Clinical outcomes of dental implants in patients with and without history of periodontitis: A 20-year prospective study

Periodontal conditions of teeth adjacent to dental implants with or without peri-implantitis after non-surgical therapy in patients treated for periodontitis: A retrospective study

OBJECTIVES

To retrospectively assess the periodontal conditions of teeth adjacent to and contralateral to implants presenting with or without peri-implantitis, following non-surgical periodontal and peri-implant mechanical therapy.

MATERIALS AND METHODS

One hundred and one patients with existing dental implants and chronic periodontitis, who underwent non-surgical periodontal and peri-implant mechanical therapy, were included. The periodontal clinical probing depth (PPD), gingival recession (GR), and bleeding on probing (BOP) were recorded at six sites around the adjacent (Adj-) teeth and the contralateral (CL-) teeth relative to the implant. The potential factors influencing the periodontal conditions of 316 teeth were analyzed by multivariate linear regression models with generalized estimating equation methods and α = .05.

RESULTS

The PPD of Adj-teeth was significantly different from that of CL-teeth before and after non-surgical therapy when the implant was diagnosed with peri-implantitis (PI) (p < .05). The PPD of teeth was shown to be affected by neighboring implants diagnosed with peri-implantitis (β = .825 mm, p < .001), teeth adjacent to implants (β = .245 mm, p = .004), a molar tooth type (β = .435 mm, p = .019), and non-surgical therapy (β = -.522 mm, p < .001).

CONCLUSIONS

Relatively compromised periodontal conditions at Adj-teeth after non-surgical PI therapy were detected. Therefore, clinicians should be aware that non-surgical therapy may be less successful at teeth adjacent to implants with PI.

Clinical and radiographic outcomes of implant-supported fixed prostheses with cantilever extension in anterior mandible: A retrospective study

OBJECTIVES

The objective of this study is to analyze the clinical and radiographic outcomes of implant-supported fixed protheses with cantilever extensions (ISFPCs) in the partially edentulous anterior mandible.

MATERIALS AND METHODS

Patients who received anterior mandible implant restoration between January 2016 and December 2021 were included. Patients with two, three, or four continuous missing teeth receiving adjacent implant supported single-unit crowns (ISSCs), ISFPCs, implant-supported fixed protheses without cantilever extensions (ISFPNs) were divided into groups: ISSC+ISSC, ISFPC, ISSC+ISFPC, three-unit ISFPN, ISFPC+ISFPC, or four-unit ISFPN, respectively. We recorded and evaluated survival rates, mechanical and biological complications, peri-implant marginal bone loss (MBL), esthetic outcomes, and patient perceptions. Statistical analysis was performed using linear mixed models (LMM).

RESULTS

The study included 87 patients and 152 implants. No implant loss occurred during an average follow-up of 3.48 ± 1.85 years (range: 1-7 years). According to LMM models, prosthetic type had a statistically significant impact on MBL during follow-up periods, in favor of the ISFPC and ISFPC+ISFPC groups (0.16 ± 0.48 mm vs. 0.51 ± 0.49 mm, p = .034; 0.22 ± 0.49 mm vs. 0.60 ± 0.62 mm, p = .043, respectively). Mechanical and biological complications were relatively low and comparable. The four-unit ISFPC group had higher subjective esthetic scores compared with the ISSC+ISSC group (98.6 vs. 83.8, p < .05), and patients in the ISFPC+ISFPC group expressed greater satisfaction with cleanability than the ISFPN group (98.8 vs. 80.6).

CONCLUSION

ISFPCs offer a highly predictable treatment option in the anterior mandible, characterized by high survival rates, and comparable complication rates, peri-implant bone stability and esthetics to adjacent ISSCs or ISFPNs.

Cementum and enamel surface mimicry influences soft tissue cell behavior

AIMS

To test whether titanium surface roughness disparity might be used to specifically guide the behavior of gingiva fibroblasts and keratinocytes, thereby improving the quality of soft tissue (ST) integration around abutments.

METHODS

Titanium discs resembling the roughness of enamel (M) or cementum (MA) were created with normal or increased hydrophilicity and used as substrates for human fibroblasts and keratinocytes. Adhesion and proliferation assays were performed to assess cell-type specific responses upon encountering the different surfaces. Additionally, immunofluorescence and qPCR analyses were performed to study more in depth the behavior of fibroblasts and keratinocytes on MA and M surfaces, respectively.

RESULTS

While enamel-like M surfaces supported adhesion, growth and a normal differentiation potential of keratinocytes, cementum-emulating MA surfaces specifically impaired the growth of keratinocytes. Vice versa, MA surfaces sustained regular adhesion and proliferation of fibroblasts. Yet, a more intimate adhesion between fibroblasts and titanium was achieved by an increased hydrophilicity of MA surfaces, which was associated with an increased expression of elastin.

CONCLUSION

The optimal titanium implant abutment might be achieved by a bimodal roughness design, mimicking the roughness of enamel (M) and cementum with increased hydrophilicity (hMA), respectively. These surfaces can selectively elicit cell responses favoring proper ST barrier by impairing epithelial downgrowth and promoting firm adhesion of fibroblasts.

Immediate versus delayed implant placement of novel fully tapered tissue-level implants - A retrospective multicenter clinical study

OBJECTIVES

To compare the clinical and radiological outcomes of novel fully tapered tissue-level implants in immediate implant placement (type 1) versus late implant placement (type 4) for the first time.

MATERIALS AND METHODS

For this clinical study, 318 fully tapered tissue-level implants in 65 patients were inserted immediately (n = 68 implants) or late (n = 250 implants) in two different centers. Implant survival and success rates and marginal bone levels were analyzed.

RESULTS

After a mean follow-up of 12.0 ± 5 months, implant survival rates were 97.8% for all implants. No statistically significant difference in implant survival rates between type 1 and type 4 could be detected (98.5% vs 97.6%, HR 0.70, 95%-CI 0.084-5.81). Neither for implant length (HR 0.53, 95%-CI 0.055-5.08) nor for implant width (HR 0.27, CI 0.028-2.55), a significant influence on implant survival could be detected. Type of used biomaterial for filling the gap and immediate loading showed no effect on implant survival. Mean marginal bone loss was 0.02 ± 0.05 mm for type 1 and 0.04 ± 0.1 for type 4.

