Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
Extraction and Immediate Implant Placement, and Provisionalization with two Y...Abu-Hussein Muhamad
Extraction and Immediate Implant Placement, and Provisionalization with two Years Follow-up: A Case Report. PDF
Abu-Hussein Muhamad, Bajali Musa, Abdulgani Azzaldeen
Immediate Placement and Provisionalization of Maxillary Posterior Single Impl...Abu-Hussein Muhamad
Functional immediate load is the most recent concept. This describes a load, within physiological limits, applied to implants before the osseo-integration process is completed. One of the treatment options offered to patients requiring replacement of one or more teeth is the use of prostheses supported by implants. Patients nowadays demand greater aesthetic and functional restorations; therefore, the clinician tries to reduce implant load time. All this leads to the implementation of several modifications to the conventional surgical and prosthetic protocol leading to a reduction in the load time of the implant. This is a case report of the immediate loading of posterior implant.
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
Abstract: Immediate implant placement has been the acceptable procedure for the past two decades. Perhaps
the most important aspect of any implant surgery in accordance with the successful procedure is implant
surgery and bone to implant contact.The aim of this article is to describe a clinical case in which a fractured
maxillary canine was replaced by an immediately loaded postextraction implant using a simplified technique,
which permits a reduction of the number of implant components and consequently a lower cost of treatment,
while at the same time maintaining acceptable aesthetic and functional outcomes.
Key words: Immediate implant placement, Immediate loading, Immediate provisionalisation, Esthetics
Extraction and Immediate Implant Placement, and Provisionalization with two Y...Abu-Hussein Muhamad
Extraction and Immediate Implant Placement, and Provisionalization with two Years Follow-up: A Case Report. PDF
Abu-Hussein Muhamad, Bajali Musa, Abdulgani Azzaldeen
Immediate Placement and Provisionalization of Maxillary Posterior Single Impl...Abu-Hussein Muhamad
Functional immediate load is the most recent concept. This describes a load, within physiological limits, applied to implants before the osseo-integration process is completed. One of the treatment options offered to patients requiring replacement of one or more teeth is the use of prostheses supported by implants. Patients nowadays demand greater aesthetic and functional restorations; therefore, the clinician tries to reduce implant load time. All this leads to the implementation of several modifications to the conventional surgical and prosthetic protocol leading to a reduction in the load time of the implant. This is a case report of the immediate loading of posterior implant.
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
Abstract: Immediate implant placement has been the acceptable procedure for the past two decades. Perhaps
the most important aspect of any implant surgery in accordance with the successful procedure is implant
surgery and bone to implant contact.The aim of this article is to describe a clinical case in which a fractured
maxillary canine was replaced by an immediately loaded postextraction implant using a simplified technique,
which permits a reduction of the number of implant components and consequently a lower cost of treatment,
while at the same time maintaining acceptable aesthetic and functional outcomes.
Key words: Immediate implant placement, Immediate loading, Immediate provisionalisation, Esthetics
Terminologies
Introduction
Implant treatment options at the extraction site
Timing for immediate implants
Indications of immediate implants
Contraindications of immediate implants
Advantages of immediate implants
Disadvantages of immediate implants
Rule of 5 triangles
Deciding factors for immediate implant treatment modality in extraction socket
Armamentarium required for atraumatic extraction
Jumping distance or critical space
Immediate implantation in the extraction socket of anterior maxilla
Immediate implantation in the extraction socket of anterior mandible
Immediate implantation in the extraction socket of multi-rooted posterior teeth
Clinical guidelines for esthetic outcomes when using immediate implant protocol.
Hard tissue changes after immediate implant placement
Soft tissue changes after immediate implant placement
Criteria and guidelines for immediate implant placement site
Risk and complication in immediate implant placement
Loading options for the immediately inserted implant
Survival and success rate of immediate implants
Recent advances: socket shield
Review of Literature
Conclusion
References
This seminar deals with implant-related complications that lead to implant failure.this also discus diagnostic criteria and preventive methods for an implant failure.
socket shield technique is a modified method of implant placement where many short comings of implant placement can be solved...
it is nothing but retaining of buccal cortical plate during extraction and implant is placed immediatly
Advanced soft tissue & hard tissue grafting Clinical TrainingDr. Rajat Sachdeva
Growth Factors, Tenting screws, Sinuslifts, Endoscopic evaluation of sinuslifts, Block grafts, Particulate grafts, Exomed application, Bone ring, CT/FGG grafts harvest/application, Peri-implantitis management, Suturing. Armamentarium, Choice of Biomaterial.
Course Insight :-
Ø Harvesting of autogenous bone from different intraoral sites
Ø Selection of the appropriate graft substitute
Ø Performing minimal invasive grafting procedures
Ø Successfully performing all the intraoral bone grafting procedures in implant practice such as
a) Using Particulate bone substitutes to graft the periimplant bone defects
b) Socket grafting
best dental care, best dental clinic in ashok vihar, best orthodontic treatment in delhi, braces treatment in ashok vihar, bright smile, dental clinic in new delhi, dentist in ashok vihar, dr.rajat sachdeva, india, modi dental clinic, one hour teeth whitening treatment delhi, oral health care, orthodontic treatment in delhi, sachdeva dental clinic, smile designing, smile makeover, teeth whitening delhi, tooth whitening delhi
This presentation reviews common functional and esthetic problems associated with extraction of teeth and current methods and surgical techniques to minimize loss of bone and soft tissue
Minimally Invasive Extraction and Immediate Implant Placement with Single-Sta...Abu-Hussein Muhamad
This case report describes extraction of a fractured left maxillary lateral incisor tooth, followed by immediate placement of a dental implant in the prepared socket and temporization by a bonded restoration. Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted. An impression was made 4 months after implant insertion, and a definitive restoration was placed. Results: The atraumatic operating technique and the immediate insertion of the Implant resulted in the preservation of the hard and soft tissues at the extraction site. The patient exhibited no clinical or radiologic complications through 12 months of clinical monitoring after loading. Conclusion: The dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues.
