The Journal of Contemporary Dental Practice

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2009 | May | Volume 10 | Issue 3

RESEARCH ARTICLE

Carmen Llena, Leopoldo Forner, Pilar Baca

Anticariogenicity of Casein Phosphopeptide-amorphous Calcium Phosphate: A Review of the Literature

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:9] [Pages No:1 - 9]

PDF  |  DOI: 10.5005/jcdp-10-3-1  |  Open Access |  How to cite  | 

Abstract

Aim

This review of the literature examines the role of the natural components of saliva in maintaining tooth mineralization and the role of different casein phosphopeptide amorphous calcium phosphate-based (CPP-ACP) compounds in controlling demineralization/ remineralization and their clinical applications.

Background

A group of peptides, known as CPP, have been shown to stabilize calcium and phosphate preserving them in an amorphous or soluble form known as amorphous calcium phosphate (ACP). Calcium and phosphate are essential components of enamel and dentine and form highly insoluble complexes, but in the presence of CPP they remain soluble and biologically available. This CPP-ACP complex applied to teeth by means of chewing-gum, toothpaste, lozenges, mouth rinses, or sprays is able to adhere to the dental biofilm and enamel hydroxyapatite providing bioavailable calcium and phosphate ions.

Review Results

Significantly high levels of calcium and phosphate have been found in both biofilm and subsurface incipient caries lesions and in lower level demineralization of enamel or dentine surfaces previously treated with CPP-ACP based compounds. When placed on the surface of a tooth with early carious lesions, pastes with CPP-ACP complexes can prevent tooth demineralization and improve enamel remineralization and enhance fluoride activity.

Conclusion

Remineralization of white spot lesions has been achieved clinically by applying pastes based on these compounds, and a similar effect to self-applied fluorides has been observed in reducing the appearance of new caries lesions in patients with xerostomia.

Clinical Significance

Use of CPP-ACP based compounds offers a potential for use in the prevention of dental caries.

Citation

Llena C, Forner L, Baca P. Anticariogenicity of Casein Phosphopeptide-amorphous Calcium Phosphate: A Review of the Literature. J Contemp Dent Pract 2009 May; (10)3:001-009.

RESEARCH ARTICLE

Sara Majidinia, Marjaneh Ghavamnasiri, Hila Hajizadeh, Mohammad Sadegh Namazikhah, Mohammad Javad Moghaddas

Effect of Posts on the Fracture Resistance of Load-cycled Endodontically-treated Premolars Restored with Direct Composite Resin

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:8] [Pages No:10 - 17]

PDF  |  DOI: 10.5005/jcdp-10-3-10  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this study was to investigate the fracture resistance and failure mode of premolars restored with composite resin using various prefabricated posts.

Methods and Materials

Sixty sound maxillary premolars were divided into four equal sized groups. All but the control group received endodontic treatment followed by placement of mesiodistocclusal (MOD) composite restorations (Tetric Ceram) as follows: Group T = no post, Group DT = fiber reinforced composite (FRC) post (DT Light), Group FL = prefabricated metal post (Filpost). The control group (C) had no cavities prepared. After thermal and load cycling, static load was applied at a 30° angle until fracture. Failure modes were categorized as restorable and non-restorable. Data were analyzed using the analysis of variance (ANOVA) and Duncan tests (α = 0.05).

Results

The mean values of fracture loads (N) for all groups were: C (880±258); T (691±239); DT (865±269); and FL (388±167). Statistically significant differences (P<0.05) were observed for all groups except between groups C and DT. The Chi Square test showed failure modes in groups C and DT were mostly restorable. The most non-restorable fractures were observed in group FT.

Conclusion

Intact teeth and the teeth restored with composite and quartz fiber posts had a similar fracture resistance and the failure modes were mostly restorable. The lowest fracture resistance and the most nonrestorable failures were observed in conjunction with metal posts.

Clinical Significance

The results of this in vitro study suggest the use of a quartz fiber post used in conjunction with an MOD composite resin restoration improves fracture resistance in an endodontically treated premolar.

