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This article defines immunophenotypes of stromal inflammatory and endothelial cells and fibroblasts 3 months after augmentation of the peri-implant soft tissue using a porcine cross-linked collagen matrix (VCMX). Peri-implant soft tissue samples were obtained from 12 patients at the lining mucosa (LM)-masticatory mucosa (MM) junction before (1) and 3 months after (2) augmentation. Immu-nohistochemical stains were performed to identify inflammatory cells (T [CD3] and B [CD20] lymphocytes, plasma cells [CD138]), macrophages (CD68-proinflammatory, CD163-anti-inflammatory/ reparative), endothelial cells (CD31, CD34), and fibroblasts (CD90, TE-7). Differences in the mean positively stained cells pre- and postaugmentation were analyzed by Wilcoxon signed-rank test. CD31+ endothelial cells showed increased mean numbers in MM2 compared to MM1 (P = .025) and in LM2 compared to LM1 (P = .047). CD163+ anti-inflammatory macrophages showed higher mean numbers in MM2 than in MM1 (P = .021) and in LM2 than in LM1 (P = .012). All other cell phenotypes showed nonsignificant changes between pre- and postaugmentation. This molecular study provides novel insight on the frequency of stromal cell phenotypes in the wound healing process at 3 months postaugmentation with VCMX, with anti-inflammatory CD163+ macrophages being predominant. This should be further investigated to help find novel therapeutic approaches to modulate and promote the VCMX-related healing process. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical concept of patient treatment with fixed tooth- and implant-supported restorations in a university-based undergraduate program after 13 to 15 years. Materials and Methods: In total, 30 patients (mean age 56 years) who had received multiple tooth- and implant-supported restorations were recalled after 13 to 15 years. The clinical assessment comprised biologic and technical parameters as well as patient satisfaction. Data were analyzed descriptively, and the 13- to 15-year survival rates for tooth- and implant-supported single crowns and fixed dental prostheses (FDPs) were calculated. Results: The survival rate of tooth-supported restorations amounted to 88.3% (single crowns) and 69.6% (FDPs); in implants, it reached 100% for all types of restorations. Overall, 92.4% of all restorations were free of technical complications. The most common technical complication was chipping of the veneering ceramic (tooth-supported restorations: 5.5%; implant-supported restorations: 13% to 15.9%) regardless of the material used. For tooth-supported restorations, increased probing depth = 5 mm was the most frequent biologic complication (22.8%), followed by endodontic complications of root canal-treated teeth (14%) and loss of vitality at abutment teeth (8.2%). Peri-implantitis was diagnosed in 10.2% of implants. Conclusions: The results of this study indicate that the clinical concept implemented in the undergraduate program and performed by undergraduate students works well. The clinical outcomes are similar to those reported in the literature. In general, the majority of biologic complications occur in reconstructed teeth, whereas implant-supported restorations are more prone to technical complications. [ABSTRACT FROM AUTHOR]

Objective: To assess the clinical, radiographic and patient‐reported outcomes (PROMs) of posterior zirconia and titanium implants at 1 year of implant loading. Materials and Methods: Forty‐two patients with two adjacent missing teeth were enrolled in a randomized controlled trial with a within‐subject controlled design. Each patient received one zirconia (Zr) and one titanium (Ti) implant, with the mesial and distal positions randomized. The implant restoration consisted of multiple layered zirconia, with the buccal aspect veneered. In group Zr, the restoration was intraorally cemented onto the one‐piece Zr implant, whereas in group Ti, the restoration was extraorally cemented onto the titanium base abutment and intraorally screw‐retained onto the Ti implant. Examinations were performed following restoration delivery at baseline (BL) and at 1 year. Measurements included clinical parameters, radiographic outcomes (MBL) and PROMs. Results: Bleeding on probing showed an increase from BL to 1 year (34 ± 30% for Zr; 25 ± 21% for Ti). MBL remained stable with minimal changes from BL to 1 year, measuring 0.1 ± 0.4 mm (mean ± SD) for Zr and −0.1 ± 0.7 mm for Ti. Veneering fractures were the most frequent technical complication and amounted to 17.5% in group Zr and 5% in group Ti (p =.100). Patients preferred Zr implants for their soft tissue color, with a significant difference in perception between patients and clinicians (p <.017). Conclusion: The study showed that both Zr and Ti implants had similar clinical outcomes, despite a high prevalence of mucositis and a few technical complications. Both implant types demonstrated stable marginal bone levels and similar patient‐reported outcome measures. [ABSTRACT FROM AUTHOR]