Vertical ridge augmentation is sometimes required for dental implant placement. The presentation looks at various conventional and newer techniques for ridge augmentation in the oral cavity.
There is no question that given the current state of the art in dentistry, that dental implants are pretty much the best way to replace teeth; they are stand alone tooth replacement systems that look and function just like natural teeth. They do not attach to adjacent teeth like a fixed bridge and don't have to be taken in and out like removable partial dentures.
A dental implant is a tooth root replacement made of titanium, which has the unique property of being osteophilic (osteo-bone, philic-loving) and actually fuses to bone. A crown, the part of the tooth that you see in your mouth, is attached to the implant. And the great thing about implants is they are not susceptible to decay or periodontal (gum) disease in the same way that teeth are.
Now here are a few important pointers, which hold for implants generally and are especially important in your case when replacing a front tooth for an imminent event . Dr Harshavardhan Patwal
Clinical Replacement Therapy and the Immediate Post-extraction Dental ImplantAbu-Hussein Muhamad
Immediate dental implants have greatly reduced the treatment time and the number of surgical intervene tions. Recently it has been noted that this treatment modality can be used in aesthetically demanding cases especially the anterior maxilla. The aim of this article is to describe a clinical case in which a fractured maxillary canine was replaced by an osseointegrated implant using a simplified technique in a patient who was a smoker and presented poor oral hygiene. The technique adopted permits a reduction of the number of implant components and consequently a lower cost of treatment, while at the same time maintaining acceptable aesthetic and functional outcomes.
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Terminologies
Introduction
Implant treatment options at the extraction site
Timing for immediate implants
Indications of immediate implants
Contraindications of immediate implants
Advantages of immediate implants
Disadvantages of immediate implants
Rule of 5 triangles
Deciding factors for immediate implant treatment modality in extraction socket
Armamentarium required for atraumatic extraction
Jumping distance or critical space
Immediate implantation in the extraction socket of anterior maxilla
Immediate implantation in the extraction socket of anterior mandible
Immediate implantation in the extraction socket of multi-rooted posterior teeth
Clinical guidelines for esthetic outcomes when using immediate implant protocol.
Hard tissue changes after immediate implant placement
Soft tissue changes after immediate implant placement
Criteria and guidelines for immediate implant placement site
Risk and complication in immediate implant placement
Loading options for the immediately inserted implant
Survival and success rate of immediate implants
Recent advances: socket shield
Review of Literature
Conclusion
References
This seminar deals with implant-related complications that lead to implant failure.this also discus diagnostic criteria and preventive methods for an implant failure.
socket shield technique is a modified method of implant placement where many short comings of implant placement can be solved...
it is nothing but retaining of buccal cortical plate during extraction and implant is placed immediatly
Advanced soft tissue & hard tissue grafting Clinical TrainingDr. Rajat Sachdeva
Growth Factors, Tenting screws, Sinuslifts, Endoscopic evaluation of sinuslifts, Block grafts, Particulate grafts, Exomed application, Bone ring, CT/FGG grafts harvest/application, Peri-implantitis management, Suturing. Armamentarium, Choice of Biomaterial.
Course Insight :-
Ø Harvesting of autogenous bone from different intraoral sites
Ø Selection of the appropriate graft substitute
Ø Performing minimal invasive grafting procedures
Ø Successfully performing all the intraoral bone grafting procedures in implant practice such as
a) Using Particulate bone substitutes to graft the periimplant bone defects
b) Socket grafting
best dental care, best dental clinic in ashok vihar, best orthodontic treatment in delhi, braces treatment in ashok vihar, bright smile, dental clinic in new delhi, dentist in ashok vihar, dr.rajat sachdeva, india, modi dental clinic, one hour teeth whitening treatment delhi, oral health care, orthodontic treatment in delhi, sachdeva dental clinic, smile designing, smile makeover, teeth whitening delhi, tooth whitening delhi
This presentation reviews common functional and esthetic problems associated with extraction of teeth and current methods and surgical techniques to minimize loss of bone and soft tissue
Minimally Invasive Extraction and Immediate Implant Placement with Single-Sta...Abu-Hussein Muhamad
This case report describes extraction of a fractured left maxillary lateral incisor tooth, followed by immediate placement of a dental implant in the prepared socket and temporization by a bonded restoration. Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted. An impression was made 4 months after implant insertion, and a definitive restoration was placed. Results: The atraumatic operating technique and the immediate insertion of the Implant resulted in the preservation of the hard and soft tissues at the extraction site. The patient exhibited no clinical or radiologic complications through 12 months of clinical monitoring after loading. Conclusion: The dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues.
Vertical ridge augmentation is sometimes required for dental implant placement. The presentation looks at various conventional and newer techniques for ridge augmentation in the oral cavity.
There is no question that given the current state of the art in dentistry, that dental implants are pretty much the best way to replace teeth; they are stand alone tooth replacement systems that look and function just like natural teeth. They do not attach to adjacent teeth like a fixed bridge and don't have to be taken in and out like removable partial dentures.
