Mean Marginal Bone Level Change Research Articles

Maxillary and mandibular overdentures retained by two unsplinted narrow-diameter titanium-zirconium implants - Aclinical pilot study.

To evaluate the survival rates and marginal bone loss of narrow-diameter titanium-zirconium implants supporting complete maxillary and mandibular overdentures up to 3 years after loading. Ten completely edentulous patients who were dissatisfied with their complete dentures were enrolled. Two narrow-diameter implants were placed in the canine region of the maxilla and mandible. After second-stage surgery, implant-supported overdentures (palatal-free) attached by parallel alignable stud-attachments were placed. Patients were followed periodically for up to 36 months. Standardized radiographs were taken at baseline, 12 and 36 months to analyze mean marginal bone level changes around the implants. The Kaplan-Meier survival rates were 100% for mandibular and 68.0% (SE ± 10.9%) for maxillary implants at 36 months (p = .008). Six maxillary implants failed after loading; no mandibular implants were lost. Five implants failed due to loss of osseointegration. One implant fractured. The mean marginal bone level changes around the analyzed implants (n = 28, 9 patients) were -0.71 ± 0.82 mm in the mandible and -2.08 ± 1.52 mm in the maxilla at the 36-month follow-up. The difference in marginal bone level changes between the maxilla and mandible was significant (p = .019) at the 12- and 36-month follow-ups. Two narrow-diameter titanium-zirconium implants with stud-attachments showed a highly satisfactory outcome in the mandible. The maxillary implants showed a high failure rate and significantly more bone loss over time than the mandibular implants. The minimal concept of two implants and an overdenture should be limited to the edentulous mandible.

A randomized clinical trial on zirconia versus titanium implants in maxillary single tooth replacement.

This RCT aimed to compare zirconia and titanium dental implants in the maxillary premolar region. The comparison was based on marginal bone level (MBL) changes, clinical parameters, aesthetic outcomes, and patient related outcome measures (PROMs) 1 year after prosthetic loading. Fifty patients were randomly assigned to receive either a zirconia (ZrO2, n = 25) implant or a titanium (Ti, n = 25) bone-level implant. Implants were provided with a lithium disilicate crown 3 months after placement. Follow-up was at 1 month and after 1 year. The primary outcome pertained to changes in MBL. Reported secondary outcomes consisted of implant survival, peri-implant tissue health, aesthetics, and PROMs. Mean MBL change after 1 year was 0.01 mm (SD = 0.45; min = 0.72, max = 0.86) for ZrO2 and -0.09 mm (SD = 0.34; min = 0.53, max = -1.06) for Ti (p = .439). Scores for the other clinical outcome parameters and PROMs were generally favorable, with no significant differences. However, significant differences were found for the aesthetic outcomes regarding two criteria: (a) level of facial mucosa (p = .022), in favor of Ti, and (b) root convexity/soft tissue color and texture (p = .005) in favor of ZrO2. The ZrO2 and Ti implant types used in this study, replacing a single missing maxillary premolar, show a comparable outcome in terms of MBL change after 1 year. Clinical and aesthetic parameters, as well as PROMs, are favorable and similar between both implant types after 1 year of prosthetic loading. These short-term study results suggest that both are suitable for clinical use.

Immediate implant placement with immediate or delayed provisionalization in the maxillary aesthetic zone: A 10-year randomized trial.

