Incidence of Palatal Fistula at Time of Secondary Alveolar Cleft Reconstruction.

OBJECTIVE: We aim to establish consistent time points for evaluating palatal fistula incidence to standardize reporting practices and clarify prospective literature. DESIGN: An institutional retrospective chart review was conducted on 76 patients with unilateral or bilateral complete cleft lip and palate who underwent secondary alveolar bone grafting between 2006 and 2015. MAIN OUTCOME MEASURES: Early fistula incidence rates were reported prior to maxillary expansion, and late fistula rates were reported at the time of alveolar bone grafting. Fistula recurrence rates after primary repair were also measured. RESULTS: We found an early fistula incidence rate of 20% (n = 15) and a late fistula rate of 55% (n = 42) at the time of secondary ABG. Fistulae recurred after initial repair in 43% of cases. Fistulae were classified using the Pittsburgh Classification System as type III (33%), type IV (60%), or type V (7%). The presence of a bilateral cleft ( P = 0.01) and history of early fistula repair ( P < 0.01) were associated with late fistula incidence in a univariate analysis. In a logistic regression model, only early fistula repair was associated with late fistula incidence (OR = 17.17) and overall likelihood of recurrence (OR = 70.89). CONCLUSIONS: Early fistulae should be reported prior to orthodontic expansion of the maxillary arch. Late fistulae should be reported at the time of ABG, following palatal expansion. Patients who develop an early fistula after palatoplasty are likely to experience recurrent fistula formation.

Disease Stage and Mode of Therapy Are Important Determinants of Treatment Outcomes for Medication-Related Osteonecrosis of the Jaw.

PURPOSE: The treatment of patients with medication-related osteonecrosis of the jaw (MRONJ) is challenging. The purpose of the present study was to estimate the frequency and identify the factors associated with clinical improvement during treatment. PATIENTS AND METHODS: We designed and implemented a retrospective cohort study and enrolled a sample of subjects diagnosed with MRONJ between 2004 and 2015. The primary predictor variables were a set of heterogeneous variables grouped into the following categories: demographic (age and gender) and clinical (location of necrosis, therapy duration, medication type, disease stage, and treatment type). The primary outcome variable was the treatment outcome, defined as stable or worse and improved or healed. The descriptive, bivariate, and multiple logistic statistics were computed, and statistical significance was defined as P < .05. RESULTS: The sample included 337 subjects with a mean age of 68.9 years. Of the 337 subjects, 256 were women (76%). A total of 143 patients (42.2%) experienced spontaneous necrosis. Twenty-four (7.1%) had had exposure to targeted antiangiogenic agents. Those with stage 1 or 2 disease were more likely to have better outcomes than those with stage 3 disease (stage 1, adjusted odds ratio [OR] 3.4, P = .005; stage 2, adjusted OR 2.2, P = .03). Treatment type was a significant variable. Subjects undergoing surgery were 28 times more likely to have a positive outcome than those receiving nonoperative therapy (adjusted OR 28.7, P < .0001). CONCLUSIONS: Subjects with MRONJ who presented with less severe disease or who underwent operative treatment were most likely to have improvement or complete healing of their MRONJ-related lesions.

Periodontal regeneration - furcation defects: a systematic review from the AAP Regeneration Workshop.

