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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]

Purpose: The aim of this pilot exploratory cohort study was to assess the value of buccal augmentation in immediate implant placement and immediate restoration of anterior teeth in maxillae with missing buccal lamellar bone with regard to esthetic parameters, as well as soft and hard tissue level changes. Materials and Methods: This study compared three groups of 10 patients each with immediate implant placement and immediate restoration in the anterior maxilla: (1) patients with partially to totally missing buccal bone with simultaneous augmentation with bovine collagen (test group augmented [TGA]); (2) patients with partially to totally missing buccal bone without augmentation (test group nonaugmented [TNA]); and (3) patients with intact buccal lamellar bone (control group [CG]). The pink esthetic score (PES) and the course of the peri-implant bone level after 1, 3, and 12 months were used as assessment criteria. Results: Af ter 12 months, the PES in the TGA was assessed as being better than it was preoperatively (mean ± SD: 8 ± 3.09 vs 9.25 ± 3.01, respectively, P = .8243), while it remained almost identical in the other two groups (TNA = 8.75 ± 2.7 vs 8.6 ± 3.3, P = .4098; CG = 10.6 ± 2.41 vs 10.6 ± 2.22, P = .7085). A significant difference among the PES values of the three groups was not observed at any point in time (preoperative: P = .118, 12 months: P = .383). In total, the TNA and CG showed an improvement in 3 out of 7 parameters of the PES after 12 months, while this was the case in 5 out of 7 parameters in the TGA. No significant difference among the three groups could be seen at any time point regarding peri-implant bone level. In the CG and TGA patients, a nonsignificant improvement in peri-implant bone level was seen after 12 months (respectively: 1.6 mm to 0.99 mm; P = .08068; 1.89 mm to 1.73 mm; P = .5866). In contrast, TNA patients showed a nonsignificant deterioration vs the postoperative situation (1.16 mm to 1.45 mm; P = .08208). Conclusion: Within the limitations of this pilot study, it can be concluded that a missing buccal lamellar bone appears to be no contraindication for immediate implant placement and immediate restoration, provided the baseline esthetic situation is accepted. As compared to the nonaugmented defect group or the group with intact lamellar bone, neither the esthetic nor the radiologic results could be improved significantly by augmentation with bovine collagen. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the use of chemically unchanged tooth material in lateral alveolar ridge augmentation or for the filling of jaw defects. Materials and Methods: A total of 20 patients underwent either lateral augmentation of the alveolar process (11 patients) or filling of jaw defects (6 patients) with autogenous unaltered tooth material in a longitudinal 2-year study. In three patients, the jaw defect was so marked that a bone block graft had to be used for augmentation in addition to particulate dental material. In four patients, an autogenous tooth block was exclusively used; in seven, crushed tooth material was exclusively used; and in the remaining six, dystopic teeth that had been extracted were removed, crushed, and reinserted into the defect in particulate form. Fully impacted teeth served as autogenous donor teeth. Results: After a healing time of 3 to 6 months, 28 implants could be placed (10 immediate implants, 18 delayed implants). At 6, 12, and 24 months postrestoration, peri-implant bone loss as assessed by x-ray was 0 mm, 0.4 mm, and 0.6 mm, respectively. Peri-implant probing depth was 1 mm after 1 year and 2 mm after 2 years. Bleeding on probing was not seen in any of the implants after 2 years. Conclusion: Autogenous tooth material appears to be suitable for the restoration of lateral and intraosseous defects of the alveolar ridge with both complete blocks and in particulate form. However, additional long-term studies with higher case numbers will be required for substantiating these results. [ABSTRACT FROM AUTHOR]

Purpose: This prospective longitudinal study reports on the results in patients given autologous tooth material for augmentation in a sinus elevation procedure. Materials and Methods: Six patients with inadequate bone supply for augmentation in the maxillary posterior tooth region and at least one impacted maxillary third molar underwent sinus elevation surgery with lateral access using the particulate tooth material. One of the patients received four implants during the same session, while the other patients had a total of 15 implants placed after a healing phase of an average 5.5 months. Drill cylinders collected from the implant bed during the procedure were subjected to histologic/immunohistochemical evaluation. Results: All six patients showed normal and unobtrusive postoperative healing, having undergone prosthetic restoration up to 5 years before. The average peri-implant probing pocket depth after a period of up to 5 years ranged between 1.86 mm (mesial and lingual) and 2.07 mm (distal and buccal). No bleeding could be triggered with any of the peri-implant probes. The average peri-implant bone resorption measured during the first year was up to 0.63 mm, with the lowest being 0 mm and the maximum 2.9 mm. Peri-implant bone remained stable for the follow-up time of up to 5 years. Histologically, six biopsy specimens collected from five patients showed osteoconductive osteogenesis with encapsulation of tooth enamel and dentin portions and partial resorption of the tooth components. Cementum shares were no longer discernible. Immunohistochemical assessment showed intense new vessel formation that could be observed in the area of loose stroma of reorganized tissue in the augmented area. Conclusion: Within the limits of these preliminary results and with adequate consideration of the small number of patients included, the use of autogenous crushed tooth material from impacted third molars may represent an alternative augmentation material for use in sinus elevation procedures. [ABSTRACT FROM AUTHOR]

Aim To test whether the use of short dental implants (6 mm) results in an implant survival rate similar to that with longer implants (11-15 mm) in combination with sinus grafting. Methods This multicentre study enrolled 101 patients with partial edentulism in the posterior maxilla and a remaining bone height of 5-7 mm. Included patients were randomly assigned to receive short implants (6 mm; GS/group short) or long implants (11-15 mm) simultaneously with sinus grafting ( GG/group graft). Six months after implant placement ( IP), implants were loaded with single crowns ( PR) and patients were re-examined yearly thereafter. Assessed outcomes included: implant survival, marginal bone level changes ( MBL), probing pocket depth ( PPD), bleeding on probing (BoP) and plaque accumulation ( PCR) during 3 years of loading as well as recording of any adverse effects. In addition to descriptive statistics, statistical analysis has been performed for the two treatment modalities using a non-parametric approach. Results In 101 patients, 137 implants were placed. At the 3-year follow-up ( FU-3), 94 patients with 129 implants were re-examined. The implant survival rate was 100% in both groups. MBL at FU-3 was 0.45 mm ( GG) and 0.44 mm ( GS) ( p > 0.05). A statistically significant loss of MBL was observed in both GG (−0.43 ± 0.58 mm) and GS (−0.44 ± 0.56 mm) from IP to FU-3, and from PR to FU-3 in GG (−0.25 ± 0.58 mm) but not in GS (−0.1 ± 0.54 mm). PCR and BoP at FU-3 did not show any difference between the groups but for PPD ( p = 0.035). Conclusions Within the limitations of this study, implants with a length of 6 mm as well as longer implants in combination with a lateral sinus lift may be considered as a treatment option provided a residual ridge height of 5-7 mm in the atrophied posterior maxilla is present. [ABSTRACT FROM AUTHOR]