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Two conditions are necessary for a correct and functional prosthetic implant rehabilitation: maintaining pre-implant soft tissue health and stability of bone tissue, in terms of implant osseous-integration and maintenance of optimal crestal attachment levels. In addition to these parameters - necessary for the longevity of the restoration - one of the main aspects of therapy is the achievement of a final aesthetic that reproduces as faithfully as possible the natural anatomy of the lost tooth and the associated soft tissues. To achieve this last objective, an implant system was designed and used by our group. This implant is characterized by a convergent trans-mucosal emergence fixture associated with a progressive closing system of trans-mucosa healing pillars (healing abutment). This guarantee, together with the micro and macrostructure of the implant, an immediate and highly aesthetic condition of the peri-implant soft tissues, and in the same time an optimal seal on the convergent neck of the implant itself., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

This article presents a case report of transmucosal implant with a convergent collar (PRAMA) inserted in the anterior maxillary esthetic area. The purpose of this study is to evaluate soft and hard tissue after 12 months. One implant was placed in the esthetic area. The implant was immediately loaded with a screwed provisional prosthesis. After 3 months the definitive screwed prosthesis was inserted. The patient was reassessed 12 months post-implant placement, and during the examination, the soft-tissue texture, color, and amount of keratinized tissue was checked. No statistically significant horizontal dimensional changes of the alveolar ridge were observed between each time-point. Mean soft tissue levels significantly improved between base-line and 12 months. The reduced buccal width of the transmucosal component gives more space to the gingival thickness and promotes stability and give a better seal. The use of transmucosal implant creates a shift of the inflammatory cell infiltrate away from the crestal bone level., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

There are many techniques to regenerate a sufficient bone thickness, in both vertical and horizontal direction, when bone is reabsorbed after extractions or after a long period of edentulism. The present study wants to evaluate from a clinical point of view results obtained using the GBR technique with a e-PTFE titanium reinforced membrane in posterior jaw (4.5-4.7). A 57-years-old male patient presented the failure of two implants in zone 4.6-4.7; after the latter's removal and a healing period of 6 months, the wide bone defects have been filled with heterologous bovine bone mixed with autologous bone and covered with e-PTFE titanium reinforced membrane fixed to the alveolar ridge. After 6 months the site was opened to remove the fixing screws and to place two new dental implants in zone 4.5-4.7; after the osseointegration period of 6 months, the implants were uncovered and two healing-screw were positioned. A significant increase in alveolar bone both vertical and horizontal was observed, such as to allow excellent aesthetic and functional result, testifying the success of the procedure. [ABSTRACT FROM AUTHOR]

Objective. Good peri-implant tissue-health indicates that an implant is well-osseointegrated, the marginal bone levels are being maintained, and it maximizes the esthetic outcome of the restoration. This retrospective study investigated the impact of a rigid hygiene maintenance program and implant design on bone levels and peri-implant mucosa health. Methods. The study included edentulous patients who received a full-arch implant-supported prosthesis and who reported for the 3-year follow-up. Here reported are clinical and radiological outcomes as well as patient satisfaction. Results. 112 variable-thread tapered implants were placed in 28 patients according to the All-on-4 treatment concept. At 3 years, all implants were stable and the implant survival rate was 100%. The mean marginal bone level was -0.92±0.79 mm at baseline and -0.94±0.92 mm at the 3-year follow-up. All patients had healthy peri-implant mucosa with no signs of bleeding or visible inflammation. In addition, there were no signs of plaque on any of the prostheses. No adverse events were reported during the study period. Conclusion. Three years post-implant placement, there was no marginal bone loss and the soft tissue exhibited excellent health, suggesting that combining good oral hygiene maintenance with an implant geometry designed to positively impact bone response can demonstrate excellent clinical and radiological outcomes [ABSTRACT FROM AUTHOR]

Objectives. This study describes a method for the measurement of the marginal gap between abutment and prosthetic crown and analyses the influence of different variables influencing the fitting precision. Methods. The extent of marginal gap between titanium or dental abutment with different implant types composed of sintered titanium, milled titanium alloy, zirconia and translucent zirconia was evaluated. The gap at implant-abutment interface was analysed by optical stereomicroscope observation. To optimise measurement precision, samples were oriented with a specific inclination angle and properly stained to limit reflection phenomena. Captured images was processed by ImageJ virtual measuring instruments. The correlation between various factors including type of tooth (molar, canine), stump type (artificial, natural), prosthesis type (sintered titanium, titanium, zirconia and translucent zirconia), and gap type (proximal, distal) was statistically evaluated performing the study of variance (ANOVA). Results. There was a significant correlation between the type of abutment and the different materials used for implant on fitting accuracy. The variables type of tooth and gap type do not significantly correlate with the marginal gap size. Results of the ANOVA test demonstrated that the association titanium abutment and titanium implant represent the best fitting with a minimum level of marginal gap at the junction interface. Conclusions. The measurement of marginal gap with stereoscopic observation associated with the analysis of variance has been demonstrated to be a valuable method for marginal gap evaluation. This approach demonstrated that the best abutment-implant fitting is represented by the association between titanium abutment and titanium implant. This model could be used to perform preliminary evaluation in order to help the clinician to select the best match of components for prosthetic implant. [ABSTRACT FROM AUTHOR]

Different implant-abutment connections have been developed in the effort of reducing mechanical and biological failure. The most frequent complications are screw loosening, abutment or implant fracture and marginal bone loss due to overload and bacterial micro-leakage. Ideal connection should work as a one-piece implant avoiding the formation of a micro- gap at the implant-abutment interface. Different in vitro and in vivo researches have been published to compare the implant-abutment connections actually available: external hexagon, internal hexagon and conical finding different amount of micro-gap, micro-leakage and marginal bone loss. The aim of this article is to describe, according to the most recent literature, different kind of fixture-abutment connections and their clinical and mechanical advantages or disadvantages. [ABSTRACT FROM AUTHOR]

Purpose. The edentulous severely atrophic maxilla, as consequence of alveolar bone resorption and pneumatisation of the maxillary sinus, represents a serious limitation to the implant rehabilitation. Implants insertion via palatal approach (PA), in combination with relatively minimally invasive techniques aimed at increasing bone volume without the use of autologous bone harvesting is a valid alternative among the options for the rehabilitation of the upper jaw. Clinical case. In a 70-year-old female, with a severe maxillary atrophy, 6 spiral taper implants were placed with the PA, combined with the bilateral transcrestal elevation of both the sinus floors and nasal cavities; a further GBR, with resorbable pericardium membrane covering a termoplastic allograft associated to a xenograft, was performed. The second stage was performed after 6 months. Implant prosthetic functionalization was carried out in 4 months by placing the removable prosthesis in direct contact with the healing cup screws. After that period the case was finalized with a hybrid prosthesis. Clinical and radiographic follow-ups were carried out at 6 months and at one year after prosthetic finalization, during which no pathological signs were recorded. Conclusions. The PA implant insertion described by the Authors, combined with bone augmentation procedures, performed in the same stage, may represent a valid and reliable solution to rehabilitate maxillary edentulous patients. [ABSTRACT FROM AUTHOR]