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The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped platform—SLP) and control group (standard design implants with guided bone regeneration—GBR). The primary outcome was bone loss (6 months after finishing the prosthetic treatment). Secondary outcomes included the following: patient-reported outcome measures (PROMs), post-operative edema, keratinized mucosa width, and pink aesthetic score (PES). The average bone loss at 6 months was 0.23 ± 0.15 mm and 1.03 ± 0.37 mm in the SLP and GBR groups, respectively. The SLP group was characterized by lower pain intensity the first 7 days (p < 0.001), lower post-operative edema (p < 0.001), lower consumption of NSAIDs on days 1, 3, 5, and 7 (p = 0.002, <0.001, <0.001, and 0.008), and lower total OHIP-14 (p = 0.047) on day 7. The keratinized mucosa width was 3.7 (3.4–4.0) mm and 2 (1.4–2.0) mm in the SLP and GBR groups, respectively. The preservation of the mesial, distal papillae, and the level of soft tissue correspondence were significantly higher in the SLP group (p = 0.003, 0.038, <0.001). In the SLP group, more natural color and better texture of soft tissues were found (p = 0.048, p = 0.041). The use of implants with a sloped platform resulted in superior outcomes compared to the standard-design implants with GBR. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped platform—SLP) and control group (standard design implants with guided bone regeneration—GBR). The primary outcome was bone loss (6 months after finishing the prosthetic treatment). Secondary outcomes included the following: patient-reported outcome measures (PROMs), post-operative edema, keratinized mucosa width, and pink aesthetic score (PES). The average bone loss at 6 months was 0.23 ± 0.15 mm and 1.03 ± 0.37 mm in the SLP and GBR groups, respectively. The SLP group was characterized by lower pain intensity the first 7 days (p < 0.001), lower post-operative edema (p < 0.001), lower consumption of NSAIDs on days 1, 3, 5, and 7 (p = 0.002, p = 0.047) on day 7. The keratinized mucosa width was 3.7 (3.4–4.0) mm and 2 (1.4–2.0) mm in the SLP and GBR groups, respectively. The preservation of the mesial, distal papillae, and the level of soft tissue correspondence were significantly higher in the SLP group (p = 0.003, 0.038, p = 0.048, p = 0.041). The use of implants with a sloped platform resulted in superior outcomes compared to the standard-design implants with GBR.

Aim of the study The success of the implant therapy is co-dependent on the correct pre-implant assessment of the general, loco-regional and local status, the surgical and post-surgical stage or prosthetics as well as maintenance. In order to appreciate and evaluate the candidate for implanted therapy, a series of markers or clinical-biological indices are followed. The present paper proposes an updated synthesis of the opinions from the specialized literature regarding them, with the aim of preparing an update regarding the scientific results of recent years. Material and methods Systematic reviews, meta-analyses on the influence of general and local factors on the success of implant therapy, clinical-biological indices, success rate, peri-implantation, using electronic platforms available until June 26, 2023, were included for analysis. ​Results Clinical-biological indicators of general condition influence the patient’s response both in the immediate post-therapeutic healing stage and long-term implant retention. At the same time, the patient’s general condition conditions the time and extent of the surgical intervention. Conclusions A number of general conditions are mentioned in the literature that contraindicate the surgical intervention in ambulatory conditions, such as myocardial infarction more recent than 6-12 months, acute leukemia, stroke more recent than 12 months.

Introduction: The success of implant therapy is strongly related to the perceptions and expectations of the patients.Aim: This study aimed to assess the level of social appearance anxiety and oral health-related quality of life in middle-aged adults with implant-supported fixed prostheses and compare with individuals who have tooth loss without any prosthetic rehabilitation or who have natural teeth.Materials and methods: The participants (n=292) were divided into three groups: group 1, individuals with implant-supported fixed dental prostheses; group 2, individuals with tooth loss; and group 3, individuals with totally natural teeth. A questionnaire form including basic questions, Social Appearance Anxiety Scale (SAAS), and Oral Health Impact Profile-14 (OHIP-14) was distributed among patients.Results: Group 2 showed a significantly higher level of SAAS and OHIP-14 scores compared with groups 1 and 3 (p

Objective: Fundamentally, this review addresses the following question: In partially or fully edentulous patients, do implant‐supported dental prostheses preserve orofacial tissues when compared to conventional prostheses or no therapy? Materials and Methods: This study was conducted according to the 2020 PRISMA guidelines for systematic reviews. Electronic searches were conducted at PubMed and Embase databases followed by manual search. Clinical studies comparing the effect of implant‐supported prostheses with conventional rehabilitation or no treatment on alveolar bone resorption, remaining teeth, and jaw muscle thickness were considered for inclusion. A qualitative synthesis was conducted with all included studies, and data from selected studies were pooled quantitatively to perform a meta‐analysis. Results: A total of 14 studies were selected for analysis. Six studies reported on the effect of implant therapy on alveolar bone resorption (n = 453), six on the remaining teeth (n = 1014), while four studies evaluated masseter muscle thickness (n = 158). The results of the meta‐analyses assessing alveolar bone resorption in the posterior mandible and in the anterior area of the maxilla, both fixed and random effects models, yielded no benefit of rehabilitation with implant‐supported prostheses when compared to conventional prostheses. For masseter bone thickness, however, a significant benefit for implant‐supported prosthesis was observed. Conclusions: This systematic review and meta‐analysis were unable to unequivocally answer the focus question. There are some indicators of the benefit of implant‐supported prostheses over conventional prostheses or no therapy in preserving orofacial tissues, particularly for masseter muscle thickness. However, the evidence is still insufficient to confirm such perception. [ABSTRACT FROM AUTHOR]

