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Objectives To evaluate the accuracy of measuring peri-implant buccal bone when using three different computed tomography devices. Materials and methods Sixty tissue-level or bone-level dental implants were placed in bovine ribs with either buccal bone full coverage, dehiscence or fenestration. For each site, the distance from the bone defect to the implant neck and the buccal bone thickness 1 mm apical to the crest were measured using a calliper. Subsequently, all sites were scanned in a reproducible position using a multi-slice computed tomography ( CT) (Brightspeed, voxel size 0.625 mm) and two cone-beam computed tomography devices (i-CAT NG, voxel size 0.3 mm and Newtom VGi, voxel size 0.2 mm). Bone thickness was measured on images from the three systems similar to direct measurements and differences were evaluated. Factors that could influence the buccal bone identification were assessed by multiple binary logistic regression. Results Buccal bone ranged from 0.1 mm to 2.75 mm in thickness and was not visible in 68%, 63% and 60% of cases when using CT, i-CAT and Newtom, respectively. For each mm of bone thickness increment, the odds of radiographic identification increased by 30.6 ( P < 0.001). Bone defects negatively affected radiographic visibility ( P < 0.05). All devices underestimated bone dimensions although differences among them were not significant. Conclusions Within these experimental conditions, the investigated devices have equivalent low accuracy in diagnosing peri-implant buccal bone. Accuracy was significantly influenced by buccal bone thickness, especially if <1 mm, and in presence of peri-implant marginal defects. [ABSTRACT FROM AUTHOR]

Soft tissue fenestration in implants is considered not only as a situation that could negatively influence the long-term stability of the implant, but also creates an esthetic problem when it occurs in the visible area of the mouth. This article describes the resolution of a case that presented a vestibular fenestration of an osseointegrated implant placed to substitute the upper right incisor, which does not respect the recommendations of ideal three-dimensional position in a young patient with a high smile line. The case was treated using two mucogingival surgical techniques to avoid a more invasive approach. A prosthetic immediate final abutment was inserted in the day of the second surgery. The fenestration was successfully covered and 2 years later it remains stable. In this article, the details about the treatment are described. [ABSTRACT FROM AUTHOR]