Modified Bleeding Index Research Articles

Hybrid Full-Arch Rehabilitation Using Conventional And Zygomatic Implants: A Short-Term Retrospective Analysis.

To report one-year outcomes of prosthetic rehabilitation of the atrophic maxillae, supported by angled abutments on zygomatic implants and conventional implants. In the present retrospective analysis, edentulous maxillary areas treated with fixed-hybrid prostheses supported by angled abutments of 45, 52.5, and 60 degrees screwed to zygomatic implants inserted using an extrasinus surgical approach were included. Prosthesis, implant, and abutment success/survival rates, complications, Mucosal Seal Efficacy Evaluation (MSEE), modified PLaque Index (mPLI), modified Bleeding Index (mBI), and Zygomatic Implants Classification Level (ZICL) were assessed. Ninety-eight straight implants and 81 zygomatic implants (21 abutments of 45 degrees, 23 of 52.5 degrees, and 37 of 60 degrees) were inserted into 35 patients. Biological complications: postoperative sinus opacity was observed in seven patients, two of whom experienced a unilateral perforation of the sinus membrane. ZICL0-1 was recorded in 95% of zygomatic sites; the cumulative success rates were 100% and 94.3% when using the implant and prosthesis as units of analysis, respectively. Survival rate for the implants attested to the highest percentage (100%), whereas survival rate of the prostheses was 94.3%. No differences were registered among the clinical indices related to different inclinations of the abutments.

Marginal Bone Level Changes Evaluation of Long-term Functional Dental Implants with the Implant Disease Risk Assessment Diagram: A 2 to 6 Years Follow-up Retrospective Study.

Purpose: This study aimed to evaluate the relationship between risk profile assessments of dental implants that have been in function for at least two-year and peri-implant marginal bone loss during the follow-up period using the Implant Disease Risk Assessment Diagram. Material and Methods: A total of 70 patients and 170 implants who had been functionally loaded for at least two years and who attended follow-up sessions were included in the study. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing, clinical attachment level (CAL), and peri-implant modified plaque index, modified bleeding index, PD, keratinized mucosal width (KMW), CAL and GR were recorded. According to the IDRA risk diagram, participants and dental implants were divided into low, moderate, and high-risk groups. Marginal bone level (MBL) was measured on periapical radiographs obtained at functional loading (T0) and at the last follow-up session (T1), and mesial and distal marginal bone level changes (ΔMBL) were calculated as T1-T0. Results: A statistically significant correlation was found between the periodontitis history and periodontitis susceptibility and IDRA classification at the patient-level. Full-mouth GI, PD, and BOP were found to be statistically higher in the high-risk IDRA group. No statistically significant result was found between the mesial and distal ΔMBL between the IDRA risk groups.Conclusions: In this study, IDRA risk level increased especially by periodontitis susceptibility and periodontitis history, but no significant difference was found between risk groups in terms of ΔMBL.

Effect of zirconia personalized gingival penetration on peri-implant soft and hard tissue of thin gingival biotypes in the anterior region: a retrospective study

Objective: To investigate the effect of zirconia personalized gingival structure on peri-implant soft and hard tissue stability after single-tooth implant restorations in patients with thin gingival biotypes in the anterior region, with a view to provide a clinical guideline. Methods: This retrospective study included 20 patients with thin gingival biotype and implant restorations in the anterior region. These patients included 9 males and 11 females, and the age was (35.2± 10.3) years. The patients were from the Department of Periodontal Implantology, Stomatology Hospital, Southern Medical University from January 2018 to December 2022. Computer-aided design/computer-aided manufacturing (CAD/CAM) techniques were used to fabricate a titanium base zirconia personalized gingival structure to maintain the soft-tissue perforated gingival contour of the anterior esthetic zone. This structure consists of two modalities: titanium base + zirconia outer crown or titanium base personalized zirconia abutment + zirconia outer crown. Clinical outcomes were recorded immediately and after delivery of the final restorations. Implant retention was recorded, esthetic scoring was performed using the pink esthetic index, the amount of bone resorption at the implant margins was measured based on digitized apical radiographs, and periodontal health was evaluated using the modified plaque index and the modified bleeding index. Results: The survival rate of the 20 implants was 100% after 3 years of wearing the final restorations, with a pink aesthetic score of 9.3±0.9. Bone resorption at the proximal and distal mesial margins of the implants was 0.09 (-0.21, 0.20) mm, 0.17 (-0.12, 0.27) mm after 3 years, respectively, and the difference was not statistically significant when compared to bone resorption immediately after placement of the final restoration [0(0, 0) mm] (Z=-1.03, P=0.394; Z=-2.05, P=0.065). Conclusions: Zirconia personalized gingival structure maintains the stability of peri-implant hard and soft tissues of thin gingival biotypes in the anterior region.