Purposes: This aim of this cross‐sectional study was to investigate the factors associated with patient satisfaction in patients with a dental implant‐supported single crown or fixed prosthesis. Materials and methods: One hundred and ninety‐six patients with dental implants functioning more than 1 year were provided with a 13‐question questionnaire to report their satisfaction regarding the functional aspects, aesthetic outcome, cleansing ability, general satisfaction, treatment cost, and overall satisfaction. Patient satisfaction was reported using a visual analogue scale (VAS). The association of these variables and each aspect of satisfaction were investigated by multivariate linear regression analysis. Results: One hundred forty‐four of 196 patients reported high overall satisfaction (VAS > 80%). All aspects of patient satisfaction levels were very high (mean VAS > 80%), except for satisfaction in cleansing ability and treatment cost (mean VAS < 75%). The patients with a history of implant failure had significantly lower satisfaction in the functional aspects, aesthetic outcome, and general satisfaction than patients without implant failure (p ≤ 0.001). The subjects who experienced mechanical complication were less satisfied with treatment cost (p = 0.002). Sinus augmentation negatively affected functional satisfaction compared with individuals without sinus augmentation (p = 0.041). The subjects with a higher income or a posterior implant had significantly higher overall satisfaction (p = 0.003 and p < 0.001, respectively). Moreover, restoration by specialists positively affected general satisfaction compared with being restored by post‐graduate students (p = 0.01). Conclusion: Patients restored with a dental implant‐supported single crown or fixed prosthesis had very high patient satisfaction. Implant failure, mechanical complication, and sinus augmentation negatively affected patient satisfaction in multiple aspects. In contrast, the factors positively affecting patient satisfaction were a posterior implant, patient's monthly income, and restoration by specialists. These results have to be interpreted with care due to the cross‐sectional study design. [ABSTRACT FROM AUTHOR]

The periodontal ligament is located between the bone (alveolar bone) and the cementum of the tooth, and it is connected by tough fibers called Sharpey's fibers. To maintain healthy teeth, the foundation supporting the teeth must be healthy. Periodontal diseases, also known as tooth loss, cause the alveolar bone to dissolve. The alveolar bone, similar to the bones in other body parts, is repeatedly resorbed by osteoclasts and renewed by osteogenic cells. This means that an old bone is constantly being resorbed and replaced by a new bone. In periodontal diseases, the alveolar bone around the teeth is absorbed, and as the disease progresses, the alveolar bone shrinks gradually. In most cases, the resorbed alveolar bone does not return to its original form even after periodontal disease is cured. Gum covers the tooth surface so that it matches the shape of the resorbed alveolar bone, exposing more of the tooth surface than before, making the teeth look longer, leaving gaps between the teeth, and in some cases causing teeth to sting. Previously, the only treatment for periodontal diseases was to stop the disease from progressing further before the teeth fell out, and restoration to the original condition was almost impossible. However, a treatment method that can help in the regeneration of the supporting tissues of the teeth destroyed by periodontal diseases and the restoration of the teeth to their original healthy state as much as possible is introduced. Recently, with improvements in implant material properties, implant therapy has become an indispensable treatment method in dentistry and an important prosthetic option. Treatment methods and techniques, which are mainly based on experience, have gradually accumulated scientific evidence, and the number of indications for treatment has increased. The development of bone augmentation methods has contributed remarkably to the expansion of indications, and this has been made possible by various advances in materials science. The induced pluripotent stem cell (iPS) cell technology for regenerating periodontal tissues, including alveolar bone, is expected to be applied in the treatment of diseases, such as tooth loss and periodontitis. This review focuses on the alveolar bone and describes clinical practice, techniques, and the latest basic research. [ABSTRACT FROM AUTHOR]

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IntroductionThe aim of this study was to evaluate the influence of different implant morphologies and immediate provisionalization options on the change of implant stability.Methods94 Patients were randomized to receive implants from Straumann® BL/Straumann® BLT/Astra OsseoSpeed® TX, meanwhile having the same opportunity to receive healing abutment or immediate provisionalization. Implant stability quotient (ISQ) and marginal bone loss (MBL) were recorded at following timepoints. Parametric statistic was used for data analysis.ResultsData showed that ISQ and MBL values of conical/straight/straight with micro-thread neck implants had no significant difference.DiscussionImmediate provisionalization options could move the dip point of ISQ values ahead or delayed around one week, which were also relevant to implant systems. MBL values were proved to be unaffected by both two factors mentioned above.

In cases of severely compromised teeth, dental practitioners are confronted with the therapeutic decision of whether to restore a tooth or replace it with an implant. Comparative scientific evidence on patient perception of both treatment approaches is scarce. The subject of this prospective clinical study was to compare oral health-related quality of life (OHRQoL) between two treatment groups: restoration of severely destroyed teeth after orthodontic extrusion (FOE) versus tooth extraction and implant-supported single crown restoration (ISC). A self-selected trial was performed with 21 patients per group. OHRQoL was assessed with the aid of the Oral Health Impact Profile (OHIP-G49) at different time intervals: before treatment (T1), after treatment (T2), after restoration (T3) and at recall (T4). Overall, OHIP scores improved from baseline to follow-up for both concepts with no significant differences between groups. There were no significant differences in subscales between FOE and ISC at T1, T3 and T4. In terms of functional limitations (p = 0.003) and physical disability (p = 0.021), patients in the FOE group temporarily exhibited lower OHRQoL at T2 in comparison to the ISC group. However, at baseline, after final restoration and at recall, the study demonstrates the same level of OHRQoL for both treatment concepts. [ABSTRACT FROM AUTHOR]

Background: Esthetic complications of dental implants in the esthetic zone can have a major negative impact on patients' quality of life and perception of implant therapy. The aim of the present study was to evaluate the prevalence of peri-implant soft tissue dehiscence (PSTD) and the clinical and ultrasonographic risk indicators for this condition.Methods: Subjects with ≥1 healthy single dental implants in the esthetic area were identified and recruited. Clinical and ultrasonographic measurements, including PSTD class and subclass, probing depth, keratinized mucosa width (KMW), mucosal thickness (MT) at 1 mm and 3 mm, buccal bone distance (BBD) and buccal bone thickness, were evaluated in healthy implants and implants with PSTD.Results: A total of 153 subjects with a total of 176 dental implants were included. The prevalence of PSTD was 54.2% and 56.8% on a patient and implant level, respectively. The most frequent type of PSTD was the one characterized by having both an implant-supported crown longer than the clinical crown of the homologous tooth and a visible abutment/implant fixture exposed to the oral cavity. The multivariate analysis showed that the presence of an adjacent implant, a longer time of the implant in function, limited MT, reduced KMW, and increased BBD were significantly associated with the presence of PSTD.Conclusions: PSTDs are common findings in the esthetic region. Several risk indicators for this condition, such as presence of an adjacent implant, increased time in function of the implant, higher BBD, lower KMW, and MT were identified. [ABSTRACT FROM AUTHOR]