Citation

Hajizadeh H, Namazikhah MS, Moghaddas MJ, Ghavamnasiri M, Majidinia S. Effect of Posts on the Fracture Resistance of Load-cycled Endodontically-treated Premolars Restored with Direct Composite Resin. J Contemp Dent Pract 2009 May; (10)3:010-017.

RESEARCH ARTICLE

Horieh Moosavi, Fathemeh Maleknejad, Nasrin Sarabi, Resa Shahriari, Taybeh Shayankhah

The Effect of Different Adhesive Types and Curing Methods on Microleakage and the Marginal Adaptation of Composite Veneers

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:9] [Pages No:18 - 26]

PDF  |  DOI: 10.5005/jcdp-10-3-18  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this in vitro study was to evaluate the influence of application techniques (with pre-curing vs without pre-curing) for dentin adhesive on microleakage and marginal adaptation of indirect composite veneer restorations.

Methods and Materials

A total-etch bonding system, Excite/Variolink II (EXV), and a self-etching primer system, Panavia F2.0 (PF2), were used in the study. Forty-eight human central incisors were prepared for composite veneer restorations. The teeth were divided into two groups (n=24). For each resin cement, one half of each experimental group included an adhesive pre-cure (PC) with a halogen light source while the other half received no pre-cure (NPC) prior to resin cement insertion. Thus, four experimental groups were created: A (PC+EXV), B (NPC+EXV), C (PC+PF2), and D (NPC+PF2). Veneers made of Tetric Ceram resin composite were cemented using dual-cured resin luting agents. After storage in distilled water at 37°C for 24 hours, the teeth were prepared for marginal leakage. Two samples of each group were selected at random for scanning electron microscopic (SEM) observation and evaluation of marginal adaptation at 1050x magnification. Data were analyzed using the Kruskal-Wallis and Mann-Whitney tests (Ð <0.05).

Results

The highest and lowest microleakage values were observed in dentinal margins of groups B and A, respectively. Dentin margins opposite to enamel margins had a significant difference in microleakage values of PC and NPC groups (P<0.05). The influence of the adhesive pre-cure was more pronounced than the type of resin cement used. No adhesive layer was visualized for the adhesives used without employing the pre-curing step.

Conclusion

The effect of pre-cured adhesives was not material specific. The pre-cured adhesives showed the best resistance to dye penetration although the film thickness of these luting agents was only slightly increased.

Clinical Significance

Different curing methods (with pre-curing/without pre-curing) regardless of total-etch or self-etch adhesive systems influenced microleakage and the marginal adaptation, especially dentin margins of indirect composite veneers.

Citation

Maleknejad F, Moosavi H, Shahriari R, Sarabi S, Shayankhah T. The Effect of Different Adhesive Types and Curing Methods on Microleakage and the Marginal Adaptation of Composite Veneers. J Contemp Dent Pract 2009 May; (10)3:018-026.

RESEARCH ARTICLE

Ramin Mosharraf, Bahram Soleimani, Mehdi Sanaee-Nasab

A Comparison of Two Methods of Removing Zinc Oxide-eugenol Provisional Cement Residue from the Internal Surfaces of Cast Restorations

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:8] [Pages No:27 - 34]

PDF  |  DOI: 10.5005/jcdp-10-3-27  |  Open Access |  How to cite  | 

Abstract

Aim

Remnants of provisional cement on the internal surface of cast restorations can have an adverse effect on the performance of the definitive luting agent. The purpose of this study was to evaluate the effect of eugenolcontaining temporary cement removal by an ultrasonic or an organic solvent on the retentive strength of metallic rings cemented to amalgam cores using zinc phosphate cement.

Methods and Materials

A total of 36 cylindrical amalgam cores measuring 5.9×6 mm were made by condensing amalgam in brass molds for use in this in vitro study. Thirty-six cylindrical spaces measuring 6×6 mm were machined in the center of cast rods of Rexillium III alloy to create simulated retainers. The amalgam cores were divided into two groups and provisionally cemented in these cylindrical spaces (retainers) using zinc oxide–eugenol cement. After separation of the cores from the retainers, one group was cleaned with an ultrasonic cleaning device with water and the other group was cleaned with Solitine organic solvent. All specimens were then cemented with zinc phosphate cement and the samples were stored at 100% humidity in a 37°C water bath after which they were tested with a DARTEK testing machine at a 0.02 cm/minute cross head speed. The data were analyzed using the Independent t-test.

