Management of bisphosphonate-related osteonecrosis of the jaw using teriparatide treatment: A systematic review.

OBJECTIVE: To systematically review the current literature and determine whether the additional TPTD administration for patients with BRONJ is an effective treatment modality. MATERIAL AND METHODS: The systematic review was registered in the PROSPERO (CRD42021242796) and conducted according to the PRISMA statement. An electronic search was performed using MEDLINE (PubMed), ScienceDirect, The Cochrane Library and LILACS databases using a combination of the keywords "Bisphosphonate-Associated Osteonecrosis of the Jaw"[Mesh], "treatment" to identify studies published from 2010. RESULTS: The authors found 8 articles that met the inclusion criteria of this systematic review. According to two studies, TPTD was statistically significantly associated with a greater BRONJ lesion resolution, compared to control group (p<0.05). However, one article showed no significant difference in proportion of resolved lesions (p=0.478). Regarding the effectiveness of TPTD treatment according to administration frequency, daily injection group showed no significant changes in the clinical stage of BRONJ, no difference in the percentage of bone formation on patients osteolysis, compared to weekly injections. Concerning bone resorption/regeneration markers, all the included studies showed that bone resorption markers significantly increased after 3-month TPTD administration. In a study which used multivariate analysis between TPTD and non-TPTD groups using age, BMI, duration of BP usage, the difference in s-OC values after 3 months of the treatment was significant (p<0.05). CONCLUSION: This review provides evidence for the potential benefits of additional TPTD administration for patients with BRONJ being an effective treatment modality.

Surgical treatment methods of medication-related osteonecrosis of the jaw. A systematic review.

OBJECTIVE: Relevance of the problem and the aim: A variety of surgical treatment modalities are analyzed to treat medication-related osteonecrosis of the jaw, using different adjuvant therapies (fluorescence-guided surgery, autologous platelet concentrates) and thus to improve bone and mucosa healing in the postoperative period and reduce the risk of recurrence of osteonecrosis. The purpose of the present systematic review is to compare the effectiveness of different surgical treatments for medication-related osteonecrosis of the jaw (with applications of autologous platelet concentrates, fluorescence guidance, or without adjuvant measures). MATERIALS AND METHODS: The protocol for the systematic review was prepared according to the PRISMA and Cochrane guidelines for systematic reviews. Electronic databases used: PubMed, The Cochrane Library, Science Direct, Wiley Online Library. The review includes articles investigating surgical treatment methods for medication-related osteonecrosis of the jaw. RESULTS: Twelve scientific articles were included in the review. The studies evaluated the efficacy of autologous platelet concentrates, fluorescence-guided surgery, or standard surgical treatment techniques without adjuvant therapies. The efficiency of curettage, sequestrectomy, and the use of autologous platelet concentrates have been found to range from 80% to 96.7%. The efficiency of fluorescence-guided surgery varied from 83.3% to 94.4%. The highest efficiency range of treatment results was determined by evaluating the surgical treatment without adjuvant therapies, which can reach from 22.22% to 93.2%. CONCLUSIONS: The best and most stable results in the surgical treatment of medication-related osteonecrosis of the jaw are achieved by the application of autologous platelet concentrates after surgical removal of necrotic bone or fluorescence-guided surgery.

Does persistent idiopathic facial pain relate to mood (affective) disorders.

