Implant-Prosthetic Rehabilitation of Mandibular Posttraumatic Severe Dentoalveolar Loss With a Reconstructive Staged Approach: A Clinical Report With 3-Year Follow-Up.

This clinical report describes the oral rehabilitation of a 25-year-old male patient who lost the lower incisors, right canine, and a significant amount of anterior mandibular bony and soft tissue following severe dentoalveolar trauma due to a car accident. The patient's young age, anterior esthetic zone in the lower jaw, previous mandibular fracture, and extended bony and soft-tissue defect hindering ideal 3-dimensional implant placement oriented the therapeutic plan toward a staged approach, with several reconstructive surgical procedures before implant rehabilitation. The treatment involved deepening the labiobuccal vestibule and lingual sulcus to correct cicatricial shrinkage due to previous surgical fixation of the mandibular fracture, vertical guided bony augmentation to regenerate adequate volumes of bone, free gingival graft to achieve sufficient height and thickness of peri-implant soft tissues, and a prosthetic-driven surgical procedure to place the implants in a good functional and esthetic position. This therapeutic approach restored function and esthetics and achieved outcome stability at 3-year follow-up.

Evaluation of peri-implant tissues condition after 10-15 years of loading in treated chronic periodontitis patients attending a private practice setting: A retrospective study.

OBJECTIVES: To retrospectively evaluate the conditions of the peri-implant tissues in treated patients with chronic periodontitis (CP) and in patients without chronic periodontitis (noCP). MATERIALS AND METHODS: A chart review was used to evaluate 267 implants, 134 placed in 42 CP treated patients and 133 placed in 46 noCP patients. The primary outcome was to evaluate the condition of the peri-implant tissues (health, peri-mucositis, and peri-implantitis). The secondary outcome was to evaluate the possible association of some variables, such as, Plaque Index (PI), Bleeding Index (BI), probing pocket depth (PD), bleeding on probing (BoP), bone level (BL), loading time, type of implant placement and loading protocol, type of prosthesis, type of bone, implant manufacturer, and implant diameter and length, with the implant health condition. RESULTS: The analysis of patient files revealed that after 10-15 years of loading (mean loading time 13.4 ± 2.07 years), six noCP patients (13%) experienced implant loss with a total of nine implants (6.7%) lost. The remaining 124 implants were classified: 54 (43.5%) as healthy, 45 (36.3%) with peri-implant mucositis, and 25 (20.2%) with peri-implantitis. Twelve CP subjects (28.5%) experienced implant loss with a total of 19 implants (14.1%) lost. The remaining 115 implants were classified: 34 (29.5%) as healthy, 40 (34.7%) with peri-implant mucositis and 41 (35.6%) with peri-implantitis. Compared with noCP subjects, only treated CP subjects with recurrent periodontal disease (RPD) showed differences statistically significant (p < .05). CONCLUSIONS: After 10-15 years of loading, in CP patients treated in a private practice setting, most implants (70.1%) were classified with some type of peri-implant inflammation. In patients with RPD, a higher tendency for implant loss and peri-implant biologic complications was found.

Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste.

BACKGROUND: Dental caries is a recognized worldwide public health problem. Despite being one of the most effective strategies against dental caries, the excessive use of fluorine may result in a potential risk of developing dental fluorosis especially in children under age of six. The purpose of this work is to analyze a fluorine-free toothpaste containing Biomimetic Hydroxyapatite to assess enamel re-mineralizing and repairing properties. RESULTS: The study was performed in vitro and in vivo, comparing the hydroxyapatite toothpaste with two others toothpaste containing different fluorine concentrations. The coating effect of the micro-structured Hydroxyapatite nanoparticles reintegrates the enamel with a biomimetic film reproducing the structure and the morphology of the biologic Hydroxyapatite of the enamel. As demonstrated, the coating is due to the deposit of a new layer of apatite, which presents fewer particles than the natural enamel, not based on the chemical-physical changes occurring in fluorinated toothpastes. Moreover, it shows resistance to brushing as a consequence of chemical bonds between the synthetic and natural crystals of the enamel. CONCLUSIONS: The use of Biomimetic Hydroxyapatite toothpastes has proven to be a valuable prevention measure against dental caries in primary dentition since it prevents the risk of fluorosis.

