Marginal Bone Level Research Articles

EFFECT OF DENTAL IMPLANTS SURFACE TREATMENT ON MARGINAL BONE HIGHT

Statement of problem:Marginal bone changes around implant supported complete dentures is one of the most significant factor that affect the clinical success of dental implants which depends mainly on osteointegration and surface treatment. Purpose. This study aimed to assess the change in marginal bone height of two different surface treated implants retaining and supporting complete overdenture. Materials and Methods.50-60 yearsoldcompletelyedentulous patients wereselectedandand rehabilitatedwithmaxillarycomplete dentures and mandibularoverdenturesretained by twoball and socket dental implants. The implants surface treatmentsusedwereacidetch andresorbable blast media (RBM). Marginal boneheight changes wereassessed at denture insertion, after six- and twelve-monthusingconebeamcomputedtomography (CBCT). Date wascollected and Students t-test wasperformed. Results. The change of marginal bone of the acid etched and RPM implants throughout the follow up periods showed no significant statistical difference among the two type of implants at time of loading, after the 6th and 12th month. Conclusions. Acid etchedandRBM dental implants supporting and retaining complete mandibular overdentures showed significant success rates regarding the marginal bone changes during the follow up period. Clinical Implications: Guided implant placementgranting more accurate and predictable implant position while reducing the patient fear and anxiety. The marginal bone level changes were within the reported range of the literature of both acid etched and RBM dental Implants.

Successful complete oral rehabilitation of a patient with osteopetrosis with extensive pre-treatments, bone grafts, dental implants and fixed bridges: a multidisciplinary case report

BackgroundOsteopetrosis comprises a group of inherited disorders that are rare and result in abnormal bone structure. Bone remodeling is extremely inhibited because osteoclasts are nonfunctional or lacking. This condition causes overgrowth of bone with disappearance of the bone marrow, leading to aplastic anemia; obstruction of nerve passages in the skull leads to blindness and often hearing impairment. In most cases, osteopetrosis results in oral complications such as tooth deformation, hypomineralization, and delayed or absent tooth eruption. The only curative treatment is hematopoietic stem cell transplantation (HSCT). The main treatment of the oral complications during childhood and adolescence consists in protecting the erupted teeth against caries disease through prophylactic treatment aimed at optimal oral hygiene through frequent regular dental visits throughout life. Many patients with osteopetrosis require major oral rehabilitation to treat complications of the disease. Improved results of HSCT increase the likelihood that dental professionals will encounter patients with osteopetrosis.Case presentationIn this case report, we show that individuals with osteopetrosis who have severe oral complications can be treated successfully if they are treated for osteopetrosis at an early age. The boy had his dental care in pedodontics, and regular multidisciplinary meetings were held for future treatment planning. At the age of 15, he was then referred for rehabilitation. The initial evaluations revealed no further growth in the alveolar bone. The rehabilitation was done stepwise, with extraction of malformed and malpositioned teeth. Initially, the patient received a removable partial denture followed by reconstruction of the width of the alveolar process, titanium implants, temporary fixed bridges, and finally screw-retained titanium–ceramic bridges with titanium frames for the upper and lower jaws.ConclusionsThe three-year follow-up after loading indicated a stable marginal bone level and optimal oral hygiene as a result of frequent professional oral hygiene care. The patient showed no signs of symptoms from the temporomandibular joint and has adapted to the new jaw relation without any functional or phonetical issues.

The Use of Two-Piece Transmucosal Implants Designed with a Convergent Neck: A 6-Year Clinical Prospective Cohort Study Evaluating the Impact on Soft and Hard Tissues.