Background and objectives: The aim was to evaluate the current literature on the influence of inflammatory bowel disease (ulcerative colitis/Crohn's disease) in dental implant osseointegration in human clinical studies. Materials and methods: This review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. PubMed, Scopus, and Web of Science databases were electronic screened to find relevant articles published until October 2021. The inclusion criteria consisted of human clinical studies that reported the use of dental implant in patients diagnosed with inflammatory bowel disease. Risk of bias was assessed according to The Strengthening the Reporting of Observational studies in Epidemiology criteria. Results: A total of 786 studies were identified from databases. Of these, six studies were included in the review and reported the use of implants in patients with Crohn's disease. No articles were available for ulcerative colitis. Included articles indicated that Crohn's disease may determine early and late implant failure. Besides Crohn's disease, several patients presented associated risk factors and systemic disease that determined implant failure. Conclusions: The presence of clinical studies on the influence of IBD in implant therapy is low. When recommending an implant therapy to IBD patients, the multidisciplinary team should be aware of side effects and a close collaboration between members of this team is necessary. More data are needed to sustain the effect of IBD on implant therapy. [ABSTRACT FROM AUTHOR]

Esthetic complications in implant dentistry have become a significant consideration for patients and practitioners. This review presents an appraisal on the current knowledge of the physiological peri-implant soft-tissue dimensions and factors that may compromise peri-implant tissue esthetics. Factors such as papilla fill adjacent to the implant and midfacial mucosal height are critical parameters that determine the esthetic success of implant-supported restorations. Papilla fill adjacent to a single dental implant appears to depend upon the clinical attachment level of the neighboring tooth. A horizontal inter-implant distance of at least 3 mm is necessary to ensure optimal interproximal mucosal embrasure between two adjacent implants in the anterior maxilla. In cases where implants cannot be placed at least 3 mm apart, a single implant with a cantilever bridge should be considered. Buccolingual implant positioning plays a major role in midfacial mucosal height. Soft-tissue volume grafting following immediate implant placement in the presence of a thin soft-tissue phenotype or simultaneous to surgical peri-implantitis therapy might help to overcome facial mucosa recession. [ABSTRACT FROM AUTHOR]

The periodontal ligament is located between the bone (alveolar bone) and the cementum of the tooth, and it is connected by tough fibers called Sharpey’s fibers. To maintain healthy teeth, the foundation supporting the teeth must be healthy. Periodontal diseases, also known as tooth loss, cause the alveolar bone to dissolve. The alveolar bone, similar to the bones in other body parts, is repeatedly resorbed by osteoclasts and renewed by osteogenic cells. This means that an old bone is constantly being resorbed and replaced by a new bone. In periodontal diseases, the alveolar bone around the teeth is absorbed, and as the disease progresses, the alveolar bone shrinks gradually. In most cases, the resorbed alveolar bone does not return to its original form even after periodontal disease is cured. Gum covers the tooth surface so that it matches the shape of the resorbed alveolar bone, exposing more of the tooth surface than before, making the teeth look longer, leaving gaps between the teeth, and in some cases causing teeth to sting. Previously, the only treatment for periodontal diseases was to stop the disease from progressing further before the teeth fell out, and restoration to the original condition was almost impossible. However, a treatment method that can help in the regeneration of the supporting tissues of the teeth destroyed by periodontal diseases and the restoration of the teeth to their original healthy state as much as possible is introduced. Recently, with improvements in implant material properties, implant therapy has become an indispensable treatment method in dentistry and an important prosthetic option. Treatment methods and techniques, which are mainly based on experience, have gradually accumulated scientific evidence, and the number of indications for treatment has increased. The development of bone augmentation methods has contributed remarkably to the expansion of indications, and this has been made possible by various advances in materials science. The induced pluripotent stem cell (iPS) cell technology for regenerating periodontal tissues, including alveolar bone, is expected to be applied in the treatment of diseases, such as tooth loss and periodontitis. This review focuses on the alveolar bone and describes clinical practice, techniques, and the latest basic research.

Aim This study aims to assess patient motivation during implant therapy using the newly developed implant treatment motivation scale. Materials and methods A questionnaire study was conducted, consisting of 15 questions designed to explore the motivating factors behind patients' decision to undergo implant therapy. A total of 50 patients about to undergo implant treatment at the Departments of Periodontology, Oral and Maxillofacial Surgery, and Prosthodontics participated in the study.  Results Analysis revealed a consistently high level of motivation (intrinsic and extrinsic) among all patients undergoing implant therapy. Conclusions The findings highlight the crucial role of motivation in treatment-seeking behavior, emphasizing the importance of dentists in motivating and guiding patients through the process of implant therapy., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. SRM Medical College Hospital and Research Centre issued approval ST0923-768. The IEC approves the study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, R et al.)

The use of various hard tissue cutting instruments like micromotors and carbide burs pose a certain disadvantage such as excessive heat generation, smear layer formation, difficulty in controlling the bleeding of the operating field, etc. These disadvantages not only increase the intraoperative time but also affects the overall prognosis of the treatment. At present, the use of power ultrasonics has gained popularity over conventional techniques for procedures involving hard tissues. It overcomes the various disadvantages of traditional instruments as well as provides increased precision, protection of both soft and hard tissues as well as hastens the healing after osseous surgeries. The present review article aims to highlight the impact created by the piezoelectric devices in various dental procedures, specifically periodontal and implant related therapies, its mechanism of action and the advantages over conventional osseous surgeries. [ABSTRACT FROM AUTHOR]

Prosthodontics, which is removable and fixed, is the branch dealing with the replacement of missing teeth. Implant therapy is the popular treatment modality and commonly preferred treatment option by many patients and clinicians for missing teeth in recent years. Primary implant stability (PIS) is one of the crucial factors for osseointegration. It has been considered a crucial factor in the success of implants. Moreover, several factors influence PIS. On the other hand, both secondary implant stability and osseointegration are influenced by the PIS. Bone density, bone volume, bone-to-implant contact, and other factors that enhance or degrade the primary stability. Certain host sites such as the maxillary posterior region demand more dense bone to achieve desired results as they are the low-density areas of the jaw. So, a new promising and growing innovative concept of osseodensification (OD) offers a great solution with multiple benefits and desirable results. This review article aims to enlighten the multiple benefits of OD technique and their mechanism of action., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khubchandani et al.)

