Peri-implant Bone Level Changes Research Articles

Prefabricated shouldered abutments enable successful restoration of molar crowns on implants.

This retrospective study evaluated the effect of selected clinical and patient factors on survival, success, and peri-implant bone level changes of locking taper implants supporting molar crowns on Bicon's prefabricated shouldered abutments. A total of 234 patients, who received 274 single molar crowns supported by locking taper implants were included in this retrospective study. Kaplan-Meier survival analysis was used to assess overall implant survival, prostheses survival, and success. Crowns were either monolithic (resin based) or bilayered (milled fiber-reinforced composite coping veneered with indirect composite). Early and late changes in marginal bone levels were plotted and analyzed with equivalence testing to compare the effects of different factors on crestal bone levels. At 9.5 years after implant surgery, the implant survival probability was 94.2%, the probability of prosthesis survival was 91.4%, and the probability of prosthetic success was 90.4%. Neither the use of different crown materials, nor the choice of monolithic versus bilayered crown construction, significantly affected the probability of prosthetic success. Marginal bone levels, on average, trended downwards towards the top of the implant within the first 2 years after functional loading, and remained stable on average, since then. Factors affecting bone levels included the use of nonsteroidal anti-inflammatory drugs, which precluded early implant bone loss; and subcrestal implant placement, which was linked to significantly higher long-term bone levels. The implant and abutment system studied resulted in high implant and prosthetic survival rates, regardless of prosthetic material used, with stable bone levels over time.

Comparison between the effect of splinted and segmented full arch mandibular implant supported prosthesis on peri-implant bone level changes

Comparison between the effect of splinted and segmented full arch mandibular implant supported prosthesis on peri-implant bone level changes

CLINICAL EFFECTIVENESS OF GUIDED IMPLANT SURGERY IN PATIENTS WITH FULLY EDENTULOUS PATIENTS ATROPHY OF THE LOWER JAW

Objectives: The aim of this study was to evaluate the results of mandibular prosthetics based on 6 implants placed with guided surgery and immediate loading in patients with a completely edentulous mandible. Materials and Methods: 52 patients participated in this study, referred in need of full arch implant-supported reconstructions in mandible. Jaw bones patients were diagnosed with cone beam computerized tomography. Patients were evaluated according to the results of computed tomography (CT). Computer software was used to create virtual templates for 3Diagnosys, an implant treatment. Surgical guided were made for ostectomy and for implant position using a 3D printer (Stratasys. Implants were placed flapless implantation metho through the sleeves of the surgical template tightening torque of 35–45 Ncm. Patients received 312 implants (64 UV functionalised short (≤6 mm) implants, 248 standard implants) 52 implant-supported prosthesis. The following parameters were assessed: implant success, prosthetics survival and changes in peri-implant marginal bone level (MBL), probe depth (PPD), and probe bleeding (BOP). Results: After 3 months loss of the marginal bone of 0.7 ± 0.35 mm (MBL), after 12 months of observation, there was a slight loss of the marginal bone over time 1.2 ± 0.38 mm (MBL), 1,47 ± 0.42. mm (MBL), after 5 years of observation. After 5 years of observation, the average PPD was 2.42 ± 0.47 mm, the average BOP was 1.32 ± 0.85. Of the 312 implants, 3 failed to osseointegrate, 5 implants failed (peri-implantitis) after 5 years. No serious prosthetic complications have been reported. After 5 years, the effectiveness of implants was 97.4%. Conclusion: Computer-guided implant surgery and immediate loading of implants in patients with insufficient lower jaw and completely edentulous is a predictable and effective method with a minimum rehabilitation period.

Changes in Peri-implant Marginal Bone Level by Jaw Location: A Systematic Review and Meta-Analysis of 4970 Implants.

