Advanced Surgical Interventions
A digital-based curation of articles from the Journal of Prosthetic Dentistry
Dental implants are used to assist the retention of removable prostheses. For removable partial dentures, the angulation of an implant should ideally parallel the path of insertion of the prosthesis to reduce issues with divergent fit such that the ease of wearing and longevity of attachment componentry are improved. This dental technique describes a simple way to show the path of draw when virtually planning an implant surgery and designing an implant guide for predictable placement.
An implant surgery guide can be a useful tool even after placement osseointegration of the implants. This technique article describes how a surgical guide can facilitate minimally invasive second stage surgery to uncover implants and preserve keratinized tissue.
Real-time, robot-assisted implant surgery that uses haptic guidance is an emerging form of digital dentistry that can broaden surgical and prosthetic care approaches while improving accurate and predictable clinical outcomes. This JPD Digital article evaluates published studies and case reports on robotic dental implant placement.
Periodontal pre-prosthetic surgery
Developing interdental papilla in the anterior smile zone is a complex endeavor for restoring dental implants. This technique article describes a surgical approach with minimal flap reflection for conservative tunneling a connective tissue graft with fixation by the implant prosthesis at the time of second stage surgery of an implant.
Removal of an ankylosed tooth can cause significant trauma and increase treatment length if bone augmentation and delayed implant surgery are indicated. This clinical report shows an alternative periodontal surgical approach that camouflages and preserves an unideally positioned tooth.
Esthetic crown lengthening is frequently employed to enhance tooth and gingival tissue forms. A full digital workflow that utilizes intraoral scanning and CBCT to plan, design, and fabricate a 3D printed guide are described in this dental technique article.
Complex pre-prosthetic surgery
Tooth extrusion can be employed to increase the vertical height of the coronal aspect of a natural tooth such that it can be more predictably restored. The disadvantage of orthodontics-based extrusion is prolonged time of treatment and root resorption. This dental technique describes a surgical approach to tooth extrusion that minimizes trauma to the surrounding periodontium with only axial vertical force to better preserve the periodontal ligament.
Zygomatic implants are an effective means of stabilizing an oral prosthesis for a patient with a maxillary defect. This case report describes the treatment process of placing a unilateral zygomatic implant within an open oral fistula to retain an obturator with tooth-supported telescopic crowns.
Implants and implant-based oral prosthesis can be used to facilitate complex multidisciplinary treatments to improve craniofacial relationships as well as providing a means for oral functions like mastication and speech. This case report describes the combination of orthognathic and implant surgeries, orthodontics, and maxillofacial prosthetics to reconstruct and rehabilitate significant acquired craniofacial defects in an adolescent patient.