Managing Peri‐Implant Bone Loss: Current Understanding

Purpose: With the improved macro‐ and micro‐designs, dental implants enjoy a high survival rate. However, peri‐implant bone loss has recently emerged to be the focus of implant therapy. As such, researchers and clinicians are in need of finding predictable techniques to treat peri‐implant bone loss and stop its progression. Materials and Methods: Literature search on the currently available treatment modalities was performed and a brief description of each modality was provided. Results: Numerous techniques have been proposed and none has been shown to be superior and effective in managing peri‐implant bone loss. This may be because of the complex of etiological factors acting on the implant‐supported prosthesis hence the treatment approach has to be individually tailored. Conclusion: Due to the lack of high‐level clinical evidence on the management of peri‐implant bone loss, the authors, through a literature review, attempt to suggest a decision tree or guideline, based on sound periodontal surgical principles, to aid clinicians in managing peri‐implantitis associated bone loss.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92084/1/j.1708-8208.2011.00387.x.pd

Biologic Agents for Tissue and Bone Regeneration

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141905/1/cap0079.pd

A randomized clinical trial evaluating the efficacy of the sandwich bone augmentation technique in increasing buccal bone thickness during implant placement surgery

Objectives Sandwich bone augmentation ( SBA ) has been proposed to augment the width of edentulous ridges for implant placement. This study aimed to investigate the effect of a membrane on SBA for the regeneration of buccal implant dehiscence defects. Material and methods Twenty‐six healthy patients, each with a single defect, were randomly assigned into two groups. Both groups received an inner and outer layer of mineralized human cancellous and cortical particulate allograft. In the test group, a bovine pericardium membrane covered the bone grafts, while no membrane was placed in the control group. Cone beam computed tomography ( CBCT ) scans were taken before and immediately after implant placement and at 6 months post‐surgery. Results All implants placed were successfully osseointegrated at 6 months. Clinical re‐entry measurements showed significant buccal bone gain in the test group compared with the control group ( P   0.05). Cone beam computed tomography analysis demonstrated significant buccal bone gain of 1.22 mm in the test group. Radiographic vertical bone loss at 1‐year post‐surgery showed no significant differences between the groups. Conclusion Sandwich bone augmentation is a predictable technique for regenerating buccal bone on implant dehiscence defects. Addition of a barrier membrane prevented significant horizontal buccal bone resorption as space was maintained more effectively when compared with sites treated without a membrane.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106765/1/clr12171.pd

Flap Thickness as a Predictor of Root Coverage: A Systematic Review

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141980/1/jper1625.pd

Periodontal Regeneration With or Without Limited Orthodontics for the Treatment of 2â or 3â Wall Infrabony Defects

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141194/1/jper1734.pd

Relationship of Sulcular Sulfide Level to Severity of Periodontal Disease and BANA Test

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141051/1/jper0074.pd

Esthetic Buccal Flap for Correction of Buccal Fenestration Defects During Flapless Immediate Implant Surgery

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141057/1/jper0517.pd

Relationship Between Sulcular Sulfide Level and Oral Malodor in Subjects With Periodontal Disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141394/1/jper0079.pd

Efficacy of using a dual layer of membrane (d PTFE placed over collagen) for ridge preservation in fresh extraction sites: a micro‐computed tomographic study in dogs

Objective To assess if overbuilding the buccal plate or using a dual‐layer socket grafting technique prevents alveolar bone resorption and enhances final ridge width, height, and volume after tooth loss in an animal model. Material and methods In eight beagle dogs bilateral second (P2)‐, third (P3)‐, and fourth (P4) premolars were endodontically treated. All bilateral mandibular first premolars and distal roots of P2, P3, and P4 were hemisectioned and atraumatically extracted. Animals were randomly divided into four groups: (i) Control–Socket alone, (ii) Particulate allograft in the alveolum, socket covered with high‐density polytetrafluoroethylene ( dPTFE ) membrane and sutured over the alveolum, (iii) Particulate allograft in the alveolum and overbuilding the buccal plate, socket covered with dPTFE membrane and sutured over the alveolum, (iv) Particulate allograft in the alveolum and covered with dual layer ( dPTFE placed over collagen membrane), and sutured over the alveolum. After 16 weeks, the animals were sacrificed. Mandibular blocks of the jaws were assessed for bone volume ( BV ), vertical bone height ( VBH ), alveolar ridge thickness, and bone mineral density ( BMD ) using micro‐computed tomography. Results The BV in groups 1, 2, 3, and 4 was 169.5, 207.57, 242.4, and 306.1 mm 3 , respectively. The VBH in groups 1, 2, 3, and 4 was 4.2, 6.4, 6.2, and 7.3 mm, respectively. Ridge widths in groups 1, 2, 3, and 4 were 5.45 ± 0.75, 5.91 ± 0.86, 6.05 ± 0.63, and 6.28 ± 1.01 mm, respectively. There was no significant difference in BMD between the groups. Conclusions The RP using a dual layer of membrane following tooth extraction results in more BV , VBH , and alveolar ridge width as compared to when a single layer of membrane is used.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100133/1/clr2526.pd

Management of inter-dental/inter-implant papilla

Objectives : The aims of this paper are to review and compare existing techniques for creation of interdental/interimplant papillae, to address factors that may influence its appearance and to present an approach that authors developed that could help clinicians to manage and recreate the interproximal papillae. Methods : Papers related to interdental and interimplant papillae published over the last 30 years were selected and analyzed. Results : Thorough treatment planning is essential for maintenance of the height of the interproximal papillae following tooth removal. The key for achieving an esthetically pleasing outcome is the clinicians' ability of properly managing/creating interdental/interimplant papillae. Bone support is the foundation for any soft tissue existence, techniques such as socket augmentation, orthodontic extrusion, guided bone regeneration, onlay graft and distraction osteogenesis are often used for this purpose. Soft tissue grafts as well as esthetic mimic restorations can also be used to enhance the esthetic outcomes. Conclusions : An esthetic triangle is developed to address the foundations that are essential for maintaining/creating papilla. These include adequate bone volume, proper soft tissue thickness as well as esthetic appearing restorations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72024/1/j.1600-051X.2005.00748.x.pd