International Journal of Oral Implantology, 01/2023

Partial fixed dental prostheses supported by dental implants have become a reliable long-term treatment option. Nevertheless, the replacement of two adjacent missing teeth, irrespective of location, still represents a clinical challenge. To overcome this, the use of fixed dental prostheses with cantilever extensions has gained popularity with a view to limiting morbidity, reducing costs and avoiding major surgical interventions prior to implant placement. The present review summarises the level of evidence for the use of fixed dental prostheses with cantilever extensions both in the posterior and anterior regions and indicates the advantages and disadvantages of each treatment, focusing on available medium- to long-term outcomes.   Keywords: cantilever extension, complications, dental implants, prosthetic materials, review The authors declare no potential conflict of interests relating to this study.

Purpose: To explore whether extra-short (4-mm) implants could be used to rehabilitate sites where regenerative procedures had failed in order to avoid additional bone grafting. Materials and methods: A retrospective study was conducted among patients who had received extra-short implants after failed regenerative procedures in the posterior atrophic mandible. The research outcomes were complications, implant failure and peri-implant marginal bone loss. Results: The study population was composed of 35 patients with 103 extra-short implants placed after the failure of different reconstructive approaches. The mean follow-up duration was 41.3 ± 21.4 months post-loading. Two implants failed, leading to a failure rate of 1.94% (95% confidence interval 0.24%–6.84%) and an implant survival rate of 98.06%. The mean amount of marginal bone loss at 5 years post-loading was 0.32 ± 0.32 mm. It was significantly lower in extra-short implants placed in regenerative sites that had previously received a loaded long implant (P = 0.004). Failure of guided bone regeneration before placement of short implants tended to lead to the highest annual rate of marginal bone loss (P = 0.089). The overall rate of biological and prosthetic complications was 6.79% (95% confidence interval 1.94%–11.70%) and 3.88% (95% confidence interval 1.07%–9.65%), respectively. The success rate was 86.4% (95% confidence interval 65.10%–97.10%) after 5 years of loading. Conclusions: Within the limitations of this study, extra-short implants seem to be a good clinical option to manage reconstructive surgical failures, reducing surgical invasiveness and rehabilitation time. Keywords: bone regeneration, dental implants, reconstructive surgical procedure, treatment failure This study did not receive any external funding. Prof Felice receives research grants from Global D (Brignais, France). The other authors report no conflicts of interest.

Purpose: To evaluate the impact of immediate and delayed zirconia implant placement on crestal bone loss and the clinical outcomes achieved with this approach 1 year after prosthetic loading. Further objectives were to evaluate the influence of age, sex, smoking, implant dimensions, platelet-rich fibrin application and location of the implants in the jawbone on the crestal bone level. Materials and methods: Clinical and radiographic analysis were performed to evaluate the success rates for both groups. The data were analysed statistically through a linear regression analysis. Results: No significant difference was found between immediate and delayed implant placement concerning the amount of crestal bone loss. Sex, age, bone augmentation, diabetes and prosthetic complications did not have a statistically significant influence; only smoking had a negative and statistically significant influence on crestal bone loss (P < 0.05). Conclusions: Immediate or delayed placement of one-piece zirconia implants may be a good alternative to the use of titanium implants concerning success and survival. Keywords: delayed implant placement, immediate implant placement, one-piece zirconia implant, radiographic bone loss The authors report no conflicts of interest related to this study.

Introduction: Papilla reformation is one of the most difficult and elusive surgical techniques for clinicians. Although it involves similar tenets to those applied for soft tissue grafting at recession defects, crafting a small tissue in restricted space remains unpredictable. Numerous grafting techniques have been developed to correct interproximal and buccal recession, but so far, only a limited number of techniques have been prescribed for interproximal remediation. Case presentation: This report describes in detail a modern technique (the vertical interproximal tunnel approach) for reforming the interproximal papilla and treating interproximal recession. It also documents three challenging cases of papilla loss. The first case presented Class II papilla loss and a recession type 3 gingival defect adjacent to a dental implant, managed using the vertical interproximal tunnel approach through a short vertical incision. A 6-mm increase in attachment level and almost complete papilla fill were observed in this case with this surgical technique for papilla reconstruction. The second and third cases presented Class II papilla loss between two adjacent teeth, managed using the vertical interproximal tunnel approach through a semilunar incision and achieving full papilla reconstruction. Conclusion: Both described incision designs for the vertical interproximal tunnel approach require technical meticulousness. When executed carefully and using the most beneficial pattern of blood supply, predictable reconstruction of the interproximal papilla can be achieved. It also helps alleviate concerns associated with inadequate flap thickness, blood supply and flap retraction. Keywords: complications, gingival recession, peri-implantitis, root coverage The authors declare they have no conflicts of interest. They do not have any financial interests, either directly or indirectly, in the products or information listed in the paper.