Search Results (8)

Piezoelectric surgical instruments with various mini-sized tips and cutting technology offer a precise and thin cutting line that could allow the wider use of periodontal osseous wall swaging. This randomized controlled trial was designed to investigate the use of a minimally invasive piezo knife to harvest vascularized interseptal bone pedicles in treating intra-bony defects. Sixteen non-smoking patients (mean age 39.6 ± 3.9) with severe chronic periodontitis were randomly assigned into one of two groups (N = 8). The Group 1 (control) patients were treated by bone substitute grafting of the intra-bony defect, whereas the Group 2 patients were treated by intra-bony defect osseous wall swaging (OWS) combined with xenograft filling of the space created by bone tilting. In both groups, the root surfaces were treated with a neutral 24% EDTA gel followed by saline irrigation. Clinical and radiographic measurements were obtained at baseline and 6 months after surgery. The sites treated with osseous wall swaging showed a statistically significant probing-depth reduction and increase in clinical attachment compared with those of the Group 1 patients. The defect base level was significantly reduced for the OWS group compared to that of the Group 1 control. By contrast, the crestal bone level was significantly higher in the OWS group compared to Group 1. The crestal interseptal bone width was significantly higher in Group 2 at 6 months compared to the baseline value and to that of Group 1 (<0.001). The osseous wall swaging effectively improved the clinical hard- and soft-tissue parameters. The use of mini inserts piezo-cutting, sequential bone expanders for osseous wall redirection, and root surface EDTA etching appears to be a reliable approach that could allow the use of OWS at any interproximal dimension. Full article

Alveolar ridge preservation (ARP) reduces dimensional changes following tooth extraction. We evaluated the changes in alveolar ridge dimensions after ARP using bone substitutes and collagen membranes. Objectives included the tomographic evaluation of sites prior to extraction and six months after ARP and the assessment of the extent ARP preserved the ridge and reduced the need for additional augmentation at the time of implant placement. A total of 12 participants who underwent ARP in the Postgraduate Periodontics Clinic (Faculty of Dentistry) were included. Cone beam computed tomography images were used to retrospectively assess 17 sites prior to and six months after dental extraction. Alveolar ridge changes were recorded and analysed using reproducible reference points. The alveolar ridge height was measured at buccal and palatal/lingual aspects, whilst width was measured at crestal level, 2 mm, 4 mm and 6 mm below the crest. Statistically significant changes were found in alveolar ridge width at all four heights, with mean reduction differences ranging from 1.16 mm to 2.84 mm. Likewise, significant changes in the palatal/lingual alveolar ridge height (1.28 mm) were observed. However, changes of 0.79 mm in buccal alveolar ridge height were not significant (p = 0.077). Although ARP reduced dimensional changes following a tooth extraction, some degree of alveolar ridge collapse could not be avoided. The amount of resorption on the buccal aspect of the ridge was less compared to the palatal/lingual after ARP. This indicated that the use of bone substitutes and collagen membranes was effective in reducing changes in the buccal alveolar ridge height. Full article