Background and objectives: The aim was to evaluate the current literature on the influence of inflammatory bowel disease (ulcerative colitis/Crohn’s disease) in dental implant osseointegration in human clinical studies. Materials and methods: This review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. PubMed, Scopus, and Web of Science databases were electronic screened to find relevant articles published until October 2021. The inclusion criteria consisted of human clinical studies that reported the use of dental implant in patients diagnosed with inflammatory bowel disease. Risk of bias was assessed according to The Strengthening the Reporting of Observational studies in Epidemiology criteria. Results: A total of 786 studies were identified from databases. Of these, six studies were included in the review and reported the use of implants in patients with Crohn’s disease. No articles were available for ulcerative colitis. Included articles indicated that Crohn’s disease may determine early and late implant failure. Besides Crohn’s disease, several patients presented associated risk factors and systemic disease that determined implant failure. Conclusions: The presence of clinical studies on the influence of IBD in implant therapy is low. When recommending an implant therapy to IBD patients, the multidisciplinary team should be aware of side effects and a close collaboration between members of this team is necessary. More data are needed to sustain the effect of IBD on implant therapy.

Abstract Bone fragility and skeletal irregularities are the characteristic features of osteogenesis imperfecta (OI). Many patients with OI have weakened maxillary and mandibular bone, leading to poor oral hygiene and subsequent loss of teeth. Improvements in implant therapy have allowed for OI patients to achieve dental restoration. However, there is limited available literature on implant therapy for patients with OI. The greatest challenge in the restoration process for OI patients in an outpatient setting is ensuring primary stability and osseointegration. Improvements in synthetic grafts improve successful implant placement and prevent predisposing patients to unnecessary procedures. This report details the successful restoration process of an OI type I patient’s maxillary arch in addition to a review of the currently available literature.

In implant patients who have extended soft tissue deficiencies, split skin grafts have been performed for the prevention of peri-implant inflammation. The aim of this investigation was to assess a patient who received 2 interforaminal implants and a split skin graft 13 years prior. In addition to clinical, mycologic, and radiographic examinations, the condition of the split skin graft was evaluated using histologic analysis of 3 punch biopsies taken from the mucosa, grafted area, and border between both areas. The implants were found to have an overall good clinical condition. Fungal infection was not present. The histologic analysis revealed inflammation-free mucosal and submucosal tissue in all samples. In the area of the skin graft, the mucosa was not keratinized and showed an increased thickness of the submucosal connective tissue. For the patient under examination, an acceptable level of oral rehabilitation was achieved using a split skin graft. The follow-up investigation showed stable conditions for both the implants and the graft. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of type-2 diabetes on implant survival and complication rate. Materials and Methods: Prospective study enrolling type-2 diabetic patients suffering from edentulism, having a mean perioperative HbA1c level of 7.2%, and compliant with a maintenance program. All the patients underwent dental and periodontal examinations and had laboratory testing for HbA1c, fasting plasma glucose, blood lipids, and microalbuminuria. Nondiabetic patients matched for implant treatment indication served as controls. The influence of clinical diabetes-related factors and periodontal parameters (Plaque Index, bleeding on probing, probing depth) on implant survival were assessed via univariate then multivariate methods. Results: Forty-five diabetic patients, followed for 1 to 12 years, mean age 64.7 years, received 255 implants: 143 following a classical protocol and 112 in cases of sinus floor elevation, immediate loading, and guided bone regeneration. Forty-five nondiabetic control patients received 244 implants: 142 following a classical protocol and 102 in cases of advanced surgery. Implant survival following conventional or advanced implant therapy was not statistically different between the well-controlled (HbA1c < 7%, P = .33) and the fairly well-controlled group (HbA1c 7% to 9%, P =.37). The overall survival rate for the diabetic group was 97.2% (control 98.8%) and was not significantly different for age, gender, diabetes duration, smoking, or type of hypoglycemic therapy. The mean peri-implant bone loss was 0.41 ± 0.58 mm (control, 0.49 ± 0.64 mm). PI and BOP fairly correlated with postoperative complications. HbA1c was the only multivariate independent factor affecting the complication rate (P = .04). No statistically significant difference was found for patients (P = .81) or for implants (P = .66) for the advanced surgery cases or the conventional approach in diabetic patients compared to nondiabetic patients. [ABSTRACT FROM AUTHOR]

Excessive alveolar bone atrophy often confounds a conventional therapy with complete dentures. Implant therapy has found a way to solve the problem through enhanced stability and retention, thus increasing its functionality, leading to improved patient satisfaction and a higher quality of life. This article describes an implant-supported restoration of a patient with reduced oral health and high Oral Health Impact Profile values (OHIP-14) Upon improvement of oral hygiene and the compliance of the patient, the residual dentition was extracted and four implants were inserted, both in the maxillary and the mandibular arches After the healing period was completed two implant-supported prostheses with rigid bars for retention were fabricated. The patient's esthetics, phonetics, and masticatory function were properly restored at the time of delivery. A significant improvement in the patient's quality of life was noticed. In comparison to conventional dentures, the implant-supported overdentures offer better function and comfort for many patients. [ABSTRACT FROM AUTHOR]

