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Video Details
Zero Bone Loss Protocol - Part I: Influence of Vertical Soft Tissue Thickness on Crestal Bone Stability

Description:
Crestal bone stability is considered to be important for bone preservation, longevity of implants and to prevent peri-implant tissue recession. Implant placement level is important for bone stability. Mucosal tissue thickness was shown to be the factor having impact on bone stability. It was showed that platform switching does not reduce crestal bone loss, if soft tissues at the implant placement are thin.

Date Added:
12/20/2017

Author(s):

Tomas Linkevicius, DDS, Dip Pros, PhD Tomas Linkevicius, DDS, Dip Pros, PhD
Dr. Tomas Linkevicius has received DDS degree in 2000 in Kaunas University, Lithuania. In 2004 he finished post-graduate program in prosthodontics in Vilnius Universi...
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Online Videos / Surgery / Periodontic Surgery / Zero Bone Loss Protocol - Part I: Influence of Vertical Soft Tissue Thickness on Crestal Bone Stability




Questions & Comments
saadia rehman - (2/6/2018 11:04 PM)

thank you doctor,i would like to ask how much vertical soft tissue thickness is considered as thin ?when we should think that this much soft tissue thickness is safe or may be considered as thin or starting thick?

Lotta Carmelo860 - (1/26/2018 11:54 AM)

The part 2- When

henry salama - (1/25/2018 1:11 PM)

Gerald - I believe that we are at a stage where bone loss should no longer be an expected occurrence. the message is that if the treatment design accounts for the known variables that may influence bone loss, i.e. thin biotype, thin labial bone, biologic remodeling, type of connection, cement, occlusion, hygiene... etc, we can minimize, and in more and more cases, eliminate bone loss.
Tom - I believe that the message is that platform switching protocols alone will not override biological remodeling bone loss in thin tissue environments.
Osama - generally 2mm or more is deemed a minimum thickness of tissue to develop optimum and stable long-term environments.

Gerald Rudick - (1/21/2018 6:28 PM)

Bright young man, nice presentation on the advantages of a thick biotype and platform switching, however, he did not address the issue of perimplantitis and regardless of the tissue type....bone loss will occur. Gerald Rudick dds Montreal, Canada

Tom Cassidy - (1/1/2018 12:36 PM)

Nice presentation. Can we take it that you do not consider biological width a cause for bone loss in thin bio type

Osama Abdel Qader - (12/30/2017 7:05 AM)

Nice presentation of showing the importance of this new parameter... what is the minimum thickness of vertical tissue to call it "Thick Vertical Tissue" ? thank you

ward clemmons530 - (12/26/2017 6:51 PM)

I would imagine that placing an abutment one time and leaving it alone throughout the treatment would also be a factor. Only problem is that you need to use cemented restorations or use some sort of transitional abutment. Very well done. Aciu Labai!

FARHAN DURRANI492 - (12/24/2017 9:53 PM)

great concept .logical

Alberto Miselli - (12/22/2017 7:33 PM)

Excellent presentation with a wide literature review. There are many study, as you said, that don’t take into account the height of the mucosa tissue in the area of implantation before surgery. Many literatures, talking about on the amount of connective tissue from a three-dimensional point of view needs to be revised. We agree that the vascularization and organization of the collagen fibers, especially the circumferential ones, that are supported by a reduced platform, but the key is the biological width that we are going to create after the crown delivery. In my point of view, if the crown-implant system has a more space from crestal bone and sub critical crown, 2 mm at least, where a platform switching at crestal bone level is. Otherwise, In buccal view, the biotype is mandatory to increase the amount of vessel and subsequently a better blood supply. Thank you very much, I enjoyed your lecture. Looking forward for your second part. Sincerely Alberto Miselli

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Crestal bone stability is considered to be important for bone preservation, longevity of implants and to prevent peri-implant tissue recession. Implant placement level is important for bone stability. Mucosal tissue thickness was shown to be the factor having impact on bone stability. It was showed that platform switching does not reduce crestal bone loss, if soft tissues at the implant placement are thin. It is suggested that thin tissues might be thickened during implant placement, thus reducing bone resorbtion. The role of soft tissue thickness is well established in aesthetic treatment. It is known that thin soft tissues present an unfavorable situation for implant placement, crestal bone stability and subsequent prosthetic treatment.

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