The purpose of this study was to evaluate the current evidence on marginal bone-level changes (ΔMBL) around internal connection implants with fixed prostheses by jaw location over time. An electronic literature search for ΔMBL (change in marginal bone level) was conducted in 6 databases. The data from the included manuscripts were categorized by jaw sextant of the implants and duration of follow-up (<2 years, 2-5 years, and >5 years). Meta-analyses were performed on groups with at least 5 studies. A total of 1270 records were screened. Full-text review of 413 papers resulted in a total of 46 studies (representing 2259 patients with 4970 implants) included for quantitative synthesis and analysis. The ΔMBL was summarized at 2 time intervals with the following results: <2 years (anterior maxilla = 0.393 mm [95% confidence interval {CI}, 0.172, 0.613], posterior maxilla = 0.468 mm [95% CI, 0.288, 0.648], and posterior mandible 0.559 mm [95% CI, 0.397, 0.72]), 2 to 5 years (anterior maxilla = 0.683 mm [95% CI, 0.224, 1.142], posterior maxilla = 0.645 mm [95% CI, 0.42, 0.87], and posterior mandible 0.563 mm [95% CI, 0.278, 0.849]). There were insufficient studies in the anterior mandible and with follow-up data over 5 years for quantitative synthesis. Within the limitations of this study, location within the maxillary and mandibular jaws does not seem to influence ΔMBL around internal connection bone level implants with fixed restorations. Although there may be a tendency for greater initial remodeling in the posterior mandible followed by long-term stability, additional studies are needed to evaluate this further.

Minimally Invasive Treatment of Lateral Incisors with Guided One-Piece or Two-Piece Titanium-Made Narrow Diameter Implants: A Retrospective Comparative Study with Up to Two Years Follow-Up.

Restoring teeth with dental implants has become the gold standard in recent years, especially in the esthetic zone. However, limited amount of available bone as well as limited interdental space in the anterior zone may create problems for implant treatment. Narrow diameter implants (NDI) may be a treatment option to resolve the above-mentioned limitations and providing minimally invasive implant therapy without additional regenerative procedures. In this retrospective study, a comparison of clinical and radiographic outcomes between one-piece and two-piece titanium-made NDIs was done with the follow-up of two years after loading. Twenty-three NDI cases were analyzed, 11 in the one-piece implant group (group one) and 12 in the two-piece implant group (group two). The outcomes were implant and prosthetic failures, any complications occurred, peri-implant bone level changes, and as well as the Pink Esthetic score. No implant or prosthetic failures, as well as, no complications were reported at the two-year follow-up examination. At the same time the marginal bone loss was 0.23 ± 0.11 in the group one and 0.18 ± 0.12 in the group two. Difference was not statistically significant (p = 0.3339). The Pink Esthetic Score, recorded two years after definitive loading, was 12.6 ± 0.97 in the group one and 12.2 ± 0.92 in the group two, with no statistically significant difference between groups (p = 0.3554). With the limitations of the present study, including the small sample size and short follow-up, it is possible to conclude that either one and two-piece NDI can be successfully used to restore lateral incisors with comparable results within the two years of follow-up.

Influence of implant restorative emergence angle and contour on peri-implant marginal bone loss: A systematic review and meta-analysis.

Implant restorative emergence angle and profile may have a negative impact on peri-implant marginal bone level and may increase the risk of developing peri-implantitis. However, the role of these prosthetic features on peri-implant health is still unclear. The aim of this systematic review and meta-analyses was to evaluate the long-term outcomes of implant restorations with an emergence angle of >30° in comparison to those with ≤30° in terms of changes in peri-implant marginal bone level, periodontal parameters, and prevalence rate of peri-implantitis. Electronic databases were searched to identify observational studies that compared implant restorations with an emergence angle of >30° to those with ≤30°. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Four studies with 912 dental implants in 397 participants were included in the present review. Of these, 455 implants had restorations with an emergence angle of >30°, while the remaining implants had restorative emergence angle of ≤30°. The follow-up time varied between 3.8 and 10.9 years. Implant restorations with an emergence angle of ≤30° were associated with less changes in peri-implant marginal bone level compared to those with emergence angle of >30°. The difference, however, was not statistically significant (mean difference 0.80; 95% confidence interval (CI) -0.13 to 1.72; p = 0.09). In platform-matched implants, the difference between the two groups was statistically significant in favor of implant restorations with emergence angle of ≤30°. In terms of emergence profile, implant restorations with convex profile had significantly higher rate of peri-implantitis (57.8%) compared to implant restorations with concave or straight profile (21.3%) (risk ratio 2.32; 95% CI 1.12-4.82; p = 0.02). Within the limitation of this review, implant restorations with an emergence angles of >30° or ≤30° seem to have no significant influence on peri-implant marginal bone level. Platform-matched implants with an emergence angle of ≤30° may have positive effects on the peri-implant marginal bone level changes, but the evidence support is of low to moderate certainty.

