Takanori Suzuki

Energy output reduction and surface alteration of quartz and sapphire tips following Er:YAG laser contact irradiation for tooth enamel ablation†

Despite the recent increase in application of Er:YAG laser for various dental treatments, limited information is available regarding the contact tips. This study examined the changes in energy output and surface condition of quartz and sapphire contact tips after Er:YAG laser contact irradiation for tooth enamel ablation.

Various Techniques to Increase Keratinized Tissue for Implant Supported Overdentures: Retrospective Case Series.

Purpose. The purpose of this retrospective case series is to describe and compare different surgical techniques that can be utilized to augment the keratinized soft tissue around implant-supported overdentures. Materials and Methods. The data set was extracted as deidentified information from the routine treatment of patients at the Ashman Department of Periodontology and Implant Dentistry at New York University College of Dentistry. Eight edentulous patients were selected to be included in this study. Patients were treated for lack of keratinized tissue prior to implant placement, during the second stage surgery, and after delivery of the final prosthesis. Results. All 8 patients in this study were wearing a complete maxillary and/or mandibular denture for at least a year before the time of the surgery. One of the following surgical techniques was utilized to increase the amount of keratinized tissue: apically positioned flap (APF), pedicle graft (PG), connective tissue graft (CTG), or free gingival graft (FGG). Conclusions. The amount of keratinized tissue should be taken into consideration when planning for implant-supported overdentures. The apical repositioning flap is an effective approach to increase the width of keratinized tissue prior to the implant placement.

Comparison of the bond strength of composite resin to Er:YAG laser-irradiated enamel/dentin pre-treated with various methods

Abstract The purpose of this study was to compare the effects of pre-treatment on bond strength between composite resin and Er:YAG laser-irradiated enamel/dentin. The Er:YAG laser was irradiated on 60 extracted human teeth at following conditions; for enamel: 200 mJ/4 Hz, total energy 30 J, for dentin: 100 mJ, total energy 15 J. The irradiated 60 teeth were divided into six groups (n=5); Gr.1: ground with silicon carbide paper; Gr.2: laser was irradiated at foregoing condition; Gr.3: 37% phosphoric acid was applied to irradiated surface; Gr.4: ultrasonic scaler was applied to irradiated surface; Gr.5: air scaler was applied to irradiated surface; Gr.6; air-powder polisher applied to irradiated surface. SE bond and AP-X (Kuraray) were applied and cured. Tensile bond strengths (TBS) were measured after 24 h. The data were analyzed using ANOVA and Sheffes-tests. TBS of dentin was significantly higher than that of enamel. Significant differences among Gr.1 and 2, 3, 4, 5, Gr.2 and 3,4,5,6, Gr.3 and 6, Gr.4 and 6, Gr.5 and 6 were observed. The application of air-powder polisher for Er:YAG laser-irradiated enamel/dentin was effective to obtain high TBS.

A Three-Stage Split-Crest Technique: Case Series of Horizontal Ridge Augmentation in the Atrophic Posterior Mandible

This paper introduces a three-stage split-crest (TSSC) technique for horizontal ridge augmentation in the atrophic posterior mandible. The first stage consists of splitting the ridge. Following a 3- to 4-week healing interval, the second stage consists of expansion of the cortical plate (without elevating the periosteum) and placement of a bone replacement graft material. After 3 to 4 months of healing, the implants are placed. The advantages of this three-stage technique are increased vascularization to the surgical area, a decrease in procedure complications, and improved implant survival rates. An extended treatment time is the main disadvantage. The purpose of this retrospective case series is to review and discuss a new step-by-step surgical procedure of a TSSC technique using a delayed implant placement protocol. The results, advantages, and limitations were also presented.

Incision Design and Soft Tissue Management to Maintain or Establish an Interproximal Papilla Around Integrated Implants: A Case Series

Maintenance or reconstruction of interproximal papilla for a successful dental implant restoration can be challenging. To date, the results from various surgical and prosthetic techniques to maintain or regenerate papilla adjacent to dental implants have been unpredictable. To maintain the quality of the soft tissue around an implant, the blood supply must be preserved and formation of scar tissue must be minimized during surgery. Therefore, incision design is vital to producing an esthetic and successful dental implant restoration. In this study, specific incision designs and soft tissue management techniques were used to preserve or create interproximal papilla around single or adjacent implants.