To compare the marginal bone level of immediately placed implants, with either immediate or delayed provisionalization (IP or DP), in the maxillary aesthetic zone after 10 years of function. Participants with a failing tooth in the maxillary aesthetic zone were randomly assigned to immediate implant placement with either IP (n = 20) or DP (n = 20) after primary wound closure with a free gingival graft. The final restoration was placed 3 months after provisionalization. The primary outcome was change in marginal bone level. In addition, implant survival, restoration survival and success, peri-implant tissue health, mucosa levels, aesthetic indices, buccal bone thickness and patient satisfaction were evaluated. After 10 years, the mean mesial and distal changes in marginal bone level were -0.47 ± 0.45 mm and -0.49 ± 0.52 mm in the IP group and -0.58 ± 0.76 mm and -0.41 ± 0.72 mm in the DP group (p = .61; p = .71). The survival rate was 100% for the implants; for the restorations, it was 88.9% in the IP group and 87.5% in the DP group. Restoration success, according to modified USPHS criteria, was 77.8% in the IP group and 75.0% in the DP group. The prevalence of peri-implant mucositis was 38.9% and 35.7% and of peri-implantitis 0.0% and 6.3%, respectively, in the IP group and DP group (p = 1.0; p = .40). The Pink Esthetic Score and White Esthetic Score was 15.28 ± 2.32 in the IP group and 14.64 ± 2.74 in the DP group, both clinically acceptable (p = .48). The buccal bone thickness was lower in the DP group. Patient satisfaction was similar in both groups (p = .75). The mean marginal bone level changes after immediate implant placement with IP were similar to those after immediate placement with DP. Registered in the National Trial Register (NL9340).

Immediate repair of bony defects in the posterior mandibular region following removal of a fractured implant: a feasible treatment?

The aim of this study was to assess whether immediate bone reconstruction after removal of a fractured dental implant in the posterior mandible provides a sound base for implant replacement, with a favourable treatment outcome and high patient satisfaction. Eight consecutive patients with a fractured implant neck were included. The implant was removed via osteotomy, following which the site was immediately repaired with a mixture of autogenous bone and bone substitute. After a 4-month healing period, sufficient bone and favourable soft tissue conditions were present, allowing implant placement with adequate primary stability. After a further 3 months, the implants were restored with an all-ceramic restoration. Patient satisfaction, the aesthetic outcome, complications, and postoperative morbidity were assessed using standardized clinical and radiographic examinations up to 5 years after crown placement. No implant failures were observed during the follow-up. Plaque accumulation, the presence of calculus, bleeding tendency, and peri-implant inflammation indices were low, indicating healthy peri-implant conditions. The mean marginal bone level change at the 5-year follow-up was − 0.17 ± 0.46 mm. All patients reported a high level of satisfaction (mean overall score 9.3 ± 0.5). In conclusion, immediate reconstruction of the hard tissue after removal of a fractured dental implant is a viable treatment option. This approach facilitates rehabilitation, reduces morbidity, and leads to favourable aesthetic outcomes.

Association of selective serotonin reuptake inhibitor use with marginal bone level changes around osseointegrated dental implants: A retrospective study.

Selective serotonin reuptake inhibitors (SSRIs) are used for the management of anxiety and depression. Existing evidence shows their negative impact on implant osseointegration, survival rates, and peri-implant health. Currently, there are limited data on their effect on peri-implant marginal bone levels. The primary goal of this retrospective study is to evaluate the association between SSRIs use and marginal bone level (MBL) changes around osseointegrated dental implants over time. Records from patients who received at least one dental implant between 2010 and 2021 were reviewed. Information related to medical history, SSRI use, and the implant site was obtained from patients' electronic charts. Mesial and distal MBLs were measured relative to the implant platform on digital intraoral radiographs, taken at the time of prosthesis installation and at the most recent follow-up visit. MBL changes were calculated. A total of 152 dental implants from 105 patients were included. The mean follow-up period was 46.97±21.87 months. The mean MBL change was significantly greater for SSRI users (0.41±0.76mm) compared to non-users (0.04±0.65mm) [MD=0.37mm, p=0.00, 95% CI: (-0.61)-(-0.15mm)]. Mesial MBL change of 0.42±0.84mm and 0.02±0.71mm was noted for SSRI users and non-users, respectively. The distal MBL change was 0.4±0.93mm and 0.07±0.73mm, respectively. Smoking, sex, and implant location did not seem to influence the MBL differences between groups. Use of SSRIs is associated with greater marginal bone loss around osseointegrated dental implants in function for a mean period of 3.8 years.

Outcomes of Fixed Full-Arch Rehabilitations Supported by Tilted and Axially Placed Implants: A Systematic Review and Meta-Analysis.