OBJECTIVE: Persistent idiopathic facial pain (PIFP) is a condition in the absence of clear pathology. Pathogenesis is still enigmatic, although comorbidity with mood/affective disorders is observed. The aim of this study was to investigate the association between personality traits, mood and sleep disorders, and PIFP; and to compare them with posttraumatic chronic orofacial pain. METHOD AND MATERIALS: A cross-sectional, single-center study was designed to evaluate patients diagnosed with PIFP according to ICOP (International Classification of Orofacial Pain) diagnostic criteria through Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Five Factor Model, and visual analog scale indexes. Data were analyzed and compared with patients suffering from organic pathology - unilateral chronic mandibular fracture pain. RESULTS: A total of 67 respondents enrolled as the experimental group and 28 participants as a control group. Pain scores were higher in the experimental group (P < .001) and had positive correlation with depression (r = .44, P < .001) and sleep index scores (r = .415, P < .001). Personality trait scores did not differ between the groups. However, neuroticism correlated with depression (r = .466, P < .01) and anxiety (r = .634, P < .01) scores in the experimental group. Depression (P = .002) and anxiety scores (P = .007) were higher in the experimental group, as well as sleep indexes (P = .038). Depression (r = .609, P < .001) and anxiety (r = .655, P < .001) scores had positive correlation with sleep index scores. Sleep scores in the experimental group positively correlated with neuroticism score (r = .442, P < .001). PIFP increases the chance of experiencing depression (OR 10.688; 95% CI 1.355-84.309, P = .006) as well as poor quality of sleep (OR 3.389; 95% CI 1.023-11.228, P = .006). CONCLUSIONS: The results suggest that personality traits (neuroticism), anxiety, depression, and sleep disorders are associated with PIFP.

Chronic Odontogenic Rhinosinusitis: Optimization of Surgical Treatment Indications.

BACKGROUND: The treatment of chronic odontogenic and nonodontogenic rhinosinusitis is different. It requires the elimination of odontogenic cause and optimal sinus surgical treatment. To date, there are no clear indications when sinus surgical treatment is necessary. OBJECTIVE: Our aim was to define clear indication(s) for sinus surgical treatment in patients with chronic odontogenic rhinosinusitis after elimination of odontogenic cause. METHODS: A group of 96 patients with chronic odontogenic rhinosinusitis caused by apical periodontitis completed a Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire with incorporated additional symptom "malodor" before treatment. Moreover, they were distributed according to computed tomography (CT) radiological criteria such as degree of periapical pathology, anatomical ratio between maxillary lateral teeth and sinus floor, sinus mucosal thickening, and ostiomeatal complex condition. The elimination of odontogenic cause was performed by extracting causative tooth. Questionnaire was filled again 2 weeks, 3 months, and 6 months after treatment. All data were analyzed to search the clear indications for sinus surgical treatment. RESULTS: Of 96 patients, 74 (77.1%) patients had full resolution of symptoms after dental cause was eliminated. For other 22 (22.9%) patients, symptoms persisted and sinus surgical treatment was indicated. In recovered group, mean SNOT-22 score was different between all periods of measuring, while within nonrecovered group, small differences were seen only when compared to before treatment. No statistically significant correlation between radiological criteria and rhinosinusitis healing after tooth extraction was found (P > .05). Statistically significant correlation was found between the disappearance of malodor/SNOT-22 score reduction after elimination of dental cause and healing success (P < .005). CONCLUSIONS: Our study revealed that extraction of causative tooth is an effective treatment of chronic odontogenic rhinosinusitis caused by apical periodontitis. CT criteria are not valuable indicator for sinus surgery, but persistence of malodor after 2 weeks is the strongest indication for this type of treatment.

Bone regeneration in rabbit calvarial defects using PRGF and adipose-derived stem cells: histomorphometrical analysis.

Aim: The aim of this study was to evaluate the osteogenic potential of adipose-derived stem cells (ADSCs) and to assess the influence of plasma rich in growth factors (PRGF) on bone regeneration using ADSCs. Materials & methods: Bone defects were randomly allocated to the five treatment modalities: spontaneous healing, natural bovine bone mineral (BBM), BBM loaded with PRGF, BBM loaded with ADSCs and BBM loaded with a combination of ADSCs and PRGF. Results: The PRGF significantly enhanced the biomaterial-to-bone contact. Defects treated with ADSCs and PRGF or a combination of both showed the greatest bone regeneration. Conclusion: Combining PRGF and ADSCs boosts the bone graft regenerative potential at the earliest period of healing.

Plasma rich in growth factors injection effectiveness for myofascial pain treatment in masticatory muscles. Randomised controlled trial.

