Peri-implant Tissue Conditions Research Articles

РАЗРАБОТКА КОМПЬЮТЕРНОЙ ЭКСПЕРТНОЙ ПРОГРАММЫ ОЦЕНКИ СОСТОЯНИЯ ПЕРИИМПЛАНТАТНЫХ ТКАНЕЙ

The subject of the research – expert assessment of the quality of implant prosthetics.
 The goal – creation of an instrument and clinical testing of the TAPATR computer program for assessing the condition of soft and hard peri-implant tissues, which is a diagnostic, prognostic and control method.
 Methodology. The subjects of the study were 48 people (11 men, 37 women) aged from 48 to 65 years (average age 58.2 ± 4.8 years). A comparative assessment of the proposed method (questionnaire) and the X-ray examination method (cone-beam tomography) was carried out. Statistical processing of materials was carried out using SAS v9.4 software.
 Results. Successful initial clinical validation of the method was carried out. A comparison of the survey and radiological assessment led to reliably identical results, namely, a direct pattern of deterioration in the health of peri-implant tissues depending on the degree of peri-implantitis. Statistical analysis showed that there are significant correlations between all indicators: between a high level of health and the absence of illness, a good level of health and class 2 illness, (r = 0.42 and r = 0.42, respectively). A moderate correlation has been proven between a low level of health and disease class 2 (r = 0.56) and severe – between a satisfactory level of health and class 3 (r = 0.76).
 Conclusion 
 1. An expert method for assessing the condition of soft and hard peri-implant tissues has been developed.
 2. High objectivity, validity and reliability of the presented method have been proven.
 3. The proposed method can be used in clinical settings, in expert assessment of the quality of prosthetics, and also in the work of conflict expert commissions.

КОМПЬЮТЕРНАЯ ПРОГРАММА САМООЦЕНКИ ОКОЛОИМПЛАНТАТНЫХ ТКАНЕЙ

The subject of the study is a method for assessing the quality of implant prosthetics.
 The goal is to develop a method for patient self-assessment of the condition of peri-implant tissues.
 Methodology. Two computer programs developed at the Department of Orthopedic Dentistry of the First St. Petersburg State Medical University served as an analogue and prototype for the development of a visual analogue scale (VAS). acad. I.P. Pavlova: “KULOS” “Comprehensive assessment of the tissues of the prosthetic bed and the quality of dental and jaw prostheses” (Trezubov V.N. et al., 2008) and “PARMIT” “Automated portable visual analogue scale (VAS)” (Trezubov V.N. et al., 2023).Clinical testing of the developed scale was carried out. The study involved 48 people (11 men, 37 women) aged from 48 to 65 years (average age 58.2 ± 4.8 years). Statistical processing of materials was carried out using SAS v9.4 software.
 Results. This scale is intended for patients to self-assess the condition of peri-implant tissues. Completed by us as a questionnaire, it actually represents a six-step visual analogue scale – VAS. Successful initial clinical validation of the method was carried out. Parallel use of the questionnaire by Wolfart S. (2006) and Mericske-Stern R. et al. in the same patients. (2009), “PARMIT” (Trezubov V.N. et al., 2023) demonstrated a reliable general direction and an average degree of closeness of these questionnaires with the author’s method (respectively: r_1 = 0.468; r_2 = 0.573; r_3 = 0.698).
 Conclusions. A method for patient self-assessment of the condition of peri-implant tissues has been developed. The proposed method can be used in expert assessment of the quality of implant prosthetics.