BACKGROUND: The aim of this review is to present the available evidence regarding the effectiveness of different regenerative approaches for the treatment of furcation defects in specific clinical scenarios compared with conventional surgical therapy to provide clinical guidelines for the therapeutic management of furcation defects and to identify priorities for future research that may advance the understanding of periodontal regenerative medicine. METHODS: A comprehensive search based on predetermined eligibility criteria was conducted to identify human original studies and systematic reviews on the topic of periodontal regeneration of furcation defects. Two reviewers independently screened the title and abstract of the entries yielded from the initial search. Subsequently, both reviewers read the full-text version of potentially eligible studies, made a final article selection, and extracted the data of the selected studies considering specific clinical scenarios. The clinical scenarios contemplated in this review included the following: 1) facial and interproximal Class I defects in maxillary molars; 2) facial and lingual Class I defects in mandibular molars; 3) facial and interproximal Class II furcation defects in maxillary molars; 4) facial and lingual Class II furcation defects in mandibular molars; 5) Class III furcation defects in maxillary molars; 6) Class III furcation defects in mandibular molars; and 7) Class I, II, or III furcation defects in maxillary premolars. Endpoints of interest included different clinical, radiographic, microbiologic, histologic, and patient-reported outcomes. RESULTS: The initial search yielded a total of 1,500 entries. The final selection consisted of 150 articles, of which six were systematic reviews, 109 were clinical trials, 27 were case series, and eight were case reports. A summary of the main findings of previously published systematic reviews and the available evidence relative to the indication of regenerative approaches for the treatment of furcation defects compared with conventional surgical therapy are presented. Given the marked methodologic heterogeneity and the wide variety of materials and techniques applied in the selected clinical trials, the conduction of a meta-analysis was not viable. CONCLUSIONS: On the basis of the reviewed evidence, the following conclusions can be drawn. 1) Periodontal regeneration has been demonstrated histologically and clinically for the treatment of maxillary facial or interproximal and mandibular facial or lingual Class II furcation defects. 2) Although periodontal regeneration has been demonstrated histologically for the treatment of mandibular Class III defects, the evidence is limited to one case report. 3) Evidence supporting regenerative therapy in maxillary Class III furcation defects in maxillary molars is limited to clinical case reports. 4) In Class I furcation defects, regenerative therapy may be beneficial in certain clinical scenarios, although most Class I furcation defects may be successfully treated with non-regenerative therapy. 5) Future research efforts should be primarily directed toward the conduction of clinical trials to test novel regenerative approaches that place emphasis primarily on patient-reported outcomes and also on histologic demonstration of periodontal regeneration. Investigators should also focus on understanding the influence that local, systemic, and technical factors may have on the outcomes of regenerative therapy in furcation defects.

Periodontal regeneration - furcation defects: a consensus report from the AAP Regeneration Workshop.

BACKGROUND: Treatment of furcation defects is a core component of periodontal therapy. The goal of this consensus report is to critically appraise the evidence and to subsequently present interpretive conclusions regarding the effectiveness of regenerative therapy for the treatment of furcation defects and recommendations for future research in this area. METHODS: A systematic review was conducted before the consensus meeting. This review aims to evaluate and present the available evidence regarding the effectiveness of different regenerative approaches for the treatment of furcation defects in specific clinical scenarios compared with conventional surgical therapy. During the meeting, the outcomes of the systematic review, as well as other pertinent sources of evidence, were discussed by a committee of nine members. The consensus group members submitted additional material for consideration by the group in advance and at the time of the meeting. The group agreed on a comprehensive summary of the evidence and also formulated recommendations for the treatment of furcation defects via regenerative therapies and the conduction of future studies. RESULTS: Histologic proof of periodontal regeneration after the application of a combined regenerative therapy for the treatment of maxillary facial, mesial, distal, and mandibular facial or lingual Class II furcation defects has been demonstrated in several studies. Evidence of histologic periodontal regeneration in mandibular Class III defects is limited to one case report. Favorable outcomes after regenerative therapy for maxillary Class III furcation defects are limited to clinical case reports. In Class I furcation defects, regenerative therapy may be beneficial in certain clinical scenarios, although generally Class I furcation defects may be treated predictably with non-regenerative therapies. There is a paucity of data regarding quantifiable patient-reported outcomes after surgical treatment of furcation defects. CONCLUSIONS: Based on the available evidence, it was concluded that regenerative therapy is a viable option to achieve predictable outcomes for the treatment of furcation defects in certain clinical scenarios. Future research should test the efficacy of novel regenerative approaches that have the potential to enhance the effectiveness of therapy in clinical scenarios associated historically with less predictable outcomes. Additionally, future studies should place emphasis on histologic demonstration of periodontal regeneration in humans and also include validated patient-reported outcomes. CLINICAL RECOMMENDATIONS: Based on the prevailing evidence, the following clinical recommendations could be offered. 1) Periodontal regeneration has been established as a viable therapeutic option for the treatment of various furcation defects, among which Class II defects represent a highly predictable scenario. Hence, regenerative periodontal therapy should be considered before resective therapy or extraction; 2) The application of a combined therapeutic approach (i.e., barrier, bone replacement graft with or without biologics) appears to offer an advantage over monotherapeutic algorithms; 3) To achieve predictable regenerative outcomes in the treatment of furcation defects, adverse systemic and local factors should be evaluated and controlled when possible; 4) Stringent postoperative care and subsequent supportive periodontal therapy are essential to achieve sustainable long-term regenerative outcomes.

