Practical Techniques in Periodontics and Implant Dentistry

ISBN-13: 9781119793557 / Angielski / Twarda / 2023

Spis treści

List of Contributors xiiiIntroduction xvPart I Fundamentals 11 Anatomy and Physiology 3Edgard El Chaar and Thierry AbitbolOverview of Gingival Tissue and Periodontium 3Embryonic Development 3Formation of the Epithelial Attachment 4Formation of the Cementum, Periodontal Ligament, and Alveolar Bone 4Soft Tissue Physiology 6Gingiva 6Width and Thickness of the Gingiva 6Histological Composition 6Epithelial-Connective Tissue Interaction 7Gingival Fiber Groups 7Alveolar Mucosa 7Junctional Epithelium 8Biotype 8Periodontal Biotype 8Anatomy Is Destiny 9Anatomy 9Root Surface Anatomy 9Anterior Teeth 10Developmental Anterior Grooves 10Premolars 10The Root Trunk 11Maxillary First Molars 11Mandibular First Molars 11Cervical Enamel Projections (CEPs) 12References 12Further Reading 132 Wound Healing 14Steven EngebretsonDefinitions and Terms for Clinical Outcomes 14Inflammatory Phase 14Proliferative Phase 14Remodeling Phase 15Epithelium and Connective Tissue Healing 15Flap Surgery 15Free Graft 15Bone Healing 15Healing of Extraction Sockets 16Osseointegration 16Modifiers of Wound Healing 16References 173 Diagnosis and Pathology of Periodontal Diseases 18Cecilia WhiteFormulating a Periodontal Diagnosis 18Periodontal Health and Gingival Health 18Gingivitis: Dental Plaque-Induced 19Necrotizing Periodontal Diseases 19Periodontitis 19Other Conditions Affecting the Periodontium 20Periodontal Abscesses 20Endodontic-Periodontal Lesions 20Mucogingival Deformities and Conditions Around the Teeth 20Traumatic Occlusal Forces 20Prosthesis and Tooth-Related Factors 20References 214 Oral Pathology and Oral Medicine 22Edgard El Chaar and Arthi M. KumarIntroduction 22Non-Dental-Biofilm Induced Gingival Diseases 22Genetic/Developmental Disorders 22Hereditary Gingival Fibromatosis (HGF) 22Specific Infections 22Infections of Bacterial Origin 22Infections of Viral Origin 24Infections of Fungal Origin 25Inflammatory and Immune Conditions 27Hypersensitivity Reactions 27Autoimmune Diseases of Skin and Mucous Membranes 27Granulomatous Inflammatory Conditions 30Reactive Processes 31Epulides 31Pre-Malignant Lesions and Malignant Neoplasms 32Endocrine, Nutritional, and Metabolic Diseases 34Traumatic Lesions 34Physical/Mechanical Insults 34Chemical/Thermal Insults 36Gingival Pigmentation 36Endocrine, Nutritional, and Metabolic Diseases 38Genetic Disorders 38Diseases Affecting the Connective Tissues 39Acquired Immunodeficiency Diseases 41Inflammatory Diseases 41Systemic Disorders that Influence the Pathogenesis of Periodontal Disease 41Further Reading 445 Patient Examination and Initial Therapy 50Claire Mc Carthy, Steve Engeberston, Edgard El Chaar, Mea Weinberg, Stuart L. Segelnick, and Dena M. SapanaroMedical History for the Dental Patient 50Clinical and Radiographical Examination 50Clinical Examination 50Radiographic Examination 51Radiographic Artifacts 51Oral Hygiene 51Toothbrushing 52Interproximal Cleaning 52Interproximal Brushes 52Dental Floss or Tape 52Specialized Oral Hygiene Aids 53Single Tufted Brush 53Behavior Change Techniques 53Non-surgical Periodontal Therapy 54Benefits 54Limitations 54Armamentarium 54Hand Instruments 54Powered Instruments 54Techniques 55Supragingival Debridement 55Fundamental Elements of Hand Instrumentation 55Calculus Detection Technique 55Fulcrums 56Powered (Ultrasonic) Technique 56Reevaluation of Initial Therapy 56Occlusal Therapy 56Medications and Implications for Periodontal Therapy 57Sedation: Minimal and Moderate Sedation 57References 58Further Reading 58Part II Principles and Practice of Periodontal