CONCLUSIONS

Within the limitations of this retrospective study and the short follow-up, the results demonstrated comparable high survival and success rates and stable marginal bone levels for type 1 and type 4 placement of this novel tissue-level implant (no clinical trial registration as retrospective study design).

History of periodontitis as a risk factor for implant failure and incidence of peri-implantitis: A systematic review, meta-analysis, and trial sequential analysis of prospective cohort studies

INTRODUCTION

Dental implants are widely employed as dependable replacements for lost teeth. However, it is crucial to establish, solely through prospective cohort studies, whether a history of periodontitis indeed constitutes a significant risk factor for implant failure.

METHODS

A systematic literature search was conducted in October 2022 in several electronic databases with subsequent manual updates. Only original prospective cohort studies evaluating the implant (loss) rate ≥1 year after implant loading were included. Logarithmic risk ratio and weighted mean differences were calculated. Study results were summarized using random effects meta-analyses evaluated by trial sequential analyses. The Newcastle-Ottawa scale evaluated study bias and the GRADE approach assessed the certainty/quality of the evidence.

RESULTS

A total of 14 publications reporting on 12 prospective cohort studies were included. Low evidence certainty/quality evidence due to the absence of randomized clinical trials revealed significantly greater odds of failure in patients with a history of periodontitis at follow-ups both after ≤5 years (RR = 1.62; 95% CI: 1.71-2.37; p = 0.013) and >5 years (RR = 2.26; 95% CI: 1.12-4.53; p = 0.023). The incidence of peri-implantitis (RR = 4.09; 95% CI: 1.93-8.58; p < 0.001) and the weighted mean (WM) of marginal bone loss (WM difference = 0.75 mm; 95% CI: 0.18-1.31; p < 0.05) were statistically significantly greater in the periodontally compromised group, whereas there was no significant difference between the two groups for peri-implant probing depth.

CONCLUSION

A history of periodontitis can be considered a significant risk factor for incident implant failure, peri-implantitis, and greater marginal bone loss.

Implant and implant restoration trends among adults 50 years and older in the United States, National Health and Nutrition Examination Survey 1999-2020

BACKGROUND

Dental implants are an important treatment option in contemporary clinical dentistry. The objective of this study was to determine trends in the prevalence of dental implants and implant-supported restorations in adults 50 years and older across demographic groups over a 20-year period.

METHODS

The authors used data from the National Health and Nutrition Examination Survey collected during 1999-2004, 2009-2014, and 2015-2020 for analyses. The authors used data from 2011 through 2020 to analyze implant-supported restoration trends. Participants 50 years or older were included in the study analytic sample. The primary outcome was the presence of dental implants and implant-supported restorations. Covariates assessed included dentition status, age, sex, race and ethnicity, education, poverty status, and smoking status. The authors used population estimates, weighted percentages, SEs, and logistic regression models for study analyses.

RESULTS

There was a total of 17,114 adults from 1999 through 2020 and 11,292 adults from 2011 through 2020 meeting the inclusion criteria. The prevalence (SE) of at least 1 dental implant increased over time, from 1.3% (0.22%) in 1999-2004 to 8.4% (0.68%) in 2015-2020. In general, those who were non-Hispanic Black, experiencing poverty, and had less than a college education were less likely to have implants than their counterparts.

CONCLUSIONS

Although the overall prevalence of implants has increased over time, disparities in prevalence were observed among certain demographic groups.

PRACTICAL IMPLICATIONS

The use of dental implants in clinical dentistry has increased over time. Future research and policy initiatives could help address disparities in implant prevalence.

Clinical outcomes and risk factor analysis of dental implants inserted with lateral maxillary sinus floor augmentation: A 3- to 8-year retrospective study

AIM

To evaluate the 3- to 8-year outcomes of dental implants placed with lateral sinus floor augmentation (LSFA) and to identify factors affecting implant survival.

MATERIALS AND METHODS

This retrospective study was performed by screening all implants placed with LSFA procedures, which were conducted between January 2012 and December 2016. Subantral bone gain (SABG) and apical bone height (ABH) were assessed using panoramic radiographs. The cumulative survival rate of implants was analysed using life-table analysis and Kaplan-Meier survival curves. The influential risk factors affecting survival were assessed using univariate log-rank tests and multivariable mixture cure rate model. Implant complications were recorded.

RESULTS

Based on the established criteria, a total of 449 patients (760 implants) were included in this study. In the 3- to 8-year follow-up (mean ± SD, 5.81 ± 1.33 years), 15 implants in 14 patients failed, with a CRS of 96.81% on an implant basis and 95.07% on a patient basis. A history of periodontitis and poor compliance with supportive periodontal treatment was associated with a significantly higher risk of implant failure at both implant and patient levels. Significant decreases in ABH occurred during each yearly interval except for 3 years. A similar trend has been observed for SABG at 1, 2, 6 and 8 years. The total complication rate was 31.84% on implant basis, with peri-implant mucositis (21.58%) being the most frequent biologic complication and porcelain cracking (5.00%) being the most common technical complication.

CONCLUSIONS

Implant with LSFA is a reliable treatment option in atrophic maxilla. A history of periodontitis without regular supportive periodontal treatment was identified as a predictor for implant failure. Slight but significant shrinkage of vertically augmented bone can be observed after implant placement.

BSP Implementation of Prevention and Treatment of Peri-implant Diseases - The EFP S3 Level Clinical Practice Guideline

OBJECTIVES

to adapt the supranational European Federation of Periodontology (EFP) Prevention and Treatment of Peri-implant Diseases - The EFP S3 Level Clinical Practice Guideline for UK healthcare environment, taking into account a broad range of views from stakeholders and patients.

SOURCES

This UK version, based on the supranational EFP guideline [1] published in the Journal of Clinical Periodontology, was developed using S3-level methodology, combining assessment of formal evidence from 13 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 55 clinical recommendations for the Prevention and Treatment of Peri-implant Diseases, based on the classification for periodontal and peri-implant diseases and conditions [2].

