Peri-implant Marginal Bone Loss Research Articles

The Relationship Between Marginal Bone Loss Around Dental Implants and the Specific Characteristics of Implant-Prosthetic Treatment

Abstract The marginal bone loss around dental implants is an important indicator that helps to evaluate the course and the final outcome of implant-prosthetic treatment. It is, therefore, important to understand the factors that may affect this. The aim of the study was to assess the impact of the specific characteristics of implant-prosthetic treatment on the marginal bone loss around implants. The study included 28 patients, aged 37-66 years, treated with dental implants. Every patient received at least one of the two types of implants: with Morse taper connection and with internal hexagonal connection. The average marginal bone loss around the implants was evaluated on the basis of the panoramic radiographs. The maximum follow-up period after implantation was 46 months. The peri-implant marginal bone loss was evaluated taking into consideration the implant localisation, the procedure of sinus lift with bone augmentation, implant type, implant diameter, vertical implant position relative to the compact bone level and the type of prosthetic restoration, the time between implantation and loading with prosthetic restoration, as well as the time between loading and the measurement of marginal bone loss. The correlation between bone loss and the selected characteristics of the treatment was assessed using generalised estimating equations (GEE). An objective analysis was enabled via the applied research model: evaluation of an impact of the specific implant-prosthetic treatment characteristics on peri-implant marginal bone loss in patients treated with implants with different implant-abutment interface systems. The results of the study showed that peri-implant marginal bone loss increased significantly with implant localisation in canine sites (compared to the localization in premolar sites), as well as with prosthetic restorations in the form of dentures (compared to bridges), and decreased when implants were placed below the compact bone level (compared to those placed at the bone level). At the same time, marginal bone loss was not significantly related to implant diameter or to the sinus lift procedure. The results obtained seem extremely useful in everyday clinical practice

Decision Making for Management of Periimplant Diseases.

Nonsurgical and surgical management of periimplant mucositis and periimplantitis have shown promising results in arresting periimplant marginal bone loss (MBL) and preventing implant loss. However, management of periimplant diseases still remains unpredictable for full reconstruction of lost tissues and completely arrests disease progression. The present study proposes a decision tree that compiles both clinical and radiographic presentation of failing implants to aid in the decision making for their management. An extensive literature review was performed using 3 electronic databases (PubMed, Ovid MEDLINE, and Cochrane Central) on the most recent treatment modalities for the management of periimplant diseases. Evidence-based treatment suggestions were primarily derived from periimplant defect morphology, presence, and severity of periimplant MBL. More evidence is required supporting soft-tissue augmentation for the treatment of periimplant diseases. Management of periimplant diseases can include lasers, mechanical instrumentation, chemical detoxification, and antimicrobial agents for nonsurgical approaches. On the other hand, removal of failing implants, resective surgery, guided bone regeneration, and soft-tissue grafting are presented as valid options for the surgical treatment of periimplantitis.

Association of advanced glycation end products with peri-implant inflammation in prediabetes and type 2 diabetes mellitus patients.

It is postulated that peri-implant sulcular fluid (PISF) levels of advanced glycation end products (AGEs) are higher with high glycemic levels. In the present clinico-biochemical study, we explored the clinical and radiographic peri-implant parameters and levels of AGEs among prediabetic, type 2 diabetic (T2DM), and non-diabetic patients and to evaluate the correlation of AGEs with clinical peri-implant parameters. Ninety patients were divided into three groups of 30 patients each; group 1: patients with prediabetes; group 2: patients with T2DM; and group 3: non-diabetic individuals. Clinical and radiographic peri-implant parameters assessed included plaque index (PI), bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL). PISF was collected and analyzed for AGEs levels using enzyme-linked immunosorbent assay. Between-group comparison of means was verified with Kruskal-Wallis test and Pearson correlation coefficient for correlations of AGE levels with peri-implant parameters. Mean peri-implant PI, BOP, PD, and MBL was significantly higher in group 1 and 2 as compared with non-diabetic patients (P < .05). Mean PI, BOP, PD, and MBL were comparable between group 1 and group 2 patients (P > .05). Mean levels of AGEs in PISF were significantly higher among prediabetic and T2DM patients as compared with non-diabetic patients (P < .05). Between group 1 and group 2, mean levels of AGEs was significantly higher in group 2 (P < .05). A significant positive correlations were found between levels of AGEs and PD (P = .0371) and MBL (P = .0117) in T2DM patients, respectively. Clinical and radiographic peri-implant parameters were worse and levels of AGEs in PISF were increased in individuals with prediabetes and T2DM. AGEs may play an important role in peri-implant inflammation in prediabetes and T2DM.