Leucocyte-rich and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study.

Our aim was to assess the feasibility of using leucocyte-rich and platelet-rich fibrin (L-PRF) for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a single group study. After treatment with L-PRF, the response of each patient was recorded 1 month and 4 months postoperatively. Further assessments were made of the site, stage, concentration of c-terminal crosslinked telopepide of type 1 collagen, and actinomycosis. Among the total of 34 patients, 26 (77%) showed complete resolution, 6 (18%) had delayed resolution, and 2 (6%) showed no resolution. There was a significant association between the response to treatment and the stage of BRONJ (p=0.002) but no other significant associations were detected. This study has shown that it is feasible to use L-PRF for the treatment of BRONJ, but the effectiveness cannot be judged with this study design. Randomised prospective trials are needed to confirm this.

Staging of osteonecrosis of the jaw requires computed tomography for accurate definition of the extent of bony disease.

Management of osteonecrosis of the jaw associated with antiresorptive agents is challenging, and outcomes are unpredictable. The severity of disease is the main guide to management, and can help to predict prognosis. Most available staging systems for osteonecrosis, including the widely-used American Association of Oral and Maxillofacial Surgeons (AAOMS) system, classify severity on the basis of clinical and radiographic findings. However, clinical inspection and radiography are limited in their ability to identify the extent of necrotic bone disease compared with computed tomography (CT). We have organised a large multicentre retrospective study (known as MISSION) to investigate the agreement between the AAOMS staging system and the extent of osteonecrosis of the jaw (focal compared with diffuse involvement of bone) as detected on CT. We studied 799 patients with detailed clinical phenotyping who had CT images taken. Features of diffuse bone disease were identified on CT within all AAOMS stages (20%, 8%, 48%, and 24% of patients in stages 0, 1, 2, and 3, respectively). Of the patients classified as stage 0, 110/192 (57%) had diffuse disease on CT, and about 1 in 3 with CT evidence of diffuse bone disease was misclassified by the AAOMS system as having stages 0 and 1 osteonecrosis. In addition, more than a third of patients with AAOMS stage 2 (142/405, 35%) had focal bone disease on CT. We conclude that the AAOMS staging system does not correctly identify the extent of bony disease in patients with osteonecrosis of the jaw.

Giant cell lesions of the jaws: does the level of vascularity and angiogenesis correlate with behavior?

PURPOSE: To compare vascularity and angiogenic activity in aggressive and nonaggressive giant cell lesions (GCLs) of the jaws. MATERIALS AND METHODS: This is a retrospective study of 14 GCLs treated at the University of California, San Francisco. Immunohistochemistry was used to determine of the expression of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), CD34, and CD31. VEGF and bFGF expression in giant cells (GCs) and surrounding mononuclear stroma was classified into 1) high immunoreactivity (>50% staining) and 2) low immunoreactivity (<50% staining). CD31- and CD34-stained vessels were counted at 200× magnification. Clinical and radiographic records were reviewed to classify lesions as aggressive or nonaggressive. RESULTS: Of the lesions, 8 were aggressive and 6 were nonaggressive. High VEGF expression was found within the GCs in 4 of 8 aggressive lesions compared with 1 of 6 nonaggressive lesions. The stroma in both groups had low staining. High staining of the GCs for bFGF was found in 6 of 8 aggressive lesions compared with 3 of 6 nonaggressive lesions. The stroma of all aggressive cases showed high expression of bFGF compared with 3 of 6 nonaggressive cases. The aggressive group had a mean of 20.1 ± 5.4 vessels/high-powered field (hpf) stained for CD31 compared with 11.5 ± 5.6 vessels/hpf in the nonaggressive group. The aggressive group had 24.6 ± 7.0 vessels/hpf stained with CD34 compared with 18.5 ± 4.0 vessels/hpf in the nonaggressive group. CONCLUSIONS: The vascularity and level of angiogenesis within aggressive GCLs are higher than those in nonaggressive lesions.

