaches. The mean follow-up duration was 41.3±21.4 months post-loading. Two implants failed, leading to a failure rate of 1.94%(95% confidence interval 0.24%–6.84%) and an implant survival rate of 98.06%. The mean amount of marginal bone loss at 5 years post-loading was 0.32±0.32 mm. It was significantly lower …

ObjectivesThe treatment of gingival recessions (GRs) is operator-sensitive and dependent upon several local anatomical factors. The aim of this study was to introduce a difficulty score for the treatment of localized GRs with the coronally advanced flap (CAF) and to test its consistency among different operators.Materials and methodsA rubric (difficulty score) consisting of the assessment and grading of 8 anatomical parameters (anatomical papilla, apical and lateral keratinized tissue width, apical and lateral frenum, vestibulum depth, scar tissue, and mucosal invagination) is described based on the available evidence and the authors’ experience. Inter-examiner agreement, with the score, was tested on 32 localized GRs among four different experienced practitioners.ResultsMinor discrepancies were observed in the total scores between the reviewers (intraclass correlation coefficient [ICC] 0.95). A good …