PIEZOELECTRIC VERSUS CONVENTIONAL SURGICAL DRILLING FOR IMPLANT PLACEMENT IN ANTERIOR MAXILLA

INTRODUCTION: Osteotomies done for implant placement has been classically performed using drills of various shapes to conform the siteto the implant’s geometry. Drilling procedures may cause not only mechanical trauma to the bone but also heat-induced bone necrosis,representing a significant risk for failed osseointegration. As an alternative, ultrasonic drilling for implant placement allows precise andeffective bone cutting without damaging adjacent soft tissues.OBJECTIVES: This study evaluated the effect of Piezoelectric drilling in decreasing the peri-implant marginal bone loss as well as increasingthe implant stability values throughout a 6 months healing period.MATERIALS AND METHODS: A clinical and radiographic study with a split-mouth design was carried out on 10 patients. Each patientreceived two implants in both sides of anterior maxilla, one implant was placed with piezoelectric drilling (study group) and the other wasplaced with conventional drilling (control group). Assessments included measurements of implant stability using Osstell and measurements ofthe linear changes in the peri-implant marginal bone using cone beam computed tomography images. Measurements were done immediatelypost-operative, at 3 months and 6 months.RESULTS: The clinical and radiographical results of the Piezoelectric study sides were better than the conventional control sides. Marginalbone loss was significantly lower in the study group. Implant Stability Quotient (ISQ) values were significantly higher in the study group atthe immediate time of placement and at 6 months.CONCLUSIONS:Within the limitations of this clinical trial, it can be concluded that the piezoelectric drilling for implant placement inthe anterior maxilla is a successful option for reducing marginal bone loss and increasing implant stability throughout the healing period.KEYWORDS: Ultrasonic/piezoelectric drilling, piezotome, implants, maxilla.

A clinical assessment of periimplant marginal bone loss and soft tissue status in dental implant placed by flapless implant surgery. (A one-year prospective study)

Despite several studies have been conducted to evaluate the clinical outcomes offlapless implant surgery limited information presents regarding the clinical conditionsafter flapless implant surgery, for this reason this study was carried out to evaluate theperi-implant marginal bone loss and soft tissue status in dental implant placed byflapless implant surgery.In the present study, 143 implants were placed in 68 patients by using a flapless 1-stage procedure. In these patients, peri-implant soft tissue conditions and radiographicmarginal changes were evaluated one year after surgery.Results: None of the implants was lost during follow-up, giving a success rate of100%. The mean score of GI was (0.28 mm SD = 0.21), the average BOP index was(0.12, SD= 0.05) and the mean pocket probing depth was (2.7 mm, SD= 1.1).The mean marginal bone loss (0,4 mm, SD = 0.49) range ( 0.0 – 1.2 mm ).Whereas 34 implants showed no bone loss at all.The results of this study demonstrate that flapless implant surgery is a predictableprocedure. In addition, it is advantageous for preserving crestal bone and mucosalhealth surrounding dental implants.

Immediate functional loading of single implants: a multicenter study with 4 years of follow-up.