Anti-Apoptotic and Pro-Apoptotic Bcl-2 Family Proteins in Peri-Implant Diseases.

Intrinsic apoptosis, which is regulated by Bcl-2 family proteins, has an important role in chronic inflammatory diseases. The aim of the study was to identify the tissue levels and ratios of anti- and pro-apoptotic Bcl-2 family proteins in peri-implant diseases. Twenty-three individuals with peri-implant mucositis, 25 individuals with peri-implantitis, and 24 controls were included. The following clinical parameters were recorded: keratinized mucosa width, modified bleeding index, probing depth, modified plaque index, modified gingival index, and keratinized tissue thickness. Marginal alveolar bone assessments were performed by a software program. Granulation tissues were collected during treatments of peri-implant diseases. The control tissue samples were collected during the second stage of implant surgery. The tissue levels of Bcl-2 family pro-apoptotic (Bak, Bax, active caspase-3) and anti-apoptotic (Bcl-2, Bcl-xL, Mcl-1) proteins were determined by multiplex immunoassay method. The pro-apoptotic proteins; Bak, Bax and anti-apoptotic proteins Bcl-2, Bcl-xL, Mcl-1 were detected significantly higher in controls compared with patients with peri-implant mucositis and peri-implantitis (p < .001), respectively. The higher active caspase-3 levels were also detected in controls in comparison with peri-implant mucositis (p = .018) and peri-implantitis (p = .005). Anti-apoptotic: pro-apoptotic protein ratios (Bcl-2:Bax, p < .001; Bcl-2:Bak, p = .01; Bcl-xL: Bax, p = .006, Bcl-xL:Bak, p = .011; Mcl-1:Bak, p < .001) were significantly increased in diseased groups. A positive correlation was demonstrated between clinical variables and anti-apoptotic: pro-apoptotic ratios. Our findings indicate dysregulation of the Bcl-2 family proteins in peri-implant diseases. This unregulated response may disturb the homeostasis of peri-implant tissue.

Evaluation of the significance of keratinized mucosa on peri-implant tissue health: a prospective clinical trial.

The effect of keratinized mucosa on peri-implant tissue health is still inconclusive. This study aimed to evaluate the importance of keratinized mucosa and investigate the impact of the free gingival graft procedure on peri-implant health. At prosthesis delivery, the implants were allocated into three groups, based on the width of keratinized mucosa (KM) and patients' agreement on the free gingival graft procedure: KMS (KM ≥2 mm), KMD (KM <2 mm), and FGG (KM <2 mm initially and having surgically increased keratinized mucosa). Modified plaque index (mPI), probing depth (PD), modified bleeding index (mBI), KM, and marginal bone loss (MBL) were assessed at the baseline, 6-, 12-, and 24-month follow-up periods. Of the 47 patients, 17 belonged to the KMS group, 17 belonged to the KMD, and the remaining 13 patients belonged to the FGG. KMD demonstrated significantly fewer mPI and higher mBI than KMS and FGG at 6 and 12 months. At 24 months, MBL did not differ between the groups; however, PD was significantly greater in the KMD group. Implants with inadequate keratinized mucosa had higher bleeding and pocket depth values despite less plaque accumulation. According to the results, soft tissue grafting should be performed as early as possible. © 2023 Australian Dental Association.

Levels of interleukin 1-beta and soluble urokinase plasminogen activation factor in peri-implant sulcular fluid of cement- and screw-retained dental implants.