BACKGROUND: Myofascial pain in masticatory muscles is one of the most common temporomandibular disorder. Nowadays, the most usable treatment methods are based on the muscle taut band cell membrane disruption, which releases the taut band. Platelet-rich plasma, made with PRGF Endoret® method, gives an opportunity to use platelet-derived growth factors in treatment processes. It has been proven that platelet-derived growth factors can relief pain and activate muscle regeneration. OBJECTIVE: To test a hypothesis that PRGF injections can be effective for treating myofascial pain in masticatory muscles. METHODS: Fifty adult patients participated in the study. Participants were randomly divided into two groups. The first group received 1-mL lidocaine injections to trigger point in their masseter muscle. The second group of patients received 1-mL PRGF injections. The patients' pain was measured by using visual analogue scale (VAS). RESULT: Statistically significant difference in pain levels before the procedure and 4 weeks after it was found in both groups. There was no statistically significant difference between groups in pain levels before the procedure (P = .063) and 2 weeks after it (P = .123); however, statistically significant difference was noticed 4 weeks after the procedure (P < .001). Four weeks after the procedure, patients' average pain in lidocaine group was 3.4 on VAS, and it was 0.9 in PRGF group. CONCLUSIONS: PRGF injections in masseter muscle affected by myofascial pain syndrome are an effective treatment method. PRGF injections more effectively relief myofascial pain in masseter muscle than lidocaine injections.

Randomized and Controlled Clinical Trial of Bone Healing After Alveolar Ridge Preservation Using Xenografts and Allografts Versus Plasma Rich in Growth Factors.

The aim of this study was to compare bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation. Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the following 4 treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM), and plasma rich in growth factors (PRGF) alone. Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, newly formed nonmineralized tissue, and residual bone-grafting material (if applicable). Statistical analysis was performed to provide descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in the PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4% ± 15.2% vs 75.5% ± 16.3%), control/(BBM/CM) (46.4% ± 15.2% vs 20.3% ± 21.9%), control/(FDBA/CM) (46.4% ± 15.2% vs 7.2% ± 8.6%), PRGF/(BBM/CM) (75.5% ± 16.3% vs 20.3% ± 21.9%), and PRGF/(FDBA/CM) (75.5% ± 16.3% vs 7.2% ± 8.6%) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM > FDBA. Alveolar ridge preservation in the esthetic zone with PRGF was the most effective for bone regeneration of the alveolar ridge.

Clinical and Histologic Evaluations of Porcine-Derived Collagen Matrix Membrane Used for Vertical Soft Tissue Augmentation: A Case Series.

This case series aimed to clinically and histologically evaluate porcine-derived membrane used for vertical thickening of thin soft tissues. Twenty porcine-derived collagen membranes and bone-level implants were placed in 20 patients. After 2 months, thickened soft tissues were measured and biopsy samples were harvested. All xenografts healed successfully. The average thickness of thin soft tissue before vertical thickening was 1.65 ± 0.36 mm, while tissue thickness increased to 3.45 ± 0.52 mm after the procedure (P < .001); the mean thickness increase was 1.8 ± 0.13 mm. Histologic analysis showed complete integration of the graft and no differences (P = .4578) in vascularization between the host (39.74 ± 17.15 vessels/mm2) and graft (30.43 ± 11.26 vessels/mm2). It can be concluded that porcine-derived membrane can be used for vertical soft tissue thickening with substantial gain in tissue height.

Comparison of Sino-Nasal Outcome Test 22 Symptom Scores in Rhinogenic and Odontogenic Sinusitis.

BACKGROUND: Odontogenic maxillary sinusitis (OMS) and rhinogenic sinusitis (RS) are the main types of chronic rhinosinusitis (CRS) and have a significant impact on health-related quality of life (HRQL), but the difference in HRQL and symptom presentation between them has not been specifically evaluated to date. Obejctive: Our aim was to compare patterns of symptoms and HRQL disease-specific domains in patients affected with these 2 types of CRS. METHODS: A group of 201 patients with CRS (99 with rhinogenic and 102 with odontogenic origin) completed the Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire before treatment. Data sets were analyzed by using principal component analysis (PCA) to identify a set of symptom components together with the items excluded from PCA, which were then analyzed for differences between patients with OMS and RS. RESULTS: PCA of SNOT-22 items identified 5 components: "rhinologic," "extranasal rhinologic," "ear/facial," "sleep and functional disturbance," and "emotional disturbance." Sneezing was excluded from PCA and treated as separate outcome variable and was significantly worse in RS patients. Patients with OMS scored significantly higher scores with regard to emotional disturbance, while RS patients scored significantly worse in sleep and functional disturbance. The extra symptom "malodor" was the most different symptom and was significantly worse in OMS patients. The total SNOT-22 score was not significantly different between the groups. CONCLUSION: With controlling of covariates that may influence the severity of the disease, this study showed some significant differences in symptom patterns and HRQL impairment between patients with OMS and RS. Malodor is the most characteristic feature of OMS. Therefore, OMS should always be suspected in patients complaining of bad breath.