The use of dental implants is nowadays a well-accepted and highly predictable treatment modality for restoring the dentition and reestablishing the masticatory function of edentulous and partially edentulous patients. Despite the high predictability and excellent long-term survival rates reported for implant therapy, complications may still occur and can jeopardize both short- and long-term success. The present paper provides an overview on the most important aspects related to the etiology, prevention, and management of complications associated with implant therapy. Data from the literature indicate that a number of factors, such as surgical trauma, implant diameter, type of implant-abutment connection, abutment disconnection and reconnection, presence of microgap, and implant malpositioning, can substantially influence the biologic processes of bone remodeling and biofilm formation, thus increasing the rate of short- and long-term hard- and soft-tissue complications. Other factors, such as excess cement at cement-retained prosthetic restorations, abutment mobility, and infections (e.g. peri-implant mucositis and peri-implantitis) caused by bacterial biofilm, are further causes for complications and failures. More recent evidence also indicates that besides the need for sufficient bone volume surrounding the implant, the presence of an adequate width and thickness of attached mucosa may improve biofilm control and limit crestal bone resorption. Furthermore, emerging evidence points also to the pivotal role of human factors as one of the most important causes of complications in implant dentistry. It can be concluded that clinicians need to consider all biologic and biomechanical factors affecting implant placement and survival, as well as undergo adequate training to improve their surgical skills to control and prevent implant complications. Careful patient selection and control of environmental and systemic factors, such as smoking, diabetes etc., coupled with an accurate surgical and prosthetic planning, enable a better prevention and control of infections. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to evaluate and analyze the factors affecting patients' perceptions and satisfaction after receiving implant treatment. Material and methods: Questionnaires were mailed to 691 patients who had completed implant treatment for at least 6 months. The questionnaire consisted of 23 items, including demographic data, seven items on perceptions, and nine items on satisfaction. Results: Of the returned 382 questionnaires, 188 and 194 were from patients treated by postgraduate students and specialists, respectively. Dentists were the most common main source of implant information (55.8%). Although 90% of the patients felt that they were well informed about implant treatment, some inaccurate perceptions remained: 18% believed that "Dental implants require less care than natural teeth," 35.6% that "Dental implants last longer than natural teeth," and 75% that "Treatment with dental implants has no risks or complications." Approximately 90% of the patients were satisfied with their chewing, phonetics, aesthetic outcome, and dental implant treatment; however, some were dissatisfied with the cost. Although gender, age, educational level, main source of information, implant number, and implant position had some impact on patients' perceptions and satisfaction; monthly income did not. The clinicians' expertise affected patients' perceptions, but not satisfaction. Conclusions: Although most patients had accurate perceptions with regards to implant treatment, some misperceptions about the need for a maintenance care still exist after treatment. Most patients were satisfied with their treatment outcome regardless of monthly income and the clinicians' expertise level. [ABSTRACT FROM AUTHOR]

The range of indications for implant-borne prostheses in partially edentulous patients has expanded in recent years as a consequence of advances in regenerative techniques for bone and soft tissues. The esthetic demands of both patients and dentists have risen in parallel with these advances. Esthetic compromises in prostheses have become increasingly less tolerable, particularly in the anterior region of the maxilla. If the presenting situation is less than optimal, extensive preprosthetic measures may be required to prepare local tissues for acceptance of esthetically and functionally adequate prostheses. Particularly in difficult situations, collaboration by a team is recommended. The exchange of ideas and experience among specialists should begin as early as the treatment planning stage and extend over the entire course of therapy. The objective should be defined and the various steps of treatment should be coordinated with participation from all team members. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of platelet‐rich plasma (PRP) on implant dentistry. The primary focused question was as follows: What are the clinical, histological, and radiographic outcomes of PRP administration for bone regeneration and implant therapy? Methods: A literature search was conducted involving three databases: MEDLINE, EMBASE and Cochrane database followed by a hand search of relevant scientific journals. Human studies using PRP for bone regeneration and implant therapy were considered and articles published up to December 31, 2017 were included. Eligible studies were selected based on the inclusion criteria, and quality assessments were conducted. Results: In total, out from the 9,497 titles meeting the original search criteria, 22 fulfilled the inclusion criteria and were chosen for data extraction. Among them were 15 randomized controlled trials (RCT) and seven controlled clinical trials (CCT). Overall, the risk of bias was moderate to high. A total of seven studies showed superior outcomes when PRP was added during sinus floor elevation and five showed no superior outcome. Three studies found a significant advantage of PRP for alveolar bone regeneration and another three studies for soft tissue healing. Three studies reported on beneficial effects of PRP directly during implant placement while another study failed to find significant differences. Due to the heterogeneity of study designs, no meta‐analysis could be performed. Summary and Conclusions: Despite the lack of consistent evidence supporting the clinical benefit of PRP in healthy patients, PRP might have a positive effect on wound healing and bone regeneration in compromised patients. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of platelet‐rich fibrin (PRF) on implant dentistry. The primary focused question was as follows: What are the clinical, histological, and radiographic outcomes of PRF administration for bone regeneration and implant therapy? Method: A systematic literature search comprised three databases: MEDLINE, EMBASE, and Cochrane followed by a hand search of relevant scientific journals. Human studies using PRF for bone regeneration and implant therapy were considered and articles published up to December 31, 2017 were included. Eligible studies were selected based on the inclusion criteria. Randomized controlled trials (RCT) and controlled clinical trials (CCT) were included. Results: In total, 5,963 titles were identified with the search terms and by hand search. A total of 12 randomized controlled trials (RCT) met the inclusion criteria and were chosen for data extraction. Included studies focused on alveolar ridge preservation after tooth extraction, osseointegration process, soft tissue management, bone augmentation, bone regeneration after sinus floor elevation and surgical peri‐implantitis treatment. Overall, the risk of bias was moderate or unclear. Nine studies showed superior outcomes for PRF for any of the evaluated variables, such as ridge dimension, bone regeneration, osseointegration process, soft tissue healing. Three studies failed to show any beneficial effects of PRF. No meta‐analysis could be performed due to the heterogeneity of study designs. Conclusions: There is moderate evidence supporting the clinical benefit of PRF on ridge preservation and in the early phase of osseointegration. It remains unclear whether PRF can reduce pain and improve soft tissue healing. More research support is necessary to comment on the role of PRF to improve other implant therapy outcomes. [ABSTRACT FROM AUTHOR]