Cutting efficiency of nickel-titanium rotary and reciprocating instruments after prolonged use.

The aim of the present study was to compare the cutting efficiency of Twisted File instruments used in continuous rotation or TF Adaptive motion and evaluate if prolonged use significantly affected their cutting ability. 20 new NiTi instruments were used in the present study (TF tip size 35, 0.06 taper; Sybron-Endo, Orange, CA, USA), divided into 2 subgroups of 10 instruments each, depending on which movement was selected on the endodontic motor. Group 1: TF instruments were activated using the program TF continuous rotation at 500 rpm and torque set at 2 N; Group 2: TF instruments were activated using the reciprocating TF Adaptive motion. Cutting efficiency was tested in a device developed to test the cutting ability of endodontic instruments. Each instrument cut 10 plastic blocks (10 uses) and the length of the surface cut in a plastic block after 1 min was measured in a computerized program with a precision of 0.1 mm. Maximum penetration depth was calculated after 1 use and after 10 uses, and mean and standard deviation (SD) of each group was calculated. Data were statistically analyzed with a one-way ANOVA test (P < 0.05). TF instruments used in continuous rotation (Group 1) cut a mean depth of 10.4 mm (SD = 0.6 mm) after the first use and 10.1 mm (SD 1.1 mm) after 10 uses, while TF instruments used with the Adaptive motion cut a mean depth of 9.9 mm (SD = 0.7 mm) after the first use and 9.6 mm (SD = 0.9 mm) after 10 uses. There was no statistically significant difference between the two groups investigated (P > 0.05) nor between instruments after 1 or 10 uses. In conclusion, the TFA motion showed a lateral cutting ability similar to continuous rotation and all tested instruments exhibited the same cutting ability after prolonged use.

Altered transcription of inflammation-related genes in dental pulp of coeliac children.

BACKGROUND: Coeliac disease is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten, and possible relationships between coeliac disease and dental pathogenic conditions during childhood have been poorly investigated. AIM: The dental pulp plays a pivotal role in the immune defence against possible entry of pathogens from teeth, and the aim of this work was to investigate quantitative transcription levels of selected genes (IL-9, IL-11, IL-15, IL-18, IL-21, IL-27, MICA, IFN-γ) coding for pro-inflammatory immune innate activities in the pulp of primary teeth from healthy children and children with coeliac disease. DESIGN: The pulp from primary teeth of 10 healthy children and 10 children with coeliac disease was used to extract RNA and prepare cDNA for quantitative PCR transcription analysis employing commercial nucleotide probes for selected genes. RESULTS: In children with coeliac disease, the genes coding for pro-inflammatory cytokines IFN-γ, IL-11, IL-18, and IL-21 were significantly overexpressed, suggesting the possible importance of these cytokines in the relationships between coeliac disease and dental disorders. CONCLUSION: For the first time, we reported in dental pulp of children possible relationships between coeliac disease and modulation in transcription of cytokine-dependent inflammatory activities.

Investigation of Oral Health in Children from Urban Slums of Nairobi, Kenya.

For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral health status of children living in Nairobi slums. A cross-sectional study on school-aged subjects was conducted in June 2022 in three urban slum areas of Nairobi through a pediatric dental screening. The PI (Plaque Index), CPITN (Community Periodontal Index of Treatment Needs), and dmft (decayed, missing, and filled teeth index-deciduous) were considered as primary outcomes of dental health. Multivariate statistical analysis, based on ordinal and zero-inflated negative binomial regression models, was conducted to identify determinants of the oral outcomes in a wide set of potential predictors. A sample of 359 children aged 2-17 was examined. The PI was significantly associated with age, the type of bite, and the use of a toothbrush. The CPITN is influenced by different types of malocclusions, abnormal frenulum, dental trauma, and fluorosis. Dietary habits were found to significantly impact the susceptibility to dental caries. Fluorosis and a dental visit in the last year were highlighted as risk and protective factors, respectively, against higher rates of caries. The oral health features of children living in Nairobi slums are differently affected by socio-demographic conditions, dietary habits, dental characteristics, and oral care practices.

The Application of a Fluoride-and-Vitamin D Solution to Deciduous Teeth Promotes Formation of Persistent Mineral Crystals: A Morphological Ex-Vivo Study.