Efficacy of mechanical/physical approaches for implant surface decontamination in non-surgical submarginal instrumentation of peri-implantitis. A systematic review.

To evaluate the efficacy of non-surgical submarginal peri-implant instrumentation with mechanical/physical decontamination compared to non-surgical submarginal instrumentation alone or with placebo decontamination in patients with peri-implantitis. Three focused questions were addressed, and a systematic search for randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective cohort studies with definitions of peri-implantitis and a minimal follow-up of 6 months was conducted. The main outcome variables were reduction in pocket probing depth (PD) and bleeding on probing (BOP). Suppuration on probing, marginal peri-implant bone level changes, patient-related outcomes and adverse events, implant survival, treatment success, and disease resolution were assessed as secondary outcomes. Out of 239 findings, full-text articles were assessed for eligibility, and 9 (n=9 RCTs) were included in the present review. Five studies evaluated the effects of various laser types, and in four studies efficacy of air-abrasive mechanisms and of a novel ultrasonic device was determined. At 6 months, PD reductions were observed in nine studies but only Er, Cr:YSGG laser-treated group showed statistically significant higher reductions compared to the control group. BOP was statistically significantly reduced at 6 months in two studies following the application of Er:YAG laser compared to controls. One study reported statistically significant reduction in BOP following application of air-polishing device compared to control treatment. No statistically significant differences between treatment groups were reported for the secondary outcome variables. Owing to the large heterogeneity of study designs, no meta-analysis was performed. Available evidence on the efficacy of non-surgical submarginal peri-implant instrumentation with mechanical/physical decontamination is limited by the small number of controlled studies and the high heterogeneity of study protocols. Clinical and patient-reported benefits remain to be demonstrated.

Fiber-reinforced composite partial fixed dental prostheses supported by short or extra-short implants: A 10 year retrospective study.

This study evaluated the 10-year survival and success of partial fixed dental prostheses (P-FDPs) fabricated with a milled fiber-reinforced composite (FRC) framework, supported by short or extra-short implants. Patients restored with FRC P-FDPs supported by short or extra-short implants were included in this retrospective study. Kaplan-Meier analysis was used to calculate the survival and success rates of the prostheses. Univariate and multivariate Cox regression models, clustered to adjust for multiple implants and prostheses being placed in the same patient, were used to correlate changes in peri-implant bone levels with patient, implant, and prosthesis-related covariates. This study followed 121 FRC P-FDPs supported by 261 implants, placed in 96 patients. At 118 months in function, the P-FDP survival rate was 95.9% (95% CI: 87.5%-98.7%), and the success rate was 89.8% (95%CI: 80.4%-94.8%). Differences in prosthesis span length, abutment/pontic ratio, and the presence of distal extensions (cantilevers) did not affect the prosthetic outcomes. Bone levels around implants were stable, with an average rate of change of -0.01 ± 0.05 mm/month. Cox regression revealed that grafted sites were correlated with peri-implant bone loss, while longer prosthetic spans were correlated with bone gain. P-FDPs comprised of milled fiber-reinforced composite frameworks, supported by short and extra-short implants, had high survival and success rates for up to 10 years.

Comparison Of Peri-implant Bone Level Changes In Immediate Implant With Functional Versus Non- Functional Loading In Mandibular Posterior Region

Introduction: Traditionally, teeth that are absent are substituted by partial dentures or by complete dentures. Many prefer a dental implant as it tries to imitate the natural tooth. Though the notion of immediate loading reduced the time of prosthetic treatment, debate arose whether the loading should be functional or non-functional. The objective of this study was to compare the Peri-implant Bone Level (PIBL) deviations in immediate implant placement with instantaneous functional versus non-functional loading in the mandibular posterior region. Material and Methods: Fifty patients were incorporated in the study and distributed by random sampling into two groups of equal members each. Group A had patients in whom implant was placed followed by immediate functional loading. Group B were those who had non-functional loading. After bone implant integration, temporary crowns were replaced with metal ceramic prosthesis. PIBL change (in mm) of each implant was assessed by periapical radiograph which were taken at immediate post op, after one month and then on three and six months follow up. Statistical analysis was done using software SPSS v 21.0. Comparison between the groups (Mann Whitney U test), intragroup (Friedman’s) and Wilcoxon Signed rank test for pairwise comparison were done. Results: There was PIBL gain mesially and distally of the implants in both the groups in all time intervals of one, three and six months follow up. Conclusions: To conclude immediate implants restored instantly yielded affirmative result as far as survival of the implants, bone level changes and aesthetics of the soft tissues are concerned irrespective of the type of loading.

