Tissue-level Implants Research Articles

Ten years follow-up of tissue level implants: case series

Ten years follow-up of tissue level implants: case series

Esthetic Outcomes of Immediately Placed Implants with Convergent Transmucosal Profile: A Retrospective Single-Cohort Study.

Purpose: Immediate implant placement is a reliable solution to replace hopeless teeth, but this procedure may be associated to an increased risk of soft tissue complications in case of thin biotype. The use of tissue-level implants with a convergent transmucosal profile has been advocated to increase space for soft tissue, contributing to improve their stability and esthetics. The aim of this retrospective study was to evaluate the esthetic outcomes and the Patient-Reported Outcome Measures (PROMs) of immediately placed implants with a convergent transmucosal profile. Materials and methods: This single-cohort, monocentric, retrospective clinical study was conducted on patients treated with an immediately placed implant in the esthetic zone (from premolar to premolar). All the eligible patients were recalled for a clinical and radiographic follow-up visit. Results: This study included 20 patients (8 males, 12 females) with an average age of 55.5± 6.8 years, who received 20 implants, with a mean follow-up of 46.5± 15.3 months. At the time of follow-up, immediately placed implants showed a mean Marginal Bone Loss of 0.42± 0.49 mm, and a statistically significant improvement of the esthetic parameters from baseline to the last available follow-up; in particular, Pink and White esthetic scores (p=.001) and Papilla Index at mesial and distal sites (p<.001). All the patients reported a high satisfaction (VAS>9) both from esthetic and functional point of view. Conclusion: Immediately placed implants with convergent transmucosal profile in the esthetic zone showed good clinical and esthetic outcomes, with stable results over time.

Randomized controlled trial on the efficacy of a custom-made, fully guided implant system for flapless crestal sinus floor elevation: Accuracy and patient-reported outcomes.

To compare fully guided flapless implant surgery using a light-cured surgical guide (FG group) with partially guided open flap surgery (PG group) in the posterior maxilla when performing simultaneous sinus floor elevation in terms of the accuracy, time requirements, and patient/clinician-reported outcomes (PROMs and CROMs). In this study, 56 tissue-level implants were placed with crestal sinus floor elevation in 56 patients at single-tooth sites, with 28 implants allocated to the PG group and 28 to the FG group. The deviations of the placed implants from the virtually planned positions were measured at the implant platform and apex and for the angular deviation. The presurgical preparation time and the duration of surgery were measured. PROMs and CROMs were made by administering questionnaires at multiple time points. Horizontal deviations at the platform and apex and the angular deviation were significantly smaller in the FG group than the PG group (p < .05). Presurgical preparation and surgery times were significantly shorter in the FG group (p < .001). Patient satisfaction and willingness to receive repeat treatment were significantly better in the FG group than in the PG group (p < .005 and .025, respectively). Clinicians were more satisfied in the FG group than the PG group (p < .05). When placing an implant with sinus floor elevation, the flapless approach using a fully guided surgical system can be more accurate, faster, and increase the satisfaction of both the clinician and patient compared to the partially guided surgery.

Comparative osseointegration of hydrophobic tissue-level tapered implants-A preclinical invivo study.

To histometrically compare the osseointegration and crestal bone healing of a novel tapered, self-cutting tissue-level test implant with a standard tissue-level control implant in a submerged healing regimen. In a mandibular minipig model, implants were inserted and evaluated histometrically after a healing period of 3, 6, and 12 weeks. The primary outcome was the evaluation of bone-to-implant contact (BIC) and secondary outcomes were primary stability as per insertion torque and first BIC (fBIC). Outcomes for the test and control implants were compared using Wilcoxon signed-rank tests and mixed linear regression models. Insertion torque values were significantly higher for the test (50.0 ± 26.4 Ncm) compared to the control implants (35.2 ± 19.7 Ncm, p = .0071). BIC values of test implants were non-inferior to those of control implants over the investigated study period. After 12 weeks, the corresponding values measured were 81.62 ± 11.12% and 90.41 ± 4.81% (p = .1763) for test and control implants, respectively. Similarly, no statistical difference was found for fBIC values, except for the 12 weeks outcome that showed statistically lower values for the test (-675.58 ± 590.88 μm) compared to control implants (-182.75 ± 197.40 μm, p = .0068). Novel self-cutting tissue-level implants demonstrated noninferior osseointegration and crestal bone height maintenance to the tissue-level implants. Histometric outcomes between both implants demonstrated test implants were statistically noninferior to control implants, despite substantial differences in the bone engagement mechanism and resulting differences in insertion torque and qualitative bone healing patterns.