Objective: To investigate the early impact of plaque accumulation in a buccal dehiscence defect on peri‐implant marginal bone resorption. Materials and Methods: In six male Mongrel dogs, four dental implants were placed in the posterior maxilla on both sides (two implants per side). Based on the group allocation, each implant was randomly assigned to one of the following four groups to decide whether buccal dehiscence defect was prepared and whether silk ligation was applied at 8 weeks post‐implant placement for peri‐implantitis induction: UC (no defect without ligation); UD (defect without ligation); LC (no defect with ligation); and LD (defect with ligation) groups. Eight weeks after disease induction, the outcomes from radiographic and histologic analyses were statistically analyzed (p <.05). Results: Based on radiographs, the exposed area of implant threads was smallest in group UC (p <.0083). Based on histology, both the distances from the implant platform to the first bone‐to‐implant contact point and to the bone crest were significantly longer in the LD group (p <.0083). In the UD group, some spontaneous bone fill occurred from the base of the defect at 8 weeks after implant placement. The apical extension of inflammatory cell infiltrate was significantly more prominent in the LD and LC groups compared to the UC group (p <.0083). Conclusion: Plaque accumulated on the exposed implant surface had a negative impact on maintaining the peri‐implant marginal bone level, especially when there was a dehiscence defect around the implant. [ABSTRACT FROM AUTHOR]

Objective: To histomorphometrically determine the effects of hard‐ and/or soft‐tissue augmentation by applying the early implant placement protocol. Materials and Methods: The distal roots of the maxillary second and third premolars were extracted in 10 mongrel dogs. After 1 month, early implant placement was performed in the distal roots, resulting in buccal dehiscence defects. Four treatments were then randomly applied: (1) guided bone regeneration (GBR), (2) connective tissue grafting (CTG), (3) simultaneous GBR and CTG (GBR + CTG) and (4) no further treatment (control). Healing abutments were connected to all implants to allow non‐submerged healing. At 4 and 16 weeks, tissue sections were harvested and histomorphometric analyses were performed. Results: Group GBR presented the largest total tissue thickness at 4 weeks, but underwent a greater remodelling compared with the other groups between 4 and 16 weeks. At 16 weeks, the overall tissue thickness was largest in group GBR + CTG. This group was also the most favourable in terms of the level of the margo mucosae and the presence of mineralized tissue at the coronal level. Group CTG demonstrated a stable tissue thickness over time, with a larger thickness at 16 weeks compared with group GBR. Conclusion: Simultaneous CTG and GBR resulted in the most‐favourable tissue thickness when applying the early implant placement protocol. [ABSTRACT FROM AUTHOR]

Objective: To determine whether combining cross‐linked (CL) collagen‐integrated xenogeneic bone blocks stabilized with the fixation of resorbable collagen membranes (CM) can enhance guided bone regeneration (GBR) in the overaugmented calvarial defect model. Materials and Methods: Four circular defects with a diameter of 8 mm were prepared in the calvarium of 13 rabbits. Defects were randomly assigned to receive one of the following treatments: (i) non‐cross‐linked (NCL) porcine‐derived collagen‐embedded bone block covered by a CM without fixation (NCL + unfix group); (ii) NCL bone block covered by CM with fixation using bone‐tack (NCL + fix group); (iii) cross‐linked (CL) porcine‐derived collagen‐embedded bone block covered by CM without fixation (CL + unfix group); and (iv) CL bone block covered by CM with fixation using bone‐tack fixation (CL + fix group). The efficacy of GBR was assessed through histological and molecular analyses after 2 and 8 weeks. Results: At 2 weeks, there were no significant differences in histologically measured areas of newly formed bone among the groups. At 8 weeks, however, the CL + fix group exhibited a larger area of new bone (5.08 ± 1.09 mm2, mean ± standard deviation) compared to the NCL + unfix (1.62 ± 0.42 mm2; p <.0083), NCL + fix (3.97 ± 1.39 mm2) and CL + unfix (2.55 ± 1.04 mm2) groups. Additionally, the expression levels of tumour necrosis factor‐alpha, fibroblast growth factor‐2, vascular endothelial growth factor, osteocalcin and calcitonin receptor were significantly higher in the CL + fix group compared to the other three groups (p <.0083). Conclusion: Cross‐linked bone blocks stabilized with collagen membrane fixation can significantly enhance GBR. [ABSTRACT FROM AUTHOR]