Displasia fibrosa monostótica del adulto en maxilar superior: presentación de un caso clínico / Monostotic fibrous dysplasia of the adult in the upper jaw: report of a clinical case

La displasia fibrosa es una patología poco frecuente, benigna, que afecta al tejido óseo. Puede tomar un solo hueso (monostótica) o tomar varios huesos (poliostótica). Se llega al diagnóstico definitivo tras el estudio histopatológico. Se presenta un caso clínico y se realiza la revision bibliográfica correspondiente.

Dental implants placed in grafted maxillary sinuses: a retrospective analysis of clinical outcome according to the initial clinical situation and a proposal of defect classification.

OBJECTIVE OF THE STUDY: To present a classification of maxillary defects necessitating sinus floor elevation procedures (SFEPs) with two objectives: (a) to propose a standardization of surgical procedures according to initial type of atrophy and (b) to allow the evaluation of the success/survival rates of implants placed in the grafted areas according to the initial situation. MATERIALS AND METHODS: Nine-hundred and fifty-two consecutive SFEP were performed on 692 patients. Initial defects were classified according to a new classification, which considered not only residual bone height below the sinus but also the width of the alveolar crest and horizontal/vertical intermaxillary relationship. Results were evaluated according to the different classes. The sinuses were grafted with autogenous bone taken from intra-oral or extra-oral sites: 579 SFEP were associated with vertical and/or horizontal onlay grafts to correct concomitant alveolar ridge deficits. A total of 2037 implants were inserted into the grafted sinuses either immediately or 4-6 months later. Three to 6 months afterwards, implants were loaded. The mean follow-up was 59 months (range: 12-144 months). RESULTS: The success rate of the reconstructive procedures varied between 93.2% and 100%, according to class of atrophy; the overall survival and success rates of implants were 95.8% and 92.5%, respectively, whereas the survival and success rates according to class of atrophy varied between 90% and 97.6%, and between 85.4% and 95.5%, respectively. Lower success rates were found in classes presenting with more severe atrophy. CONCLUSION: The results obtained demonstrated that sinus floor elevation, alone or in association with reconstructive procedures with autogenous bone grafts, is a reliable procedure to allow implant placement in atrophic edentulous maxillae, irrespective of the initial clinical situation. However, it must be underlined that the success rates of reconstructive procedures and implants differ according to class of atrophy, showing lower success rates in classes presenting with more severe atrophy.

How to name it: a rare case of odontogenic cyst.

Odontogenic cysts and tumors are well-recognized entities to the specialist oral pathologist and they seldom pose problems in differential diagnosis. This paper deals with an aggressive cystic lesion in the maxilla of a 65-year-old male that was characterized by a large radiographically multilocular lesion and a multicystic pattern microscopically. The categorization of this lesion was complicated by the presence of features suggestive of both glandular odontogenic cyst and cystic ameloblastoma with aggressive histologic phenotypes.

Implant treatment without bone grafting in edentulous severely resorbed maxillas: a long-term follow-up study.

PURPOSE: To evaluate retrospectively the surgical outcome of tilted implants in severely resorbed edentulous maxillas as an alternative to bone grafting and the prosthodontic outcome of posterior extension bridges on tilted implants. PATIENTS AND METHODS: A total of 33 consecutive patients with severely resorbed edentulous maxillas participated in the study. In these patients, the maxillary bone volumes were insufficient for conventional placement of implants to support a fixed prosthesis. As an alternative to bone transplantation, a surgical technique with fenestration of the maxillary sinus to visualize the total amount of maxillary bone was used, followed by implant placement in a tilted manner along the anterior maxillary sinus wall. Thus, 4 to 6 implants of optimal length could be installed in each patient. Nineteen patients were included in this long-term follow-up study and were eligible for clinical evaluation at 8 to 12 years (mean, 10 years) after second-stage surgery. Each patient was examined clinically and radiographically. RESULTS: The 19 patients had a total of 103 implants. In 2 of these patients, 3 fixtures were lost during the first year after second-stage surgery. All other patients had all implants intact with functionally fixed dental prostheses, corresponding to a success rate of 97%. Radiographic examination showed bone resorption in 10% of the implants (10 implants in 5 patients with a total number of 27 implants), with a mean bone loss of 1.2 mm. Mucositis was seen in 47% of the patients. CONCLUSIONS: This long-term follow-up study (mean time, 10 years) demonstrates that patients with a severely resorbed maxilla can be treated successfully with conventional implant treatment. This simplified surgical technique can be an alternative to the more resource-demanding technique with bone grafting.