The present study compares interleukin 1-beta (IL-1β) and soluble urokinase plasminogen activation factor receptor (suPAR) levels in periimplant sulcular fluid (PISF) of patients with cement-retained (CR) and screw-retained (SR) implants. Patients with CR and SR implants were encompassed. Demographic data was collected and implant-related characteristics (geometry, insertion torque, loading and retention protocol, jaw location, duration in function and depth of insertion) were retrieved from records. Modified plaque index (mPI), crestal bone loss (CBL) probing depth (PD) and modified bleeding index (mBI) were measured. suPAR and IL-1β levels were assessed in PISF. Statistical comparisons were done and correlation between clinicoradiographic parameters and PISF IL-1β and suPAR were assessed. P<0.05 were judged statistically significant. Clinical and radiographic parameters showed no difference among SR and CR implants. There was no difference PISF volume among patients with CR (0.22±0.004 μl) and screw-retained (0.19±0.005 μl) implants. Levels of IL-1β and suPAR in patients with CR and SR implants were 50.08±0.6 ng/ml and 44.6±0.08 ng/ml, and 0.28±0.05 ng/ml and 0.22±0.006 ng/ml, respectively. Implants with CR or SR restorations are comparable to one another in terms of clinico-radiographic status and demonstrate IL-1β and suPAR levels within the normal range in the PISF provided oral hygiene is stringently maintained.

Difference of Two Antiseptic Gels for the Treatment of Peri-Implant Mucositis on Plaque Index and Bleeding Score: A Randomized Controlled Clinical Study

Aim: To analyze and compare the effectiveness of two antibacterial gels in the treatment of mucositis. Methods: After signing the informed consent, in accordance with the Helsinki Declaration of 1975, revised in 2000, 21 patients were included in the study and divided by randomization into two groups. At the baseline, the modified bleeding index (mBI) and plaque index (PI) values were measured, and an oral hygiene and implant disinfection session was carried out. The session was repeated at 7, 15, and 30 days and after 2 and 3 months from the baseline. Two products were used—a bioadhesive gel in the test group and a 1% chlorhexidine gel in the control group. Results: Due to three dropouts, the final sample was composed of 18 patients. An improvement in periodontal indices was observed, similar to mBI and PI values, in both groups. There were no complications except for the appearance of pigmentations in the control group. Conclusions: The antibacterial power and effectiveness of the two gels are comparable. Considering the small sample size of the study cohort, further studies are needed to validate the results obtained from this pilot study.

Implant abutment disinfection using plasma of argon and 0.2% and chlorhexidine gel applications immediately before prosthesis delivery: clinical and radiographic status at 5-years of follow-up.

The purpose of this five-year follow-up study was to investigate the clinical and radiologic status of implants that had undergone abutment disinfection immediately prior to prosthetic loading (PL) using plasma of argon (PA) or 0.2% chlorhexidine (CHX) gel. Sixty patients who had had an implant-supported prosthesis fitted at least five years previously were recruited for this study. In groups 1, 2, and 3, implant abutment disinfection was performed using PA, 0.2% CHX, and a vapor protocol, respectively. Modified plaque index (mPI), modified bleeding index (mBI), probing depth (PD), and mesial and distal crestal bone loss (CBL) were measured. A questionnaire on routine oral hygiene, smoking habits, and systemic health status was also administered. Sample size estimation was performed, and group comparisons were made. Probability values less than 0.05 were considered statistically significant. Group 1, 2, and 3 included 20 (20 implants) patients each. At five-year's follow-up, there was no difference in mBI, mPI, and PD in all groups. There was no significant difference in peri-implant CBL in all patients. None of the patients were immunosuppressed or had periodontal disease, and or had used nicotinic products within the past five years. Toothbrushing twice daily was reported by at least 90% of individuals in all groups. Flossing of interproximal spaces once daily was reported by at minimum 60% of individuals in all groups. Disinfection of implant abutments directly before PL can be performed using AP, or 0.2% CHX gel.

Peri-implant crevicular fluid and serum levels of soluble ST2 in peri-implant diseases: A pilot study.