Causes of Implant Failure and Subsequent Removal: A Retrospective Study in a Hospital setting.

Despite high rates of success for dental implants, implant failure due to several causes may require explantation. In the present retrospective study, implants removed between 2000 and 2022 have been registered and the cause of removal has been established. All implants were removed by a single operator (PPM) in the department of Oral Surgery of the George Eastman Dental Hospital in Rome, Italy. Characteristics of removed implants such as implant surface, morphology (bone versus tissue level implants), type of restoration (fixed versus removable), in the case of fixed restorations, mode of retention (cement versus screw-retained), location of the implant (maxillary versus mandibular arch) were recorded. Furthermore, patient-level characteristics were also recorded (systemic health conditions and medications taken, smoking habits and previous history of periodontitis). In total, 381 implants in 381 patients were removed in the 20-year time-span. The most frequent cause of removal was peri-implantitis (82.4% of implants), followed by implant malposition and loss of osteointegration. The survival time was not affected by the cause of removal, while bone level implants had a longer survival time versus tissue level implants. Maxillary implants had a higher prevalence of peri-implantitis compared to mandibular implants.

Primary stability and osseointegration comparing a novel tapered design tissue-level implant with a parallel design tissue-level implant. An experimental invivo study.

The aim of the present study was to compare a novel tapered, double-threaded self-tapping tissue-Level design implant (TLC) to a well-established parallel walled tissue-level (TL) implant in terms of primary and secondary stability over time. Test TLC (n = 10/per timepoint) and control TL (n = 10/per timepoint) implants were placed in the mandible of minipigs and left for submerged healing for 3, 6, and 12 weeks. Maximum insertion torque and implant stability quotient (ISQ) were measured for each implant at placement. Osseointegration and cortical bone maintenance were histologically evaluated by measuring total bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC). A significantly higher maximum insertion torque was measured for the test implant TLC compared to the control TL implant (57.83 ± 24.73 Ncm and 22.62 ± 23.16 Ncm, respectively; p < .001). The mean ISQ values were comparable between the two implant types (75.00 ± 6.70 for TL compared to 75.40 ± 3.20 for TLC, p = .988). BIC was comparable between both implant types at each of the evaluated time points. The fBIC was found to be significantly more coronal at 12 weeks for the TLC implant compared to the TL implant (0.31 ± 0.83 mm for TLC compared to -0.22 ± 0.85 for TL, p = .027). The novel tapered tissue level design implant showed improved primary stability and an overall improved crestal bone height maintenance compared to the parallel walled design at 12 weeks.

