Marginal Bone Level Research Articles

Interproximal contact loss at implant sites: a retrospective clinical study with a 10-year follow-up.

AimTo assess the frequency and quantity of interproximal contact loss (ICL) between implant restorations and adjacent teeth after at least 10 years of follow‐up (FU).MethodsThirty‐nine patients (median age 57.3 years) with 80 implants were re‐examined at least 10 years after insertion of final restorations (single crowns or fixed dental prostheses (FDPs)). Baseline (insertion of the restorations) and FU examinations encompassed the following: Stone casts were scanned and superimposed for metric assessment of tooth movements, radiographs, and clinical measurements. Outcome measures at implant sites were as follows: the extent of tooth movement and the frequency of interproximal contact loss [ICL], peri‐implant marginal bone levels [MBLs], and clinical measurements (plaque control record [PCR], Bleeding on Probing [BOP], and probing depth [PD]). Data were analyzed statistically with generalized regression modeling with robust standard errors to account for within‐patient clustering at 5%.ResultsInterproximal contact loss for at least one contact point after 10 years was observed in 50% of all implants (with open interproximal spaces up to 1.64 mm). Mesial contact points were significantly more prone to ICL than distal ones (relative risk [RR] = 1.79; 95% confidence interval [CI] = 1.07–2.99; p = .03). The type of restoration had a significant effect on ICL, with FDPs of 2 implants being significantly more prone to mesial ICL than single crowns (RR = 1.52; 95% CI = 1.02–2.25; p = .04). ICL was also associated with a significant increase in PD (+0.46 mm (95% CI = 0.04–0.88 mm; p = .03)) compared to implant sites without ICL. BOP, MBLs, and PCR were not significantly influenced by ICL.ConclusionInterproximal contact loss was a common finding in 50% of the implant sites and was significantly associated with an increase in PD.

Alveolar bone remodeling in virtually planned, bone-grafted vs non-grafted guided flapless implant surgery in the anterior maxilla: a cross-sectional retrospective follow-up study

PurposeIn patients who underwent virtual planning and guided flapless implant surgery for teeth missing in the anterior maxilla, we compared buccal bone loss between those treated with and without autogenous bone augmentation.MethodsOf 22 patients with teeth missing because of trauma or aplasia, 10 (18 implant sites) were reconstructed with buccally placed bone graft harvested from the mandibular ramus, and 12 were non-reconstructed (16 sites). Baseline cone-beam computed tomography allowed for implant planning using the NobelClinician® software and was performed again at 1 year after functional loading. The marginal bone level was assessed radiographically at post-implant baseline and at follow-up.ResultsAt follow-up, buccal bone loss differed significantly between groups at the central level of the implant (p = 0.0005) but not at the coronal level (p = 0.329). The mean marginal bone level change was 0.6 mm, with no significant between-group difference (p = 0.876). The actual implant position often deviated in the vertical or sagittal plane by an average of 0.3–0.6 mm from the planned position.ConclusionCompared with non-reconstructed patients, reconstructed patients experienced significantly more buccal bone loss at the central level of implants. The groups did not differ at the coronal level or in marginal bone loss, possibly because of the more augmented bone at the central level among reconstructed patients. Differences between planned versus actual implant positions should be considered in situations of limited bone volume at the planned implant site.

Accuracy of bone-level assessments following reconstructive surgical treatment of experimental peri-implantitis.

AimsThe purpose of this study was to evaluate the accuracy of bone‐level assessments using either cone‐beam computed tomography (CBCT), intra‐oral peri‐apical (PA) radiographs or histology following reconstructive treatment of experimental peri‐implantitis.Materials and MethodsSix Labrador dogs were used. Experimental peri‐implantitis was induced 3 months after implant placement. Surgical treatment of peri‐implantitis was performed and peri‐implant defects were allocated to one of four treatment categories; no augmentation, bone graft materials with or without a barrier membrane. Six months later, intra‐oral PA radiographs and block biopsies from all implants sites were obtained. Marginal bone levels (MBLs) were measured using PA radiographs, CBCT and histology.ResultsSignificant correlations of MBL assessments were observed between the three methods. The measurements in PA radiographs consistently resulted in an overestimation of the bone level of about 0.3–0.4 mm. The agreement between the methods was not influenced by the use of bone substitute materials in the management of the osseous defects.ConclusionsAlthough MBL assessments obtained from PA radiographs showed an overestimation compared to MBL assessments on corresponding CBCT images and histological sections, PA radiographs can be considered a reliable technique for peri‐implant bone‐level evaluations following reconstructive surgical therapy of experimental peri‐implantitis.

