Athanasios Ntounis

A technique for managing and accurate registration of periimplant soft tissues

This article describes an indirect impression technique that accurately captures the soft tissue contours around an implant-supported provisional restoration. Customized impression copings are used to transfer the soft tissue architecture created by the interim prosthesis. The definitive restoration is shaped like the provisional restoration, maintaining the emergence profile and optimizing esthetics.

Digital data acquisition for a CAD/CAM-fabricated titanium framework and zirconium oxide restorations for an implant-supported fixed complete dental prosthesis

This dental technique report describes a digital workflow with digital data acquisition at the implant level, computer-aided design and computer-aided manufacturing fabricated, tissue-colored, anodized titanium framework, individually luted zirconium oxide restorations, and autopolymerizing injection-molded acrylic resin to fabricate an implant-supported, metal-ceramic-resin fixed complete dental prosthesis in an edentulous mandible. The 1-step computer-aided design and computer-aided manufacturing fabrication of titanium framework and zirconium oxide restorations can provide a cost-effective alternative to the conventional metal-resin fixed complete dental prosthesis.

Clinician assessments and patient perspectives of single-tooth implant restorations in the esthetic zone of the maxilla: A systematic review

Statement of problem. Esthetic outcomes associated with implant dentistry are important to both clinicians and patients. However, esthetic satisfaction may vary between the 2 groups. In order to evaluate the current publications relating to this topic, the following focused question was developed, “what are the quantitative and qualitative differences between clinician evaluations and patient perspectives in the assessment of single‐tooth implant outcomes in the esthetic zone?” Purpose. The purpose of this systematic review was to identify differences in esthetic satisfaction between clinicians and patients when evaluating single‐tooth implant‐supported restorations. Material and methods. An electronic search of the Medline database and Cochrane Central Register of Controlled Trials (2000 to 2014) was performed. The search was supplemented by a manual search of specific journals. A quality assessment of full‐text articles was performed according to Cochrane Collaborations tool and Newcastle‐Ottawa scale for risk of bias assessment. Information regarding outcomes was collected and compared. Results. The search term combinations identified 555 titles. Subsequent to further review, 11 publications, including 2 randomized controlled trials, were selected for inclusion. Because of the heterogeneity of the study designs, study interventions, and esthetic assessment methods, no meta‐analysis was performed. The clinicians identified a satisfactory outcome in 51% to 100% for peri‐implant soft tissue and 62% to 90% for implant restorations. Patients showed a mean range score of 43% to 93% for peri‐implant soft tissue and 81% to 96% for implant restorations. The visual analog scale score of the dentists was always lower than that of the patients. The review identified correlations between subjective and objective assessments for the Pink Esthetic Score (PES), the Papilla Index (PI), the Implant Crown Aesthetic Index (ICAI), and the modified (mod‐ICAI) indices. Conclusions. Clinicians are more critical of esthetic outcomes than patients. The PES and the PI correlated with the patients’ responses concerning the peri‐implant soft tissue. The ICAI and the mod‐ICAI showed a correlation of both the peri‐implant mucosa and implant‐supported crown satisfaction. Thus, a comprehensive and practical index should be developed to assess the esthetic outcomes for single‐tooth implant restorations in the esthetic zone.

Definitive abutment-driven stage-two surgery as a means to reduce peri-implant soft tissue changes: introduction of a new concept.

This report introduces an innovative approach for optimizing esthetics and minimizing soft tissue changes in clinical scenarios that involve extensive site preparation and submerged implants. The existing soft tissue morphology is registered at the time of implant uncovery, and an optimal peri-implant transmucosal contour is created indirectly in the lab. The customized definitive abutment is inserted during stage-two surgery and subsequently guides the peri-implant soft tissue, replicating an optimal emergence profile. The concept is demonstrated through the presentation of two clinical cases.

The ABC Protocol in the Esthetic Zone: A Comprehensive Surgical and Prosthetic Approach.

The purpose of this article is to present a surgical and restorative protocol for the replacement of missing teeth in the esthetic zone. The ABC protocol consists of digitally guided implantation, autogenous bone graft (A), followed by bovine bone xenograft (B) and connective tissue graft (C). Autogenous bone is placed in contact with the implant surface to induce osseointegration; bovine bone xenograft is then applied to augment the ridge dimension and provide long-term stability. Connective tissue is used to provide additional volume. The ABC biomaterial sequence offers favorable hard and soft tissue dimensions and immediate provisional restoration predictably leads to an esthetically pleasing definitive prosthesis.

Treatment of Hemi-Mandibulectomy Defect with Implant-Supported Telescopic Removable Prosthesis. A Clinical Report

Excision of head and neck tumors (benign or malignant) often leads to large segmental resections of the mandible. The following clinical report describes the oral rehabilitation of a 60-year-old Caucasian man after partial mandibulectomy due to primary oral leiomyosarcoma. Treatment consisted of a free fibula flap and an implant-supported telescopic removable prosthesis.