Epidemiology of primary oral cancer diagnostics in Kaunas.

INTRODUCTION: Ability for general practitioners and dentists to successfully identify oral cancer (OC) and knowledge about it has a huge influence in further primary diagnosis and good specialized treatment and care. It is very important to realize what obstacles appear in medical care professionals (dentists and general medical practitioners(GPs)) way for primary oral cancer diagnostics. PURPOSE: To find out the insight of primary oral cancer diagnostics in Kaunas city. GOALS: to analise knowledge of society about oral cancer and its primary symptoms; to evaluate and compare the insight of POCD for general medical practitioners and dentists; to appraise the oncological awareness and evaluate the experience in oral oncology for mentioned medical care proffesionals. MATERIALS AND METHODS: Questionnaires were prepared for patients and medical professionals. Permission for investigation was confirmed by LUHS Bioethical centre. Questioning was done in Kaunas city (Lithuania) and its districts. RESULTS: 100 questionnaires were collected from random people, questioned at health care centers and 106 questionnaires were given to medical staff (64 for dentists and 42 for general medical practitioners); 81% of GPs and 75% of dentists claims to have low insight on POCD; 83,3% of GPs and 46.9% of dentists claims that they have not enough learning experience on POCD from graduated university. Although, only 4,8% of GPs and 6,2% of dentists updated their knowledge on POCD after graduation. CONCLUSIONS: Society agrees having a poor knowledge on POCD; GPs and dentists are not educated enough for POCD; GPs pay too little attention for oral cavity examinations and are in shortage collaborating with dentists about POCD.

Quality of life in patients with temporomandibular disorders. A systematic review.

OBJECTIVE: The purpose of this study was to systematically review the literature concerning the quality of life of patients with temporomandibular joint disorder. MATERIAL AND METHODS: Systematic review was performed with the information contained in international databases: PubMed and Google Scholar. Keywords and their combinations were used to find relevant articles and publications concerning the subject. RESULTS: A total of 320 publications were initially retrieved. After further examination 12 articles were selected due to their relevance to inclusion criteria and were included in the systematic review. The selected 12 articles published between year 2006 and 2016. CONCLUSION: In this systematic review it was found that there is a direct correlation between temporomandibular disorders and lower quality of life. Out of questionnaires used for identification of patient satisfaction SF-36 and OHIP-14 were most popular in these studies. Statistical analysis of studies mentioned lead us to believe that psychological and physical ailments caused by TMD result in lower quality of life in patients.

The efficacy of short (6 mm) dental implants with a novel thread design.

OBJECTIVE: To assess efficacy of short (6 mm) implants with a novel macrostructure and thread design placed in a compromised bone situations of edentulous posterior regions of maxilla (3-4 mm of bone height under sinus floor) as compared to results of clinical situations treated with simultaneous maxillary sinus grafting and placement of long (≥10 mm) implants of the same company. STUDY DESIGN: Clinical cases of conducted clinical study. PATIENTS AND METHODS: Patients with compromised bone height in edentulous posterior regions of maxilla were randomly divided into two groups. Short (6mm length) implant treatment conducted in the test group and simultaneous sinus lift with standard length implant placement treatment in the control group. RESULTS: In general implant stability quotient (ISQ) and marginal bone level (MBL) changes values in both groups were comparable. However, significant negative correlation was found between implant's diameter and MBL changes. CONCLUSIONS: Implant's length has little if none impact on initial implant anchorage, especially in greatly compromised residual bone situations. Results have confirmed that implant initial stability mainly depends on implant's macro-design and further its development on implant's micro-design: namely, implant diameter rather than length, tapered shape and improved thread design determines primarily acquired mechanical anchorage, while bioactive surface treatment ensures development of biological stability.