Airflow for initial nonsurgical treatment of peri-implantitis: A systematic review and meta-analysis.

Nonsurgical treatment of peri-implantitis may help in reducing microbial load and inflammatory parameters. The potential clinical benefits of using different treatment approaches, in the initial nonsurgical treatment phase, particularly the airflow, are still not clear. The aim of this systematic review and meta-analyses was to evaluate the outcomes of nonsurgical treatment of peri-implantitis using airflow method in terms of changes in periodontal parameters, peri-implant marginal bone level, postoperative pain/discomfort, and patient satisfaction. Electronic databases were searched to identify randomized controlled trials (RCTs) that compared airflow with mechanical debridement using ultrasonic/curettes. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program. A total of 316 studies were identified, of which, five RCTs with 288 dental implants in 174 participants were included. Overall meta-analysis showed more reduction in probing pocket depths at 1-3 months (mean difference [MD] -0.23; 95% confidence interval [CI] -0.50-0.05; p=0.10) and 6 months (MD -0.04; 95% CI -0.34 to 0.27; p=0.80) in favor of airflow, but the difference was not statistically significant. The use of airflow was associated with significant reduction in bleeding on probing and increase in peri-implant mucosal recession. The differences in plaque score, peri-implant marginal bone level changes, and patient reported outcomes between airflow and mechanical debridement were not statistically significant. The short-term clinical and radiographic outcomes following nonsurgical treatment of peri-implantitis using airflow or mechanical debridement were comparable. The airflow has short-term positive effects on reducing bleeding on probing. Further evidence from RCTs are still required to substantiate the current findings.

Randomized controlled clinical study comparing two types of two-piece dental implants supporting fixed restorations-Results at 8 years of loading.

ObjectivesTo assess clinical, technical, biological, and radiographic outcomes of implants supporting fixed restorations using two types of dental implants with non‐matching implant–abutment junctions at 8 years.Materials and methodsSixty‐four patients were randomly assigned to receive one of two implant systems (S1 or S2) and eventually fixed restorations. Patients were examined at loading (TL), one (T1), three (T3), five (T5), and eight years (T8). Outcome measures included implant and restoration survival, technical and biological complications, and radiographic bone levels. All data were analyzed on the implant and patient level.ResultsNinety‐eight implants were inserted in 64 patients and loaded with fixed restorations. At 8 years, 49 patients with 42 (S1) and 36 (S2) implants (25 in group S1 and 24 in group S2 on the patient level) were re‐examined. The survival rates on the patient level were 97.6% (S1) and 97.2% (S2). The marginal bone levels (the primary endpoint) amounted to a gain of 0.21 mm (Q1: −0.11 mm; Q3: 0.5 mm) (S1) (p = .007) and to a loss of 0.24 mm (Q1: −0.79 mm; Q3: 0.05 mm) (S2) (p = .001) between baseline (TL) and T8 (intergroup p < .001). The technical complication rates were 28% (S1) and 12.5% (S2) (intergroup p = .289). Peri‐implant mucositis was observed in 24% (S1) and 50% (S2) of the implants on the patient level (intergroup p = .792). The respective figures for peri‐implantitis were 0% (S1) and 12.5% (S2) (intergroup p = .11).ConclusionsDental implants with non‐matching implant–abutment junctions supporting fixed restorations resulted in high survival rates independent of the system used. Differences, mainly observed in terms of technical complications (in favor of S2), biological complications (in favor of S1), and marginal bone‐level changes (in favor of group S1), appear to be clinically negligible.

Cemented versus screw-retained zirconia-based single-implant restorations: 5-year results of a randomized controlled clinical trial.

