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Osseointegration of Dental Implants in Organ Transplant Patients Undergoing Chronic Immunosuppressive Therapy.

The depressive impact of immunosuppressive medications used by patients after organ transplantations is commonly known and well proven. The aim of research is the assessment of functional and esthetic results of implantoprosthetic treatment in patients subject to immunosuppressive treatment after organ transplants. The study encompassed a group of 21 patients in the course of maintenance immunosuppression after transplantation procedures, in whom altogether 24 implants were inserted. The control group comprised 15 people with 15 implants in place. The research protocol assumed replacing a single missing tooth with a titanium implant. After 4 months, a prosthetic reconstruction in the form of a single crown was performed. After 24 months, the preliminary assessment of treatment results was attempted. The measured parameter was crestal bone level (CBL). The mechanical assessment was performed by measuring the torque indispensable to locate the implant and by an objective measurement of implant stability. The basic measured parameter of CBL median in the experimental group and in the control group amounted to 0.325 mm (min 0-max 0.95) and 0.5 mm (min 0.15-max 1.8), respectively. The comparison of CBL medians revealed lack of significant differences between the experimental group and the control group (P = 0.089). Patients with organ transplants can safely and effectively undergo dental implant treatment.

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Effect of 5 Popular Disinfection Methods on Microflora of Laboratory: Customized Implant Abutments.

To compare the efficacy of 5 different decontamination methods of titanium abutments and to assess their possible effects on surface roughness of titanium. Micrococcus luteus, Acinetobacter baumannii, Enterococcus faecalis, and Candida albicans were cocultured to form a multispecies biofilm on 18 titanium discs. In another group, Bacillus subtilis, a spore-forming species, was cultivated on another set of 18 titanium discs. Each group was further divided into 5 test groups: high-pressure steam cleaning (4 Mpa, 5 seconds), NaOCl (1% active chlorine, 5 minutes), H2O2 (3%, 5 minutes), GaAlAs laser (810 nm, CW, 1 W, 400-μm fiber, 1-mm distance, 1 minute), Er:YAG laser (2940 nm, pulse mode, 100 mJ, 10 Hz, 230-μm noncontact handpiece, 4-mm distance, 50/50% air/water, 1 minute), and a control group of no treatment. After each decontamination procedure, the remaining microbial load was reported as colony-forming unit/disc. To evaluate the effect of each treatment on titanium discs, surface roughness parameters including Sa, Sq, Ssk, Sku, Sal, and Sdr were measured at 6 points of each disc using an atomic force microscope. Complete disinfection was achieved using high-pressure steam, NaOCl, H2O2, and Er:YAG laser. GaAlAs laser was able to reduce microbial count over 90%. Sa and Sq parameters were only increased significantly in diluted NaOCl group in comparison with control group, whereas Sdr was increased significantly in both absolute and diluted NaOCl groups. All the methods could decontaminate machined titanium surfaces, although complete microbial elimination was not achieved by diode laser. None of the treatments altered surface roughness significantly, except for sodium hypochlorite (NaOCl).

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Effect of Implant-Abutment Connection Type on Bone Around Dental Implants in Long-Term Observation: Internal Cone Versus Internal Hex.

The purpose of this study was to evaluate the influence of the implant-abutment connection type on the bone level around dental implants in long-term observation and the survival rate for the different types of implant-abutment connections. Two groups of implants made of titanium grade 23 alloy and with sandblasted and acid-etched (SLA) surface were included in the study: (a) the internal hex implant-abutment connection group (480 SPI dental implants; Alpha-Bio Tec, Petach Tikwa, Israel, 184 patients) and (b) the internal cone implant-abutment connection group (60 C1 dental implants; MIS Implant Technologies, Shlomi, Israel, 34 patients). Certain inclusion and exclusion criteria were applied. Marginal bone loss (MBL) around the dental implants was measured in intraoral radiographs taken with parallel technique with a film holder and by bite recording index. X-rays were performed at the moment of functional loading, and at 12, 24, 36, and 60 months after loading. The digital analysis was conducted using Dental Studio 2.0 computer software. Average MBL was significantly lower in the conical connection compared with internal hex group-0.68 ± 0.59 versus 0.99 ± 0.89 mm (12 months), 0.78 ± 0.80 versus 1.12 ± 1.00 mm (24 months), 0.83 ± 0.87 versus 1.22 ± 1.03 mm (36 months), and 0.96 ± 1.02 versus 1.30 ± 1.15 mm (60 months after loading). Both groups of implants achieved a 100% survival rate. The internal cone connection reduced bone resorption compared with the internal hex. Both groups of implants had a 100% survival rate.

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Maxillary Sinusitis Associated With Peri-implantitis at Sinus Floor Augmented Sites: Case Series.

The purpose of this case series was to investigate treatment outcomes of maxillary sinusitis associated with peri-implantitis at sinus floor augmented sites for a 3-year follow-up. Eighteen implants in 8 patients diagnosed with maxillary sinusitis associated with peri-implantitis were reviewed. Four patients were treated with implant removal and antibiotics, and 4 patients were treated with implant removal, the modified Caldwell-Luc operation (CLOP), and antibiotics. Seven patients, who had 7 survived implants, were followed up to 3 years after treatment. The characteristics between failed and survived implants were compared. Radiographic parameters of survived implants were analyzed using the Friedman test. Eleven failed implants from 8 patients exhibited approximately 10-mm pocket depths and mobility at diagnosis. Seven survived implants from 7 patients exhibited no significant changes in crestal bone loss at the facial side for 3 years after the treatments. Sinus mucosal thickening was significantly reduced during the 3-year follow-up after the treatments. The progression of peri-implantitis in sinus floor augmented sites may lead to maxillary sinusitis. To confirm the efficacy of the intraoral approaches, such as the modified CLOP, systematic clinical studies with a large sample size and a long-term follow-up should be conducted.

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