This prospective study evaluated the marginal bone level and periodontal parameters 6 years after placement of a convergent transmucosal neck implant. In total, 71 implants were placed in 60 patients. Of these, 52 implants were placed with a flapless technique and with the convergent neck exposed by 1 mm (early and delayed placement), while 19 implants were placed immediately after extraction (immediate placement). At least 3 months after insertion, customized abutments were applied and provisional resin crowns were cemented, while being careful to prevent any tissue compression. After 3 weeks, definitive metal-ceramic crowns were designed with the finish line at the soft tissue level and free from any compression. The implant survival rate at 6 years, marginal bone level changes (ΔMBL, mm), and Pink Esthetic Score (PES) were evaluated. Gingival phenotype was determined before the implant surgeries (thin/thick). A three-level hierarchical model was examined with a random intercept and random slope on follow-up time at the patient level and a random intercept at the implant level. In all, 57 patients with 67 implants reached the 6-year point; 3 patients (5.0%) dropped out. The implant survival rate was 100%. ΔMBL from baseline to 24 months was 0.58 mm (95% CI: 0.48, 0.68), while ΔMBL from 24 to 72 months was 0.33 mm (95% CI: 0.19, 0.47). PES improved steadily from 6 to 48 months (+0.96; 95% CI: 0.71, 1.20), with overall stability at 72 months. No correlation between MBL and PES was observed. A significant association was found between thick gingival phenotype and less MBL variation. Greater implant diameter offered more MBL stability after 3 years but resulted in lower PES values. The use of convergent transmucosal neck implants placed with a flapless transmucosal approach with the crown margin positioned at the gingival level preserved marginal bone and guided gingival morphology for up to 72 months. The gingival phenotype was the parameter that most affected the soft and hard tissues. In the long term, implant placement timing was not related to MBL.

Effects of Piezoelectric Surgery on Implant Stability and Marginal Bone Level: Systematic Review and Meta-analysis

Effects of Piezoelectric Surgery on Implant Stability and Marginal Bone Level: Systematic Review and Meta-analysis

Influence of Crestal Implant Position and Smooth Collar on Marginal Bone Level: A 2-Year Retrospective Radiographic Analysis.

The aim of this retrospective study was to establish the survival rate and the clinical outcome of a an endoosseous implant system and to evaluate the marginal bone level and the impact of the positioning of the machined collar neck on crestal bone level changes up to two years follow-up. 96 implants were placed in 57 patients and loaded with final restoration after at least three months of healing time. 15 of these implants were immediately placed into fresh extraction sockets while 81 implants were inserted in healed ridges. Marginal Bone Loss around implants were determined radiographically after a mean observation time ranging between twelve and twenty-four months after loading. The effect of location (mandible v/s maxilla, anterior v/s posterior), immediate implant v/s native bone, smoking habit, gender, implant length and diameter, the type of prosthesis (screw-retained/cemented) and the positioning of the machined collar on the marginal bone loss was evaluated. Survival rates were evaluated based on the criteria as determined by Misch et al. in 2008. The Survival Rate at the implant level was 98, 96% at 1 year follow-up period. The mean marginal bone level has significantly changed over time in the overall sample after a follow-up period of one year (-p-value<0.001); it (average) decreased significantly by 0.238 mm between baseline and loading (-p-value<0.001; post-hoc test). It also decreased by 0.154 mm between loading and 1 year, however the decline was not significant (-p-value=0.085; post-hoc tests). After a follow-up period of two years, the mean marginal bone level has significantly changed over time in the overall sample (-p-value<0.001); it has decreased significantly by 0.263 mm between baseline and loading. It (Average) has also decreased by 0.111 mm between loading and 1 year and by 0.199 mm between loading and 2 years, but these declines were not significant (-p-value>0.05; post-hoc tests). The mean bone loss after 1-year and 2 years was not significantly associated with implants type, implant site (maxilla/mandible or anterior/posterior implants), smoking habits and type of implant's surgery (-p-value=0.792).However, it was significantly associated with the type of prosthesis; it was significantly elevated with cemented prosthesis compared to screw-retained prosthesis. A supracrestal positioning of the machined collar (tissue level placement) was associated with no bone loss, while placing the smooth part of the implant below the alveolar crest has led to bone loss over 2 years. Marginal bone loss after 1 and 2 years was not significantly associated with implants type, implant site (maxilla/mandible or anterior/posterior implants), smoking habits and type of surgery. However, it was significantly elevated with cemented prosthesis compared to screw-retained prosthesis. It was dependent also on the positioning of the machined collar.

