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Objectives: The aim of the present study was to evaluate the efficacy of a supportive peri‐implant care (SPIC) protocol after surgical therapy of peri‐implantitis, combining ultrasonic mechanical debridement and glycine powder air polishing. Materials and Methods: Thirty subjects diagnosed with peri‐implantitis and treated by means of access flap were randomized 6 months later into two different SPIC groups: the test group combined a piezoelectric ultrasonic instrumentation with a specific implant PEEK tip and glycine powder air polishing, while control group received the same ultrasonic instrumentation together with a rubber cup and a polishing paste. Patients were followed for 12 months, with intermediate SPIC visits every 3 months. Clinical, radiological, microbiological and biochemical outcome variables were registered and calculated. Results: After 12 months of SPIC, probing depths (PD) showed a mean reduction of 0.33 ± 0.11 mm, with significant differences (p <.001) between the test (−0.84 ± 0.43 mm) and the control group (+0.18 ± 0.73 mm). Healthy peri‐implant tissues defined by PD <5 mm, absence of BoP (or in only one site around the implant), and no additional bone loss (<0.5 mm), were observed at the final visit in 83% of the implants (87% in the test group and 80% in the control group, p =.255). No adverse events were reported by the subjects participating in the study. Conclusions: The SPIC protocol including mechanical ultrasonic debridement and glycine powder air‐polishing demonstrated significantly better efficacy in terms of PD reductions. A strict SPIC protocol can maintain for 1 year, or even improve, the results obtained after surgical treatment of peri‐implantitis. [ABSTRACT FROM AUTHOR]

Background: The aim of this study, a prospective case series, was to evaluate the clinical, microbiological, and biochemical impact of the surgical treatment of peri-implantitis. Methods: Thirty subjects with diagnosis of peri-implantitis were treated following a surgical protocol including access flaps, surface decontamination with ultrasonics and glycine powder air-polishing, and systemic antibiotics. Disease resolution was defined by the composite outcome including presence of probing depths (PD) ≤5 mm, absence of bleeding on probing (BoP)/suppuration, and no additional radiographic bone loss (>1 mm). Regression analysis was used to evaluate the patient-, implant-, and prosthetic-related factors possibly influencing treatment outcomes. Results: Patients were evaluated at 6 months post treatment, demonstrating statistically significant reductions in PD (2.14 ± 1.07 mm) and increase in mucosal recession (1.0 ± 0.77 mm). Plaque, BoP, and suppuration were also reduced by 40.56%, 62.22%, and 7.78%, respectively. Disease resolution was achieved in 56.67% of patients. No significant changes were detected in microbiological parameters except for a significant reduction in proportions of Parvimonas micra. Similarly, the levels of the biomarker interleukin-8 in crevicular fluid were significantly lower at 6 months. Conclusions: The proposed surgical treatment of peri-implantitis demonstrated statistically significant clinical improvements although the impact on microbiological and biochemical parameters was scarce. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the efficacy of a xenogeneic collagen matrix to augment the width of keratinized mucosa (KM), concomitantly to the surgical treatment of peri‐implantitis, when compared to the use of an autologous soft tissue graft. Material and methods: In this 12‐month parallel‐arm randomized controlled clinical trial, patients with peri‐implantitis were randomly assigned, one month after non‐surgical therapy, to surgical resective treatment of peri‐implantitis consisting on an apically positioned flap (APF) in combination with a KM augmentation procedure, either with an autologous free gingival graft (FGG) or a collagen matrix (CM). Primary outcomes were the increase in the width of KM and probing pocket depth (PPD) reduction at 12 months. As secondary outcomes, peri‐implant radiographic and patient‐reported outcomes were assessed. Results: The intention‐to‐treat population consisted of 49 subjects, assigned to either the APF + FGG (n = 23) or APF + CM (n = 26) group. PPDs were reduced by 1.6 mm (SD 1.0) and 1.7 mm (SD 1.2), respectively, being these differences non statistically significant (p =.782). However, the increase in KM was significantly higher in the APF + FGG compared with APF + CM (2.5 mm [SD 1.6] vs. 1.6 mm [SD 1.2], respectively (p =.033). Conclusion: The tested surgical modalities resulted in similar improvements of the clinical parameters. Both free gingival graft and collagen matrix significantly increased the peri‐implant keratinized mucosa, but this KM gain was significantly higher with the free gingival graft. Use of CM, however, was better appreciated by the patients, in terms of pain perception and analgesic consumption, although the surgical time was similar. [ABSTRACT FROM AUTHOR]

Most people want to look beautiful. The ability to express feelings is fundamental to the quality of life, but expressing emotions is impossible without the freedom to smile. A patient with an ill-fitting removable denture and a fixed, porcelain-fused-to- metal bridge sought care to improve her smile. This fixed bridge was removed and direct provisional restorations placed, followed by crown-lengthening surgery and implant placement, waiting 10 months for the patient to heal. We waited one month to check occlusal stability and patient satisfaction and then made the final precision impressions and master casts. We cemented the final restorations; lithium disilicate allowed the creation of an esthetic result without sacrificing strength with use of both full-anatomy and layered techniques. Dental implants make it possible to have non-removable teeth that can be integrated esthetically and functionally, allowing the recreation of tooth color, form, and structure to reestablish a patient's smile. [ABSTRACT FROM AUTHOR]