Odontogenic cysts: analysis of 2,944 cases in Chile.

INTRODUCTION: Odontogenic cysts constitute a group of frequent intraosseous lesions characteristic in the maxillary bones and one of the main causes of the destruction of these bones. In Chile there are no retrospective studies of these lesions as a whole. OBJECTIVE: The purpose of this study is to determine the frequency of these lesions in so far as they were diagnosed and registered in the Referral Institute for Oral Pathology (IREPO) of the University of Chile in two age groups as well as to analyze and to compare the data obtained with the data published in previous studies. MATERIAL AND METHOD: We studied the records from IREPO of the University of Chile for the period between 1976 and September, 2004; and we determined the frequency according to age, gender and site of each of these lesions. We compare two age groups: younger than or equal to 15 years old and older than 15 years old. Those cases in which the information did not suffice for the purposes of analysis were not considered. All the histological slides were reclassiffed according to the diagnostic criteria included in the Histological Typification of the World Health Organization. RESULTS: We found 2.944 odontogenic cysts (OC), of which 1.935 (65.7%) were inflammatory cysts and 1.009 were developmental cysts. Out of this total, there were 1.554 cysts (52.8%) in men and 1.390 (47.2%) in women. The most frequent cysts were 1.494 radicular cysts (50.7%), 546 dentigerous cysts (18.5%), 421 keratocysts (14.3%) and 328 residual cysts (11.1%). These four varieties represent 94.7% of the OC , that is, 2789 cases. In the population younger than or equal to 15 years of age the developmental cysts (354 cases) are more frequent than the inflammatory cysts (155 cases), the most frequent being dentigerous cysts (240 cases).

Granuloma gigantocelular central del maxilar inferior: Presentación de un caso pediátrico / Giant cell granuloma of the lower jaw: Description of a pediatric case

El granuloma gigantocelular central (GGCC), es una lesión tumoral o seudotumoral, infrecuente de los huesos de la cabeza y cuello, que afecta más frecuentemente los maxilares. Su etiología y patogenia son poco conocidas, sus características histológicas son benignas y su comportamiento biológico puede ser agresivo localmente. Presentamos el caso de un niño de 6 años con esta afección y realizamos una revisión de la entidad y sus diagnósticos diferenciales con otras lesiones de los maxilares.

Giant Cell Granuloma (GCG) is an uncommon condition affecting the bones of the head and neck. The ethiology and pathophysiology are not completely understood. The histlogic characteristics of GCG are benign, but its biologic behavior could locally aggressive. We describe the case of a 6 year-old boy with GCG and performed a review of the entity ant their differential diagnosis with other lesions of the maxillary bones.

Bioactive glass and bioabsorbable membrane in the treatment of a maxillary class II furcation defect: case report with 6-month re-entry.

The combination of bone graft materials with guided tissue regenerative procedures has been shown to have predictable positive results in periodontal defects, especially furcations. The following case report will demonstrate a severe class II furcation defect in a maxillary molar that was treated with combination therapy using bioactive glass and a bioabsorbable membrane made of a copolymer of polylactic/polyglycolic acid. Six-month re-entry revealed substantial clinical fill of the furcation defect. Comparison radiographs also demonstrated fill in the region.

Odontogenic cysts: a clinical study of 90 cases.

The maxillofacial region is affected by a greater number of cysts than any other part of the body. In this study, 90 odontogenic cysts were collected from 90 patients over a five-year period. Patients with radicular cysts, dentigerous cysts and odontogenic keratocysts were further analyzed with regard to age, sex and anatomical distribution. Using the histological classification of the World Health Organization, 53 cases (59%) were classified as radicular cysts, 24 (27%) as keratocysts and 13 (14%) as dentigerous cysts. Radicular cysts occurred most frequently in the anterior region of the maxilla, odontogenic keratocysts in the ramus and angular region of the mandible, and dentigerous cysts in the mandible. No recurrences were observed during the limited follow-up period.

Analysis of bone resorption after secondary alveolar cleft bone grafts before and after canine eruption in connection with orthodontic gap closure or prosthodontic treatment.

