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A Standardized Approach to Extra-Oral and Intra-Oral Digital Photography

Contemporary dentistry mandates a more comprehensive and personalized analysis of each patient. Technological advances in digital photography have played ...

Columbia University College of Dental Medicine

The presence of hard tissue dehiscence and thin periodontal biotype in the esthetic area is a challenge that can jeopardize function and aesthetic outcome of implants. Here, we present a successful simultaneous soft tissue and bone regeneration of dehiscence defects in the maxillary incisor region. The novelty of this case lies in the simultaneous bone regeneration and soft tissue augmentation and the use of acellular dermal matrix as a barrier for regeneration and biotype conversion around dental implants. Reentry surgery 5 months after soft tissue and bone augmentation showed more than 95% new bone formation at the facial surface of implants and histological evidence of new vital bone formation. Biotype conversion from thin (<0.8 mm) to thick (2 mm) was noted in the area.

Acellular Dermal Matrix as a Barrier for Guided Bone Regeneration of Dehiscence Defects Around Dental Implants: A Clinical and Histological Report.

Von Willebrand disease (vWD) is the most common hereditary disorder affecting coagulation. Patients with this disorder are at a higher risk of postoperative complications after dental surgery. This article discusses the successful treatment for a patient with vWD undergoing implant therapy.

Dental Implant Therapy on a Patient With von Willebrand Disease: A Case Study.

Orthodontic extrusion or forced eruption has been a treatment modality used to improve future implant sites. A controlled force exerted on a tooth in a coronal direction can enhance both soft-and hard-tissue dimensions of implant recipient sites. However, this seemingly simple and effective treatment may, in fact, result in the loss of bone rather than gain if orthodontic mechanics are used improperly. Such unfavorable outcomes have been discussed in the literature along with various proposed techniques to overcome these poor results. This article is intended to evaluate these techniques and their results by elucidating possible reasons for complications in orthodontic extrusion cases. Also, mechanical aspects of orthodontic extrusion, such as various methods of bracket positioning and wire usage, will be discussed through a report of three clinical cases.

Possible Complications With Implant Site Development Utilizing Orthodontic Extrusion: Three Case Reports.

This case report documents root coverage after using an acellular dermal matrix (ADM) combined with a tunneling procedure. The photographs and objective clinical measurements are presented to document a gain of new clinical attachment and subsequent creeping attachment.

Creeping Clinical Attachment After Acellular Dermal Matrix Augmentation to Attain Root Coverage.

The aim of this case report is to present a clinical example of successful osseointegration of an implant placed immediately following extraction of a mandibular left first molar (tooth No. 19) with a horizontal gap of more than 2 mm and implant threads exposed within the socket, with healing by secondary intention without flap closure, bone grafting, or barrier membrane placement. The healing was photographed every day for the first week to provide photodocumentation of early healing and then was subsequently photographed weekly for the first month and monthly for the first 6 months. The outcome showed that osseointegration of an implant placed immediately in a posterior extraction site is possible without having to graft the gap around the implant.

Observed Healing of an Immediately Placed Implant in a Molar Site Without Bone Replacement Graft or Primary Closure.

Severe atrophy of the maxillary anterior region may make implant placement difficult and, as a result, iatrogenic complications such as nasal floor perforation may occur. The purpose of the present case reports is to present radiographic and nasal endoscopic features in the anterior nasal floor when dental implants were inadvertently perforated into nasal cavities. Between 1996 and 2018, 4 patients recorded with anterior nasal floor perforation with dental implants were followed and reviewed with panoramic radiographs and cone-beam computerized tomography. Also, nasal endoscopic examinations were performed by one otolaryngologist. Four implants in 4 patients were included in this case report. All implants achieved osteointegration and survived for 5-23 years without clinical complications. Three implants did not show any mucosal thickening and only one had minor mucosal thickening as visible on the radiographs. Nasal endoscopy examinations revealed that 3 implants were covered with mucosa and one had threads exposed. Intraorally, only one had clinical signs of peri-implant mucositis. Dental implants that perforated into the anterior nasal floor did not show clinical, radiographic, and nasal endoscopic complications during the long-term follow-up period. Nasal endoscopy was a better diagnostic tool to evaluate the implants perforated into the nasal cavity than conventional panoramic or cone-beam computerized tomography.

