The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.
Alveolar Ridge Augmentation ; Bone Substitutes ; Dental Implants ; Humans ; Mandible* ; Maxilla* ; Sinus Floor Augmentation ; Survival Rate

PURPOSE: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. METHODS: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. RESULTS: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. CONCLUSIONS: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.
Alveolar Bone Loss ; Ankylosis ; Anti-Bacterial Agents ; Bone Remodeling ; Follow-Up Studies ; Humans ; Inflammation ; Intention ; Kaplan-Meier Estimate ; Osteogenesis ; Periodontal Diseases ; Replantation* ; Retrospective Studies* ; Root Resorption ; Survival Rate ; Tooth Replantation ; Tooth*

No abstract available.

No abstract available.

PURPOSE: The objective of this study was to comparatively assess the bone regenerative capacity of absorbable collagen sponge (ACS), biphasic calcium phosphate block (BCP) and collagenated biphasic calcium phosphate (CBCP) loaded with a low dose of recombinant human bone morphogenetic protein-2 (rhBMP-2). METHODS: The CBCP was characterized by X-ray diffraction and scanning electron microscopy. In rabbit calvaria, four circular 8-mm-diameter defects were created and assigned to one of four groups: (1) blood-filled group (control), (2) rhBMP-2-soaked absorbable collagen sponge (0.05 mg/mL, 0.1 mL; CS group), (3) rhBMP-2-loaded BCP (BCP group), or (4) rhBMP-2-loaded CBCP (CBCP group). The animals were sacrificed either 2 weeks or 8 weeks postoperatively. Histological and histomorphometric analyses were performed. RESULTS: The CBCP showed web-like collagen fibrils on and between particles. Greater dimensional stability was observed in the BCP and CBCP groups than in the control and the CS groups at 2 and 8 weeks. The new bone formation was significantly greater in the BCP and CBCP groups than in the control and CS groups at 2 weeks, but did not significantly differ among the four groups at 8 week. The CBCP group exhibited more new bone formation in the intergranular space and in the center of the defect compared to the BCP group at 2 weeks, but a similar histologic appearance was observed in both groups at 8 weeks. CONCLUSIONS: The dose of rhBMP-2 in the present study enhanced bone regeneration in the early healing period when loaded on BCP and CBCP in rabbit calvarial defects.
Animals ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins* ; Bone Regeneration ; Calcium ; Collagen ; Humans ; Microscopy, Electron, Scanning ; Osteogenesis ; Porifera ; Skull ; X-Ray Diffraction

The publication of this article unfortunately contained several mistakes.
Humans ; Orthognathic Surgery ; Publications ; Snoring

PURPOSE: Decision-making by dental and medical experts can be influenced by their biases, interests, and experiences, and academic arguments about controversial issues may additionally be considered indirect experiences capable of affecting decision-making. This study reports on the use of interactive communication devices to evaluate preferences and flexibility in decision-making among dental care providers who attended two distinct academic conferences. METHODS: Two debates were presented by a team of two lecturers at two academic conferences (focusing on periodontology and implant dentistry, respectively) and the audience members of each session were surveyed. Before each lecture, two case modules about the diagnosis and treatment of multirooted molar lesions were provided, and interactive communication devices were used to collect responses about decision-making preferences in treatment planning immediately before and after a debate about treatment strategies. RESULTS: In total, 81 and 84 completed answers from both conferences were obtained for the first and second case modules, respectively. The preferred treatment plan differed significantly according to the focus of the conference, and a tendency emerged for the clinicians participating in each conference to express uniform preferences. However, attending the debates resulted in significant changes in decision-making preferences regardless of the conference focus or the characteristics of the participants. CONCLUSIONS: Our findings suggest that providing continuing education via debates on controversial issues may be effective in widening conceptual knowledge and reducing biases among experts in the dental and medical fields.
Bias (Epidemiology) ; Clinical Protocols ; Congresses as Topic* ; Decision Making ; Dental Care ; Dental Implants ; Dentistry ; Diagnosis ; Education, Continuing ; Education, Dental, Continuing ; Molar ; Periodontics ; Pliability* ; Tooth*