A dental implant is a tooth root replacement made of titanium, which has the unique property of being osteophilic (osteo-bone, philic-loving) and actually fuses to bone. A crown, the part of the tooth that you see in your mouth, is attached to the implant. And the great thing about implants is they are not susceptible to decay or periodontal (gum) disease in the same way that teeth are.
Now here are a few important pointers, which hold for implants generally and are especially important in your case when replacing a front tooth for an imminent event . Dr Harshavardhan Patwal
Clinical Replacement Therapy and the Immediate Post-extraction Dental ImplantAbu-Hussein Muhamad
Immediate dental implants have greatly reduced the treatment time and the number of surgical intervene tions. Recently it has been noted that this treatment modality can be used in aesthetically demanding cases especially the anterior maxilla. The aim of this article is to describe a clinical case in which a fractured maxillary canine was replaced by an osseointegrated implant using a simplified technique in a patient who was a smoker and presented poor oral hygiene. The technique adopted permits a reduction of the number of implant components and consequently a lower cost of treatment, while at the same time maintaining acceptable aesthetic and functional outcomes.
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Immediate Implants Placed Into Infected Sockets: Clinical Update with 3-Year ...Abu-Hussein Muhamad
Dental implants can be placed immediately into healthy extraction sites with high success and survival rates. It has been suggested, however, that immediate placement of implants into infected extraction sites is contraindicated due to the pathology interfering with osseointegration resulting in decreased implant survival and success With many potential implant sites presenting with a preexisting periapical or periodontal infection, treatment protocols have been advocated for immediate placement of implants in these infected sites. Advancements in surgical techniques and implant surface technology have made immediate placement of implants a more predictable and accepted treatment option; however, there is still debate about whether infected extraction sites should be used for immediate implant treatment approaches. The purpose of this clinical update is to report on the success and survival of implants placed immediately into infected extraction sites.
Immediate implant placement following tooth extraction a case reportAbu-Hussein Muhamad
Immediate dental implants are an attractive option to patients and dentists. This paper report the management of a
fractured right permanent maxillary central incisor with extraction of the root followed by immediate implant placement
with two years follow-up.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...Abu-Hussein Muhamad
Abstract: Severe atrophy of the inferior alveolar process and underlying basal bone often results in problems with a lower denture. These problems include insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. In this case report, patient with resorbed edentulous mandible was successfully rehabilitated using two dental implants placed in the interforaminal region with ball abutments opposing conventional maxillary complete denture. Key Words: dental implants; dental prosthesis, implant-supported; resorption,
Overdentures can be either tooth or implant supported. Completely edentulous patients whose economic condition Thwarts them to invest in the expensive implant (number based) treatments should be motivated to have at least a two implant-supported overdenture since the prosthesis offers most of the advantages of conventional tooth-supported overdenture. We report a case of an elderly female patient who was reluctant toward surgery, but with moderate education was treated successfully with a two staged, two implant-supported overdenture using a ball abutment with o ring attachment.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Split ridge and expansion techniques are effective for the correction of moderately resorbed edentulous ridges in selected cases.
Transverse expansion is based on osseous plasticity obtained by corticotomy. It progressively allows for an adequate transversal intercortical diameter large enough to insert one or several dental implants.
The gap created by sagittal osteotomy expansion undergoes spontaneous ossification, following a mechanism similar to that occurring in fractures.
Prosthodontic rehabilitation of maxillary defect in a patientNishu Priya
Restoration of maxillectomy defects demand varied modifications in prosthesis fabrication, to make them lighter and well-tolerated by the patient.
Literature suggests the use of various retentive aids for the construction of conventional obturator to improve retention and oral function.
Full body is the most of I don't have a lot more then I have been on my phone is a new one number and my heart is a new phone is it possible to be fine and I have a good day of the year and I am a good time with my family and I have to do not know what you do not know how to do with your family is a good day of
Patients with resorbed ridges often have difficulty retaining conventional dentures. An implant supported overdenture is a good alternative treatment to a conventional denture for patients with complaints about the retention and stability of their removable complete denture. . These complaints more often have to do with the mandibular than the maxillary denture. Implantsupported overdentures offer better results in the mandible than in the maxilla. The two implant overdenture in the mandible has since become standard for edentulous patients. This article describes a clinical procedure for an implant supported mandibular overdenture.
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
canine to the lateral incisor site and single tooth implants represent the available treatment modalities to replace congenitally missing teeth. This case report
demonstrates the team approach in prosthetic and surgical considerations and techniques for managing the lack of lateral incisors. The aims of this case
report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations.
Impacted Maxillary Central Incisors: Surgical Exposure and Orthodontic Treat...Abu-Hussein Muhamad
The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent
central incisor has multiple etiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally,
the earlier treatment is provided, the higher the likelihood of success and the less the complexity. Our results suggest that close monitoring and interdisciplinary
cooperation during the treatment phases led to a successful esthetic result, with good periodontal health and functional occlusion.