Results

The statistical analysis revealed a significant difference between the two groups (p<0.0005) with the ultrasonic group having significantly higher separation forces than the Solitine group.

Conclusion

Specimens treated with the ultrasonic cleaner showed a higher mean separation force (282.2 MPa) than the solvent group (439.5 MPa).

Clinical Significance

Despite the convenience of using an organic solvent for cleaning the internal surface of cast restorations, the ultrasonic cleaning method is more effective for removing zinc-oxide temporary cement.

Citation

Mosharraf R, Soleimani B, Sanaee-Nasab M. A Comparison of Two Methods of Removing Zinc Oxide-eugenol Provisional Cement Residue from the Internal Surfaces of Cast Restorations. J Contemp Dent Pract 2009 May; (10)3:027-034.

RESEARCH ARTICLE

Özgür Er, Burak Sagsen, Duygu Esel, Gülhan Yagmur, Yasemin Altintop

In vitro Pharmacodynamic Activities of Root Canal Sealers on Enterococcus faecalis

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:8] [Pages No:35 - 42]

PDF  |  DOI: 10.5005/jcdp-10-3-35  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this study was to evaluate the antimicrobial efficiency of different root canal sealers on Enterococcus faecalis (E. Faecalis) at different time intervals.

Methods and Materials

All sealers used were mixed according to the manufacturers’ instructions then 75 mg of each sealer was added to different sterile tubes and evaluated at 20 minutes, 24 hours, 7 days, and 30 days. A time-kill assay (TKA) was used to determine the antimicrobial efficiency of the sealers.

Results

AH Plus and MCS were found to be bactericidal at 20 minutes and 24 hours, but only MCS was bactericidal at the seventh and thirtieth days. Epiphany and Sealapex were found to be bacteriostatic at the seventh and thirtieth days but indifferent at 20 minutes and 24-hours. MCS and AH Plus were both found to be bactericidal in freshly mixed samples, but only MCS was bactericidal at longer time periods. Epiphany Sealer and Sealapex were found to be bacteriostatic at longer time periods but indifferent at 20 minutes and 24 hours.

Conclusion

The antibacterial effect of MCS was greater than the other sealers evaluated.

Clinical Significance

Sealers containing eugenol and epoxy resin might be preferable due to their antibacterial effect.

Citation

Sagsen B, Er O, Esel D, Yagmur G, Altintop Y. In vitro Pharmacodynamic Activities of Root Canal Sealers on Enterococcus faecalis. J Contemp Dent Pract 2009 May; (10)3:035-042.

RESEARCH ARTICLE

Naser Asl Aminabadi, Ramin Mostofi Zadeh Farahani

The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:8] [Pages No:43 - 50]

PDF  |  DOI: 10.5005/jcdp-10-3-43  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of the study was to evaluate the effect of cooling the soft tissue of injection sites on the pain perceptions of pediatric patients during the administration of local anesthesia for routine dental procedures.

Methods and Materials

A total of 160 children aged 5-6 years were included in the present study. On a random basis, the subjects were allocated to the without ice pretreatment (WIP) group (topical anesthesia + counterstimulation + distraction) or the ice pretreatment (IP) group (cooling + topical anesthesia + counterstimulation + distraction). During the administration of an inferior alveolar nerve block, the children's behavior was assessed using the sound, eye, and motor (SEM) scale. The statistical analysis of data was performed based on the analysis of variance (ANOVA).

Results

There were no significant differences within the groups between the values of the sound, eye, and motor components for either the WIP or the IP groups (P>0.05). All three components of the SEM in the IP group were consistently lower than the WIP group (P<0.05). Moreover, the SEM value for the WIP group surpassed the IP group (P<0.05).

Conclusions

Cooling the site of infiltration block prior to the injection of local anesthesia significantly reduced the pain perceived during injection of local anesthetic agent in pediatric patients.