A two-year prospective study to compare the peri-implant parameters of posterior implant-supported single crowns with and without mesial proximal contact loss

Background/purposeInterproximal contact loss may lead to food impaction and result in subsequently periodontal complications. The purpose of this prospective study was to investigate the peri-implant parameters of posterior implant-supported single crowns (SCs) with and without mesial proximal contact loss after 2 years of follow-up. Material and methodsTwenty-six patients with a total of 40 posterior implant-supported SCs with mesial adjacent natural teeth were observed for 24 months after crown insertion. The mesial proximal contacts were assessed by dental floss, then were classified as tight, weak, and open contacts. The following peri-implant parameters were evaluated, including modified plaque index (MPI), modified gingival index (MGI), and probing depth (PD) were conducted at six sites per tooth (mesiofacail, midfacial, distofacial, mesiolingual, mid-lingual and distolingual) in the 6-, 12-, 18- and 24-month following visits. Furthermore, radiographs were taken regularly in 12- and 24-month recall sections for measuring the marginal bone loss (MBL). ResultsAt 12-month observation, the incidence rates of weak and open contacts were 22.5 % and 12.5 %; whereas after 24 months of clinical service, the rates came up with 12.9 % and 25.6 %, respectively. No significant differences were found between the tight, weak, and open contact groups in the parameters of MPI, MGI, or PD (P > 0.05) at 12- and 24-month follow-up. None of the mean differences of the peri-implant parameters: MPI, MGI, PD and MBL had significant differences between the tight, weak, and open contact groups after 1 and 2 years of clinical service (P > 0.05). ConclusionThe presence of open, weak, and tight mesial proximal contacts had no significant effects on the peri-implant tissue conditions.

Peri-Implant Tissue Health and Disease in the Pre- and Post-Loading Phases.

Considering the widespread use of dental implants, a precise definition for peri-implant tissue health and an appropriate classification for peri-implant diseases are imperative for researchers and dental clinicians. However, absence of a unanimous definition and an efficient classification system has created controversies in the published reports regarding the epidemiology and prevalence of peri-implant diseases. Moreover, lack of a standard system for differentiation of different grades of peri-implantitis further complicates the interpretation of reports regarding the diagnosis prevalence, treatment, and outcome of such conditions, and highlights the need for a classification system based on the severity of disease. Almost all of the currently available classification systems focus on the assessment of health or disease status of the tissues around loaded implants. The purpose of the present study is to propose a classification/scoring system for peri-implant tissue health before and after prosthetic loading. This grading system can aid the researchers and dental clinicians in assessment of peri-implant tissue condition both before and after prosthetic loading of dental implants.

Radiographic Assessment of Buccolingual Dimension of Allogenic Bone Ring When Used Simultaneously with Dental Implant Placement

Purpose: This study aimed to evaluate the use of allogenic bone ring technique to restore the bucco-lingual dimension of the alveolar bone defects combined with simultaneous dental implant placement. Subjects and methods: Ten patients requiring bone augmentation horizontally or both horizontally and vertically at the time of implant placement were included in this retrospective study. All patients received simultaneous bone augmentation surgery and implant placement with allogenic bone ring grafts. Postoperative efficacy of the technique was evaluated using CBCT as a radiographical parameter. Results: Survival rates of implants were 100%. Cone-beam computed tomography revealed that the allogenic bone ring graft had significantly sufficient horizontal bone augmentation below the implant neck platform to 0 mm, 1 mm, 2 mm, and 3 mm. It could also provide an excellent peri-implant tissue condition during the 6 months’ follow-up after loading. Conclusion: The bone ring technique with allogenic bone ring graft could increase and maintain horizontal bone mass in the region of the implant neck platforms in serious horizontal bone defects.

Issue microcirculation around extended implant-supported prostheses with few abutment sites in patients with terminal mandibular dentition