Objectives: The task of this working group was to update the knowledge about the use of drugs and biologicals affecting healing of soft tissue and bone during implant treatment or procedures associated with it. Moreover, the impact of titanium particles and biocorrosion on complications and implant survival has been analysed. Materials and Methods: The literature in the areas of interest (platelet concentrates, antiresorptive drugs as well as implant–host interaction) was screened using systematic reviews for the former two areas, whereas a narrative critical review was performed for the latter topic. Two manuscripts on platelet concentrates, one manuscript on antiresorptive drugs and one manuscript on the effects of biocorrosion, were presented for group analysis with subsequent discussion in the plenum and final consensus approval. Results: Results and conclusions of the individual reviews of the three topics are presented in the respective papers. Conclusions of the group on strengths and weaknesses of available evidence as well as consensus statements and directions for further research are provided in this study. The following papers were subject to group discussions and formed the basis for the consensus statements: Stähli A, Strauss FJ, Gruber R. () The use of platelet‐rich‐plasma to enhance the outcomes of implant‐related therapies: a systematic reviewStrauss FJ, Stähli A, Gruber R. (2018) The use of platelet‐rich‐fibrin to enhance the outcomes of implant‐related therapies: a systematic reviewMombelli A, Hashim D, Cionca N. () What is the impact of titanium particles and bio‐corrosion on implant survival and complications? A critical reviewStavropoulos A, Bertl K, Pietschmann P, Pandis N, Morten Schiødt, Klinge B. () The effect of antiresorptive drugs on implant therapy: a systematic review. [ABSTRACT FROM AUTHOR]

Objectives. Introduction of dental implant therapy has completely revolutionized the treatment for partially and completely edentulous patients. The aim of the current study was to assess the patient's knowledge regarding improvement in function and appearance and expectations with dental implant therapy. Methods. The required information was collected via a self-designed questionnaire. A total of 106 patients (response rate 70.66%) participated in the study. The subjects answered the questionnaire prior to dental implant therapy at universitybased dental hospital. Results. Almost equal number of males (48.1%) and females (51.9%) participated. The patients either self-contacted (53%) for the implants or were referred by their dentists (42%). 55% of participants were in need of > 1 implant. Two thirds of the participants got their first information about implants from dentists and for majority (68.9%) the feedback was positive. Dentists (85.8%) were the main source of information.75.5% of the patients regularly visited dentists and their experiences were pleasant. Satisfactory chewing (37.7%) followed by longevity (27.4%) and improvement in esthetics (26.4%) were the main reasons for seeking implants, while cost was not an issue for majority (53.8%). The responses about the time for completion of the treatment ranged from 1-day to 1-year. However, most of them (38.7%) believed that treatment will be completed within 6-months. For 41.5% of the participants the implants would last for 10 to 20 years while a third (33%) believed it will last for the rest of their life. Conclusions. Participants had moderate awareness about dental implants. Chewing/function and appearance/esthetics were found to be the primary reasons for seeking dental implant therapy. Expectations of the patients from the dental implant therapy were high. [ABSTRACT FROM AUTHOR]

This article analyses published prior article regarding the questions: is the study setup correct (true) and if comparable cases are evaluated for the compared methods. Futhermore the content, the pictures, the tables, the graphs and the pictures legends of the article and statistics are analysed for truth, relevance and applicability. We investigate furthermore if this article addresses all relevant questions regarding bias, the study groups, the evaluation of the outcomes and the evaluation of patient parameters such as burden of the treatment. As a result of the analysis, we state that the analysed article is misleading and it does not provide valuable information regarding decision making for other healthcare professionals in the dental implant field. [ABSTRACT FROM AUTHOR]

Objective: To analyze patients’ perception of implant therapy in partial edentulism, after 5 years with implant-supported reconstructions. Material and methods: Patients who received dental implants at the National Dental Centre, Singapore 3–9 years earlier (mean: 5.2 years) were invited to participate in the study. Responders were examined clinically, and asked to answer a questionnaire with 13 statements. Results: Of the 880 patients, 206 patients, with 329 implants, agreed to participate. Of the implants, 82% supported single crowns, while 18% were reconstructed with splinted crowns or fixed dental prostheses. Function and chewing comfort yielded high patient satisfaction. Comparing chewing comfort for teeth and implants, respectively, 51% perceived no difference between the two. Patients were largely satisfied with the phonetic function and esthetic outcome. Only two in three patients were able to cleanse the implant reconstruction well, and majority of the patients reported no difference comparing the time taken to clean implants and teeth. Patients were generally unsure if the tissues around their implants or teeth bled more. Pertaining to expectations, most patients were satisfied with the treatment, and majority were willing to undergo the same treatment again. Most patients would recommend such treatment to friends, if indicated. Only slightly over one-third of the patients felt certain that the cost of the treatment was justified. Conclusion: The large majority was satisfied with the functional outcomes of implant treatment. However, the patients had a less than ideal understanding of gingival health around teeth and implants. Patients were less discerning than clinicians in the assessment of esthetic outcomes. [ABSTRACT FROM AUTHOR]

Parkinson's Disease (PD) is one of the most frequent neurodegenerative diseases, second only to Alzheimer's disease. It is a progressive disease that inevitably leads the patient to death, in most cases for pneumonia ab ingestis. It affects 120 people out of 100,000 and more frequently affects men than women. The main symptoms are divided into motor, nonmotor and behavioral ones. The main motors symptoms are tremor, bradykinesia and postural instability. Non-motor symptoms include autonomic nervous dysfunction (orthostatic hypotension, cardiac arrhythmia, sexual dysfunction, excessive sweating due to hypothalamic dysfunction, constipation), insomnia, OSAS, and olfactory dysfunction. Behavioral symptoms are depression, dementia and psychosis. The purpose of this study is to evaluate, through a systematic review of literature, the oral health status of the Parkinson's patient compared with the general population with particular reference to the incidence of caries and periodontal disease, the patient's management during dental interventions and the possibility of rehabilitating the patient with implanted therapy. [ABSTRACT FROM AUTHOR]

Aim To analyse the effect of leucocyte- and platelet-rich fibrin (L-PRF) on bone regeneration procedures and osseointegration. Materials and Methods An electronic and hand search was conducted in three databases (MEDLINE, EMBASE and Cochrane). Only randomized clinical trials, written in English where L-PRF was applied in bone regeneration and implant procedures, were selected. No follow-up restrictions were applied. Results A total of 14 articles were included and processed. Three subgroups were created depending on the application: sinus floor elevation (SFE), alveolar ridge preservation and implant therapy. In SFE, for a lateral window as well as for the trans-alveolar technique, histologically faster bone healing was reported when L-PRF was added to most common xenografts. L-PRF alone improved the preservation of the alveolar width, resulting in less buccal bone resorption compared to natural healing. In implant therapy, better implant stability over time and less marginal bone loss were observed when L-PRF was applied. Meta-analyses could not be performed due to the heterogeneity of the data. Conclusions Despite the lack of strong evidence found in this systematic review, L-PRF might have a positive effect on bone regeneration and osseointegration. [ABSTRACT FROM AUTHOR]