Aim: To determine the effects of implant timing and type of soft‐tissue grafting on histological and histomorphometric outcomes in a preclinical model. Materials and Methods: Four implant placement protocols were randomly applied at the mesial root sites of the third and fourth mandibular premolars in 10 mongrel dogs: immediate placement (group IP), early placement (group EP), delayed placement with/without alveolar ridge preservation (groups ARP and DP, respectively). A connective‐tissue graft (CTG) or porcine‐derived volume‐stable collagen matrix (VCMX) was applied to enhance the ridge profile (simultaneously with implant placement in group IP and staged for others), resulting in five sites for each combination. All dogs were sacrificed 3 months after soft‐tissue grafting. Histological and histomorphometric analyses were performed, and the data were analysed descriptively. Results: CTG and VCMX were difficult to differentiate from the augmented area. The median total tissue thickness on the buccal aspect of the implant was largest in group IP/CTG (between 2.78 and 3.87 mm). The soft‐tissue thickness was generally favourable with CTG at all implant placement timings. Within the DP groups, CTG yielded statistically significantly larger total and soft‐tissue thickness than VCMX (p <.05). Among the groups with VCMX, group EP/VCMX showed the largest soft‐tissue thickness at apical levels to the implant shoulder. Conclusions: CTG generally led to greater tissue thickness than VCMX. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether the lack of keratinized mucosa (KM) affects peri‐implant health after 10 years of loading. Materials and Methods: Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5‐year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri‐implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one‐piece or two‐piece) and compliance. Results: A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri‐implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri‐implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two‐piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two‐piece implants were associated with reduced MBL and MBL changes (p < 0.05). Conclusion: The lack of buccal KM appears to be linked with peri‐implant parameters such as BOP and MBL, but the association is weak. The design of one‐piece implants may account for their increased odds of exhibiting BOP. [ABSTRACT FROM AUTHOR]

Aim: To test whether early implant placement into the extraction socket containing an uncalcified provisional matrix leads to successful osseointegration and stable marginal bone levels. Materials and Methods: In six mongrel dogs, the mandibular molars were extracted. Three weeks later, early implant placement was performed according to three experimental protocols: (i) flapless implant placement with preservation of the provisional matrix; (ii) flap elevation, socket debridement and implant placement; and (iii) flap elevation, socket debridement, implant placement and guided bone regeneration (GBR). One untreated extraction socket served as a control group. Data analyses were based on histologic slides 3 months after implant placement. Results: There were no differences in bone‐to‐implant contact between the three experimental groups (66.97%, 58.89% and 60.89%, respectively) (inter‐group comparison p =.42). Marginal bone levels, first bone‐to‐implant contact as well as the thickness of the connective tissue did not reveal any significant differences between the groups (p =.85,.60 and.65, respectively). Conclusions: Flapless early implant placement into posterior extraction sockets was as effective as an open flap approach in conjunction with GBR. Mineralization of the socket seems to occur irrespective of the presence of dental implants or biomaterials. [ABSTRACT FROM AUTHOR]

Aim: To histomorphometrically assess three treatment modalities for gaining keratinized tissue (KT) at teeth and at dental implants. Materials and Methods: In five dogs, the distal roots of the mandibular second, third and fourth premolars were extracted. Dental implants were placed at the distal root areas 2 months later. After another 2 months, KT augmentation was performed at both distal (implants) and at mesial root (teeth) areas in the presence (wKT groups) or absence (w/oKT groups) of a KT band at the mucosal/gingival level. Three treatment modalities were applied randomly: apically positioned flap only (APF), free gingival grafts (FGGs) and xenogeneic collagen matrices (XCMs). A combination of the above produced six groups. Two months later, tissue sections were harvested and analysed histomorphometrically. Results: The median KT height and length were greatest at implants with FGG in both wKT (3.7 and 5.1 mm, respectively) and w/oKT groups (3.7 and 4.6 mm), and at teeth with FGG in wKT groups (3.7 and 6.1 mm) and with APF in the w/oKT groups (3.9 and 4.4 mm). The XCM and APF produced more favourable results at teeth than at implants. Conclusions: FGG was advantageous in gaining KT, especially at implants. [ABSTRACT FROM AUTHOR]

