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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 one or more healthy single dental implants in the esthetic area were identified and recruited. Clinical and ultrasonographic measurements, including PSTD class and subclass, pocket 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 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 multi-variate 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 a 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. This article is protected by copyright. All rights reserved.

OBJECTIVES To assess, retrospectively, whether older age has an impact on implant osseointegration when compared with younger age. METHODS All patients ≥65 years old at implant installation, in an university setting over a time-period of 11.5 years, with complete anamnestic data and follow-up until prosthetic restoration were included, and any early implant loss (EIL; i.e. lack of osseointegration prior to or at the time-point of prosthetic restoration) was recorded. Further, one implant, from each of the elderly patients, was attempted matched to one implant in a younger patient (35 to

Background Resolution and prevention of peri‐implant mucositis are a key in preventing peri‐implantitis. This case–control study aims to assess the modifying effect of a deep mucosal tunnel (DMT) on the induction and resolution phases of experimental peri‐implant mucositis. Methods Nineteen subjects with a tissue level implant were assigned to cases (DMT, depth ≥3 mm) or controls (shallow mucosal tunnel ≤1 mm, SMT). Subjects underwent a standard experimental peri‐implant mucositis protocol characterized by an oral hygiene optimization phase, a 3‐week induction phase using an acrylic stent to prevent self‐performed oral hygiene at the experimental implant, and a 3 + 2 weeks resolution phase. Modified plaque (mPI), gingival index (mGI) and peri‐implant sulcus fluid IL‐1β concentrations were measured over time. Differences between DMT and SMT were assessed with the Mann–Whitney test. Results Modified plaque index and mGI increased in parallel during the induction phase. After resumption of oral hygiene practice, mPI and mGI resolved towards baseline values in the SMT group. In DMT, mPI and mGI values diverged: plaque resolved but resolution of inflammation was delayed and of smaller magnitude during the first 3 weeks after resumption of oral hygiene. IL‐1β concentrations were significantly higher in DMT at 21 days (end of induction) and during the resolution phase corroborating the clinical findings. Removal of the crown and submucosal professional cleaning were needed to revert mGI to baseline values in DMT implants. Conclusions The depth of the mucosal tunnel modifies the resolution of experimental peri‐implant mucositis at transmucosal implants. This observation raises important questions on the effectiveness of self‐performed oral hygiene in cases where implants are placed deeper and the ability to resolve mucositis and effectively prevent peri‐implantitis in such situations.

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.

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 review Strauss FJ, Stähli A, Gruber R. (2018) The use of platelet-rich-fibrin to enhance the outcomes of implant-related therapies: a systematic review Mombelli A, Hashim D, Cionca N. () What is the impact of titanium particles and bio-corrosion on implant survival and complications? A critical review Stavropoulos A, Bertl K, Pietschmann P, Pandis N, Morten Schiødt, Klinge B. () The effect of antiresorptive drugs on implant therapy: a systematic review. ispartof: CLINICAL ORAL IMPLANTS RESEARCH vol:29 pages:93-99 ispartof: location:SWITZERLAND, Pfaffikon status: published

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 randomised 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. This article is protected by copyright. All rights reserved.

Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy.

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.