Relevance. The success of implant-supported prostheses depends on the quality of the jawbone. Traditionally, it is assessed radiographically, but this method is not only invasive but also unreliable and inaccurate for predicting the outcome of treatment.Material and methods. The study included 80 patients (49 women and 31 men) with a mean age of 71 ± 7 years, which formed four groups. Group A (control group, n = 20) consisted of patients with healthy periodontium; comparison group B, n = 20, comprised patients with terminal dentition; the main group C (n = 20) included patients with extended rehabilitation, fixed 7-10 days before; group G (n = 20) was composed of patients with “Trefoil” implant-supported prostheses, fixed three years earlier. The blood flow of peri-implant tissues was assessed using ultrasound Doppler flowmetry (UDF). All patients (n = 20) underwent dual-energy X-ray absorptiometry (DXA) before the prosthetic treatment.Results. The analysis of pre-prosthetic-treatment ultrasound Doppler flowmetry results showed low values of microcirculation in the alveolar ridge mucous membrane in patients with terminal dentition compared with the control group. On the 7th day after implant-supported prosthetic treatment, group C demonstrated an increase in microcirculation by 11.42% compared to the control group and by 147.36% compared to group B. Three years after implant-supported prosthetic treatment, the ultrasound data revealed a statistically significant increase in blood flow velocity 0.342 ± 0.04 (cm/s) (p < 0.01). The Pearson coefficient determined a high correlation between T-scores of DXA and ultrasound Doppler flowmetry data (r = 0.829, p = 0.0001).Conclusion. Ultrasound Doppler flowmetry (UDF) can be the main method for studying the peri-implant tissue condition at various stages of implant-supported prosthetic treatment.

Dynamics of the state of supporting implants of covering and fixed prostheses in the complete absence of teeth

BACKGROUND: The functional duration of implant prostheses in the complete absence of teeth is insufficiently represented in the special literature. Hence, the experience of using such prostheses of various designs over 20 years is summarized.
 AIM: To analyze the effectiveness of implant prostheses in the complete absence of teeth in terms of peri-implant tissue status
 MATERIAL AND METHODS: This study examined 23 patients with fixed dentures on 4 implants after 5 years and 30 patients with fixed dentures on 6 implants after 10 years from the manufacture date. Overdentures on 4 implants with rigid attachments were analyzed in 24 patients after 10 years and with elastic attachments in 28 patients after 20 years. Additionally, 20 years ago, 73 patients received overdentures with bar fixation on 2 implants. The evaluation criteria include the detection of mucositis, peri-implantitis with 1/3 and 1/2 bone resorption, and implant removal.
 RESULTS: When summarizing the state of implants over 20 years, the following results were obtained: removable dentures are more effective with rigid attachments on a bar and 4 implants and less effective on 2 implants (47.9% and 65.2% of implant removals, respectively); fixed prostheses with complete absence of teeth (experience of 10 years of use) are preferred with support for 6 implants (28.3% of removals vs. 42.4% with support for 4 implants).
 CONCLUSIONS: In conclusion, the proportion of removed implants is 50% of the installed ones. The functional average period of fixed prostheses on 6 implants in the absence of teeth is 10 years (on 4 implants is 5 years) and removable prostheses on 24 implants with elastic and rigid attachments is 5 years.

Comparative clinical study of conventional dental implant and mini dental implant-retained mandibular overdenture: A 5- to 8-Year prospective clinical outcomes in a previous randomized clinical trial.

To compare the long-term prospective clinical outcomes in a previous randomized controlled clinical trial (RCT) of 2 Mini Dental Implant (2MDI), 4 Mini Dental Implant (4MDI), and 2 Conventional Dental Implant (2CDI)-retained mandibular overdenture with follow-up between 5 to 8 years. Thirty-seven patients formerly participated in the Comparative Clinical Study of CDI and MDI for Mandibular Overdenture were requested for examination of clinical outcomes. A total of 104 implants were placed with mean follow-up periods 6.64 ± 0.60 years. In Group 1 (2MDI) and Group 2 (4MDI), implants were placed and immediately loaded with Equator® attachments to retained mandibular overdenture. In Group 3 (2CDI), implants were placed and delayed 3months for denture loading with ball attachment. The success rate, survival rate, clinical implant performance scale (CIP scale), peri-implant tissue status, prosthetic complication, implant stability quotient (ISQ), marginal bone level change (MBLC), and patient satisfactions were analyzed. After 5 to 8 years follow-up, the success rate in Groups 1, 2, and 3 were 90.91%, 93.33%, and 54.55%, respectively. The success rate in Group 3 was significantly lesser than Group 1 (p=0.016) and Group 2 (p < 0.001). The survival rate in Groups 1, 2, and 3 was 100%, 96.67%, and 90.91%, respectively, and showed no significant differences. Mean ISQ reported no significant differences between groups. Mean MBLC were 0.57 ± 1.19 mm, 0.68 ± 0.90 mm, and 1.55 ± 1.60 mm in Groups 1, 2, and 3, respectively. Group 3 reported significantly greater mean MBLC than Group 1 (p=0.016) and Group 2 (p=0.011), but Groups 1 and 2 were not significantly differences. The overall patient satisfactions were reported as not significant differences between groups. Two MDI-retained mandibular overdentures with immediate loaded protocol performed had favorable clinical outcomes, cost effectiveness, and overall patient satisfactions after 5 to 8 years follow-up.