Background: The use of effective, low-cost, and easy-to-use products for early caries management will avoid loss of dental vitality and impairment in oral function. The ability of fluoride to re-mineralize dental surfaces has been widely reported as well as vitamin D demonstrated to have significant potential in improving the remineralization of early lesions on enamel surfaces. The aim of the present ex vivo study was to evaluate the effect of a fluoride and vitamin D solution in terms of formation of mineral crystals on the enamel of primary teeth, and their permanence over time on dental surfaces. Methods: Sixteen extracted deciduous teeth were cut to obtain 64 specimens that were divided into two groups. The first consisted of immersion of specimens for 4 days in a fluoride solution (T1); in the second group, the specimens were immersed for 4 days (T1) in fluoride and Vitamin D solution, and for a further 2 (T2) and 4 days (T3) in saline solution. Then, samples were morphologically analyzed by using Variable Pressure Scanning Electron Microscope (VPSEM) and underwent 3D surface reconstruction. Results: After a 4-day immersion in both solutions, octahedral-shaped crystals were formed on the enamel surface of primary teeth, demonstrating any statistically significant differences in terms of number, size, and shape. Moreover, the binding of the same crystals seemed to be strong enough to be maintained until 4 days in saline solution. However, a partial dissolution was observed in a time-dependent manner. Conclusions: A topical application of fluoride and Vitamin D promoted the formation of persistent mineral crystals on enamel surfaces of deciduous teeth and should be further studied to be potentially used as an alternative strategy in preventive dentistry.

Root Fractures in the Primary Teeth and Their Management: A Scoping Review.

(1) Background: Traumatic dental injuries constitute a major global health problem. Primary deciduous teeth of the upper frontal group are frequently affected by trauma, especially at an early age. It is important to treat primary traumatic injuries because early tooth loss can lead to aesthetic and functional alterations. The most common injuries are extrusion, lateral luxation, and intrusion. Root fracture is a less common complication that can lead to tooth extraction if not properly diagnosed and managed. However, there are a lack of data regarding primary root fracture treatment. The literature was reviewed to study the current knowledge on the treatment of these injuries, and to propose an operative protocol based on the results obtained. (2) Methods: A literature search was performed on Web of Science, PubMed/MEDLINE, and SCOPUS. The research focused on the following features: age of the patient; localization of the root fracture and type of displacement suffered (intrusive, extrusive, or lateral); type of emergency treatment or diagnostic test performed and their compliance with IADT guidelines; follow-up duration. (2) Results: Only 8 articles fully met the inclusion criteria, with a total of 46 patients and 62 root fractures. Out of a total of 62 root fractures, regarding only upper incisors, the most common treatment was splinting (n = 39) for a period ranging from 3 weeks to 3 months (with an average of six weeks). No treatment was performed for 23 of the root fractures. The splinting performed in most of the included cases was semi-rigid, with the splint held in place using a composite resin material. An orthodontic splint using brackets and 0.5 mm stainless steel wire was used in only in one study. (4) Conclusions: We deduced that the root fracture of primary teeth is a rare traumatic dental injury that can cause numerous complications, such as eruptive problems in the permanent teeth. Correct radiological diagnosis, immediate repositioning and semi-rigid splinting could be conservative methods to prevent premature tooth loss in very young patients.

Characteristics, Diagnosis and Treatment of Compound Odontoma Associated with Impacted Teeth.

Compound odontoma is a malformation typical of young adults below the age of 20, with a slight preference for the male gender and the anterior region of the maxilla. Clinically asymptomatic, it can be detected during a radiological investigation in connection with the persistence of deciduous dental elements and the impaction of definitive ones. The treatment of choice is excisional surgery and recurrence is a rare event. The need for orthodontic therapy for impacted elements is usually not necessary because in most cases, odontomas are small, circumscribed lesions the size of a permanent tooth. In this article, the diagnostic and therapeutic surgical excision procedure is presented in three patients at developmental age with large compound odontomas associated with at least one retained canine, and in two of the cases, with serious transmigration to the impacted tooth elements.

Baby Food and Oral Health: Knowledge of the Existing Interaction.