Excess of space in the dental arch is diagnosed as a
generalised spacing or a local divergence, often
observed in the maxillary anterior region, as a median
diastema, traumatic loss of central incisors, or
congenital absence of lateral incisors. Furthermore,
spacing is observed in aging individuals, due to
pathological migration of teeth caused by
periodontitis. Finally, adult individuals with partial
edentulous jaws demand pre-prosthetic orthodontic
treatment from functional aspects. Thus, indication for
orthodontic treatment in subjects with spacing of teeth
exists for aesthetic reasons, but also for facilitating
prosthetic restorations with optimal occlusalstability.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting
cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically
induced failures, since low primary implant stability, low bone density, short implants and overload have been
identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a
successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations
Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
The multifactorial factors influenc cleft Lip-literature review Abu-Hussein Muhamad
Congenital cleft-Lip and cleft palate have been the subject of many genetic
studies, but until recently there has been no consensus as to their modes of
inheritance. In fact, claims have been made for just about every genetic
mechanism one can think of. Recently, however, evidence has been
accumulating that favors a multifactorial basis for these malformations. The
purpose of the present paper is to present the etiology of cleft lip and cleft palate
both the genetic and the environmental factors. It is suggested that the genetic
basis for diverse kinds of common or uncommon congenital malformations may
very well be homogeneous, whilst, at the same, the environmental basis is
heterogeneous.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically induced failures, since low primary implant stability, low bone density, short implants and overload have been identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
Immediate Restoration of Single Implants Replacing Lateral Incisor Compromis...Abu-Hussein Muhamad
Today, the diagnosis of internal root resorption is significantly improved by the three-dimensional imaging. Furthermore, the CBCT’s superior diagnosis accuracy resulted in an improved management of the resorptive defects and a better outcome of Implant therapy of teeth with internal resorption.Implant has become a wide option to maintain periodontal architecture. Diagnosis and treatment planning is the key factors in achieving the successful outcomes after placing and restoring implants placed immediately after tooth extraction. The purpose of this clinical update is to report on the success and survival of Immediate restoration of single implants replacing right lateral incisor compromised by internal resorption.
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber
with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and
requires special handling because of the proximity and apical displacement of the roots. The present article describes the
diagnosis and management of hypertaurodontism by endodontic treatment in a left mandibular second molar.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Immediate Implant Placement And Restoration With Natural Tooth In The Maxillary Central Incisor: A Clinical Report
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 5 Ver. III (May. 2017), PP 72-80
www.iosrjournals.org
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 72 | Page
Immediate Implant Placement And Restoration With Natural
Tooth In The Maxillary Central Incisor: A Clinical Report
Abdulgani Azzaldeen1
,Abdulgani Mai2
,Abu-Hussein Muhamad3
Al-Quds University, School Of Dentistry,Jerusalem, Palestine
Abstract: Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The
prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically
pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an
increasingly desirable treatment that offers numerous benefits over conventional delayed loading.
Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final
aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very
similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after
extraction to provisionalize an implant.
Keywords: Dental implant, immediate,natural tooth , immediate restoration
I. Introduction
The loss of a tooth in the anterior aesthetic region as a result of periodontal disease, trauma, endodontic
failure, or root resorption can be a traumatic experience for a patient. Traditional implant therapy often required
2 to 3 months of alveolar ridge remodeling after tooth extraction and an additional 6 months of non-loaded
healing for implant osseointegration to be successful.[1] Aesthetic single-tooth implant placement using a
traditional two-stage surgery has been well-documented in the literature. Many complications can occur during
the healing phase, such as loss of papilla as a result of flap elevation or blunting of the papilla caused by
provisionalization with a removable appliance that is not stable. Bone and gingival tissue loss after maxillary
anterior tooth extraction and implant surgery may present additional aesthetic challenges.[2] Clinical and
histologic studies have demonstrated that non-submerged implants osseointegrate as well as submerged implants
and function comparably under load over extended periods.
Osseointegrated dental implants have traditionally been placed in accordance with the Brεnemark's two
stage protocol. Implants were submerged and left to heal for a period of 3 to 4 months in mandible and 6 to 8
months in maxilla.[1] This meant that patients had to wait a significant time before prosthesis placement and
often had to wear suboptimal provisional prostheses. Initial attempts to load the implant earlier were associated
with increased failure rates.[2,3] But with the many advances being made in the field of implantology, implants
can now be successfully loaded early or immediately in selected cases.[4]
Figure 1. The preoperative condition.
Immediate replacement of single tooth by provisional restoration of dental implants is a procedure of
growing interest among clinicians worldwide. Single tooth loss is probably the most common indication for
implant placement.[5] The loss of a single tooth is a traumatic experience for many patients and early/immediate
implant loading is therefore an attractive treatment option. However, single teeth replaced by
2. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 73 | Page
implants in the aesthetic zone are one of the most challenging situations facing a clinician, even when using a
two-stage implant protocol.[6] Careful assessment thus must be made of mucosal and bone volumes for
optimum implant aesthetics.[6,7] Immediate implant placement allow advantages over conventional approach
such as reduction in the number of surgical procedures and hence the treatment time required,[1] ideal axial
orientation of the implant,[2-4] preservation of the bone at the extraction site and optimal soft-tissue
aesthetics,[2,4] significantly reduced period of wearing of an interim prosthesis.[4] Studies showing high
success rates of immediately placed implants have made this protocol more favorable for implantologists.[5,7]
Figure 2. The preoperative view
However, this protocol has been associated with shortcomings like ideal modality for the treatment of
marginal voids. These are the gap present between the implant body and the wall of the bony socket. The
procedure is also technically more demanding. Although, implant placement in fresh extraction socket has been
described previously, it is only recently that such clinical approach has gained popularity.[8]
Figure 3;Pre-Operative IOPA
The form of the periodontium plays an important part in the final aesthetics of the implant restoration.
[9] The three categories of gingival scallop are high, normal, and flat. Based on a clinical survey of 100 patients,
the average or normal gingival scallop is positioned 4 mm to 5 mm more incisally than the free gingival margin.