One-year clinical evaluation of bone-level and tissue-level implants

Aim: This study aimed to retrospectively examine and compare the clinical conditions of different implant levels at the end of 1 year. The clinical success is closely related to the loading time, the primary stability, oral hygiene, the features of the implant neck, and the bone structure. Methodology: A total of 41 implants were applied to patients with a mean age of 52.76±11.39 years. Among these patients, 10 (47.6%) were female, and 11 (52.4%) were male. Out of the total of 19 implants, 46.3% were placed in the left mandible. Specifically, 14.6% were placed in the premolar area and 31.7% were placed in the molar region. The 22 (53.7%) remaining cases were placed in the right mandible, with 10 (24.4%) in the premolar region and 12 (29.3%) in the molar region. In all, 21 implants (51.2%) were placed at the bone level, whereas 20 implants (48.8%) were placed at the tissue level. Out of the total of 41 implants, 25 (61%) had a diameter of 3.3 mm, whereas 16 (39%) had a diameter of 4.1 mm. X-rays were taken to detect bone loss in the mesial and distal regions, transferred to the computer, and evaluated via IBM SPSS Statistics V22 software. Results: In the study, 19 (46.3%) of the implants were placed in the left mandible and 22 (53.7%) in the right mandible. Approximately 51.2% of the implants were placed at the bone level, and 48.8% were at the tissue level. Initial Osstell values ranged from 72.88 ± 6.4 ISQ to 75.83 ± 5.92 ISQ. The initial X-ray results varied between 0.03 ± 0.09 mm and 0.38 ± 0.99 mm, whereas the final X-ray measurements were 0.15 ± 0.24 mm to 0.71 ± 1.54 mm. Conclusion: Bone loss was determined to be less than 2 mm in both groups. Plaque accumulation occurred in the lingual region; however, it was observed more at the bone level. Hygiene control is the key for success, which could easily be accomplished with the gingival level of implants or the gingival positioning height of the abutments.

Immediate versus delayed implant placement of novel fully tapered tissue-level implants - A retrospective multicenter clinical study.

To compare the clinical and radiological outcomes of novel fully tapered tissue-level implants in immediate implant placement (type 1) versus late implant placement (type 4) for the first time. For this clinical study, 318 fully tapered tissue-level implants in 65 patients were inserted immediately (n = 68 implants) or late (n = 250 implants) in two different centers. Implant survival and success rates and marginal bone levels were analyzed. After a mean follow-up of 12.0 ± 5 months, implant survival rates were 97.8% for all implants. No statistically significant difference in implant survival rates between type 1 and type 4 could be detected (98.5% vs 97.6%, HR 0.70, 95%-CI 0.084-5.81). Neither for implant length (HR 0.53, 95%-CI 0.055-5.08) nor for implant width (HR 0.27, CI 0.028-2.55), a significant influence on implant survival could be detected. Type of used biomaterial for filling the gap and immediate loading showed no effect on implant survival. Mean marginal bone loss was 0.02 ± 0.05 mm for type 1 and 0.04 ± 0.1 for type 4. Within the limitations of this retrospective study and the short follow-up, the results demonstrated comparable high survival and success rates and stable marginal bone levels for type 1 and type 4 placement of this novel tissue-level implant (no clinical trial registration as retrospective study design).

A Multicenter Cohort Study on 301 Tissue-Level Implants: Cumulative Implant Survival Rate and Marginal Bone Level Change up to 4.5 Years.

To retrospectively determine the cumulative survival rate (CSR) and marginal bone level change (ΔMBL) around novel hybrid design tissue-level (TL) dental implants that support multiple-screw-retained restorations. Implant CSRs were analyzed at the implant and patient level using Kaplan-Meier estimates. ΔMBL was measured by comparing the periapical loading and follow-up visit radiographs using an improved standardized digital methodology based on image gray levels. ΔMBL outcomes were subject to linear mixed regression to identify potential risk factors. A total of 301 TL implants in 69 patients with an average age of 62.6 ± 11.7 years (range: 36 to 87 years) at the time of implant placement were considered for the analysis. All 301 implants were successfully restored and loaded. The 54-month CSRs at the implant and patient levels were 98.9% (95% CI: 96.7 to 99.6) and 95.3% (95% CI: 86.1 to 98.5), respectively. ΔMBL after a mean follow-up of 22 ± 10.7 months after loading was 0.00 ± 0.57 mm. None of the implant sites showed marginal bone loss exceeding 1.5 mm. Multivariate regression analysis revealed a significant association between ΔMBL and the loading protocol (P = .027) but not between ΔMBL and age or transgingival height. The high CSRs and stable peri-implant marginal bone levels support the use of recent TL implants, which have a hybrid design inherited from the bone-level implant-abutment connection, as a suitable treatment option for restoring partially or fully edentulous patients with a good mid-term prognosis. These results should be complemented by further prospective studies in a real-world multicenter private practice setup that represents the daily realities of implant treatment.

