Comparing Single Tooth Implant Placement With and Without Allogenic Soft Tissue Augmentation. A Randomized Clinical Trial.

OBJECTIVE: To explore the effect of adding an allogenic soft tissue graft at time of single implant placement using a fully digital workflow for single implant placement and restoration without making either analog or digital impressions. MATERIALS AND METHODS: A prospective randomized clinical study was performed enrolling thirtynine participants requiring single tooth implant randomized into (+ graft) group which received an allogenic dermal graft at the time of implant placement (n=19), or (- graft) group (n=20). A fully digital surgical and restorative protocol was implemented. Intraoral scans were taken before implant placement (T0), at time of final crown delivery (T1) and at one-year post placement (T2). Intraoral scans were aligned using Geomagic Control X 2020 software), linear and volumetric changes in buccal tissues were measured at T0, T1 and T2. Implant survival, probing depths, and complications were recorded. Participants were asked to complete an OHIP-14 survey at T0 and T2. Marginal bone levels were measured at T0 and T2 on peri-apical x-rays. RESULTS: 39 participants completed surgery and restoration in incisor, canine, premolar and molar positions. Two early failures were recorded in central incisor positions (95% survival). Crown delivery without complication from the digital workflow (impressionless) was achieved for 36/39 of cases (92%) with implant depth control being implicated as the chief challenge. Thirtyseven participants attended the one-year follow-up visit. Both groups showed gain in buccal tissues thickness without significant differences between the two groups for both linear and volumetric measurements (P>0.05). Soft tissue grafting was associated with minimal added morbidity. The interproximal marginal bone changes recorded were -0.16mm mesial and - 0.12mm distal for the graft group and -0.01mm mesial and -0.11mm distal for the non-graft group (p=0.07 for mesial and 0.83 for distal). OHIP score was significantly reduced at T2 compared to T0 (P=0.003) for the entire cohort. CONCLUSIONS: The augmentation of alveolar mucosa on the buccal aspect of single tooth implants is associated with clinically favorable outcomes. A fully digital workflow has been validated to permit crown delivery on CAD/CAM abutments without implant impressions.

Retrospective Cohort Evaluation of Full-Arch Zirconia Implant-Supported Fixed Prostheses.

Objective: To determine the median event-free survival and relative complication rates of monolithic and minimally layered full-arch zirconia prostheses, as well as to identify risk factors for prosthesis complications. Materials and Methods: In this retrospective cohort study, a total of 129 subjects (173 prostheses) were included in the chart review and 56 subjects (75 prostheses) participated in a clinical follow-up visit. All subjects had either single- or dual-arch monolithic or minimally layered zirconia implant-supported prostheses. Data related to patient, implant, and prosthesis factors were extracted from charts. The subgroup that presented for a clinical visit were asked to complete a satisfaction questionnaire. For this subgroup, the following clinical measures were assessed: routine intraoral examination, number of occluding units, cantilever length on each side of the prosthesis (right and left), prosthesis height, occlusal scheme, and oral hygiene methods. Periapical radiographs were obtained when the last radiographs of the patient were taken more than 12 months prior. Results: The follow-up period ranged from 12 months to 7.1 years (mean: 1.9 years). Observed complications included implant loss, peri-implantitis, mucositis, purulence, sinus tract formation, oroantral communication, implant fracture, titanium base debonding, ceramic chipping, prosthetic screw fracture or loosening, damage to opposing teeth, and clicking sounds. There was an insufficient number of complications to evaluate the effect of covariates on the risk of specific complications, such as titanium base debonding (eight events), ceramic chipping (nine events), and peri-implantitis (eight events). The unadjusted event-free median survival time was 5.8 years. The proportion of all prostheses with at least one complication was 30%. There were no observed prosthesis losses during the follow-up period. Conclusion: Monolithic and minimally layered zirconia full-arch implant-supported prostheses demonstrate an acceptable median event-free survival time. Event-free survival times were increased and the number of complications was reduced in prostheses with five to eight implants and conventional (as opposed to zygomatic) implants. There was a reduced hazard of complications with a regular recall regimen. Patient satisfaction with these prostheses was high.

Defining salivary biomarkers using mass spectrometry-based proteomics: a systematic review.

Recent advancements in mass spectrometric proteomics provide a promising result in utilizing saliva to explore biomarkers for diagnostic purposes. However, the issues of specificity or redundancy of disease-associated salivary biomarkers have not been described. This systematic review was therefore aimed to define and summarize disease-related salivary biomarkers identified by mass spectrometry proteomics. Peer-reviewed articles published through July 2009 within three databases were reviewed. Out of 243 articles, 21 studies were selected in this systematic review with conditions including Sjögren's syndrome, squamous cell carcinoma, dental caries, diabetes, breast cancer, periodontitis, gastric cancer, systemic sclerosis, oral lichen planus, bleeding oral cavity, and graft-versus-host disease. The sample size ranged from 3-41 in both diseased and control subjects, with no consensus on sample collection protocol. One hundred eighty biomarkers were identified in total; 87 upregulated, 63 downregulated, and 30 varying based on disease. Except for Sjögren's syndrome, the majority of studies with the same disease produce inconsistent biomarkers. Larger sample size and standardization of sample collection/treatment protocol may improve future studies.