Nonsurgical genioplasty

Chin contributes to facial balance and harmony. Appropriate treatment of aesthetic deformities of the will often improves the appearance of the mouth, lips, and nose. Augmentation of the chin can be performed with injectable fillers or autologous fat, placement of an alloplastic chin implant, or with chin's bony osteotomy. Determining the best procedure for a patient requires careful consideration of his anatomy, as well as the risks and benefits of each treatment. Fillers offer a nonsurgical, nonpermanent method of correction of chin retrusion in the appropriate patient

New collagen matrix to avoid the reduction of keratinized tissue during guided bone regeneration in postextraction sites.

Abstract For decades, there has been an ongoing controversy regarding the need for an "adequate" width of keratinized gingiva/mucosa to preserve periodontal and implant health. Today, the presence of a certain width of keratinized tissue is recommended for achieving long-term periodontal and implant success, and therefore, a new collagen matrix has been developed to enhance the width of keratinized gingiva/mucosa. During postextraction socket preservation, guided bone regeneration techniques require complete coverage of the barrier membrane to reduce the risk of infection, occasionally causing a reduction of the width of keratinized tissue. Using the new collagen matrix, it is possible to leave the membrane intentionally uncovered, without suturing the surgical flap above it, to avoid the reduction of such tissue

Two techniques for the preparation of cell-scaffold constructs suitable for sinus augmentation: steps into clinical application.

The objective of this clinical trial was the analysis of 2 methods for engineering of autologous bone grafts for maxillary sinus augmentation with secondary implant placement. Group 1 (8 patients, 12 sinuses): cells of mandibular periosteum were cultured in a good manufacturing practice laboratory (2 weeks) with autologous serum and then transferred onto a collagen matrix. After another week, these composites were transplanted into the sinuses. In group 2A (2 patients, 3 sinuses), cells of maxillary bone were cultivated with autologous serum for 2 weeks, seeded onto natural bone mineral (NBM, diameter [Ø] = 8 mm) blocks, and cultivated for another 1.5 months. These composites were transplanted into the sinuses. Group 2B (control, 3 patients, 5 sinuses) received NBM blocks alone. In the course of implant placement 6 (group 1) and 8 (group 2) months later, core biopsy were taken. Clinical follow-up period was 1 to 2.5 years in group 1 and approximately 7 years in groups 2A and 2B. New vital bone was found in all cases at median densities of 38\% (n = 12) in group 1, 32\% in group 2A (n = 3), and 25\% in group 2B (n = 5). Differences between group 1 and 2B as well as 2A and 2B were statistically significant ( p = 0.025). No adverse effects were seen. All methods described were capable of creating new bone tissue with sufficient stability for successful implant placement

Survival rates of ultra-short (<6 mm) compared with short locking-taper implants supporting single crowns in posterior areas: A 5-year retrospective study

Background Short and ultra-short implants represent a predictable treatment, in terms of implant survival, with patients presenting insufficient available bone volumes. Moreover, single crown restorations represent a gold standard in terms of oral hygiene. Purpose The aim of this retrospective study was to evaluate implant survival, marginal bone loss, and peri-implant complications in 333 locking-taper short and ultra-short implants. Materials and Methods Implants were placed in the maxillary and mandibular posterior regions of 142 patients. Clinical and radiographic examinations were performed at 5-year recall appointments. Results All implants placed consisted of 8.0-, 6.0-, and 5.0-mm length, 38.14%, 34.53%, and 27.33%, respectively. Three hundred thirty-two implants (one early failure) were rehabilitated with single crowns in 141 patients. In 45.48% of the implants the crown-to-implant ratio was &gt;= 2, with a mean value of 1.94. Overall implant-based survival after 5 years of follow-up was 96.10%: 96.85%, 95.65%, and 95.60% for 8.0-, 6.0-, and 5.0-mm length implants, respectively (p = 0.82). Overall patient-based survival was 91.55%. Regarding crestal bone level variations, average crestal bone loss and apical shift of the "first bone-to-implant contact point" position were 0.69 and 0.01 mm, respectively. Setting the threshold for excessive bone loss at 1 mm, during the time interval from loading to follow-up, 28 implants experienced loss of supporting bone greater than 1 mm: 19 of them (67.85%) were surgically treated with a codified surgical regenerative protocol. After 60 months, a peri-implantitis prevalence of 5.94% was reported, with an overall implant success of 94.06%: 95.93%, 92.73%, and 93.10% for 8.0-, 6.0-, and 5.0-mm length implants, respectively (p = 0.55). Conclusion Long-term outcomes suggest that short and ultra-short locking-taper implants can be successfully restored with single crowns in the posterior area of the maxilla and mandible