Survival and complication rates of two dental implant systems supporting fixed restorations: 10-year data of a randomized controlled clinical study

ObjectivesTo compare clinical, radiographic, biological and technical long-term outcomes of two types of dental implants over a period of 10 years.Materials and methodsNinety-eight implants were placed in 64 patients, randomly allocated to one of two manufacturers (AST and STM). All implants were loaded with fixed restorations. Outcome measures were assessed at implant insertion (Ti), at baseline examination (TL), at 1, 3, 5, 8 and 10 (T10) years. Data analysis included survival, bone level changes, complications and clinical measures.ResultsRe-examination was performed in 43 patients (23 AST and 20 STM) at 10 years. The implant level analysis was based on 37 (AST) and 32 (STM) implants. Survival rates of 100% were obtained for both groups. The median changes of the marginal bone levels between baseline and T10 (the primary endpoint) amounted to a loss of 0.07 mm for group AST and a gain of 0.37 mm for group STM (intergroup p = 0.008).Technical complications occurred in 27.0% of the implants in group AST and in 15.6% in group STM.The prevalence of peri-implant mucositis was 29.7% (AST) and 50.1% (STM). The prevalence of peri-implantitis amounted to 0% (AST) and 6.3% (STM).ConclusionsIrrespective of the implant system used, the survival rates after 10 years were high. Minimal bone level changes were observed, statistically significant but clinically negligible in favor of STM. Technical complications were more frequently encountered in group AST, while group STM had a higher prevalence of peri-implant mucositis.

Prosthesis Emergence Angle Influences Marginal Bone Level for External Connection Implants: A Cross-Sectional Study.

To retrospectively evaluate the influence of prosthetic features on marginal bone level changes around bone-level implants with an external hex connection. A total of 100 patients with 166 implants and cemented crowns were included. Demographic and clinical data were collected. Prosthetic features were radiographically evaluated, including emergence angle (EA), emergence profile (EP), crown-implant ratio (CIR), and abutment height. Marginal bone levels were measured on intraoral radiographs taken at baseline and after at least 1 year. The correlation between prosthetic features and marginal bone loss (MBL) was then investigated. The mean follow-up time was 43.94 months. Implant length varied between 5 and 13 mm. The mean height of the abutments used was 1.55 mm. EA measured an average 30.62 degrees (± 13.20) mesially and 29.45 degrees (± 13.07) distally. The CIR was 0.99 (± 0.26). The mean MBL was 0.19 mm on the mesial side and 0.20 mm on distal side of the implants. Significant positive associations emerged between MBL and implant length (P < .005) and with EA (P < .05). A convex profile of the crown was shown to be associated with a higher distal MBL (P = .025) compared to concave and straight profiles.

Effects of maintenance implant therapy with and without periodic removal and decontamination of prosthetic components on inflammatory peri-implant parameters.

A retrospective analysis based on patient records was used to assess inflammatory clinical and biochemical parameters around dental implants installed by the same clinician in a private clinic. The plaque index (PI), peri-implant probing depth (PPD), mucosa! recession (MR) bleeding on probing (BOP) and radiographic marginal bone level were determined at baseline and at each year during the follow-up period. Moreover, at last follow-up visit the peri-implant intrasulcular levels of active metalloproteinasis 8 (aMMP-8) were also assessed. All participants were under MT with a 6-month recall interval. Ninety-two patients with 132 implants were selected. At the end of the study period, 12 patients with 12 implants were classified as "dropouts". Remained 80 patients and 120 implants were classified into two groups: Group 1, (42 patients with 62 implants) received MT with periodic removal and decontamination of prosthetic components; Group 2, (38 patients with 58 implants) received MT without periodic removal and decontamination of prosthetic components. No statistical differences were found between the groups regarding presence of plaque, probing depth, and mean mucosal recession. Group 1 presented a statistically significant higher number of sites with BOP (12.4% vs. 6.2%). Marginal bone loss was statistically higher in Group 2 than in Group 1 (0.23 ± 0.6 mm vs. and 0.78 ± 0.3 mm). Intrasulcular levels of aMMP-8 were statistically higher in Group 1 than in Group 2. The supplemental application of periodic removal and decontamination of prosthetic components during MT had a significant additional benefit in the peri-implant tissues inflammatory status.

