ASSOCIATION OF GINGIVAL BIOTYPE AND FLAP DESIGN CONSIDERED AT STAGE TO UNCOVERY - A RETROSPECTIVE STUDY
DOI:
https://doi.org/10.61841/3290dy04Keywords:
Gingival biotype, Flap design, Implant placement, Bone resorption, Hard tissueAbstract
AIM: To evaluate the association between gingival biotype and flap design consideration at the time of stage two uncovery.
MATERIAL AND METHOD: A retrospective study was done in which 528 implants were placed from 1 June 2019 till 1 March 2020 were included. Data was reviewed from the patient records and analysed the data of 86,000 patients between June 2019 and March 2020 that were documented in a private institution. Statistical analysis was performed to assess the association between gingival biotype and flap design consideration at the time of stage two uncovery.
Results: Gingival biotype had no significant difference when compared between males and females and different age groups. Flap design consideration had no significant difference when compared between males and females, but the difference was statistically significant when seen between different age groups. There was a statistically significant association between gingival biotype and flap design consideration at the time of stage two uncovery (p<0.05).
Conclusion: There is a significant association between gingival biotype and flap design consideration at the time of stage two uncovery. Therefore, it should be one of the factors considered during the planning of implant placement in a particular case for successful implant treatment.
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References
1. The Glossary of Prosthodontic Terms: Ninth Edition. J Prosthet Dent. 2017 May;117(5S):e1–105.
2. Jain A, Ranganathan H, Ganapathy D. Cervical and incisal marginal discrepancy in ceramic laminate veneering materials: A SEM analysis [Internet]. Vol. 8, Contemporary Clinical Dentistry. 2017. p. 272. Available from: http://dx.doi.org/10.4103/ccd.ccd_156_17
3. Duraisamy R, Krishnan CS, Ramasubramanian H, Sampathkumar J, Mariappan S, Sivaprakasam AN. Compatibility of Nonoriginal Abutments With Implants [Internet]. Vol. 28, Implant Dentistry. 2019. p.289–95. Available from: http://dx.doi.org/10.1097/id.0000000000000885
4. Fu J-H, Lee A, Wang H-L. Influence of tissue biotype on implant esthetics. Int J Oral Maxillofac Implants. 2011 May;26(3):499–508.
5. Cosyn J, Eghbali A, De Bruyn H, Collys K, Cleymaet R, De Rouck T. Immediate single-tooth implants in the anterior maxilla: 3-year results of a case series on hard and soft tissue response and aesthetics. J Clin Periodontol. 2011 Aug;38(8):746–53.
6. Kan JYK, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. J Periodontol. 2003 Apr;74(4):557–62.
7. Claffey N, Shanley D. Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy. J Clin Periodontol. 1986 Aug;13(7):654–7.
8. Abraham S, Deepak KT, Ambili R, Preeja C, Archana V. Gingival biotype and its clinical significance – A review [Internet]. Vol. 5, The Saudi Journal for Dental Research. 2014. p. 3–7. Available from:http://dx.doi.org/10.1016/j.ksujds.2013.06.003
9. Subasree S, Murthykumar K, Dhanraj. Effect of Aloe Vera in Oral Health-A Review [Internet]. Vol. 9,Research Journal of Pharmacy and Technology. 2016. p. 609. Available from:http://dx.doi.org/10.5958/0974-360x.2016.00116.5
10. Vijayalakshmi B, Ganapathy D. Medical management of cellulitis [Internet]. Vol. 9, Research Journal of Pharmacy and Technology. 2016. p. 2067. Available from: http://dx.doi.org/10.5958/0974- 360x.2016.00422.4
11. Becker W, Ochsenbein C, Tibbetts L, Becker BE. Alveolar bone anatomic profiles as measured from dry skulls [Internet]. Vol. 24, Journal of Clinical Periodontology. 1997. p. 727–31. Available from: http://dx.doi.org/10.1111/j.1600-051x.1997.tb00189.x
12. Hahn J. Single-stage, Immediate Loading, and Flapless Surgery [Internet]. Vol. 26, Journal of Oral Implantology. 2000. p. 193–8. Available from: 2.3.co;2">http://dx.doi.org/10.1563/1548-1336(2000)026<0193:silafs>2.3.co;2
13. Ganapathy DM, Kannan A, Venugopalan S. Effect of Coated Surfaces influencing Screw Loosening in Implants: A Systematic Review and Meta-analysis [Internet]. Vol. 8, World Journal of Dentistry. 2017. p. 496–502. Available from: http://dx.doi.org/10.5005/jp-journals-10015-1493
14. Ashok V, Nallaswamy D, Benazir Begum S, Nesappan T. Lip Bumper Prosthesis for an Acromegaly Patient: A Clinical Report [Internet]. Vol. 14, The Journal of Indian Prosthodontic Society. 2014. p. 279–82. Available from: http://dx.doi.org/10.1007/s13191-013-0339-6
15. Saadoun AP, Touati B. Soft tissue recession around implants: is it still unavoidable?--Part I. Pract Proced Aesthet Dent. 2007 Jan;19(1):55–62; quiz 64.