METHODOLOGY

The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework, following the S3-process, the underlying evidence was updated and a representative guideline group of 111 delegates from 26 stakeholder organisations was assembled into four working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly.

RESULTS AND CONCLUSION

Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline for the Prevention and Treatment of Peri-implant Diseases was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the UK healthcare community including the public.

CLINICAL SIGNIFICANCE

The S3-level-guidelines combine evaluation of formal evidence, grading of recommendations and synthesis with clinical expertise of a broad range of stakeholders. The international S3-level-guideline was implemented for direct clinical applicability in the UK healthcare system, facilitating a consistent, interdisciplinary, evidence-based approach with public involvement for the prevention and treatment of peri-implant diseases.

Immediately placed implants using simvastatin and autogenous tooth graft combination in periodontally compromised sites: a randomized controlled clinical trial

OBJECTIVES

The present study aimed to assess clinically and radiographically the usage of autogenous tooth bone graft (ATBG) combined with and without Simvastatin (SMV) around immediately placed dental implants in periodontally compromised sites.

METHODS

Thirty-nine patients required a single extraction of periodontally compromised tooth were divided into three groups (13 patients each). Group I received immediate implant placement (IIP) without grafting. Group II received IIP with ATBG filling the gap around IIP. Group III received SMV gel mixed with ATBG around IIP. Radiographic changes were reported at the baseline, 6-, and 12-months post-surgery.

RESULTS

All implants achieved the success criteria with no complications. At 6- and 12-months post-surgery, group III showed a statistically lower mean ridge width loss compared to Group I and Group II (P < .001). Group II revealed less reduction in the mean alveolar ridge width compared to group I (P < .001). Group III showed a statistically significantly less MBL loss than group I and group II (P < .001). All groups showed a statistically significant increase in BD gain compared to baseline (P < .001). Group III showed statistically significant high BD compared to group II (P < .001). Group II showed statistically significantly higher mean BD gain than that of group I (P < .001).

CONCLUSION

SMV combined with ATBG boosts the hard tissue parameters around dental implants over ATBG alone. Clinical trial registration was on August 1, 2021 (NCT04992416).

CLINICAL RELEVANCE

ATBG with SMV in periodontally compromised sites could improve implant osseointegration and promote favorable changes in peri-implant tissues.

Patient-reported outcomes following dental implant rehabilitation according to reason for missing teeth: A survey from a Norwegian population 8 years following treatment

AIM

The aim of this study was to assess patient-reported outcomes (PROs) 8 years after dental implant rehabilitation in a sample with tooth loss due to periodontitis (TLP) and a sample with missing teeth for other reasons (MTOR).

MATERIALS AND METHODS

The Norwegian National Insurance Scheme registry of subsidized dental implant therapy was searched, and patients (n = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire. PROs were described by relative frequencies, and the TLP and MTOR subsamples were compared using chi-square test. Multiple linear regression analyses were used to investigate variables potentially predicting PROs.

RESULTS

Of the respondents (n = 1299), more than 90% were partly or fully satisfied with the treatment outcome. Complications were reported by 44.2%. Patients who lost teeth due to periodontitis (n = 784) reported greater oral function improvement and better pre-treatment information, and were more likely to experience complications when compared with patients who lost teeth for other reasons (n = 515). Age, level of education, self-funded cost, pre-treatment information, history of complications and the reason for missing teeth were found to predict PROs.

CONCLUSIONS

In a Norwegian population rehabilitated with dental implants in 2014, satisfaction with the treatment outcome and the aesthetic outcome was high, irrespective of the reason for missing teeth. Self-report of complications and lack of pre-treatment information were the strongest predictors of inferior patient satisfaction and also predicted inferior oral function.

Long-term treatment outcomes of single maxillary buccal peri-implant soft tissue dehiscences: A 10-year prospective study

INTRODUCTION

To evaluate the 10-year clinical outcomes following surgical treatment of shallow isolated peri-implant soft-tissue dehiscences (PSTD) at single tissue level dental implants.

METHODS

The baseline population included 16 patients (16 implants) displaying an isolated peri-implant maxillary buccal soft-tissue dehiscence. The recipient bed was prepared with a minimally-invasive split-thickness flap limited to the buccal aspect to stabilize the tuberosity connective tissue graft (CTG) onto the periosteum. At the end of treatment, patients were enrolled in an individualized supportive peri-implant care (SPC) program. The aesthetic outcome was evaluated on photographs by three clinicians using a visual analog scale (VAS).

RESULTS

SPC during the 10-years proceeded uneventfully in all patients. A total of 12 patients completed the 10-year examination, as 3 patients dropped-out and 1 implant was lost. Complete PSTD coverage was obtained at 7 implant sites (i.e., 58%) while the mean PSTD coverage amounted to 89.6% ± 17.1% without statistically significant differences between 1 and 10 years (p > 0.05). Stable peri-implant parameters (i.e., PD and BoP) and full-mouth scores (i.e., FMPS, FMBS) were recorded throughout the observation period (p > 0.05). The aesthetic improvements obtained in the short-term were maintained up to 10 years.

CONCLUSION

Within their limits, the present results indicate that the proposed surgical technique is a simple and reliable treatment option for the treatment of single maxillary buccal PSTDs in selected cases with positive results up to 10 years in patients under regular SPC (NCT04983758-this clinical trial was not registered prior to participant recruitment).

Prevalence of peri-implantitis after alveolar ridge preservation at periodontitis and nonperiodontitis extraction sites: A retrospective cohort study

INTRODUCTION

Periodontitis is the main indication for dental extraction and often leads to peri-implantitis (PI). Alveolar ridge preservation (ARP) is an effective means of preserving ridge dimensions after extraction. However, whether PI prevalence is lower after ARP for extraction after periodontitis remains unclear. This study investigated PI after ARP in patients with periodontitis.

MATERIALS AND METHODS

This study explored the 138 dental implants of 113 patients. The reasons for extraction were categorized as periodontitis or nonperiodontitis. All implants were placed at sites treated using ARP. PI was diagnosed on the basis of radiographic bone loss of ≥3 mm, as determined through comparison of standardized bitewing radiographs obtained immediately after insertion with those obtained after at least 6 months. Chi-square and two-sample t testing and generalized estimating equations (GEE) logistic regression model were employed to identify risk factors for PI. Statistical significance was indicated by p < 0.05.