PURPOSE: The aim of the present study was to analyze 7-year cumulative survival rate (CSR, %) of dental implants in the controlled diabetic patients and to evaluate the influence of the position, diameter and length of fixture, bone quality, age, gender and the method of maxillary sinus elevation on the survival rate. METHODS: The data of 342 placed implants in the 104 diabetic patients collected between 1995 and 2007 at the Department of Periodontology in Yonsei University Hospital were analyzed. RESULTS: Seven-year CSR of the 342 dental implants in the 104 controlled diabetic patients was 96.5%. The survival rates of the placed implants according the position have no statistically significant difference. The survival rates according to the length or diameter of the fixtures have no statistically significant difference. The survival rates according to the bone quality were 100% (Type I), 97.1% (Type II), 97.7% (Type III) and 85.7%(Type IV). The difference between the survival rate of Type I, II and III and that of Type IV was statistically significant. The survival rates according to patient gender were 96.8% (male), 95.5% (female). The survival rates according to patient age were 100% (< or = 59), 93.8% (> or = 60). The survival rates according to the method of sinus elevation in the maxillary posterior area were 96.8% (without sinus elevation), 92.9% (lateral approach) and 89.8% (crestal approach). CONCLUSIONS: Dental implants can be used successfully in the controlled diabetic patients. In case of upper posterior region which has poor bone density and older patients, the implant treatment should be more properly planed, executed, and followed-up.
Bone Density ; Dental Implants ; Diabetes Mellitus ; Humans ; Maxillary Sinus ; Retrospective Studies ; Survival Rate

PURPOSE: The aim of this study was to determine the effect of overlaying titanium mesh (TM) with an adjunctive collagen membrane (CM) for preserving the buccal bone when used in association with immediate implant placement in dogs. METHODS: Immediate implant placements were performed in the mesial sockets of the third premolars of five dogs. At one site the TM was attached to the fixture with the aid of its own stabilizers and then covered by a CM (CM group), while the contralateral site received only TM (TM group). Biopsy specimens were retrieved for histologic and histomorphometric analyses after 16 weeks. RESULTS: All samples exhibited pronounced buccal bone resorption, and a high rate of TM exposure was noted (in three and four cases of the five samples in each of the TM and CM groups, respectively). A dense fibrous tissue with little vascularity or cellularity had infiltrated through the pores of the TM irrespective of the presence of a CM. The distances between the fixture platform and the first bone-implant contact and the bone crest did not differ significantly between the TM and CM groups. CONCLUSIONS: Our study suggests that the additional use of a CM over TM does not offer added benefit for mucosal healing and buccal bone preservation.
Animals ; Bicuspid ; Biopsy ; Bone Regeneration ; Bone Resorption ; Collagen* ; Dental Implants ; Dogs ; Membranes* ; Postoperative Complications ; Titanium* ; Tooth Extraction

PURPOSE: The aim of this pilot study was to determine the osteoconductivity and dimensional stability of augmented sinuses using different ratios of biphasic calcium phosphate (BCP) in a rabbit sinus model. METHODS: Each sinus of New Zealand white rabbits (2.5-3.5 kg) was assigned to one of two groups: BCP with a hydroxyapatite to beta-tricalcium phosphate (HA:beta-TCP) ratio of 70:30 (group TCP30) and BCP with an HA:beta-TCP ratio of 30:70 (group TCP70). After preparing a window in the antral wall of a sinus, the Schneiderian membrane was elevated, and the applicable material was grafted. A fluorochrome calcein green was injected five days before euthanizing the animals at four months post-surgery. The specimens were analyzed histologically, histomorphometrically, and by using micro-computed tomography (micro-CT). RESULTS: Micro-CT analysis revealed that the total augmented volume and the new bone volume did not differ significantly between the two groups whereas the resorption of materials was greater in the TCP70 group. The trabecular thickness, number, and separation also did not differ significantly between the two groups. Histomorphometrically, the areas of total augmentation, new bone, and residual material, as well as the ratio of new-bone-material contact did not differ significantly between the groups. Histologically, the residual particles were more scattered in the TCP70 group than in the TCP30 group. The fluorescence of the calcein green did not differ notably between the two groups. CONCLUSIONS: The osteoconductivity and dimensional stability of the two BCPs with different ratios tested in this study were comparable after four months of healing. Therefore, we conclude that both BCPs show promise as a bone substitute for sinus augmentation.
Animals ; Bone Regeneration ; Bone Substitutes ; Calcium* ; Durapatite ; Fluorescence ; Nasal Mucosa ; Pilot Projects* ; Rabbits ; Transplants