Background
The compliance rate with supportive therapy following peri‐implantitis treatment (SPIT) remains unknown. The present retrospective study was carried out to assess the compliance rate and ...the factors influencing compliance in a private practice setting.
Materials and Methods
Patients were divided into three groups according to compliance rate: regular compliance (RC ≥2 SPIT/year), erratic compliance (EC <2 SPIT/year), and non‐compliance (NC <1 SPIT/year). Overall, 17 patient‐ (n = 8) and site‐related variables (n = 9) were explored as potential confounders of compliance. The Chi2 test was applied to assess the association between categorical variables and determine the odds ratio (OR).
Results
The study comprised 159 patients restored with 1075 implants, of which 469 were treated for peri‐implantitis and met the inclusion criteria. A total of 57.2% were RC, 25.8% EC, and 17% NC. The multivariate analysis showed that smoking and grade C periodontitis reduced the likelihood of RC (OR = 0.28, p < .001) when compared to complete edentulism or non‐smoking. Moreover, age demonstrated being associated with follow‐up when SPIT was interrupted in EC and NC (OR = 0.94, p = .007).
Conclusion
Comprehensive information, provided prior to peri‐implantitis treatment, regarding the importance of adhering to SPIT after peri‐implantitis treatment to achieve/maintain peri‐implant health, resulted in ~60% regular compliance rate (NCT05772078).
Aim
The aim of this study was to analyze marginal bone loss (MBL) rates around implants to establish the difference between physiological bone loss and bone loss due to peri‐implantitis.
Materials ...and methods
Five hundred and eight implants were placed in the posterior maxilla in 208 patients. Data were gathered on age, gender, bone substratum (grafted or pristine), prosthetic connection, smoking and alcohol habits, and previous periodontitis. MBL was radiographically analyzed in three time frames (5 months post‐surgery and at 6 and 18 months post‐loading). Nonparametric receiver operating curve (ROC) analysis and mixed linear model analysis were used to determine whether implants could be classified as high or low bone loser type (BLT) and to establish the influence of this factor on MBL rates.
Results
Marginal bone loss rates were significantly affected by BLT, connection type, bone substratum, and smoking. Bone loss rates at 18 months were associated with initial bone loss rates: 96% of implants with an MBL of >2 mm at 18 months had lost 0.44 mm or more at 6 months post‐loading.
Conclusion
Implants with increased MBL rates at early stages (healing and immediate post‐loading periods) are likely to reach MBL values that compromise their final outcome. Initial (healing, immediate post‐loading) MBL rates around an implant of more than 0.44 mm/year are an indication of peri‐implant bone loss progression.
Objectives
To evaluate alveolar ridge dimensional changes of different alveolar ridge preservation techniques after 3 months of tooth extraction and to compare the efficacy of autologous plasma rich ...in growth factor (PRGF) to the bone substitutes in alveolar ridge preservation and sites left to heal spontaneously.
Materials and Methods
Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze‐dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and PRGF alone. Cone beam computed tomography (CBCT) scans were taken after surgery and 3 months later. The measurements of height and width (at 1, 3, and 5 mm below the crest) were performed after superimposing the 2 consecutive CBCT scans.
Results
The greatest horizontal alveolar bone resorption at 1 mm below bone crest was observed in the control group (−1.61 ± 1.76 mm, P = .037), whereas the least reduction in width was found in the BBM/CM group (−0.68 ± 0.67 mm, P = .037). The most pronounced alveolar height reduction was observed in the control group (−0.86 ± 0.43 mm), whereas alveolar ridge preservation with BBMC/CM (−0.26 ± 0.91 mm) and PRGF (−0.54 ± 0.86 mm) successfully reduced the alveolar height reduction as compared to the control group.
Conclusions
Alveolar ridge preservation technique in the esthetic zone using BBM/CM or using PRGF is beneficial to reduce horizontal and vertical bone changes.
Background: Multiple variables have been shown to affect early marginal bone loss (MBL). Among them, the location of the microgap with respect to the alveolar bone crest, occlusion, and use of a ...polished collar have traditionally been investigated as major contributory factors for this early remodeling. Recently, soft tissue thickness has also been investigated as a possible factor influencing this phenomenon. Hence, this study aims to further evaluate the influence of soft tissue thickness on early MBL around dental implants.
Methods: Electronic and manual literature searches were performed by two independent reviewers in several databases, including Medline, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to May 2015 reporting soft tissue thickness at time of implant placement and MBL with ≥12‐month follow‐up. In addition, random effects meta‐analyses of selected studies were applied to analyze the weighted mean difference (WMD) of MBL between groups of thick and thin peri‐implant soft tissue. Metaregression was conducted to investigate any potential influences of confounding factors, i.e., platform switching design, cement‐/screw‐retained restoration, and flapped/flapless surgical techniques.