BACKGROUND: The purpose of this study is to verify parents' knowledge of child nutrition and their awareness of the interaction between unhealthy sugars in their child's diet and caries formation. METHODS: a questionnaire was proposed using Instagram to analyze type of breastfeeding; type of weaning and diet; home oral hygiene maneuvers; bad habits (use of pacifiers, bottles, and sugary substances); knowledge on the usefulness of fluoride; and first dental visit. A total of 200 parents from different regions of Italy with children aged 2 months to 6 years were contacted. Results showed that 66% parents preferred breastfeeding, while the remaining 34% chose artificial breastfeeding. Fifty percent (100 babies) started weaning at six months, 20% (40 babies) at the fifth month, 13.5% (27 babies) at the fourth month, and only 11.5% (23 babies) in a range from the seventh to ninth month of life. Oral hygiene practices were performed only by 25% of parents before eruption of the first tooth. After eruption of the first tooth, there is greater attention to home oral hygiene practices: 59% of parents carry out and teach their children daily home oral hygiene maneuvers. CONCLUSIONS: it is possible to raise awareness among parents and caregivers on the importance of food education.

Correlations of Obstructive Sleep Apnea Syndrome and Daytime Sleepiness with the Risk of Car Accidents in Adult Working Population: A Systematic Review and Meta-Analysis with a Gender-Based Approach.

Obstructive sleep apnea syndrome (OSAS) is an under-recognized clinical condition and is correlated with sleepiness and impaired cognitive function. Objectives: The primary aim of this systematic review, developed within the Sleep@OSA project, was to determine the correlations of obstructive sleep apnea syndrome, daytime sleepiness and sleep-disordered breathing with the risk of car accidents in adult working populations; a secondary aim was to analyze the epidemiologic data with a gender-based approach to identify differences between women and men in the data and in associated risk factors. Methods: Clinical trials and studies reporting data on the frequency of car accidents involving adult working population with daytime sleepiness and/or OSAS compared with a control group of participants were included. Literature searches of free text and MeSH terms were performed using PubMed, Google Scholar, the Cochrane Library and Scopus from 1952 to 3 May 2021. Results and Conclusions: The search strategy identified 2138 potential articles. Of these, 49 papers were included in the qualitative synthesis, and 30 were included in the meta-analysis. Compared with controls, the odds of car accidents were found to be more than double in subjects with OSAS (OR = 2.36; 95% CI 1.92−2.91; p < 0.001), with a similar risk between commercial motor vehicle drivers (OR = 2.80; 95% CI 1.82−4.31) and noncommercial motor vehicle drivers (OR = 2.32; 95% CI 1.84−2.34). No significant correlation was found between sleepiness and car crashes, but subjects with sleep-disordered breathing were at increased risk of car accidents (OR = 1.81; 95% CI 1.42−2.31; p < 0.001). To our surprise, although epidemiological studies on the risk of road accidents in the adult population with OSAS and daytime sleepiness are currently very abundant, specific data on the female population are not available.

External Root Resorption Management of an Avulsed and Reimplanted Central Incisor: A Case Report.

Background: Avulsion and reimplantation of permanent teeth represent a major challenge in terms of treatment and long-term prognosis. The present study reported clinical management of external root resorption of an avulsed and reimplanted maxillary central incisor. Case report: A 9-year-old boy reported an uncomplicated crown fracture and avulsion of tooth 11 and complicated crown fracture of tooth 21 due to trauma. Reimplantation of element 11 was obtained within 30 min post-trauma and 3 days after both elements were diagnosed with necrotic pulp. In addition, tooth 11 showed early external root resorption. Both elements underwent endodontic treatment and root closure with apical plug using calcium-silicate-based cement. At 6-month follow-up root resorption appeared to be arrested. Twenty-four months after trauma the clinical results were stable, although signs and symptoms of ankylosis were observed. Conclusions: An immediate endodontic approach and use of calcium-silicate-based cement seemed to contrast the progression of root resorption of an avulsed and reimplanted central incisor after 24 months of follow-up.

Bond Strength of Self-Adhesive Flowable Composites and Glass Ionomer Cements to Primary Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies.

