Immediate Implant and Customized Healing Abutment Promotes Tissues Regeneration: A 5-Year Clinical Report.

Significant alveolar bone resorption follows tooth extraction. Immediate implant placement alone is not sufficient to prevent this phenomenon. The present study aims at reporting the clinical and radiologic outcome of an immediate implant with a custom healing abutment. In this clinical case, a fractured upper first premolar was replaced by an immediate implant and a customized healing abutment designed on the perimeter of the extractive alveolus. After 3 months, the implant was restored. The facial and interdental soft tissue was maintained with appreciable success after 5 years. The pre-and 5-year post-treatment computerized tomography scans showed bone regeneration of the buccal plate. Use of an interim customized healing abutment helps prevent hard- and soft-tissue collapse and promotes bone regeneration. This technique is straightforward and may represent a smart preservation strategy when there is no indication for adjunctive hard or soft tissue grafting. Given the limited nature of this case report, further studies are needed to confirm the present findings.

Immediate Implant and Customized Healing Abutment Promotes Tissues Regeneration: a 5-year Clinical Report.

INTRODUCTION: Significant alveolar bone resorption follows tooth extraction. Immediate implant placement alone is not sufficient to prevent this phenomenon. CASE PRESENTATION: In this clinical case, a fractured upper first premolar was replaced by an immediate implant and a customized healing abutment designed on the perimeter of the extractive alveolus. After 3 months, the implant was restored. The facial and interdental  soft  tissue  was maintained with  appreciable  success after 5 years. The pre- and 5-year-post-treatment CT scans showed no bone loss. CONCLUSION: The use of an interim customized healing abutment helps preventing hard and soft tissues collapse.  This technique is very straightforward and might represent a smart preservation strategy when there is no indication for adjunctive hard or soft tissue grafting.

Effect of bleaching treatments on the adhesion of orthodontic brackets: a systematic review.

BACKGROUND: Nowadays bleaching procedures have gained popularity in orthodontic patients. Peroxide and Carbamide acids are the common agents which are used in in-office and at home bleaching techniques. Consequently, the Bonding adhesion to the enamel can be influenced by the orthodontic phase and the residual peroxide might interfere with the polymerization and the adhesion of the brackets. Frequent debonding of the brackets from teeth after the bleaching procedure could cause the lengthening of the therapy and promote irregularities on enamel surface derived from an additional bonding phase of the brackets. The aim of this systematic review is to appraise the influence regarding the effect of the bleaching procedure on the bond strength of orthodontic brackets. METHODS: An electronic database search was performed. Search terms included: bleaching, brackets, adhesion; data were extracted and summarized. Risk of bias was assessed using the Chocrane risk of bias tool, adapted for in vitro studies. RESULTS: A total of 8689 articles were screened and 11 studies met the inclusion criteria of this systematic review. 1000 teeth of human and bovine origin were analyzed for the shear bond strength (SBS) of stainless and ceramic brackets after the bleaching treatments. All the authors divided the groups in different subgroups with different bleaching agents and in different concentration. The SBS value allowed to demonstrate the necessity to delay the bonding of the brackets for two weeks after a bleaching treatment and its improvement when tooth mousse or antioxidants agents are used. CONCLUSIONS: The SBS values and the delay of the bonding procedure must be considered in dental practice and clinical strategies are necessary in order to avoid drawbacks which could cause the debonding of the brackets after bleaching due to the alterations of the dental substrate, thus interfering with the orthodontic treatments.

Standardization of three-dimensional pose of cylindrical implants from intraoral radiographs: a preliminary study.

BACKGROUND: To introduce a theoretical solution to a posteriori describe the pose of a cylindrical dental fixture as appearing on radiographs; to experimentally validate the method described. METHODS: The pose of a conventional dental implant was described by a triplet of angles (phi-pitch, theta-roll, and psi-yaw) which was calculated throughout vector analysis. Radiographic- and simulated-image obtained with an algorithm were compared to test effectiveness, reproducibility, and accuracy of the method. The length of the dental implant as appearing on the simulated image was calculated by the trigonometric function and then compared with real length as it appeared on a two-dimensional radiograph. RESULTS: Twenty radiographs were analyzed for the present in silico and retrospective study. Among 40 fittings, 37 resulted as resolved with residuals ≤ 1 mm. Similar results were obtained for radiographic and simulated implants with absolute errors of - 1.1° ± 3.9° for phi; - 0.9° ± 4.1° for theta; 0° ± 1.1° for psi. The real and simulated length of the implants appeared to be heavily correlated. Linear dependence was verified by the results of the robust linear regression: 0.9757 (slope), + 0.1344 mm (intercept), and an adjusted coefficient of determination of 0.9054. CONCLUSIONS: The method allowed clinicians to calculate, a posteriori, a single real triplet of angles (phi, theta, psi) by analyzing a two-dimensional radiograph and to identify cases where standardization of repeated intraoral radiographies was not achieved. The a posteriori standardization of two-dimensional radiographs could allowed the clinicians to minimize the patient's exposure to ionizing radiations for the measurement of marginal bone levels around dental implants.