Non-surgical mechanical therapy of peri-implantitis with or without repeated adjunctive diode laser application. A 6-month double-blinded randomized clinical trial.

ObjectivesThe objective of this study is to investigate the outcomes following non‐surgical therapy of peri‐implantitis (PI) with or without adjunctive diode laser application.Materials and methodsA double‐blinded randomized controlled clinical trial was carried out in 25 subjects with 25 implants diagnosed with PI. Following curettage of granulation tissue, test implants (T) were treated with adjunctive application of a diode laser for 90 s (settings: 810 nm, 2.5 W, 50 Hz, 10 ms), while at control implants (C) non‐activated adjunctive diode laser was applied. The entire treatment procedure was performed at days 0 (i.e., baseline), 7 and 14. The primary outcome measure was change in mean pocket probing depth (PPD). Clinical and microbiological outcomes, as well as host‐derived inflammatory markers were evaluated at baseline, 3 and 6 months, while radiographic outcomes were assessed at baseline and at the 6‐month follow‐up.ResultsNo statistically significant differences with respect to baseline patient characteristic were observed. After 6 months, both test and control implants yielded statistically significant PPD changes compared with baseline (T: 1.28 and C: 1.47 mm) but without statistically significant difference between groups (p = .381). No statistically significant changes in peri‐implant marginal bone levels were detected (p = .936). No statistically significant differences between test and control implants were observed with respect to microbiological and host‐derived parameters (p > .05). At the 6‐month follow‐up, treatment success was observed in 41.7% (n = 5) of test and 46.2% (n = 6) of control patients, respectively (p = .821).ConclusionRepeated adjunctive application of diode laser in the non‐surgical management of PI failed to provide significant benefits compared with mechanical instrumentation alone.

The effect of different implant location in mandibular implant assisted partial overdentures restoring Kennedy class I cases on peri-implant bone level changes and patient’s satisfaction

The effect of different implant location in mandibular implant assisted partial overdentures restoring Kennedy class I cases on peri-implant bone level changes and patient’s satisfaction

The Effect of Locator Attachment and Ball-O-Ring Attachment on Bone Height Change in Implant Retained Overdenture

Objectives. This study was conducted to evaluate and compare the effect of locator attachment and Ball-O-ring attachment on the peri-implant crestal bone level changes in edentulous patients rehabilitated with implant retained lower over denture. Methods. Twenty edentulous patients (male) were participating in this study, they were rehabilitated by mucosa supported maxillary complete denture and implant retained mandibular over denture by two implants installed in the canine region, patients were divided into two equal groups according to the type of attachment used, the locator attachment was used for group I and Ball-O-ring attachment was used for group II. Peri-implant crestal bone level changes were assessed using intra-oral radiographs taken with the standardized long cone paralleling technique using custom made acrylic template and the Rinn-xcp system. Periapical radiographs were taken every six months to complete a period of 18 months follow up period. The marginal bone loss at different intervals was obtained by calculating the difference in bone height at that interval from the base line measurement and statistically analyzed (t-test P &lt; 0.05). Results. The result of this study showed that the time has significant effect on the mean values of the peri-implant bone height on both groups. Moreover, group I had significantly less bone resorption from insertion to twelve months in compare to group II. Conclusion. The insignificant difference observed between comparing the peri-implant bone loss between the two groups indicates that the two treatment modalities are effective for the rehabilitation of lower denture. Locator attachments have the ability to control the amount bone loss. It could be advantageous in cases where the retention of implants retained overdentures is compromised.