Implant rehabilitation of the edentulous jaws: Does tilting of posterior implants at an angle greater than 45\ub0 affect bone resorption and implant success?: A retrospective study

Purpose: This study aimed to (1) investigate the success of posterior implants tilted &gt;45\ub0 when 4 immediately loaded implants were used to support full-arch prostheses, eliminating any distal cantilever and (2) examine the effect on marginal bone loss (MBL) of different combinations of anterior multi-unit abutment (MUA) angles and posterior implant tilting angles. Materials and Methods: Records of patients rehabilitated according to the Columbus Bridge Protocol were analyzed. Peri-implant bone levels (PBLs) and MBL were measured for each implant. The influence of posterior implant tilting angle on PBL, MBL, and implant and prosthetic success rate was investigated. The impact on the same endpoints of different anterior MUA angles, and different combinations of anterior MUA and tilted posterior implant angles was also examined. Results: Records of 41 patients were analyzed, for a total of 46 complete rehabilitations, and 142 implants (52 anterior, 63 posterior tilted 6445\ub0 [group 1], and 27 posterior tilted &gt;45\ub0 [group 2]). No implants were lost during the follow-up (25.9 months), and no prosthetic complications were reported. Success rate for posterior implants was 100% in group 1 and 96.3% in group 2. Mean MBL differed significantly between the 2 groups (0.45 mm in group 1, 0.66 in group 2 [P =.04]), but not when the analysis was limited to implants in the same jaw. Implant tilting angle did not correlate with MBL and the MUA angle had no effect on bone resorption around posterior implants, neither in the sample as a whole nor in individual patients. Conclusions: Posterior implants tilted &gt;45\ub0 to eliminate distal cantilever may be as safe as those tilted less in severely atrophic jaws rehabilitated with immediately loaded, full-arch prostheses supported on 4 implants. Further prospective studies on larger samples of patients and implants and with longer follow-up are needed to confirm these findings

Fresh-frozen homologous bone in sinus lifting: histological and radiological analysis

BACKGROUND: The aim of this study was to evaluate radiological and histological characteristics of fresh-frozen homologous bone as grafting material for maxillary sinus floor augmentation. Radiological, histological and clinical evaluations were made. METHODS: Twenty-three patients with a 2 mm to 6 mm alveolar ridge height in the posterior maxilla have been enrolled. Unilateral or bilateral sinus floor augmentations were performed with fresh frozen morcelized homologous bone. Together with implant placement, 7 months after surgery, a bone core was harvested for histological analysis. Radiological measurements were obtained by superimposition of CT scans carried out at the surgery time and six months later. A total of 93 implants were positioned. RESULTS: A mean (\ub1SD) increase in mineralized tissue height of 10.74\ub12.82 mm was noticed by comparing the CT scans. Histological analysis revealed the presence of newly formed bone in the grafted sites. The follow up period after the prosthetic load ranged from 8 to 31 months. One implant failure occurred. CONCLUSIONS: Fresh frozen homologous bone seems to have a good healing pattern and to be a successful and steady grafting material for the treatment of maxillary ridge atrophy. It might be considered a valid alternative to autologous bone in sinus floor augmentation procedures

Keratocyst, conservative treatment: case report

The odontogenic keratocyst is now designated as a keratocystic odontogenic tumor and is defined as a benign uni- or multicystic, intraosseus tumor of odontogenic origin, with a characteristic lining of parakeratiniezed tumour as a better reflects is neoplastic nature. This case report presents the marsupialization procedure for the treatment of a keratocystic lesion