[10] The high or long gingival scallop will have a much higher risk for gingival loss or flattened papilla after
extraction vs the normal or flat scallop. The flat scallop has less volume of papilla in the interproximal area;
therefore, it is much more predictable and maintainable after extraction. One of the principal advantages of the
immediate technique is the prevention of post-extraction bone resorption. Bone loss may affect approximately
23% of the anterior alveolar crests during the 6 months after extraction. [11]Infection affecting the tooth being
extracted may be a contraindication to the immediate technique, as it is most often accompanied by apical or
lateral bone loss that can impair primary stability. Primary stability after implant placement is important when
provisionalizing immediately. Drilling 3 mm to 5 mm beyond the apical limit (in a palatal direction) can ensure
sufficient stability.[12]
Not all extraction sites lend themselves to immediate implantation. Careful evaluation based on clinical
guidelines must direct the clinician as to the suitability of the socket and the appropriate surgical procedures.
Various pertinent classification systems have been formulated in the last few years that may serve as useful
diagnostic tools.
Salama and Salama's[13] pre-operative classification of extraction sites is based on the classical
definition of periodontal intrabony defects. They divided the extraction sites into three types, each possessing
distinctive characteristics:
3. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 74 | Page
Type 1. Ideal for immediate implantation because of 4- or 3-wall sockets with minimal bone
resorption, sufficient bone available beyond the apex, acceptable discrepancy between the fixture head and the
necks of the adjacent teeth, and manageable gingival recession or esthetics is not essential.
Type 2. Requiring orthodontic extrusive augmentation in view of dehiscence >5 mm, substantial
discrepancy between the fixture head and the necks of the adjacent teeth, and significant recession or
esthetics is essential.
Type 3. Not suitable for immediate implantation owing to inadequate vertical and buccolingual bone
dimension, recession and severe loss of the labial bone plate, and severe circumferential and angular defects.
This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
Case presentation
An 23-year old female patient presented with root resorption of the maxillary right central incisor
(Figure 1,2,3). Available restorative options were presented to the patient and included a removable partial
denture, a fixed bridge or an implant-supported restoration. The adjacent teeth had not been previously restored,
so the patient chose to have an implant-supported restoration to avoid preparation of the adjacent teeth. The
patient also did not want to wear a removable appliance during the implant healing phase. There was no active
infection present and no apical pathology was seen radiographically. Periodontal evaluation revealed a thick,
normal-scalloped periodontal biotype. Approximately 85% of the population present with thick, flat periodontal
forms, whereas the periodontal architecture of the remaining population is thin and scalloped. [14]Though the
amount of postoperative soft tissue modifications is generally minimal for patients with thick and flat gingiva,
significant changes have been observed in those with thin and scalloped biotypes.26 The projected interproximal
tissue height depends on the interproximal bone height of the adjacent teeth. Bone sounding of the teeth adjacent
to the failing tooth can ascertain predictable interproximal tissue height. In this patient, a normal osseous crest
was revealed after bone sounding. Gingival tissue was approximately 3 mm from the osseous crest facially and
5 mm interproximally.
The risks and benefits of treatment were presented to the patient and an implant was selected for
immediate placement and fixed provisionalization using the patient’s natural tooth on the abutment. Using the
natural tooth as a provisional will allow tissue support and create an emergence profile similar to the pre-
extraction condition. Before extraction of the tooth, stone models were made and a putty index was formed over
the teeth. This would act as a guide to placing the tooth in the proper orientation after surgery. Local anaesthetic
was administered and periotomes were used to loosen the periodontal ligament. The tooth was extracted
atraumatically, without flap reflection. A periodontal probe was used to verify the integrity of the facial plate,
and the socket was thoroughly debrided. Figure4
Figure 4: Probing of the extraction socket showed intact bony walls, especially the buccal walls.
Primary stability was achieved by engaging the palatal wall and bone approximately 4 mm beyond the
apex to the extraction socket with a An Ankylos implant, 3.5 x 11mm. The top of the implant was placed
approximately 3 mm from the final proposed free gingival margin in the mid-facial area. Ideally, the 1-mm
polished collar should be above the bone level. With a flapless surgical approach, this is sometimes difficult to
visualize. The implant diameter was within the confines of the tooth socket, without engaging the facial plate to
prevent possible perforation. A minimal distance of approximately 1.5 mm to 2 mm between the implant and
adjacent teeth is recommended to minimize marginal bone loss resulting from encroachment. Although not
necessary with a horizontal distance less than 2 mm from the implant to the facial bone, synsynthetic bone was
placed around the implant and a healing cap (Figure 5 ) was lightly tightened. Immediate provisionalization was
4. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 75 | Page
then begun; the healing cap was removed and a solid abutment was placed on the implant and hand tightened .
No preparation was necessary as this is a stock component and the occlusion did not interfere. The coronal
portion of the patient’s tooth was to be used as the provisional restoration.
Figure 5; A healing cap was placed after extraction
The extraction was necessary because of the resorption of the root .The root of the tooth was sectioned
horizontally with a diamond bur approximately 3 mm from the cementoenamel junction . The tooth was then
hollowed out so that it would fit over the abutment Figure.6 Before relining the tooth, it was placed on the solid
abutment to make sure it would fit and that there would be no occlusal contact on the final provisional (Figure
7). After confirming an accurate fit, the tooth was etched for 30 seconds (Figure 8), then rinsed and air-dried. A
bonding agent was applied and light-cured for 20 seconds A bis-acryl material was injected into the tooth
(Figure 8) and then placed intraorally onto the abutment and allowed to self-cure for 2 minutes.