RESULTS

The overall PI prevalence was 24.6% (n = 34). The GEE univariate logistic regression demonstrated that implant sites and implant types were significantly associated with PI (premolar vs. molar: crude odds ratios [OR] = 5.27, 95% confidence intervals [CI] = 2.15-12.87, p = 0.0003; bone level vs. tissue level: crude OR = 5.08, 95% CI = 2.10-12.24; p = 0.003, respectively). After adjustment for confounding factors, the risks of PI were significantly associated with implant sites (premolar vs. molar: adjusted OR [AOR] = 4.62, 95% CI = 1.74-12.24; p = 0.002) and implant types (bone level vs. tissue level: AOR = 6.46, 95% CI = 1.67-25.02; p = 0.007). The reason for dental extraction-that is, periodontitis or nonperiodontitis-was not significantly associated with PI.

CONCLUSION

ARP reduces the incidence of periodontitis-related PI at extraction sites. To address the limitations of our study, consistent and prospective randomized controlled trials are warranted.

Tactile misfit detection ability at the implant-abutment interface of internal connection dental implants: an in-vitro study

OBJECTIVE

The aim of this in-vitro study was to investigate the tactile assessment ability at the implant impression-taking stage.

METHODS

Thirty clinicians (18 novices, 12 experts) were included for a tactile fit assessment by using a used/new probe (tip diameter 100 µm/20 µm). Six implant replicas and related impression copings of two internal connection implant systems were used, each with a perfect fit (0 µm) and defined vertical micro gaps of 8, 24, 55, 110 and 220 µm at the interface. Statistical analysis was performed using descriptive methods and non-parametric tests with a focus on specificity (ability to detect perfect fit), sensitivity (ability to detect misfit), and predictive values. P-values <5% were considered statistically significant.

RESULTS

The tactile assessment showed a mean total sensitivity for the Straumann and Nobel Biocare systems of 83% and 80% with a used probe, and 91% and 92% with a new probe, respectively. The mean total specificities were 33% and 20% with a used probe and 17% and 3% with a new probe, respectively. No statistical significance was observed between novice and expert clinicians concerning their tactile assessment ability.

CONCLUSIONS

The ability to detect a perfect fit (specificity) with a probe was very poor for both implant systems and impaired with the use of a new probe. The use of a new probe improved the gap detection ability (sensitivity) significantly at the expense of the specificity. A combination of additional chairside techniques with training and calibration could improve clinicians' ability to correctly assess the fit/misfit at the implant-abutment interface.

Prevalence and risk factors of peri-implant diseases at patient-level: A cross-sectional study in Syria

OBJECTIVES

This research aims to assess the prevalence of peri-implant diseases and to analyze variables of the probable risk at the patient level associated with the occurrence of peri-implant diseases in Syrian patients.

MATERIALS AND METHODS

A cross-sectional study has been carried out on 142 patients with 380 dental implants placed between 2015 and 2021. Patients were invited by phone to return to Damascus University's Periodontology Department for clinical and radiological examination. A descriptive statistical analysis was implemented for the prevalence of peri-implant diseases at the level of the patients. Also, the peri-implant diseases' factors of risk were determined by the multivariate analytical model.

RESULTS

The prevalence rate of peri-implant mucositis and peri-implantitis in patients was 58.5% and 25.4%, respectively. Peri-implant disease is associated with multivariate risk indices, gender female (peri-implant mucositis [OR = 0.269; 95% CI: 0.131-0.552] and peri-implantitis [OR = 0.561; 95% CI: 0.561-0.216]), diabetes (peri-implant mucositis [OR = 3.4; 95% CI: 1.73-12.73]), periodontitis (peri-implant mucositis [OR = 2.409; 95% CI: 1.760-2.613], peri-implantitis [OR = 10.445; 95% CI: 4.097-26.629]).

CONCLUSIONS

Peri-implant diseases are common in the Syrian community. Several patient-level variables (gender female, diabetes, and periodontitis) are associated with peri-implant disease.

The effect of reconstructive techniques as treatment modality for peri-implant osseous defects - a systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review is to compare conventional peri-implant flap surgery and reconstructive surgical techniques regarding evidence of remission from peri-implantitis.

MATERIAL AND METHODS

Searches were made among randomized controlled trials evaluating clinical aspects and the changes in marginal bone level before and after surgical treatment of peri-implantitis, with and without bone substitute.

RESULTS

Nine published articles and 442 patients were eligible for inclusion in the study. Reconstructive techniques exhibited a greater extent of defect fill than conventional surgical techniques alone. No significant differences could be found for clinical measures of peri-implant disease (bleeding on probing and reduction of probing depth) from baseline to the 12-month follow-up.

CONCLUSIONS

With regards to the clinical measures of disease, our review shows that there are no differences between open flap debridement and regenerative surgery. From an esthetic standpoint, it may however be that regenerative measures may lead to improvement but further publications with this focus will be necessary to verify this.

The importance of soft tissue condition in bone regenerative procedures to ensure long-term peri-implant health

Bone regenerative procedures have been widely proved to be a reliable treatment option to re-create the ideal pre-implant clinical conditions. Nevertheless, these techniques are not free from post-operative complications which might result in implant failure. Consequently, as demonstrated by the increasing recently published evidence, a careful pre- and intra-operative flap evaluation to ensure an ideal and hermetic tension-free wound closure is of paramount importance to successfully treat bony defects. In this respect, several surgical interventions mainly aimed to increase the amount of keratinized mucosa either to allow an optimal healing after a reconstructive procedure or to establish an optimal peri-implant soft tissue seal have been proposed. The present review summarizes the level of evidence on the surgical clinical aspects which have an impact on the soft tissue handling associated with bone reconstructive procedures and on the importance of soft tissue conditions to enhance and maintain peri-implant health in the long-term.

Clinical and radiographic outcomes of implant-supported zirconia fixed dental prostheses with cantilever extension: A proof-of-principle study with a follow-up of at least 1 year

OBJECTIVES

To test the reliability of full zirconia implant-supported fixed dental prostheses with cantilever extension (FDPCs) after at least 1 year of function.

