Long-Term Esthetic Evaluation of the Roll Flap Technique in the Implant Rehabilitation of Patients with Agenesis of Maxillary Lateral Incisors: 10-Year Follow-Up.

PURPOSE: The use of the roll pedicle flap has been recommended by various authors, but there are no studies evaluating the stability of the augmented soft tissue in the long term. The aim of this retrospective study was to evaluate the stability of peri-implant soft tissue augmented with the roll flap technique in patients with congenitally missing maxillary lateral incisors after 10 years of function. MATERIALS AND METHODS: Patients with congenitally missing maxillary lateral incisors restored with dental implants in the period between 2000 and 2002 were invited for reexamination after 10 years. The esthetic of the peri-implant soft tissue was evaluated with Furhauser's pink esthetic score (PES). RESULTS: The peri-implant soft tissue of 21 implants in 17 patients was evaluated at the 10-year follow-up. No implants were lost within the duration. The PES score was slightly improved from 11.43 ± 1.504 at baseline to 11.70 ± 1.793 at the 10-year follow-up examination without a statistically significant difference (P > .05). CONCLUSION: Within the limitations of this study, the roll flap technique was found to be a sustainable method for the achievement of durable peri-implant esthetics in the anterior maxillary region, especially in terms of variables related to tissue contour and appearance.

Investigation of the Association Between Cement Retention and Prevalent Peri-Implant Diseases: A Cross-Sectional Study.

BACKGROUND: The aim of this study is to examine the association between retention type (cement-retained versus screw-retained restorations) and prevalence of peri-implant diseases in a German university-treated population. METHODS: Data were analyzed from individuals that underwent clinical and radiographic peri-implant examinations as part of a university-based cross-sectional study from September 2011 to October 2012. RESULTS: Data from 139 individuals (mean age: 57.59 years) having 394 implants were analyzed: 192 implants supporting single crowns and 202 fixed partial dentures. Overall, 11.9% of the participants had peri-implantitis, whereas 68.9% had peri-implant mucositis. Crude odds ratios (95% confidence intervals) for peri-implantitis and peri-implant mucositis for cement- versus screw-retained restorations were 1.43 (0.45, 4.60) and 0.89 (0.53, 1.48), respectively. Results remained non-significant in multivariable models adjusting for type of restoration and smoking (all P values >0.50). There was also no effect of splinting restorations on disease prevalence in adjusted analyses (P values >0.32). CONCLUSIONS: In this university-treated sample, there is no association between the type of prosthesis retention and peri-implant diseases. Current findings show that, when appropriate selection and removal of cement is performed, cement retention is not a risk indicator for peri-implant diseases.

Prospective evaluation of zirconia based tooth- and implant-supported fixed dental prostheses: 3-year results.

OBJECTIVES: This prospective clinical study compared the performance of implant-retained (study group) and tooth-retained (control) zirconia based fixed dental prostheses (FDPs) with at least 4 units. The null-hypothesis stated that complication rates in both groups are equally distributed. METHODS: The study included patients in need of one 4- to 6-unit implant- or tooth-retained FDP each. All patients were examined 2 weeks after insertion (baseline) and then at 6 month intervals up to 3 years. At follow-up all restorations were examined for framework fracture, chipping, marginal integrity, surface roughness and biological complications. Kaplan-Meier estimation was used for data analysis. RESULTS: 20 patients received tooth-retained and 7 patients implant-retained FDPs. The study was halted early when differences in chipping rates reached a statistically significant level. One FDP in the study group was lost due to implant abutment failure. FDP related chipping rates were 71% in the study group (mean observation time 32 months) and 15% in the control (mean observation time 34 months). Unit (abutment crown/pontic) related chipping rates were 32% in the study group and 6% in the control. Chipping rates differed statistically significant (log-rank test, p<.05). However, all ceramic defects could be corrected by grinding and polishing. No framework fracture was detected. CONCLUSIONS: Within the study limitations, survival rates seem satisfactorily in both implant- and tooth retained long-span zirconia based FDPs. However, implant-supported FDPs seem more susceptible to veneering ceramic chippings. CLINICAL SIGNIFICANCE: The high chipping rates found in this study discourage the use of long-span implant-retained FDPs with zirconia frameworks. The study was registered in ClinicalTrials.gov with the ID Number NCT02220764.

Cross-sectional study on the prevalence and risk indicators of peri-implant diseases.

PURPOSE: To evaluate the prevalence of peri-implant diseases in a university patient sample and to analyse possible risk variables associated with their occurrence. MATERIALS AND METHODS: One hundred and eighty-six patients with 597 implants were examined clinically and radiographically. The mean period of function was 5.5 years (range 1 to 16.5 years). A subgroup analysis was performed for implants with a minimum function time of 5 years. Outcome measures were implant failures, prevalence and risk indicators of peri-implant diseases. In order to identify statistically significant risk indicators of peri-implant mucositis and peri-implantitis multi-level logistic regression models were constructed. RESULTS: The prevalence of peri-implantitis and peri-implant mucositis on patient levels were 12.9% (13.3% for ≥ 5 years) and 64.5% (64.4% for ≥ 5 years), respectively. Multi-level analysis showed that a high plaque score (OR = 1.365; 95% CI: 1.18 to 1.57, P < 0.001) was a risk indicator for periimplant mucositis, while augmentation of the hard or soft tissue at implant sites had a protective effect (OR = 0.878 95% CI: 0.79 to 0.97, P = 0.01). It was also shown that the odds ratio for having peri-implant mucositis increased with the increase of plaque score in a dose-dependent manner. With respect to peri-implantitis, loss of the last tooth due to periodontitis (OR = 1.063; 95% CI: 1.00 to 1.12, P = 0.03) and location of the implants in the maxilla (OR = 1.052, 95% CI: 1.00 to 1.09, P = 0.02) were identified as statistically significant risk indicators. CONCLUSIONS: Within the limitations of this study, the history of periodontal disease was the most significant risk indicator for peri-implantitis and the level of oral hygiene was significantly associated with peri-implant mucositis.