Background. Despite successful results of implant therapy, complications occasionally occur in challenging situations. Apart from academic courses for implantology, dental associations also offer training courses for general practitioners. We sought to assess dentists' attitude towards peri-implant diseases. Methods. The subjects in thisquestionnaire-based cross-sectional study consisted of dentists participating in the annual congress of the Iranian Dental Association in 2013, whose knowledge and attitudes towards peri-implant diseases were assessed using a five-section questionnaire (implant therapy training, peri-implant soft tissue assessment, peri-implant diseases and treatment planning for peri-implant diseases). Data were analyzedwith SPSS 22, using descriptive and analytical methods. Results. The results showed that due to extensive placement of implants and high prevalence of complications, academic and organized training courses are essential. Conclusion. The results showed that due to extensive placement of implants and high prevalence of complications, academic and organized training courses are essential. [ABSTRACT FROM AUTHOR]

Introduction: The success of implant therapy is strongly related to the perceptions and expectations of the patients., Aim : This study aimed to assess the level of social appearance anxiety and oral health-related quality of life in middle-aged adults with implant-supported fixed prostheses and compare with individuals who have tooth loss without any prosthetic rehabilitation or who have natural teeth., Materials and Methods : The participants (n=292) were divided into three groups: group 1, individuals with implant-supported fixed dental prostheses; group 2, individuals with tooth loss; and group 3, individuals with totally natural teeth. A questionnaire form including basic questions, Social Appearance Anxiety Scale (SAAS), and Oral Health Impact Profile-14 (OHIP-14) was distributed among patients., Results: Group 2 showed a significantly higher level of SAAS and OHIP-14 scores compared with groups 1 and 3 (p<0.001). The SAAS scores were similar between groups 1 and 3, with no significant differences. The median OHIP-14 score was the lowest in group 3. For all groups, education was related to SAAS and OHIP-14 scores (p=0.037 and 0.002, respectively). The SAAS and OHIP-14 scores were significantly and positively related (p<0.001, r=0.501)., Conclusions: It was concluded that patients with tooth loss had higher levels of SAAS and OHIP-14 scores. Besides, the SAAS scores were similar for patients with implant-supported fixed prostheses and those with natural teeth. Middle-aged adults with higher educational levels tended to present better oral health-related quality of life and lower social appearance anxiety., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Acceptable short-term survival rates (>90 %) of mini-implants (diameter < 3.0 mm) are only documented for mandibular overdentures. Sound data for mini-implants as strategic abutments for a better retention of partial removable dental prosthesis (PRDP) are not available. Methods/design: The purpose of this study is to test the hypothesis that immediately loaded mini-implants show more bone loss and less success than strategic mini-implants with delayed loading. In this four-center (one university hospital, three dental practices in Germany), parallel-group, controlled clinical trial, which is cluster randomized on patient level, a total of 80 partially edentulous patients with unfavourable number and distribution of remaining abutment teeth in at least one jaw will receive supplementary min-implants to stabilize their PRDP. The mini-implant are either immediately loaded after implant placement (test group) or delayed after four months (control group). Follow-up of the patients will be performed for 36 months. The primary outcome is the radiographic bone level changes at implants. The secondary outcome is the implant success as a composite variable. Tertiary outcomes include clinical, subjective (quality of life, satisfaction, chewing ability) and dental or technical complications. Discussion: Strategic implants under an existing PRDP are only documented for standard-diameter implants. Mini-implants could be a minimal invasive and low cost solution for this treatment modality. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to investigate the bone regenerative properties of a heat treated cross-linked GBR membrane with zinc hydroxyapatite powders in the rat calvarial defect model over a 6-week period. Material and Methods In vitro physio-chemical characterization involved X-ray diffraction analysis, surface topology by scanning electron microscopy, and zinc release studies in physiological buffers. Bilateral rat calvarial defects were used to compare the Zn- HAp membranes against the commercially available collagen membranes and the unfilled defect group through radiological and histological evaluation. Results The synthesized Zn- MEM (100 μm thick) showed no zinc ions released in the phosphate buffer solution ( PBS) buffer, but zinc was observed under acidic conditions. At 6 weeks, both the micro- CT and histological analyses revealed that the Zn- MEM group yielded significantly greater bone formation with 80 ± 2% of bone filled, as compared with 60 ± 5% in the collagen membrane and 40 ± 2% in the unfilled control group. Conclusion This study demonstrated the use of heat treatment as an alternative method to cross-linking the Zn- MEM to be applied as a GBR membrane. Its synthesis and production are relatively simple to fabricate, and the membrane had rough surface features on one side, which might be beneficial for cellular activities. In a rat calvarial defect model, it was shown that new bone formation was accelerated in comparison with the collagen membrane and the unfilled defect groups. These results would suggest that Zn- MEM has the potential for further development in dental applications. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the influence of different implant morphologies and immediate provisionalization options on the change of implant stability., Methods: 94 Patients were randomized to receive implants from Straumann ® BL/Straumann ® BLT/Astra OsseoSpeed ® TX, meanwhile having the same opportunity to receive healing abutment or immediate provisionalization. Implant stability quotient (ISQ) and marginal bone loss (MBL) were recorded at following timepoints. Parametric statistic was used for data analysis., Results: Data showed that ISQ and MBL values of conical/straight/straight with micro-thread neck implants had no significant difference., Discussion: Immediate provisionalization options could move the dip point of ISQ values ahead or delayed around one week, which were also relevant to implant systems. MBL values were proved to be unaffected by both two factors mentioned above., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Qi, Deng and Tan.)