Distally Tilted Implants According to the All-on-Four® Treatment Concept for the Rehabilitation of Complete Edentulism: A 3.5-Year Retrospective Radiographic Study of Clinical Outcomes and Marginal Bone Level Changes.

Bone grafting procedures during the use of dental implants may be avoided by the use of tilted implants in the maxilla and the mandible; advantages of angled implants are associated with the extension of the distal cantilever, leading to better implant survival rates. However, the bending effect on the single tilting implants may increase the marginal bone stress. The purpose of the present study was to retrospectively assess the clinical success and proximal bone loss rate following the implantation of distally tilted implants according to the All-on-Four™ prosthetic concept—based on radiographic findings—in a single-center experience, in addition to the assessment of the outcomes in the context of various clinico-epidemiological correlates. During the study period, n = 36 patients (24 males and 12 females) with complete records of periapical radiographs, received a full-arch fixed bridge supported by two axial and two distal tilted implants; overall n = 144 and n = 144 implants (Nobel B) were place in the maxilla and mandibles of patients, respectively. Mean age of patients at the time of fixture installation was 58.75 ± 13.71 years; n =11 patients presented with relevant underlying conditions/habits. To assess peri-implant bone-level changes, matched and calibrated orthopantomogram (OPT) images were taken at follow-ups after 1.5 years, 2.5 years, and 3.5 years post-restoration, and marginal bone levels were assessed on the mesio- (MA) and disto-approximal (DA) aspects. All implants were successful, resulting in a 100% overall survival rate. The radiographic mean bone loss levels at baseline (mean ± SEM) were 0.181 ± 0.011 mm and 0.178 ± 0.017 mm in the maxilla and mandible, respectively, while by the 3.5-year mark, bone loss was 0.770 ± 0.029 mm and 0.713 ± 0.026 mm in the maxilla and mandible (p > 0.05), respectively; bone-level changes were significant over time (p = 0.035 and p = 0.033). Peri-implant bone loss was more aggressive around titled distal implants versus mesial actual position implants. The effect of smoking and other underlying conditions showed significantly higher (p < 0.05) bone resorption levels when assessed on an individual implant-level, while during patient-level analysis, only a tendency was shown for higher bone loss rates for both MA and DA implants (p > 0.05). Within its limitations, our study has concluded that the use of All-on-Four™ prosthetic concept for total arch rehabilitation yields higher bone loss in association with tilted implants and, in some cases, on the MA surfaces at vertically positioned implants after >40 months in function.

Bone remodeling around dental implants after 1-1.5 years of functional loading: A retrospective analysis of two-stage implants.

ObjectivesThis study aims to retrospectively assess to what extent peri‐implant bone level changes occur from exposing the implant to the oral environment at the second stage of surgery (SSS) to the baseline assessment and, additionally, after 1–1.5 years of functional loading. Further, this study aims to examine the role of the emergence angle in marginal bone changes.Material and MethodsThis retrospective study included 46 patients treated between 2012 and 2019. These patients received 64 bone‐level dental implants. After implant placement, SSS, and baseline assessment, relevant clinical peri‐implant conditions and radiographical data were collected. A radiographic examination of the marginal bone level was performed after SSS, the baseline assessment, and 1–1.5 years of follow‐up.ResultsThe peri‐implant periodontal probing depth increased significantly from 3.08 ± 0.7 mm at the baseline to 3.27 ± 0.81 mm at the 1–1.5‐year follow‐up. The mean marginal bone level at the implant level was 0.12 ± 0.23, 0.35 ± 0.43, and 0.47 ± 0.47 mm at the SSS, baseline, and the 1–1.5‐year follow‐up, respectively. Most changes occurred at the implant's distal site. A significant relationship was found between the emergence angle and the extent of change in the marginal bone level between the SSS and baseline (r = .430, p ≤ .001).ConclusionsMost changes in the marginal bone level occurred between SSS and baseline assessments. For diagnostic purposes, it is advised to obtain a standardized radiograph after SSS to monitor peri‐implant bone‐level alterations.