Coronectomy of Mandibular Third Molar: Four Years of Follow-Up of 130 Cases.

Inferior wisdom teeth extraction surgery may have some complications that, in some cases, could be prevented by a correct diagnosis and minimal surgery. Coronectomy is a technique used for wisdom teeth surgery where only the crown is extracted and the root/roots are left in situ. This procedure may be controversial, but it could limit the common risks of the extraction procedure. Nowadays, the indication and contraindication of this technique are debated, and clinicians normally extract the entire tooth. The following case series includes the data and follow-up radiographs of 130 patients who received a coronectomy, reporting the safety of the procedure. After a mean follow-up period of four years, no complications occurred. A total of 13 patients showed mobile roots but had no complications or symptoms. The roots migrated in a mesial or coronal direction in 31 patients; in 4 cases, they were removed because of patient preference. Coronectomy is a useful oral surgical procedure in certain complicated cases of mandibular wisdom tooth extraction.

Local Formula with Mucoadhesive Property: A Randomized Clinical Trial of a Therapeutic Agent for the Treatment of Oral Aphthous Ulcers.

BACKGROUND: Recurrent or occasional aphthous lesions represent a painful oral condition with high prevalence. Since the etiology is still unclear and most likely related to a dysfunction in the local immune system, several treatment strategies have been proposed, including systemic agents, local agents, and laser therapy, to reduce the pain and discomfort for the patient without acting on the causes. MATERIALS AND METHODS: The purpose of the present randomized study was to assess the clinical efficacy of a new topical gel with mucoadhesive property to reduce the pain and the dimension of the aphthosis lesions. Fifty patients presenting at least one minor ulcer were randomized to a control group (placebo prescription), a first test group (topical agent with laser), and a second test group (topical agent only). The healing rate, the visual analog scale (VAS) score for pain, and the diameter reduction were monitored for 10 days. RESULTS: Both test groups showed better results than control group, significant clinical efficacy, and a median total reduction time of 4 days with no significant adjunctive benefit from the use of laser. CONCLUSION: The clinical results are encouraging; nevertheless other studies are needed to valid this kind of treatment. CLINICAL SIGNIFICANCE: The present randomized clinical study suggested that the use of topical mucoadhesive agents could represent a valid therapy for minor aphthous lesions. How to cite this article: Giammarinaro E, Cosola S, Oldoini G, et al. Local Formula with Mucoadhesive Property: A Randomized Clinical Trial of a Therapeutic Agent for the Treatment of Oral Aphthous Ulcers. J Contemp Dent Pract 2019;20(11):1249-1253.

Volume assessment of the external contour around immediate implant with or without immediate tooth-like crown provisionalization: A digital intraoral scans study.

PURPOSES: To examine differences between immediate and delayed dental implant loading in maxillary aesthetic areas. METHODS: In this retrospective controlled analysis, 43 subjects who underwent immediate placement of the dental implant in a post-extraction socket were ranked into either immediate (24 implants loaded with non-occlusal tooth-like profile provisional prostheses fabricated by virtual diagnostic impressions and an in-office dental milling machine) or delayed group (19 implants loaded with conventional cover screws and secondary intention healing). Intraoperatively and then four months later, scans of the external layers were acquired with an optical scanner. The width of the alveolar crest and Jemt papilla index were acquired. Non-parametric tests were applied with a level of significance set at p < 0.01. RESULTS: In both groups, the volumes and areas showed significant reductions from the baseline to the 4-month survey. Reductions in volume appeared to be statistically different between the two groups (-39±31 mm3 for the immediate and 89 ± 30 mm3 for the delayed group). The final Jemt papilla index appeared significantly different between the immediate (mesial, 2.5 and, distal, 3) and delayed groups (2 for both aspects). CONCLUSIONS: Immediate provisionalization significantly reduced volume loss and area shrinkage at the external layer when data were compared to a delayed rehabilitation strategy.