Surgery 616 Surgical Anatomy and Local Anesthesia 63Roya Afshar-Mohajer and Babak HamidiAnatomic Landmarks 63Mandible 63Anatomic Spaces 65Maxilla 65Conclusion 67Properties of Local Anesthesia 67Properties of Ideal Anesthetic 68Techniques of Local Anesthesia 68Maxillary Anesthesia 68Mandibular Anesthesia 68Further Reading 697 Suturing Techniques 70Mea A. Weinberg, Stuart L. Segelnick, and Edgard El ChaarPrinciples of Surgical Wound Closure 70Properties of Suture Materials 70Suturing Techniques and Indications for Use 72References 768 Osseous Surgery 77Thierry AbitbolIntroduction 77Osseous Surgery 77Limitations and Contraindications to Osseous Resective Surgery 78References 789 Functional Crown Lengthening 79Thierry AbitbolIntroduction 79Checklist 79Osseous Surgery 80References 8110 Root Amputation 83Wayne Kye and Gretchen SternOverview 83Terminology 83Indications and Contraindications 84Indications Include 84Contraindications Include 84Advantages and Disadvantages 85Armamentarium 85Surgical Technique 85Complications 86Outcome and Follow-up 86Implants Versus Root Resection 87Vital Root Resection 87References 88Further Reading 8911 Guided Tissue Regeneration 90Edgard El Chaar and Michael BralOverview 90Indications 91Repair and Regeneration in Periodontal Defects 91GTR for Furcation Defects 91Technique 91GTR for Periodontal Intrabony and Circumferential Defects 93Techniques 94GTR for the Treatment of Recession Defects 95Follow-up 97Further Reading 9712 Esthetic Crown Lengthening 98Edgard El ChaarOverview 98Etiology 98Treatment 99Case Surgical Description 99Post-Elongation Gingival Margin Stability 101References 101Further Reading 10213 Soft Tissue Management in Natural Dentition 103Edgard El ChaarOverview 103Classifications 104Determination of the CEJ 104Diagnostic and Treatment Considerations Based on Classification of Periodontal Biotypes, Gingiva Recession, and Root Surface Conditions 106Surgical Management of Mucogingival Deficiencies 106Free Gingival Graft (FGG) 106Pedicle Soft Tissue Graft 106Coronally Advanced Flap (CAF) 107Sub-epithelial Connective Tissue Graft (SCTG) 107Allograft 108Acellular Dermal Matrix 108Clinical Studies Comparing Soft Tissue Allograft to the SCTG 109Histological Studies on Soft Tissue Allograft 109Clinical Case 109References 111Further Reading 113Part III Principles and Practice of Implant Dentistry 11514 Principles of Implant Dentistry 117Edgard El Chaar and Aikaterini GeorgantzaIntroduction 117Steps for Implant Success 117Factors Affecting the Implant Success 118Bone Quality Classification 118Bone to Implant Contact 118Transmucosal Attachment Around Dental Implants 118Probing Around Dental Implants 118Biological Width Around Implants 119The Microgap: Interface Between Implant and Abutment 119Platform Switching 119Fundamental Criteria in Implant Placement: Healed Ridges 120Implant Surface Topography 120Implant Topography on Wound Healing 120Implant Materials 120Bone Healing 120Principles of Surface Treatment, Topographies, and Roughness 121Implant Design 121Implant Surface Topography 121Implant Surface Specificities: Advantages and Disadvantages 121References 122Further Reading 12415 Examination and Diagnosis 125Zahra BagheriRadiographic Examination 125Cone Beam Computed Tomography 125Clinical Parameters 125Clinical Examination 126Factors Influencing Surgical Management 126Factors Influencing Prosthetic Parameters 126References 127Further Reading 12716 Prosthetic Considerations 128Zahra BagheriReview of the Esthetic Parameters 128The Prosthetic Space 129Temporization 129Critical Space 129Subcritical Space 130Buccal Contour 130Final Restoration 130Abutment Options 130Cemented Versus