Background: This study aims to explore the detailed correlation between the movement of maxillary and mandibular central incisors and alveolar bone resorption in adults who had orthodontic premolar extraction treatment. Methods: A total of 63 adult patients (mean age, 24.41 years) who received orthodontic treatment with the extraction of four first premolars were included in this study. CBCT images were obtained before and after treatment. Three-dimensional evaluations of the movement of 252 central incisors (126 maxillary and 126 mandibular incisors) and alveolar bone changes were conducted. Four points were used to describe the incisor movement: C (cusp point), R (root apex point), M (mid-point of root neck), and L (labial cementoenamel junction point). The thickness of labial and palatal alveolar bone was assessed at the crestal, mid-root, and apical levels of incisors. The results were analyzed with Spearman’s correlation and multilinear regression. Results: Matching the measurements of central incisor movement and alveolar bone resorption, significant correlations could be observed. For maxillary central incisors, the labial alveolar bone resorption at the crestal level was correlated with the movement of Point L (r = 0.290, p < 0.05), and the labial alveolar bone resorption at the apical level was correlated with Point M (r = 0.387, p < 0.05). For mandibular central incisors, the labial alveolar bone resorption at the apical level was correlated with the movement of Point M (r = 0.493, p < 0.05) and R (r = 0.498, p < 0.01); the palatal alveolar bone resorption at the mid-root level with Point M (r = -0.170, p < 0.01); and the palatal alveolar bone resorption at the apical level with Point R (r = 0.177, p < 0.01). Conclusions: This study investigated the concrete correlations between central incisor movement and alveolar bone resorption in adults after orthodontic treatment with premolar extraction. It is potentially helpful for orthodontists to have a relatively accurate prediction of alveolar bone resorption based on the specific movements of central incisors and to reduce the risk of alveolar bone resorption by better adjusting the three-dimensional movement types of incisors. Full article

Background and Objectives: The study aimed to compare the mean crestal bone level (CBL) and peri-implant soft tissue parameters in laser micro-grooved (LMG) platform switched implants and abutments (I&A) post 1 year of functional loading among non-diabetic and type II diabetic individuals. Materials and methods: Patients with an edentulous site having minimum bone height and width of ≥13 mm and ≥6 mm, respectively, were divided into two groups: (i) Non-diabetic-8 (control) and (ii) diabetic-8 (test). LMG Implants were placed and loaded immediately with a provisional prosthesis. Mean crestal bone level (MCBL) was evaluated radiographically at baseline and at 1 year. Peri-implant attachment level (PIAL) and relative position of the gingival margin (R-PGM) were recorded. Implant stability quotient (ISQ) level and implant survival rate (ISR) were evaluated at 1 year. Results: Early MCBL within the groups 1 year postloading was similar both mesially and distally (control—0.00 to 0.16 mm and 0.00 to 0.17 mm, respectively; test—0.00 to 0.21 mm and 0.00 to 0.22 mm, respectively) with statistical significance (p ≤ 0.003, p ≤ 0.001 and p ≤ 0.001, p ≤ 0.001, respectively). However, intergroup comparison showed no significant difference statistically in the MCBL in 1 year post functional loading. The peri-implant soft tissue parameters showed no significant difference between the groups. ISQ level between both groups did not reveal any significant changes (p ≤ 0.92), and ISR was 100%. Conclusions: LMG Implants resulted in minimal and comparable early crestal bone loss and soft tissue changes post 1 year of functional loading in moderately controlled diabetic and non-diabetic individuals, suggesting that this could be a reliable system for use in systemically compromised individuals. Full article

Objectives: Repeated abutment disconnection/reconnection may compromise the mucosal barrier and result in crestal bone level changes. The clinical significance of this phenomenon is not yet clear, as most studies on this topic are short-term. Therefore, the aim of the present study was to evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss over a medium-term follow-up period. Material and methods: Twenty-one patients (6 men and 15 women) with a mean age 66.23 ± 9.35 year at the time of implant placement were included. All patients who received two adjacent nonsubmerged implants were randomly assigned into one of the two groups: definitive multiunit abutments (DEFs) connected to the implant that were not removed (test group) or healing abutments (HEAs) placed at surgery, which were disconnected and reconnected 3–5 times during the prosthetic phase (control group). Peri-implant marginal bone levels (MBL) were measured through periapical X-rays images acquired immediately after the surgery (baseline), at 4–7 months immediately after prosthetic delivery, and at 1-year and 3-year follow-up visits. Results: No implant was lost or presented bone loss of more than 1.9 mm during the 3-year follow-up; thus, the survival and success rate was 100%. Peri-implant mucositis was noticed in 38.1% DEFs and 41.9% of HEAs at the 3-year follow-up assessment. At the end of 3 years, the MBL was −0.35 ± 0.69 mm for participants in the DEFs group and −0.57 ± 0.80 mm for the HEAs group, with significant statistical difference between groups. Conclusions: Immediate connection of the multiunit abutments reduced bone loss in comparison with 3–5 disconnections noted in the healing abutments 3 years after prosthetic delivery. However, the difference between the groups was minimal; thus, the clinical relevance of those results is doubtful. Full article