MATERIALS AND METHODS

Thirty-five patients in need of implant-supported single unit crowns (SUC) and FDPCs in posterior areas were enrolled. After implant placement, patients were rehabilitated with screw-retained full-zirconia FDPCs. Implant survival rate, pocket probing depth (PPD), presence/absence of bleeding on probing (BoP), and presence/absence of mechanical/technical complications were recorded. Mesial and distal radiographic marginal bone levels (mBLs) from baseline (i.e., recall appointment 3-6 months after implant loading [T0]) to the follow-up examination (i.e., latest recall appointment after at least 12 months after T0 [T1]), were calculated.

RESULTS

Thirty patients with 34 FDPCs (31 SUCs and 3 FDPs) supported by 37 implants were available for analysis after a mean loading time of 2.6 ± 1.5 years (range: 13-87 months). No implants were lost. MBLs and mean PPD values did not change statistically significantly from T0 to T1 from 0.92 mm ± 0.42 to 0.96 mm ± 0.38 (95% CI: -0.07/0.17; p = .418) and from 2.99 mm ± 0.70 to 3.27 mm ± 0.71 (95% CI: -0.11/0.68; p = .25) respectively. Peri-implant mucositis was diagnosed in 22 cases. Screw-loosening and zirconia chipping occurred 1× in 4 patients.

CONCLUSION

Within the limitations of the present proof-of-principle study, the use of full-zirconia FDPCs in posterior areas seems a valid and safe short-term treatment option.

Root-analogue implants compared to forced orthodontic extrusion: a retrospective analysis of clinical, radiological and esthetic outcomes after restoration

OBJECTIVES

To assess clinical, radiological and esthetic outcomes of restorations supported by root-analogue implants (RAIs) or roots of severely damaged teeth after forced orthodontic extrusion (FOE).

MATERIALS AND METHODS

Clinical data regarding milled one-piece (titanium/zirconia roots and zirconia abutments) RAIs (REPLICATE™ System) and FOE were recorded and retrospectively evaluated for 40 patients by two investigators. Strict inclusion and exclusion criteria were applied. Functional and esthetic outcomes were assessed for n = 20 pre-molars and n = 20 anterior teeth via comparison of radiographic and digital images applying the novel Functional Implant Prosthodontic Score (FIPS). Krippendorff's alpha coefficient was calculated to assess inter-rater reliability. Mann-Whitney-U-Test was used to compare the assessed parameters. Level of significance was set to p < 0.05.

RESULTS

After a mean observation period of 18.4 ± 5.7 months for restorations supported by RAIs and 43.9 ± 16.4 months for restorations after FOE, mean FIPS scores were 9.2/8.8 ± 1.1/1.2 (RAIs) and 7.4/7.7 ± 1.3/1.5 (FOE), respectively. Krippendorff's alpha coefficients did not reveal unacceptable inter-rater reliabilities regarding the investigators and applicability of FIPS. Significant differences were documented when comparing restorations after FOE or supported by RAIs regarding bone loss (p < 0.01), presence of papillae (p < 0.05) and quality and quantity of mucosa (p < 0.02) in favor of FOE.

CONCLUSIONS

Within the main limitations of sample size and the retrospective study design, both concepts seem to provide clinically acceptable results.

CLINICAL RELEVANCE

Bone- and tissue-preserving characteristics regarding the concept of FOE are promising. It could be applicable for socket preservation and subsequent conventional implant placements in an adapted workflow.

Prevalence of Peri-Implant Disease in Patients with Stage III or IV Periodontitis: Results of a Long-Term Follow-Up from a Specialized Periodontal Practice

The aim of this study was to examine the conditions of implants that had been in function for 5-17 years in stage III/IV periodontitis patients of a specialized periodontal practice. There were 83 patients (43 female/40 male, mean age 64.4 (9.69) years), with a total of 213 implants, who participated in the study. Assessments included periodontal and peri-implant probing depths, bleeding and plaque scores, and a radiographic examination. Smoking habits, participation in a supportive care program (SCP), and the Implant Disease Risk Assessment (IDRA) scores were recorded. A total of 44 patients presented with stage III periodontitis, and 39 with stage IV. In all, 85% of patients had adhered to regular SCP. On an implant/patient level, peri-implant health was found in 37.1.7% (79 implants)/24.1% (20 patients), peri-implant mucositis in 58.7% (125 implants)/66.3% (55 patients), and peri-implantitis in 4.2% (9 implants)/9.6% (8 patients). IDRA scores showed 30.5% of implants at moderate and 69.5% at high risk. The present long-term analysis shows a high prevalence of peri-implant disease in patients treated for advanced periodontitis. These findings underline the challenges involved in the long-term maintenance of oral health in stage III/IV periodontitis patients restored with dental implants.

Marginal bone level changes around dental implants with one or two adjacent teeth - A clinical and radiographic retrospective study with a follow-up of at least 10 years

AIM

To compare mean bone level (mBL) changes around dental implants with one or two adjacent teeth after a function time of ≥10 years.

MATERIALS AND METHODS

One hundred thirty three periodontally compromised patients (PCPs) with 551 implants enrolled in supportive periodontal care (SPC) were screened. Implants were categorized either into group TIT (tooth-implant-tooth) or into group TIG (tooth-implant-gap). MBL changes from delivery of restoration (i.e., baseline) to follow-up were calculated in millimeters and compared between implants and adjacent teeth. Survival rates and the need for surgical interventions during SPC were recorded.

RESULTS

Eighty seven patients with 142 implants were re-evaluated after a mean observation time of 14.5 ± 3.5 years. The mBL at mesial implant sites in the TIT group increased -0.07 ± 0.92 mm and decreased in the TIG group 0.52 ± 1.34 mm, respectively (95% CI: 0.04/1.14, p = .037). At distal implant sites, the mBL in the TIT group increased -0.08 ± 0.84 mm and decreased 0.03 ± 0.87 in the TIG group, respectively (95% CI: -0.20/0.42, p = .48). The overall implant loss rate was 3.5% (n = 5; 2 TIT, 3 TIG), without a statistically significant difference between the two groups (95% CI: 0.18/7.07, p = .892). Tooth loss rates (TIT: 12.3%, TIG: 12.3%) were not statistically significantly different (OR = 1.00, p = .989).