Screw Retained 130Restorative Materials 130References 13117 Digital Workflow in Surgery 132Edgard El ChaarIntroduction to Digital Dentistry 132Terminology 132Description of STL 132Description of 3D Volume 133Applications of Interactive Software 133Intra-Oral Scanners (IOS) 133Virtual Implant Software Planning 133Drilling Surgical Guide 134Use of Guided Surgery in Immediate Implant Placement 134Full Arch Guided Surgery 135Aid in Ridge Deficiency Diagnosis 135References 137Further Reading 13718 Socket Management 138Aikaterini GeorgantzaAnatomical Features of the Alveolar Process 138The Alveolar Process 138The Alveolar Bone Proper 138Alveolus and Extraction Socket 138The Alveolar Ridge 138Classification of Remaining Bone 138Alterations of the Alveolar Process Following Tooth Extraction 138Biological Events and Histologic Ridge Alterations 138Overview of the Histologic Sequence of Healing 139Dimensional Ridge Alterations 139Clinical Implications for Ridge Preservation and Implant Treatment 139Atraumatic Tooth Extraction 140Indications for Ridge Preservation 140Contraindications for Ridge Preservation 140Ridge Preservation Procedures 140Maintenance of the Root and the Socket Shield Technique 140Forced Eruption 140Socket Grafting 140Management of Socket at the Esthetic Zone 141Extraction Socket Classifications 141Timing of Implant Placement 142Immediate Implant Placement 142Early Implant Placement with Partial Bone Healing (12-16 Weeks) 144Late Implant Placement Complete Bone Healing (>6months) 144References 145Further Reading 14619 Deficient Ridges Augmentation 147Edgard El Chaar, Aikaterini Georgantza, and Wayne KyeCrestal Sinus Elevation 147Background 147Indications 147Armamentarium 148Surgical Technique 148Complications 148Follow-Up 149Lateral Sinus Floor Elevation 149Background 149Indications 149Grafting Materials 149Anatomical Considerations 150Armamentarium 150Surgical Technique 150Complications 151Prevention of Complications 151Follow-up 151Ridge Augmentation 151Fundamentals of Ridge Augmentation 151Surgical Techniques 152Ridge Classifications 152Seibert 152Expectations of Ridge Augmentation 153Horizontal Ridge Augmentation 153Vertical Ridge Augmentation 153Fundamentals of Successful Surgical Technique 156Clinical Case of Ridge Augmentation 156References 158Further Reading 15920 Soft Tissue Assessment and Enhancement in Implant Dentistry 161Edgard El ChaarIntroduction 161Techniques to Create Contour, Thickness, and Increase Keratinized Tissue 161A-Flap Management 161Roll Technique 163Autograft Subepithelial Connective Tissue (CTG), a Free Gingival Graft (FGG), or Allograft Dermis 165Free Gingival Graft (FGG) 165Connective Tissue Grafts (CTG) 166Techniques for Papilla Management 172Rotated Pediculated Marginal Tissue 172Rotated Pediculated Lingual Marginal Tissue 172Techniques of Soft Tissue for Extraction Socket Grafting 173References 176Further Reading 17721 Peri-Implant Diseases 178Edgard El Chaar and Cecilia WhiteIntroduction 178Prevalence 178Criteria for Diagnosis of Peri-implantitis: Case Definition 179Risk Factors 179History of Periodontitis 179Implant Maintenance 179Number of Implants 179Clinician Experience 179Implant Brand 179Smoking 179Microbiota 180Treatment 180Nonsurgical Therapy 180Peri-implant Mucositis 180Peri-implantitis 180Surgical Treatment 181What Is the Most Predictable or Superior Treatment Modality? 181Clinical Case to Illustrate Peri-implantitis Treatment 182References 184Index 187

O autorze

Edgard El Chaar, DDS, MS, is the former Director of the Advanced Education Program in Periodontics at New York University and currently Professor at University of Pennsylvania, Philadelphia, PA, USA.