Epicrestal and subcrestal placement of platform-switched implants: 18 month-result of a randomized, controlled, split-mouth, prospective clinical trial

OBJECTIVESnTo evaluate the changes in marginal bone levels (MBL) and soft tissue dimension around platform-switched implants with the implant-abutment junction (IAJ) placed at the crest or 1.5-2xa0mm subcrestally.nnnMATERIALS AND METHODSnIn all, 96 platform-switched implants were placed in either the posterior maxilla or mandible in 48 partially edentulous patients in a split-mouth study. All implants were provisionally restored after 4-5xa0months and definitively after 6xa0months (T6). Radiographic assessment of MBL was assessed at implant placement (T0), T6, 12xa0months (T12), and 18xa0months (T18) after placement. Mid-buccal soft tissue and papilla measurements were performed at T6, T12, and T18.nnnRESULTSnIn all, 43 patients with 86 implants completed the study. The T18 examination showed an implant survival rate of 100% in both groups. Analysis showed that MBL varied as a function of IAJ location, which indicated more coronal bone levels with subcrestal (2.39xa0±xa00.08xa0mm) than with epicrestal placements (0.88xa0±xa00.08xa0mm) (pxa0<xa0.05). Greater average marginal bone loss was found in the subcrestal group (0.40xa0±xa00.07xa0mm) compared to the epicrestal group (0.13xa0±xa00.08xa0mm) although no statistically significant difference was found at T18 (pxa0>xa0.05). Levels of mid-buccal soft tissue had no significant changes over time, regardless of group (pxa0>xa0.05). There was a significant difference in increase in papilla between T6 and T12 and T18 (pxa0=xa0.005 and .001), but not between T12 and T18 (pxa0=xa0.61). These papilla levels and changes were similar between groups (pxa0>xa0.05).nnnCONCLUSIONSnThe MBL changes around platform-switched implants with same geometry were not affected by the epicrestal or subcrestal location of the IAJ. Furthermore, the location of the IAJ did not affect the implant survival and soft tissue dimensions. However, no bone loss was located apical to the IAJ when the implants were placed subcrestally.

The Palatal Window for Treating an Incompletely Augmented Maxillary Sinus

Maxillary sinus augmentation through a lateral window is reported as one of the most predictable bone augmentation procedures before implant placement. The elevation of the membrane represents a delicate and crucial step that allows the creation of the space for the bone graft material. If the elevation is not completed, the regenerated bone might be inadequate for the implant placement. In this case, a new intervention will be necessary to complete the bone augmentation. Reaccessing from a lateral window, however, would be challenging due to thickness of the buccal boney wall because of the first grafting procedure; therefore, a different approach has to be used. The aim of this case report is to present the palatal window technique for treating incompletely augmented maxillary sinus. The detailed step-by-step diagnostic and surgical procedures are described, and the advantages and limitations of the technique are discussed through a review of the literature.

New Surgical Protocol to Create Interimplant Papilla: The Preliminary Results of a Case Series.

The aim of this study was to introduce a new surgical technique to regenerate the papilla adjacent to multiple or single implants using a novel instrument and a new incision design. A total of 10 consecutively treated patients with maxillary anterior implant-supported provisional restorations and missing interproximal papillae received a subepithelial connective tissue graft. The recipient site was prepared with a buccal incision apical to the mucogingival junction and to the defective papilla, and a palatal incision, followed by buccolingual tunneling performed with a translingual curette (EBINA). A total of 10 sites were treated and evaluated pre- and postoperatively with the papilla score based on the Jemt classification. The final prosthesis was delivered 3 months after the papilla regeneration surgical procedure. An average improvement in papilla index score from 0.8 to 2.4 was found after an average follow-up period of 16.3 months. This case series demonstrated that interimplant papilla regeneration can be successful over a period of 11 to 30 months postloading. Long-term prospective studies on tissue stability and esthetic outcomes are needed to corroborate the findings in this study.

Utilization of extracted teeth as provisional restorations following immediate implant placement - A case report.

This case report utilized a patients natural teeth as provisional restorations supported by immediately placed implants to provide a seamless transition from hopeless teeth to implant supported restorations.