ObjectivesTo compare cemented and screw‐retained one‐piece zirconia‐based restorations in terms of clinical, radiographic, and technical outcomes 5 years after insertion.Materials and methodsThirty‐four patients with single‐tooth implants were randomly restored with either a cemented lithium disilicate crown on a one‐piece customized zirconia abutment (CEM, 17 patients) or a screw‐retained crown based on a directly veneered one‐piece customized zirconia abutment (SCREW, 16 patients). All patients were recalled for a baseline examination (7–10 days after crown insertion) and then annually up to 5 years. The following outcomes were assessed: marginal bone level (changes), technical, and clinical (bleeding on probing, plaque control record, probing depth, and keratinized tissue) parameters. The Mann–Whitney U‐test was used to assess differences between the two groups.ResultsAt 5 years, 26 patients (13 in each group) were re‐examined. The survival rates on the implant and restorative levels were 100% and 82.4% (equally for both groups), respectively. At 5 years, the median marginal bone level was located at −0.15 mm (IQR: −0.89 mm; 0.27 mm) (CEM) and −0.26 mm (IQR: −0.38 mm; 0.01 mm) (SCREW) below the implant shoulder (intergroup p = .9598). The median changes between baseline and the 5‐year follow‐up amounted to −0.23 mm (CEM; intragroup p = .0002) and −0.15 mm (SCREW; intragroup p = .1465) (intergroup p = .1690). The overall technical complication rate at 5 years was 15.4% (CEM) and 15.4% (SCREW) (intergroup p = 1.00). Clinical parameters remained stable over time (baseline to 5 years).ConclusionsAt 5 years, screw‐retained and cemented restorations rendered largely the same clinical, technical, and radiographic outcomes. Technical complications were frequent in both groups.

Comparison of clinical outcomes of immediate versus delayed placement of dental implants: A systematic review and meta-analysis.

Two focused questions were addressed: Focused question (Q1) 1) Are there any differences between immediate and delayed placement in terms of (i) survival rate, (ii) success rate, (iii) radiographic marginal bone levels, (iv) height/(v)thickness of buccal wall, (vi) peri-implant mucosal margin position, (vii) aesthetics outcomes and (viii) patient reported outcomes? Focused question 2 (Q2) What is the estimated effect size of immediate implant placement for all parameters included in Q1? An electronic search (MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials and OpenGray) and hand search were conducted up to November 2019. Randomised controlled trials (RCT) with delayed implant placement as controls were eligible in the analysis for Q1. Immediate dental implant arms RCTs, controlled clinical trials (CCTs) and prospective case series of immediate implant placement were eligible in the analysis for Q2. Six papers (RCTs) were included in the analysis for Q1 and 53 papers (22 RCTs, 11 CCTs and 20 case series) for Q2. Q1: Meta-analyses did not show any significant difference in implant survival, but it did for bone levels and PES scores at 1year post-loading, favouring the immediate group. Q2: Meta-analyses showed that immediate implants had a high survival rate (97%) and presented high PES scores (range 10.36 to 11.25). Information regarding marginal bone loss and gingival/papillary recession varied among all included studies. Similar survival rate was found between immediate and delayed implants. Immediate implants presented threefold early complications and twofold delayed complications. Success criteria should be reported more consistently, and the incidence/type of complications associated with immediate implants should be further explored.

Monolithic zirconia single tooth implant-supported restorations with CAD/CAM titanium abutments in the posterior region: A 1-year prospective case series study.

PurposeTo assess the clinical, radiographic, and patient‐reported outcome measures, including the success of screw‐retained monolithic zirconia implant‐supported restorations with CAD/CAM titanium abutments in the posterior region during a 1‐year follow‐up.MethodsIn a prospective case series, 50 molar sites in the posterior region of 46 patients with a minimum age of 18 years and sufficient bone volume and anatomical conditions for placing an implant (≥8 mm) and an anatomical restoration were included. Parallel‐walled implants with a conical connection were inserted in a two‐stage surgical procedure. Implant uncovering and healing abutment placement occurred 12 weeks after insertion. Two weeks after mucosa healing, a screw‐retained monolithic zirconia restoration with a CAD/CAM titanium abutment was placed. Clinical, radiographic, and patient‐reported outcome measures were collected at baseline before implant placement and then during the 1 month and 1 year follow‐ups.ResultsAt the 1 year follow‐up, 49 restorations could be evaluated. The plaque accumulation, presence of calculus, bleeding tendency and peri‐implant inflammation indices were low, representing healthy peri‐implant conditions. The mean marginal bone level change between the 1 month and the 1 year follow‐up was −0.17 ± 0.46 mm. The mean patient satisfaction was high. The restoration success was, according to the modified USPHS criteria, 95.9%.ConclusionMonolithic zirconia implant‐supported restorations with CAD/CAM titanium abutments have very good clinical, radiographic and patient‐reported outcomes after 1 year in function.