Bone augmentation and simultaneous soft tissue thickening with collagen tissue matrix derivate membrane in an aesthetic area. A case report.

Aesthetic implant restoration in the anterior maxilla is a challenge for clinicians. Alveolar ridge and surrounding gingiva deficiencies aggravates implant placement in the aesthetic area. This case report describes a technique for aesthetic single implant placement with simultaneous bone grafting and soft tissue thickening. At the time of implant surgery, allogenic (Maxgraft, Botiss Biomaterials, Germany) and xenogenic bone substitute (Cerabone, Botiss Biomaterials, Germany) was used for bone grafting, soft tissues were augmented simultaneously with collagen tissue matrix derivate membrane (Mucoderm, Botiss Biomaterials, Germany). After 4 months during second stage surgery the implant was exposed. Subsequently healing abutment was replaced with provisional crown for gingival contouring. An individual zirconia abutment was made and a cemented full-ceramic crown was placed for final restoration. The 12-month follow-up check-up revealed a pleasing aesthetic treatment outcome, as well as clinically healthy peri-implant soft tissues. Radiological examination showed a stable bone crest with minor bone remodelling around the implant platform. The use of an collagen tissue matrix derivate, simultaneously with GBR, in the aesthetic area can provide excellent results, by establishing and maintaining facial bone wall and thick soft tissue in aesthetic area.

Oral Behaviors and Parafunctions: Comparison of Temporomandibular Dysfunction Patients and Controls.

The aim of this study is to evaluate the frequency of oral behaviors in patients with temporomandibular disorders (TMD) and a control group without TMD.In this baseline case-control study, 260 controls and 260 subjects with TMD completed the oral behaviors checklist defined as a "self-report scale for identifying and quantifying the frequency of jaw overuse behavior" and underwent clinical examinations using the DC/TMJ international examination form (version May 12, 2013). Relationships of oral parafunctions' frequencies between groups were examined. The statistical analysis was performed with IBM SPSS Statistics 23 software.Age and gender distribution in the study groups did not reveal statistical differences (P > 0.05). Multivariate logistic regression analysis was conducted to establish system of independent oral behaviors for prognosis TMD. The stepwise regression analysis demonstrated that very frequent expression of holding, tightening, or tense muscles is associated with 10.83 times (P < 0.05) higher risk of TMD, grinding teeth together during waking hours with 4.94 times (P < 0.05) higher risk, and sustained talking with 2.64 times (P < 0.05) higher risk of TMD. By contrast, it was determined that 3 oral behaviors were less common in the TMD patients compared with the control group: clenching teeth together during waking hours, facing grimaces, and yawning (P < 0.05). The individuals with TMD reported a significantly higher frequency of 10 behaviors (P < 0.05), 3 of which may be regarded as independent risk factors for TMD. In addition, 3 oral behaviors were more frequently observed in the healthy subjects than in the TMD patients.

Clinical efficacy of main radiological diagnostic methods for odontogenic maxillary sinusitis.

The objective of the study was to compare the ability of dental, ENT and radiology specialists to identify the dental cause of maxillary sinusitis with conventional computed tomography, dental and panoramic radiographs. Out of 34 dental records from subjects treated at ENT and Oral and Maxillofacial Surgery Department, LUHS Kaunas Clinics, 22 females and 12 males with the diagnosis of odontogenic maxillary sinusitis, periapical (DPA), panoramic (DPR) and computed tomography (CT) images of posterior maxilla were selected for further studies. In total, 39 sinuses with an odontogenic and 37 sinuses with only rhinogenic cause (control group) were included in the study. Sinuses with mucosal thickening less than 3 mm were excluded from the research. Each image was evaluated by 5 endodontologists, 5 oral surgeons, 6 general dentists, 6 otorhinolaryngologists and an experienced oral radiologist. DPR and DPA views were not evaluated by ENT specialists. The dental cause of maxillary sinusitis was marked according to the given scale. Intraclass correlation coefficient and ROC curve statistical analysis were performed. The best accuracy was observed when CT views were evaluated by experienced oral radiologist and oral surgeons: the AUC was 0.958 and 0.859, respectively. DPR views showed the best accuracy when evaluated by oral surgeons (0.763) and DPA-by endodontologists (0.736). The highest inter-rater agreement was observed between experienced oral radiologist and oral surgeons/otorhinolaryngologists (0.87/0.78) evaluating CT. Sensitivity and specificity of CT were 89.7 and 94.6%, DPR-68.2 and 77.3%, DPA-77.9 and 67%. Identification of dental cause of maxillary sinusitis sometimes is a challenge, which depends on radiological method and, more importantly, on evaluator's experience.