Peri-implant tissue conditions following transcrestal and lateral sinus floor elevation: 3-year results of a bi-center, randomized trial.

ObjectivesThe present study was performed to comparatively evaluate the peri-implant bone stability and conditions of marginal tissues at 3 years following transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively).Materials and methodsPatients included in a parallel-arm randomized trial comparatively evaluating tSFE and lSFE were recalled at 3 years post-surgery. Twenty-one and 24 patients in tSFE and lSFE groups, respectively, participated in the follow-up visit. Peri-implant bone support was evaluated as the proportion of the entire implant surface in direct contact with the radiopaque area (totCON%) on 3-year periapical radiographs. The conditions of the marginal peri-implant tissues at 3-year visit were classified as peri-implant health, peri-implant mucositis, or peri-implantitis.ResultsAt 3 years, both groups showed an implant survival rate of 100%. Median totCON% was stable at 3 years, being 100% in both groups (p = 0.124). Peri-implant health and mucositis were diagnosed in 10 (47.6%) and 11 (52.4%) patients, respectively, in the tSFE group, and in 8 (33.3%) and 16 (66.7%) subjects, respectively, in the lSFE group (p = 0.502).ConclusionsAt 3 years following surgery, implants placed concomitantly with tSFE and lSFE fully maintain peri-implant bone support. Peri-implant mucositis was the most prevalent condition, with a similar prevalence between groups.Clinical relevance.Based on 3-year data on peri-implant bone support and prevalence of peri-implant diseases, the study suggests that tSFE and lSFE represent two equally valid options for the rehabilitation of the posterior maxilla. ClinicalTrials.gov ID: NCT02415946.

Клинико-рентгенологическая оценка состояния имплантатов с несъемными конструкциями в динамике за 20 лет

The statistically significant long-term results of the implant survival and the effectiveness of prostheses are inadequately represented in scientific literature. The study was aimed to assess the effectiveness of prosthetics with fixed structures on the intraosseous dental implants for the replacement of partially absent dentition in the dynamics of the 20-year follow-up. A total of 671 patients with partially missing teeth were examined at the Clinical Center of Dentistry of the FMBA of Russia, who were fitted with 1,700 intraosseous titanium dental implants with the terms from the moment of completion of prosthetics on implants of 5, 10, 15 or 20 years. The criteria for clinical and radiological evaluation of the implant condition were as follows: no complications affecting the condition of periimplant tissues (normal), mucositis, periimplantitis with bone resorption at 1/3 or 1/2 of the implant height, implant removal. Based on 20 years of experience, prosthetics with fixed structures on implants is highly effective in replacing the partial defects of dentition. In total, 62.2% of implants remain functional for 20 years. The average life of implant-supported fixed prostheses is 15 years for bridges, and 20 years for single and combined implant-supported crowns. The most effective are single implant-supported crowns, and the least effective are prostheses supported by implants and teeth. The significantly preserved implant-supported prostheses make it possible to support the concept of the long-term implant installation with respect to the implant-supported non-removable prostheses. The view is thus confirmed that the effectiveness of the implant-supported prosthetics is reduced with the inclusion of teeth in the bridge support, along with implants.

