Analyses of clinical and osteoimmunological parameters on keratinized mucosa around dental implants.

INTRODUCTION: This study investigated the effects of keratinized mucosa width (KMW) on peri-implant tissues by evaluating peri-implant clinical and bone resorption parameters. SUBJECTS AND METHODS: Seventy-one dental implants (DIs) were separated based on adequacy/inadequacy of KMW. DIs with inadequacy KMW were grouped as peri-implant plastic surgery (PIPS) (free gingival graft/free periosteal graft groups) and maintenance (M) groups. DIs with adequacy KMW were grouped as the controls. Peri-implant clinical parameters were measured at the baseline and 6th month. Levels of receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) in peri-implant sulcular fluid were determined after clinical measurements using enzyme-linked immunosorbent assay. RESULTS: In baseline, gingival index, bleeding on probing, and plaque index (PI) were lower in controls compared to the PIPS and M groups, and KMW was higher. At 6th month, peri-implant pocket depth and PI were lower in the PIPS groups and controls compared to the M group, and KMW was higher. While RANKL and OPG values and RANKL/OPG ratio at baseline were not significantly different between groups, OPG concentration and RANKL/OPG ratio in the 6th month were higher in the PIPS group compared to the M group (P < 0.05). The RANKL/OPG ratio decreased at 6th month in the PIPS groups and controls (P < 0.05). Positive and negative correlations were observed between peri-implant clinical and osteoimmunological parameters. CONCLUSION: This study demonstrated that adequate KMW and PIPS techniques exhibited positive effects on clinical peri-implant parameters and osteoimmunological mediators.

Immediate implant placement in fresh sockets versus implant placement in healed bone for full-arch fixed prostheses with conventional loading.

This retrospective study assessed the success of immediate and non-immediate implants installed in patients undergoing planned extraction of all remaining teeth and rehabilitation with implant-supported full fixed prostheses. Patients in need of dental implants for full fixed prostheses to replace teeth extracted in the maxilla and mandible were included in this study. Dental implants were installed in the same surgical procedure, immediately at the extraction site, or in healed bone. Implant success, complications, and failures were recorded during follow-up. Forty-one patients with 512 implants were included in the study. Healing progressed uneventfully for 501 installed implants, but nine implants were lost in the non-immediate group and two were lost in the immediate group, during a mean follow-up of 44.9 months. All failures in both groups were observed in the maxilla. The success rate was the same in both groups, at 97.8%. This retrospective analysis showed that with thorough patient evaluation, the extraction of all residual teeth and implant installation in a single surgical procedure is a safe and predictable treatment modality for the successful rehabilitation of the edentulous patient with a fixed prosthesis.

Clinical, pathological and radiological evaluation of disseminated Langerhans' cell histiocytosis in a 30-month-old boy.

Langerhans' cell histiocytosis is a rare disease characterized histologically by the proliferation of Langerhans' cells. Oral involvement is frequent and the disease simulates severe localized periodontitis. In this report, we present a case of disseminated Langerhans' cell histiocytosis in a 30-month-old boy who had a mass covering the entire maxillopalatine region and suffered severe periodontal destruction in the posterior maxilla and mandible. We discuss the radiological, histopathological and immunohistochemical findings.