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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]

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]

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 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]

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]

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]

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]

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]

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]

Modern dental education should have in on one hand the necessary education and training to make modern dentists capable of implementing population and individual preventive strategies, and on the other make them competent to satisfy current public demands to most patients. Amongst the restorative procedures most demanded by patients implant therapy has reached a clear pre-dominance. Although specialists have traditionally rendered this therapeutic procedure, in simple cases there is seldom need for extensive surgical procedures and therefore there is a clear need to introduce these studies in modern dental curricula. To facilitate the harmonisation and convergence of dental education in Europe, the Association for Dental Education in Europe and DentEd have defined a set of competencies for the graduating dentist in the EU. Using the same framework, we herein define the agreed competencies in implant dentistry, within the different domains, for both the undergraduate and the postgraduate student. Within a context of a competence-based curriculum implant dentistry should be taught as part of the major and supportive competencies described with a strong emphasis on inter-disciplinarity and integration. [ABSTRACT FROM AUTHOR]

The use of oral implants in the rehabilitation of partially and fully edentulous patients is widely accepted even though failures do occur. The chance for implants to integrate can for example be jeopardised by the intra-oral presence of bacteria and concomitant inflammatory reactions. The longevity of osseointegrated implants can be compromised by occlusal overload and/or plaque-induced peri-implantitis, depending on the implant geometry and surface characteristics. Animal studies, cross-sectional and longitudinal observations in man, as well as association studies indicate that peri-implantitis is characterised by a microbiota comparable to that of periodontitis (high proportion of anaerobic Gram-negative rods, motile organisms and spirochetes), but this does not necessarily prove a causal relationship. However, in order to prevent such a bacterial shift, the following measures can be considered: periodontal health in the remaining dentition (to prevent bacterial translocation), the avoidance of deepened peri-implant pockets, and the use of a relatively smooth abutment and implant surface. Finally, periodontitis enhancing factors such as smoking and poor oral hygiene also increase the risk for peri-implantitis. Whether the susceptibility for periodontitis is related to that for peri-implantitis may vary according to the implant type and especially its surface topography. [ABSTRACT FROM AUTHOR]