Advantages of Tissue Level Implants in Case of Alveolar Ridge and Mucosal Atrophy

In the modern market, there is a great variety of dental implants, which differ from each other in design, geometry, connection type, surface treatment technology, etc. However, the most fundamental and main differentiating component between implants is how the implants are inserted into the bone and how it is positioned concerning the soft tissues. Accordingly, they are divided into sunken, i.e., bone level implants and non-sunken, i.e., tissue level implants, in which case the implant-abutment connection, or interface, is located at the gum level. This study shows advantages of tissue level - implants in atrophy of the alveolar ridge, also studies comparison of bone loss in case of bone - level implants and tissue level implants.

Effect of implant type on the stability of cantilever fixed dental prostheses: An invitro study.

To simulate the replacement of a premolar with an implant-supported cantilever fixed dental prosthesis (ICFDP) and how the fracture load is affected by implant type, positioning within the zirconia blank, and aging protocol. Seventy-two ICFDPs were designed either within the enamel- or dentin layer of a 4Y-PSZ blank for bone-level and tissue-level titanium-zirconium implants. Fracture load was obtained on the cantilever at baseline (no aging) or after aging in a chewing simulator with the load applied within the implant axis (axial aging) or on the cantilever (12 groups with n = 6). A three-way ANOVA was applied (α = .05). A three-way ANOVA revealed a significant effect on fracture load values of implant type (p = .006) and aging (p < .001) but not for the position within the zirconia blank (p = .847). Fracture load values significantly increased from baseline bone level (608 ± 118 N) and tissue level (880 ± 293 N) when the implants were aged axially, with higher values for tissue level (1065 ± 182 N) than bone level (797 ± 113 N) (p < .001). However, when the force was applied to the cantilever, fracture load values decreased significantly for tissue-level (493 ± 70 N), while values for bone-level implants remained stable (690 ± 135 N). For ICFDPs, the use of bone-level implants is reasonable as catastrophic failures are likely to be restricted to the restoration, whereas with tissue-level implants, the transmucosal portion of the implant is susceptible to deformation, making repair more difficult.

Comparison between Bone-Level and Tissue-Level Implants in Immediate-Loading Full-Arch Rehabilitations: A Retrospective Multi-Center 1-Year Follow-Up Study

The objective of the present retrospective multi-center study was to analyze the outcomes of bone-level (BL) implants and tissue-level (TL) implants in immediate-loading full-arch rehabilitations. Patients who were previously rehabilitated with full-arch immediate-loading rehabilitations with either BL or TL implants were considered. Data regarding implant survival rate, marginal bone loss (MBL), peri-implant probing depth (PPD), plaque index (PI), and bleeding on probing (BOP) were recorded, and the 1-year follow-up data were statistically analyzed between the two groups. In total, 38 patients were evaluated for a total implant number of 156 (n = 80 TL implants and n = 76 BL implants). An implant survival rate of 97.37% was recoded for the BL group while an implant survival rate of 100% was noted for the TL group. A total MBL of 1.324 ± 0.64 mm was recorded for BL implants, while a total MBL of 1.194 ± 0.30 mm was recorded for TL implants. A statistically significant difference was highlighted regarding MBL at the mesial aspect (p = 0.01552) of the implants, with BL implants presenting with higher MBL. Within the range of acceptable healthy values, a statistically significant difference was also highlighted regarding BOP (p &lt; 0.00001), with TL implants presenting higher values. No statistically significant difference (p &gt; 0.05) was recorded for any of the other variables analyzed. Within the limitations of the present retrospective study, both TL and BL implants seem to provide good clinical outcomes after a 12-month observational period when employed in immediate-loading full-arch rehabilitation.