Background. In the current scientific literature there are only few studies on the immediate functional loading of single implants. The aim of the present present study was to evaluate the 4-year survival rate, complication rate and peri-implant marginal bone loss (PIMBL) of immediately loaded single implants inserted in healed ridges and fresh post-extraction sites. Methods. Six centers were involved in this prospective study. The surgical and prosthetic protocol was defined in detail, before the start of recruiting patients. Recruitment of patients and performance of surgeries took place between February 2012 and February 2013. Criteria for inclusion were single-tooth gaps in healed ridges and fresh post-extraction sockets. All the fixtures (Anyridge®, Megagen Corporation, Gyeongbuk, South Korea) were functionally loaded immediately after insertion and followed for a period of 4 years. Outcome measures were implant survival, complications and PIMBL. Results. Forty-six patients (18‒73 years of age) were selected. In total, 57 fixtures were placed (10 in fresh post-extraction sockets). After 4 years of functional loading, only one fixture was lost; therefore, high survival rates (97.6% patient-based; 98.1% implant-based) were reported. In addition, a limited incidence of biologic (4.8% patient-based; 3.8% implant-based) and prosthetic (9.7% patient-based; 7.6% implant-based) complications was reported. The overall 4-year PIMBL amounted to 0.38±0.21 mm (healed ridges: 0.4±0.21 mm; fresh post-extraction sockets: 0.33±0.20 mm). Conclusion. Loading single implants immediately seems to be a highly successful treatment modality. However, long-term data are needed to confirm these positive outcomes.

Comparison of digital protocols for the measurement of peri-implant marginal bone loss.

BackgroundThe measurement of peri-implant marginal bone loss is currently carried out using digital methods of radiographic analysis assisted by various types of software. The purpose of this study was to compare the characteristics of three different softwares: specific radiology software for the development and visualization of radiological images in DICOM format (3Dicom Viewer®), advanced level software for professional editing of bitmap images (or raster graphics) (Adobe Photoshop®), and mid-level software for processing bitmap-type images, programmed in Java and in the public domain (ImageJ®).Material and MethodsIt was verified that the three softwares used are valid for the measurement of peri-implant marginal bone loss provided that the appropriate protocol is fulfilled.ResultsThe results showed no significant differences between Adobe Photoshop® and ImageJ® with respect to 3Dicom Viewer® in the measurements of mesial and distal bone loss of the implants, without influence of the dental sector where they were located.ConclusionsThe measurements made with ImageJ® looked more like those of the control software (3Dicom Viewer®) than those of Adobe Photoshop®, but with a greater degree of dispersion. Thus, Adobe Photoshop® is a slightly inaccurate method but with less dispersion. Key words:Digital measurement, measurement software, peri-implant marginal bone loss, implants.

Risk Indicators for Implant Therapy on Periodontitis

Periodontitis is one of the most common chronic inflammatory disease triggered by microbial dysbiosis and is considered to be the major cause of losing tooth in the adult. With the development of oral implantology, dental implant has become widely accepted alternative method for replacing poor prognosis teeth in patients with periodontitis. However, over the years, researchers have been concerned about the prognosis and clinical survival of patients with periodontitis after implant treatment. Studies have shown that individuals with previous tooth loss caused by periodontitis have an increased risk of loss implants, peri-implant marginal bone loss, and peri-implantitis. The aim of the present review was to evaluate the risk indicators for implant therapy on periodontitis.

Optimization of emergence profile of implant prosthesis: A literature review

In order to achieve esthetically optimal outcome with implant prosthesis, appropriate topography of emergence profile is crucial. The objective of this review is to explorer current evidence regarding this topic and relevant issue. Extent of interproximal papilla is determined not by the shape of emergence profile but the length between interproximal alveolar bone prominence and interproximal contact of crowns. There have been concerned that multiple times of disconnection and reconnection of abutment enhance peri-implant marginal bone loss, but it’s certified not to be a clinically significant level. Current digital workflow makes this step faster and easier, by copying emergence profile of contralateral tooth or extracted teeth.

Maxillary Sinus Floor Augmentation With Synthetic Bone Substitutes Compared With Other Grafting Materials: A Systematic Review and Meta-analysis.

To test the hypotheses of no differences in implant treatment outcome after maxillary sinus floor augmentation (MSFA) with synthetic bone substitutes (SBS) compared with other grafting materials applying the lateral window technique. A MEDLINE/PubMed, Embase and Cochrane Library search in combination with hand-search of selected journals was conducted. Five randomized controlled trials with low risk of bias fulfilled the inclusion criteria. SBS disclosed high survival rate of suprastructures and implants with no significant differences compared to autogenous bone graft or xenograft. Meta-analysis revealed a patient-based implant survival rate of 0.98 (confidence interval: 0.89-1.08), indicating no differences between SBS and xenograft. SBS demonstrated significant less newly formed bone compared with autogenous bone graft, whereas no significant difference was revealed as compared to xenograft. High implant stability values, limited periimplant marginal bone loss, and few complications were reported with SBS. There seem to be no differences in implant treatment outcome after MSFA with SBS compared to other grafting materials.