To examine the association between self-perceived pain (SPP), clinical and radiographic peri-implant parameters, and biomarker levels among smokers and never smokers with and without peri-implantitis. Sixty individuals (20 smokers with peri-implantitis [group-1], 20 never smokers with peri-implantitis [group-2] and 20 never smokers without peri-implantitis [control-group]) were included. SPP was evaluated using a numeric pain rating scale (NPRS). Peri-implant plaque index (PI), probing depth (PD), and bleeding on probing (BOP) were recorded. After obtaining the samples, the levels of TNF-α, MMP-1, and IL-8 were measured. The mean SPP score in group-1, group-2, and the control group was 1.3 ± 1, 3.4 ± 1, and zero, respectively. The peri-implant mean PD (p < 0.05), BOP (p < 0.05), PI (p < 0.05), and crestal bone loss (CBL) (p < 0.05) were significantly higher among test groups than the control group. The levels of TNF-α, MMP-1, and IL-8 were significantly raised among group-1 and group-2 than the control group. A significant correlation between increasing SPP and PICF TNF-α, MMP-1, and IL-8 levels was observed based on regression analysis. Proinflammatory biomarkers were higher in smokers with peri-implantitis than never smokers with and without peri-implantitis, with a significant association between the proinflammatory cytokines and SPP. Full article

Implant design factors and the abutment connection are correlated with crestal bone stability. The aim of the present study was to evaluate a new type of screw-retained prostheses delivered on tissue-level implants with conical external vertical seal and internal hexagon connection. Implants 4.25 mm in diameter and 10 mm in length (Prama, Sweden and Martina) were placed in partially edentulous patients needing at least one implant in the healed site, having sufficient bone volume. The implant neck was positioned above the bone crest. A healing abutment was placed according to a one-stage approach. Outcome measures were implant and prosthesis survival rate, any complications, marginal bone loss (MBL), periodontal parameters, and pink esthetic score (PES). Overall, 13 patients (4 women and 9 men; mean age 50 ± 22 years) with the same number of implants were treated and followed for one year after loading. At the 12-month follow up, no implant and no prosthesis failed, and no complications were experienced. The mean MBL experienced at the one year follow-up was 0.65 ± 0.48 mm. One year after loading, 2 out of 13 implants present bleeding on probing (15.4%), 4 out of 13 patients presented with plaque at the one year of follow-up (30.8%) and the PES was 10.5 ± 2.3 mm. Within the limitations of the present study, the analyzed implants seem to be a viable treatment option for the rehabilitation of a single tooth gap. Full article

Background: Early peri-implant bone loss has been associated to long-term implant-prosthetic failure. Different technical, surgical, and prosthetic techniques have been introduced to enhance the clinical outcome of dental implants in terms of crestal bone preservation. The aim of the present cohort study was to observe the mean marginal bone level around two-part implants with gingivally tapered abutments one year after loading. Methods: Mean marginal bone levels and change were computed following radiological calibration and linear measurement on standardized radiographs. Results: Twenty patients who met the inclusion criterion of having at least one implant with the tapered prosthetic connection were included in the study. The cumulative implant success rate was 100%, the average bone loss was −0.18 ± 0.72 mm, with the final bone level sitting above the implant platform most of the time (+1.16 ± 0.91 mm). Conclusion: The results of this cohort study suggested that implants with tapered abutments perform successfully one year after loading and that they are associated with excellent marginal bone preservation, thus suggesting that implant-connection macro-geometry might have a crucial role in dictating peri-implant bone levels. Full article