Soluble ST2 (sST2) is a current biomarker of cardiovascular disease. It is used to predict susceptibility to cardiovascular diseases and to analyze their prognosis. Serum sST2 level increases in inflammatory diseases such as periodontitis. However, the level of sST2 in peri-implant diseases and crevicular fluid has not been investigated yet. Thus, the aim of this cross-sectional study is to analyze the level of sST2 in peri-implant health and diseases. Sixty-nine participants were divided into 3 groups as peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (P-I). Peri-implant crevicular fluid (PICF) and serum samples were collected from each participant. The levels of sST2 and IL-6 in PICF and sST2, IL-6, and CRP in serum were compared between the groups. Pocket depth (PD), modified bleeding index (mBI), modified plaque index (mPI), keratinized mucosa index (KTW), and gingival/mucosal recession (REC) were recorded as clinical parameters. Biomarkers in the serum and PICF were analyzed by ELISA kit. Sixty-nine patients were included in the study. The differences in the following parameters were statistically significant between groups: age (p=.009), implant function time (p=.027), PD (p < .001), mBI (p < .001), mPI (p < .001), and KTW (p=.043). The PICF volume of P-I and PM groups were statistically higher than PH (p < .001). The amount of sST2 in P-I and PM groups were higher than PH (p=.043). Serum CRP was higher in the P-I group than in other groups (p=.034). There were no significant differences in serum sST2 (p=.247) and IL-6 (p=.110) levels between groups. The PICF levels of sST2 were significantly higher in PM and P-I groups compared to the healthy group. However, no significant difference was observed between the groups in terms of serum sST2 level.

Atraumatic Extraction Followed By Immediate Implant Placement In An Infected Tooth Socket: A Clinical And Radiographic Study

Aim and Objectives: The present study was undertaken to assess success rate of immediately placed implant in infected dento- alveolar sockets with simultaneous placement of PRF gel in the horizontal gap between implant and bone, PRF membrane covering implant using a two stage protocol. Methods : Implants were immediately placed in 12 patients following a 2-stage submerged protocol. The extraction sockets were irrigated with tetracycline solution. PRF was used to fill the gap between the implant body and the surrounding socket wall. The final restoration was placed after 3-months following implant placement. The modified plaque index (MPI) and modified bleeding index (MPI) were measured at baseline and 3 months. Vertical and horizontal bone loss was measured at baseline, 6 and 9 months using IOPA with grid scale. Result : The mean FMPI score was 0.35±0.03 and at 6 months it was 0.25±0.03. At 9 months follow up, the FMPI was slightly increased as compared to the baseline, but the increase was not significant. The mean horizontal bone level at mesial surface of implant at baseline was 0.20±0.25mm, at 9 months it was increased to 0.25±0.26mm at mesial surface. Immediate implants with placement of PRF in infected extraction socket, as a 2 stage protocol resulted in horizontal alveolar bone crest resorption of 0.26mm and 0.3 mm on the mesial and distal surface of implant respectively. Conclusion : Atraumatic extraction followed by placement of implant in infected socket with placement of PRF and implant covered by PRF membrane resulted in 100% survival rate. Clinical and radiographic data after 3 months of loading showed that peri- implant tissue was healthy and marginal bone resorption values were minimal around implants.

Evaluation of peri-implant conditions of two immediate loaded unsplinted implants supporting mandibular overdenture and quality of life

This clinical prospective study evaluated the clinical and radiographic peri-implant conditions of two unsplinted implants immediate loaded with mandibular overdentures, as well, evaluated the oral health related quality of life (OHRQoL) in these patients. Materials and Methods: Ten totally edentulous patients received 20 implants with ball attachment, being 6 immediate loaded (test group) and 4 conventional loaded (control group). For OHRQoL assessment, the OHIP-EDENT questionnaire was applied before the implants insertion, 3 and 6 months after. After 6 months of implant insertion, the following clinical parameters were evaluated: probing depth, width of the keratinized mucosa, modified bleeding index, modified plaque index. The marginal bone loss was obtained by analyses of periapical radiographs at the day of implant insertion, 3 and 6 months after. Results: There was a significant improvement of quality of life at 3 months in immediate loaded group and at 6 months at the conventional loaded group comparing to initial time (P&lt;0,001) with no significant difference between groups (P=0,488). There was no significant difference between groups for the clinical and radiographic parameters at 6 months. Conclusion: There was no significant difference between groups in all quality of life, clinical and radiographic parameters, however the immediate load provided a better quality of life before the conventional load. Long term studies may be conducted due to follow peri-implant parameters and to obtain implant survival rate.