The Influence of History of Severe Periodontitis on Estimated Long-Term Marginal Bone Loss around Implants Restored with Fixed Segmented Full-Arch Rehabilitation.

The aim of this study was to analyze the long-term marginal bone level (MBL) of implants supporting fixed full-arch restoration in patients who had previously lost their dentition due to severe periodontitis. This retrospective study included 35 patients in whom 342 implants with internal tapered conical connections were placed. MBL was analyzed radiographically over time and a long-term estimation of MBL was calculated. A mixed linear model with abutment height, graft, diameter and location (maxilla/mandible) as factors and gender, age, implant length and prosthetic variables as covariates was used to evaluate the influence on MBL. MBL in these patients showed an estimator of predictions at 4108 days after loading of -0.307 mm, SE = 0.042. Only 0.15% of implants were radiographically affected with MBL of 3 mm or more. The mixed linear model results showed a main effect of the type of opposing dentition, gender, implant diameter, and abutment height. Particularly, an abutment height of 1 mm had associated larger MBL than the remaining heights. Thus, it can be concluded that dental implants restored with fixed segmented full-arch rehabilitation in patients with a history of severe periodontal disease do not suffer important marginal bone loss if some specific factors are considered, mainly the use of long transmucosal abutments (≥2 mm).

Maxillary Rehabilitation using the All-on-Four Technique and Computer-Guided Surgery: A Case Report

The aim of this study was to evaluate the clinical and radiographic outcomes of the All-on-4 technique in fully edentu-lous maxilla using R2GATE software for flapless, computer-guided surgery and immediate loading. Ten adult patients with fully edentulous maxilla, aged between 35 and 60 years, were included in the study between April 2021 and April 2022. The surgical procedure was performed under local anesthesia and followed the All-on-4 approach with immediate loading of implants using a screw-retained provisional acrylic resin prosthesis on the same day. Final prosthesis was de-livered four months after the surgery. Clinical and radiographic outcomes were evaluated at four- and twelve-months post-operation. The study reported a 95% implant survival rate using the All-on-4 technique. The mean marginal bone level was recorded at 0.35 mm and 0.66 mm during the 4 and 12-month follow-up periods, respectively. Fixed provi-sional prosthesis fracture, abutment, and prosthesis screw loosening were the most frequent mechanical complications reported. Within the limitations of this study, the use of computer-guided surgery in the All-on-4 technique seemed to be a promising treatment option with high implant survival rates that may help reduce post-surgical discomfort and me-chanical complications in the rehabilitation of the edentulous maxilla.

Single Crown Restorations Supported by One-Piece Zirconia Dental Implants: Case Series with a Mean Follow-Up of 58 Months

The main aim of this case series was to report the clinical and radiographic outcomes of 22 one-piece zirconia dental implants positioned in 19 patients to restore single edentulisms and followed up for at least 2 years. The mean observation period was 58.18 months. At the last follow-up visit, no issues, such as foreign body sensation, discomfort or pain, were reported by the patients. No implant showed signs of infection with suppuration or implant mobility. Marginal bone levels (MBL) were assessed through standardized dental radiographs and a dedicated software. The mean distance between the implant head and the first detectable bone to implant contact was calculated at the mesial and distal aspect of each implant. The mean MBL at baseline was 1.82 ± 0.63 mm while the mean MBL at the last follow-up visit was 2.57 ± 0.72 mm. The results obtained in the present case series over a mean follow-up period of 58.18 months (range 27–96) showed that one-piece zirconia dental implants could be an alternative option to support single crowns in patients requiring metal-free restorations. Nevertheless, further better-controlled research featuring an adequate study design and longer follow-up is needed in order to clarify advantages and limitations which are related to this treatment modality.