Figure 6; Ankylos implant, 3.5 x 11mm.
It is very important when relining the restoration extraorally that an analog is used that is exactly the
same as intraorally. Do not use a laboratory implant abutment analog for this purpose. It is important to get an
accurate fit of the restoration. The final provisional should be refined and contoured flat or slightly under-
contoured (Figure 9) on the facial so as not to put too much pressure on the free gingival margin, which can
cause apical migration of the tissue. This is done with finishing disks and polishing points to create a smooth
surface. The interproximal tissue should be supported by the natural emergence profile of the tooth. It is
impossible to create too much interproximal pressure, as it is the exact emergence profile that existed before the
extraction.[15] One of the possible complications from immediate placement and provisionalization using a
cement-retained restoration is the possibility of leaving excess cement subgingivally. If the implant is placed too
deeply and it is impossible to remove all of the cement, it is better to use a screw-retained provisional.
5. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 76 | Page
Figure 7; Root resorption of the tooth
A technique first described by Higginbottom [16] allows the majority of the provisional cement to be
removed extraorally using the same analog as that used for the fabrication of the temporary. A temporary
cement is placed in the crown and then placed on the abutment extraorally (Figure.9 ). The excess cement is
then removed before placing the temporary intraorally. This allows minimal clean-up intraorally and prevents
possible gingival irritation. Do not be fooled into placing more cement into the restoration after cleaning. There
is adequate cement to hold the restoration on. Place the restoration on the abutment and allow the cement to
fully set. Clean off any excess cement. Figure .10 shows the restoration on the day of surgery. The tooth was
taken out of occlusion and the patient was advised against using the surgical site and instructed not to have any
contact on that tooth while eating. It is very important for the patient to understand the importance of their part
in the success of the restoration. If the patient is not willing to accept some responsibility in the final success,
then an immediate restoration may be contraindicated.[17]
Figure 8; The hollowed-out tooth. The tooth was etched for 15 to 20 seconds. The tooth was tried on the
abutment
Patients with deep bites, bruxers, or who have active infection present are not good candidates for this
type of treatment. The patient presented 2 weeks postsurgery for clinical evaluation. The area was healing
without any complications (Figure 11). After 3 months of healing, the patient returned for a final impression of
the implant. A fixture-level impression was made for a custom abutment . This is a UCLA-type abutment that is
waxed cast, and then porcelain is added to it. The custom abutment was placed and torqued to 35 Ncm
(Figure.11 ). The final restoration was cemented with resin-reinforced glass-ionomer cement. The final
restoration is shown in Figure 11. The preoperative smile is shown in Figure 1 and the postoperative smile is
shown in Figure 11.
II. Discussion
The clinical, anatomic, and radiologic characteristics of the socket immediately after tooth extraction
are distinctly different from the socket environment after 1 year of healing.[18]
6. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 77 | Page
Implants placed immediately in fresh extraction sites engage precisely prepared bony walls only in theirapex,
while the coronal space is filled by at end of the healing phase.[19]
Figure 9 The polished provisional.
Therefore, the main difference occurs during the initial stage of osseointegration, most of the studies
focus on this interval to define survival rates.[18] The level of implant insertion into the alveolar crest is crucial,
since its placement below the crest prevents bone preservation, one of the main advantages of immediate
implantation. Crestal placement without radical alveoplasty is preferable, because it does constitute an
impediment to desirable outcome.[18.19]
Figure 10; The restoration on the day of surgery
The studies of single implant placement and prostheses have described good treatment prognosis.
Nevertheless, an accurate diagnosis and treatment planning is important for the immediate implant placement
and restoration. Immediate implant placement would be a sensitive technique because of the placement of
implants in fresh extraction sites is difficult.[20] The reasons for tooth extraction included retained root, trauma,
and nonrestorable crowns.
Immediate implant placement should be avoided in case of ongoing inflammatory processes, such as
active periodontal and periapical infection.[20,21,22] In addition, it should be avoided when bone around root
apex area is insufficient after extraction of the tooth. Several studies have reported low success rates when the
prostheses were in light occlusal contact or in full functional loading. [22,23]
7. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 78 | Page
Figure 11; The preoperative smile.