Clinical Significance

Pre-cooling of the soft tissues of an injection site prior to the administration of a local anesthetic can minimize the discomfort and anxiety associated with the injection procedure and facilitates the management of pediatric patients during this phase of a dental procedure.

Citation

Aminabadi NA, Farahani RMZ. The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia. J Contemp Dent Pract 2009 May; (10)3:043-050.

RESEARCH ARTICLE

Anwar Bataineh, Abdalla Hazza'a, Abd-albaset Odat

Angulation of Mandibular Third Molars as a Predictive Factor for Pericoronitis

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:8] [Pages No:51 - 58]

PDF  |  DOI: 10.5005/jcdp-10-3-51  |  Open Access |  How to cite  | 

Abstract

Aim

The aims of this study were to investigate the association between pericoronitis and the angular position, state of eruption, and the depth of impaction of mandibular third molars as well as to compare these findings with similar studies.

Methods and Materials

A total of 242 patients ranging in age from 18 to 41 years of age suffering from pericoronitis were examined. Subjective and objective observations were recorded on a checklist that included the name, age, gender, type of pericoronitis and state of eruption, position of the affected tooth for each patient as well as any radiographic changes in the mandibular third molars.

Results

The peak age for the occurrence of pericoronitis was in the 21-25 year-old age group. The soft tissues adjacent to vertically inclined, partially erupted mandibular third molars at the level of or above the occlusal plane were the most commonly affected. There was a statistically significant association between radiographic changes and the mesioangular position of the tooth (p<0.002) and the age group of the subject (p=0.004), but the association was not statistically significant between the gender of the subject, type of pericoronitis, state of eruption, and depth of impaction.

Conclusion

The soft tissues adjacent to vertically inclined, partially erupted mandibular third molars were more frequently affected by pericoronitis than teeth that are soft tissue impacted or erupted. Mesioangular erupted third molars were the teeth most frequently associated with bone loss.

Clinical Significance

The soft tissues at highest risk of developing pericoronitis are those adjacent to mandibular third molars that are partially erupted, in a vertical position, and erupted to the level of or above the occlusal plane.

Citation

Hazza'a A, Bataineh A, Odat A. Angulation of Mandibular Third Molars as a Predictive Factor for Pericoronitis. J Contemp Dent Pract 2009 May; (10)3:051-058.

RESEARCH ARTICLE

Omid Savabi, Farahnaz Nejatidanesh, Elham Peimannia

Effect of Labial Frenum Notch Size and Palatal Vault Depth on Stress Concentration in Maxillary Complete Dentures: A Finite Element Study

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:8] [Pages No:59 - 66]

PDF  |  DOI: 10.5005/jcdp-10-3-59  |  Open Access |  How to cite  | 

Abstract

Aim

Fracture is a common cause of acrylic resin denture failure due to crack development in a site of excessive concentration of stress in the denture. The purpose of this study was to evaluate the effect of labial frenum notch size and palatal depth on stress concentration in maxillary complete dentures.

Methods and Materials

Three-dimensional finite element models of maxillary complete dentures with different palatal vault depths (shallow, medium, and deep) and different frenum notch sizes (small, medium, and large) were constructed. The stress concentration was analyzed using Nastran software and displayed in terms of von Mises stress generated under two conditions: dropping on a hard flat surface from a standard distance and applying vertical load to the occlusal surface.

Results

The greatest stress concentration was observed in the labial frenum notch. Stress increased with an increase in the size of the labial frenum notch and a decrease in the depth of the palatal vault. The stress concentration in maxillary denture bases was greater when a vertical load was applied compared with dropping the denture on a hard surface from a standard distance.

Conclusion

Using finite element analysis, the presence of a large labial frenum notch and a shallow palatal vault increased the concentration of stress in maxillary complete dentures. Stress concentration in a maxillary denture base is much greater during the application of a vertical load than when dropping the denture on a hard flat surface.