Osteotome-Mediated Sinus Floor Elevation With or Without a Grafting Material: A Systematic Review and Meta-analysis of Long-term Studies (≥5-Years).

To test the hypothesis of no difference in the long-term treatment outcome after osteotome-mediated sinus floor elevation with or without a grafting material. A MEDLINE/PubMed, Cochrane Library, and EMBASE search in combination with a hand-search of relevant journals was conducted, including human studies published in English from January 1, 1986 to December 1, 2017. One comparative and 7 noncomparative studies fulfilled the inclusion criteria. Survival of suprastructures had never been compared within the same study. Meta-analysis demonstrated an overall estimated patient-based implant survival of 94%. Gain in vertical alveolar bone height was similar with the 2 treatment modalities. Noncomparative studies demonstrated high long-term survival rate of suprastructures and implants with the 2 treatment modalities, as well as limited periimplant marginal bone loss. High long-term implant survival was demonstrated after osteotome-mediated sinus floor elevation with or without a grafting material. However, long-term randomized controlled trials comparing the 2 treatment modalities are sparse. Hence, conclusions drawn from this systematic review should be interpreted with caution.

One-stage laser-microtextured implants immediately placed in the inter-radicular septum of molar fresh extraction sockets associated with GBR technique. A case series study.

BackgroundThe outcome of one-stage trans-mucosal immediate implants with simultaneous guided bone regeneration (GBR) technique has become highly predictable. Furthermore, when this approach is performed to place one-stage implants into the inter-radicular septum of fresh extraction sockets in the molar region, the risk of incorrect emergence profile and off-angle loading is reduced. The aim of the present study was to clinically evaluate the horizontal hard and soft tissue changes, and radiographically the vertical socket walls remodeling, and the early peri-implant marginal bone loss (EMBL) following the placement of immediate one-stage implants in the inter-radicular septum of molar fresh extraction sockets, associated with a collagen membrane.Material and MethodsTwenty patients were selected to receive a one-stage implant with laser-microtextured collar surface into the inter-radicular septum of a fresh molar extraction sockets, associated with a simultaneous placement of a collagen membrane. Intraoral radiographs and model casts were used for the evaluation. Correlation between the amount of the keratinized tissue thickness (KTT) with EMBL was also analyzed.ResultsAfter 4 months, the vertical radiographic mesial and distal EMBL around implants was of 0.06 ±0.01 mm and 0.04±0.02 mm, respectively, with no statistically significant difference between T0 and T1 (P >0.05). No statistical differences were found also for each radiographic measure used for the examination of implant sites vertical bone changes (p >0.05). Clinically, horizontal changes of the bucco-lingual central width were found statistically significant (p<0.05), whereas no statistical differences were found for bucco-lingual mesial and distal width changes (p >0.05). In addition, no statistically significant correlation between EMBL and the amount of KTT was found (P >0.05).ConclusionsResults suggest that the immediate placement of one-stage laser-microtextured implants could provide advantages in preserving the extraction socket’s hard and soft tissue remodeling, and the peri-implant marginal bone level before the prosthetic loading. Key words:One-stage implant, laser-microtextured collar surface, GBR, collagen membrane.

The effect of using prefabricated bars on marginal bone loss around tilted or axially placed and immediately loaded implants for retaining mandibular overdentures