Results: Eight articles were included in the systematic review, and five were included in the quantitative synthesis and meta‐analyzed to examine the influence of tissue thickness on early MBL. Meta‐analysis for the comparison of MBL among selected studies showed a WMD of −0.80 mm (95% confidence interval −1.18 to −0.42 mm) (P <0.0001), favoring the thick tissue group. Metaregression of the selected studies failed to demonstrate an association among MBL and confounding factors.
Conclusion: The current study demonstrates that implants placed with an initially thicker peri‐implant soft tissue have less radiographic MBL in the short term.
Aim
To compare the influence of the abutment height and its insertion timing on the marginal bone change (MBC) variation of implants placed at posterior mandibular partial edentulous areas in a ...medium follow‐up period.
Material and methods
This randomized clinical trial (RCT) comprised a sample of patients with posterior mandibular edentulous areas, treated with at least two implants and distributed into three groups: implants connected to a 2 mm height abutment during the surgical stage (Group A); implants connected to a 1 mm height abutment during the surgical stage (Group B); and implants connected to a 2 mm height abutment after 2 months (Group C). Clinical and radiographic measurements were performed during a 36‐month period (T4). The MBC was set as the main variable in study. Statistical significance was set at 0.05.
Results
A total of 29 subjects and 59 implants were enrolled in this study. A mean MBC of 0.35 ± 0.46 mm, 0.60 ± 0.81 mm, and 0.71 ± 0.90 mm was computed for groups A, B and C, respectively, at T4. Significant differences were found between groups A and C in terms of MBC variation after 3 years of treatment (p = .048). Multiple linear regression analysis showed a significant influence of the first‐year MBC and the abutment insertion timing has independent predictor variables for the MBC assessed at T4.
Conclusion
The installation of 2‐mm prosthetic abutments, at the time of implant placement, in areas with limited keratinized mucosa presents as a favorable treatment option in terms of periimplant marginal bone maintenance.
Objective
Cone‐beam computed tomography (CBCT) and radiographic outcomes of crestal sinus elevation, performed using mineralized human bone allograft, were analyzed to correlate results with ...maxillary sinus size.
Material and methods
A total of 60 sinus augmentations in 60 patients, with initial bone ≤5 mm, were performed. Digital radiographs were taken at surgical implant placement time up to post‐prosthetic loading follow‐up (12–72 months), when CBCT evaluation was carried out. Marginal bone loss (MBL) was radiographically analyzed at 6 months and follow‐up time post‐loading. Sinus size (BPD), implant distance from palatal (PID) and buccal wall (BID), and absence of bone coverage of implant (intra‐sinus bone loss – IBL) were evaluated and statistically evaluated by ANOVA and linear regression analyses.
Results
MBL increased as a function of time. MBL at final follow‐up was statistically associated with MBL at 6 months. A statistically significant correlation of IBL with wall distance and of IBL/mm with time was identified with greater values in wide sinuses (WS ≥ 13.27 mm) than in narrow sinuses (NS < 13.27 mm).
Conclusions
This study is the first quantitative and statistically significant confirmation that crestal technique with residual ridge height <5 mm is more appropriate and predictable, in terms of intra‐sinus bone coverage, in narrow than in WS.
Purpose
To review the most up to date scientific evidence concerning the technical implications, soft tissue biocompatibility, and clinical applications derived from the use of titanium nitride hard ...thin film coatings on titanium alloy implant abutments.
Materials and Methods
A review was performed to answer the following focused question: “What is the clinical reliability of nitride coated titanium alloy abutments?”. A MEDLINE search between 1980 and 2021 was performed for investigations pertaining to the clinical use of nitride coated titanium alloy implant abutments (TiN) in case reports, case series, and short‐ and long‐term non/randomized controlled clinical trials. Literature analysis led to addition evaluation of research related to the technical and biological aspects, as well as the physicochemical characteristics of TiN hard thin film coatings and their impact on titanium abutment biocompatibility, mechanical properties, macroscopic surface topography, and optical properties. Therefore, preclinical data from biomechanical and in vitro investigations were also considered as inclusion criteria.
Results
The limited number of clinical investigations published made a systematic review and meta‐analysis not possible, therefore a narrative review was conducted. TiN coatings have been applied to dental materials and instruments to improve their clinical longevity. Implant abutments are coated with titanium nitride to mask the titanium oxide surface and enhance its surface characteristics providing the TiN abutment surface with a low friction coefficient and a very high chemical inertness. TiN coating is suggested to reduce early bacterial colonization and biofilm formation and enhance fibroblast cell proliferation, attachment and adhesion when compared to Ti controls. Additionally, studies indicate that hard thin film coatings enhance the mechanical properties (hardness and wear resistance) of titanium alloy and appears as a yellow color when deposited on the titanium alloy substrate. To date, clinical investigations show that nitride coated titanium abutments provide promising short‐term clinical outcomes.
