Blocks 3-4 (IIP & GBR) Flashcards
Cosyn 2018
Cosyn et al. 2018 completed a sys.rev & met.anal on the effectivenes of immediate implants vs delayed implants. Please, determine the survival rate of each group. Was the difference between the survival rate of IIP & DIP statistically significant?
implant survival amounted to 95% for IIP and 99%for DIP
This 4% difference in implant survival between IIP and DIP appeared statistically **significant **
de Rouck 2009
In terms of midfacial recession, de Rouck 2009:
a) How much apical displacement at the midfacial area did they observe in those implants that were not restored inmediately?
b) What two reasons do they state to explain this disparity?
a) recession was systematically 2.5–3 times higher in the DRG pointing to a mean additional loss of 0.75 mm in case of submerged healing. IRG indicated an average apical displacement of ~0.5mm.
b) (1) Primary wound closure was incomplete in all cases of the DRG as no attempt was made to perform vertical incisions and release of the periosteum. Consequently, membrane exposure occurred possibly causing some inflammation, additional bone and soft tissue loss. (2) The soft tissues were allowed to collapse in the DRG during a 3-month period, whereas they were constantly supported in the IRG.
Pitman 2022: When considering intact alveoli, IIP + IP demonstrated 0.87 mm less apical migration of the midfacial soft tissue level when compared to IIP alone.
DRG - Delayed restoration group; IRG - Immed.restoration group
Seysseens 2021
Midfacial recession has become a concern following immediate implant placement, Seysseens 2021 evaluated the effect of soft tissue grafting by means of a met.anal. State the vertical mid facial soft tissue change.
Mean vertical soft tissue change: -0,7 to -0,5 mm without CTG & -0,32 to +0.1mm with CTG
Significant difference in mid facial vertical soft tissue change of 0.41 mm (in favour of CTG)
Tonetti 2017 (consensus)
Tonetti et al. 2017 “Management of extraction socket and timing of implant placement”:
a) When should immediate implant placement be avoided?
b) How do immediate implant and delayed implant placement compare in terms of implant loss?
a) Immediate implant placement should be avoided when Should be avoided when:
- Severely damages sockets (+ than 50% BL)
- Primary stability requires incorrect position
- Primary stability requires improper implant diameter
Shorter treatment time and cost-efficiency
Should be limited to low risk patients
b) Level of buccal bone loss is a major prognostic factor
Greater early implant loss compared to delayed placement: 95% vs 99%
Jung 2016
According to the studied articles, what are the consequences of left a dehiscence type defect on implants?
Jung 2016
Small bony dehiscence defects left for spontaneous healing demonstrated high implant survival rates with healthy and stable soft tissues. However, more** vertical bone loss** (bone loss of -0.17 ± 1.79 mm) at the buccal aspect 6 months post Placement and more MBL (slight bone loss of -0.39 ± 0.49 mm) between crown delivery to 18 months post-loading
Schwartz 2011
* Implants with RDH ≥1mm were identified as having a higher risk of peri-implant disease.
* Positive RDH values were associated with increased MR, potentially compromising esthetic outcomes.
RDH: Residual Defect Height
Berglundh 1997
Justify the use of xenograft on bone regeneration on implants (histological evidence and long term follow up).
Berglundh 1997
After 3 & 7 months of healing, Histological analysis around implants showed Bio-Oss® particles integrated with newly formed bone over time, indicating its osteoconductive properties.
Bone Density: Bio-Oss® particles density reduced over time, indicating gradual replacement by natural bone. However, significant amounts of Bio-Oss® remained even after 7-month.
Study suggests that Bio-Oss® acts as an osteoconductive material, promoting bone regeneration and facilitating osseointegration of dental implants. The gradual replacement of Bio-Oss® by natural bone indicates its potential for long-term stability in dental applications.
De Bruckere 2019
According to De Bruckere 2019, what would you do in a case of anterior implant placement with volume defect regarding PROMs during the early stages of healing?. Please report the main outcomes.
De Bruckere 2019: GBR and CTG yielded favorable aesthetic outcomes, but GBR exhibited more scarring, (PROMs) discomfort, pain, oedema and hematoma. In aesthetically demanding cases, careful consideration of incision placement is recommended for GBR.
Which is the most commonly used biomaterial regarding lateral bone augmentation? Justify with literature.
Sarnachiaro 2015
Immediate vs delayed implant placement
1) In these two cases, which is the best option for implant placement after tooth extraction?
Sarnachiaro 2015
Membrane + bone** graft and custom healing abutment, at the time of anterior tooth extraction + IIP in type 2 socket, can reconstitute the absence of labial bone plate (Mean gain 3mm) maintaining the gingival architecture.
Tonetti 2019
Absence of primary stability / inability to place it properly contro-indicates IIP → ARP and delayed/late implant placement w/ simultaneous / staged alveolar ridge augmentation are recommended.
‣ A damaged alveolus (presenting dehiscence or coronal fenestration) is associated with higher unfavorable therapeutic outcomes when combined to immediate implant → early implant or ridge reconstruction are recommended
Implant placement and simultaneous GBR
2) Based on the literature, justify the treatment approach in this implant dehiscence case.
Thoma 2019
Lateral bone augmentation is successful; optimal defect reduction needs a barrier membrane and grafting material combination.