A 5-year randomized controlled clinical trial comparing 4-mm ultrashort to longer implants placed in regenerated bone in the posterior atrophic jaw.

Short implants (up to 5-mm long) have shown good results when compared to longer implants placed in augmented bone. To evaluate if 4-mm ultrashort implants could also be an alternative to bone augmentation in the severely atrophic posterior jaws. The primary aim of the study was to compare implant survival rates between study groups. Eighty partially edentulous patients with posterior atrophic jaws (5-6 mm of bone above the mandibular canal and 4-5 mm below the maxillary sinus) were included: 40 patients in the maxilla and 40 in mandible. The patients were randomized to receive one to three 4-mm ultrashort implants or one to three implants at least 10-mm long in augmented bone. Results are reported 5 years after loading with the following outcome measures: implant and prosthetic failures, complications and peri-implant marginal bone level changes. Thirty-two complications were reported for the control group in 18 patients versus 13 complications in 10 patients in the test group, the difference being not statistically significant (p= 0.103). In the augmented group, 12 implants failed in 6 patients versus 7 short implants in 6 cases, and 9 prostheses failed in the control group while 4 in the test one, without statistically significant differences (p= 1.000 and 0.363, respectively). At 5 years after loading, short implants lost on average 0.58 ± 0.40 mm of peri-implant marginal bone and long implants 0.99 ± 0.58 mm, the difference was statistically significant (p= 0.006). Four-millimeter ultrashort implants showed similar if not better results when compared to longer implants placed in augmented jaws 5 years after loading. For this reason, their use could be in specific cases preferable to bone augmentation since the treatment is less invasive, faster, cheaper and associated with less morbidity. However, longer follow-ups and larger trials are needed.

Comparison between Early Loaded Single Implants with Internal Conical Connection or Implants with Transmucosal Neck Design: A Non-Randomized Controlled Trial with 1-Year Clinical, Aesthetics, and Radiographic Evaluation.

To evaluate the implant and prosthetic of two implants with different surfaces and neck design. Enrolled patients received bone level, 12° conical connection implants (Nobel Parallel, Nobel Biocare; NOBEL group) with anodized surface (TiUnite) and roughness of 1.35 μm, or transmucosal implant system (Prama, Sweden and Martina; PRAMA group) with convergent collar, ZIrTi surface, and roughness 1.4–1.7 μm. Both implants were made of pure grade IV titanium, with similar diameter and length, chosen according to the dentistry department availability and patient’s request. After early prosthesis delivery, patients were filled for at least one year. Outcome measures were: implant and prosthetic survival and success rates, physiological marginal bone remodeling, periodontal parameters and pink esthetic score (PES). Results: Fifteen patients were allocated and treated in each group. At the one-year follow-up, three patients dropped out, one in the NOBEL group and two in the PRAMA group. During the entire time of investigation, all implants survived and the prostheses were successful. No statistically significant differences were found in term of marginal bone loss, periodontal parameters, and aesthetics (p > 0.05). Conclusion: With the limitations of the present study, both implant systems showed successful clinical results. Finally, many other clinical and surgical variables may influenced marginal bone levels, implant survival, and periodontal parameters. More homogenous clinical trials with larger samples are needed to confirm these preliminary conclusions.

Informative title: Guided bone regeneration with and without rhBMP-2: 17-year results of a randomized controlled clinical trial.