Differences in Titanium, Titanium-Zirconium, Zirconia Implants Treatment Outcomes: a Systematic Literature Review and Meta-Analysis.

The objective of this systematic review is to test the hypothesis that treatment with titanium, titanium-zirconium and zirconia dental implants has different clinical outcomes in survival rate, marginal bone loss, bleeding on probing, plaque control record, and probing depth. A systematic electronic search through the PubMed (MEDLINE) and Cochrane Library databases was performed to identify studies published between January 1, 2013 and January 1, 2023 containing a minimum of 10 patients per study comparing titanium (Ti), titanium-zirconium (Ti-Zr), and zirconia (Zr) dental implants. Ti, Ti-Zr, and Zr dental implant clinical outcomes were determined by evaluating survival rate, marginal bone level, bleeding on probing, probing depth, plaque control record. Quality and risk-of-bias assessment were evaluated by Cochrane risk of bias tool. A total of 1361 articles were screened, with 10 meeting the inclusion criteria and being utilized for this systematic review and meta-analysis. A total of 301 patients with 637 implants (304 Ti, 134 Ti-Zr, and 199 Zr) were evaluated, showing a survival rate of 97.7% for Ti, 98.6% for Ti-Zr, and 93.8% for Zr implants respectively. In a meta-analysis, no difference in marginal bone level was found between Ti, Ti-Zr, and Zr implants (P = 0.84). Dental implant survival rate was lower in zirconia group. Assessment of marginal bone loss and bleeding on probing showed better results with titanium-zirconium dental implants. Plaque control result was similar in all groups. Due to limited sample size assessed it was not possible to obtain conclusion on probing depth parameter.

Extra-short implants (≤ 6.5 mm in length) in atrophic and non-atrophic sites to support screw-retained full-arch restoration: a retrospective clinical study

PurposeIncreasing scientific evidence support extending the application of short dental implants to non-atrophic dental arches. The purpose of this study has been the evaluation of extra-short implants (≤ 6.5 mm in length) that were placed in atrophic and non-atrophic anatomical sites to support the same prosthesis.MethodsFor that, a retrospective study was conducted by including complete dentures that were solely supported by extra-short implants in the maxilla and/or the mandible. Clinical data about patients, implants, anatomy, and prosthesis were obtained. Statistical analysis was performed to assess implant- and prosthesis-survival, changes in the marginal bone level and prosthetic complications.ResultsA total of 87 implants in 15 screw-retained complete dentures were assessed. None of the prostheses nor the extra-short implant failed during the follow-up of 27.2 ± 15.4 months. The changes in the mesial and distal marginal bone level were + 0.15 ± 0.51 mm and + 0.11 ± 0.50 mm, respectively. Comparing the implants according to the availability of sufficient bone to place longer implants, indicated the absence of significant differences in the changes of the mesial marginal bone level. However, the changes in the distal marginal bone level showed a statistically significant difference in favor of implants that were placed in non-atrophic sites. Two events of screw loosening were reported that were resolved by retightening the screws.ConclusionsImplant- and prosthesis-related outcomes support the use of extra-short implants in atrophic and non-atrophic site to support complete prosthesis.Graphical

Clinical performance of monolithic zirconia crowns on titanium-zirconium reduced-diameter implants in the molar area: Interim data at three years of a randomized controlled trial.

