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Objective: To compare patient satisfaction during surgery, postoperative pain and inflammation and quality of life between high‐speed drilling with irrigation and low‐speed drilling without irrigation for implant bed preparation. Materials and Methods: Sixty‐six posterior single edentulous patients were included in a randomized controlled clinical trial. Implant beds were created using high‐speed drilling with irrigation (control group) or low‐speed drilling without irrigation (test group). Patient satisfaction during surgery (in relation to drilling‐time perception, vibration, pressure, noise, comfort, and drowning sensation) and postoperative pain and inflammation were evaluated using a 100‐mm visual analogue scale (VAS)‐based questionnaire. Quality of life was analyzed with a Likert scale (in relation to mouth opening, chewing, speaking, sleeping, daily routine, and job). The follow‐up period was 7 days. Results: Patient satisfaction in relation to drilling‐time perception, vibration, pressure, and noise did not show statistically significant differences (p >.05). The highest scores of drowning sensation (p <.05) were correlated (moderate correlation (r =.57)) with lowest scores of comfort (p <.005). Both postoperative pain and inflammation means were significantly higher in the control group than in the test group. No significant differences in quality of life were observed during the postoperative period (p >.05). Conclusion: Low‐speed drilling without irrigation for single implant site preparation was more comfortable for patients than high‐speed drilling with irrigation, due to the correlation between important drowning sensation and low perceived comfort. Postoperative pain and inflammation were lower for low‐speed drilling without irrigation. Further studies are needed to validate or refute these results. [ABSTRACT FROM AUTHOR]

Objective: To analyze the influence of 3‐mm high abutments with different shapes (cylindrical abutment vs. wide abutment) on marginal bone‐level changes (bone loss and bone remodeling). The influence of abutment shape on implant success, probing pocket depth (PPD), and bleeding on probing (BoP) was studied as secondary objectives. Materials and Methods: Patients with a partially edentulous area requiring fixed dental prostheses by two implants in the posterior mandible or maxilla were included. The implants were 1 mm subcrestally placed, and osseointegration healing was submerged. Three‐mm high abutments with two different shapes were randomly placed in second‐stage surgery: cylindrical abutments (cylindrical group) and wide abutments (wide group). Marginal bone‐level changes were measured using parallelized periapical radiographs at abutment placement, at definitive prosthesis placement, and at 1, 3, 6, and 12 months after loading. PPD and BoP were likewise measured at the control visits. Results: Sixty‐four dental implants in 25 patients were included. Statistically significant differences were found in bone‐level changes. The cylindrical group exhibited less mean marginal bone remodeling (MBR) and marginal bone loss (MBL) than the wide group (p <.05). Moreover, the cylindrical group showed significantly less BoP (p <.05). Conclusion: Abutment shape had a significant influence upon marginal bone‐level changes during the first 12 months. Cylindrical abutments caused less MBR and MBL than wide abutments. More clinical studies involving longer follow‐ups and analyzing other abutment modifications are needed to improve our understanding of how abutments can affect peri‐implant tissue stability. [ABSTRACT FROM AUTHOR]

The present systematic review and meta‐analysis was carried out to determine the extent to which supracrestal tissue attachment (STA) thickness affects marginal bone loss (MBL) around dental implants. An electronic search was conducted in PubMed (MEDLINE), EMBASE, and complementary sources covering the period up to June 2018. The studies were meta‐analyzed based on implant position with respect to the alveolar bone crest (crestal/supracrestal). The MBL values were categorized according to STA width (thick/thin). Of the 1062 eligible titles, nine articles were included in the review. The implants were positioned crestal or supracrestal with respect to the alveolar ridge. The difference between (thin/thick) STA was statistically significant among analytical subsets in terms of lesser MBL (crestal‐positioned: weighted mean difference [WMD] = 0.52, 95% CI [0.03‐1.01]; P = 0.036; supracrestal‐positioned: WMD = 1.26; 95% CI [1.12‐1.39]; P = 0.00; pooled analysis: WMD = 0.73; 95% CI [0.033‐1.13]; P < 0.01). Implant positioning and patient age showed statistical significance in the meta‐regression analysis. The heterogeneity explained by age was R2 = 39.8%. Despite its limitations, the present study demonstrates that implants with thin STA result in greater MBL. There is moderate certainty of the evidence for a large effect of MBL prevention "in favor" of a thick STA environment in crestal‐positioned implants and the pooled analysis, but lesser certainty when only supracrestal‐positioned implants are considered. No trials studying this topic in subcrestal‐positioned implants were found. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to perform an ultrastructural study of the bone-to-biomaterial interface and biomaterial mineral degradation in retrieved bone biopsies following maxillary sinus augmentation using bovine xenografts (Endobon®) in 15 clinical cases. Materials and methods Nine months after sinus lifting, bone cores were harvested from the maxillary sinus. The specimens were processed for observation under a scanning electron microscope with backscattered electron imaging ( SEM- BSE). In addition, chemical analysis and elemental mapping of the mineral composition were generated using a microanalytical system based on energy-dispersive X-ray spectrometry ( EDX). Results No clinical complications occurred during surgery. Scanning electron microscopy revealed that newly formed bone was closely attached to the xenograft. Elemental analysis showed a significantly high Ca/ P ratio in the residual biomaterials (3.031 ± 0.104) compared with the interface (2.908 ± 0.115) and new bone (2.889 ± 0.113), which suggests that there may be a gradual diffusion of Ca ions from the biomaterial into the newly forming bone at the interface as part of the biomaterial's resorption process. EDX analysis of the residual bovine biomaterial showed particle categories with different mean Ca/ P ratios according to size, pointing to different stages of the resorption process. Conclusions The biomaterial proved to be biocompatible and osteoconductive when used as a bone substitute for maxillary sinus elevation. The grafting material used is not a completely resorbable material over the time period covered by this study. [ABSTRACT FROM AUTHOR]