CONCLUSION

High tooth and implant survival rates were observed in PCPs. The presence of one or two adjacent teeth seemed to have no impact on marginal bone level changes.

Spontaneous regeneration of keratinized tissue at implants and teeth

AIM

To investigate the spontaneous regeneration of the implanto-mucosal and dento-gingival unit after complete removal of keratinized tissue (KT).

MATERIALS AND METHODS

One hemi-mandible per dog (n = 4) was allocated to receive three dental implants (test sites, premolar region), whereas three premolars on the contralateral side were controls. After osseointegration, the entire KT (buccal + lingual) was surgically excised on all test and control sites, leaving the bone exposed. Clinical measurements were performed before excision (T0 ) and after 12 weeks (T1 ). Following healing, the animals were euthanized, and the specimens were histologically processed. Descriptive statistical analyses were performed.

RESULTS

Clinical measurements revealed that at T1 , on all teeth, a band of KT was spontaneously regenerated (mean width: 2.60 ± 0.66 mm), whereas on implants, KT was detected only occasionally at mesial or distal but not at buccal sites (mean total: 0.35 ± 0.53 mm; p < .0001). Histologically, spontaneous regeneration of the dento-gingival unit was evident, displaying masticatory mucosa. At the implant sites, on the other hand, the implanto-mucosal unit was characterized by a non-keratinized epithelium and elastic fibres, indicating the characteristics encountered in alveolar mucosa.

CONCLUSION

After excision of KT at implant sites, the spontaneous regeneration of the soft tissue is characterized by a non-keratinized epithelium typical for alveolar mucosa, while at tooth sites the spontaneous regeneration was characterized by soft tissue resembling gingiva.

Clinical periodontal diagnosis

Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.

Peri-implantitis as the consequence of errors in implant therapy

Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. It is a highly prevalent disease, as extensively estimated by large-population, cross-sectional studies. As peri-implant diseases represent opportunistic infections, it is reasonable to assume that nonideal conditions, local and/or general, may favor the progression of peri-implant inflammation. Some of these conditions could be a result of poor planning and/or inadequate execution of any step of the entire process treatment. This article describes the major possible factors in implant therapy that may lead to peri-implantitis. For some of these (ie, inappropriate patient selection, insufficient periodontal therapy, lack of diagnosis and management of peri-implant mucositis, erratic supportive peri-implant/periodontal therapy) there is a good level of evidence, whereas for others (ie, wrong implant placement, poor postoperative care, inadequate prosthetic reconstruction, lack of assessment and management of peri-implant soft-tissue deficiencies) there is little scientific evidence. More research is therefore needed to clearly identify the errors and/or complications possibly leading to peri-implantitis, particularly over the long term.

A novel porcine dentin-derived bone graft material provides effective site stability for implant placement after tooth extraction: a randomized controlled clinical trial

OBJECTIVES

Assessment of the clinical performance of a porcine dentin-derived particulate bone graft material for bone regeneration after tooth extraction with implant placement at 4 months, in comparison to a commercially available porcine bone-derived graft.

MATERIAL AND METHODS

This study was a randomized, parallel-group, semi-double-blinded clinical trial evaluating the clinical safety, tolerability, and performance of Ivory Dentin Graft™ in comparison with a commercial bone-derived material in alveolar ridge preservation following tooth extraction (registered at ClinicalTrials.gov, May 12th, 2017, Identifier NCT03150472). Extraction sites were grafted with test or comparator material and a titanium implant placed at 4 months after taking a graft site biopsy. Primary endpoints were the extent of new bone growth and bone-graft integration at 4 months.

RESULTS

The dentin graft material had statistically significantly more new bone formation (60.75% vs 42.81%, p = 0.0084, N = 20 vs 16), better bone-graft integration scores (good integration in 85% vs 40%, p = 0.0066), and higher mean radiodensity of the bone (981.5HU vs 727.7HU, p = 0.0011) at the graft site compared to the bone-derived material. The mean implant insertion torque force was similar for the dentin and bone materials (34.75 Ncm vs 34.06 Ncm). Titanium implant placement was successful in 95% of patients with the dentin graft material compared to 81.25% for the bone graft. Both materials had similar clinical safety and tolerability as determined by adverse events and local site reactions. Physician-assessed ease of grafting and ease of implant placement on a 10-point scale showed no statistical differences (8.78 vs 8.27, p = 0.2355; 8.05 vs 8.75, p = 0.1118, respectively).

CONCLUSIONS

A porcine dentin-derived bone graft material has clinical safety, tolerability, and performance for implant placement at 4 months after tooth extraction at least as good as a commercial bone-derived material.

CLINICAL RELEVANCE

The availability of porcine dentin-derived bone graft material allows wider use of dentin-derived material which has so far only been available in the form of autologous dentin from the patient's own teeth.

Survival analysis of implants after surgical treatment of peri-implantitis based on bone loss severity and surgical technique: a retrospective study

BACKGROUND

Few trials have compared the results of surgical treatment for peri-implantitis based on severity of peri-implantitis and surgical method. This study investigated the survival rate of implants based on type of surgical method used and initial severity of peri-implantitis. Classification of severity was determined based on bone loss rate relative to fixture length.

METHODS

Medical records of patients who underwent peri-implantitis surgery from July 2003 to April 2021 were identified. Classification of peri-implantitis was divided into 3 groups (stage 1: bone loss < 25% (of fixture length), stage 2: 25% < bone loss < 50%, stage 3: bone loss > 50%) and performance of resective or regenerative surgery was investigated. Kaplan-Meier survival curves and Cox hazards proportional models were used to analyze the cumulative survival rate of implants. Median survival time, predicted mean survival time, hazard ratio (HR), and 95% confidence interval (CI) were calculated.

