A new index for rating aesthetics of implant-supported single crowns and adjacent soft tissues - the Implant Crown Aesthetic Index:A pilot study on validation of a new index

Objectives: The important item of aesthetics is rarely included in evaluation studies. The aim of this study was to develop and validate an index for rating aesthetics of implant-supported single crowns and adjacent soft tissues. Material and methods: Nine items were selected, which have an influence on the aesthetic result. The items are based on the anatomic form, colour and surface characteristics of the crown and on the anatomic form, colour and surface characteristics of the peri-implant soft tissues. Two oral-maxillofacial surgeons and two prosthodontists rated 24 implant-supported single-tooth restorations and adjacent soft tissues on a form with the nine items of the rating index. The rating was carried out twice by each of the examiners. Weighted Cohen's kappa was calculated to express the intra- and interobserver agreement. Results: Intraobserver results indicated that the agreement between the first and second rating of both the prosthodontists was good (both 0.7) and that the agreement of the oral-maxillofacial surgeons was moderate (0.49 and 0.56). The best interobserver agreement was found between the two prosthodontists (0.61, good agreement). Conclusions: The Implant Crown Aesthetic Index is an objective tool in rating aesthetics of implant-supported single crowns and adjacent soft tissues. The rating is best be carried out by one prosthodontist to have the highest reliability

Hydroxyapatite crystallinity does not affect the repair of critical size bone defects

OBJECTIVE: The physicochemical properties of hydroxyapatite (HA) granules were observed to affect the biological behavior of graft materials. The aim of this work was to analyze the tissue response of two HA granules with different crystallinity and Ca/P ratio in vivo. MATERIAL AND METHODS: The HA granules were produced in the Biomaterials Laboratory (COPPE/UFRJ). The testing materials were HA granules presenting a Ca/P molar ratio of 1.60 and 28% crystallinity (HA-1), and a Ca/P molar ratio of 1.67 and 70% crystallinity (HA-2). Both HAs were implanted into a critical-size calvaria rat defects. RESULTS: To note, in the control group, the bone defects were filled with blood clot only. Descriptive and histomorphometric analyses after 1, 3, and 6 months postoperatively showed mild inflammatory infiltrate, mainly comprising macrophage-like and multinucleated giant cells, and an increase in the volume density of the fibrous tissues (p<0.05), which was in contrast to the similar volume density of the newly formed bone and biomaterials in relation to the control group. CONCLUSION: Thus, we concluded that HA-1 and HA-2 are biocompatible and non-degradable, and that crystallinity does not affect bone repair of critical size defects

Surgical dilemmas. Bone augmentation procedures for single-tooth replacements

Wanneer na verlies van een of meer gebitselementen onvoldoende bot aanwezig is om een implantaat te kunnen plaatsen is een botaugmentatie geïndiceerd. Bij grote botdefecten, zoals botdeficiënties in de edentate kaak en defecten groter dan 3 gebitselementen, kan uit de orale regio niet altijd voldoende bot worden geoogst en moet men zo nodig zijn toevlucht nemen tot een autoloog bottransplantaat van een extraorale donorplaats (crista iliaca). Ook bij verticale botdefecten zal de keuze gewoonlijk vallen op een autoloog bottransplantaat, al kan dit dan veelal uit de orale regio worden geoogst. Bij kleine botdefecten kan worden gekozen voor een augmentatie met autoloog bot uit de orale regio (ramus mandibulae of kinregio) of voor een botsubstituut.When, following the loss of one or more teeth, insufficient bone is present for the placement of a dental implant, bone augmentation is indicated. For large bone defects (e.g. severely atrophic edentulous jaws and large vertical/horizontal bony defects larger than 3 teeth), an autogenous bone transplant from an extra-oral donor site (iliac crest) will have to be chosen. An autogenous bonegraft is also usually preferred for vertical bone deficiencies, though this can generally be harvested in the oral region. For smaller bone defects, augmentation with autogenous bone from the oral region (mandibular ramus, symphysis region) can be selected or a bone substitute.</p

Surgical dilemmas. Bone augmentation procedures for single-tooth replacements

Wanneer na verlies van een of meer gebitselementen onvoldoende bot aanwezig is om een implantaat te kunnen plaatsen is een botaugmentatie geïndiceerd. Bij grote botdefecten, zoals botdeficiënties in de edentate kaak en defecten groter dan 3 gebitselementen, kan uit de orale regio niet altijd voldoende bot worden geoogst en moet men zo nodig zijn toevlucht nemen tot een autoloog bottransplantaat van een extraorale donorplaats (crista iliaca). Ook bij verticale botdefecten zal de keuze gewoonlijk vallen op een autoloog bottransplantaat, al kan dit dan veelal uit de orale regio worden geoogst. Bij kleine botdefecten kan worden gekozen voor een augmentatie met autoloog bot uit de orale regio (ramus mandibulae of kinregio) of voor een botsubstituut.When, following the loss of one or more teeth, insufficient bone is present for the placement of a dental implant, bone augmentation is indicated. For large bone defects (e.g. severely atrophic edentulous jaws and large vertical/horizontal bony defects larger than 3 teeth), an autogenous bone transplant from an extra-oral donor site (iliac crest) will have to be chosen. An autogenous bonegraft is also usually preferred for vertical bone deficiencies, though this can generally be harvested in the oral region. For smaller bone defects, augmentation with autogenous bone from the oral region (mandibular ramus, symphysis region) can be selected or a bone substitute.</p