Prosthetic rehabilitation in the Posterior Mandible with Tissue Level Implant: A Case Report

Implant is becoming the most appropriate option nowadays for replacement of single or multiple missing teeth which offers the predictable long-term results. Continuous innovations in implant design and approaches for placement have been proposed to achieve good osseointegration, esthetics and predictable soft tissue contour. Soft tissue level (STL) implants are placed trans-mucosally with platform away from alveolar bone crest so the microbial deposits in the micro-gap at implant abutment connection has less effect on alveolar bone. This type of implant has a rough surface placed subcrestally to facilitate osseointegration and a polished coronal part to facilitate soft tissue adaptation. This case report highlights about soft tissue level implant, its advantages and clinical success on replacing single missing posterior tooth.

Extra-Short 4-mm Implants Splinted to 10-mm Implants in the Posterior Maxilla: 3-year Results.

To evaluate the 3-year success and survival rates of fixed prostheses supported by 4-mm extra-short implants splinted to 10-mm implants in patients with shortened maxillary arches and low maxillary sinus floors. A total of 11 patients with reduced alveolar bone heights due to low maxillary sinus floors received two or three titanium-zirconium tissue-level implants: one or two extra-short (4 mm) implants, and one implant 10 mm in length. After 6 months, prosthetic rehabilitation with splinted crowns connecting the 4- and 10-mm implants was performed. Follow-up visits and maintenance protocols were implemented every 4 to 6 months. The 11 patients were treated with 11 10-mm implants and 17 4-mm implants. One extra-short implant failed and was removed before loading, and its planned design was modified from three splinted crowns to a bridge between the 10- and 4-mm implants. After 36 months, all (11/11) prosthetic rehabilitations connecting the 10-mm (11/11) and 4-mm (16/16) implants were functional. At the 10-mm implant sites, the median (interquartile range [IQR]) probing depth and marginal bone loss measured 2.9 mm (2.3 to 3.2) and 1.3 mm (1.0 to 1.5), respectively. At the 4-mm implant sites, the median (IQR) probing depth and marginal bone loss measured 2.9 mm (2.4 to 3.1) and 0.3 mm (0.1 to 0.5), respectively. Prosthetic rehabilitation with splinted crowns connecting 4-mm and 10-mm implants showed promising outcomes in shortened maxillary dental arches after 3 years. Additional studies are needed to further validate these findings.

Implantoplasty and the risk of fracture of narrow implants with advanced bone loss: A laboratory study.

To assess the impact of implantoplasty (IP) on maximum implant failure strength of narrow diameter implants of different type/design and material, with simulated advanced bone loss. Narrow, parallel-walled implants (3.3 mm in diameter × 10 mm long) with an internal connection of different type/design [bone level (BL), tissue level (TL)] and material [Titanium grade IV (Ti), Titanium-Zirconium alloy (TiZr)] from one specific manufacturer were used. Half of the implants were subjected to IP in their coronal 5 mm; the remaining were used as controls (seven implants per group). Dynamic loading prior to maximum load strength testing was included. During dynamic loading, the fracture rate of BL implants was low and independent of IP, while that of TL implants increased significantly with IP compared with controls (p = .001). Maximum implant failure strength reduction (in %) due to IP, was 1.3%-25.4%; TiZr BL implants were least affected. Implants subjected to IP compared to those without IP as well as TL implants compared to BL implants showed a significantly lower maximum implant failure strength (p < .002); implant material was not significant (p = .845). Based on data from implants of one specific manufacturer, IP has a significant negative impact on the fracture strength of narrow implants suffering from advanced peri-implantitis. TL implants have been more severely affected compared to BL implants and presented an increased risk for failure during normal chewing forces. In addition, this negative impact of IP on TL implants was independent of the implant material (i.e., Ti or TiZr). Narrow single TL implants with advanced horizontal bone loss (e.g., 5 mm), when subjected to IP, appear to have an increased fracture risk during normal function.