Long-Term Effect of Keratinized Tissue Width on Peri-implant Health Status Indices: An Updated Systematic Review and Meta-analysis

The keratinized tissue (KT) around dental implants may be useful to ease plaque control. This meta-analysis aimed to compare peri-implant health parameters based on KT width (≥ 2 mm vs < 2 mm). A highly sensitive search of five databases was performed up to February 1, 2020. The quality of eligible studies was assessed using a modified version of the Newcastle-Ottawa checklist. A random-effects model was used to pool standardized mean differences with 95% confidence intervals. To discover sources of heterogeneity, subgroup analysis and meta-regression were used. Publication bias was evaluated by the Egger and Begg tests. From 7,934 identified studies, 22 papers were included in the meta-analysis, representing 3,004 implants in the case group (KT ≥ 2 mm) and 1,829 implants in the control group (KT < 2 mm). The results indicated that most of the parameters, including gingival recession (GR), Gingival Index (GI), modified Gingival Index (mGI), Plaque Index (PI), modified Plaque Index (mPI), bleeding on probing (BOP), modified Bleeding Index (mBI), and bone loss (BL) revealed substantial differences between the control and case groups. On the contrary, no statistically significant association was detected for pocket depth (PD) between the two groups. The presence of at least 2 mm of KT around implants has a protective effect on the peri-implant tissue condition. Narrow KT was related to higher BL, BOP, mBI, GI, mGI, PI, mPI, and GR. In addition, with regard to PD, no significant difference was found.

Horizontal bone augmentation and simultaneous implant placement using xenogeneic bone rings technique: a retrospective clinical study

This study evaluated the use of bone ring technique with xenogeneic bone grafts in treating horizontal alveolar bone defects. In total, 11 patients in need of horizontal bone augmentation treatment before implant placement were included in this retrospective study. All patients received simultaneous bone augmentation surgery and implant placement with xenogeneic bone ring grafts. We evaluated the postoperative efficacy of the bone ring technique with xenogeneic bone grafts using radiographical and clinical parameters. Survival rates of implants were 100%. Cone-beam computed tomography revealed that the xenogeneic bone ring graft had significantly sufficient horizontal bone augmentation below the implant neck platform to 0 mm, 1 mm, 2 mm, and 3 mm. It could also provide an excellent peri-implant tissue condition during the 1-year follow-up after loading. The bone ring technique with xenogeneic bone ring graft could increase and maintain horizontal bone mass in the region of the implant neck platforms in serious horizontal bone defects.

Health Indicator Bacteria That Is Useful for Risk Assessment of Peri-Implantitis

We established a novel identification method for oral Rothia species using one-step multiplex PCR analysis to investigate whether the monitoring of oral Rothia species levels is useful for peri-implantitis risk assessment, and to examine the oxygen concentration that these organisms need for growth in vitro. The mean number and proportion of Rothia aeria in peri-implant sulcus fluid (PISF) samples was significantly higher in the healthy implant group than in the peri-implantitis group (P R. aeria under aerobic conditions vigorously grew compared with those under anaerobic conditions, and this organism grew only at the upper layer where high oxygen concentrations existed in a semi-liquid nutrient medium. Therefore, the monitoring of R. aeria levels may be suitable as an indicator of healthy peri-implant tissue conditions for the prevention of peri-implantitis.

Multivariate analysis of the influence of prosthodontic factors on peri-implant bleeding index and marginal bone level in a molar site: A cross-sectional study.