ObjectivesTo assess long‐term outcomes of implants placed in conjunction with guided bone regeneration (GBR) with or without recombinant human bone morphogenetic protein‐2 (rhBMP‐2).Materials and MethodsEleven patients with at least two lateral bone defects (split‐mouth design) received a total of 34 implants. The defects were treated with a xenogenic bone substitute with (test) or without (control) rhBMP‐2 and covered with a collagen membrane. Eight patients could be reexamined after at least 17 years. Wilcoxon signed‐rank tests were performed to assess differences between test and control groups.ResultsThe implant survival rate was 100% for all test and control sites. Mean marginal bone levels were 2.51 mm (SD ±1.64) (mesial test), 1.83 mm (SD ±0.93) (mesial control) (p = .055), 2.36 mm (SD ±1.70) (distal test), and 2.13 mm (SD ±0.84) (distal control) (p = 1.000). Compared with the mean values at baseline, a mean bone loss of 1.16 mm (SD ±1.60) (test) and 0.70 mm (SD ±1.02) (control) was found. The mean buccal bone gain after 17 years was 5.38 mm (test) and 3.14 mm (control) based on the comparison between the measurements at the cone beam CT after 17 years and the data from the intraoperative measurements at baseline. Further, mean values for (i) bone thickness ranged from 1.36 to 3.09 mm (test) and 1.18 to 3.39 mm (control) and for (ii) mucosal thickness of 1.24 mm (test) and 1.26 mm (control).ConclusionImplants placed in conjunction with GBR applying a xenogenic bone substitute and a collagen membrane with and without the addition of rhBMP‐2 demonstrate excellent clinical and radiographic results after at least 17 years.

Marginal Bone Level and Bone Thickness Reduction in Delayed and Immediate Implant Placement Protocol 6Months Post-loading: An Observational Clinical Prospective Study.

The aim of this prospective study was to assess marginal bone level (MBL), buccal and palatal bone thickness reduction (BTR) around implants in delayed and immediate placement protocols, 6months after loading. Twenty-four patients were assigned to two treatment groups, and treated with an immediate (Test) or delayed implant placement (Control). Baseline and 6months post-loading periapical and Cone Beam Computed Tomography radiographs were used to measure mesial, distal, buccal, and palatal MBL change, and buccal and palatal BTR. There was no statistically significant difference between groups, in MBL change, mesially (p = 0.4220), distally (p = 0.774), buccally (p = 0.221), and palatally (p = 0.195). There was more MBL change on the buccal side than on the palatal side in both groups, control (p = 0.012) and test (p = 0.005). Buccal bone thickness decreased significantly in both groups, and at all four levels (p < 0.05). Buccal BTR was higher in test implants at 0, 2, and 4mm (p = 0.005, p = 0.0018, p = 0.006) on the buccal side, and at 0mm (p = 0.006) on the palatal side. Implant stability increased in both groups (p < 0.001). A positive correlation was found between insertion torque and stability in the control group (p = 0.024). Within the study limitations, MBL changes occur around implants and are comparable between groups. More buccal than palatal MBL change occurs in both groups. Buccal BTR is higher in immediate cases. Implant stability augmented in both groups. This data call for additive therapy to compensate for the expected bone loss, particularly in esthetically demanding cases. ClinicalTrials.govIdentifier: NCT04346706 Registered 14 April 2020 - Retrospectively registered, http://www.clinicalTrials.gov.

Survival of surface-modified short versus long implants in complete or partially edentulous patients with a follow-up of 1 year or more: a systematic review and meta-analysis.

