Implant placement in extraction sockets: a short review of the literature and presentation of a series of three cases.

Successful placement of dental implants in extraction sockets has been reported in the literature. There are numerous practical considerations in relation to immediate implant placement that make the procedure more complex as compared with placement in healed extraction sites. A short review of the literature is presented to understand the scientific principles and controversies related to immediate implants. This is followed by a presentation of 3 completed cases of immediate implants. Some of the important practical considerations in relation to immediate implant placement are also highlighted.

Assessment criteria for compliance with oral hygiene: application of ROC analysis.

PURPOSE: Diabetes is an established risk factor for periodontal disease. Management of periodontal disease is highly dependent upon effective oral hygiene. Assessment of plaque and gingivitis has been commonly used and arbitrarily set in clinical practice to evaluate patients' adherence with oral hygiene recommendations. This study aims to determine an objective cut-off criterion for assessing oral hygiene compliance utilising a combination of plaque and bleeding scores. MATERIALS AND METHODS: 161 patients with diabetes, from a prospective clinical trial, provided the clinical periodontal parameters at baseline to be used to determine the oral hygiene compliance criterion in relation to a composite score of pocket depth, subgingival calculus and supragingival calculus. A sequence of different combinations of plaque and gingival bleeding scores were used. Receiver operator characteristic (ROC) curve assessment, sensitivity, specificity, and predictive values were utilised for the determination of the criterion. RESULTS: The combination of 25% plaque scores and 15% gingival bleeding scores obtained the highest ROC value (using a probability cut-off of 0.5) of 0.868 with sensitivity 98.6%, specificity 75.0%, positive predictive value (PPV) 97.3% and negative predictive value (NPV) 85.7%. According to this criterion, amongst the cohort of subjects examined, 145 (90.1%) were categorised as non-compliant, and only 16 (9.9%) were considered compliant with oral hygiene at baseline. CONCLUSIONS: Based upon the clinical periodontal parameters of subjects from this study, a combination of 25% plaque score and 15% bleeding score appears to be a valid target for determining compliance with oral hygiene in oral health programmes.

Management of retrograde peri-implantitis: a clinical case report.

The term retrograde peri-implantitis has been commonly used to describe lesions in the periapical region of dental implants. There are very few reports on this condition, and the exact etiology and pathogenesis are subject to speculation. Management of retrograde peri-implantitis is even more scarcely discussed in the literature. The current article briefly reviews the literature on this subject and presents a case report of retrograde peri-implantitis. Special emphasis is placed on the management of the condition, and different strategies are critically evaluated. If the fixture is stable despite bone loss in the periapical region, it is suggested that surgical debridement be carried out with the use of a surface antiseptic like chlorhexidine. Also all possible efforts should be made to prevent damage to the implant surface. Bone loss due to this condition may be regenerated on the basis of the principle of guided bone regeneration.