Background: Conventional composites are largely used in pediatric restorative dentistry and demonstrate successful clinical outcomes. However, the need for simplification of operative steps in young or uncooperative children demands reliable alternatives. Therefore, the aim of the present systematic review and meta-analysis was to evaluate the in vitro bond strength of glass ionomer cements (GICs) and self-adhesive flowable composites (SFCs) on deciduous teeth. Methods: A comprehensive literature search according to the PRISMA checklist was manually and electronically performed by two independent reviewers through the following databases: MEDLINE/PubMed, Google Scholar, Scopus, and Embase, to include in vitro studies comparing GICs and SFCs bond strength values of restorations on primary teeth. In addition, three groups of meta-analyses were conducted using random-effects models. Results: Three articles meeting the inclusion criteria were selected and subjected to both qualitative and quantitative assessment. No statistically significant difference was found between SFC versus GIC; however, both groups significantly differed with conventional flowable composites (CFs). Conclusions: Despite the absence of significant difference in bond strength values, SFCs may be considered a valid alternative to GICs in the restoration of deciduous teeth, although CFs proved better in vitro performances.

Root Fracture and Extrusive Luxation in Primary Teeth and Their Management: A Case Report.

BACKGROUND: Extrusion, lateral luxation, and intrusion are among the most serious types of dental trauma. Only a few studies have specifically focused on extrusion; the present one was aimed at reporting a case of domestic traumatic dental injury to primary tooth and describing the measures taken in managing the trauma in order to avoid future consequences to the underlying permanent tooth germ. CASE REPORT: A 3.5-year-old boy reported a dental injury with extrusion and root fracture of deciduous tooth 5.1. After intraoral and radiographic evaluation, the element was repositioned and stabilized by an orthodontic flexible splint attached to the adjacent teeth. Several follow-up checkups were made and showed good healing of the tissues and physiological exfoliation of the tooth, with a healthy and unaffected corresponding central permanent incisor. CONCLUSION: This case report strengthens the importance of well-timed diagnosis and treatment and of regular follow-up of traumatized teeth as they may affect both dentitions with a negative impact on Oral Health-Related Quality of Life. Conservative treatment should be taken into consideration when possible, being in some cases more appropriate.

Computer-Guided Bone Biopsy: A Technical Note with the Description of a Clinical Case.

AIM: The aim of this technical note is to present a computer-aided design-computer-aided manufacturing (CAD-CAM) surgical guide to perform a computer-guided bone biopsy. Traditionally, to diagnose abnormal conditions affecting jawbone, a bone biopsy is performed with the use of a trephine bur. The positioning of the bur, during the biopsy, is based on the skill of the surgeon; therefore, an inaccurate placement of a trephine bur may occur. The use of a guide, however, can minimize this risk and achieve a better result. MATERIALS AND METHODS: To determine the site and the extension of bone sampling, the stereolithography file (STL) file of cone-beam computed tomography (CBCT) images is acquired using a specific planning software and superimposed with the STL file of a dental cast; a virtual surgical guide is designed, using the same software that allows a 3D (three-dimensional) view of the guide from different perspectives and planes. The number and site of guide tubes are determined on the basis of the width and the extension of the sampling; thanks to a 3D printer, the surgical guide is manufactured. RESULTS: The use of a customized surgical guide realized with CAD-CAM technology allows a precise and minimally invasive approach, with an accurate three-dimensional localization of the biopsy site. CONCLUSIONS: The high precision, great predictability, time-effectiveness and versatility of the present guide should encourage the clinician to use this minimally invasive surgical approach, but controlled clinical trials should be conducted to evaluate the advantages as well as any possible complications.

Longevity of Teeth and Dental Implants in Patients Treated for Chronic Periodontitis Following Periodontal Maintenance Therapy in a Private Specialist Practice: A Retrospective Study with a 10-Year Follow-up.