To evaluate the performance of fixed complete dental prostheses supported by axial and tilted implants after at least 3 years of follow-up. An electronic search plus a hand search up to April 2021 was undertaken. Clinical studies were selected using specific inclusion criteria, independent of the study design. The main outcomes were cumulative implant survival rate, marginal bone level changes, and complications, after ≥ 3 years of follow-up. The difference in outcomes between axial and tilted implants and between the maxilla and mandible was evaluated using meta-analysis and the Mantel-Cox test. Out of 824 articles retrieved, 24 were included. In total, 2,637 patients were rehabilitated with 2,735 full prostheses (1,464 maxillary, 1,271 mandibular), supported by 5,594 and 5,611 tilted and axial implants, respectively. In a range between 3 and 18 years of follow-up, 274 implants failed. The cumulative implant survival rate was 93.91% and 99.31% for implants and prostheses, respectively. The mean marginal bone level change was moderate, exceeding 2 mm in only two studies. Marginal bone loss was significantly lower around axial compared with tilted implants (P < .0001), whereas it was not affected by arch (maxilla vs mandible; P = .17). Fixed complete dental prostheses supported by tilted and axially placed implants represent a predictable option for the rehabilitation of edentulous arches. Further randomized trials are needed to determine the efficacy of this surgical approach and the remodeling pattern of marginal bone in the long term.

A Retrospective Observational Study Assessing the Clinical Outcomes of a Novel Implant System with Low-Speed Site Preparation Protocol and Tri-Oval Implant Geometry.

A novel, biologically friendly implant concept system introduces low-speed (50 rpm) site preparation instruments used without irrigation and a tri-oval, tapered implant designed to reduce stress on cortical bone without sacrificing mechanical stability. This retrospective, observational, multicenter study (clinicaltrials.gov NCT04736771) collected data from consecutive patients treated with at least one novel concept system implant to evaluate clinical outcomes after 1 year in function. The primary endpoint was a marginal bone level change (MBLC) from loading to 1 year, and secondary endpoints included implant survival and clinician feedback. Ninety-five patients (54 women and 41 men, mean age: 58 ± 12 years) were treated with 165 implants. For 94.5% of implants, site preparation was performed in two steps. The mean follow-up from implant insertion was 1.8 ± 0.2 years. Mean MBLC from implant loading to 1-year follow-up was +0.15 ± 0.85 mm (n = 124 implants). At the last follow-up, the implant survival rate was 98.0%. Clinician satisfaction with the novel concept system was high. The novel concept system offers an easy-to-use implant placement protocol, with most implants placed using two steps. The minimal bone remodeling and high survival rate observed across a variety of indications and treatment protocols demonstrate broad versatility and confirm the clinical benefits of this biologically friendly innovation.

Are Mini Dental Implants Suitable for Support of Crowns or Small Bridges in the Mandibular Incisor Region? A 5-year Longitudinal Study

It has not been previously studied whether 1-piece category 1 narrow dental implants (≤2.5mm wide) can successfully support crowns or small bridges. The purpose of this study was to evaluate the long-term benefits of the fixed-type mini dental implants (MDIs) for replacement of mandibular incisors. In a prospective cohort study, fixed-type 1-piece MDIs, replacing single or multiple mandibular incisors, supporting metal-ceramic single crowns (unsplinted group), or splinted crowns/small bridges (splinted group) were observed over the period of 5years. The primary predictor was the splinting status. The primary outcome variables were peri-implant marginal bone level (MBL) change, success, and survival rates (assessed as per Pisa Consensus Conference). The secondary outcomes were dental patient-reported outcome measures (dPROMs) and oral hygiene assessment. Descriptive statistics, Chi-squared test, t-test, Mann-Whitney and Wilcoxon tests, Kaplan-Meier survival analysis, log-rank (Mantel-Cox) comparison, Cox proportional hazard analyses adjusting for number of implants, Spearman correlation, and repeated measures were used for data analysis. From 44 participants (mean age 56.02±5.72years), 40 completed the 5-year study: 23 in the splinted and 17 in unsplinted group. Three subjects did not respond, while 1 MDI failed (third year) in the unsplinted group. Mean marginal bone level (MBL) change in both groups was small; however, it increased over time (-0.22±0.38mm after 1 year; -0.54±0.56mm after 5years; P<.05). After 5years mean MBL change was -0.59±0.71mm in the unsplinted and -0.50±0.41mm in the splinted group (P>.05). Survival analysis revealed no significant difference between the unsplinted (85.7% success, 4.8% failures, and 9.5% satisfactory survivals) and splinted group (93.4% success and 6.6% satisfactory survivals) (P>.05). The group affiliation (unsplinted vs splinted) and number of implants were not significant predictors of MDI failure or survival rates (P>.05). Significant improvement in dPROMs after rehabilitation remained unchanged over 5years (P>.05). Modified plaque index significantly increased over time, correlating with the MBL loss. MDIs supporting crowns and/or small bridges in the mandibular incisor region showed small rates of marginal bone loss, acceptable success, and survival rates and improved dPROMs over a 5-year observation period.