Immediate Implant and Customized Healing Abutment for a Periodontally Compromised Socket: 1-Year Follow-Up Retrospective Evaluation.

Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 cases with a 1-year follow-up were selected to propose the technique of an immediate provisional non-loading prosthesis being delivered on the same day of the post-extraction implant placement in multiradicular teeth affected by chronic periradicular and periapical lesions. Post-extractive sockets underwent immediate dental implant placement by filling the empty space with sterile, re-absorbable gelatin sponges. The widths of the alveolar ridge were measured on three-dimensional radiographs before and after the operation, 4 and 12 months later. Non-parametric statistics were performed to compare the outcomes over time with a level of significance of 0.05. Comparing the preoperative cross-sectional images of cone beam computerized tomography (CBCT) scans to the postoperative ones, it was noted that changes in the crestal ridge width, ΔCW, (compared to baseline) were negligible and not clinically appreciable. However, while ΔCW at 4 months appeared to be negative (-0.17 ± 045 mm), crestal width at 12 months was at the same level as the baseline (ΔCW = 0.02 ± 0.48 mm), with a significant difference between 4 and 12 months (p-value = 0.0494). Immediate implant placement with an immediate non-loading provisional customized healing abutment of polyether-ether-ketone placed into the post-extractive sockets with asymptomatic and large chronic periapical and periradicular lesions could represent a further treatment strategy for patients' rehabilitation and soft tissue preservation to replace a hopeless tooth.

Assessment of the alveolar bone loss in fresh socket implant procedures with immediate implant loading via temporary preformed anatomical healing caps: Comparison of two different lengths of the implant collar.

PURPOSES: The aim of the present clinical and radiologic retrospective study was to evaluate alveolar bone remodeling, in terms of alveolar width and peri­implant bone level, two years after immediate implant positioning (with two different collar lengths, 0.8 mm and 2.0 mm) and loading of preformed healing cap. The Null hypothesis, H0 is: there was no difference between the two groups of implants. METHODS: Patients suffering from single-tooth edentulous areas in premolar, cuspid, and incisive areas were treated with fresh-socket implants and immediate preformed anatomical healing caps. Each final crown restoration was fabricated 3 months later. Primary outcomes (related to loss of the alveolar width and peri­implant bone level) and secondary outcomes (testing adverse events, and measuring implant/prosthesis survival) were acquired and analyzed. RESULTS: A two-year retrospective analysis was conducted on 31 patients (19 female and 12 male), who underwent dental implant placement with implants having two different lengths of the collar: group A, 0.8 mm, and group B, 2.0 mm. As for the width of the alveolar crest, there was a negligible loss (less than half a millimeter) reported for both the groups, anyway reaching a statistical significance. Preoperative alveolar widths (9.50±0.67 mm and 9.45±0.90 mm, respectively for groups A and B) were different from the two-year alveolar widths (9.20±0.74 mm and 8.93±0.99 mm, respectively for groups A and B) with p-values ≤ 0.0049. When the marginal bone loss was assessed, significant differences were registered between the two procedure groups (-1.42±0.34 mm for group A and -0.11±0.15 mm for group B with a p-value < 0.0001). CONCLUSIONS: The proper design of a healing abutment was very important to preserve the emergence profile immediately after extraction and implant placement. The length of the implant collar used with an immediate healing abutment appeared to affect the preservation of the alveolar crest with predictable final results.

Alveolar Bone Remodeling with or without Collagen Filling of the Extraction Socket: A High-Resolution X-ray Tomography Animal Study.

The healing process of the tooth extraction socket often leads to significant resorption of the alveolar bone, eventually causing clinical difficulties for future implant-supported rehabilitations. The aim of the present animal study was to evaluate alveolar bone remodeling after tooth extraction in a rabbit model, either with or without the use of a plain collagen plug inside the socket, by means of micro-computed tomography. The study included the micro-tomography analysis of 36 rabbits' incisor extraction sockets, either left empty or filled with a collagen plug. All animals were euthanized in a staggered manner, in order to address molecular, histologic, and radiographic analyses at different time-points, up to 90 days after surgery. The three-dimensional evaluation was carried out using micro-computed tomography technology on excised bone blocks including the alveolus and the contralateral bone. Both linear and volumetric measures were recorded: the percentage of bone volume change (ΔBV) within the region of interest was considered the primary endpoint of the study. The micro-CT analysis revealed mean volumetric changes of -58.1% ± from baseline to 3 months for the control group, and almost no bone loss for the test group, -4.6%. The sockets treated with the collagen plug showed significantly less dimensional resorption, while the natural-healing group showed an evident collapse of the alveolar bone three months after extraction surgery.

