Immediate implant placement in combination with platelet rich-fibrin into extraction sites with periapical infection in the esthetic zone:A case report and review of literature

BACKGROUND In this case,platelet-rich fibrin(PRF)was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.CASE SUMMARY With the history of endodontic failure in maxillary central incisor,a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation.Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue.Before operation,cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone.The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration.The barrier was a three-layer structure of PRF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing.At 6 mo postoperatively,the definitive crown was placed after accomplished finial impression.One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue.CONCLUSION The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome.

A Case Report of Immediate Implant Placement Combined with Flap Surgery,Guided Bone Regeneration and Non-submerged Healing with a Labial Bone Wall Defect in the Esthetic Zone

[Basckground]This case report presented a methodology for immediate implantation in the esthetic zone with a facial bone defect along with flap surgery,guided bone regeneration,and non-submerged healing.[Case presentation]A 27-year-old female patient was complaining of the aesthetic complication that was caused via metallic staining of the neck of ceramic crowns in the maxillary right anterior region for one year.She has experienced immediate implantation along with flap surgery,guided bone regeneration(GBR),and non-submerged healing.The torque of the implant reached to the 35 N·cm to confirm primary stability.Six months after surgery,the healing abutment and the implant were fixed,the gingiva was healthy in the surgical area,and the nearby teeth and the opposite teeth were normal.[Results]The results of cone-beam computer tomography(CBCT)revealed that bone defects were filled with the newly formed bone.At the same time,the final impressions accomplished,and an all-ceramic crown was fit-placed.As a whole,the patient satisfaction rate was high.[Conclusions]Immediate implant placement with flap surgery,GBR,and non-submerged healing with a facial bone wall defect in the esthetic zone is an achievable process.

A randomized retrospective clinical study on the choice between endodontic surgery and immediate implantation

Background:Periapical endodontic surgery(PES)for root amputation and tooth replacement by immediate implant placement are two possible treatment options for bone lesions in the root apex of a tooth that has previously undergone endodontic treatment.Treatment methods are performed when the effectiveness of orthograde canal revision is questionable or when such treatment cannot be performed.The effectiveness of these methods varies from study to study.Objective:clinical evaluation of the efficacy of periapical endodontic surgery for root amputation and immediate implant placement with simultaneous tooth extraction in the proximate and long-term treatment.Materials and methods:The study included 183 patients between the ages of 24 and 63.Patients were divided into 2 groups;group I-endodontic surgery was performed to resect the apex of the tooth root(108 patients)and group II-an operation to install an implant with simultaneous tooth extraction(75 patients).In group I,in 36 cases,PES was performed in the area of the first molars and premolars,and 72 cases in the area of incisors and canines.In group II,75 patients received 231 implants.Results:In all 108 patients of group I in the postoperative period and within 1 month,the wounds healed without complications.In none of the 36 operated premolars and molars,there was no definitive elimination of the radiographic bone loss(Rude grade 2 and 3)after 12 months.In the area of incisors and canines,complete healing was observed only in 37.5%of cases(I class according to Rud).In group II,out of 184 implants installed immediately after tooth extraction,one was removed one month after implantation.In other cases,all implants were successfully integrated with the subsequent fabrication of prosthetic construction.Conclusion:The complex“implant(installed in the socket of the tooth immediately after its removal)-bone-soft tissues-prosthetic construction”is stable over time in terms of functional and aesthetic parameters,preservation of bone tissue,and mucous membrane.

Effect of immediate implant placement and loading on soft tissue management

The recent article describes immediate implant placement and loading in the anterior segment. The main aim of this treatment option was to deliver provisional prosthesis to the patient in the same day of surgery, form papilla contours, and eliminate waiting of osseointegration time and the second surgery.

Effects of Immediate Dental Loading Implant Therapy on Electroencephalography (EEG) and Stress

Purpose: Implant therapy restores masticatory function by restoring lost tooth morphology. It has been shown that mastication contributes not only to food intake and digestion, but also to the improvement of overall health. However, there have been no studies on the effects of implant treatment on electroencephalography (EEG). In this study, we investigated the effects of restoration of masticatory function by implant treatment on EEG and stress. Methods: 13 subjects (6 males, 7 females, age 64.1 ± 5.8 years) who had lost masticatory function due to tooth loss and 11 healthy subjects (6 males, 5 females, age 47.6 ± 2.4 years) as a control group. EEG (θ, α, β waves, α/β ratio) and salivary cortisol were measured before immediate dental implant treatment and every month of treatment for 6 months. EEG (θ, α, β waves, α/β ratio) was measured with a simple electroencephalograph miniature DAQ terminal (Intercross-410, Intercross Co., Ltd., Japan) in a resting closed-eye condition, and salivary cortisol was measured using an ELISA kit. Results: Compared to the control group, the appearance of θ and α waves were significantly decreased and β waves were increased, and α/β ratio was significantly decreased. The cortisol level of the subject group was significantly higher compared with the control group. With the course of implant treatment, the appearance of θ and α waves of the subject group increased, while β waves decreased. However, no significant difference was observed. The α/β ratio of the subject group increased from the first month after implant treatment and increased significantly after 5 and 6 months (0 vs. 5 months: p < 0.05, 0 vs. 6 months: p < 0.01). The cortisol levels in the subject group decreased from the first month after implant treatment and significantly decreased after 3 or 4 months (0 vs. 3 months: p < 0.05, 0 vs. 4 months: p < 0.01). These results suggest that tooth loss causes mental stress, which decreases brain stimulation and affects function. Restoration of masticatory function by implants was suggested to alleviate the effects on brain function and stress.