PurposeShort implants are a potential alternative to long implants for use with bone augmentation in atrophic jaws. This meta-analysis investigated the survival rate and marginal bone level (MBL) of surface-modified short vs. long implants.MethodsElectronic and manual searches were performed for articles published between January 2010 and June 2021. Twenty-two randomized controlled trials (RCTs) comparing surface-modified short and long implants that reported the survival rate with at least 1 year of follow-up were selected. Two reviewers independently extracted the data, and the risk of bias and quality of evidence were evaluated. A quantitative meta-analysis was performed regarding survival rate and MBL.ResultsThe failure rates of surface-modified short and long implants differed significantly (risk ratio, 2.28; 95% confidence interval [CI], 1.46, 3.57; P<0.000). Long implants exhibited a higher survival rate than short implants (mean follow-up, 1–10 years). A significant difference was observed in mean MBL (mean difference=−0.43, 95% CI, −0.63, −0.23; P<0.000), favoring the short implants. Regarding the impact of surface treatment in short and long implants, for hydrophilic sandblasted acid-etched (P=0.020) and titanium oxide fluoride-modified (P=0.050) surfaces, the survival rate differed significantly between short and long implants. The MBL differences for novel nanostructured calcium-incorporated, hydrophilic sandblasted acid-etched, and dual acid-etched with nanometer-scale calcium phosphate crystal surfaces (P=0.050, P=0.020, and P<0.000, respectively) differed significantly for short vs. long implants.ConclusionsShort surface-modified implants are a potential alternative to longer implants in atrophic ridges. Long fluoride-modified and hydrophilic sandblasted acid-etched implants have higher survival rates than short implants. Short implants with novel nanostructured calcium-incorporated titanium surfaces, hydrophilic sandblasted acid-etched surfaces, and dual acid-etched surfaces with nanometer-scale calcium phosphate crystals showed less marginal bone loss than longer implants. Due to high heterogeneity, the MBL results should be interpreted cautiously, and better-designed RCTs should be assessed in the future.Trial RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42020160185

Lateral Sinus Floor Elevation in the Severely Atrophied Maxilla: Concentrated Growth Factors Versus Bone Substitutes. A Controlled Clinical Trial

The present study clinically and radiographically compares the outcome of implants inserted in maxillary sinuses augmented with concentrated growth factors (CGFs) or demineralized bovine bone matrix (DBBM) in a one-stage lateral approach. In 20 patients with a residual bone height of 1 to 4 mm, lateral sinus floor elevation was performed, using CGFs or DBBM as the sole grafting material, with simultaneous implant placement. Outcome variables were implant and prosthesis failures, complications, subjective satisfaction, and radiographic changes in marginal bone level (MBL) 12 months after surgery. The patients were consecutively recruited: 10 to the CGF group and 10 to the DBBM group. No implant failed in either group at 12 months postsurgery, and there were no complications. There was no statistically significant difference in MBL change between the CGF and DBBM groups (difference of -0.3 mm, favoring the CGF group; 95% confidence interval [CI]: -0.8 to 0.2; P = .18). There was no statistically significant difference in satisfaction (difference of 0.2, favoring the CGF group; 95% CI: -0.2 to 0.6; P = .29). Within the limitations of the present study, the lateral sinus floor elevation performed with the use of CGFs as the sole grafting material showed implant survival rates and marginal bone level changes comparable to DBBM grafting.

Marginal bone level change during sequential loading periods of partial edentulous rehabilitation using immediately loaded self-tapping implants: a 6.5-year retrospective study.

PURPOSEA large number of studies have suggested the practicability and predictability of immediate implant function, but few studies have reported marginal bone level changes during sequential loading periods. The purpose of this study was to evaluate the marginal bone remodeling of immediately loaded self-tapping implants both at each time point and during each loading period between two time points.MATERIALS AND METHODSThe patients included in this retrospective study were treated with immediately loaded NobelSpeedy Replace implants between August 2008 and July 2009. Differences in the marginal bone level (MBL) at each time point and the marginal bone level change (ΔMBL) between two time points were analyzed with Bonferroni correction (P < .05).RESULTSOverall, 24 patients (mean age, 47.3 ± 12.8 years) with 42 immediately loaded implants and a median follow-up of 6.5 years (IQR, 67.8 months) were included. The cumulative survival rate after 10 - 12 years was 95.2%. Continuous but slow marginal bone loss was observed during long-term follow-up. MBL at both 7.5 years and 11 years was significantly lower than that at loading, 6 months, 2 years and 4 years (P < .05). No bone loss difference was found in any period before 4 years of follow up (P > .05). The loading period of 4 years to 7.5 years showed the largest ΔMBL compared to those of other time periods (P < .05).CONCLUSIONSlight bone loss occurred continuously, and more radical changes of marginal bone can be observed during the period of 4-7.5 years. Thus, long-term effective follow-up of immediately loaded implants is needed.

Long-term outcomes after peri-implantitis treatment and their influencing factors: a retrospective study.