Narrow diameter titanium-zirconium tissue-level implants supporting multi-unit FDPs in the anterior area: A 5-year prospective study.

Narrow diameter implants (NDIs) are used in cases of limited mesio-distal space, or if the alveolar ridge does not allow placement of a standard diameter implant. The aim of this prospective case series study is to present the 5-year clinical-, radiological-, and patient-reported outcome measures (PROMs) of patients with partial edentulism in the anterior area of the jaws requiring the placement of two narrow diameter implants to support a 3- or 4-unit fixed partial denture (FPD). Thirty partially edentulous patients missing 3 or 4 adjacent teeth in the anterior area of the jaws were included in the study. Two titanium-zirconium tissue-level NDIs were placed in each patient in healed anterior sites (60 implants). A conventional loading protocol was performed to provide a FPD. Implant survival, success, marginal bone-level changes (MBL), clinical parameters, buccal bone stability with CBCT, adverse events and PROMs were recorded. The survival and success rates for the implants were 100%. The mean MBL (±SD) after prosthesis delivery, and 5-year follow-up (mean 58.8 months; range: 36-60) was 0.12 ± 0.22 and 0.52 ± 0.46 mm, respectively. Decementation and screw loosening were the most frequent prosthetic complications, yielding a prosthetic survival and success rates of 100% and 80%, respectively. Patient satisfaction was high with a mean (±SD) score of 89.6 ± 15.1. The use of tissue-level titanium-zirconium NDIs supporting splinted multi-unit FPDs in the anterior area seems to be a safe and predictable treatment option after a 5-year follow-up period.

Radiographic Comparison of the Crestal Bone Loss in the Bone-Level and Tissue-Level Implants in Implant-Supported Mandibular Overdentures

Introduction: To preserve the peri-implant bone level during implant restorations, multiple variations have been made in the implant-abutment connections and bone level, and tissue level implants have been placed at the bone or tissue levels to restore the function of the lost teeth. This study compared the radiographic amount of crestal bone loss in bone-level and tissue-level implants in the implants supported mandibular overdentures.&#x0D; Methods and materials: This study included 40 patients receiving bone-level and tissue-level implants with mandibular overdentures. A total number of 120 implants were placed by an experienced surgeon in a one-stage surgery. Panoramic images of patients immediately after surgery and at least one year after prosthetic loading were assessed. Bone loss values (distance between implant shoulder to proximal bone) were assessed in the bone-level and tissue-level implants on the radiographs using digital caliper on the surrounding areas of implants, including mesial and distal aspects. The data were subjected to a Student t-test.&#x0D; Results: The mean of Mesial Bone Loss (MBL) of the right canine was reported 0.74 mm. The mean amount of Distal Bone Loss(DBL) of the right canine was 0.78 mm, the mean of DBL of the first incisal was 0.75 mm. The mean of MBL of the first incisal was 0.77 mm, the mean of DBL of the left canine was 0.76 mm. The mean of MBL of the left canine was 0.78 mm. Distal and mesial bone loss in the canine and first incisor bone-level implants were slightly higher than respective tissue-level implants, but no statistically significant differences were noted in this regard.&#x0D; Conclusion: According to the results of this study, both bone-level and tissue-level implants can be successfully used for supporting mandibular overdentures. Since the amount of cervical bone loss was clinically acceptable in both groups (in a period of one to four years with an average of 2.1 years). This study recommends that clinicians choose the type of implant according to clinical need and judgement.

Immediate loading full-arch rehabilitation using transmucosal tissue-level implants with different variables associated: a one-year observational study.