16. Soadoun AP, Touati B. Soft tissue recession around implants: is it still unavoidable?--Part II. Pract Proced Aesthet Dent. 2007 Mar;19(2):81–7; quiz 88.
17. Nart J, Valles C. Subepithelial Connective Tissue Graft in Combination with a Tunnel Technique for the Treatment of Miller Class II and III Gingival Recessions in Mandibular Incisors: Clinical and Esthetic Results [Internet]. Vol. 36, The International Journal of Periodontics & Restorative Dentistry. 2016. p. 591–8. Available from: http://dx.doi.org/10.11607/prd.2748
18. Ganapathy D, Sathyamoorthy A, Ranganathan H, Murthykumar K. Effect of Resin Bonded Luting Agents Influencing Marginal Discrepancy in All Ceramic Complete Veneer Crowns. J Clin Diagn Res. 2016 Dec;10(12):ZC67–70.
19. Carmagnola D, Araujo M, Berglundh T, Albrektsson T, Lindhe J. Bone tissue reaction around implants placed in a compromised jaw [Internet]. Vol. 26, Journal of Clinical Periodontology. 1999. p. 629–35. Available from: http://dx.doi.org/10.1034/j.1600-051x.1999.261001.x
20. Cardaropoli G, Wennstrom JL, Lekholm U. Peri-implant bone alterations in relation to inter-unit distances. A 3-year retrospective study [Internet]. Vol. 14, Clinical Oral Implants Research. 2003. p. 430–6. Available from: http://dx.doi.org/10.1034/j.1600-0501.2003.00895.x
21. Papalexiou V, Novaes AB, Ribeiro RF, Muglia V, Oliveira RR. Influence of the Interimplant Distance on Crestal Bone Resorption and Bone Density: A Histomorphometric Study in Dogs [Internet]. Vol. 77, Journal of Periodontology. 2006. p. 614–21. Available from: http://dx.doi.org/10.1902/jop.2006.050172
22. Kan JYK, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of Peri-Implant Mucosa: An Evaluation of Maxillary Anterior Single Implants in Humans [Internet]. Vol. 74, Journal of Periodontology. 2003. p.557–62. Available from: http://dx.doi.org/10.1902/jop.2003.74.4.557
23. Ramfjord SF, Costich ER. Healing after Exposure of Periosteum on the Alveolar Process [Internet]. Vol.39, Journal of Periodontology. 1968. p. 199–207. Available from: http://dx.doi.org/10.1902/jop.1968.39.4.199
24. Wood DL, Hoag PM, Walter Donnenfeld O, Rosenfeld LD. Alveolar Crest Reduction Following Full and Partial Thickness Flaps [Internet]. Vol. 43, Journal of Periodontology. 1972. p. 141–4. Available from: http://dx.doi.org/10.1902/jop.1972.43.3.141
25. Zee EV der, Van der zee E, Oosterveld P, Van waas MAJ. Effect of GBR and fixture installation on gingiva and bone levels at adjacent teeth [Internet]. Vol. 15, Clinical Oral Implants Research. 2004. p. 62–5. Available from: http://dx.doi.org/10.1111/j.1600-0501.2004.01005.x
26. Ariga P, Nallaswamy D, Jain AR, Ganapathy DM. Determination of Correlation of Width of Maxillary Anterior Teeth using Extraoral and Intraoral Factors in Indian Population: A Systematic Review [Internet]. Vol. 9, World Journal of Dentistry. 2018. p. 68–75. Available from:http://dx.doi.org/10.5005/jp-journals-10015-1509
27. Sclar AG. Guidelines for Flapless Surgery [Internet]. Vol. 65, Journal of Oral and Maxillofacial Surgery. 2007. p. 20–32. Available from: http://dx.doi.org/10.1016/j.joms.2007.03.017
28. Auty C, Siddiqui A. Punch Technique for Preservation of Interdental Papillae at Nonsubmerged Implant Placement [Internet]. Vol. 8, Implant Dentistry. 1999. p. 160–6. Available from: http://dx.doi.org/10.1097/00008505-199902000-00009
29. D’Elia C, Baldini N, Cagidiaco E, Nofri G, Goracci C, de Sanctis M. Peri-implant Soft Tissue Stability After Single Implant Restorations Using Either Guided Bone Regeneration or a Connective Tissue Graft: A Randomized Clinical Trial [Internet]. Vol. 37, The International Journal of Periodontics & Restorative Dentistry. 2017. p. 413–21. Available from: http://dx.doi.org/10.11607/prd.2747
30. Landsberg CJ, Bichacho M, Fugazzotto PA. Implant Placement Without Flaps Part II Utilizing a TwoStage Surgical Protocol [Internet]. Vol. 8, Implant Dentistry. 1999. p. 287. Available from:http://dx.doi.org/10.1097/00008505-199903000-00011
31. Rocci A, Martignoni M, Gottlow J. Immediate loading in the maxilla using flapless surgery, implants placed in predetermined positions, and prefabricated provisional restorations: a retrospective 3-year clinical study. Clin Implant Dent Relat Res. 2003;5 Suppl 1:29–36.