Marginal Bone Maintenance and Different Prosthetic Emergence Angles: A 3-Year Retrospective Study.

The aim of the present retrospective study was to assess marginal bone changes around implants restored with different prosthetic emergence profile angles. Patients were treated with implants supporting fixed dentures and were followed for 3 years. Marginal bone levels (MBL) measured at the prosthesis installation (t0) and at the 3-year follow-up visit (t1) were considered. The MBL change from t0 to t1 was investigated. Two groups were considered: Group 1 for restorations with an angle between implant axis and prosthetic emergence profile >30°, and Group 2 for those with an angle ≤30°, respectively. Moreover, peri-implant soft tissue parameters, such as the modified bleeding index (MBI) and plaque index (PI) were assessed. Seventy-four patients were included in the analysis and a total of 312 implants were examined. The mean EA in groups 1 and 2 was 45 ± 4 and 22 ± 7 degrees, respectively. The mean marginal bone level change (MBL change) of 0.06 ± 0.09 mm and 0.06 ± 0.10 mm were, respectively, in groups 1 and 2. The difference in the MBL change between the two groups was not statistically significant (p = 0.969). The MBL change does not seem to be influenced by the emergence angle for implants with a stable internal conical connection and platform-switching of the abutment diameter.

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.

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.

One-year outcomes of dental implants with a hybrid surface macro-design placed in patients with history of periodontitis: A randomized clinical trial.

To evaluate the radiological, clinical, and microbiological outcomes of implants with a hybrid surface macro-design in patients with a history of periodontitis. The study was designed as a 12-month, parallel-arm, randomized controlled trial where patients with a history of treated periodontitis in need of dental implants for single-unit or short-span prosthesis were randomly allocated to a test [implants with a machined titanium surface in the coronal collar (hybrid; HS)] or a control group [conventional implants with moderately rough surface up to the implant shoulder (RS)]. Patients were followed at 3, 6, and 12 months after loading with assessment of radiological, clinical, and microbiological outcomes, as well as patient-related outcome measures (PROMs). Forty patients were randomly assigned to either the RS group (n=20) or the HS (n=20) group. At 1 year, the mean marginal bone level changes were 0.22 [standard deviation (SD) 0.36] mm for the HS group and 0.22 (SD 0.29) mm for the RS group, with no significant differences between them (p=.961). Similarly, no significant differences in clinical, microbiological, or PROMs were observed between groups. HS implants demonstrated radiographic, clinical, and microbiological characteristics equal to RS implants in patients with a history of periodontitis. ClinicalTrials.gov (identifier NCT05010382).

Effectiveness of implant-supported fixed partial denture in patients with history of periodontitis: A systematic review and meta-analysis.

