International Journal of Periodontics & Restorative Dentistry, 6/2022
Online OnlyDOI: 10.11607/prd.6124Pages e161-e174, Language: EnglishVelasquez, Diego / Araújo, Mauricio G / Clem, Donald S / Gunsolley, John C / Heard, Rick H / Janakievski, Jim / McClain, Pamela K / McGuire, Michael K / Misch, Craig M / Nevins, Marc / Pickering, Steve / Pope, Bryan / Richardson, Chris / Santarelli, Greg / Scheyer, E Todd / Schallhorn, Rachel / Toback, GregoryPostextraction bone grafting and implant placement help preserve alveolar bone volume. Collagen wound dressings and soft tissue graft substitutes may help protect extraction socket bone grafts and provide better gingival contours. This randomized, controlled, multicenter, and double-blinded study was conducted to compare a control (wound dressing) and a test (soft tissue graft) substitute in nearly intact extraction sockets. Both test and control sockets were grafted with a xenogeneic bone graft. Graft containment, extraction socket soft tissue gap closure, gingival contour, and gingival thickness were examined over 16 weeks, at which time implants were placed. Healing was uneventful for both groups, and there was no significant difference (P < .05) between the times required to close the extraction socket soft tissue gap (~80% of sites closed by 8 weeks). Bone grafts were covered and contained longer in the test group (~4 weeks vs ~2 weeks), with less contour disruption out to 4 weeks; however, at implant placement, soft tissue contours in both groups were comparable, and soft tissue thicknesses were not significantly different.
International Journal of Periodontics & Restorative Dentistry, 4/2019
DOI: 10.11607/prd.4158, PubMed ID (PMID): 31226185Pages 479-489, Language: EnglishClem, Donald / Gunsolley, John C.An effective treatment regime for peri-implantitis (P-I) should include disinfection and regeneration of peri-implant tissues. Twenty consecutive patients exhibiting 23 P-I implants with 84 deep (≥ 6 mm) defects were treated using an Er:YAG laser for implant surface decontamination, removal of defect granulomatous tissues, and grafting therapy for bony defect resolution. Probing pocket defects (PPD) ≥ 6 mm (deep probing depths) before surgery were reduced on average to approximately 3.5 mm at 12 months. Probing depths 6 mm (shallow probing depths) remained stable (mean PPD 3.2 mm at 12 months). Radiographs indicated PPD reductions were achieved along with peri-implant defect fill.
International Journal of Periodontics & Restorative Dentistry, 1/2015
DOI: 10.11607/prd.1888, PubMed ID (PMID): 25734712Pages 98-103, Language: EnglishSchallhorn, Rachel A. / McClain, Pamela K. / Charles, Allan / Clem, Donald / Newman, Michael G.Implant-supported prostheses often present with mucogingival deficiencies that may cause esthetic or hygienic issues. These issues may present as limited or no keratinized tissue, irregular soft tissue contour or concavity, and gray "showthrough" of the implant abutment and root forms. An interpositional soft tissue graft substitute that generates keratinized tissue and increases soft tissue thickness would be beneficial, as it would reduce donor site morbidity and be available in unlimited, off-the-shelf supply. Thirty patients were assessed as part of a multicenter, practice-based evaluation of the material. A xenogeneic collagen matrix was placed as an interpositional graft on the buccal aspect of implant sites; sites were reassessed at 6 months posttreatment. Results indicated that the collagen matrix increased tissue thickness and keratinized tissue around existing dental implants.
International Journal of Periodontics & Restorative Dentistry, 3/2005
Pages 231-237, Language: EnglishCammack, Gerald V./Nevins, Myron/Clem, Donald S./Hatch, John P./Mellonig, James T.The objective of this study was to quantify new bone formation from biopsies of demineralized freeze-dried bone allograft (DFDBA) and freeze-dried bone allograft (FDBA) following ridge and sinus augmentations. Ninety-three patients who received maxillary sinus or ridge augmentation grafts agreed to core biopsies of their grafts when the implants were placed. Samples ranged from 6 to 36 months postgrafting. These samples were sectioned, stained, and examined histomorphometrically. Seventy-two FDBA and 21 DFDBA samples were examined, and the mean percentages of new bone formed were 41.89% and 41.74%, respectively. There was no statistical difference, irrespective of graft site.
The International Journal of Oral & Maxillofacial Implants, 4/2002
Pages 550-556, Language: EnglishLevine, Robert A. / Clem, Donald / Beagle, Jay R. / Ganeles, Jeffrey / Johnson, Peter / Solnit, Gary / Keller, G. WilliamPurpose: This report involves the retrospective analysis of ITI implants placed and/or restored by a group of 7 clinicians located throughout the United States (5 periodontists and 2 prosthodontists). Materials and Methods: Six hundred seventy-five posterior single-tooth implants were restored in 471 patients (average time of loading 21.30 months, with a range of 1 to 78 months). Three hundred seventy implants and 71 implants were placed in mandibular and maxillary molar sites, respectively, and 108 and 126 were placed in mandibular and maxillary premolar sites, respectively. Results: A cumulative survival rate of 99.1% was obtained for all sites (6 failures). The survival rates for individual sites were as follows: 98.4% mandibular molars, 100% maxillary molars, 100% mandibular premolars, and 100% maxillary premolars. "At-risk" implants (1 to 2 mm of radiographic bone loss) were noted at 5 sites. Discussion: Minimal restorative problems were found with either screw-retained (n = 71) or cemented restorations on solid abutments (n = 600); 80.3% of screw-retained and 98.2% of cemented restorations were free of complications, respectively. Patient satisfaction scores were high (97.4%) as determined by the Patient Satisfaction Questionnaire. Conclusion: The data suggest that solid-screw (4.1 or 4.8 mm wide) ITI implants can be a satisfactory choice for posterior single-tooth restorations.