A Retrospective Digital Analysis of Contour Changing after Tooth Extraction with or without Using Less Traumatic Surgical Procedures.

BACKGROUND: The present retrospective analysis aimed to compare two different single tooth extraction surgical approaches in both premolar and molar areas: less traumatic magneto-electrical versus conventional tooth extraction in minimizing the edentulous ridge volume loss. METHODS: In the present retrospective control trial, 48 patients who underwent one-tooth extraction, were allocated either to control (28 sites treated with conventional tooth extraction procedures) or test group (20 subjects treated with less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric roots subluxation). Intraoperatively (during tooth extraction surgery just after the subsequent filling of the alveolar socket with the sterile fast re-absorbable gelatin sponge), and then four months later, contours of the sockets were acquired through a laser intra-oral scanner. The digitally superimposed models were converted to dicom (Digital Imaging and Communications in Medicine) format first, then volumetric and area evaluations were performed with a DentaScan tool package. Non-parametric tests were applied with a level of significance set at p < 0.01. RESULTS: significant reductions of anatomical features were observed four months later in all the groups (p-values < 0.001) with volume losses leading to a final alveolar ridge volume of 0.87 ± 0.34 cm3 for atraumatic extractions and 0.66 ± 0.19 cm3 for conventional extractions. No significant differences were registered for outcomes related to the basal surface variables. When just molar tooth were considered, the outcomes relating to volume loss between baseline and four months (ΔV) and its percentage (ΔV%) showed a better behavior in the less traumatic procedure (ΔV = -0.30 ± 0.10 cm3 and ΔV% = -22.3 ± 8.4%) compared to the conventional extractions (ΔV = -0.59 ± 0.10 cm3 and ΔV% = -44.3 ± 5.8%) with p-values < 0.0001. CONCLUSIONS: at four months, the less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric root subluxation seemed to be able to better preserve the volume of the alveolar crest (reduction close to 22% with less traumatic extraction in molar sites) when compared to subjects treated with the conventional tooth extraction techniques.

Amino Acid-Enriched Formula for the Post-Operative Care of Extraction Sockets Evaluated by 3-D Intraoral Scanning.

BACKGROUND: Hyaluronic acid and amino acids play an important role in the wound healing process, stimulating the development of the connective tissue and the activity and proliferation of fibroblasts. The aim of the present controlled clinical study was to evaluate the clinical efficacy of a topical gel formula containing hyaluronic acid and amino acids in terms of wound closure rate, painkiller intake, and patients' reported pain and edema. METHODS: This study included patients in need of a single tooth extraction. Patients were randomized into two groups with differing post-operative care regimens. Patients in the test group used the amino acid and hyaluronic acid-based gel, while the control group did not use any product. Each parameter was measured in both groups at different time points: immediately after surgery, and after 7, 14, 30, and 60 days. RESULTS: A total of 40 patients (46.52 ± 9.84 years old) completed the observational period, and 40 extraction sockets were examined. After 7 days, the edema was significantly lower in the test group. The reported pain was lower in the test group without a significant difference, except for the first time point at 7 days. With the follow-up questionnaire, patients declared to have taken painkillers mainly during the first 7 days after surgery; however, the test group showed a lower need for painkillers than the control group. CONCLUSION: The post-operative and domiciliary use of an amino acid and hyaluronic acid-based gel for the management of soft tissue closure after tooth extraction is a valid coadjutant to reduce swelling, pain, and the need for painkillers. Additional studies are required to support the results of the present study.

The effectiveness of the information-motivation model and domestic brushing with a hypochlorite-based formula on peri-implant mucositis: A randomized clinical study.