This systematic review investigates the effectiveness of implant-supported fixed partial denture (IS-FPD) in patients with history of periodontitis (HP) vs. patients with no history of periodontitis (NHP). A literature search was performed on different databases on May 2020. Prospective and retrospective studies assessing survival (primary outcome), success and biological/mechanical complications of IS-FPDs in HP vs. NHP patients at ≥1year after implant loading were evaluated. Meta-analyses were conducted by estimating hazard ratio (HR), risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) using random effect models. Of the initially identified 4096 articles, 349 underwent a full-text evaluation. Finally, 17 were included. Pooled data analyses showed that overall implant survival was significantly higher in the NHP than the HP group (HR=2.06; 95% CI=1.37-3.09; I2 =0%). This difference was noted when follow-up ≥5years. The risk of peri-implantitis was higher in HP than NHP patients (RR=3.3; 95% CI=1.31-8.3; I2 =0%), whereas the mean marginal bone level change over time was not different between the groups (SMD=-0.16mm; 95% CI=-1.04-0.73; I2 =98%). In partially edentulous patients receiving IS-FPDs, a history of periodontitis is associated with poorer survival rate and higher risk of peri-implantitis during a 5-10years period after implant loading.

Assessment of Implant Stability in Immediate Implant Placement using Different Bone Grafting materials: A Clinical Study.

Aim:The aim of the present study was to assess the implant stability in immediate implant placement using different bone grafting materials.Materials and Methods:Twelve patients (5 males, 7 females, range of 40–58 years) were included in the study. All patients were divided into two groups based on the graft material used. For Group 1, Xenograft bone grafting material was used, and for Group 2, Freeze-dried bone allograft was used. The patients were suggested to rinse with 0.2% chlorhexidine mouth wash for 1 min. Periotome was used for atraumatic tooth extraction, and necessary care was taken to avoid fracture of socket wall. The implant was placed with respective bone grafting materials. An Orthopantomogram (OPG) radiograph is taken at the day of the operation to serve as baseline data for the marginal bone level. Clinical and radiological parameters were evaluated at baseline, 3 months, 6 months, and 12 months to assess the mean marginal bone level changes. Periotest was used for the measurement of implant stability.Results:The mean marginal bone level in Group 1 at baseline (13.58 ± 1.09), 3 months (12.64 ± 0.88), 6 months (12.02 ± 1.42), and 12 months (11.20 ± 1.26), respectively. In Group 2, the marginal bone level was at baseline (14.22 ± 0.26), 3 months (13.52 ± 1.28), 6 months (13.10 ± 0.32), and 12 months (12.12 ± 1.26), respectively. There was a statistically significant difference found in both the groups. Moreover, there was no statistically significant differences found between the groups at all the duration on intergroup comparison of the mean marginal bone level. The mean difference of implant stability in Group 1 the implant stability was 188.6 ± 22.5 and in Group 2 was 191.5 ± 18.2, and there was no statistically significant difference found between the groups.Conclusion:Both bone grafting materials used in the study showed improvement in implant stability and marginal bone levels after immediate placement of implant.

Clinical Performance of a Novel Two-Piece Abutment Concept: Results from a Prospective Study with a 1-Year Follow-Up.

Development of a stable and healthy soft-tissue barrier around dental implants is key to long-term success of implant-supported prostheses. The novel two-piece abutment concept shifts the prosthetic interface to the soft-tissue level to protect bone interface/connective tissue during the healing phase and restorative procedures. This prospective study included 72 patients treated with 106 implants to support a single-tooth or a three-unit bridge restored with two-piece abutments. The evaluation included marginal bone level change (MBLC), implant and prosthetic survival, soft-tissue health including keratinized mucosa height and mucosal margin position, patient quality of life (QoL) and satisfaction, and clinician satisfaction and ease-of-use rating of the concept. Mean MBLC from implant placement to 1 year was −0.36 ± 1.26 mm (n = 89), the 1-year implant and prosthetic survival rates were 97.1 and 96.7%, respectively, while keratinized mucosa height increased from 2.9 ± 1.2 mm at prosthetic delivery to 3.2 ± 1.3 mm, and mucosal margin migrated coronally by 0.49 ± 0.61 mm by 1 year. Patient satisfaction and QoL were high. Clinicians were satisfied with the esthetic and functional results and rated the concept as easy to use. In conclusion, the novel two-piece abutment concept promotes good peri-implant tissue health, while providing an easy-to-use workflow and high treatment satisfaction to both patients and clinicians.

