Influence of the 3-D bone-to-implant relationship on esthetics.

There are biologic limits of the soft tissue dimension around implants; therefore, the limiting factor for the esthetic result of implant therapy is the bone level at the implant site. Clinicians must focus on the 3-D bone-to-implant relationship to establish the basis for an ideal and harmonic soft tissue situation that is stable over a long period. In some situations, missing bone is a limiting factor for esthetics; in others, it is possible to regenerate new bone around implants. As a certain amount of bone resorption occurs around implants as soon as the implant is in contact with the oral environment, the distance between an implant and adjacent tooth, as well as the distance between two implants, is as important as the bone volume on the buccal side of the implant head and in the papillary area, especially for the long-term result. This article discusses the 3-D bone-to-implant relationship and its influence on soft tissue esthetics around implants.

[1]  U. Velden.  Regeneration of the interdental soft tissues following denudation procedures , 1982 .

[2]  H Salama,et al.  The interproximal height of bone: a guidepost to predictable aesthetic strategies and soft tissue contours in anterior tooth replacement. , 1998, Practical periodontics and aesthetic dentistry : PPAD.

[3]  D Buser,et al.  Biologic width around titanium implants. A physiologically formed and stable dimension over time. , 2000, Clinical oral implants research.

[4]  U Grunder,et al.  Stability of the mucosal topography around single-tooth implants and adjacent teeth: 1-year results. , 2000, The International journal of periodontics & restorative dentistry.

[5]  J. Kois,et al.  The restorative-periodontal interface: biological parameters. , 1996, Periodontology 2000.

[6]  J. Wennström,et al.  The peri-implant hard and soft tissues at different implant systems. A comparative study in the dog. , 1996, Clinical oral implants research.

[7]  P I Brånemark,et al.  A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. , 1981, International journal of oral surgery.

[8]  P. Wohrle,et al.  Nobel Perfect esthetic scalloped implant: rationale for a new design. , 2003 .

[9]  D P Tarnow,et al.  The effect of inter-implant distance on the height of inter-implant bone crest. , 2000, Journal of periodontology.

[10]  D Buser,et al.  Biologic width around titanium implants. A histometric analysis of the implanto-gingival junction around unloaded and loaded nonsubmerged implants in the canine mandible. , 1997, Journal of periodontology.

[11]  P. Glantz,et al.  The mucosal attachment at different abutments. An experimental study in dogs. , 1998, Journal of clinical periodontology.

[12]  M. Esposito,et al.  Radiological evaluation of marginal bone loss at tooth surfaces facing single Brånemark implants. , 1993, Clinical oral implants research.

[13]  Kitichai Rungcharassaeng,et al.  Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. , 2003, Journal of periodontology.

[14]  H. F. Morris,et al.  The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. , 2000, Annals of periodontology.

[15]  P. Thomsen,et al.  The soft tissue barrier at implants and teeth. , 1991, Clinical oral implants research.

[16]  U. Grunder,et al.  Implant-supported single tooth replacement in the aesthetic region: a complex challenge. , 1996, Practical periodontics and aesthetic dentistry : PPAD.