OBJECTIVE: Management of mucositis is essential for the long-term maintenance of dental implants. This study determined the efficacy, in terms of clinical parameters, of an adjunctive domiciliary agent paired with non-surgical periodontal therapy (NSPT) for patients with peri-implant mucositis. MATERIALS AND METHODS: Patients involved in a periodontal maintenance program were randomly distributed to the domestic use of a chlorhexidine toothpaste and mouthwash (control) or a hypochlorite-based formula brushing solution (test) after diagnosis of peri-implant mucositis. A modified approach towards NSPTwas performed after 10 days of domestic use of the assigned maintenance product in both groups. Clinical and patient-related outcomes were recorded during a 90-day follow-up period. RESULTS: Forty patients completed the three-month study (20 patients per group). Both groups showed relevant clinical and patient outcome improvements after the NSPT (T2) and between T1 and T2 (p < 0 0.01), except for PPD. For the test group, the clinical improvement was significantly greater than that for the control group at the seventh-day evaluation (T1 ) in the gingival index (0-3) and FMBS (%). Favorable outcomes were maintained during the entire follow-up period. CONCLUSION: The present study showed that the modified NSPT paired with the domestic use of nitradine-based formula helps resolve peri-implant mucositis and that nitradine might represent an alternative to chlorhexidine in these cases. CLINICAL RELEVANCE: The gold standard for nonsurgical maintenance is full-mouth disinfection. A previous decontamination of the oral cavity with chlorhexidine or nitradine domiciliary for 10 days could reduce plaque and inflammation, resulting in a painless operative session. This protocol may help reduce airborne contamination and the risk of cross-infection, and during the pandemic, the protocol is safer for clinicians. In the same clinical cases, nitradine may be more efficient than chlorhexidine, and the former has no side effects such as discolouration.

Correction: Preda et al. The Efficacy of Powered Oscillating Heads vs. Powered Sonic Action Heads Toothbrushes to Maintain Periodontal and Peri-Implant Health: A Narrative Review. Int. J. Environ. Res. Public Health 2021, 18, 1468.

There was an error in the original article [...].

Radiographic and Histomorphologic Evaluation of the Maxillary Bone after Crestal Mini Sinus Lift Using Absorbable Collagen-Retrospective Evaluation.

BACKGROUND: After tooth extraction, the alveolar bone loses volume in height and width over time, meaning that reconstructive procedures may be necessary to perform implant placement. In the maxilla, to increase the bone volume, a mini-invasive surgery, such as a sinus lift using the crestal approach, could be performed. METHODS: A crestal approach was used in this study to perform the sinus lift, fracturing the bone and inserting collagen (Condress®). The single dental implant was placed in the healed bone after six months. RESULTS: The newly formed bone was histologically analyzed after healing. Histomorphological analyses confirmed the quality of the new bone formation even without graft biomaterials. This is probably due to the enlargement of the space, meaning more vascularization and stabilization of the coagulum. CONCLUSION: Using just collagen could be sufficient to induce proper new bone formation in particular clinical situations, with a minimally invasive surgery to perform a sinus lift.

Effects of Non-Surgical Periodontal Treatment on Reactive Oxygen Metabolites and Glycemic Control in Diabetic Patients with Chronic Periodontitis.

BACKGROUND: Periodontal infection may contribute to poor glycemic control and systemic inflammation in diabetic patients. The aim of the present study is to evaluate the efficacy of non-surgical periodontal treatment in diabetic patients by measuring oxidative stress outcomes. METHODS: Sixty diabetic patients with periodontitis were enrolled, treated with scaling and full-mouth disinfection, and randomly prescribed chlorhexidine mouthwash, antioxidant mouthwash, or ozone therapy. Reactive oxygen metabolites (ROMs), periodontal parameters, and glycated hemoglobin were measured at baseline and then at 1, 3, and 6 months after. RESULTS: At baseline, all patients presented with pathologic levels of plasmatic ROM (388 ± 21.36 U CARR), higher than the normal population. Probing depth, plaque index, and bleeding on probing values showed significant clinical improvements after treatment, accompanied by significant reductions of plasma ROM levels (p < 0.05). At the 6-month evaluation, the mean ROM relapsed to 332 ± 31.76 U CARR. Glycated hemoglobin decreased significantly (∆ = -0.52 units) after treatment. Both the test groups showed longer-lasting improvements of periodontal parameters. CONCLUSION: In diabetic patients, periodontal treatment was effective at reducing plasma ROM, which is an indicator of systemic oxidative stress and inflammation. The treatment of periodontal infection might facilitate glycemic control and decrease systemic inflammation.

In-vitro fatigue and fracture performance of three different ferrulized implant connections used in fixed prosthesis.