Alveolar ridge preservation in defect sockets in the maxillary aesthetic zone followed by single-tooth bone level tapered implants with immediate provisionalization: a 1-year prospective case series

BackgroundClinical studies of single-tooth replacement in compromised bone using bone level tapered implants in the aesthetic zone are scarce.AimTo assess clinically, radiographically and aesthetically over 1 year the performance of a bone level tapered implant in the maxillary aesthetic zone in sites after alveolar ridge preservation.Material and methodsThirty patients (16 male, 14 female) with a failing tooth and large bone defect after removal received alveolar ridge preservation. After 3 months, implants were placed with immediate provisionalization. Definitive restorations were placed after 3 months. The treatment was evaluated 1 year following the definitive restoration.ResultsAll the patients attended the 1-year follow-up. One implant was lost (96.7% implant survival rate). The mean implant stability quotient value was 68.9 ± 8.74 at implant placement. The mean marginal bone level change was minor (− 0.07 ± 0.12 mm). The mean mid-buccal mucosa changed with + 0.01 ± 0.45 mm. The median Pink Esthetic Score and White Esthetic Score after 1 year were 6 [4; 7] and 8 [7; 9], respectively. The patients’ mean overall satisfaction (0–100 VAS scale) was 86.6 ± 10.3.ConclusionBone level tapered implants with immediate provisionalization perform well after alveolar ridge preservation in the maxillary aesthetic zone, according to implant stability, clinical, radiographic, aesthetic and patient-centred outcomes.Trial registrationNTR, NL8755. Registered on 1 January 2016

Immediate placement of single implants with or without immediate provisionalization in the maxillary aesthetic region: A 5-year comparative study.

AimTo compare marginal bone level changes around immediately placed and immediately provisionalized implants with immediately placed and delayed provisionalized implants in the aesthetic region after five years of function.Materials and MethodsForty patients with a failing tooth in the maxillary anterior region were randomly assigned immediate implant placement with immediate (Group A: n = 20) or delayed (Group B: n = 20) provisionalization. Definitive crown placement occurred three months after provisionalization. The primary outcomes were changes in marginal bone level. In addition, survival rates, buccal bone thickness, soft peri‐implant tissues, aesthetics and patient‐reported outcomes were assessed.ResultsAfter 5 years, the mean mesial and distal marginal bone level changes were 0.71 ± 0.68 mm and 0.71 ± 0.71 mm, respectively, in group A and 0.49 ± 0.52 mm and 0.54 ± 0.64 mm, respectively, in group B; the difference between the groups was not significant (p = .305 and p = .477, respectively). Implant and restoration survivals were 100%. No clinically relevant differences in buccal bone thickness or in mid‐facial peri‐implant mucosal level, aesthetic and patient outcomes were observed.ConclusionsThe mean marginal bone level changes following immediate implant placement and provisionalization were comparable with immediate implant placement and delayed provisionalization. (www.isrctn.com: ISRCTN57251089 and www.trialregister.nl: NL8255).

Comparison of 6‐mm and 11‐mm dental implants in the posterior region supporting fixed dental prostheses: 5‐year results of an open multicenter randomized controlled trial

ObjectiveThe aim of this multicenter, randomized controlled trial was to compare the clinical and radiographic outcomes of 6‐mm or 11‐mm implants, placed in the posterior maxilla and mandible, during a 5‐year follow‐up period.Materials and methodsNinety‐five patients with adequate bone height for 11‐mm implants, were randomly allocated to a 6‐mm group (test group with short implants) or an 11‐mm group (control group with standard‐length implants). Two or three implants of the same length were placed in each patient and after 6 weeks loaded with a splinted provisional restoration. This was followed by definitive splinted restoration 6 months after implant placement. Clinical and radiographic parameters, including the occurrence of complications were recorded.ResultsA total of 49 patients were enrolled to receive 6‐mm implants (n = 108) and 46 patients to receive 11‐mm implants (n = 101). Three implants (two of 6 mm and one of 11 mm in length) were lost before loading and one 6‐mm implant after 15 months of function, and one 11‐mm implant was lost during the first year of function. The 5‐year survival rates were 96.0% and 98.9% in the 6‐mm and 11‐mm group, respectively. The mean marginal bone level changes 5 years post‐loading were 0.01 ± 0.45 mm (bone gain) in the 6‐mm group and −0.12 ± 0.93 mm (bone loss) in the 11‐mm group (p = .7670). Clinical parameters, including plaque, bleeding on probing and pocket probing depth were not significantly different between the groups, and also technical complications were low.ConclusionThe clinical and radiographic outcomes of 6‐mm short and 11‐mm standard‐length implants were not different during a 5‐year evaluation period.