Clinical outcomes and associated factors in the treatment of peri-implant mucositis, combining mechanical debridement and prosthesis modification: A 30-month follow-up prospective case series.

To evaluate the clinical outcome and the associated factors of a treatment protocol for peri-implant mucositis. Patients were evaluated 30 months after a treatment protocol including professional mechanical debridement and modification of the prosthesis contours to improve access for biofilm control. Clinical performance was assessed by means of probing with an electronic pressure-calibrated periodontal probe. The possible impact of implant- and patient-level factors on the changes in peri-implant mucosal inflammation measured with the modified bleeding index (mBI) was evaluated. Twenty patients and 61 implants were included in the analysis. At the final visit, 50% of the patients presented bleeding on probing, with a mean mBI of 0.22 (SD 0.27). The adjusted linear regression model showed a significant association between patient's compliance with supportive care visits (p= .006) and mucosal inflammation. Similarly, at the implant level, modified plaque index (p&lt; .001) and an irregular use of interdental brushes (p= .017) had a significant impact on final mBI. Prosthesis modification when needed in association with non-surgical treatment may be an important intervention in the treatment of peri-implant mucositis. Compliance with supportive care visits and the regular use of inter-dental brushes were identified as important factors to achieve mucosal inflammation control.

Effect of sterile tetracycline ophthalmic ointment as an adjuvant to mechanical debridement on the treatment of peri-implantitis: A randomized controlled clinical trial.

Background Peri-implantitis is an infectious disease that affects the tissues around dental implants, with clinical signs of inflammation and irreversible loss of supporting bone. This study aimed to compare the effect of sterile topical tetracycline ophthalmic ointment as an adjuvant to mechanical debridement with mechanical debridement alone in the treatment of peri-implantitis. Methods In this single-blind randomized clinical trial, 32 patients (16 patients in each group) with peri-implantitis were treated topically using sterile tetracycline ophthalmic ointment. Four clinical parameters, including modified bleeding index (mBI), modified plaque index (mPI), probing depth (PD), and clinical attachment level (CAL), were measured at baseline and at 3- and 6-month follow-up intervals. Results PD reduction was statistically significant after 3 and 6 months in the test and control groups (P=0.001). Also, mPI and mBI reduction rates were significant in the test and control groups (P=0.001) after 3 and 6 months. However, in all the samples in the two groups, the mean of CAL before and after treatment was constant, with no significant difference (P>0.05). Conclusion Using sterile ocular tetracycline ointment could be an adjunctive treatment in improving and enhancing the therapeutic effects of mechanical debridement in the treatment of peri-implantitis. (IRCT20210909052418N1)

Using Different Low-Profile Abutments for Assisting Mandibular Implant Overdenture: A Split-Mouth Study.

Background Using a pair of different low-profile abutments to assist mandibular implant overdenture (MIOD) in limited restorative space is questionable due to the different morphology. Objective To investigate the marginal bone level (MBL) change and peri-implant-tissue health (PITH) around a pair of OT Equator® and Locator® suprastructures assisting MIOD. Methods Seventeen edentulous patients received MIOD assisted by OT Equator® and Locator®. MBL change was investigated at the implant loading (T1), after six months (T2) and twelve months (T3) of implant loading. PITH was evaluated at T2 and T3. Results There was within abutment significant difference in MBL change after T2 and T3 of loading for Locator (0.05 ± 0.02 and 0.32 ± 0.08, respectively) (P=0.01); and for Equator (0.11 ± 0.08 and 0.21 ± 0.09, respectively) (P=0.01). Also, there was a significant difference between Locator and Equator on the modified plaque index (MPI) after T3 (P=0.01). The significant results were recorded for the MPI at T2 and T3 for Locator (0.92 ± 0.26 and 1.5 ± 0.51, respectively) (P=0.01) and for Equator (0.82 ± 0.26 and 1.42 ± 0.51, respectively) (P=0.003). For modified bleeding index, there was significant difference at T2 and T3 for Locator (0.57 ± 0.19 and 1.14 ± 0.41, respectively) (P=0.03) and for Equator (0.46 ± 0.22 and 1.07 ± 0.41, respectively) (P=0.01). For gingival index, there was significant difference at T2 and T3 for Locator (0.57 ± 0.11 and 1.28 ± 0.35, respectively) (P=0.001) and for Equator (0.35 ± 0.21 and 1.1 ± 0.46, respectively) (P=0.001). Conclusions Using different pairs of the low-profile OT Equator® and Locator® abutments to assist MIOD is clinically acceptable based on the MBL change and PITH outcomes.