RESULTS

Based on Kaplan-Meier analysis, 89 patients and 227 implants were included, and total median postoperative survival duration was 8.96 years. Cumulative survival rates for stage 1, 2, and 3 were 70.7%, 48.9%, and 21.3%, respectively. The mean survival time for implants in stage 1, 2, and 3 was 9.95 years, 7.96 years, and 5.67 years, respectively, with statistically significant difference (log-rank p-value < 0.001). HRs for stage 2 and stage 3 were 2.25 and 4.59, respectively, with stage 1 as reference. Significant difference was not found in survival time between resective and regenerative surgery groups in any peri-implantitis stage.

CONCLUSIONS

The initial bone loss rate relative to the fixture length significantly correlated with the outcome after peri-implantitis surgery, demonstrating a notable difference in the long-term survival rate. Difference was not found between resective surgery and regenerative surgery in implant survival time. Bone loss rate could be utilized as a reliable diagnostic tool for evaluating prognosis after surgical treatment, regardless of surgical method used.

TRIAL REGISTRATION

Retrospectively registered. (KCT0008225).

Sequential osseointegration of a novel implant system based on 3D printing in comparison with conventional titanium implants

OBJECTIVES

To evaluate the sequential osseointegration of a novel titanium implant system based on a 3D printing technology in comparison with conventional titanium implants.

MATERIAL AND METHODS

Two novel titanium implants based on 3D printing were tested in the mandible of eight Beagle dogs. As a control, two different commercially available titanium implants were used. The implants were staged to accommodate healing periods of 2 and 6 weeks. The primary outcome variable was bone-to-implant contact (BIC) in non-decalcified tissue sections and micro-CT analysis.

RESULTS

Histomorphometrically, the proportions of tissues adjacent to the implant surfaces were similar for all implants, whereas the BIC percentage of new mineralized bone was greater for the control implants after both 2 and 6 weeks (p < .05). Micro-CT analysis revealed increasing osseous volume and BIC from 2 to 6 weeks. In contrast to the histomorphometry, the BIC evaluation with the micro-CT data revealed a significantly higher BIC for the two test implants compared with controls (p < .001). The analysis of the total implant surface area disclosed a value that was approximately double as high for the test compared to the control implants.

CONCLUSIONS

The novel titanium implant system based on 3D printing yielded values for osseointegration that were adequate and satisfactory. The higher percentage of new mineralized bone in the control implants is explained by the fact of a completely different three-dimensional surface area.

Evaluation of the Oral Health Conditions and Oral Health-Related Quality of Life in a Community-Dwellers Population Aged ≥ 45 Years in the Canton of Bern: A Preliminary Pilot Study

OBJECTIVE

To evaluate oral health conditions and oral health-related quality of life in community-dwellers aged ≥ 45 years in the Canton of Bern, Switzerland.

MATERIALS AND METHODS

One hundred subjects (63% males; mean age: 73 years), selected randomly using a cluster procedure within the Canton of Bern, underwent a clinical oral examination after completing questionnaires on socio-economic level, medical history, oral health behaviour, and Geriatric Oral Health Assessment Index (GOHAI). Descriptive analyses and multinomial regression models were applied to investigate the association between oral health diseases (dental caries and periodontitis) and specific participant characteristics.

RESULTS

The mean number of decayed, missing, and filled teeth (DMFT) was 0.30, 4.20, and 8.75, respectively; the mean DMFT score = 13.35. Dental caries prevalence (ICDAS > 0) was 15% and periodontitis prevalence was 46%. Logistic regression models revealed that living in an urban area was associated with lower odds (OR 0.03, _95%CI 0.00-0.36) of having periodontal disease. Male gender was associated with lower odds for dental caries (OR 0.31, _95%CI 0.09-1.01) and total lack of professional tooth cleaning was associated with higher odds for dental caries (OR 41.99, _95%CI 0.01-0.38). Ordinal logistic regression revealed that both the presence of dental caries (RR 12.80, _95%CI 1.47-111.20) and periodontal disease (RR 6.91, _95%CI 1.16-84.00) were statistically significantly associated with rheumatoid arthritis.

CONCLUSION

Within the study limitations, untreated dental caries and periodontal disease are prevalent in the Swiss population, despite the high level of self-performed oral hygiene and access to the dental care system.

Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis

AIM

This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention).

MATERIALS AND METHODS

A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome.

RESULTS

Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03-0.96; I² : 0%), and lower marginal bone level (MBL) changes (OR = -0.36 mm; 95% CI: -0.65 to -0.07; I² : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24-0.75; I² : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50-9.45; I² : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = -1.18; 95% CI: -1.85 to -0.51; I² : 69%) and lower MBL changes (MD = -0.25; 95% CI: -0.45 to -0.05; I² : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive.

CONCLUSIONS

Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs.

Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis

OBJECTIVES

This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6 months of follow-up.

METHODS

This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500 mg 3 times a day for 7 days. At baseline and at 6 months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5 mm without bleeding on probing or < 5 mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6 months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models.

RESULTS

A total of 74 patients and 107 implants were analyzed at 6 months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5 mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6 months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06 mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56 mm was observed.

CONCLUSION

Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5 mm).

CLINICAL RELEVANCE

This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.

Maxillary vertical alveolar ridge augmentation using sandwich osteotomy technique with simultaneous versus delayed implant placement: A proof of principle randomized clinical trial

BACKGROUND

The sandwich osteotomy technique usually requires high surgical skills and prolonged intraoperative time and had some technical drawbacks with a subsequent deficient amount of vertical bone gain. The aim of this study was to evaluate the final vertical bone gain using sandwich osteotomy with simultaneous versus delayed implant placement in the anterior maxilla.

MATERIAL AND METHODS

This study included 16 patients having multiple missing maxillary anterior teeth with a vertically deficient alveolar ridge. Patients were randomly assigned into two equal groups. Both groups were treated using sandwich osteotomy with interpositional particulate bovine bone graft. In the study group (8 patients, 17 implants), the transport mobilized bone segment was fixed in position using simultaneous implant placement. Whereas in the control group (8 patients, 18 implants), micro-plates and screws were used, followed by a second-stage surgery for plates removal and delayed implant placement. Radiographic assessment included 4 months postoperative mean of vertical gain in alveolar ridge height, taken from cross-sectional cuts of cone beam CT.