Aim: To compare implant survival and complication rates between shorter and standard‐length implants with sinus augmentation and restored with single crowns, at 10 years of loading. Materials and Methods: One‐hundred and one patients (137 implants) with a ridge height of 5–7 mm in the posterior maxilla were randomly assigned to two treatment modalities: shorter implants (6 mm) (group short [GS]) or standard‐length implants (11–15 mm) with sinus grafting (group graft [GG]). Following the insertion of final restorations, patients were regularly recalled for up to 10 years. Assessed outcomes encompassed implant survival, marginal bone levels (MBLs), biological and technical parameters and patient‐reported outcome measures (OHIP‐49 = Oral Health Impact Profile). Non‐parametric statistical analysis was used to analyse the data. Results: For the 5‐ to 10‐year follow‐up period, 77 patients with 105 implants (GS: 36 patients/48 implants; GG: 41/57) were available for re‐examination (drop‐out rate 21%). Implant survival rates at the patient level were 96.0% (GS; 2 failures) and 100% (GG) (inter‐group p =.24). Median MBLs amounted to 0.00 mm (min 0.00; max 3.25; GS) and 0.00 mm (min 0.00; max 4.55; GG) (inter‐group p =.73). Technical complications predominantly occurred within the first 5 years (inter‐group p >.05). Peri‐implantitis rates were 4.2% (GS) and 13.3% (GG) (intergroup p =.37). Median OHIP‐49 scores were 7.00 (0.00; 39.00; GS) and 9.00 (0.00; 196; GG) (inter‐group p =.61) at 10 years. Conclusions: Based on similar 10‐year implant survival rates, reduced patient morbidity and lower costs, the use of shorter dental implants might well serve as an alternative treatment concept to longer implants placed in conjunction with sinus grafting for patients with a limited ridge height in the posterior maxilla. Study register: https://clinicaltrials.gov/ct2/show/NCT01030523. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of a self‐retaining block‐type bone substitute (srBB) on the dimensional stability of the horizontal ridge width at the coronal level in a buccal dehiscence model. Materials and Methods: Four box‐shaped bone defects with a buccal dehiscence were surgically prepared in the partially edentulous mandible (n = 6). Experimental biomaterials were randomly assigned to each site: (1) Control group: no treatment, (2) particle‐type bone substitute (PBS) group, (3) collagenated soft block bone substitute (csBB) group, and (4) self‐retaining synthetic block bone (srBB) group. In all grafted groups, a collagen membrane covered the biomaterials. At 16 weeks, clinical, histological, and radiographic analyses were performed. Results: Three of the six blocks in the srBB group became exposed and fell out during the first week after surgery. Therefore, the remaining three specimens were renamed RsrBB group. The RsrBB group showed an increase horizontal ridge compared to the pristine bone width at 2–4 mm below the CEJ, while the other groups showed resorption (augmented width at 2 mm below: 4.2, 42.4, 36.2, and 110.1% in the control, PBS, csBB, and RsrBB groups, respectively). The mineralized bone area was largest in the RsrBB group (4.74, 3.44, 5.67, and 7.77 mm2 in the control, PBS, csBB, and RsrBB groups, respectively.). Conclusions: The srBB group demonstrated the highest volume stability at the coronal level. These findings would potentially suggest that self‐retaining block bone substitute might be a good candidate for alveolar ridge preservation. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the progression of wound healing of standardized palatal defects in groups using three different collagen‐based wound dressings and a control group, in terms of wound closure, pain perception and descriptive histology. Materials and Methods: Twenty participants were enrolled in this experimental study, in whom four palatal defects were created. The defects (6 mm diameter, 3 mm depth) were randomly assigned to one of four treatment modalities: C (control), MG (Mucograft®), MD (mucoderm®) and FG (Fibro‐Gide®). Photographs were taken, and pain assessment was performed before and after treatment and at 5, 7, 9, 12, 14 and 16 days after surgery. All participants wore a palatal splint for a duration of 16 days. Results: All groups achieved complete wound closure at 14 days. The percentage of the remaining open wound on day 7 amounted to 49.3% (C; interquartile range [IQR]: 22.6), 70.1% (FG; IQR: 20.7), 56.8% (MD; IQR: 26.3) and 62.2% (MG; IQR: 34.4). Statistically significant differences were found between FG and C (p =.01) and between MD and FG (p =.04). None of the participants rated pain higher than 4 out of 10 during the entire study period. Conclusions: Collagen‐based wound dressings provide coverage of open defects, albeit without acceleration of wound closure or reduction of pain. FG (which is not intended for open oral wounds) showed slower wound closure compared to C and MD. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess volumetric and linear changes of buccal mucosal thickness at implant sites following soft tissue augmentation with a volume-stable collagen matrix (VCMX). Soft tissue augmentation using a VCMX was performed in 12 patients at the time of implant placement. Hydrocolloid impressions were taken prior to surgery and at 1 and 6 months postsurgery. Stone cast models were scanned, and stereolithography (STL) files from the three time points were uploaded to an image-analysis software. At all time points, linear and volumetric measurements of the contour changes up to 3 mm apical to the mucosal margin were performed and were analyzed statistically. At 1 mm apical to the mucosal margin, the change in soft tissue thickness between presurgery (T1) and 1 month (T2) amounted to 0.21 ± 1.22 mm, and the change between T1 and 6 months (T3) was 0.08 ± 1.47 mm. At 3 mm apical to the mucosal margin, the change in soft tissue thickness was 1.92 ± 1.70 mm between T1 and T2 and 0.31 ± 1.26 mm between T1 and T3. Contour (volumetric) changes revealed an increase of 0.58 ± 0.73 mm between T1 and T2 and an overall gain of 0.55 ± 0.73 mm between T1 and T3. Soft tissue augmentation with VCMX increased the ridge profile. The increase in ridge width was greater at 3 mm below the ridge crest than at 1 mm below the ridge crest. Remodeling processes during healing showed a decrease in the ridge contour between 1 and 6 months. [ABSTRACT FROM AUTHOR]