Conclusions
Published research on nitride‐coated abutments is still limited, however, the available biomedical research, mechanical engineering tests, in vitro investigations, and short‐term clinical trials have, to date, reported promising mechanical, biological, and esthetic outcomes.
Aim
To evaluate the healing outcomes in non‐molar post‐extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM‐C) as a function of time.
Materials and Methods
Patients in ...need of non‐molar tooth extraction were randomly allocated into one of three groups according to the total healing time (A—3 months; B—6 months; C—9 months). The effect of alveolar ridge preservation (ARP) therapy via socket filling using DBBM‐C and socket sealing with a porcine collagen matrix (CM) was assessed based on a panel of clinical, digital, histomorphometric, implant‐related, and patient‐reported outcomes.
Results
A total of 42 patients completed the study (n = 14 in each group). Histomorphometric analysis of bone core biopsies obtained at the time of implant placement showed a continuous increase in the proportion of mineralized tissue with respect to non‐mineralized tissue, and a decrease in the proportion of remaining xenograft material over time. All volumetric bone and soft tissue contour assessments revealed a dimensional reduction of the alveolar ridge overtime affecting mainly the facial aspect. Linear regression analyses indicated that baseline buccal bone thickness is a strong predictor of bone and soft tissue modelling. Ancillary bone augmentation at the time of implant placement was needed in 16.7% of the sites (A:2; B:1; C:4). Patient‐reported discomfort and wound healing index scores progressively decreased over time and was similar across groups.
Conclusions
Healing time influences the proportion of tissue compartments in non‐molar post‐extraction sites filled with DBBM‐C and sealed with a CM. A variable degree of alveolar ridge atrophy, affecting mainly the facial aspect, occurs even after performing ARP therapy. These changes are more pronounced in sites exhibiting thin facial bone (≤1 mm) at baseline (Clinicaltrials.gov NCT03659617).
Aim
The aim of this study was to compare the influence of the abutment height and insertion timing on early marginal bone loss (MBL) in posterior mandibular partial implant‐supported restorations.
...Material and methods
The study was planned as a prospective, randomized, controlled parallel group including subjects in need of at least two implants for the restoration of an edentulous posterior mandibular area. The patients were allocated into Groups A (implants immediately connected to 2‐mm height abutments), B (immediately connected 1‐mm height abutments), and C (2‐mm abutments were inserted in a second‐stage surgery). Each subject was placed in a 1‐year follow‐up program, including examination assessment of various soft tissue and bone‐level parameters.
Results
A total of thirty‐three patients, including sixty‐eight implants, were enrolled in this study. One implant was lost on group C after the first month of healing. A mean MBL change of 0.719 ± 0.361, 0.651 ± 0.379, and 0.754 ± 0.672 mm was computed for groups A, B, and C, respectively, with no significant differences found. The early MBL at T1 was an independent predictor variable for the marginal bone alterations that were assessed at T3 (p < 0.001).
Conclusion
The first‐month MBL variation is a predictor factor of the bone alterations that might occur after 1 year of treatment. The early connection of final prosthetic abutments with distinct heights does not seem to reduce the 1‐year MBL rate when compared with traditional treatment protocols.
Objectives
The aim of the present review and meta‐analysis was to evaluate the influence of soft tissue thickness on initial bone remodeling after implant installation.
Materials and Methods
A ...literature search was conducted by two independent reviewers on electronic databases up to May 2022. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) performed on human subjects were included. The risk of bias was evaluated using Cochrane Collaboration's tool. Meta‐analysis and Trial Sequential Analysis (TSA) were performed on the selected articles. The primary outcome was marginal bone loss.
Results
After screening, 6 studies were included in the final analysis, with a total of 354 implants, and a follow‐up from 10 to 14 months. 194 implants were placed in a ≥ 2 mm soft tissue thickness, while 160 had <2 mm soft tissue thickness before implant placement. The included studies had a high level of heterogeneity (I2 > 50%). The meta‐analysis indicated a statistically significant difference between the two groups (0.54; p = .027) and the TSA analysis confirmed the results, despite the limited number of dental implants. Additional analysis showed that age and follow‐up parameters were not statistically significant factors influencing the bone loss (p = .22 and p = .16, respectively).
Conclusions
Based on the available RCTS and CCTs, initial soft tissue thickness seems to influence marginal bone loss after a short follow‐up period. Based on TSA analysis, further studies are needed to assess the influence of the soft tissue thickness on marginal bone loss.
PROSPERO registration number: CRD42021235324.
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