Clinical Significance

The concentration of stress at the tip of a large frenum notch and in a shallow palatal vault could have a weakening effect on the maxillary complete acrylic resin denture base making it more vulnerable to fracture. In this scenario alternative denture base strengthening strategies, such as using a metal framework, should be considered in the fabrication of maxillary complete dentures.

Citation

Nejatidanesh F, Peimannia E, Savabi O. Effect of Labial Frenum Notch Size and Palatal Vault Depth on Stress Concentration in Maxillary Complete Dentures: A Finite Element Study. J Contemp Dent Pract 2009 May; (10)3:059-066.

RESEARCH ARTICLE

Valentim Adelino Ricardo Baräo, Wirley Gonçalves Assunção, Claudia Misue Kanno, Célia Tomiko Matida Hamata Saito, Juliana Aparecida Delben

Overdenture as a Restorative Option for Hypocalcified-hypoplastic Amelogenesis imperfecta: A Case Report

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:7] [Pages No:67 - 73]

PDF  |  DOI: 10.5005/jcdp-10-3-67  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this report is to describe the restorative treatment of an 18-year-old patient diagnosed with autossomal recessive hypocalcified-hypoplastic amelogenesis imperfect (AI).

Background

Esthetic and functional rehabilitations in AI cases are challenging and should consider individual aspects, such as age, socioeconomic status, AI type, and intraoral condition.

Report

AI was diagnosed in an 18-year-old patient.

Summary

Considering the short length of crowns and roots, patient life expectancy, minimal invasiveness, amount of treatment time required, and lower costs, oral rehabilitation with overdentures provided an adequate functional and esthetic rehabilitation of the patient.

Clinical Significance

This report demonstrated overdentures to be a viable, relatively inexpensive, and noninvasive treatment choice of a patient with AI with concerns about treatment longevity, invasiveness, cost, esthetics, and long-term maintenance.

Citation

Assunção WG, Barão VAR, Kanno CM, Saito CTMH, Delben JA. Overdenture as a Restorative Option for Hypocalcified-hypoplastic Amelogenesis imperfecta: A Case Report. J Contemp Dent Pract 2009 May; (10)3:067-073.

RESEARCH ARTICLE

Andac Barkin Bavbek, Orhan Murat Dogan, Tamer Yilmaz, Arife Dogan

The Role of Saliva in Dental Erosion and a Prosthetic Approach to Treatment: A Case Report

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:7] [Pages No:74 - 80]

PDF  |  DOI: 10.5005/jcdp-10-3-74  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this report is to describe the relationship of some salivary parameters to dental erosion resulting from excessive citric acid consumption and present a description of a prosthetic approach used to restore the damaged dentition of a patient with severe erosion.

Background

The high consumption of dietary sources of acids can lead to erosion or the excessive wear of dental hard tissues. Erosion may be modified by salivary parameters such as flow rate, pH, and buffering capacity. Porcelain-fused-to-metal (PFM) restorations and composite resin veneers can be used successfully to restore impaired esthetics and eliminate tooth hypersensitivity in such cases.

Results

A 37-year-old woman with a history of excessive lemon consumption presented with a complaint of tooth hypersensitivity and the poor appearance of her dentition due to erosion. Stimulated and unstimulated salivary samples of the patient were evaluated for flow rate, pH, and buffering capacity before and after treatment. The pre-treatment values were found to be higher than post-treatment values. Stimulated samples showed an increase of salivary flow rate, pH, and buffering capacity. The measured parameters put forth the defensive potential of saliva against the acidic diet, and the salivary flow rate and buffering capacity decreased after reducing acidic consumption. The excessively eroded teeth were restored using PFM restorations whereas the superficially eroded teeth were restored with composite resins.

Summary

The introduction of acidic foods, beverages, or other agents can exceed the natural buffering capacity of saliva. The result is a lowering of the pH of the oral environment which can lead to erosion of enamel and dentin. Loss of tooth structure due to erosion can compromise the esthetics of the dentition and lead to hypersensitivity of the teeth. Teeth damaged by erosion can be successfully restored by composite resin or porcelain restorations and esthetics and function of dentition can be improved.