Objectives: The goal of this study was to evaluate the effect of using prefabricated stress-free implant bar (SFI-Bar) on marginal bone loss around tilted or axially placed and immediately loaded two implants for retaining mandibular overdentures. Materials and Methods: Thirty patients with a mean age of 56.5 years were chosen. Patients were divided into two groups as follows: Group (AB) (n = 15): Patients received two axially implants connected by SFI-Bars for retaining mandibular overdentures. Group (TB) (n = 15): Patients received two mesially tilted implants connected by SFI-Bars for retaining mandibular overdentures. For each patient, two dental implants (3.8 mm × 12 mm) were bilaterally inserted in the canine regions. Implants were immediately loaded with SFI-Bar system overdentures. Digital periapical radiographs were scheduled at implant placement (baseline) and subsequently after every 12 months up to 36 months to measure peri-implant bone loss (PiBL). The recorded data were subjected to statistical analysis. Results: Both groups showed insignificant PiBL at 12 and 24 months, while at 36 months, patients in Group TB showed significantly higher marginal PiBL than that with Group AB. Conclusions: Prefabricated SFI-Bar retained mandibular overdentures could offer an alternative attachment for two angulated, immediately loaded implants with predictable radiographic outcomes.

Clinical applications and effectiveness of guided implant surgery: a critical review based on randomized controlled trials

BackgroundNowadays implant placement protocols are widespread among clinicians all over the world. However, available literature, only partially analyses what can be potential benefits for the clinicians and patients, often focusing just on specific aspects, such as accuracy. The purpose of this review is to compare computer guided implant placement with conventional treatment protocols.MethodsA search strategy according to the P-I-C-O format was developed and executed using an electronic MEDLINE plus manual search from 2000 up to December 2016. This review included only randomized controlled trials (RCTs) focusing on subjects treated with digital workflow for oral implant placement compared to conventional procedures. Data were extracted from eligible papers and analysed. All kinds of outcomes were considered, even patient-related and economical outcomes.ResultsThe search strategy revealed 16 articles; additional manual searches selected further 21 publications. Afterwards the evaluation of articles, only two studies could be selected for subsequent data extraction. The two identified RCTs analysed primary outcomes as prosthesis failure, implant failure, biological or prosthetic complications, and secondary outcomes as periimplant marginal bone loss. One RCT evaluated also the duration of treatment, post-surgical progress, additional treatment costs and patient satisfaction. The other RCT focused instead on evaluating eventual improvement of patient’s quality of life. In both selected studies, were not observed by the authors statistically significant differences between clinical cases treated with digital protocols and those treated with conventional ones. In one RCT, however post-surgical progress evaluation showed more patients’ self-reported pain and swelling in conventional group.ConclusionsWithin the limitation of this review, based on only two RCTs, the only evidence was that implant survival rate and effectiveness are similar for conventional and digital implant placement procedures. This is also confirmed by many other studies with however minor scientific evidence levels. Reduction of post-operative pain, surgical time and overall costs are discussed. Authors believe that scientific research should focus more in identifying which clinical situations can get greatest benefits from implant guided surgery. This should be done with research protocols such as RCT that assess comprehensively the advantages and disadvantages of fully digital surgical protocols.

The Influence of Prosthesis Design on the Outcomes of Tooth Implants Immediately Placed and Loaded by Means of One-Piece Titanium Machined Restoration.

Our purpose was to evaluate the occurrence of complications and the degree of bone loss in a cohort of patients treated with fixed prostheses supported by immediately loaded dental implants. The primary aim was to compare partial versus full-arch fixed dental prostheses. We then tested the effect of sinus lifting. In the present retrospective cohort study, the patients had their implants restored with fixed dental prostheses supported by dental implants positioned in the posterior maxilla and mandible. When necessary, the maxillary sinuses were grafted with particulate autogenous bone. Patients were then ranked according to the following predictors: length of prosthesis, crown-to-implant ratio, number of crowns to number of implants ratio, and presence of sinus lifting. Outcomes were evaluated for up to 2 years regarding the peri-implant marginal bone loss and implant/prosthesis survival rates. Fifty-eight subjects (209 implants) were rehabilitated with 25 fixed full-arch prostheses and 33 partial fixed dental implant bridges (16 supported by implants placed in grafted sinus). The mean marginal bone loss for implants supporting partial fixed dental prostheses amounted to 0.81 mm, whereas that for implants within the group of full-arch fixed dental prostheses was 1.21 mm; the comparison of the levels in the 2 groups showed a significant difference ( P = .0055). A statistically significant difference ( P = .0006) was found between the bone loss around maxillary implants (1.53 mm) and the bone loss around mandibular implants (1.10 mm). Two implants and 4 prostheses failed; 2-year survival rates of partial and of full-arch fixed dental prostheses, respectively, were 94.1% and 96%. Bone loss in full-arch prostheses appeared to be higher than in that of partial prosthesis. Implant-supported prostheses in the maxillae exhibited a bone loss higher than that registered in mandibles.