The aim of the present study was (i) to evaluate the clinical performance of reduced-diameter implants placed in the molar area and (ii) to test whether monolithic zirconia implant-supported crowns lead to similar clinical outcomes compared to porcelain-fused-to-metal crowns. A total of 76 patients needing a single implant crown in the posterior region were recruited. All patients received a titanium-zirconium reduced-diameter implant (Straumann Roxolid, Tissue Level, Standard Plus, diameter 3.3 mm, regular neck) randomly allocated to receive either a (1) monolithic zirconia crown (test) or (2) porcelain-fused-to-metal crown (control). Implant survival, prosthetic outcomes, and patient-reported outcomes were assessed at crown delivery and after 3 years of follow-up. Marginal bone levels (MBL) as well as clinical parameters including probing depth (PD), bleeding on probing (BOP), and plaque levels (PCR) were also recorded. A total of 59 patients were available at the 3-year follow-up; 32 patients with a monolithic zirconia crown (TEST) and 27 patients with a porcelain-fused-to-metal crown (CONTROL). 14 implants (11 implant fractures/3 aseptic losses) were lost leading to an estimated implant survival rate of 80% ± 5.1% (95% CI 70.8%-90.8%). Prosthetic complications were limited to the control group and involved minor chippings. This type of reduced-diameter implant to support single implant molar crowns in the molar area cannot be recommended. Monolithic zirconia crowns appear to be a viable option in the posterior region showing similar prosthetic outcomes to porcelain-fused-to-metal crowns.

The effect of different abutment materials on peri-implant tissues-A systematic review and meta-analysis.

In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri-implant tissues after at least 1 year? This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow-up of 1 year and including at least 10 patients/group. Primary outcomes were peri-implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta-analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2-tool. This review is registered in PROSPERO with the number (CRD42022376487). From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = -0.24, 95% CI: -0.65 to 0.16, alumina: MD = -0.06, 95% CI: -0.29 to 0.17) (PD: zirconia: MD = -0.06, 95% CI: -0.41 to 0.30, alumina: MD = -0.29, 95% CI: -0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material. Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.

Bone Volume Assessment Around Immediate Dental Implant in the Esthetic Area with Immediate Tooth-Like Single Crown Provisionalization: A Laser and Computed Tomography 1-Year Retrospective Study.

To examine the remodeling process of both the soft and hard tissue components of the postextraction socket around immediately loaded dental implants after tooth extraction in maxillary esthetic areas. Subjects underwent immediate placement of single implants in postextraction sockets without bone grafting, and their immediate provisionalization with custom tooth-like interim crowns were fabricated using digital diagnostic impressions and a dental milling machine. Intraoperative and 1-year follow-up layered scans of the postextraction sockets after implantation were acquired using a 3D optical system. In the short term, subjects underwent computed tomographic scans. Digital impressions for gingival contours, originally stored as STL (standard tessellation language) files, were converted to DICOM (Digital Imaging and Communications in Medicine) files with the implant shoulder working as a referral point, which were then superimposed to 3D radiologic images. The observed volumetric and linear outcomes were measured using a program known as DentaScan. The width of the alveolar crest at the level of the implant shoulder and marginal bone levels were acquired. Nonparametric tests were applied with a level of significance set at P < .01. No failure was reported after a follow-up of 1 year. Little or no inflammation of the treated areas was registered, and there were practically no signs of suppuration. The areas showed a significant reduction in the overall volumes for both soft and bone tissue, with a P value < .0001 from the baseline (0.983 ± 0.172 cm3) to the 1-year survey (0.865 ± 0.156 cm3). If the soft and bone tissue changes were separately evaluated, a significant loss (with a P value < .0001) was registered for only the bone tissues (from 0.434 ± 0.075 to 0.355 ± 0.061 cm3). Moreover, changes in gingival tissue from baseline to the 1-year survey (-0.040 ± 0.067) appeared to be significantly different from the overall volume loss (-0.118 ± 0.083 cm3). A shrinkage in width (-0.5 ± 0.7 mm) was found from baseline (12.6 ± 0.6 mm) to the 1-year follow-up (12.1 ± 0.9 mm). Marginal bone levels were 0.97 ± 0.70 mm and 0.39 ± 0.78 mm, respectively, at the mesial and distal aspects of the implants. The present analysis suggested that immediately customized provisionalization was effective enough to prevent both volume loss and linear shrinkage at the layers of the treated areas. Moreover, the buccal aspects seemed to be the areas most affected by the loss of volume. The mean loss in width, which amounted to roughly 0.5 mm, appeared to be negligible when compared to the overall width measured before surgery.