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.

Assessment of inflammatory status of peri-implant soft tissue around functionally loaded immediate implants placed in periodontally compromised tooth extraction sockets

The present study was aimed at assessment of the soft tissue condition around immediate implants used to replace periodontally compromised mandibular anterior teeth.A longitudinal study was conducted on 17 functionally loaded immediate implants placed in periodontally compromised sockets at mandibular anterior region. Clinical and biochemical assessment of inflammatory status of peri-implant mucosa were recorded at 2 week, 6and 12-month intervals after loading. Clinical parameters included modified Plaque Index (mPI), modified Bleeding Index (mBI), marginal soft tissue level (ML), Papilla Index (PI) and width of attached mucosa (AM). Biochemical parameter was the levels of Aspartate aminotransferase (AST) enzyme in peri-implant crevicular fluid (PCF).Inter-comparison of observations were statistically analysed using repeated-measures ANOVA. The mean mPI score was 0.71, 0.41 and 0.53 at three intervals (p=0.354) indicating moderate score. The mean mBI was1.06, 0.35 and 0.29 at various intervals (p=0.000), pointing reduced bleeding tendency. Throughout the study, 70.588% of sites had positive ML, suggesting soft tissue stability. Mean PI scores were 1.71, 2.06 and 2.65 and for AM were 2.41, 2.41 and 2.94 respectively at the three intervals, with a statistically significant p-value of 0.000 for both. The mean AST level in PCF was 1876.47 μIU, 1729.41 μIU and 2117.65 μIU (p=0.431), pointing no increase in inflammation.Considering the results obtained, implants under study exhibited no major inflammatory changes in the soft tissue, during the study period.

Role of antimicrobial photodynamic therapy in reducing subgingival oral yeasts colonization in patients with peri-implant mucositis

The aim was to assess the role of antimicrobial photodynamic therapy (aPDT) in reducing subgingival oral yeasts colonization (OYC) in patients with peri-implant mucositis (PIM). Patients diagnosed with PIM were included. Patient demographics were recorded and implant placement and prosthetic rehabilitation protocols were retrieved from patients' records. Peri-implant clinical parameters (modified plaque index [mPI], modified bleeding index [mBI] probing depth [PD]) and subgingival OYC and were assessed using standard techniques. All patients were randomly divided into test- and control-groups. In the test-group, patients underwent mechanical debridement (MD) of implant surfaces and supra and sub-gingival peri-implant sulci peri-implant immediately followed by a single session of aPDT. In the control-group, patients underwent MD alone. Peri-implant clinical parameters and OYC were re-assessed at 3-months' follow-up. Sample-size estimation was done on data from a pilot investigation and group-comparisons were done using the paired t- and Mann Whitney U-tests. Correlation between age, mPI, mBI, PD and OYC at baseline and 3-months' follow-up was assessed using regression analysis models. A statistically significant difference between the groups was recorded when P-values were less than 0.01. Thirty-four individuals (17 and 17 in the test- and control groups, respectively) were included. There was no significant difference in the mean age, scores of mPI, mBI, PD and OYC among patients in the test- and control-groups at baseline. At 3-months of follow-up, there was a statistically significant reduction in scores of mPI (P<0.001), mBI (P<0.001), PD (P<0.001) and OYC (P<0.001) among patients in the test- compared with the control-groups. There was no significant correlation between age, mPI, mBI, PD and OYC in both groups. In the short term, a single session of aPDT as an adjunct to MD is effective in reducing peri-implant soft tissue inflammation and OYC in patients with PIM.

Extramaxillary Zygomatic Implant Coverage with a Pedicled Buccal Fat Pad Flap Through a Tunnel Approach: A Prospective Case Series.

