Biomedical subjects

Cyril I Evian

Publications and source records attributed to Cyril I Evian.

4 recordsLinked to original sources

PubMed2003

Soft tissue augmentation for implant dentistry.

This article describes the soft tissue gingival augmentation techniques used in periodontal therapy and their advantages in implant dentistry. The procedures described include the free gingival graft, apically and coronally positioned grafts, the pouch procedure (or subepithelial connective tissue graft), the inverted pouch procedure or roll technique, and combination techniques. The author presents solutions that most clinicians commonly use when placing implants in the esthetic zone.

Alveolar Ridge Augmentation↗

PubMedDate not supplied

Retrospective analysis of implant survival and the influence of periodontal disease and immediate placement on long-term results.

PURPOSE: The purpose of this study was to investigate the cumulative survival rates of dental implants placed in a private periodontal practice and the effects of periodontal disease and immediate placement on implant survival. MATERIALS AND METHODS: A retrospective chart review was conducted on 149 consecutive patients. Each patient had a single implant placed. For the purpose of analysis, patients were divided into 2 groups: those who were periodontally healthy and those who had periodontal disease. Implants were placed into available bone either immediately or after a healing period. All failed implants were removed and recorded. The effects of periodontal status and placement time on implant survival were evaluated using Cox proportional hazards regression and log-rank tests. RESULTS: Of the 149 implants in the study, 22 failed during the observation period. The 127 censored cases (i.e., implants that had not failed at the end of the observational period) were observed for a mean of 943 days (SD 932, range 35 to 4,030). Failed implants were observed for a mean of 722 days (SD 1,026, range 18 to 3,548). The presence of periodontal disease appeared to be associated with a greater failure rate, but there was no observed effect associated with time of placement. The percentages of censored immediate placement cases and delayed placement cases were nearly identical. Among the 77 implants associated with periodontal disease, placement time was not strongly associated with percentage censored. Forty-three of the 55 immediately placed implants (78.18%) and 18 of the 22 implants (81.18%) whose placement was delayed were censored. Both Cox proportional hazards regression and log-rank tests established that survival was adversely affected by periodontal disease (P < .05) but unaffected by time of placement (P > .50). The lower 1-sided 95% confidence limit for median survival time was 3,548 days for patients without periodontal disease and 1,799 days for patients with disease. DISCUSSION AND CONCLUSION: Implant survival was compromised by a history of periodontitis but not affected by immediate or delayed placement.

Dental Implantation, Endosseous↗

PubMedDate not supplied

A comparison of characteristics of implant failure and survival in periodontally compromised and periodontally healthy patients: a clinical report.

PURPOSE: This study compares implant survival and patterns of implant failure in periodontally compromised and periodontally healthy patients. MATERIALS AND METHODS: In a private periodontal practice, over a 13-year period, implants were placed in both periodontally compromised and periodontally healthy patients. Implants were classified in 5 different groups according to surface texture. Survival rates in each group were compared according to implant location, diameter, length, and phase of treatment. RESULTS: A total of 1,511 implants were placed in 334 patients. One hundred fifty-one of these patients, classified as periodontally compromised patients (PCP), received 923 implants. The remaining 183 patients, classified as periodontally healthy patients (PHP), received 588 implants. The overall survival rate for implants placed in the PHP group was 93.7%, compared to 90.6% in the PCP group. The survival rate of hydroxyapatite-coated implants was 92.6% in the PHP group and 81% in the PCP group. The survival rate of the turned-surface implants was similar in both groups. DISCUSSION: Two types of implant failure were identified. The first was failure of the implant to osseointegrate. This type of failure occurred early in treatment and appeared to be related to smooth-surface implants placed in bone of low density. Failures of this type were distributed equally between the PHP and PCP groups. The second type of failure was related to peri-implantitis. It was observed most often with implants with hydroxyapatite surfaces, occurred as the result of a progressive condition, and was most prevalent in the PCP group. CONCLUSION: Further long-term controlled investigations are needed to determine the influences of implant suface and host susceptibility on implant failure in both PHP and PCP.

Coated Materials, Biocompatible↗

PubMedDate not supplied

Therapeutic management for immediate implant placement in sites with periapical deficiencies where coronal bone is present: technique and case report.

A surgical approach is presented that enables the clinician to repair apical bony defects during immediate dental implant placement without compromising the integrity of the coronal bone and gingiva. This apical surgical technique retains the soft tissue form in the coronal aspect of the gingiva and allows the clinician to repair the apical bone loss or fenestration. A clinical case is presented to describe the technique. This technique is utilized in cases of immediate implant placement. After extraction of the tooth, the socket is evaluated. In cases where coronal bone is intact but apical bone is deficient, a flap technique is utilized to expose the defect. The implant osteotomy is prepared, and the implant is placed. A healing cap or gingival prosthetic component is connected. The bony defect is repaired with a bone graft and, where necessary, a membrane. The apicoectomy flap is sutured. The clinical results obtained using this technique will enable the clinician to accomplish the bone regenerative procedure without extending the flap to the coronal aspect of the socket during immediate implant placement. This technique assists in the maintenance and integrity of the soft tissue form, which is critical for optimal esthetic results.

Apicoectomy↗