PurposeThis study aimed to determine the long-term outcomes after peri-implantitis treatment and the factors affecting these outcomes.MethodsThis study included 92 implants in 45 patients who had been treated for peri-implantitis. Clinical data on the characteristics of patients and their implants were collected retrospectively. The change in the marginal bone level was calculated by comparing the baseline and the most recently obtained (≥3 years after treatment) radiographs. The primary outcome variable was progression of the disease after the treatment at the implant level, which was defined as further bone loss of >1.0 mm or implant removal. A 2-level binary logistic regression analysis was used to identify the effects of possible factors on the primary outcome.ResultsThe mean age of the patients was 58.7 years (range, 22–79 years). Progression of peri-implantitis was observed in 64.4% of patients and 63.0% of implants during an observation period of 6.4±2.7 years (mean±standard deviation). Multivariable regression analysis revealed that full compliance to recall visits (P=0.019), smoking (P=0.023), placement of 4 or more implants (P=0.022), and marginal bone loss ≥4 mm at baseline (P=0.027) significantly influenced the treatment outcome.ConclusionsThe long-term results of peri-implantitis treatment can be improved by full compliance on the part of patients, whereas it is impaired by smoking, placement of multiple implants, and severe bone loss at baseline. Encouraging patients to stop smoking and to receive supportive care is recommended before treatment.

Surgical Regenerative Treatment in Combination with Magnetic Laser Supportive Therapy of Peri-Implantitis

Objective: The objective this study is to evaluate the potential of magnetic-lazer therapy as a supportive treatment of peri-implantitis. Materials and Methods: The 34 patients suffering from Peri-Implantitis were selected for this study. The patients randomly divided into two groups; 18 patients first group received surgical conventional treatment,16 patients second group received surgical conventional treatment and magnetic-lazer application. A total of 46 implants were treated with moderate peri-implantitis. Diagnostic parameters used to evaluate peri-implantitis include clinical indicators, Probing Pocket Depth (PPD), Bleeding On Probing (BOP), Marginal Bone Level (MBL) suppuration, mobility. Clinical and radiographical parameters were recorded before treatment (baseline) and at 3, 6 and 12, 36 months after therapy. Results: Reduction PPD and BOP was observed in comparison with basic clinical measurements. The mean BOP in 34 patients before treatment of peri-implantitis was 2.5 ± 0.31, after treatment, the first group of patients had mean 0.6 ± 0.1, the second group had mean 0.4 ± 0.12. The mean PPD in patients before treatment of peri-implantitis was 5,2±0,24, after treatment, the first group of patients had mean 3,9±0,28, the second group had mean 3,2±0,17. The mean MBL concomitant bone level gain averaged was 1, 54 mm in first group and 2.35 mm in second group. Stable clinical measurements PPD and BOP were demonstrated during the following 1,3 years. Conclusion: Surgical regenerative treatment combined with magnetic-laser supportive therapy reliable method for treatment peri-implantitis and may be considered an adjunct to the conventional surgical treatments of peri-implantitis

Implant Supported Full-Arch Zirconia-Based Restorations Manufactured (CAD/CAM) From Monolithic Zirconium Dioxide:6-Year Eight-Year Results Prospective Clinical Study

Purpose: To evaluate the survival of implants, the success of prosthetics of implant-supported reconstructions based on monolithic zirconium dioxide, functioning up to 5 years. Materials and Methods: In this study 87 patients were participated referred in need of full arch implant-supported reconstructions in maxilla, mandible or both. All patients underwent a thorough clinical examination according to a generally accepted scheme. After the diagnostic workup was completed, a treatment plan was developed by using a cone beam computed tomography and software system. Using surgical guides 46 patients' dental implants were installed. Postoperative clinical and radiological monitoring was regularly conducted, and criteria for thesuccess of implantation and success of prosthetics of implant-supported reconstructions were evaluated 642 implants (6 to 8 dental implants in the edentulous arches) were installed for monolithic zirconia full arch reconstructions.prosthodontic treatment was performed 3 to 6 months after implants healing time. Digitaltechnologies were included in the work flow with the laboratory scanning of the master casts andCAD/CAM manufacturing software. The monolithic zirconia block were milled using CAD/CAM software according to the manufacturer‘s specifications and then a monolithic zirconia restorations sintering. Outcome measures were: Implant success; prosthesis success; complications and marginal bone levels. Results: No intra-operative or immediate post-operative complications were noted. During a 3-year observation fracture of the monolithic zirconia or any other mechanical complications of prostheses, no registered, screws fractured in 3 prosthesis was observed over the 3-year study period. Conclusion: Our studies have shown good aesthetic, functional and mechanical properties of monolithic zirconia restorations and fewer complications