Statement of Problem: Emerging evidence indicates that the emergence profile and subsequent restorative angle play a crucial role in clinical outcomes and can potentially affect the development and progression of peri‐implant diseases. However, the traditional evaluation of the emergence profile and angle has been limited to mesial and distal sites using periapical x‐rays, without considering the buccal sites. Purpose: To describe a novel 3D method to estimate the emergence profile and restorative angles around single implant‐supported crowns including buccal sites. Materials and Methods: A total of 30 implant‐supported crowns (11 molars, 8 premolars, 8 central incisors and 1 canine) were extra‐orally scanned using an intraoral scanner and the STL files produced were imported into a 3D software. The crown/abutment interface of each crown was delineated, and apico‐coronal lines were automatically drawn following the shape of the crown. Three reference points were defined on the apico‐coronal lines at the transition edge of the biological (BC) and the esthetic zone (EC) and the resulting angles were then calculated. The reliability of the measurements (2D and 3D) were assessed using the intraclass correlation coefficient (ICC). Results: In anterior restorations, the mean angle of the esthetic zone amounted to 162 ± 14° at mesial sites, to 140 ± 10° at buccal sites and to 163 ± 11° at distal sites. The corresponding angles at the biological zones, amounted to 155 ± 13° at mesial sites, 139 ± 15° at buccal sites and 157 ± 5° at distal sites. In posterior restorations, the mean angle of the esthetic zone amounted to 162 ± 12° at mesial sites, to 157 ± 13 at buccal sites and to 162 ± 11 at distal sites. The corresponding angles at the biological zone, amounted to 158 ± 8 at mesial sites, 150 ± 15° at buccal sites and 156 ± 10 at distal sites. The ICC for all measurements ranged between 0.77 and 0.99 indicating a good intra‐examiner reliability. Conclusion: Within the limitations of the present study, the 3D analysis seems to be a reliable and applicable method for the quantitative evaluation of the emergence profile in daily practice. Future randomized clinical trials are needed to assess whether a 3D analysis with the ensuing the emergence profile serves as a predictor for clinical outcomes. Clinical Significance: The development and implementation of a 3D workflow will provide technicians and dentists with the ability to assess the restorative angle of implant‐supported restorations during the provisional phase and the final restoration. This approach may help achieve an aesthetically pleasing restoration while minimizing potential clinical complications. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical, technical, and esthetic outcomes of directly veneered zirconia abutments cemented onto non-original titanium bases over 3 years.Materials and Methods: A total of 24 healthy patients with a single missing tooth in the maxilla or mandible (incisors, canines, or premolars) received a two-piece implant with a screw-retained veneered zirconia restoration extraorally cemented on a titanium base abutment. Baseline measurements and follow-up examinations were performed at 6 months, 1 year, and 3 years following loading. Radiographic, clinical, technical, and esthetic parameters were assessed. Wilcoxon signed rank test was used to analyze the data.Results: Mean marginal bone levels measured 0.54 ± 0.39 mm (median: 0.47 mm, range: 0.07 mm to 1.75 mm) at baseline and 0.52 ± 0.39 mm (median: 0.39 mm, range: 0.06 mm to 1.33 mm) at 3 years. Mean probing depth around the implants increased from 3.0 ± 0.6 mm at baseline to 3.8 ± 0.8 mm at 3 years (P = .001). Bleeding on probing changed from 27.1% ± 20.7% (baseline) to 51.5% ± 26.1% (3 years) (P = .001). The mean plaque control record amounted to 11.1% ± 21.2% (baseline) and 14.4% ± 13.89% (3 years) (P = .261). Two implants were lost at 3.5 and 30 months postloading due to peri-implantitis, resulting in a 91.7% implant survival rate. Patient satisfaction was high at 3 years.Conclusion: Zirconia restorations cemented onto the tested non-original titanium bases should not be recommended for daily clinical use, as they were associated with significant increases in BOP and PD values and varying marginal bone levels 3 years after placement. [ABSTRACT FROM AUTHOR]