Objectives The aim of this prospective pilot study was to evaluate the prosthodontic maintenance as well as the implant outcome of single implant-retained mandibular overdentures over an observation period of 6 years. Methods Eleven edentulous patients received one single implant in the midline of the mandible. Denture bases were temporarily relined and 2 months later provided with a ball attachment for implant retention. Implant related parameters and prosthodontic maintenance interventions were assessed 4 weeks after implant loading and then once a year. Results Over a mean observation period of 75.9 months, no implant was lost. The most frequent prosthetic maintenance intervention was activation of the matrix due to loss of retention, followed by exchange of the female part. Eight denture bases had to be repaired after a fracture in the midline area. Conclusions Within the limitations of this preliminary clinical study, the concept of a single midline implant to retain a mandibular complete denture was a successful treatment option for elderly edentulous patients. [ABSTRACT FROM AUTHOR]

Purpose : The aim was to correlate the level of the inferior alveolar canal on cadaver specimens and as evaluated with three-dimensional radiographic cone-beam computed tomography (CBCT) imaging. Methods: Twenty-one skulls with intact mandibles (42 inferior alveolar canals) were imaged with an I-CAT Cone-Beam 3D Imaging System and multi-planar reformatted images obtained were scored to assess the level of the canal (Level I, Level II, and Level III). The mandibles were later dissected and level of the canal was directly visualized, scored, and further correlated with results from CBCT imaging. Results: There was no difference in the level of the inferior alveolar canal between the dissected cadaver specimen and CBCT images. Also, there was no statistically significant difference in the level of the canal among the gender assigned to the specimens and corresponding CBCT images. There were no statistical differences in the level of the canal (cadaver specimen vs. CBCT) between the left and right sides of the specimens, as studied individually. Conclusion: Our study indicates that there is close correlation of the level of the inferior alveolar canal between cadaver specimens and CBCT images. Well-designed studies would be required to further validate the findings in this study. [ABSTRACT FROM AUTHOR]

Objectives: The concept of a single midline implant retaining a complete mandibular denture is controversially discussed among experts. Studies are rare in the literature, and commonly accepted recommendations for this treatment options are not available. This systematic literature review was performed to give an overview over the current literature on the single midline implant therapy for the edentulous mandible and to reveal whether this treatment option might be an alternative to commonly accepted treatment modalities with more implants. Methods: A review of the literature published until 24th of May 2013 was conducted to identify in vivo studies on the single midline implant concept with a mean follow-up time of at least 3 months. Results: From the electronic search, 11 studies were finally included. After an observation period of 3-60 months, the implant survival rate ranged from 62.5 to 100 %. The most frequent prosthetic maintenance intervention was 'activation of the matrix' followed by 'repair of fractured denture base.' Conclusions: The concept of one single midline implant to retain a mandibular complete denture can be an alternative, especially for elderly patients. Immediate loading of the implants should be avoided, and the way of integrating the matrix into the denture base should be carefully considered. [ABSTRACT FROM AUTHOR]

Objectives. The authors conducted a study to determine the types, outcomes, risk factors and esthetic assessment of implants and their restorations placed in the general practices of a practice-based research network. Methods. All patients who visited network practices three to five years previously and underwent placement of an implant and restoration within the practice were invited to enroll. Practitioner-investigators (P-Is) recorded the status of the implant and restoration, characteristics of the implant site and restoration, presence of peri-implant pathology and an esthetic assessment by the P-I and patient. The P-Is classified implants as failures if the original implant was missing or had been replaced, the implant was mobile or elicited pain on percussion, there was overt clinical or radiographic evidence of pathology or excessive bone loss (> 0.2 millimeter per year after an initial bone loss of 2 mm). They classified restorations as failures if they had been replaced or if there was abutment or restoration fracture. Results. The authors enrolled 922 implants and patients from 87 practices, with a mean (standard deviation) follow-up of 4.2 (0.6) years. Of the 920 implants for which complete data records were available, 64 (7.0 percent) were classified as failures when excessive bone loss was excluded from the analysis. When excessive bone loss was included, 172 implants (18.7 percent) were classified as failures. According to the results of univariate analysis, a history of severe periodontitis, sites with preexisting inflammation or type IV bone, cases of immediate implant placement and placement in the incisor or canine region were associated with implant failure. According to the results of multivariate analysis, sites with preexisting inflammation (odds ratio [OR] = 2.17; 95 percent confidence interval [Cl], 1.41-3.34]) or type IV bone (OR = 1.99; 95 percent Cl, 1.12-3.55) were associated with a greater risk of implant failure. Of the 908 surviving implants, 20 (2.2 percent) had restorations replaced or judged as needing to be replaced. The majority of P-Is and patients were satisfied with the esthetic outcomes for both the implant and restoration. Conclusions. These results suggest that implant survival and success rates in general dental practices may be lower than those reported in studies conducted in academic or specialty settings. Practical Implications. The results of this study, generated in the private general practice setting, add to the evidence base to facilitate implant treatment planning. [ABSTRACT FROM AUTHOR]

Background Over the years, there has been a strong consensus in dentistry that at least two implants are required to retain a complete mandibular denture. It has been shown in several clinical trials that one single median implant can retain a mandibular overdenture sufficiently well for up to 5 years without implant failures, when delayed loading was used. However, other trials have reported conflicting results with in part considerable failure rates when immediate loading was applied. Therefore it is the purpose of the current randomized clinical trial to test the hypothesis that immediate loading of a single mandibular midline implant with an overdenture will result in a comparable clinical outcome as using the standard protocol of delayed loading. Methods/design This prospective nine-center randomized controlled clinical trial is still ongoing. The final patient will complete the trial in 2016. In total, 180 edentulous patients between 60 and 89 years with sufficient complete dentures will receive one median implant in the edentulous mandible, which will retain the existing complete denture using a ball attachment. Loading of the median implant is either immediately after implant placement (experimental group) or delayed by 3 months of submerged healing at second-stage surgery (control group). Followup of patients will be performed for 24 months after implant loading. The primary outcome measure is non-inferiority of implant success rate of the experimental group compared to the control group. The secondary outcome measures encompass clinical, technical and subjective variables. The study was funded by the Deutsche Forschungsgemeinschaft (German research foundation, KE 477/8-1). Discussion This multi-center clinical trial will give information on the ability of a single median implant to retain a complete mandibular denture when immediately loaded. If viable, this treatment option will strongly improve everyday dental practice. [ABSTRACT FROM AUTHOR]