Prospective Evaluation of Bone Remodeling in Full-Arch Rehabilitations with Morse Taper Implants: A Case Series Study with One-Year Follow-Up.

This case series study evaluated the survival, success rate and marginal bone remodeling of Morse taper hydrophilic implants placed for full-arch rehabilitations over a 1-year follow-up period. Ten patients in need of maxillary and/or mandibular full-arch rehabilitation were selected. Sixty-six Morse taper implants and sixty-six abutments were inserted. All implants were placed using a surgical flap approach without bone regeneration and were immediately loaded with definitive prostheses according to the passive fitting technique. The patients underwent clinical and radiographic follow-up at different postoperative periods: T0 = immediate (up to 1 month after surgery); T1 = 3-4 months after surgery; T2 = 6-8 months after surgery; and T3 = 1 year after surgery. The survival and success rate of the implants and the marginal bone remodeling were evaluated. Normal distribution of the outcomes was verified by Kolmogorov-Smirnov tests. Therefore, changes in vertical and horizontal marginal bone levels were assessed with paired t-tests. Results were considered significant for P < 0.05. Survival and success rates of 100% and 92.4%, respectively, were observed. Statistically significant vertical bone level changes were shown for all periods. From T0 to T3, there was a mean difference in vertical bone loss of -1.02 mm on the mesial surface and of -0.93 mm on the distal surface, for horizontal bone loss in the same period, it was observed mean changes of -0.14 mm on the mesial surface and -0.09 mm on the distal surface. This 1-year case series follow-up of immediate full-arch rehabilitation, using one-step hybrid passive fitting supported by four to six hydrophilic tapered implants, suggests predictability with high survival and success rates in edentulous patients.

Bone changes associated with rehabilitation of mandibular defects with polyetheretherketone removable partial implant-assisted overdentures

Background/aimRehabilitation of the reconstructed mandibular defect is a challenge. Computer-aided design and computer-aided manufacturing have opened a new successful approach to the fabrication of maxillofacial prostheses. This study aimed to evaluate marginal bone changes of abutments, implant, and bone graft height changes for patients treated with polyetheretherketone removable partial implant-assisted overdenture (RPIAO) in mandibular defect rehabilitation.Patients and methodsTen patients of both sexes (ages ranging from 55 to 65 years with mean age 60 years) having reconstructed mandibular defects and unsatisfied with their conventional partial dentures participated in the study. Each patient was rehabilitated using telescopic RPIAO. The telescopic RPIAO was fabricated digitally from milled polyetheretherketone, and the implant was inserted using a fully guided surgical guide. Marginal bone changes of abutments, implant and bone graft height changes measurements were performed using cone-beam computed tomography during the 9-month follow-up period.ResultsRange repeated measure analysis of variance was used to comparing bone parameters throwing the durations. After the 9-month follow-up period, the mean and SD of marginal bone level of implants were 7.53 ± 1.25 mm. There was a statistically significant difference between the durations where P value of 0.029. The higher bone loss around the implants occurred in the first 6 months from loading. At the end of the 9-month follow-up period, the mean and SD of marginal bone level of abutments were 10.69 ± 1.53 mm. Between the durations where P value of 0.053, there was no statistically significant difference. At the end of the 9-month follow-up period, the mean and SD of graft height was 16.43 ± 3.04. Between the durations where (P = 0.064), there was no statistically significant difference.ConclusionWithin the limitations of this study, regarding marginal bone height around implants, there was a significant decrease in height during 6 months and decreased amount of marginal bone resorption from 6 to 9 months. While for marginal bone height around abutments and bone graft height, there was an insignificant decrease in height during the overall 9 months.