Objectives: To test whether soft tissue volume augmentation using a collagen matrix (VCMX) leads to noninferior results in terms of gain of mucosal thickness at single implant sites, compared to connective tissue grafts (SCTG). Methods: The study was designed as a multi‐center randomized controlled clinical trial. Subjects in need of soft tissue volume augmentation at single tooth implant sites were consecutively recruited at nine centers. The deficient mucosal thickness at the implant sites (one per patient) was augmented by applying either a VCMX or a SCTG. Patients were examined at 120 days (abutment connection = primary endpoint), 180 days (final restoration), and 360 days (1‐year after insertion of the final restoration). Outcome measures included: transmucosal probing of the mucosal thickness (crestal = primary outcome), profilometric measurements of the tissue volume, and patient‐reported outcome measures (PROMs). Results: Out of the 88 patients, 79 attended the one‐year follow‐up. The median increase of the crestal mucosal thickness between pre‐augmentation and 120 days was 0.3 ± 2.1 mm in the VCMX group and 0.8 ± 1.6 mm in the SCTG group (p =.455). Non‐inferiority of the VCMX compared to the SCTG was not observed. The respective numbers at the buccal aspect amounted to 0.9 ± 2.0 mm (VCMX) and 1.1 ± 1.4 mm (SCTG; p =.431). PROMs including pain perception favored the VCMX group. Conclusion: It remains inconclusive whether soft tissue augmentation using a VCMX is noninferior to SCTG in terms of crestal mucosal thickening at single implant sites. However, the use of collagen matrices favors PROMs especially pain perception, while achieving similar buccal volume gains along with comparable clinical and aesthetic parameters to SCTG. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to assess the perceptibility and acceptability threshold values for color differentiation at the restoration and mucosa levels.Materials and Methods: One restored single-tooth implant and the contralateral reference tooth were spectrophotometrically assessed in 20 patients. Perceptibility and acceptability were evaluated by dentists, dental technicians, and laypeople.Results: Dental technicians had the highest sensitivity in the perception of tooth color differences (ΔE = 2.7), followed by dentists (ΔE = 3.3) and laypeople (ΔE = 4.4). Acceptability threshold values were generally higher than perceptibility threshold in all groups. Dental technicians exhibited the highest sensitivity in the perception of mucosa color differences (50% perceptibility at ΔE = 2.65), followed by dentists (ΔE > 3.7) and laypeople (ΔE > 6).Conclusion: Color differences were tolerated with varying degrees among the three groups. Laypeople accepted higher color differences at the mucosa level. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical outcomes of single-retainer resin-bonded fixed dental prostheses (RBFDPs) and the profilometric changes of pontic sites after a mean of 10 years in function.Materials and Methods: Ten patients (mean age 32.4 years) who had received an RBFDP replacing a single anterior tooth were recalled after 10 years. Five patients had received a subepithelial connective tissue graft (SCTG) at the pontic site. The clinical assessment comprised the following parameters: probing depth, bleeding on probing, modified plaque control record, gingival recession, measurement of the width of keratinized mucosa, and intraoral photographs and radiographs. The modified criteria of the United States Public Health Services evaluation system were applied. Additionally, patient satisfaction was recorded. Data were analyzed descriptively, and the 10-year RBFDP survival rates were calculated using Kaplan-Meier analysis.Results: The RBFDP survival rate after a mean follow-up of 10.0 years (range 7.4 to 13.3 years) was 100%. Neither technical failures nor biologic complications were observed. All abutment teeth remained vital, and no secondary caries were detected. Between baseline and follow-up examinations, the profilometric changes at the pontic sites were minimal, exhibiting a loss of -0.03 ± 0.10 mm (no SCTG) and 0.00 ± 0.37 mm (SCTG).Conclusion: The present study exhibited high survival rates and low complication rates of the restorations, as well as excellent profilometric stability of the pontic sites over 10 years. The use of an RBFDP is a viable long-term treatment option for replacing a single anterior tooth. [ABSTRACT FROM AUTHOR]