Patients have parafunctional occlusal habits must use a habit appliance or occlusal guard. [24]This
report presented the immediate implant placement and temporization on the upper right central incisor. The soft
tissue reaction was favorable because of the existence of a temporary crown during the healing period. The
temporary crown maintained the interdental papilla and gingiva, occurring highly esthetic results.[25] The
clinician should instruct the patient to perform adequate oral hygiene during the healing phase. Moreover, the
temporary crown or fixed partial denture should not be taken out during the healing period of approximately 6
weeks. Several studies have reported that the marginal bone dimension was similar with immediate and
conventional approach in the short term period of 5 years. However, more long-term research is required to
support these conclusions.[25,26]
Studies on extraction socket preservation have shown that atraumatic tooth extraction is a prerequisite
in socket preservation. Various socket preservation techniques have been employed and it can be prudent to
decipher from numerous studies, that socket preservation is a validation for management of extraction site and
future prosthetic rehabilitation. Studies have claimed gain in alveolar crestal width and height after socket
preservation procedures, and also lesser resorption not only in horizontal but also in vertical
dimension.[1,2,3,22,26] Most grafting materials have been used as filling materials in fresh extraction sockets
and to avoid collapse of the membrane. Increased mineralization was seen in socket preservation sites especially
in the apical area of the socket. This proved that bone formation initiated from the old bone of the lateral and
apical sockets walls toward the centre of the wound.[27]
Early publications and clinical experience seem to indicate that PRF improves early wound closure,
maturation of bone grafts, and the final esthetic result of the peri-implant and periodontal soft tissues. It also
provides a significant postoperative protection of the surgical site and seems to accelerate the integration and
remodeling of the grafted biomaterial .[1,3] Practitioners are often faced with the dilemma of restoring patients
as quickly as possible.(3) However, it often takes time to provide optimal treatment. By incorporating new
techniques and materials, we as practitioners are able to treat our patients with the most optimal treatment
without making sacrifices due to the length of time it has previously taken to accomplish this treatment. By
using immediate placement and immediate function we can bring our patients through treatment in a stable,
natural manner while better supporting the biological complex.[28] The final restoration can take advantage of
newer biologically compatible materials and provide a longer-lasting, more esthetic end result.[28,29]
Many clinical reports and experimental studies in the animal model demonstrated the favourable
outcome of dental implants immediately inserted in freshly extraction socket, without the use of any
regenerative materials .[30] The outcome is always better when regenerative materials like Bio-Oss & PRF are
used .Our data shows a survival rate of immediate implantation carried out on this patient at three year after
immediate implantation and does not differ from the cases in which implant was placed in healed sites.
[31]These data agree with those from other authors who evaluated the clinical success rate of immediate
implantation without use of any membrane or graft material in both humans and animals.
It must be kept in mind that the present study is related to immediate implant not subjected to
functional loading and therefore not fully comparable with the results from loaded implants. However, it has
been demonstrated that functional loading does not impair, but rather enhances, bone maturation.[31,32]
8. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 79 | Page
The primary disadvantage of immediate loading is the risk of implant failure or greater crestal loss
around the healing implants. Overloading of the implant could be a factor for implant failure in immediate
loading.[20] Hence, we considered immediate temporization and not immediate functional
loading.[19]Temporary crowns had a positive impact on the soft tissue with respect to thepreservation of the
papillae.[22] Placement of implant at correct angulation is again very important.[18]The one-piece implant
design enables undisturbed healing of the peri-implant soft tissue and avoids disruption of the soft tissue seal
when placing the definitive prosthetic restoration.[18,19,20,21]
The natural tooth with implant offer a unique simple treatment modality, and have been specially
designed for immediate loading of fixed restorations. They are considered an alternative to the conventional
implant placement regimen and are ideal for immediate loading in varying bone qualities and quantities. They
allow minimally invasive transmucosal flapless placement and limit the requirement for hard tissue grafting
procedures
III. Conclusion
This clinical report demonstrates esthetic treatment of fractured upper right central incisor using
immediate implant placement and temporization with natural tooth. The clinical outcome showed black triangles
not only of prosthesis but also adjacent teeth, however the patient was satisfied with the prosthesis and lack of
anterior edentulous period.
References
[1]. Abu-Hussein M,, Abdulghani A., Sarafianou A., Kontoes N.; Implants into fresh extraction site: A literature review,case immediate
placement report, Journal of Dental Implants. 2013;3(2):160-164
[2]. Bajali M., Abdulgani Azz., Abu-Hussein M, Extraction and immediate implant placement, and provisionalization with two years
follow-up: a case report, Int J Dent Health Sci 2014; 1(2): 229236.
[3]. Muhamad et al; Tooth extraction, immediate implant placement: a case report, Asian Pac. J. Health Sci., 2014; 1(4): 543-549
[4]. Abu-Hussein Muhamad ,Chlorokostas Georges , Abdulgani Azzaldeen ; Immediate Implants Placed Into Infected Sockets: Clinical
Update with 3-Year Follow-Up. . J Dent Med Sci2017,16,1,105-111DOI: 10.9790/0853-160109105111
[5]. Abu-Hussein Muhamad Chlorokostas Georges , Abusalih Ahmet , Ismail Hakki Bayraktar , Abdulgani Azzaldeen; Immediate
Implant Placement and Loading in Esthetic Zone. Journal of Dental and Medical Sciences 2016 ,1, 71-79,DOI: 10.9790/0853-
15187179
[6]. Abdulgani Azzaldeen, Chlorokostas Georges, Kontoes Nikos, Abu-Hussein Muhamad; Zirconium Dental Implants And Crown for
Congenitally Missing Maxillary Lateral; Clinical Case. Journal of Dental and Medical Sciences 2017,16, 3 .72-77 DOI:
10.9790/0853-1603137277
[7]. Abdulgani Azzaldeen, Chlorokostas Georges, Abu-Hussein Muhamad; “One-Piece” Immediate-Load Post-Extraction Implant
InMaxillary Central Incisor.Journal of Dental and Medical SciencesVolume2017 ,16, 3,78-83DOI: 10.9790/0853-1603137883
[8]. Mai A, Azzaldeen A, Nezar W, Chlorokostas G, Muhamad AH; Extraction and Immediate Implant Placement with Single-
StageSurgical Procedure: Technical Notes and a Case Report. J Dent Med Sci2016, 15: 95-101
[9]. Kois J. Predictable single tooth peri-implant aesthetics: five diagnostic keys. Compend Contin Educ Dent. 2001;22(3):199-206.
[10]. Kois J. Altering gingival levels; the restorative connection part 1: biologic variables. J Esthet Dent. 1994;6(1):3-9.