Clinical and radiographic outcomes of implant-supported fixed dental prostheses with cantilever extension. A retrospective cohort study with a follow-up of at least 10 years.

To report the clinical and radiographic outcomes of implant-supported fixed dental prostheses with cantilever extensions (FDPCs) after a function time ≥10years. Patients with FDPCs in posterior areas were clinically and radiographically re-evaluated. Mesial and distal radiographic marginal bone levels (mBLs) from baseline (i.e. delivery of FDPC) to the follow-up examination were calculated and compared between implant surfaces adjacent to and distant from the cantilever extension. Implant survival rate, pocket probing depth (PPD), presence/absence of bleeding on probing (BoP) and presence/absence of mechanical/technical and biological complications were recorded. Twenty-six patients with 30 FDPCs supported by 60 implants were re-evaluated after a mean loading time of 13.3±2.7years (range: 10-18.6years). One diameter-reduced implant carrying a cantilever extension fractured, yielding a patient-based survival rate of 96.2% (95% CI: 0.95/1.0). The mean marginal bone level change was not statistically significantly different from baseline to follow-up (1.2mm±0.9 to 1.6mm±1.7; 95% CI: -0.1/0.9; p>.05). The mean PPD changed statistically significantly from 3.4mm±0.7 to 3.7mm±0.7 (95% CI: 0.04/0.6; p=.02). Loss of retention occurred≥1x in 9 patients (34.6%, 95% CI: 0.44/0.83). At follow-up, peri-implant health was diagnosed in 12 (46.2%), peri-implant mucositis in 7 (26.9%) and peri-implantitis in 7 (26.9%) patients, respectively. Despite a high rate of loss of retention, the use of implant-supported FDPCs in posterior areas represents a reliable long-term treatment option with a high implant survival rate and minimal peri-implant bone level changes irrespective of the location of the cantilever extension.

Facial Gingival Changes With and Without Socket Gap Grafting Following Single Maxillary Anterior Immediate Tooth Replacement: One-Year Results.

This 1-year prospective study evaluated horizontal and vertical facial gingival tissue changes after immediate implant placement and provisionalization (IIPP) with and without bone graft in the implant-socket gap (ISG). During IIPP, 10 patients received bone graft material in the ISG (G group), while the other 10 patients did not (NG group). The implants were evaluated for implant stability quotient (ISQ), modified plaque index (mPI), modified bleeding index (mBI), marginal bone level (MBL), facial gingival level (FGL), and facial gingival profile (FGP) changes. The mean ISQ value at 9-month follow-up was statistically significantly greater than on the day of implant surgery (P < .05). The mPI and mBI scores demonstrated that patients were able to maintain a good level of hygiene. There were no statistically significant differences in the mean MBL changes between the G and NG groups (P > .05). There were statistically significant differences in FGL changes between the G (-0.77 mm) and NG (-1.35 mm) groups (P = .035). There were no statistically significant differences in FGP changes between the G and NG groups (P > .05). However, statistically significant differences were noted in FGP change between the 3-12 and 0-12 month intervals in both groups (P < .05). Within the limitations of this study, although no significant differences were noted in FGP changes between groups, G group experienced significantly less FGL changes than NG group. Bone graft material placement into ISG seems to be advantageous for tissue preservation during IIPP. However, future long-term studies, with larger sample size, are needed to validate the efficacy of such procedure.