Purpose: To clinically and histomorphometrically compare a biphasic calcium phosphate (BCP) and deproteinized bovine bone mineral (DBBM) for sinus floor elevation. Materials and Methods: Sinus floor elevation procedures (lateral window) were performed randomly applying either BCP (test) or DBBM (control). At 6 months, bone biopsy specimens were harvested and dental implants were placed. The proportions of new bone, residual grafting material, and nonmineralized soft tissue were calculated. Four months after implant placement, the prosthetic reconstructions were inserted and the implant survival was assessed. Results: Fifty-one patients were treated; 25 were randomly allocated to the BCP group and 26 to the DBBM group. After 6 months in 50 patients, bone biopsy specimens could be harvested, and a total of 121 implants could be placed subsequently. The histomorphometric analysis revealed a comparable percentage of new bone in both groups (BCP 35.9%, DBBM 35.4%; P > .05). The remaining grafting material was significantly lower with BCP (25.3%) compared with DBBM (45.9%; P < .001). Nonmineralized tissue was significantly higher for the BCP group (38.1%) compared with the DBBM group (18.2%; P < .001). The implant survival rate at loading was assessed at the level of the patients (96.0% for BCP and 88.8% for DBBM; P > .05) and at the level of the implants (96.9% for BCP and 94.7% for DBBM; P > .05). Conclusion: Grafting with DBBM or BCP showed similar percentages of new bone 6 months after sinus floor elevation. Implant survival presented no significant difference until loading. [ABSTRACT FROM AUTHOR]

Peri-implant bone dehiscences were grafted either with deproteinized bovine bone mineral (DBBM) block or with particulate DBBM, both covered with a collagen membrane and stabilized with resorbable pins. After 6 months, 17 biopsy samples were included for histologic assessment. Block and particulate DBBM rendered successful tissue integration. Particulate DBBM showed a median of 25.2% of new bone and 31.3% of bone substitute. In the block group, there was a median of 11.5% of new bone and 36.0% of bone substitute. When interpreting the discrepancy in new bone between the groups, the difference in the size of the augmented hard tissue needs to be taken into account. [ABSTRACT FROM AUTHOR]

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