[11]. Carlsson GE, Bergman B, Hedegard B. Changes in contour of the maxillary alveolar process under immediate dentures. A
longitudinal clinical and x-ray cephalometric study covering 5 years. Acta Odontol Scan. 1967;25(1):45-75.
[12]. Schwartz-Arad D, Chaushu G. Placement of implants into fresh extraction sites: 4 to 7 years retrospective evaluation of 95
immediate implants. J Periodontol. 1997;68(11): 1110-1116.
[13]. Salama H, Salama M. The role of orthodontic extrusive remodeling in the enhancement of soft and hard tissue profiles prior to
implant placement: A systematic approach to the management of extraction site defects. Int J Periodontics Restorative Dent
1993;13:313-333.
[14]. al Ansari BH, Morris RR. Placement of dental implants without flap surgery. A clinical report. Int J Oral Maxillofac Implants.
1998; 13:861-865.
[15]. Esposito M, Ekestubbe A, Grondahl K. Radiological evaluation of marginal bone loss at tooth surfaces facing single Bränemark
implants. Clin Oral Impl Res. 1993;4(3): 151-157.
[16]. Higginbottom F. Transfer system for cementretained restorations on nonsubmerged dental implants. Quintessence Dent Technol.
1997;20:55-62.
[17]. Omkar Shetye, Nandita Keni Shetye, Archana Louis, Indraniil Roy, “Immediate implantation in an extraction socket: A review”, Int
J Contemp Dent Med Rev, vol. 2015, Article ID: 160115, 2015. doi: 10.15713/ins.ijcdmr.39
[18]. Abu-Hussein M, Watted N, Shamir D ;A Retrospective Study of the AL Technology Implant System used for Single-Tooth
Replacement. Int J Oral Craniofac Sci 2016,2(1): 039-046. DOI: 10.17352/2455-4634.000017
[19]. Abu-Hussein M, Georges C, Watted N, Azzaldeen A ;A Clinical Study Resonance Frequency Analysis of Stability during the
Healing Period. Int J Oral Craniofac Sci 2016,2(1): 065-071. DOI: 10.17352/2455-4634.000021
[20]. Abdulgani Mai , Abdulgani Azzaldeen , Watted Nezar ,Chlorokostas Georges ,Abu-Hussein Muhamad;Extraction and Immediate
Implant Placement with Single-Stage Surgical Procedure: Technical Notes and a Case ReportJournal of Dental and Medical
SciencesVolume 2016 , 15, Issue 11 ,95-101,DOI: 10.9790/0853-15110195101
[21]. Abdulgani A.,. Kontoes N., Chlorokostas G.,Abu-Hussein M Interdisciplinary Management Of Maxillary Lateral IncisorsAgenesis
With Mini Implant Prostheses: A Case Report; Journal of Dental and Medical Sciences2015 ,14 (12) , 36-42 DOI:
[22]. 10.9790/0853-141283642
[23]. Abu-Hussein M , Chlorokostas G , Watted N , Abdulgani A , Jabareen A, Pre-Prosthetic Orthodontic Implant for Management of
Congenitally Unerupted Lateral Incisors – A Case Report Journal of Dental and Medical Sciences 2016.2 . 15 (2 ) ,99-104 DOI:
10.9790/0853-152899104
[24]. Muhamad AH, Azzaldeen A, Nezar W, Mohammed Z. ; Esthetic Evaluation of Implants Placed after Orthodontic Treatment in
Patients with Congenitally Missing Lateral Incisors. J Adv Med Dent Scie Res2015 ;3(3):110-118
9. Immediate Implant Placement And Restoration With Natural Tooth In The….
DOI: 10.9790/0853-1605037280 www.iosrjournals.org 80 | Page
[25]. Nezar Watted , Muhamad Abu-Hussein ;Multidisciplinary Aesthetic Dental Treatment; Peg lateral with Congenitally Maxillary
lateral Incisors. Journal of Dental and Medical Sciences 2016, 15, 10, 83-91,DOI: 10.9790/0853-1510018391
[26]. Abu-Hussein M. , Watted N . ,Abdulgani M ., Abdulgani Az; Tooth Autotransplantation; Clinical Concepts Journal of Dental and
Medical Sciences2016, 15 (7) 105-113 DOI: 10.9790/0853-15078105113
[27]. Abu-Hussein M, Watted N, Abdulgani A ;Managing congenitally missing lateral incisors with single tooth implants. Dent Oral
Craniofac Res 2016,2: 318-324.
[28]. Cardaropoli G, Araujo M, Lindhe J Dynamics of bone tissue formation in tooth extraction sites. An experimental study in dogs. J
Clin Periodontol 2003; 30: 809–18.
[29]. Kourtis S, Psarri C, Andritsakis P, Doukoudakis A. Provisional restorations for optimizing esthetics in anterior maxillary implants:
a case report. Journal of Esthetic and Restorative Dentistry. 2007;19(1):6-17.
[30]. Mishra P, Chandrasekaran S, Mohamed JB. Implants in periodontally compromised sites. International Journal of Dental Clinics.
2011;3 (1):100-1.
[31]. Fugazzotto PA. Treatment options following single-rooted tooth removal: A literature review and proposed hierarchy of treatment
selection. Journal of Periodontology 2005; 76(5):821–31.
[32]. Yukna RA. Clinical comparison of hydroxyapatite-coated titanium dental implants placed in fresh extraction sockets and healed
sites. Journal of Periodontology 1991; 62(7):468–72.
[33]. Moghe S etal, Platelet-rich Plasma in the Periodontal defect treatment after extraction of impacted third molar, NJMS/Vol.III/ Issue
II) July 2012