Radiographic and Nasal Endoscopic Observation of Accidentally Perforated Anterior Nasal Cavity With Dental Implants: Case Reports with 5-23 Years of Follow-Up.

This randomized, controlled clinical trial aimed to compare the differences in periodontal clinical outcomes, duration of the procedure, and patient's experience between conventional scaling and root planing and erbium-doped: yttrium-aluminum-garnet (Er:YAG) in the treatment of generalized moderate to severe chronic periodontitis or generalized Stages II or III, and Grade B periodontitis based on the Centers for Disease Control (CDC), American Academy of Periodontology (AAP), and European Federation of Periodontology (EFP) definitions.

Erbium-doped: yttrium-aluminum-garnet (Er:YAG) versus scaling and root planing for the treatment of periodontal disease: A single-blinded split-mouth randomized clinical trial.

Root fracture during extraction is not uncommon due to the presence of multiple and thin roots, which are often divergent and curved. The retained root fragments (RF) are usually radiographic incidental findings and often asymptomatic without associated pathology. However, careful and conservative surgical strategies for the removal of RF must be incorporated to allow for simultaneous implant placement and to avoid potential complications such as compromised osseointegration or retrograde peri-implantitis. Conventional RF removal techniques may lead to a significant amount of bone removal, involving more trauma and a prolonged healing period.

Window Approach for Simultaneous Root Fragment Removal and Implant Placement: Two Case Reports.

The purpose of this case report is to introduce a novel guided bone regeneration (GBR) technique that utilized bone harvested from previously grafted maxillary sinus with deproteinized bovine bone mineral (DBBM) 16 years ago. The patient is a 63-year-old male with hopeless maxillary right molars due to severe bone loss. Two months after the extraction, two bone blocks were harvested with a trephine drill from the lateral wall. One was used for histologic analysis and the other was crushed into particulate forms, which was used for a GBR procedure around an implant at the time of implant placement. The grafted site was then covered with a resorbable collagen membrane. The histological specimen showed newly-formed bone containing residual DBBM particles. The DBBM in the harvested bone was mostly resorbed; DBBM particles comprised only 3.6% of the total bone volume. The final prosthesis was delivered six months post-operatively. No change in crestal bone around the implant was observed throughout the 2 year follow-up period. Within the limitation of the present case report, previously grafted sinus can be a good donor site for further harvesting for a successful GBR procedure.

Utilizing Previously Grafted Sinus as Intraoral Donor Site for Successful Augmentation in Peri-Implant Osseous Defect: A Case Report.

Mucociliary clearance (MCC) allows ventilation of graft particles that are displaced through a perforated Schneiderian membrane during maxillary sinus augmentation (MSA). However, it is very rarely confirmed by cone-beam computed tomographic (CBCT) images. It is not yet known how long the dislodged bone graft particles remain in the maxillary sinus or how quickly they are ventilated after MSA. The purpose of these case reports is to introduce tomographic imaging of ventilation of bone graft particles displaced through a perforated Schneiderian membrane after MSA. Four patients, who needed implant placement in the posterior maxilla, received MSA, during which the Schneiderian membrane was perforated but was not repaired. Therefore, some bone graft particles were dislocated into the sinus cavity. The sizes of the perforated membranes were measured and recorded. CBCT scans were taken at multiple time points after the surgery to visualize and trace the ejected material. In addition, the time from when the bone graft substitute was delivered to the sinus until the CBCT scans were taken was recorded. The expelled bone graft particles migrated to the ostium along the sinus wall immediately after MSA on CBCT images taken immediately after the surgery. No displaced graft particles were observed in the maxillary sinus on CBCT scans after 1 week. The CBCT scans at 6 months showed no unusual radiographic images. Within the limitations of the case reports, tomographic imaging revealed an MCC system that allows displaced graft particles to be ventilated into the ostium very early during MSA healing and not stagnate in the maxillary sinus.

Philip Kang

Department of Periodontics

Columbia University College of Dental Medicine

A Standardized Approach to Extra-Oral and Intra-Oral Digital Photography

Philip Kang

.css-o250i3{font-size:18px;font-family:Open Sans,sans-serif;line-height:21.6px;}Department of Periodontics

Columbia University College of Dental Medicine

A Standardized Approach to Extra-Oral and Intra-Oral Digital Photography

Department of Periodontics