Clinical Significance

This report is a profound example of how the over consumption of acidic agents affect not only dental tissues but also the chemical balance of the oral environment as well as the oral habitat.

Citation

Bavbek AB, Dogan OM, Yilmaz T, Dogan A. The Role of Saliva in Dental Erosion and a Prosthetic Approach to Treatment: A Case Report. J Contemp Dent Pract 2009 May; (10)3:074-080.

RESEARCH ARTICLE

Shilpa Kolhatkar, Leyvee Cabanilla, Monish Bhola

Inadequate Vertical Bone Dimension Managed by Bone-added Osteotome Sinus Floor Elevation (BAOSFE): A Literature Review and Case Report

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:8] [Pages No:81 - 88]

PDF  |  DOI: 10.5005/jcdp-10-3-81  |  Open Access |  How to cite  | 

Abstract

Aim

The purpose of this report is to provide a brief literature review of the bone-added osteotome sinus floor elevation (BAOSFE) procedure and to present a case utilizing this technique.

Background

Implant placement in the posterior maxillary region is often compromised due to anatomic limitations. In clinical situations where there is inadequate vertical bone dimension, the BAOSFE technique can be employed to increase bone height and allow placement of implants with an appropriate length dimension.

Case Report

A case of a 60-year-old female with inadequate vertical bone dimension in the area of an extracted #13 is presented. The BAOSFE technique was performed which facilitated the placement of a 3.75 X 13 mm implant.

Summary

Anatomic limitations such as inadequate vertical bone dimension in the posterior maxillary region may result in placement of shorter implants. Sinus floor elevation (SFE) procedures using a crestal approach such as the BAOSFE, in certain selected cases, can effectively and predictably increase bone height.

Clinical Significance

The BAOSFE technique is an excellent procedure that can overcome limitations associated with the posterior maxillary region.

Citation

Kolhatkar S, Cabanilla L, Bhola M. Inadequate Vertical Bone Dimension Managed by Bone-added Osteotome Sinus Floor Elevation (BAOSFE): A Literature Review and Case Report. J Contemp Dent Pract 2009 May; (10)3:081-088.

RESEARCH ARTICLE

Ilser Turkyilmaz, Jose Carlos Suarez

An Alternative Method for Flapless Implant Placement and an Immediate Provisional Crown: A Case Report

[Year:2009] [Month:May] [Volume:10] [Number:3] [Pages:7] [Pages No:89 - 95]

PDF  |  DOI: 10.5005/jcdp-10-3-89  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this case report is to present a description of bone mapping as an alternative method to determine the dimensions of bone prior to placement of a flapless implant and an immediate provisional crown.

Background

The use of a temporary removable partial denture (RPD) or “flipper” during healing following an extraction is not acceptable for some highly demanding patients. As a result, flapless implant placement is gaining popularity because it offers some advantages such as less bleeding, less swelling, and the protection of soft tissue contours.

Case Report

A 65-year-old woman missing a maxillary left lateral incisor was treated using flapless implant placement and an immediate provisional acrylic crown. Under local anesthesia, the bone anatomy was mapped by inserting a standard periodontal probe in the gingiva. By using the recorded measurements, the thickness of soft tissue was removed from the cast. A surgical guide based on this adjusted model was fabricated prior to surgery. The guide was seated on the teeth when actual surgery was performed to facilitate bone drilling and then the implant was placed. Utilizing the previously fabricated acrylic tooth index, the temporary acrylic crown was fabricated on the adjusted temporary metal abutment and delivered to the patient the same day.

Summary

In this case report the missing maxillary left lateral tooth was restored using flapless implant placement and an immediate provisional single crown. The dimension of the bone at the implant recipient area was determined by an alternative bone mapping method.

Clinical Significance

This case report suggests the use of flapless implant placement using the bone mapping method and immediate provisional crowns for single crowns when esthetics are a high priority and preserving ideal soft tissue contours and papillary heights are critical.

Citation

Turkyilmaz I, Suarez JC. An Alternative Method for Flapless Implant Placement and an Immediate Provisional Crown: A Case Report. J Contemp Dent Pract 2009 May; (10)3:089-095.

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