RADIOGRAPHIC AND CLINICAL EVALUATION OF FIXED D TACHABLE PROSTHESES VERSUS TELESCOPIC OVERDENTURES SUPPORTED BY OSSEOINTEGRATED IMPLANTS

The purpose of the present study was to evaluate radiographically (the crestal bone level change) and clinically (gingival crevicular fluid and implant stability) in cases with four implants supporting mandibular fixed detachable prostheses versus telescopic overdenture.Methodology: Twenty completely edentulous patients were treated with four interforaminal implants to support either fixed detachable prostheses with distal cantilevers or telescopic overdenture. The peri-implant marginal bone loss was assessed radiographically at distal surface of posterior implant bilaterally was calculated in two different intervals. The first interval (0-6months) and the second interval (0-12months) using a digital panoramic imaging system. Also clinical evaluation for checking the implant stability using the perio-test and measuring the gingival crevicular fluid.Results: Regarding the gingival crevicular fluid, the comparison between both groups at the time of delivery and after 6 months, there was no significant difference between the two groups. But there was a significant difference after 12 months. From the obtained data of periotest, it was recognized that there was no significant difference between the two groups regarding the implant stability. But there was a significant difference within each group at the different follow-up periods. The data of marginal bone loss at the distal surface of posterior implant on both sides revealed that there was a significant difference between the two groups at the 1st and 2nd intervals.Conclusion: Both telescopic overdenture and fixed detachable prostheses considered a viable successful treatment option for rehabilitating completely edentulous cases. Telescopic overdentures showed less crestal bone loss at the distal implants than that with the fixed detachable design. The gingival crevicular fluid decreases gradually throughout the study period in both designs denoting successful oral hygiene measurements.

Combination of straight and tilted implants for supporting screw-retained dental prostheses in atrophic posterior maxillae: A 2-year prospective study

ObjectivesTo evaluate the two-year survival rate (SR) and marginal bone loss (MBL) of fixed dental prostheses (FDPs) supported by straight (S) and tilted (T) implants under the influence of diverse study variables. MethodsA prospective investigation comprising 21 patients provided with a total of 27 maxillary screw-retained restorations fixed to 70 dental implants was developed. Two groups of implants were considered depending on their inclination with respect to the occlusal plane: Group 1 (S, n=37): straight/axial implants and Group 2 (T, n=33): tilted/angled fixations. Each FDP was supported by a combination of S and T implants. SR and MBL were assessed at the time of loading and two years after surgery. Patient-, surgical- and/or rehabilitation-related information was gathered. Data were statistically analysed at the α=0.05 significance level. ResultsAfter 24 months, a 100% SR was achieved and the MBL of S and T implants were statistically similar. T implants located in the molar region showed lower MBL than did those replacing premolars (p=0.031). ConclusionsUpright and angled fixations inserted at posterior maxillary areas resulted in comparable survival rates and peri-implant MBL after two years. The marginal bone resorption around tilted implants depended on their location. Clinical significanceScrew-retained restorations fixed to straight and tilted implants seem to be a safe treatment option in posterior atrophic maxillae.