Fixed Full Arches Supported by Tapered Implants with Knife-Edge Thread Design and Nanostructured, Calcium-Incorporated Surface: A Short-Term Prospective Clinical Study.

Purpose. To evaluate implant survival, peri-implant bone loss, and complications affecting fixed full-arch (FFA) restorations supported by implants with a knife-edge thread design and nanostructured, calcium-incorporated surface. Methods. Between January 2013 and December 2015, all patients referred for implant-supported FFA restorations were considered for enrollment in this study. All patients received implants with a knife-edge thread design and nanostructured calcium-incorporated surface (Anyridge®, Megagen, South Korea) were restored with FFA restorations and enrolled in a recall program. The final outcomes were implant survival, peri-implant bone loss, biologic/prosthetic complications, and "complication-free" survival of restorations. Results. Twenty-four patients were selected. Overall, 215 implants were inserted (130 maxilla, 85 mandible), 144 in extraction sockets and 71 in healed ridges. Thirty-six FFAs were delivered (21 maxilla, 15 mandible): 27 were immediately loaded and 9 were conventionally loaded. The follow-up ranged from 1 to 3 years. Two fixtures failed, yielding an implant survival rate of 95.9% (patient-based). A few complications were registered, for a "complication-free" survival of restorations of 88.9%. Conclusions. FFA restorations supported by implants with a knife-edge thread design and nanostructured, calcium-incorporated surface are successful in the short term, with high survival and low complication rates; long-term studies are needed to confirm these outcomes.

Validation of Therapeutic Anatomy-Oriented Classification in Endosseous Dental Implant Treatment: A Pilot Study.

BACKGROUND: The purpose of the study was to validate a newly proposed therapeutic anatomically based clinical and radiological classification for dental implant treatment. METHODS: Eighty-one patients with at least 1 edentulous jaw segment (EJS) from 2 dental clinics were included in this study. Both clinical and radiological parameters were assessed in aesthetic and nonaesthetic zones. The data were then compared at preoperative, intraoperative, and postoperative (subdivided into early and late stage) study stages. RESULTS: Based on the hard and soft tissue support, EJSs were divided into 3 types. The outcomes were then validated at preoperative, intraoperative, and early postoperative stages. Data were then analyzed using paired sample t test and the Wilcoxon signed ranks test. No statistically significant difference (P > 0.05) was identified between any the measurements. CONCLUSIONS: The proposed therapeutic anatomically based clinical and radiological classification for the dental implant treatment seems to be reproducible, objective, and helpful in planning dental implant treatment. Future studies with a larger sample size are needed to further validate the outcome obtained in this pilot study.

Short (6-mm) dental implants versus sinus floor elevation and placement of longer (≥10-mm) dental implants: a randomized controlled trial with a 3-year follow-up.