Influence of mechanical debridement with adjunct probiotic therapy on clinical status and salivary cortisol levels in patients with periodontal inflammation.

The null hypothesis is that there is no difference in periodontal parameters and salivary cortisol levels (CL) among patients with periodontal inflammatory conditions (PIC) who receive non-surgical mechanical debridement (NSMD) with or without adjunct probiotic therapy (PT). The aim of this study was to assess the influence of NSMD with and without adjunct PT on clinical status and whole salivary CL in patients with PIC. Participants were randomly divided into four groups: Group-1: NSMD alone (n=19); Group-2: NSMD + PT (n=18); Group-3: PT + oral hygiene instructions (OHI) (n=17); and Group-4: PT alone (n=18). Lactobacillus rhamnosus SP1 (2×107 colony-forming units/day) was used for PT. Plaque and gingival indices (PI and GI), probing depth (PD) and clinical attachment loss (AL) were assessed, and whole salivary CL was assessed at baseline and at 6-week follow-up. Marginal bone levels were assessed at baseline and demographic data was collected using a questionnaire. Sample-size estimation was performed, and statistical significance was determined at p<0.05. At follow-up, PI (p<0.01), GI (p<0.01), and PD (p<0.01) were significantly higher in PT + OHI and PT alone groups compared with individuals who underwent NSMD + PT and NSMD alone. At baseline and follow-up, there was no significant difference in CL in all groups. There was no statistically significant correlation between age, gender, PI, PD, GI, clinical AL, salivary flow rate, education status and salivary CL in all groups at baseline and follow-up. NSMD continues to be the "gold standard" and most reliable treatment strategy for managing PIC. It is imperative to reach a consensus regarding the duration, dosage, and frequency of PT that would yield optimal results for managing PIC.

Comparative Evaluation of Survival Rates and Marginal Bone Levels of Nonsplinted Immediately Loaded Interforaminal Mandibular Implant-Retained Overdentures: A Randomized Controlled Clinical Trial with 5-Year Results.

Τo evaluate and compare the marginal bone loss (MBL), survival rates, and periodontal parameters of immediately loaded implants with either Dolder bar or Locator attachments placed in the interforaminal region of edentulous mandibles. A total of included 19 patients with edentulous mandibles each received two implants in the interforaminal area of the symphysis. Randomly allocated Dolder bar or Locator attachments were then attached immediately, and both clips and a framework were fastened to the denture by the dental laboratory within 24 hours. A total of 28 subjects with 56 implants were treated in accordance with the immediate-loading study protocol. Of these, 9 patients were lost to follow-up; 1 patient reported a serious illness and 8 patients moved and couldn't be reached. The 19 subjects not lost to follow-up (11 women and 8 men; average age: 68 years) were included. Every patient received either two Locator abutments and were assigned to group A (7 patients; 36.8%) or two multiunit abutments and were assigned to group B (12 patients; 63.2%). No implant failure was detected for either group, and therefore the survival rate for both groups was 100% after 5 years. After 5 years without any symptoms, 2 implants from group A and 7 implants from group B showed > 2 mm of MBL, which makes the group A success rate 85.7% and the group B success rate 70.8%. Modified sulcular bleeding index (mSBI) did not differ significantly at any of the measurement intervals. However, the modified plaque index (mPI) of group B was significantly higher than group A at the 60-month follow-up. It can be concluded that either splinting or not splinting the immediately loaded interforaminal implants to retain mandibular overdentures (OVDs) does not affect marginal bone levels after 5 years and immediate loading of nonsplinted implants with Locator attachments can be safely preferred to retain mandibular OVDs.

