• Title/Summary/Keyword: Flapless

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Immediate implant placement in fresh extraction sockets

  • Lee, Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.1
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    • pp.57-61
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    • 2021
  • Immediate implant placement (IIP) in fresh extraction sockets exhibits similar survival and success rates to delayed implant placement in healed sockets. Several advantages of IIP involve shortened total treatment time, reduction of the number of invasive surgeries, and subsequent reduction of patient discomfort due to lack of additional surgeries. The major shortcomings in IIP, however, include the inability to obtain early bony support, presence of a gap between the extraction socket and fixture, and the inability to cover the fixture with soft tissue, leading to increased risk of infection and implant loss. When IIP is performed, atraumatic or minimally traumatic extractions, conservation of the septal bone in molars, minimal flap elevation or flapless surgery, bone grafting the gap between the fixture and the extraction socket, and coverage with soft tissue or a membrane must be considered.

Immediate Connection of Customized Zirconia Abutment Using Flapless Guided Surgery: A Clinical Report (무절개 수술을 이용한 맞춤형 지르코니아 지대주의 즉시 장착 증례)

  • Lee, Gyeong-Je;Choi, Byung-Ho;Kim, Hee-Jun;Jung, Seng-Mi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.201-212
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    • 2012
  • There are some similar aspects at histological and morphological characteristics between the peri-implant tissue and periodontal tissue and the direct attachment between the titanium and soft tissue around the implant called as "Functional ankylosis" can prevent the apical infiltration of inflammatory and bone resorption around implant. But, the repeated connection and disconnection of the abutment can destroy the mucosal barrier of soft tissue around the implant and can cause the marginal bone resorption. The amount of marginal bone resorption may reduced if the prosthetic abutment is placed at that time of surgery. Connection of the prosthetic abutment at surgery was limited because the low accuracy of conventional method, but by using of Cone Beam Computed Tomography(CBCT) and guide surgery, the 3-dimensional accuracy of implant placement became much higher than before and it became possible. This is a clinical case of immediate connection of prosthetic abutment and provisional restoration by using of precise CBCT diagnosis and pre-fabricated zirconia customized abutment at surgery and the alternative method is described in this article because of the clinically contentable results.

What is the effect of initial implant position on the crestal bone level in flap and flapless technique during healing period?

  • Al-Juboori, Mohammed Jasim;Ab Rahman, Shaifulizan;Hassan, Akram;Ismail, Ikmal Hisham Bin;Tawfiq, Omar Farouq
    • Journal of Periodontal and Implant Science
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    • v.43 no.4
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    • pp.153-159
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    • 2013
  • Purpose: The level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods. Methods: Twenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface. Results: At 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient= 0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018). Conclusions: A larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.

Implant Supported Fixed Restoration for Maxillary Edentulism using CAD/CAM Guided Implant Surgery (NobelGuide$^{TM}$) and Immediate Loading (상악 완전 무치악 환자의 CAD/CAM 을 이용한 임플란트 식립(NobelGuide$^{TM}$) 및 즉시하중 후 고정성 보철수복 증례)

  • Huh, Yoon-Hyuk;Yi, Yang-Jin;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.423-439
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    • 2012
  • This case report described a technique utilizing a computer-aided design (CAD)/computer-aided machining (CAM) - guided surgical implant placement and prefabricated temporary fixed prosthesis for an immediately loaded restoration. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla received 8 implants in maxilla using CAD/CAM surgical templates. Prefabricated provisional maxillary implant supported fixed prosthesis were connected immediately after implant installation. Provisional prosthesis was evaluated for aesthetics, function during 6 months. Definitive implant supported fixed porcelain fused metal bridges were fabricated.

Flapless implant placement with digital 3D imaging and planning system in fully edentulous patient: A case report and 5-year follow-up (완전무치악 환자에서 디지털 가이드 수술 방식을 이용한 무피판절개 임플란트 식립증례: 증례보고 및 5년 추적관찰)

  • Shin, Mi-sun;Paek, Janghyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.312-320
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    • 2019
  • One of the fastest growing segments of implant dentistry is the utilization of computed tomography (CT) scan data and treatment planning software in conjunction with guided surgery for implant reconstruction cases. Computer assisted planning systems and associated surgical templates have established a predictable, esthetic, functional technique for placing and restoring implants. Especially, a philosophy of restoratively driven implant placement has been generally adopted. Recently, a variety of commercial dental fields have released their scanning and fabricating protocols and methods for restorations. This process is still being investigated and developed for the most precise and predictable outcome. This case report describes a female patient who wanted dental implants in fully edentulous areas. Restoratively driven implant placements were performed with surgical guide and the patient was fully satisfied with the clinical results, and at 5-year post restorative follow-up assessment, both implant and prosthesis were proved clinical success.

The effectiveness of corticotomy and piezocision on canine retraction: A systematic review

  • Viwattanatipa, Nita;Charnchairerk, Satadarun
    • The korean journal of orthodontics
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    • v.48 no.3
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    • pp.200-211
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    • 2018
  • The aim of this systematic review was to evaluate the effectiveness and complications of corticotomy and piezocision in canine retraction. Five electronic databases (PubMed, SCOPUS, Web of Science, Embase, and CENTRAL) were searched for articles published up to July 2017. The databases were searched for randomized control trials (RCTs), with a split-mouth design, using either corticotomy or piezocision. The primary outcome reported for canine retraction was either the amount of tooth movement, rate of tooth movement, or treatment time. The secondary outcome was complications. The selection process was based on the PRISMA guidelines. A risk of bias assessment was also performed. Our search retrieved 530 abstracts. However, only five RCTs were finally included. Corticotomy showed a more significant (i.e., 2 to 4 times faster) increase in the rate of tooth movement than did the conventional method. For piezocision, both accumulative tooth movement and rate of tooth movement were twice faster than those of the conventional method. Corticotomy (with a flap design avoiding marginal bone incision) or flapless piezocision procedures were not detrimental to periodontal health. Nevertheless, piezocision resulted in higher levels of patient satisfaction. The main limitation of this study was the limited number of primary research publications on both techniques. For canine retraction into the immediate premolar extraction site, the rate of canine movement after piezocision was almost comparable to that of corticotomy with only buccal flap elevation.

