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Aim: To evaluate the effectiveness of a flapless surgical approach in the treatment of peri‐implantitis and to explore the factors influencing its outcome. Materials and Methods: The present retrospective study evaluated patients with at least one implant diagnosed with peri‐implantitis and treated with a flapless surgical access, with or without systemic antimicrobials, curettage and, when needed, prostheses modification. Clinical and radiographic parameters were assessed at baseline and at 3 months and at least 12 months. The primary outcome was disease resolution (≤1 bleeding sites, probing depth [PD] ≤5 mm, no bone loss >0.5 mm). Multilevel regression analyses were used to identify predictors influencing the probability of attaining disease resolution. Results: One hundred and seventeen patients with 338 implants were included. Disease resolution was attained in 54.4% of the 338 implants receiving flapless surgical access. At the end of the follow‐up period, 111 patients (94.9%) with 295 implants (87.3%) did not require any further treatment, with 81.4% of these implants presenting PD ≤ 5 mm. History of periodontitis and PD at baseline were identified as negative predictors, while compliance with supportive peri‐implant care, a machined surface and the adjunctive use of systemic azithromycin or metronidazole were identified as positive predictive factors for disease resolution. Conclusions: A flapless surgical approach led to disease resolution in 54.4% of the implants with peri‐implantitis. Several risk/protective predictors for disease resolution were identified. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the survival and biological and mechanical complications of one‐piece and two‐piece zirconia implants at five years of loading. Materials and Methods: Consecutive patients receiving zirconia implants were studied, collecting data at five years of loading on their clinical history, peri‐implant health status, mechanical complications, esthetic results, and patient related outcomes. Results: The study included 18 patients with 29 implants. The survival rate was 86% in implant‐based analysis and 78% in patient‐based analysis. There were no cases of peri‐implantitis, but mucositis was present in 53% of implants. A mean of 4.1 ± 0.81 mm was obtained for probing depth and 1.6 ± 0.9 mm for crestal bone loss (radiographic assessment). There were no implant fractures. Major (10%) and minor (10%) prosthesis complications were observed. The esthetic outcome was moderate to almost perfect, with a high level of patient satisfaction. No significant association was found between survival rate and the presence of mucositis around one‐ or two‐piece implants or any other study variable. Conclusions: The survival rate is low for one‐ and two‐piece zirconia implants. Both types of implants demonstrated a low mechanical complication rate. The incidence of periimplantitis is low but mucositis is present in 50%. Patient satisfaction related to esthetics and function is moderate to high. They represent a good option for patients requiring an alternative to titanium implants. Clinical Relevance: Zirconia implants appear to be an alternative to the titanium option and may be indicated for patients requiring "metal‐free" restorations. [ABSTRACT FROM AUTHOR]

Aim: To obtain input from multiple stakeholders and generate agreement on essential outcomes in implant dentistry using the Delphi methodology and incorporate them into an international consensus defining a core outcome set. Materials and Methods: Candidate outcomes in implant dentistry were generated from scientific evidence through five commissioned systematic reviews and from people with lived experience in dental implants (PWLE) through four international focus groups. A steering committee identified stakeholders among representatives from dental professionals, industry‐related experts and PWLE. Participants underwent a three‐round Delphi survey using a multi‐stakeholder approach; they assessed candidate outcomes and additional outcomes identified in the first Delphi round. The process followed the COMET methodology. Results: From the 665 potential outcomes identified in the systematic reviews and 89 in the PWLE focus group, the steering committee selected 100 and organized them into 13 categories, to be included in the first‐round questionnaire as candidate outcomes. A total of 99 dental experts, 7 dental‐industry‐related experts and 17 PWLE participated in the first round, and 11 additional outcomes were added to the second round. There was no attrition between the first and second rounds, where 61 (54.9%) outcomes exceeded the pre‐established threshold of agreement. PWLE and experts participated in the third round that applied "a priori" standard filters to distil a list of candidate essential outcomes. Conclusion: This Delphi study utilized a standardized, transparent and inclusive methodology and preliminarily validated 13 essential outcomes organized into four core areas. These results informed the final stage of the ID‐COSM consensus. [ABSTRACT FROM AUTHOR]