32. Ashok V, Suvitha S. Awareness of all ceramic restoration in rural population [Internet]. Vol. 9, Research Journal of Pharmacy and Technology. 2016. p. 1691. Available from: http://dx.doi.org/10.5958/0974-360x.2016.00340.1
33. Kannan A, Venugopalan S. A systematic review on the effect of use of impregnated retraction cords on gingiva [Internet]. Vol. 11, Research Journal of Pharmacy and Technology. 2018. p. 2121. Available from: http://dx.doi.org/10.5958/0974-360x.2018.00393.1
34. Agarwal V, Sunny, Mehrotra N, Vijay V. Gingival biotype assessment: Variations in gingival thickness with regard to age, gender, and arch location [Internet]. Vol. 9, Indian Journal of Dental Sciences. 2017. p. 12. Available from: http://dx.doi.org/10.4103/0976-4003.201639
35. Jyothi S, Robin PK, Ganapathy D, Anandiselvaraj. Periodontal Health Status of Three Different Groups Wearing Temporary Partial Denture [Internet]. Vol. 10, Research Journal of Pharmacy and Technology. 2017. p. 4339. Available from: http://dx.doi.org/10.5958/0974-360x.2017.00795.8
36. Agarwal V, Sunny, Mehrotra N, Vijay V. Gingival biotype assessment: Variations in gingival thickness with regard to age, gender, and arch location [Internet]. Vol. 9, Indian Journal of Dental Sciences. 2017. p.12. Available from: http://dx.doi.org/10.4103/0976-4003.201639
37. Venugopalan S, Ariga P, Aggarwal P, Viswanath A. Magnetically retained silicone facial prosthesis. Niger J Clin Pract. 2014 Mar;17(2):260–4.
38. Ajay R, Suma K, Ali S, Sivakumar JK, Rakshagan V, Devaki V, et al. Effect of surface modifications on the retention of cement-retained implant crowns under fatigue loads: An In vitro study [Internet]. Vol. 9, Journal of Pharmacy And Bioallied Sciences. 2017. p. 154. Available from: http://dx.doi.org/10.4103/jpbs.jpbs_146_17
39. Basha FYS, Ganapathy D, Venugopalan S. Oral Hygiene Status among Pregnant Women [Internet]. Vol.11, Research Journal of Pharmacy and Technology. 2018. p. 3099. Available from: http://dx.doi.org/10.5958/0974-360x.2018.00569.3
40. Velvart P, Peters CI, Peters OA. Soft tissue management: suturing and wound closure [Internet]. Vol. 11, Endodontic Topics. 2005. p. 179–95. Available from: http://dx.doi.org/10.1111/j.1601-1546.2005.00165.x
41. Muammer G. Hybrid implant placement using papillae-sparing incisions in the esthetic zone [Internet]. Available from: http://dx.doi.org/10.26226/morressier.5ac3831d2afeeb00097a477b
42. Selvan SR, Ganapathy D. Efficacy of fifth generation cephalosporins against methicillin-resistant Staphylococcus aureus-A review [Internet]. Vol. 9, Research Journal of Pharmacy and Technology. 2016.p. 1815. Available from: http://dx.doi.org/10.5958/0974-360x.2016.00369.3
43. Rouck TD, De Rouck T, Collys K, Cosyn J. Immediate single-tooth implants in the anterior maxilla: a 1-year case cohort study on hard and soft tissue response [Internet]. Vol. 35, Journal of Clinical Periodontology. 2008. p. 649–57. Available from: http://dx.doi.org/10.1111/j.1600-051x.2008.01235.x
44. Influence of the prosthetic restoration design on the peri-implant bone loss [Internet]. Vol. 28, Clinical Oral Implants Research. 2017. p. 235–235. Available from: http://dx.doi.org/10.1111/clr.234_13042
45. Farhat Yaasmeen Sadique Basha, Rajeshkumar S, Lakshmi T, Anti-inflammatory activity of Myristica fragrans extract . Int. J. Res. Pharm. Sci., 2019 ;10(4), 3118-3120 DOI: https://doi.org/10.26452/ijrps.v10i4.1607
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