Clinical trials

Post-extraction labio-palatal ridge collapse is a significant challenge in restorative and implant dentistry particularly in anterior maxilla. Following tooth extraction, marked dimensional alveolar ridge changes occur. The buccal plate of bone in the anterior zone is primarily composed of bundle bone, a tooth dependent structure that derives its blood supply from the periodontal ligament (PDL). The PDL loss after tooth extraction results in rapid resorption of the bundle bone, leading to horizontal and vertical ridge reduction (Araújo and Lindhe, 2005, Schropp et al., 2003). Studies have shown that 50% of ridge width reduction occurs within 12 months, with two thirds of this reduction occurring within the first 3 months (Schropp et al., 2003). Moreover, the labial plate thickness in the anterior maxilla is frequently thinner than 1 mm in the majority of cases (Huynh-Ba et al., 2010). The high incidence of mid-facial recession and soft tissue volume loss is attributed to those biological events. Although IIP has become increasingly popular due to its short treatment time, it doesn't prevent physiological remodeling associated with bundle bone resorption (Araújo and Lindhe, 2005). Consequently, soft tissue collapse and midfacial recession remain common complications, especially in thin periodontal phenotypes (Chappuis et al., 2013, Cosyn et al., 2012). In order to overcome the inevitable consequences of tooth extraction, a variety of ridge preservation techniques were proposed in the literature including; flapless implant placement, bone grafting, soft tissue augmentation procedures, immediate provisionalization, a more palatal orientation of the implant in the socket and the socket shield technique.

This retrospective cohort study evaluates clinical, surgical, and prosthetic factors associated with early and mid-term outcomes of immediate implant placement in the anterior maxilla. The primary objective is to identify predictors of implant survival and complications (e.g., infection, soft-tissue dehiscence, esthetic failure) within 12 months following placement. Secondary objectives include assessment of peri-implant marginal bone loss, prosthetic complications, and esthetic outcomes (pink esthetic score).

Rehabilitation of the maxillary posterior region is a challenge in every-day clinical practice. Following extraction of maxillary molars, alveolar ridge atrophy along with maxillary sinus pneumatization decrease the bone volume and increase implant placement complexity (Lyu et al., 2023). Several surgical procedures have been proposed to overcome these complications, including; short implants (Bechara et al., 2017), tilted implants (Meng and Zhang, 2022) as well as different sinus floor elevation techniques (Irinakis, 2011, Bishbish et al., 2023, Dragonas et al., 2023). Crestal maxillary sinus floor elevation has been considered a predictable and less invasive approach, providing sufficient vertical ridge height with high rates of implant survival (Guruprasad et al., 2024). However, there's limited body of evidence comparing the efficacy of different trans-crestal approaches as PISE and crestal implant approach with no bone graft. Thus, further clinical trials are recommended to determine whether the adjunctive use of piezoelectric instrumentation in internal sinus elevation offers significant clinical advantages over the crestal implant approach.

The present study aims to compare the dimensional stability of the supra-implant complex following flapless immediate implant placement using two socket management approaches: the connective tissue graft and the socket shield technique. Three-dimensional volumetric analysis and cone-beam computed tomography (CBCT) will be employed to assess and quantify changes in soft and hard tissue thickness and height surrounding the implant site.

clinical trial The goal of this clinical trial is to record the esthetic outcome of the 3d printed hybrid resin crowns. It will also test which method of fabrication is advantageous than the other one. The main questions it aims to answer are: Does any of the fabrication methods differ in its esthetic outcome? Researcher will compare 3d printing fabrication to conventional fabrication method which is the milling technique to see if 3d printing of hybrid resin serves patients a better crown's esthetic outcome. Participants will: Receive a crown after implants are osseointegrated Visit the clinic once every 3 months for checkups and tests Keep records of level of patient's satisfaction.