Effect of Primary Stability and Soft- and Hard-Tissue Thickness on Marginal Bone Loss: A Prospective Pilot Study.

OBJECTIVE: To compare prospectively the effect of different insertion torques (ITs) on marginal bone stability and study the effect of soft-tissue and buccal bone thickness as confounding factors while using a 3-dimensional radiographic evaluation. MATERIALS AND METHODS: Thirty-nine implants were placed in 22 patients. IT, soft-tissue thickness, and buccal bone thickness were recorded at implant placement. Marginal bone loss was evaluated on individualized periapical radiographs and cone-beam computed tomography at 1 year after loading. RESULTS: Three groups of implants emerged based on their IT: group I (<30 Ncm), group II (between 30-45 Ncm), and group III (>45 Ncm). Soft-tissue thickness was ≤2 mm in 10 implants (25.6% thin biotype) and more than 2 mm in 29 implants (74.4% thick biotype). No significant difference in marginal bone loss was found for different IT and different soft-tissue thickness. A significant correlation was found between initial buccal bone thickness (≥2 mm or <2 mm) and marginal bone loss at 1 year. CONCLUSIONS: IT and mucosal tissue thickness did not influence marginal bone loss. Buccal bone thickness of ≥2 mm was associated with a minimal marginal bone remodeling.

Resonance frequency analysis, insertion torque, and bone to implant contact of 4 implant surfaces: comparison and correlation study in sheep.

INTRODUCTION: Primary stability is evaluated using resonance frequency analysis (RFA) and insertion torque (IT). Although there is a strong correlation between RFA and IT, studies failed to find a correlation between RFA and bone to implant contact (BIC) or IT and BIC. OBJECTIVE: To compare RFA, IT, and BIC of SLA, SLActive, Euroteknika, and TiUnite implant surfaces and evaluate the correlation between them. MATERIALS AND METHODS: Thirty-two implants were placed in 8 sheep. RFA and IT were recorded. Animals were killed at 1 and 2 months. RESULTS: A significant difference was found in RFA between the 4 surfaces. No significant difference was found for IT. Mean BIC was different between all 4 surfaces. A significant positive correlation was found between RFA and IT with SLA. No significant correlation was found between RFA and BIC and between IT and BIC at 1 and 2 months. CONCLUSIONS: Implants with 4 different surfaces have similar IT values but different RFA and BIC. Additionally irrespective of the implant surface, there is no correlation between IT and BIC and between RFA and BIC.

A Multidisciplinary Approach for the Management of Iatrogenic Severe Periodontitis Following Orthodontic Treatment with a 12-Year Follow-up.

Orthodontic treatment aims to realign teeth in a functional and esthetic manner. When applied on an unhealthy periodontium, this may lead to advanced periodontal tissue breakdown. The present 12-year follow-up report describes the multidisciplinary management of a severe, iatrogenic, generalized periodontitis case that was caused/aggravated by orthodontic therapy on unhealthy periodontal tissues. Prompt therapy was applied through nonsurgical and surgical approaches, including soft and hard tissue grafting procedures combined with corrective orthodontic treatment on healthy tissues. This report is a clear demonstration that early disease detection and proper diagnosis combined with appropriate therapeutic approaches concomitant with strict supportive periodontal therapy could lead to long-term successful and maintainable outcomes, even in hopeless cases.

Marginal Bone Level and Bone Thickness Reduction in Delayed and Immediate Implant Placement Protocol 6 Months Post-loading: An Observational Clinical Prospective Study.

Objectives: The aim of this prospective study was to assess marginal bone level (MBL), buccal and palatal bone thickness reduction (BTR) around implants in delayed and immediate placement protocols, 6 months after loading. Materials and Methods: Twenty-four patients were assigned to two treatment groups, and treated with an immediate (Test) or delayed implant placement (Control). Baseline and 6 months post-loading periapical and Cone Beam Computed Tomography radiographs were used to measure mesial, distal, buccal, and palatal MBL change, and buccal and palatal BTR. Results: There was no statistically significant difference between groups, in MBL change, mesially (p = 0.4220), distally (p = 0.774), buccally (p = 0.221), and palatally (p = 0.195). There was more MBL change on the buccal side than on the palatal side in both groups, control (p = 0.012) and test (p = 0.005). Buccal bone thickness decreased significantly in both groups, and at all four levels (p < 0.05). Buccal BTR was higher in test implants at 0, 2, and 4 mm (p = 0.005, p = 0.0018, p = 0.006) on the buccal side, and at 0 mm (p = 0.006) on the palatal side. Implant stability increased in both groups (p < 0.001). A positive correlation was found between insertion torque and stability in the control group (p = 0.024). Conclusions: Within the study limitations, MBL changes occur around implants and are comparable between groups. More buccal than palatal MBL change occurs in both groups. Buccal BTR is higher in immediate cases. Implant stability augmented in both groups. Clinical Relevance: This data call for additive therapy to compensate for the expected bone loss, particularly in esthetically demanding cases. Trial Registration: ClinicalTrials.gov Identifier: NCT04346706 Registered 14 April 2020 - Retrospectively registered, http://www.clinicalTrials.gov.

Bone Lid Technique Using a Piezoelectric Device for the Treatment of a Mandibular Bony Lesion.

Different techniques for the enucleation of jaw cyst lesion in the oral and maxillofacial regions have been proposed, including the bone lid technique. The purpose of this case report is to describe the case of a cystic lesion, approached with the bone lid technique performed using a piezoelectric device, with an 8-month clinical and radiographic follow-up. A 14-year-old male patient was treated for a suspicious lesion detected on a panoramic radiograph. The concerned area was surgically accessed, and a radiographically predetermined bony window was drawn, and the beveled bony lid was removed. The underlying lesion was enucleated and sent for pathology as a routine procedure, and the removed bony lid was repositioned in situ and secured with a collagen tape. Healing was uneventful with limited swelling and reduced pain. A complete radiographic bone healing at the previously diseased site was confirmed with an 8-month cone beam computed tomography (CBCT) scan with no buccal bone resorption nor ridge collapse. The bone lid technique with a piezoelectric device was noninvasive and atraumatic in this case. Further studies are needed and could lead to the adaptation of this approach as a possible standard of care.

Physicochemical characteristics of bone substitutes used in oral surgery in comparison to autogenous bone.

Bone substitutes used in oral surgery include allografts, xenografts, and synthetic materials that are frequently used to compensate bone loss or to reinforce repaired bone, but little is currently known about their physicochemical characteristics. The aim of this study was to evaluate a number of physical and chemical properties in a variety of granulated mineral-based biomaterials used in dentistry and to compare them with those of autogenous bone. Autogenous bone and eight commercial biomaterials of human, bovine, and synthetic origins were studied by high-resolution X-ray diffraction, atomic absorption spectrometry, and laser diffraction to determine their chemical composition, calcium release concentration, crystallinity, and granulation size. The highest calcium release concentration was 24. 94 mg/g for Puros and the lowest one was 2.83 mg/g for Ingenios ß-TCP compared to 20.15 mg/g for natural bone. The range of particles sizes, in terms of median size D50, varied between 1.32 µm for BioOss and 902.41 µm for OsteoSponge, compared to 282.1 µm for natural bone. All samples displayed a similar hexagonal shape as bone, except Ingenios ß-TCP, Macrobone, and OsteoSponge, which showed rhomboid and triclinic shapes, respectively. Commercial bone substitutes significantly differ in terms of calcium concentration, particle size, and crystallinity, which may affect their in vivo performance.