PURPOSE: We sought to analyze the success rate of secondary alveolar cleft bone grafts before and after canine eruption in connection with orthodontic gap closure or gap opening. PATIENTS AND METHODS: Sixty-eight secondary alveolar cleft bone grafts with iliac crest spongiosa were carried out in 57 patients (mean age, 9 years; age range, 8 to 11 years) with 11 bilateral and 46 unilateral clefts of the lip, alveolus, or palate. Gap closures were carried out after 53 bone grafts (78%), and gap openings with subsequent dental implants were carried out with 15 bone grafts (22%). The parameters acquired radiologically (orthopantomograms) at the time of the surgery and the follow-up examination (mean age, 3 years; age range, 7 months to 9 years) were 1) bone resorption in relation to the interdental height of the alveolar process in the vicinity of the cleft and 2) root growth of the teeth in the vicinity of the cleft. The statistically significant differences (P <.05) were monitored with a software program. Resorption grades I and II (>50% of the interalveolar bone height) were considered to be a success. RESULTS: Resorption was grade I in 69%, grade II in 19%, grade III in 10%, and grade IV in 1% of cases. Thus, the overall success rate was 88%. At the time of the osteoplasty, the root growth of the tooth in the immediate vicinity of the cleft was fully completed in 27 teeth (39%), three-quarters completed in 23 teeth (26.5%), and semicompleted in 18 teeth (33.8%). Twelve teeth (18%) in the vicinity of the cleft (lateral incisors/canine) remained unerupted and displaced after the surgery. It was necessary to expose unerupted teeth surgically to reposition them orthodontically. The resorption losses were significantly lower with gap closures than with gap openings (P <.001). However, bone grafts performed before canine eruption were largely carried out with the objective of orthodontic gap closure, in contrast to the bone grafts that were carried out after canine eruption (P <.02). CONCLUSION: Gap closures provide more favorable results than do gap openings in regard to resorption. Controlled dental eruptions or orthodontic gap closures reduce the graft resorption. The exact timing of surgery proved to be only a secondary consideration.

Implant site development and alveolar bone resorption patterns.

Resorption of the alveolar ridges after tooth extraction can mandate site development (preparation) by augmentation, grafting, or both before implants can be placed. The fabrication of successful implant prostheses generally can be accomplished only if the artificial teeth are placed in the same position as was occupied by the natural teeth they are replacing. A knowledge of resorption patterns is necessary for satisfactory implant placement.

Outcome of implant therapy in relation to experienced loss of periodontal bone support: a retrospective 5- year study.

PURPOSE: The aim of this retrospective study was to analyse bone level alterations over a 5-year period at implants in the maxillary posterior segments in patients with varying experience of periodontal bone loss in the natural dentition before implant placement. MATERIALS AND METHODS: 97 partially dentate patients with a total of 346 Brånemark oral implants in the maxillary posterior segments were included. By assessing the degree of radiographic marginal bone loss in the remaining natural dentition at time of the implant therapy, an age-related bone loss score (ArB-score) was calculated for description of the patient's experience of periodontal destruction. The two end quartiles of the distribution of the subjects with regard to the ArB-score were defined as Non-Perio subjects and Perio subjects, respectively. The primary outcome variables were implant losses (implant failures) and radiographic peri-implant bone loss over the 5-year observation period. RESULTS: A total of 18 implants were lost during the 5 years, resulting in an overall failure rate of 5.2%. The corresponding failure rate was 3.3% for the Non-Perio and 8.0% for the Perio patients. The peri-implant bone loss from the time of abutment connection to 5 years averaged 1.8 mm (SD 0.7). Of the patients, 34% showed a mean bone loss of > 2 mm and 39% of all implants had experienced a bone loss of 2 mm at the 5-year examination. The Non-Perio and Perio patients showed a mean bone loss of 1.7 mm (0.8) and 2.2 mm (0.8), respectively. Multiple regression analysis revealed a statistically significant relationship between the ArB-score and the peri-implant bone level change from abutment connection to 5 years (P < 0.05). In all, 64% of Perio patients had a mean peri-implant bone loss of > 2 mm from the time of abutment connection, compared to 24% for the Non-Perio patients (P < 0.01). The percentage of implants showing 2 mm of bone loss between abutment connection and 5 years was 62% and 44% in the Perio and Non-Perio groups, respectively (P = 0.055). CONCLUSION: The results indicate that longitudinal bone loss around implants is correlated to previous experience of loss of periodontal bone support and that periodontitis susceptible subjects may show an increased implant failure rate.