To describe the benefits of covering the extrasinusal length of extramaxillary zygomatic implants with a pedicled buccal fat pad flap through a tunnel approach. Four extramaxillary zygomatic implants were placed in 10 patients and loaded immediately with an acrylic provisional fixed prosthesis. The extrasinusal length of every implant was covered with a pedicled buccal fat pad flap. Study variables were implant survival rate, peri-implant soft tissue recession (PISTR), peri-implant soft tissue condition (PISTC), modified Bleeding Index (mBI), and suppuration. The statistical analysis comprised the Brunner-Langer model of longitudinal data for each variable and the analysis of variance to assess main effects and interactions. All the zygomatic implants showed osseointegration, resulting in a survival rate of 100%. The PISTR was evaluated after surgery (T0) and after 12 months (T1), statistically significant differences being observed (P = .014). Recession also depended on specific implant positioning; zygomatic implants in the anterior were found to have a higher risk of recession vs implants in the posterior (P = .065). The PISTC was assessed at T0 and T1, and no statistically significant changes were observed (P = .718). Bleeding on probing was present in 10% of the implants at T0 and in 15% at T1, the difference being nonsignificant (P = .317). The use of a pedicled buccal fat pad flap to cover the extrasinusal length of extramaxillary zygomatic implants appears to reduce the risk of soft tissue recession and exposure of the implant surface to the oral cavity.

Lithium disilicate and PEEK implant-retained single crowns - a randomized, prospective clinical study

Introduction/Objective. Comparing two materials under the same conditions is the best way to define differences between them. Ceramic-reinforced polyether-etherketone (PEEK) is a polymer that has many possible uses in dentistry as already well-known lithium disilicate ceramics. The aim of this study was to compare peri-implant soft tissue healing and evaluate patient satisfaction with esthetics in different observation periods, as well as the success and survival rate of both types of crowns. Methods. The study was conducted as a clinical, prospective, randomized split-mouth study on 17 patients with bilaterally missing upper teeth of the same type, replaced with dental implants. Study outcomes have been analyzed with subjective (visual analogue scale ? VAS scale) and objective parameters (modified bleeding index ? MBI, modified plaque index ? MPI and peri-implant probing depth ? PPD) baseline, six and twelve months after fixing crowns onto the implants. Results. Comparison of the results between PEEK and lithium disilicate crowns showed no statistical differences in terms of MPI, MBI, and PPD in the observed periods. Analyzing MPI during observation periods in the PEEK group of crowns, statistical significance was registered between baseline values and after six months. Also, statistical significance was noticed in terms of PPD during the observation time both in the study and control group of crowns. Results for VAS for the esthetics showed no statistically significant difference between the groups, while VAS for restoration satisfaction showed a statistically significant difference. Conclusion. This study showed that scores of the applied subjective and objective parameters can be a reliable tool to rate the clinical outcome of implant-retained single crowns over time.

The Effect of Peri-Implant Disease on Oxidative Stress Markers Levels in Peri-Implant Sulcus Fluid: A Cross-Sectional, Pilot Study

Background: Peri-implant diseases are inflammatory diseases as periodontal disease. An array of oxidative stress markers has been examined in the disease and health of the periodontal tissues. The purpose of the study was to test whether peri-implant conditions have an impact on the peri-implant sulcus fluid oxidative stress markers.Materials and Methods: A total of 44 participants were included in the study. Collected samples divided 3 groups, 14 samples for healthy implants; 15 samples for peri-implant mucositis; and 15 samples for peri-implantitis. In clinical periodontal examination, plaque index (PI), modified bleeding index (mSBI), probing bleeding (BOP), probing pocket depth (PPD), gingival index (GI), modified plaque index (MPI) were measured. Peri-implant sulcus fluid (PISF) samples were collected for evaluating and measuring biochemical analysis of total oxidant status (TOS) and total antioxidant capacity (TAOC) and oxidative stress index (OSI).Results: The TOS level in PISF was statistically significantly higher in the peri-implantitis when compared to the healthy group (p=0.041). There was no statistically significant difference (p&amp;gt;0.05) between groups in terms of TAOC and OSI parameters.Conclusions: As a result of the current study, it can be said that, due to its inflammatory character, peri-implantitis can increase total oxidant status (TOS) in peri-implant sulcus fluid (PISF). Multicentered research is needed to explain which immunological mechanism triggers the oxidative system in peri-implantitis in order to understand the potential role of oxidative stress markers in peri-implant inflammation.