RESULTS

The mean vertical bone gain in the study group was 4.04 ± 0.59 mm compared to 3.86 ± 0.52 mm in the control group with no statistically significant difference (p = 0.518). The mean value of bone gain percentage in the study group was 33.02% compared to 31.75% in the control group, with no statistically significant difference (p = 0.656).

CONCLUSION

The sandwich osteotomy technique with simultaneous implant placement is a reliable method for vertical ridge augmentation that eliminates the need for a secondary surgery.

The peri-implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance

BACKGROUND

Peri-implant mucosa color (PMC) seems to be one of the main parameters affecting the esthetic outcome of implant therapy. However, more emphasis should be given to its assessment and reporting.

PURPOSE

To describe the available evidence on methods to assess and report the color of the peri-implant mucosa (PMC) and the respective clinical relevance.

MATERIAL AND METHODS

A comprehensive electronic and manual search was performed to identify clinical studies reporting on PMC.

RESULTS

A total of 121 studies were included. PMC was evaluated at the time of the follow-up visit (chairside) in 45.5% studies. PMC assessment was performed qualitatively, by comparing PMC with adjacent and/or contralateral gingiva (78.6%) or quantitatively, using spectrophotometry (20.7%) or a software on clinical photographs (0.8%). The most performed method to assess PMC was through esthetic indices (76.9%), either at the time of the follow-up visit (chairside) or at later time point using photographs. Quantitative reporting of PMC included averages of points from esthetic indices or color differences to natural gingiva expressed with the CIELAB color system. PMC assessment allowed describing color discrepancies compared to natural gingiva, evaluating color changes over time, and comparing the outcomes of different treatment modalities. PMC assessment through spectrophotometry was additionally utilized to assess the role of mucosal thickness (MT) on PMC.

CONCLUSIONS

Various methods for PMC assessment and reporting were described, including visual assessment, mainly through esthetic indices, and spectrophotometry. PMC evaluation has allowed to demonstrate the factors affecting the color of the peri-implant soft tissue, such as the type of abutment/restoration, MT, and soft tissue augmentation.

Long‐term impact of patients' compliance to peri‐implant maintenance therapy on the incidence of peri‐implant diseases: An 11‐year prospective follow‐up clinical study

OBJECTIVE

To prospectively evaluate the incidence of peri-implant diseases and the associated risk factors during 11 years of peri-implant maintenance therapy (PIMT).

MATERIAL AND METHODS

A sample of 80 partially edentulous individuals rehabilitated with dental implants was invited to participate in a PIMT program (T1-prior to entering the PIMT program). After 11 years, 51 individuals remained regularly or irregularly adherent to PIMT (T2-last recall after 11 years) and were classified as regular (RC; n = 27) or irregular (IC; n = 24) compliers. Data of interest were analyzed using univariate and multivariate logistic regression analyses.

RESULTS

The incidence of peri-implant mucositis and peri-implantitis observed at T2 in the IC group (70.8% and 37.5%, respectively) were significantly higher than those observed in the RC group (37.0% and 11.1%, respectively). The incidence of peri-implant diseases was mostly attributable to potentially modifiable risk factors, as such: RC group-PM (p = 0.013); IC group-high plaque index (p < 0.001), irregular compliance (p < 0.001), the presence of PM (p = 0.015) and periodontitis (p < 0.039).

CONCLUSION

Regular compliance during PIMT had a strong effect in minimizing the incidence of peri-implant diseases. Increasing regular dental visits and improving oral hygiene would provide benefits for preventing peri-implant diseases.

Investigation of Different Types of Micro- and Nanostructured Materials for Bone Grafting Application

The insufficient volume of dental ridges is one of the most severe problems regarding an oral cavity. An inadequate amount can cause problems during various types of dental treatment. Its complexity originates from the etiopathogenesis of this problem. In this study, the representatives of auto-, allo-, and xenografts are compared. The physic-chemical differences between each of them were evaluated using XRD (X-ray Powder Diffraction), a SEM (Scanning Electron Microscopy), FT-IR (Fourier transformed infrared spectroscopy), and TGA (thermogravimetric analysis). Based on the SEM images, it was observed that the origin of the material has an influence on collagen fiber compact level and porosity. Following a comparison of FT-IR spectra and XRD, the crystal and chemical structures were described. Based on TGA, different water concentrations of the investigated materials, their high thermal stability, and concentration of inorganic phase, hydroxyapatite was determined. The presented study is important because it delivers information about chemical structure and its impact on bone regeneration. This knowledge should be taken into consideration by dental clinicians, because different types of bone grafts can accommodate the achievement of various goals.

Immediate Functional Loading with Full-Arch Fixed Implant-Retained Rehabilitation in Periodontal Patients: Clinical Study

(1) Background. The immediate functional loading of implants is a clinical procedure used for treating periodontal edentulous patients. This clinical study aimed to evaluate the clinical outcomes of the immediate functional loading of implants with fully fixed rehabilitations in compromised periodontal patients. (2) Methods. Three hundred and five implants IPX screw implants were placed in 27 periodontal patients using an immediate functional loading protocol with fixed rehabilitations. All patients had a previous history of periodontitis, four patients (14.8%) were smokers and seven patients (25.9%) suffered from chronic medical conditions. (3) Results. Implant and prosthetic clinical findings were evaluated during a mean period of 41.3 ± 19.6 months. No implants were lost during the clinical follow-up. The cumulative survival rate for all implants was 100%. Regarding the prostheses designed, a total of 54 fixed prostheses were placed in the 27 patients immediately after the surgery. Forty-four hybrid fixed prostheses (81.5%) and 10 fixed rehabilitations (18.5%) were placed in the patients. The mean marginal bone loss was 1.51 ± 1.16 mm, ranging from 0 to 3.5 mm during the follow-up evaluation. Thirty-one implants (10.2%) in 10 patients (37%) were associated with peri-implantitis. Five patients (18.5%) showed some kind of technical complications (loss/fracture of the prosthetic screw, acrylic resin fracture, ceramic chipping). (4) Conclusions. The clinical outcomes of this study demonstrate that fixed rehabilitation by immediate functional loading of implants is considered a predictable procedure.

Peri-Implant Health and Diagnostic Considerations

In recent years, implant rehabilitation has become a popular method for replacing lost teeth [...]