BACKGROUND/PURPOSE: The aim of the present in vitro study was to evaluate fatigue resistance of dental fixtures in three different types of fixture/abutment finishing line. MATERIALS AND METHODS: Transmucosal dental implants, with or without ferrulized neck, underwent fatigue tests (static and dynamic load) using the following standard protocol: UNI EN ISO 14801:2016. Two types of loading devices (screw- or cement-retained restoration) were also tested, and fatigue cycle tests were run to failure. Data of static and dynamic load tests were analyzed by proper statistical methods. RESULTS: Following standard protocol for fatigue testing, the ILC type (Implant Level with ferrulized neck and cement-retained crown) showed a non-significant but higher Ultimate Failure Load (UFL = 445.7 N) compared to AL type (Abutment Level without ferrule effect, 421.6 N) and ILS type (Implant Level with ferrulized neck and Screw-retained crown, 362.8 N). No fracture of the titanium-base was registered in the tested specimens during the static loadings. Permanent deformations of the materials were observed. CONCLUSION: The number of cycles to either fracture or deformation (higher than 4 mm) occurring during fatigue tests showed that the stress rupture curve of the materials in group ILS appeared to be significantly different from those of the ILC and AL groups (p-values < 0.01): much higher life of one-half order of magnitude.

The Efficacy of Powered Oscillating Heads vs. Powered Sonic Action Heads Toothbrushes to Maintain Periodontal and Peri-Implant Health: A Narrative Review.

OBJECTIVES: To compare the efficacy of rotating-oscillating heads (ORHs) VS sonic action heads (SAHs) powered toothbrushes on plaque accumulation and gingival inflammation. METHODS: An electronic (MEDLINE, Embase, Inspec, PQ SciTech and BIOSIS) and a complementary manual search were made to detect eligible studies. RCTs meeting the following criteria were included: final timepoint longer than 15 days; year of publication after 2000; patients without orthodontic appliances or severe systemic/psychiatric diseases. Studies comparing two or more different types of sonic/roto-oscillating toothbrushes were excluded. Selection of articles, extraction of data, and assessment of quality were made independently by several reviewers. RESULTS: 12 trials (1433 participants) were included. The differences between ORHs and SAHs toothbrushes were expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). The heterogeneity of data was evaluated. Concerning Plaque Index, both toothbrushes obtained comparable results. Six trials of up to 3 months and at an unclear risk of bias provided significant outcomes in terms of gingival inflammation in favor of ORHs toothbrush. Evidence resulting from three trials of up to 6 months and at a high/low risk of bias stated SAHs toothbrush superiority in gingival inflammation. CONCLUSIONS: Both ORHs and SAHs toothbrushes improved the outcomes measured from the baseline. In most of the good quality trials included, SAHs toothbrush showed statistical better long-term results. Due to the shortage of investigations, no further accurate conclusions can be outlined with reference to the superiority of a specific powered toothbrush over the other.

Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review.

Background: to assess the radiological marginal bone loss between bone-level or tissue-level dental implants through a systematic review of literature until September 2019. Methods: MEDLINE, Embase and other database were searched by two independent authors including only English articles. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis counting a total of 1161 patients (mean age 54.4 years) and 2933 implants, 1427 inserted at Tissue-level (TL) and 1506 inserted at Bone-level (BL). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (p < 0.05). Only one study reported statistically less marginal bone loss in TL-implants (p < 0.05). Conclusion: In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant after a variable period of follow-up ranged between 1 and 5 years.

Ozone Therapy for Oral Palatal Ulcer in a Leukaemic Patient.

Chemotherapy usually causes complications affecting several tissues such as oral mucosa. In this case report, a soft palate oral ulcer caused by chemotherapy was treated by ozone gas. This kind of treatment is known for its antimicrobial, regenerative and analgesic proprieties. The results show a complete resolution of the lesion within 2 weeks of treatment. Ozone therapy demonstrates greater effectiveness with respect to this kind of oral lesion compared to traditional therapy. Considering this evidence, ozone therapy should be considered as a useful tool for the adjuvant therapy of oral complications in oncologic patients. LEARNING POINTS: Intensive chemotherapy can have side effects, particularly affecting tissue with higher turnover. Therefore, there is a clinical need to prevent or to treat such complications.Ozone therapy could improve oral mucosa healing and have anti-inflammatory, antioxidant and antibacterial effects to prevent suprainfections. To date, there are no reported cases of oral ulcers in oncologic patients being completely resolved using ozone in the literature.Medical and dental doctors should collaborate with regards to complex patients to prevent such types of complications, discovering these clinical cases that are unknown in the literature and treating patients in a more comprehensive way.