Radiographic Evaluation of Crestal Bone Level Changes for Allografts or Xenografts Placed during Implant Placement: A Retrospective Study

The aim of this study was to evaluate initial peri-implant crestal bone level changes when the allografts and xenografts were placed simultaneously during the implant placement. This retrospective study was planned with the convenient sampling total of 77 implant sites that were bone grafted either with allografts (group I) or xenografts (group II). Using the periapical radiographs obtained after placement of bone grafts as baseline, the changes in the alveolar crestal bone around the implants were evaluated by comparing periapical radiographs taken at 3 months and 6 or 8 months after the surgery. The alveolar bone loss at crestal region at the time of placement of bone grafts were -1.85 ± 1.26 mm at the xenograft sites and -1.75 ± 1.51 mm at allograft sites, respectively (p = 0.791). At the time of reentry, 3 months after tooth extraction and ridge preservation, the bone dimensions were 1.17 ± 0.83 mm for xenograft and 1.00 ± 1.14 mm for allograft (p = 0.523). At the final reentry, bone-grafted sites were divided into after 6 months and after 8 months postoperatively. After 3 months, the allografts showed lesser bone resorption (0.9 ± 0.52 mm) as compared with the xenografts (1.25 ± 1.00 mm). The bone loss after 8 months for the allografts was spiked to 1.83 ± 0.42 mm as compared with the xenografts 1.37 ± 1.12 mm with no statistically significant difference (p >0.05). Both allografts and xenografts present comparable crestal bone level changes around dental implants when simultaneously placed during implant placement surgery. Both allografts and xenografts are suitable for the preservation of the alveolar ridge regarding crestal bone level changes. Selection of allografts and xenografts may not be carried out based upon the crestal bone level changes.

Clinical outcomes of dental implants placed in the same region where previous implants failed due to peri-implantitis: a retrospective study

PurposeThere is paucity in the studies that assess dental implants replacing failed dental implants due to peri-implantitis. This study aims to evaluate the clinical outcomes of these implants in terms of implant survival and marginal bone loss.MethodsPatients in this retrospective study were selected if having one or more implants removed due to peri-implantitis and the placement and loading of dental implants in the same region from April 2010 to December 2019. Information was collected about the patient's demographic data, implant dimensions, surgical and prosthetic variables. Changes in peri-implant bone level, cumulative implant survival rate and technical complications were assessed.ResultsThree hundred and eighty one dental implants in 146 patients that were placed in the same position or one-tooth position mesially/distally to the site of explantation were included. The patients' mean age was 63 ± 10 years. Ninety seven patients were females and 49 were males. After a mean follow-up of 34 ± 17 months, two implants failed. The cumulative survival rate was 99%. The marginal bone loss was −0.1 ± 0.6. Immediate or delay replacement of the failed implant did not affect implant survival or marginal bone stability. All the prostheses were screw-retained and presented the following complications: ceramic chipping (3 events), resin tooth fracture (1 event) and prosthetic screw loosening (1 event).ConclusionsDental implants replacing failed implants due to peri-implantitis would be an option in the management of peri-implantitis. They showed high survival rate and marginal bone stability.

Peri-Implant Tissue Behaviour Next to Different Titanium Surfaces: 16-Year Post-Trial Follow-Up

The present post-trial follow-up investigated the influence of titanium implants with different surface treatments on clinical behavior of soft and hard peri-implant tissues. Each of the 18 included patients received at least two adjacent implants: one control implant with a dual acid-etched (DAE) surface in their apical portion and a machined coronal part, and one test implant with a DAE surface up to its coronal portion. Peri-implant bone level change (BLC), probing depth (PD), bleeding on probing (BOP) and plaque index (PI) were recorded. A total of 42 implants was inserted. The mean follow-up period was 9.3 years (range: 5–16 years) and there were six dropouts. No implant failed. Moderate crestal bone remodeling occurred during the first year after implant insertion, with lower bone loss next to test implants compared to control ones (0.80 vs. 1.39 mm; p = 0.002). This difference was also detected at the 5- (p = 0.011), 6- (p = 0.008) and 7-year follow-up appointment (p = 0.027). No statistically significant differences were found in bone resorption between implants rehabilitated with ceramic vs. composite resin veneering material. No statistically significant differences were detected between test and control implants for BOP, PI, and PD at any time point. The results of the present study suggest that DAE surfaces reduce peri-implant bone loss in the initial phase of healing compared to machined surfaces, while they do not significantly affect soft peri-implant tissue and bone maintenance in the long-term. In conclusion, the minimally rough surfaces favour peri-implant bone maintenance and their effect is greater in the first year post implant insertion.