Peri-implant Outcomes from Customized Healing Abutments Using Immediate Implants: A Systematic Review.

To evaluate the peri-implant outcomes of customized healing abutments (CstHA) placed on dental implants inserted in fresh tooth extraction sockets. The study was registered on PROSPERO: CRD42022304320. A systematic search in PubMed, Scopus, and Web of Science was conducted between April 2022 and October 2022 to identify clinical studies involving immediate implant surgery associated with CstHA placement. The Joanna Briggs Institute Critical Appraisal and RoB2 tool were performed for the risk of bias analysis. A total of 12 studies were included, most of them with low risk of bias. Four studies compared CstHA vs conventional healing abutments (CnvtHA), two compared CstHA vs cover screw and collagen matrix (CMa), and six were clinical case series. For the CstHA vs CnvtHA comparison, favorable results were observed for CstHA considering papilla maintenance and probing depth, yet the mean marginal bone level was statistically similar between CstHA and CnvtHA. CstHA showed advantages when compared to CMa for total bone volume, papilla height, and midfacial mucosa maintenance. Significantly less horizonal bone loss was reported when using CstHA compared with CMa. Horizontal and vertical bone loss was observed in a few (or no) sites in the case series using CstHA. CstHA provides favorable peri-implant response because in general it does not result in a significant loss of soft and hard tissues.

Clinical and Radiographic Evaluation of OsseoSpeed EV Implants.

To evaluate the survival rate (primary outcome) and the marginal bone loss (secondary outcome) of the OsseoSpeed EV Implants (Astra Tech Implant System, Dentsply Sirona Implants; hereinafter EV implants) used in a wide range of clinical scenarios and followed up to 8 years in a nonuniversity setting. All EV implants consecutively placed from 2013 to 2021 in a private dental clinic were included, and medical and radiologic records were retrospectively investigated. Independent reviewers collected 11 data types as potential influencing variables and measured the mesial and distal marginal bone levels to the nearest 0.5 mm on available radiographs, either panoramic or periapical. Tables of descriptive statistics were made at implant and patient levels. Univariate and multiple Cox regression models were adjusted for clustering effects and determined the hazard ratio (HR) and odds ratio (OR) for each independent variable collected. The study sample consisted of 597 EV implants and 235 patients. During a mean follow-up of 42.1 ± 23 months (range: 10 to 94 months), 44 implants were lost (7.4%)-34 early (5.7%) and 10 late (1.7%)-in 38 patients (16.1%). The overall survival rate (SR) was 92.6% (CI: 90.5% to 94.7%), and the proportion of patients with all their implants surviving was 83.8% (CI: 79.1% to 88.5%). At the end of the study, the probability of survival of an implant that did not fail early was 98.2% (CI: 97.1% to 99.3%). Implant-level analysis identified two significant variables: implant diameter (HR 0.37, P = .009**) and immediate postextraction placement (HR 2.35, P = .025*). At the patient level, bruxism (OR = 3.29; P = .009**), history of periodontitis (OR = 2.18, P = .030*), and the number of implants placed (OR = 1.43; P = .001**) were found to be statistically significant. After removing dropouts and early failures from a sample of 528 implants, 412 (78%) had a marginal bone loss (MBL) ≤ 0 mm at the end of the observation time, and 106 surviving implants (22%) showed a mean MBL of 1.42 ± 1.08 mm (range: 0.25 to 6.75 mm). An overall medium-term SR of the EV implants was 92.6%. Four of five EV implants showed a mid-term MBL ≤ 0 mm, and 91.86% of implants completed the observation period with an MBL < 2 mm. Thus, the EV implant system was shown to be a valid alternative for routine use in a nonuniversity setting. Clinicians should remember that there is no 100% implant survival in everyday practice and that bruxism, periodontitis, narrow-diameter implants, and immediate placement are risk factors for a higher failure rate.