Graft-Free Maxillary Sinus Floor Elevation: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aims to investigate survival rates of dental implants placed simultaneously with graft-free maxillary sinus floor elevation (GFSFE). Factors influencing amount of vertical bone gain (VBG), protruded implant length (PIL) in sinus at follow-up (PILf), and peri-implant marginal bone loss (MBL) are also evaluated. Electronic and manual searches for human clinical studies on simultaneous implant placement and GFSFE using the lateral window or transcrestal approach, published in the English language from January 1976 to March 2016, were conducted. The random-effects model and mixed-effect meta-regression were used to analyze weighted mean values of clinical parameters and evaluate factors that influenced amount of VBG. Of 740 studies, 22 clinical studies were included in this systematic review. A total of 864 implants were placed simultaneously with GFSFE at edentulous sites having mean residual bone height of 5.7 ± 1.7 mm. Mean implant survival rate (ISR) was 97.9% ± 0.02% (range: 93.5% to 100%). Weighted mean MBL was 0.91 ± 0.11 mm, and it was significantly associated with the postoperative follow-up period (r = 0.02; R2 = 43.75%). Weighted mean VBG was 3.8 ± 0.34 mm, and this parameter was affected significantly by surgical approach, implant length, and PIL immediately after surgery (PILi) (r = 2.82, 0.57, 0.80; R2 = 19.10%, 39.27%, 83.92%, respectively). Weighted mean PILf was 1.26 ± 0.33 mm (range: 0.3 to 2.1 mm). Within limitations of the present systematic review, GFSFE with simultaneous implant placement can achieve satisfactory mean ISR of 97.9% ± 0.02%.

Dimensional alterations following vertical ridge augmentation using collagen membrane and three types of bone grafting materials: A retrospective observational study.

Various biomaterials have been introduced for vertical ridge augmentation to replace autogenous block bone grafting. This retrospective study radiographically evaluated dimensional alterations of the vertically augmented alveolar ridge using collagen membrane and 3 types of materials: autogenous bone block, allogenous bone block, and particulated bone substitute. The electronic medical records of 32 patients who received vertical ridge augmentation using 3 types of materials were searched: 9 for autogenous bone block, 12 for allogenous bone block, and 11 for particulated bone substitutes. The vertical bone gain, progression of bone resorption, and peri-implant marginal bone loss after prosthetic loading were measured on follow-up radiographs. The alveolar ridge was vertically augmented by 5.13 ± 1.61, 4.54 ± 2.48, and 3.90 ± 0.85 mm (mean ± standard deviation) after grafting with autogenous bone block, allogenous bone block, and particulated bone substitute, respectively. The radiographic vertical height of the augmented ridge that received autogenous bone block reduced continuously during the first year but was stable thereafter. Sites that received allogenous bone block or particulated bone substitute exhibited dimensional shrinkage for up to 1.5 years postsurgery. However, the peri-implant marginal bone loss did not exceed 1 mm throughout the observational periods in all groups. The clinical findings of this study suggest that the alveolar ridge can be vertically augmented using either allogenous bone block or particulated bone substitute. However, they require a longer healing period to ensure dimensional stability compared to the autogenous bone block.

Effects of uncontrolled periodontitis on marginal bone alterations around implants: A case-control study.

The hypothesis of bacterial infection initiating marginal bone loss around dental implant in analogy with natural tooth is still in debate. The aim of this retrospective study was to investigate the effects of uncontrolled periodontitis on marginal bone alterations around implants compared with the periodontal health group at a mean follow-up of at least 6 years. Thirty consecutive uncontrolled periodontally compromised patients (PCP) and 30 periodontally healthy patients (PHP), with a total of 96 Straumann implants (PCP = 55, PHP = 41) were matched for age, gender, smoking, and implant characteristics. The inclusion criteria for PCPs were continuing tooth loss due to uncontrolled periodontal disease and no supportive periodontal maintenance after implant therapy. Peri-implant conditions were examined and the number of teeth lost during the follow-up periods was recorded in both groups. Radiographic marginal bone loss of implants and adjacent teeth was calculated having the restoration time point as baseline. No implant loss occurred in both groups. The mean number of teeth lost during the follow-up periods was 0.67 ± 0.80 in the PHP group, 3.93 ± 2.36 in the PCP group with statistical significance. The average overall bone loss was significantly greater at teeth than that around implants in the PCP group (0.54 ± 0.27 versus 0.22 ± 0.25 mm, P < .001), while no statistically significant differences were observed in the PHP group (0.18 ± 0.08 versus 0.22 ± 0.18 mm, P = .317). No statistically significant differences were observed between PC and PH patients when comparing the peri-implant marginal bone loss. No significant correlations were found between teeth loss and crestal bone loss at implants sites in both groups. This study indicated that the marginal bone level around implants seemed more stable in comparison to that around the natural teeth when exposed to uncontrolled periodontal disease.