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This paper presents three cases of peri-implant mucosal defects that were successfully treated with a newly proposed "pouch roll" implant soft tissue augmentation technique. This procedure uses a de-epithelialized connective tissue layer during the first or second stage of implant surgery over the underlying dental implant without the need for sutures. At 2 weeks, healing was remarkable, with excellent plaque control. At 3 months, only minimal tissue shrinkage was evident. As a result, a 2- to 3-mm increase in the width of the keratinized tissue was noted around the augmented implant site. This technique is an atraumatic, versatile, and cost-effective surgical modality that enhances the peri-implant soft tissue over the ridge with a soft tissue thickness ≥ 3 mm. The pouch roll implant soft tissue augmentation procedure provides an easy and less traumatic correction of a mild to moderate buccal ridge deficiency by thickening the soft tissue around the dental implant.

Successful osseointegration is a prerequisite for functional dental implants. Continuous monitoring in an objective and quantitative manner is important to determine the status of implant stability. Historically, the gold standard method used to evaluate degree of osseointegration was microscopic or histologic analysis. However, due to the invasiveness of this method and related ethical issues, various other methods of analysis have been proposed: radiographs, cutting torque resistance, reverse torque, modal analysis, and resonance frequency analysis. This review focuses on the methods currently available for the evaluation of implant stability. (More than 50 references.)

This case series presents the use of acellular dermal matrix (ADM) as a barrier membrane in reconstructing non-spacemaking buccal dehiscences associated with simultaneous implant placement in locally deficient ridges. Five sites in four healthy nonsmoking patients were treated with a combination of the mucogingival pouch flap technique, sandwiched layering of mineralized human cancellous and cortical bone grafts, and ADM as a barrier membrane. Three sites encountered 2 to 4 mm of membrane exposure after 2 weeks of healing time. However, all sites were completely covered at 3 months. None of the cases exhibited implant exposure throughout the entire healing period. At the 6-month re-entry surgery, ADM-assisted guided bone regeneration achieved a mean of 86.5% height gain and critical bone thickness of 1.8 mm or greater, with clinical bone density equivalent to that of the native bone.

Failures of dental implants are detrimental to both patients and dental providers. These failures are often preceded by complications at various levels of the treatment phases. Early detection of the complications that are amenable to rescue therapies may reverse the fate of the implant. This review article discusses diagnosis, classification, and treatment aspects of the reversible complications commonly encountered during routine dental implant-related procedures.

Fracture of root tips in the maxillary premolar region is not an uncommon finding because of the high incidence of bifid and root dilacerations. Therefore, a retained root tip may serve as a nidus of infection when a dental implant is placed. The likely result is the development of an implant periapical lesion. This case report shows the successful management of a rapidly developing implant periapical lesion caused by an undetected retained root tip. Initially, systemic antibiotics failed to subdue the infection. A retained root fragment was retrieved surgically, together with the implant, and a new wide-body implant was engaged with DFDBA mixed with tetracycline. A 5-month follow-up showed increased radiographic density, and clinical reentry revealed the formation of bone with a hard consistency. The second case demonstrates the management of a retained root tip via a guided bone regeneration technique when it is detected prior to or during implant placement. Finally, a systematic therapeutic approach is proposed based on 17 case reports on implant periapical lesion management.

Background: Displacement of dental implants into the maxillary sinus is rare, but it primarily occurs in patients with severe pneumatization of the maxillary sinus and/or deficiency of the alveolar process. Some complications such as the infection of the paranasal sinuses and formation of the oroantral fistula can be followed by the displacement of a dental implant. Therefore, the displaced implant has to be removed immediately with surgical intervention show and another plan for rehabilitation should be considered. Main body: The conventional procedure for the removal of a displaced implant from the maxillary sinus involves sinus bone grafting and new implant placement performed in two or more steps with a significant time gap in between. Simplification of these surgical procedures can decrease the treatment duration and patient discomfort. Conclusions: In this review, we discuss the anatomical characteristics of the maxillary sinus and the complications associated with implant displacement into the sinus. [ABSTRACT FROM AUTHOR]

Background: The purpose of this retrospective study was to evaluate the clinical utility of an implant with a sandblasted, large-grit, acid-etched (SLA) surface and internal connection. Methods: Six patients who received dental implants in the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, were analyzed by factors influencing the success rate and marginal bone loss. Factors included patient's age, sex, implant installation site, whether bone graft was done, type of bone graft materials, approaching method if sinus lift was done, and the size of the fixture. In addition, the marginal bone loss was analyzed by using a radiograph. Results: All implants were successful, and the cumulative survival rate was 100 %. Average marginal bone loss of 6 months after the installation was 0.52 mm and 20 months after the functional loading was 1.06 mm. Total marginal bone resorption was 1.58 mm on average. There was no statistically significant difference in mesial and distal marginal bone loss. Conclusions: The short-term clinical success rate of the implant with an SLA surface and internal connection was satisfactory. Moreover, the marginal bone loss was also consistent with the implant success criteria. [ABSTRACT FROM AUTHOR]

Background: Membrane exposure has been associated with poor clinical outcomes in guided bone regeneration. This prospective human study examined the effect of incision locations on flap survival and membrane exposure. Methods: Twenty-nine implant-associated buccal dehiscence defects in 25 patients were augmented using particulate mineralized human allograft. Ten sites received a collagen bioabsorbable membrane, 10 sites received acellular dermal matrix, and nine sites were treated with bone graft alone. All implants achieved primary stability and passive flap tension at the time of flap closure. Incision ideation was measured as the distance from the initial incision line to the mucogingival junction. The same measurements were made at 2 weeks and 1 month to represent the length of the flap that survived. The length of the flap that survived at 2 weeks was compared to the mean width of buccal keratinized gingiva (KG) of adjacent teeth. Other clinical parameters recorded included incidence of early membrane exposure and gingival thickness at mid-crest and 6 mm buccal and lingual to the mid-crest at baseline. Results: At 2 weeks, 10 sites experienced early exposure. Exposed sites that were not covered by 1 month remained exposed. Membrane treated groups showed no significant difference between the width of adjacent buccal KG and the length of the flap that survived at 2 weeks. The length of the flap that survived beyond the mean width of adjacent KG was significantly greater for the graft alone group (1.6 ± 0.4 mm; P= 0.002). When the gingival thicknesses of exposed and non-exposed cases were compared, only palatal/lingual gingival thickness showed a significant difference (P= 0.002). Conclusions: Within the limits of the study, it was concluded that the location of the crestal incision might be a significant factor in reducing the incidence of membrane exposure by minimizing flap necrosis. The mean KG width of adjacent teeth may be used as a guide to determine the initial incision location. However, this effect may be less significant in palatal/lingual gingiva >3.0 mm. [ABSTRACT FROM AUTHOR]