Periimplant Disease and Prosthetic Risk Indicators: A Literature Review.

PURPOSE: The purpose of this review was to search in international published peer-review articles, data regarding prosthetic risk indicators affecting the incidence, prevalence, or treatment outcome of periimplant diseases. MATERIALS AND METHODS: A literature search was performed in MEDLINE via PubMed database of the US National Library of Medicine of articles published until February 2018; a manual search was also added. Randomized controlled trials, controlled trials, prospective and retrospective cohort studies with a minimum of 20 subjects, having cases with/without exposure to the risk indicator were included. Articles written in another language than English were not included. RESULTS: The 17 articles reviewed indicated the cement residuals at abutments were identified as risk factors for both mucositis and periimplantitis. Among the screw-retained prosthetic reconstructions, prostheses screwed directly to the implants have higher risk to develop periimplant disease. The accessibility and the possibility to perform adequate plaque control around the prosthetic suprastructure decreases the risk for periimplant disease; convex emergence profiles seem to increase it. The crown margins located submucosa may impair the periimplant treatment outcome. CONCLUSION: Prosthetic reconstruction on implants should be designed in a way to allow accessibility to proper plaque control. Screw-retained suprastructure and crown margins located supra-mucosa should be preferred when possible. When using cement-retained suprastructure, attention should be given to remove cement residuals.

A Pilot Study with Randomised Controlled Design Comparing TiZr Alloy Dental Implants to Ti Implants.

OBJECTIVES: Evidence on the clinical performance of recently introduced dental implants in titanium-zirconium alloy is sparse. The aim of the present pilot study with randomized controlled design is to compare changes in supporting structures around dental titanium-zirconium alloy implants to commercially pure titanium implants. MATERIAL AND METHODS: The present material includes consecutive patients referred to a specialist clinic in Sweden. Two patient groups treated with dental implants in two different materials - titanium (Ti) and titanium-zirconium (TiZr) - were defined after block randomisation for smoking. In total, 40 implants installed in 21 patients were available for one-year follow-up. Marginal bone level, soft tissue height and width of keratinised mucosa were registered at baseline and at one-year follow-up. RESULTS: At implant level, the test group (TiZr) yielded significant marginal bone loss (P < 0.001) after one year. Additionally, marginal bone loss after one year was significantly higher for TiZr implants (P < 0.001) as compared to traditional Ti implants. Soft tissue dimensions were stable throughout the evaluation time for both implant materials. CONCLUSIONS: One-year results indicate more pronounced initial marginal bone loss for dental implants in titanium-zirconium alloy as compared to implants made of commercially pure titanium.