Peri-implant tissue condition can result from prosthodontic, surgical and bacteriological factors. This study investigated the effects of prosthodontic factors on peri-implant tissue. Subjects were 140 patients with 310 implants from Osaka University Dental Hospital. Prosthodontic factors examined were the connection type, the suprastructure retention type, the material of the abutment and the mesiodistal and buccolingual prosthetic form of the superstructure as emergence angle. The objective variables were the modified bleeding index (mBI) and marginal bone level (MBL). Statistical analysis was used as a generalized estimation equation. The taper joint had a significantly smaller MBL than the butt joint (P < .001). There was no significant difference in mBI and MBL between cement and screw retaining. Zirconium and titanium resulted in a significantly smaller mBI than gold alloy (zirconium/gold alloy: P = .037, titanium / gold alloy: P = .021), but there was no significant difference in the MBL. Both mBI and MBL tended to be smaller when the emergence angle was around 20° to 40°, although this difference was not significant. As a result of multivariate analysis, our findings suggest that to reduce MBL from the perspective of prosthodontic factors it is preferable to use an implant with a taper joint connection positioned with an emergence angle of 20° to 40°.

Peri-implant tissue conditions at implants treated with Sub-periosteal Peri-implant Augmented Layer technique: A retrospective case series.

To assess peri-implant tissue conditions on the short term in patients receiving the Sub-periosteal Peri-implant Augmented Layer (SPAL) technique and in patients with adequate thickness (≥2mm) of the peri-implant buccal bone plate (PBBP) at placement. Patients where either a dehiscence defect or thin PBBP at implant placement was corrected by SPAL technique (SPALdehiscence and SPALthin groups, respectively) and patients presenting a residual PBBP thickness ≥2mm at implant placement (control group) were retrospectively selected. The number of peri-implant sites positive to bleeding on probing (BoP) at 6months following prosthetic loading was the primary outcome. Also, height of keratinized mucosa, marginal soft tissue level, Plaque Index, peri-implant probing depth, suppuration on probing, and interproximal radiographic bone level (RBL) were evaluated. Thirty-four patients (11 in the SPALdehiscence group, 11 in the SPALthin group, and 12 in the control group) were included. In each SPAL group, 10 patients (90.9%) showed peri-implant tissue thickness ≥2mm at the most coronal portion of the implant at uncovering. The prevalence (number) of BoP-positive sites was 2, 1, and 0 in the SPALdehiscence , SPALthin , and control groups, respectively. RBL amounted to 0.3mm in the SPALdehiscence group, 0.2mm in the SPALthin group, and 0mm in the control group. After 6months of prosthetic loading, patients treated with SPAL technique show limited peri-implant mucosal inflammation in association with shallow PD and adequate KM. At implants receiving SPAL technique, however, interproximal RBL was found apical to its ideal position.

Effect of vertical soft tissue thickness on clinical manifestation of peri-implant tissue in patients with periodontitis

To observe and investigate the effect of vertical soft tissue thickness on the peri-implant tissue condition and the prevalence of peri-implant disease in patients with history of periodontitis. Among 210 patients who showed initial interest of implant therapy, 92 patients were included in this study and received implant surgery during 2010 and 2015. Sixty-six patients with 66 implants finally came back for T2 evaluation. Prior to the implant therapy, all the patients had received periodontal treatment. During the implant placement surgery, the distance from palatal soft tissue edge to the alveolar crest, which was defined as vertical soft tissue thickness (VT), was measured after the buccal full thickness flap was elevated. According to the cut off point which was adopted from the operating characteristic curve, 66 implants within 66 patients were divided into two groups, which were called normal group (VT≤4.5 mm) and thick group (VT>4.5 mm), respectively. Information of the patient's general status, periodontal situation and implant information were recorded. After a follow-up period of 42.9 months, the parameters of peri-implant tissue and condition of peri-implant disease were recorded. Mann-Whitney U test as well as Chi-square test were used to compare the parameters between two groups. Moreover, Kaplan-Meier method was chosen to draw the event(peri-implantitis)-free survival curve. The survival rate of the implants was 100%. At the end of the follow-up examination(T2), the parameters including max PDi, mean PDi, max BIi, mean BIi, mean MBL, MBL at distal side, MBL at mesial side, mean PLIi presented significantly higher values in thick group than in normal group (P < 0.05). Moreover, the prevalence of peri-implantitis and peri-implant disease (peri-implant mucositis & peri-implantitis) in thick group was respectively 34.8% and 73.9%, which was significantly higher than 2.3% and 48.8% respectively in normal group (P<0.05). The prevalence of peri-implant mucositis did not show significant difference in the two groups. In addition, Kaplan-Meier analysis showed that there was significant difference between the event-free survivals of the two groups. The vertical soft tissue thickness around implants in patients with periodontitis has a significant effect on the health of the peri-implant tissue. Excessive vertical soft tissue thickness may result in deeper peri-implant probing depth as well as more peri-implant marginal bone loss, and eventually increase the risk of peri-implant disease. The vertical remodeling of soft tissue may be a new direction to indicate the role of periodontitis in peri-implant tissue condition. Moreover, the biological mechanism of the association between soft tissue thickness and peri-implantitis risk as well as effective approaches to prevent the adverse effect of excessive soft tissue thickness on peri-implant tissue is necessary to be investigated.