Aim To compare the effectiveness of two-ridge preservation treatments. Materials and Methods 40 subjects with extraction sockets exhibiting substantial buccal dehiscences were enrolled and randomized across 10 standardized centers. Treatments were demineralized allograft plus reconstituted and cross-linked collagen membrane (DFDBA+RECXC) or deproteinized bovine bone mineral with collagen plus native, bilayer collagen membrane (DBBMC+NBCM). Socket dimensions were recorded at baseline and 6-months. Wound closure and soft tissue inflammation were followed post-operatively, and biopsies were retrieved for histomorphometric analysis at 6-months. Results Primary endpoint: at 6-months extraction socket horizontal measures were significantly greater for DBBMC+NBCM (average 1.76 mm greater, p= 0.0256). Secondary and Exploratory endpoints: (1) lingual and buccal vertical bone changes were not significantly different between the two treatment modalities, (2) histomorphometric % new bone and % new bone+graft were not significantly different, but significantly more graft remnants remained for DBBMC; (3) at 1-month incision line gaps were significantly greater and more incision lines remained open for DFDBA+RECXC; (4) higher inflammation at 1-week tended to correlate with lower ridge preservation results; and (5) deeper socket morphologies with thinner bony walls correlated with better ridge preservation. 37 of 40 sites had sufficient ridge dimension for implant placement at 6-months; the remainder were DFDBA+RECXC sites. Conclusion DBBMC+NBCM provided better soft tissue healing and ridge preservation for implant placement. Deeper extraction sockets with higher and more intact bony walls responded more favorably to ridge preservation therapy. Further investigation of implant integration and long-term survival is warranted. clinicaltrials. gov identifier NCT02330523. This article is protected by copyright. All rights reserved.

Objective Evaluation of differences in the clinical performance and crestal bone levels between implants restored with single crowns with platform-matched or platform-switched abutments after 3 years. Material and Methods The study enrolled adult patients missing two or more adjacent teeth in the posterior mandible with natural teeth mesial to the implant site. Randomization followed open-flap implant insertion and the corresponding matching or switching healing abutments placed at surgery. Conventional loading was made with cemented crowns. Clinical follow-up took place annually after loading up to 3 years. Bone level changes were measured in standardized radiographs as the variation in crestal bone from one evaluation to the next. Results Sixty-three patients with a total of 135 implants (66 platform matching, 69 platform switching) were analysed. From surgery to 36 months, mean bone loss was 0.28 ± 0.56 mm for the platform-switching group and 0.68 ± 0.64 mm for the platform-matching group. A statistically significant difference was found between groups (p = 0.002) with an estimate of 0.39 mm (0.15–0.64, 95% CI) in favour of platform switching. Conclusions After 3 years, platform-switching restorations showed a significant effect in the preservation of marginal bone levels compared to platform-matching restorations.

Riassunto Obiettivi Il presente articolo studia, attraverso l’analisi della letteratura, gli effetti del diabete sull’osteointegrazione implantare e sulla guarigione dei tessuti molli. Materiali e metodi Negli studi sperimentali si evince che nella patologia diabetica e presente un ridotto contatto fra osso e impianto. Rispetto alla popolazione non affetta da diabete si assiste a una percentuale maggiore di fallimento implantare. La maggior parte di questi fallimenti accade durante il primo anno di carico, attribuendo la causa a problematiche microvascolari. Risultati Sebbene ci sia un alto rischio di fallimento nei pazienti diabetici, studi sperimentali hanno dimostrato che un livello di glicemia controllato incrementa il grado di osteointegrazione implantare. Conclusioni L’incremento della patologia diabetica pone numerosi problemi alla chirurgia implantare, anche se non rappresenta una controindicazione. Le complicanze del diabete possono inficiare la guarigione dei tessuti molli: e necessario effettuare considerazioni preliminari in caso di soggetti diabetici. Un controllo della glicemia e di altri fattori (per esempio emoglobina glicata) puo incrementare la percentuale di sopravvivenza implantare.

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, non-motor 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.

Trials 15, 186 (2014). doi:10.1186/1745-6215-15-186, Published by BioMed Central, London

Objective The purpose of this ongoing randomized study was to assess differences in bone level changes and success rates using implants supporting single crowns in the posterior mandible either with platform matched or platform switched abutments. Material and Methods Patients aged 18 and above, missing at least two teeth in the posterior mandible and with a natural tooth mesial to the most proximal implant site were enrolled. Randomization followed implant placement. Definitive restorations were placed after a minimum transgingival healing period of 8 weeks. Changes in crestal bone level from surgery and loading (baseline) to 12-month post-loading were radiographically measured. Implant survival and success were determined. Results Sixty-eight patients received 74 implants in the platform switching group and 72 in the other one. The difference of mean marginal bone level change from surgery to 12 months was significant between groups (p