OBJECTIVES: To investigate whether short (6-mm) dental implants could be an alternative to sinus floor elevation (SFE) and placement of longer (≥10-mm) implants in the posterior maxilla. MATERIALS AND METHODS: Over a 3-year period, all patients presenting with partial edentulism in the posterior maxilla were considered for inclusion in this randomized controlled trial. Patients were randomly chosen either to receive short (6-mm) implants (test group [TG]) or to undergo SFE with simultaneous placement of standard-length (≥10-mm) implants (control group [CG]). SFE was performed using the lateral technique. In both groups, tapered implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. All implants were loaded after 4 months of healing. At each annual follow-up session, clinical and radiographic parameters were assessed. Primary outcomes were implant survival, stability (measured with the implant stability quotient [ISQ]), marginal bone loss (MBL), and complications; secondary outcomes were patient satisfaction and treatment time and cost. RESULTS: Thirty-three patients were assigned to the TG and 20 to the CG. Forty-five implants were inserted in each group. At 3 years, implant survival rates were 100% and 95.0% for the TG and CG, respectively; this difference was not statistically significant (P = 0.38). The mean ISQ values of the TG and CG did not differ at placement (68.2 vs. 67.8, P = 0.1), at delivery of the final restoration (69.5 vs. 69.4, P = 0.9), and after 1 year (71.0 vs. 71.5, P = 0.1); at 3 years, the CG had a significantly higher mean ISQ than the TG (72.4 vs. 71.6, P = 0.004). Mean MBL was significantly higher in the CG than in the TG, both at 1 year (0.14 mm vs. 0.21 mm, P = 0.006) and at 3 years (0.20 mm vs. 0.27 mm, P = 0.01). A few complications were reported. Surgical time and cost were significantly higher in the CG than in the TG (P < 0.0001). Patient satisfaction was high in both groups. CONCLUSIONS: In this randomized controlled trial, results for short (6-mm) implants were similar to those for longer (≥10-mm) implants in augmented bone. Short implants might be preferable to SFE, because the treatment is faster and less expensive. Long-term randomized controlled trials are required to confirm these results.

Influence of Peri-Implant Soft Tissue Condition and Plaque Accumulation on Peri-Implantitis: a Systematic Review.

OBJECTIVES: To systematically examine influence of soft tissue condition and plaque accumulation around dental implants on peri-implantitis development. MATERIAL AND METHODS: An electronic literature search was conducted of two databases - MEDLINE (Ovid) and EMBASE from 2011 to 2016. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported soft tissue condition or plaque accumulation influence on peri-implantitis development were included. The resulting articles were independently subjected to clear inclusion and exclusion criteria by two reviewers as follows. RESULTS: The search resulted in 8 articles meeting the inclusion criteria. These studies reported gingival index, plaque index, pocket depth, bleeding on probing/modified bleeding index for sites with "adequate" (≥ 2 mm) and "inadequate" (< 2 mm) width of keratinized mucosa. Results demonstrated that the amount of keratinized mucosa has little influence on soft-tissue inflammation in the presence of good oral hygiene. However, suboptimal oral hygiene due to difficulty in access for plaque control in the areas of minimal keratinized mucosa may lead to greater tissue damage. CONCLUSIONS: In cases with insufficient keratinized gingiva in the vicinity of implants, the insufficiency does not necessarily mediate adverse effects on the hygiene management and soft tissue health condition. Nonetheless, the risk of the increase of gingival index, plaque index, pocket depth, bleeding on probing/modified bleeding index is present. Therefore, the presence of an appropriate amount of keratinized gingiva is required.

The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group I - Peri-Implantitis Aetiology, Risk Factors and Pathogenesis.

INTRODUCTION: The task of Group 1 was to review and update the existing data concerning aetiology, risk factors and pathogenesis of peri-implantitis. Previous history of periodontitis, poor oral hygiene, smoking and presence of general diseases have been considered among the aetiological risk factors for the onset of peri-implant pathologies, while late dental implant failures are commonly associated with peri-implantitis and/or with the application of incorrect biomechanical forces. Special interest was paid to the bone cells dynamics as part of the pathogenesis of peri-implantitis. MATERIAL AND METHODS: The main areas indagated by this group were as follows: influence of smoking, history of periodontitis and general diseases on peri-implantitis development, bio-mechanics of implant loading and its influence on peri-implant bone and cellular dynamics related to the pathogenesis of peri-implantitis. The systematic reviews and/or meta-analyses were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. The literature in the corresponding areas of interest was screened and reported following the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. Method of preparation of the systematic reviews, based on comprehensive search strategies, was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic reviews and/or meta-analyses is presented in Preface chapter. RESULTS: The results and conclusions of the review process are presented in the respective papers. One systematic review with meta-analysis, three systematic reviews and one theoretical analysis were performed. The group's general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article.