Simultaneous Upper and Lower Jaw Extractions, Autogenous Bone Augmentation and Temporary Implant Placement with Immediate Loading

Aims: We expanded the known technique for simultaneously augmenting an atrophic maxilla and placement of immediate provisional implants (IPI), followed by immediate loading by performing surgery in both jaws simultaneously. Feasibility of this new technique, implant survival and success were evaluated as well as prosthetic success. Materials and Methods: All patients undergoing simultaneous bone grafting and IPI placement with immediate loading at our institute between the 1st of June 2016 and the 30th of May 2018 were included and followed up for at least one year postoperatively. Results: 3 patients were followed for a mean period of 25.67 months (20 - 29 months). 33 IPIs were placed. All were immobile at second stage surgery without signs of infection. No provisional bridges were lost and no infections were noted. After second stage surgery, none of these 36 final dental implants were lost. There was some bone loss at one implant. In all patients, good functional and aesthetic results were obtained without any unforeseen complications. This renders the implant survival at 100% and the success rate at 97%. Conclusion: The technique is complex due to the intricate step-by-step process that is required and depends on a dedicated team to ensure a proper workflow. When performed correctly, the protocol shows good and predictable results.

The Stability Analysis of Implants Installed in Osteotomies with Different Types of Controlled Bone Defects

The stability parameters of implants （ITV, ISQ ＆ PTV） according to different sizes of controlled bone defects made in implant osteotomies were analyzed and the correlation among the three kinds of implant stability parameters was tested in this study. 45 tapped screw-type dental implants were inserted in three types of implant osteotomies made in 8 fresh-frozen pig femoral bones： Typel - without coronal bone defect, Type2 - with 3 mm coronal bone defects, and Type3 - with 6 mm coronal bone defects. The insertion torque values, ISQ ＆ PTV of implants were measured and analyzed statistically. It is concluded that the circumferential coronal bone defects statistically influence the primary stability of implants; ITV, ISQ and PTV are suitable and available to detect the peri-implant coronal bone defects in 3 mm increments, and ITV and PTV are more sensitive to coronal cortical bone loss. There was a strong correlation between ITV and ISQ.

骨缺损状态下的即刻与延期种植修复的临床应用评价

目的:评估即刻种植修复与延期种植修复在不同骨缺损状态下的远期疗效。方法:对80例患者的96枚种植体在不同骨缺损条件下的远期追踪观察(平均1—3年),以种植体的稳定程度,牙龈形态色泽,唇侧骨丰满度,牙周袋的深度,及种植体与牙槽骨之间的x线影像等作为评价指标,通过采用即刻种植与延期种植技术及不同的植骨方式(引导骨再生技术与骨扩增技术GBR与ERE),评估即刻种植与延期种植的临床效果。结果:经过3年的临床观察,即刻种植与延期种植的临床成功率基本相同,Ⅳ,Ⅴ骨缺损种植牙颈部存在一定骨吸收(见表)。讨论:通过两年的临床跟踪:98%的种植患者对修复效果满意,义齿状态良好。软组织:牙龈粉红,质地坚韧,附着龈宽度正常,探诊<3mm,出血(-)通过所选取的病例的x光侧量可知(以植入种植体顶缘为基线)即刻种植修复的植体,4-6个月内平均种植体周边缘骨高度丧失为0.08mm,3年平均骨高度丧失为0.6mm。延期种植修复后,4-6月、3年的数值分别为0.09mm、0.75mm.两组在3年内牙槽骨吸收比较经t检验(检验水准0.05),均有显著的统计学差异,p<0.05。采用即刻或延期种植的牙槽骨吸收比较无统计学差异。说明种植体在负重后因受咬合力,咀嚼频率及习惯,个体差异等因素的影响较大.牙槽骨在两年内吸收较多。结论:在行使种植修复时(前牙尤其要注意美观),选择好适应症,运用正确的植骨方式,种植方式,均能达到预期的临床效果,但值得注意的是:严重骨缺损处经植骨修复后存在骨吸收,这种趋势可能存在一定的延续性,还需观察。

Experimental Stody on Immediate Endosseous Implantation.

Screw type implants (ITI series) were implanted into the socket of extracted teeth of adult dogs to investigate the histologic recovery process of implantation. Two groups of

Search of Biomarker in the Oral Rehabilitation

Are there any ways to analyze objectively if any good changes happen to the bodies for the patients with acquired edentulous by getting a treatment to recover occlusion? In this study, we focused on interleukin 6 (IL-6) as inflammatory cytokine, cortisol known as a stress related substance and secretory immune globulin A (SIgA) related to immune reaction, and chose 14 patients who had occlusion reconstructed by the immediately loaded dental implants because occlusion contact with maxillary and mandibular dentition was lost caused by edentulous jaws or maxillary and mandibular teeth crossing each other and their jaw position and central occlusion position could not settle, and verified the relationship with changes of patients’ physical and mental states during the 6 months of the treatment and the effect of the immediately loaded implants treatment by using saliva which was non-invasive and easy to sample in biomarkers in saliva. Moreover for female subjects, the changes of facial color tones were measured by using Robo Skin Analyz-er?, a digital image analyzer, to measure the condition of their skin. In conclusion, the positive correlation between the amount of IL-6 and cortisol was not admitted. However, it was admitted that IL-6 tended to increase when a systemic change which interrupted curing such as the interruption of fusion of the implant and the bone was observed even though the patient did not notice any particular symptoms and cortisol tended to increase when the patient noticed discomfort and mentioned any events under stress on his or her medical record. Moreover with the skin color analysis by Robo Skin Analyzer?, the possibility that the occlusion treatment by the immediate implant had an effect on physical and psychological health promotion through the acquisition of the masticatory function and the aesthetic recovery was indicated.