The Correlation of Clinical Outcomes (Marginal Bone Loss, Probing Depth, and Patient Satisfaction) With Different Prosthetic Aspects of Implant Overdentures: A Five-Year Retrospective Cohort Study.

Implant overdentures increase retention, stability, support, and subsequently comfort and patient satisfaction with removable dentures. This study aimed to investigate the correlation of clinical outcomes (marginal bone loss, probing depth, and patient satisfaction) with different prosthetic aspects of mandibular implant overdentures. Seventy-four implant overdenture wearers who had received their overdentures between 1 to 5 years ago were selected using simple cluster sampling. The data investigated included mucosal health of the mouth, condition of peri-implant tissues, marginal bone loss (MBL), and patient satisfaction. The relationship of MBL and probing depth (PD) with independent variables was assessed by Pearson and Spearman's rho correlation coefficients. The comparisons of MBL, PD, patient satisfaction, and tissue irritation among different states of independent variables were done by analysis of covariance, Tukey and Tamhane post-tests, and chi-square tests (α = 0.05). A total of 186 implants were evaluated. The mean ages of participants and overdentures were 61.62 ± 9.28 (year) and 38.45 ± 16.64 (month), respectively. The survival rate and success rate were calculated to be 100% and 97.8%, respectively. Higher width of attached gingiva was correlated with less PD significantly (P = .006). Gingival index (P < .001) and plaque index (P = .006) were correlated with PD positively. Mean MBL for those who needed matrix/patrix adjustment was significantly higher than that of those who did not need it (P = .025). Taking into account our small sample size, the results of this study suggest that healthy peri-implant mucosa is significantly correlated with the presence of attached gingiva and appropriate oral health care. Furthermore, patients receiving implant overdentures should be informed about the importance of regular recalls.

Effect of a single initial phase of non-surgical treatment of peri-implantitis: Abrasive air polishing versus ultrasounds. A prospective randomized controlled clinical study

BackgroundNon-surgical treatment of peri-implantitis includes a correct mechanical debridement of the implant surface to reduce the inflammation and recondition the soft tissues. The aim of the study was to evaluate the results of a single phase of non-surgical therapy by comparing the effect of curettes and ultrasounds versus curettes and abrasive air polisher (Air-Flow) in the peri-implant tissue conditions, and patient satisfaction. Material and MethodsA double-blind randomized and controlled prospective clinical study was conducted on patients in peri-implant maintenance phase diagnosed of peri-implantitis treated in the Oral Surgery Unit of the Stomatology Department of the Faculty of Medicine and Dentistry of the University of Valencia, between September of 2017 and May of 2018. They were divided into 2 groups: Group 1: curettes and ultrasounds, and Group 2: curettes and Air-Flow. The clinical and radiological baseline parameters were evaluated after 3-weeks of treatment, as well as patient satisfaction. ResultsThe sample included 34 patients. Group 1 (17 patients, 38 implants) and Group 2 (17 patients, 32 implants). All the variables improved statistically significantly after treatment in both groups, with the exception of recessions and keratinized mucosa and bone loss that did not vary. When comparing both groups, the type of treatment did not influence the majority of the variables, with the exception of the plaque index (p=0.011) and modified bleeding index from the palatine (p=0.048), which reduced statistically significant in the group 2, as well as the patient satisfaction which was higher in the group 2 (p<0.001). ConclusionsAn initial phase of non-surgical treatment achieves an improvement of the peri-implant clinical parameters, thought the method of debridement used seems not to influence. Key words:Peri-implantitis, peri-implant disease, non-surgical treatment, air-abrasive device, mechanical debridement.