The effect of low-speed drilling without irrigation on heat generation: an experimental study

  • Oh, Ji-Hyeon;Fang, Yiqin;Jeong, Seung-Mi;Choi, Byung-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.9-12
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    • 2016
  • Objectives: In this study we evaluated heat generation during the low-speed drilling procedure without irrigation. Materials and Methods: Ten artificial bone blocks that were similar to human D1 bone were used in this study. The baseline temperature was $37.0^{\circ}C$. We drilled into 5 artificial bone blocks 60 times at the speed of 50 rpm without irrigation. As a control group, we drilled into an additional 5 artificial bone blocks 60 times at the speed of 1,500 rpm with irrigation. The temperature changes during diameter 2 mm drilling were measured using thermocouples. Results: The mean maximum temperatures during drilling were $40.9^{\circ}C$ in the test group and $39.7^{\circ}C$ in the control group. Even though a statistically significant difference existed between the two groups, the low-speed drilling did not produce overheating. Conclusion: These findings suggest that low-speed drilling without irrigation may not lead to overheating during drilling.

The combined use of computer-guided, minimally invasive, flapless corticotomy and clear aligners as a novel approach to moderate crowding: A case report

  • Cassetta, Michele;Altieri, Federica;Pandolfi, Stefano;Giansanti, Matteo
    • The korean journal of orthodontics
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    • v.47 no.2
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    • pp.130-141
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    • 2017
  • The aim of this case report was to describe an innovative orthodontic treatment method that combined surgical and orthodontic techniques. The novel method was used to achieve a positive result in a case of moderate crowding by employing a computer-guided piezocision procedure followed by the use of clear aligners. A 23-year-old woman had a malocclusion with moderate crowding. Her periodontal indices, oral health-related quality of life (OHRQoL), and treatment time were evaluated. The treatment included interproximal corticotomy cuts extending through the entire thickness of the cortical layer, without a full-thickness flap reflection. This was achieved with a three-dimensionally printed surgical guide using computer-aided design and computer-aided manufacturing. Orthodontic force was applied to the teeth immediately after surgery by using clear appliances for better control of tooth movement. The total treatment time was 8 months. The periodontal indices improved after crowding correction, but the oral health impact profile showed a slight deterioration of OHRQoL during the 3 days following surgery. At the 2-year retention follow-up, the stability of treatment was excellent. The reduction in surgical time and patient discomfort, increased periodontal safety and patient acceptability, and accurate control of orthodontic movement without the risk of losing anchorage may encourage the use of this combined technique in appropriate cases.

Fixed Prosthetic Restoration in an Edentulous Patient with NobelGuideTM System (양악 무치악 환자에서 NobelGuideTM 시스템을 이용한 고정성 임플란트 보철수복)

  • Shin, Hyoung-Joo;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.3
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    • pp.243-253
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    • 2009
  • This report described a technique utilizing a computer-aided design (CAD) /computer-aided machining (CAM) - guided surgical implant placement and prefabricated fixed complete denture for an immediately loaded restoration. A patient with an edentulous maxilla and mandible received 6 implants in maxilla and 6 implants in the mandible using CAD/CAM surgical templates. Prefabricated provisional maxillary and mandibular implant supported fixed prostheses were connected immediately after implant installation. Provisional prostheses were evaluated for aesthetics, function during 6 months. Definitive prostheses were fabricated.

Comparison of tooth movement and biological response in corticotomy and micro-osteoperforation in rabbits

  • Kim, Junghan;Kook, Yoon-Ah;Bayome, Mohamed;Park, Jae Hyun;Lee, Won;Choi, Hojae;Abbas, Noha H.
    • The korean journal of orthodontics
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    • v.49 no.4
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    • pp.205-213
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    • 2019
  • Objective: The aim of this study was to evaluate the amount of tooth movement and histologic changes with different corticotomy designs and micro-osteoperforation in rabbits. Methods: The sample consisted of 24 rabbits divided into three experimental groups (triangular corticotomy [TC] and indentation corticotomy [IC] with flap, and flapless micro-osteoperforations [MP]) and a control. A traction force of 100 cN was applied by connecting the first premolars to the incisors. The amount of tooth movement was measured. Kruskal-Wallis test was used to assess differences in tooth movement between the groups. Micro-computed tomography, hematoxylin and eosin staining, and tartrate-resistant acidic phosphatase (TRAP) analysis were performed. Analysis of variance was applied to assess differences in TRAP-positive osteoclast count between the groups. Results: The amount of tooth movement increased by 46.5% and 32.0% in the IC and MP groups, respectively, while the bone fraction analysis showed 69.7% and 8.5% less mineralization compared to the control. There were no significant intergroup differences in the number of TRAP-positive osteoclasts. Conclusions: The micro-osteoperforation group showed no significant differences in the amount of tooth movement compared to the corticotomy groups, nor in the TRAP-positive osteoclast count compared to both corticotomy groups and control.