Clinical and radiographic assessment of circular versus triangular cross-section neck Implants in the posterior maxilla: A 1-year randomized controlled trial.

OBJECTIVES: Implants with a triangular neck were recently introduced to limit peri-implant bone loss. The primary objective of this randomized controlled trial was to compare peri-implant bone changes of circular versus triangular cross-section neck implants 1 year after loading. The secondary objectives were to assess buccal hard tissue thickness changes, Pink Esthetic Score (PES), and patient satisfaction. MATERIAL AND METHODS: Thirty four patients requiring replacement of the single, intercalated missing tooth of healed site for at least 4 months in the posterior maxilla were randomized into 2 groups according to the type of implant. Immediately after surgery and 1 year after final restoration, a cone beam CT (CBCT) was performed to assess proximal bone remodeling and buccal bone thickness. Peri-implant soft tissue health, PES, and patient-reported outcome measures (PROMs) were recorded. RESULTS: No implant loss occurred within the follow-up period. The mean ± SD peri-implant proximal bone loss 1 year after loading was 0.22 ± 0.30 mm for triangular and 0.42 ± 0.67 mm for circular implants necks (p = .25). Peri-implant bone loss exceeding 2 mm was observed in a single implant in the circular neck group. Buccal bone thickness remained stable and did not differ different between the 2 groups. The peri-implant soft tissue health, PES, and patient satisfaction were also comparable. CONCLUSIONS: Within the limitations of the present study, patient clinical and radiographic outcomes did not differ between triangular and circular cross-section neck implants in the posterior maxilla.

Patient Eligibility for Standardized Treatment of the Edentulous Mandible: A Retrospective CBCT-Based Assessment of Mandibular Morphology.

The aim of the study was to evaluate the proportion of patients recommended for full-arch mandibular restoration that would be eligible for treatment with a recently developed premanufactured full-arch prosthesis (Trefoil™, Nobel Biocare) based on the morphology of their lower jaw. Anonymized cone beam computed tomography (CBCT) data from 100 partially and fully edentulous patients referred for full-arch mandibular restoration were retrospectively collected from an imaging center database. Using custom-built software, CBCTs of mandibles were registered to a reference CBCT of a patient treated previously with a premanufactured full-arch prosthesis to determine if patients had adequate horizontal width and vertical height for implant placement. Bone height and thickness around simulated implants and distances to the incisive canal were evaluated. Mandibular arch width and semi-automated volume calculations were also performed. Using the system-specific 5.0 mm diameter implants with lengths of 13 and 11.5 mm, 85% and 86% of patients, respectively, were eligible for treatment with the standardized prosthesis. Eligibility was higher for men than women (odds ratio = 3.9, p = 0.045) due to increased bone volume. Based on mandibular morphology, our results suggest that the standardized treatment concept could serve a large percentage of patients with edentulous mandibles or failing dentition in the mandible.

GoPerio - impact of a personalized video and an automated two-way text-messaging system in oral hygiene motivation: study protocol for a randomized controlled trial.

BACKGROUND: Oral hygiene is of paramount importance for the preservation of oral health, and for patients affected by periodontal disease establishing an effective oral hygiene routine is the first step of therapy. Several clinical frameworks have been developed to foster behavior change, such as motivational interviewing. However, two obstacles can be identified. First, patients tend to forget the advice they were given during the consultation. Second, it is hard to maintain motivation in the long term, thus leading to relapse. An innovative eHealth solution was designed with the aim to tackle both obstacles and supplement the current clinical standard of care. The primary objective is to compare the full mouth plaque scores of study groups (eHealth plus standard of care versus standard of care only) at 8 weeks of follow up. The main secondary objective is to compare the full mouth bleeding score at 8 weeks of follow up. METHODS/DESIGN: The "GoPerio" study is a multicenter, randomized, controlled trial assessing the impact of a novel eHealth concept for oral hygiene motivation (personalized video of oral hygiene routine available for the patient via a cloud server plus interactive text messages) in addition to the current standard of care (motivational interviewing plus tooth scaling and polishing). The minimum sample size required is 86 patients. Participants will be randomized (allocation ratio 1:1): test group (eHealth plus standard of care) versus control group (standard of care only). The primary outcome is oral hygiene as measured by the full mouth (six sites per tooth) plaque control record (PCR) index. The main secondary outcome is gingival inflammation as measured by the full mouth (six sites per tooth) bleeding on probing (BOP) index. Both the primary and the main secondary outcomes are evaluated by blinded and calibrated examiners at 8 weeks of follow up. The other secondary outcomes are patient satisfaction and patient behavior change and motivation. DISCUSSION: The study will investigate the value of an innovative eHealth approach to strengthen patient motivation for oral hygiene. If proven effective, such an approach would supplement the current clinical standard of care, resulting in improved clinical outcomes with negligible impact on productivity in a dental practice. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03109808. Registered on 12 April 2017. SPONSOR: Hospices Civils de Lyon. BP 2251, 3 quai des Célestins, 69,229 Lyon cedex 02. Protocol version: 1.0 as of 21 September 2016.