Oral rehabilitation with dental implants in patients with recessive dystrophic epidermolysis bullosa: A retrospective study with 2-15 years of follow-up

Background Epidermolysis bullosa (EB) comprises a group of hereditary disorders characterized by mechanical fragility of the skin and mucous membranes, with the development of blisters and vesicles in response to minimum tissue friction. Recessive dystrophic epidermolysis bullosa (RDEB) with generalized involvement is the most common subtype in the oral cavity. The present study was carried out to investigate dental implant survival, peri-implant tissue condition, patient satisfaction, and the impact of treatment upon the quality of life of patients with RDEB rehabilitated with implants and full-arch implant-supported prostheses. Material and Methods Thirteen patients with RDEB underwent dental implant treatment between September 2005 and December 2016. A retrospective study was made to analyze implant survival, peri-implant tissue health and patient satisfaction. Results A total of 80 implants were placed (42 in the maxilla and 38 in the mandible) in 13 patients between 20-52 years of age and diagnosed with RDEB. All the implants were rehabilitated on a deferred basis with 20 full-arch prostheses. Fifteen fixed prostheses and 5 implant-supported overdentures were placed. The implant survival rate was 97.5% after a mean follow-up of 7.5 years after prosthetic loading. Fifty percent of the implants showed mucositis at the time of evaluation. Probing depth was maintained at 1-3 mm in 96.2% of the implants, and bleeding upon probing was observed in 67.5% of the implants. There was a high prevalence of bacterial plaque (85%). Conclusions The treatment of edentulous patients with RDEB by means of implants and implant-supported prostheses is predictable as evidenced by the high success rate, and improves patient self-esteem and quality of life. Key words:Epidermolysis bullosa, dental implants, implant-supported prostheses.

Bar versus ball attachments for maxillary four‐implant retained overdentures: A randomized controlled trial

To compare the clinical treatment outcomes of maxillary four-implant retained overdentures with either splinted (bar) attachments or non-splinted (ball) attachments. Forty participants who were dissatisfied with their existing conventional maxillary complete dentures were included in this randomized controlled trial. Six months after implant placement, a definitive prosthesis was inserted. Implant success, condition of peri-implant tissue, prosthodontic maintenance and complications, and patient satisfaction were assessed. Outcomes were recorded at baseline, prosthesis delivery, and at 3 and 12months following prosthesis delivery, and a statistical analysis was performed. Thirty-two of the forty patients completed the 1-year follow-up and had their treatment outcomes evaluated. The mean marginal bone loss after 1year of loading was 0.34±0.88mm, and there were no significant differences between the two groups. Plaque index, gingival index and bleeding on probing were significantly higher in the bar group (p<.001), and the implant success rate of the bar group was significantly lower than that of the ball group (p=.028). The most frequent prosthodontic maintenance and complication issue was the need to change the bar clip or O-ring as a result of retention loss. Patient satisfaction did not differ between the two groups except for aesthetics at 3months. Within the limitations of this study, the maxillary 4-implant retained overdenture exhibited predictable results regardless of the attachment systems (ball or bar) in the 1-year follow-up period. The bar group was more vulnerable than the ball group with respect to maintaining peri-implant tissue health.