Aims: The aims of this project were to establish the outcomes for dental implant research that are important to people with lived experience (PWLE) and to achieve consensus with those developed by dental professionals (DPs) for a core outcome set (COS). This paper reports the process, outcomes and experiences of involving PWLE in developing a COS for dental implant research: the Implant Dentistry Core Outcome Sets and Measures project. Materials and Methods: Overall methods were guided by the Core Outcome Set Measures in Effectiveness Trials (COMET) initiative. Initial outcome identification was achieved from focus groups with PWLE employing calibrated methods across two low‐middle‐income countries (China and Malaysia) and two high‐income countries (Spain and the United Kingdom). Following consolidation of the results, the outcomes were incorporated into a three‐stage Delphi process with PWLE participation. Finally, consensus between PWLE and DPs was achieved using a mixed live and recorded platform. The experiences of PWLE involvement in the process was also evaluated. Results: Thirty‐one PWLE participated in four focus groups. Thirty‐four outcomes were suggested across the focus groups. Evaluation of the focus groups revealed a high level of satisfaction with the engagement process and some new learning. Seventeen PWLE contributed to the first 2 Delphi rounds and 7 to the third round. The final consensus included 17 PWLE (47%) and 19 DPs (53%). Out of the total of 11 final consensus outcomes considered essential by both PWLE and health professionals, 7 (64%) outcomes mapped across to ones that PWLE initially identified, broadening their definition. One outcome (PWLE effort required for treatment and maintenance) was entirely novel. Conclusions: We conclude that engaging PWLE in COS development can be achieved across widely different communities. Furthermore, the process both broadened and enriched overall outcome consensus, yielding important and novel perspectives for health‐related research. [ABSTRACT FROM AUTHOR]

Background: The gingival thickness seems to have an important role in different dental treatments. There are different methods of quantifying this thickness, but it is not known which of them can be the most effective. The objective to assess the accuracy of two different methods for gingival thickness measurement: the transgingival needle probing (TGNP) and the tension-free caliper (TFC) in an in vitro model, by comparing them with direct physical measurements (reference standard)., Material and Methods: Gingival thickness (GT) was evaluated in 27 female pigs with four implant sites 1, 2 and 3mm from the gingival margin with three different methods: 1) transgingival needle probing 2) tension-free caliper and 3) Direct visualization after making a incision in the mucosa and measuring GT with a periodontal probe. Wilcoxon test for paired samples were used with a confident level of 95%., Results: A total of 324 points were measured, 59% of the sites presented a thin biotype with DV, it was correctly assessed with the TGNP in 84% of the times and in 86% with the TFC. 41% of the sample presented thick biotype, 76% was the percentage measured with the TGNP and 0% of the sites evaluated with TFC resulted in this biotype., Conclusions: Transgingival needle probing constitutes an accurate method when measuring GT at different levels. Tension free caliper is not a good tool for assessing the gingival biotype as long as it is unable to predict thick biotype. Key words: Periodontal Biotype, Gingival Thickness, Periodontal Tissue and Diagnosis., Competing Interests: Conflict of interest statement: The authors of this research declare no competing financial interests.

The aim of this study was to test whether zirconia abutments exhibit the same clinical and esthetic outcomes as titanium abutments in single-tooth implant restorations in the esthetic area. The 24 treated patients were randomly assigned to a test (zirconia abutment) or control (titanium abutment) group. Objective evaluations were carried out using the Implant Crown Aesthetic Index (ICAI) and the Papilla Index (PI) at the 1-month and 12-month follow-up examinations after crown cementation. No significant differences, either in ICAI or in other periodontal or radiographic measurements, were observed. At 1 year, zirconia and titanium abutments exhibited the same esthetic outcomes.