The aim of the present observational study was to investigate the application of transmucosal tissue-level implants in immediate loading full-arch rehabilitation with different variables associated. Patients needing a full-arch implant rehabilitation were recruited and rehabilitated with four transmucosal tissue level implants. Data related to implants' diameters and lengths, jaw distributions, and presence of angulated abutments were collected. The following outcomes were evaluated: survival rate, marginal bone loss (MBL), Plaque Index (PI), bleeding on probing (BoP), probing depth (PD). Descriptive statistical analysis was reported and univariate linear regression models were built to assess a significant correlation between MBL and the different implant related factors. Twenty patients were rehabilitated for a total implant number of 80; 11 rehabilitations were performed on the maxilla, while 9 were performed on the mandible; 48 implants presented a 3.8 mm diameter and 32 implants presented a 4.25 mm diameter. Implants length varied between 10 to 15 mm; 40 tilted implants were connected to angulated abutment, while 40 straight implants were connected directly to the prostheses (no abutments). At the one year follow-up visit no implants failed resulting in an implant survival rate of 100%. The overall MBL was 1.19±0.30 mm. No statistically significant difference (P>0.05) was highlighted among any of the subgroups analyzed. Despite different variables associated, tissue level implants seem to represent a valid option when applied in immediate loading full-arch rehabilitation. Further research and longer observational periods are encouraged to confirm the result.

Can radiomic features extracted from intra-oral radiographs predict physiological bone remodelling around dental implants? A hypothesis-generating study.

The rate of physiological bone remodelling (PBR) occurring after implant placement has been associated with the later onset of progressive bone loss and peri-implantitis, leading to medium- and long-term implant therapy failure. It is still questionable, however, whether PBR is associated with specific bone characteristics. The aim of this study was to assess whether radiomic analysis could reveal not readily appreciable bone features useful for the prediction of PBR. Radiomic features were extracted from the radiographs taken at implant placement (T0) using LifeX software. Because of the multi-centre design of the source study, ComBat harmonization was applied to the cohort. Different machine-learning models were trained on selected radiomic features to develop and internally validate algorithms capable of predicting high PBR. In addition, results of the algorithm were included in a multivariate analysis with other clinical variables (tissue thickness and depth of implant position) to test their independent correlation with PBR. Specific radiomic features extracted at T0 are associated with higher PBR around tissue-level implants after 3months of unsubmerged healing (T1). In addition, taking advantage of machine-learning methods, a naive Bayes model was trained using radiomic features selected by fast correlation-based filter (FCBF), which showed the best performance in the prediction of PBR (AUC=0.751, sensitivity=66.0%, specificity=68.4%, positive predictive value=73.3%, negative predictive value=60.5%). In addition, results of the whole model were included in a multivariate analysis with tissue thickness and depth of implant position, which were still found to be independently associated with PBR (p-value < .01). The combination of radiomics and machine-learning methods seems to be a promising approach for the early prediction of PBR. Such an innovative approach could be also used for the study of not readily disclosed bone characteristics, thus helping to explain not fully understood clinical phenomena. Although promising, the performance of the radiomic model should be improved in terms of specificity and sensitivity by further studies in this field.

Resolution of peri-implant mucositis at tissue- and bone-level implants: A 6-month prospective controlled clinical trial.

The objective of the study was to compare resolution of inflammation of naturally occurring peri-implant mucositis (PM) at tissue-level (TL) and bone-level (BL) implants after non-surgical mechanical debridement. Fifty-four patients with 74 Implants with PM were allocated in two groups (39 TL and 35 BL implants) and treated by means of subgingival debridement using a sonic scaler with a plastic tip without adjunctive measures. At baseline and at 1, 3, 6months, the full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), bleeding on probing (BOP), and modified plaque index (mPlI) were recorded. The primary outcome was BOP change. After 6months, the FMPS, FMBS, PD, and number of implants with plaque decreased statistically significantly in each group (p < .05); however, no statistically significant differences were found between TL and BL implants (p > .05). After 6months, 17 (43.6%) TL and 14 (40%) BL implants showed a BOP change in (17.9%) and (11.4%), respectively. No statistical difference was recorded between groups. Within the limitations of present study, the findings showed no statistically significant differences in terms of changes in clinical parameters following non-surgical mechanical treatment of PM at TL and BL implants. A complete resolution of PM (i.e., no BOP at all implant sites) was not achieved in both groups.