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Diverse surgical approaches, such as resective, reconstructive, and combined therapy, have been proposed for peri-implantitis treatment. A resective surgical approach with an adjunctive modified implantoplasty refers to the modification of the implant body into a constricted area to mimic a "waist" silhouette. This modified technique forms an adequate concave smooth area that may favor the outcomes of resective surgical therapy for soft tissue adaptation, biofilm control, and possible peri-implant bone gain over the long term. The present case series aimed to exhibit the long-term clinical and radiographic outcomes of resective surgery with adjunctive implantoplasty over a 6- to 11-year follow-up. Four patients presenting four implants (one per patient) diagnosed with peri-implantitis (according to an established case definition) were included in the present case series. Patients underwent resective surgery, a modified implantoplasty approach, and implant surface decontamination. After surgical therapy, clinical and radiographic outcomes such as bleeding on probing (BoP), suppuration on probing (SoP), probing depth (PD), marginal recession (MR), modified plaque index (mPI), and marginal bone levels (MBLs) were recorded over a long-term follow-up period. Over the 6- to 11-year follow-up, mean BoP, PD, and SoP scores amounted to 17% ± 24%, 3.2 ± 0.66 mm, and 0%, respectively. Mean BoP, PD, and SoP scores were reduced by 67% ± 24%, 2.5 ± 1.26 mm, and 100%, respectively. Radiographic analysis revealed a mean radiographic bone gain of 3.1 ± 1.84 mm. Peri-implant marginal bone loss surface area decreased by 5.7 ± 3.77 mm2 over the long-term follow-up. Resective therapy with adjunctive implantoplasty promoted favorable clinical and radiographic outcomes at treated peri-implantitis sites over a long-term period. [ABSTRACT FROM AUTHOR]

Implantoplasty has been claimed as a promising strategy to treat peri-implantitis and prevent progressive peri-implant bone loss. Consequently, the aim of the present case series is to exhibit the clinical outcomes of a 3-year-follow-up resective and implantoplasty therapy applying a novel platform-switch concept to preserve peri-implant tissue integrity and counteract progressive bone loss. Four patients who underwent dental implant therapy and were diagnosed with periimplantitis were treated through access flap surgery, a modified implantoplasty, bone recontouring, and surface decontamination. The radiographic and clinical parameters recorded before and during the 3-year follow-up were: marginal bone loss (MBL) as the primary endpoint, bleeding on probing index (BOP), probing depth (PD), presence of suppuration, pain, mobility, and fracture. The 3-year follow-up exhibited peri-implant bone stability in all cases (100%) showing radiographically an MBL reduction (mean) of 0.8 ± 0.5 mm (mesial) and 0.5 ± 0.3 mm (distal). Mean PD reduction was 4.75 ± 1 mm and mean BOP was reduced by 71%. Pain and suppuration were resolved in all cases. None of the cases reported implant fracture or mobility after the modified implantoplasty therapy. The present case series demonstrated that this modified implantoplasty can be more than a surface decontamination therapy where the narrow and smooth exposed implant surface can counteract peri-implantitis alterations providing favorable biologic conditions to maintain stability of peri-implant tissues. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of local and systemic factors on additional peri-implant bone loss. Method and Materials: From a total of 253 patients, 193 were selected (126 women) and restored with 722 implants, in place for at least 1 year. Patients had previously attended the supportive periodontal/peri-implant therapy program at the Department of Implant Dentistry at the Federal University of Santa Catarina, Brazil. The study was divided according to physiologic (PBL < 2 mm) or additional bone loss (ABL > 2 mm) evaluated from the time of prosthesis placement to the reassessment visit. Data collection and analysis included evaluation of systemic factors, such as history of periodontal disease, heart disease, hypertension, diabetes mellitus, hyperthyroidism/hypothyroidism, osteoporosis, kidney disease, alcohol abuse, smoking habits, chemotherapy, radiation therapy, menopause, and hormone replacement. Analysis of local factors included implant platform, diameter, location, time in function, and type of prosthesis. Results: No systemic factors influenced ABL (P> .05). Considering local factors, only time in function and type of prosthesis influenced ABL (P< .05). Conclusion: Fixed partial dental prostheses and full-arch fixed prostheses present higher rates of ABL. In addition, all types of prostheses showed greater ABL when in function for more than 4 years. [ABSTRACT FROM AUTHOR]

Introduction. This paper describes case reports where coronal growth of soft tissue on implant threads was observed after surgery for soft tissue graft. This phenomenon is known as "creeping attachment." Methods. Two patients were submitted to gingival graft procedure including subepithelial connective tissue graft and masticatory mucosal graft. A two-year follow-up appointment was performed. Results. After a two-year follow-up gingival growth over titanium surfaces characterizing the "creeping attachment" phenomenon was observed. This gingival growth happened over abutment and threads surfaces. Conclusion. The creeping attachment phenomenon is possible over titanium surfaces and has not yet been reported in the relevant literature over this kind of structure. [ABSTRACT FROM AUTHOR]

Background: The adverse effects of smoking on systemic and oral health are widely known. In order to understand in a clearer and more specific way the relation of smoking as an indicator of risk for peri‐implant bone loss. The time and intensity of the habit are major and decisive factors in the short and long‐term response to bone loss.Aim/Hypothesis: The purpose of this study was to evaluate the influence of smoking (time intensity) in peri‐implant bone loss in patients less or more than 5 years of control. Material and Methods: In peri‐implant bone loss in patients less or more than 5 years of control. In 290 patients (1043 implants) attended by periodontal support program of the Federal University of Santa Catarina, 36 patients had a history of smoking, including 19 with smoking frequency of moderate to heavy were selected. Rehabilitated with 74 implants of the type external hexagon at the level of the bone crest and over a year of follow‐up after installing the prosthesis. Bone loss was determined by comparing periapical radiographs taken at first (PO‐1) control of the prosthesis with the revaluation radiographs in a second phase control (PO‐2). For this comparison we used the image analysis software (Digimizer), measuring the distance between the component‐implant interface and the first implant‐bone contact. The measurements were made by a single blinded calibrated investigator evaluated the same site (M D) of each implant in both controls, were divided in control patients with more or less than 5 years. Results: The results of bone loss comparison of patients were statistically analyzed using chi‐square test, with significance level (_I_P _i_>_I_ _i_0.001). Results‐ In patients less of 5 years of control implant showed 70.2% of pathological bone loss (0.70 mm + ‐ 0.045 mm) compared to 44.4% in patients more of 5 years of control (0.04 5 mm, + ‐ 0.042 mm). Conclusions and Clinical Implications: Although, peri‐implant bone loss is a multifactorial process, this study indicates that the first 5 years of control there was greater pathological bone loss in patients with moderate and heavy consumption of tobacco, after that period, the loss is regulated and maintained, with high risk factor for developing peri‐implant mucositis and or implantitis.