Surgical approach combining implantoplasty and reconstructive therapy with locally delivered antibiotic in the treatment of peri‐implantitis: A prospective clinical case series

Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri-implantitis, with variable results. To evaluate the 1-year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri-implantitis. Forty-three patients diagnosed with peri-implantitis were included. Surgical treatment consisted of implantoplasty of the supra-crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra-osseous component of the peri-implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri-implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri-implant marginal bone levels. One implant per patient was included in the analysis. The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm (p< 0.001) and 14% (p< 0.001) at 1 year, respectively. SoP was significantly reduced from 48.8% at baseline to 0% 1 year after surgery (p< 0.001). Radiographically, a mean defect fill of 2.64 ± 1.59 mm was recorded (p< 0.001). The combination of a resective and reconstructive surgical approach together with locally delivered antibiotic achieved a high disease resolution rate after 1 year of follow-up and constitutes a viable option for the management of peri-implantitis.

Peri-implant bone-level changes in the second decade of loading with regard to the implant\u2013abutment connection: a retrospective study on implants under systematic aftercare

BackgroundThis retrospective study investigates the change in the peri-implant bone level (PBL) during the 2nd decade of intraoral function in patients complying with a ‘supportive implant therapy’ (SIT) program. The results were statistically analyzed with respect to the implant abutment connection used.MethodsIn a private practice, only patients with 20-year SIT compliance were identified. Of these, all patients with 10- and 20-year radiographs available were selected. Therefore, no control group was possible and implant losses had to be excluded. Two experienced researchers assessed the peri-implant bone levels. As three different abutment connection concepts (bone-level butt-joint, bone-level conical and tissue-level conical) and two different implant surfaces (machined vs. roughened) were involved, statistical analyses were performed to detect potential differences.ResultsNinety-three implants from 36 patients with 20-year SIT compliance and available radiographs were included in the study. At study baseline (10 years intraoral), a mean bone loss of − 1.7 mm (median − 1.2; standard deviation [sd] 1.4, range: 0 to − 7.2) was recorded. After 20 years, we found a mean bone loss of − 2.5 mm (median − 2.3, sd 1.79, range: − 0.5 to + 7.4). Furthermore, we found a mean bone loss of 0.8 mm in intraoral function from year 10 to year 20 (mean: 0.08 mm per year); this change was independent of the abutment connection type.ConclusionsDuring the 2nd decade of function, peri-implant bone loss in patients with SIT compliance might be small in value and should not be expected in all implants.

The effect of implant-abutment connections on peri-implant bone levels around single implants in the aesthetic zone: A systematic review and a meta-analysis.

ObjectiveTo systematically review literature about the effect of different implant‐abutment interface designs on peri‐implant bone level changes, implant loss and mid‐buccal mucosa changes around single implants in the anterior maxilla. Reviewing three connection configurations: Platform switched conical (PS‐conical); Platform switched parallel (PS‐parallel); Platform matched parallel (PM‐parallel).MethodsA detailed search was carried out in Pubmed, EMBASE, Cochrane, Scopus, Open Gray and African journals Online (until December 1, 2020) and was restricted to clinical prospective studies of at least 1 year and with at least 10 human participants. A meta regression analysis was carried out primarily on the pooled peri‐implant bone level changes followed by implant loss and mid‐buccal mucosa level change. Risk of bias was assessed with RoB 2.0 and ROBINS‐I. The manuscript complied with the PRISMA guidelines and was registered in the PROSPERO database (ID: 225092).ResultsA total of 5513 hits gave 44 eligible articles for the analyses. Bone level change did not differ significantly between the two platform switched connections; their bone loss scores were significantly lower than PM‐connection. The PS‐conical connections have significantly lower implant losses than the PM connection. Mid‐buccal mucosa level change was comparable between the three connection configurations. Moderate to high risk of bias was detected in the included studies.ConclusionsThe performance of PS‐conical and PS‐parallel connection configurations both favored bone loss scores compared to the PM‐parallel connection configuration. All three demonstrated mid‐buccal mucosa changes that were small and did not differ significantly amongst the groups.