Soft Tissue Consideration for Implants Placement in Esthetic Zone (original) (raw)
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Soft Tissue Consideration for Implants Placement in Esthetic Zone 1 Dr
2016
Replacement of missing teeth with implants has made a revolutionary change in restorative dentistry. There is increasing demand for esthetics along with restoration of comfort and function. Adequate zone of attached tissue around a natural tooth or implant prosthesis is desirable to better withstand the functional stresses resulting from mastication, oral hygiene efforts and to maintain predictable levels over time. The importance of soft tissue in implant dentistry is often underestimated. The present literature review focuses various non-surgical and surgical procedures for soft tissue augmentation in implantology and also discusses various approaches to preserve and restore the interdental papilla. Goals for peri-implant soft-tissue grafting are to create a stable peri-implant soft tissue environment by providing an adequate zone of attached nonmobile tissues with intimate adaptation to emerging implant structure and reconstructing soft tissue architecture for maintaining harmoni...
Preservation of Peri-Implant Papilla: A Narrative Review
Journal of Health and Allied Sciences NU
Beside osseointegration and restoration of function, the patient's subjective satisfaction with the esthetic result is a touchstone of the success of implant therapy. The long-term maintenance and reconstruction of papilla-like soft tissue between two adjacent implants in the esthetic zone which is esthetically satisfactory is generally regarded as a challenge. The road to success is much more complicated with implants, because of biologic and anatomical limitations of peri-implant tissues. Numerous techniques have been proposed to manage the hard and soft tissues in an attempt to achieve ideal esthetic results which includes surgical and nonsurgical techniques. The goal of reconstructive procedures is to provide peri-implant bone that supports and maintains gingival contours. An interdisciplinary approach has an obvious advantage of long-term preservation of a healthy peri-implant tissue which is of key importance in ensuring acceptable function and subjective satisfaction of e...
The International journal of periodontics & restorative dentistry
Maintenance or reconstruction of interproximal papilla for a successful dental implant restoration can be challenging. To date, the results from various surgical and prosthetic techniques to maintain or regenerate papilla adjacent to dental implants have been unpredictable. To maintain the quality of the soft tissue around an implant, the blood supply must be preserved and formation of scar tissue must be minimized during surgery. Therefore, incision design is vital to producing an esthetic and successful dental implant restoration. In this study, specific incision designs and soft tissue management techniques were used to preserve or create interproximal papilla around single or adjacent implants.
Clinical Oral Implants Research, 2018
OBJECTIVES Working Group 2 at the 2nd Consensus Meeting of the Osteology Foundation had a focus on the influence of vertical implant placement on papilla height at single implants adjacent to teeth and on the inter-implant mucosa fill at two adjacent implants in the anterior maxilla. MATERIALS AND METHODS Two systematic reviews were prepared in advance of the consensus meeting. Due to the heterogeneity among the studies with regard to study design, study population, method of assessment, meta-analyses were not possible. Consensus statements, clinical recommendations, and implications for future research were based on structured group discussions until consensus was reached among the entire expert group. RESULTS The systematic review about single-tooth implants included a total of 12 studies demonstrating that the vertical distance from the crestal bone level to the base of the interproximal contact point varied considerably from 2 mm up to 11 mm, and a partial or complete papilla fill was reached in 56.5% to 100% of the cases. For the systematic review regarding two adjacent implants, only four studies reported on horizontal inter-implant distances which ranged between 2.0 and 4.0 mm. More than half of the papilla presence was indicated in 21% to 88.5% of the cases. CONCLUSIONS It was concluded that for single-tooth implants, the papilla height between an implant and a tooth is predominantly dependent on the clinical attachment level of the tooth. In cases with two adjacent implants, it was concluded that it is not possible to define the optimal horizontal distance between two adjacent implants restored with fixed dental prosthess.
Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics
International journal of dentistry, 2015
Implant dentistry has been established as a predictable treatment with excellent clinical success to replace missing or nonrestorable teeth. A successful esthetic implant reconstruction is predicated on two fundamental components: the reproduction of the natural tooth characteristics on the implant crown and the establishment of soft tissue housing that will simulate a healthy periodontium. In order for an implant to optimally rehabilitate esthetics, the peri-implant soft tissues must be preserved and/or augmented by means of periodontal surgical procedures. Clinicians who practice implant dentistry should strive to achieve an esthetically successful outcome beyond just osseointegration. Knowledge of a variety of available techniques and proper treatment planning enables the clinician to meet the ever-increasing esthetic demands as requested by patients. The purpose of this paper is to enhance the implant surgeon's rationale and techniques beyond that of simply placing a functio...
Peri-Implant Soft Tissue Esthetics; A Journey from Implant Placement to Permanent Restoration
Journal of The Pakistan Dental Association, 2017
Restorations placed in the anterior part of the mouth present a unique challenge in terms of reproducing the lost soft tissue. This aspect is particularly pronounced in case of avulsed central incisors. Since 'black triangles' have been displayed in patients where the anterior teeth are replaced by implants, particular attention needs to be paid to achieve the desired soft tissue profile. This case-report explains the restoration of upper central and lateral incisors of a patient, where the central incisor was avulsed and lateral incisor fractured. The process of replacing the central incisor with an immediate implant, followed by slowly and gradually modifying the peri-implant soft tissue, leading up to transferring the modified soft tissue profile through a specialized impression technique, has been described in detail.
Surgical soft tissue improvement in the course of implant therapy
2017
Introduction When it comes to implant placement in the esthetic zone, clinicians are nowadays required to implement a lot of innovative aspects in their treatment concept and meet the standard of knowledge from tooth extraction to insertion of the final prosthetic solution. Thanks to new surgical techniques and improved materials much better results can be achieved nowadays to the benefit of the patient. This includes tissue-conserving extraction methods, scientifically documented methods for the preservation and augmentation of hard and soft tissues, the application of modern incision and suturing techniques as well as careful pre-implantation diagnostics (Bäumer et al. 2013). In contrast to earlier times when a high survival rate was the focus, special attention is now paid to the esthetic outcome. This relates not only to the appearance of the prosthetic solution, but also to that of the peri-implant tissues. Because “red-and-white esthetics” strongly influence the way in which p...
Soft tissue management at implant sites
Journal of Clinical Periodontology, 2008
Background: Dental implants are widely used to replace lost teeth. It was suggested that surgical manipulation/augmentation of peri-implant soft tissue may be beneficial to increase the width/thickness of keratinized tissue (KT) and to enhance aesthetic outcomes of implant therapy. The aim of this paper was to provide a narrative review of the literature concerning soft tissue management at implant sites. Material and Methods: Clinical studies were identified with both medline and hand searches. Three topics were considered in this review: (i) the significance of KT at implant sites, (ii) the surgical techniques to increase KT and (iii) soft tissue stability around implants. Results: Several papers concerning soft tissue management at implant sites were identified, mainly expert opinions, case reports and case series. In addition, a systematic review was selected. Generally, the level of evidence was weak. So far, literature analysis showed that (i) the width of KT did not influence the survival rate of dental implants; (ii) there is no evidence to recommend a specific technique to preserve/augment KT; and (iii) factors including bone level, KT and implant features have not been shown to be associated with future mucosal recession around dental implants. Conclusion: Although scientific evidence in most part is lacking, soft tissue augmentation at implant sites may need to be considered in some clinical situations.