The aim of the present study was to retrospectively evaluate the longevity of teeth and implants during a long-term period in a cohort of periodontally compromised patients, treated and maintained in a private specialist periodontal practice, and to analyze the associated risk factors. Fifty-eight patients (30 men, 28 women) who had received active periodontal therapy (APT) and regular periodontal maintenance (PM) ≥ 10 years were included and evaluated. The following were evaluated: (1) statistically significant differences of clinical parameters assessed at six tooth or implant sites (plaque scores, bleeding score, periodontal probing depth, bleeding on probing, and gingival recession) and radiographic parameters (mesial and distal bone crest loss) between patients with and without tooth/implant loss during PM; and (2) associations between the number of teeth and implants lost and potential risk factors. During PM, the overall average tooth loss was 0.07 teeth/patient/year (0.04 teeth/patient/year for periodontal reasons), while the overall average implant loss was 0.4 implants/patient/year. The overall implant failure was 10.08%, and the rate of implant failure due to biologic reasons was 9.8%. Incidence of implant failures in patients with vs without recurrent periodontal disease was 83.3% vs 16.7% (P < .05). Results showed that in chronic periodontitis patients, ATP followed by long-term PM is successful in keeping the majority of periodontally compromised teeth. In the same patients, a higher tendency for implant loss than tooth loss was found.

Endogenous Enzymatic Activity of Primary and Permanent Dentine.

Matrix metalloproteinases (MMPs) play an important role in tooth development and influence caries development and hybrid layer degradation. Literature is scant on the differences in the activity of MMPs between primary and permanent dentine. Accordingly, the aim of the present study was to investigate endogenous gelatinolytic activity in primary and permanent dentine. Separate batches of dentine powder were obtained from intact human primary and permanent molars (n = 6). Each batch was divided in two subgroups: (1) mineralised; and (2) demineralised with 10% H3PO4. After protein extraction, gelatine zymography was performed. Furthermore, in situ zymography was performed on dentine sections of the same groups (n = 3). The slices were polished, covered with fluorescein-conjugated gelatine and evaluated using a confocal microscope. In situ zymography data were analysed using two-way analysis of variance and post hoc Holm-Sidák statistics (α = 0.05). Primary dentine showed poorly defined bands in the zymograms that vaguely corresponded to the pro-form and active form of MMP-2 and the pro-form of MMP-9. In permanent dentine, demineralised powder demonstrated stronger gelatinolytic activity than mineralised powder. In situ zymography identified stronger enzymatic activity in primary etched dentine (p < 0.05). Stronger enzymatic activity recorded in primary dentine may be related to the differences in morphology and composition between primary and permanent dentine.

Biocompatibility and Antibiofilm Properties of Calcium Silicate-Based Cements: An In Vitro Evaluation and Report of Two Clinical Cases.

Calcium silicate-based cements have reached excellent levels of performance in endodontics, providing predictable and successful results. To better assess the properties of these bioactive materials, the present study aimed to compare the biocompatibility and antibiofilm properties of ProRoot MTA and Biodentine. Human osteogenic sarcoma (Saos-2) cells were cultured on ProRoot MTA and Biodentine samples or in the presence of both cement extracts. Cell viability assay, measurement of reactive oxygen species (ROS), immunofluorescence analysis, as well as morphological evaluations were conducted. Moreover, Streptococcus mutans was used to assess the biofilm forming ability on ProRoot MTA and Biodentine disks. Finally, both cements were applied in vivo to treat immature permanent teeth affected by reversible pulpitis. Results: Cell viability assay demonstrated that Saos-2 cells had a dose- and time-dependent cytotoxicity to both analyzed cements, although cells exposed to ProRoot MTA showed a better cell vitality than those exposed to Biodentine (p < 0.001). Both cements demonstrated ROS production while this was greater in the case of Biodentine than ProRoot MTA (p < 0.001). Immunofluorescence images of the cytoskeleton and focal adhesions showed no differences in Saos-2 cells grown in the presence of ProRoot MTA eluate; whereas in the Biodentine groups, cells showed a morphology and focal adhesions more similar to that of the control sample, as the eluate concentration decreased. Morphological analysis revealed that Saos-2 cells were more flattened and exhibited better spreading when attached to ProRoot MTA disks than to Biodentine ones. The antibiofilm properties showed a time-dependent powerful inhibition of S. mutans superficial colonization and an antibiofilm effect of both cements. Clinically, complete root formation of the treated elements was achieved using the two studied cements, showing stable results over time. ProRoot MTA and Biodentine was demonstrated to be biocompatible and to possess antibiofilm properties. Their clinical application in vital pulp therapy provided successful outcomes after 2 years of follow-up.

Immediate non-submerged implants with laser-microtextured collar placed in the inter-radicular septum of mandibular molar extraction sockets associated to GBR: Results at 3-year.

BACKGROUND: The aim of the present study was to radiographically evaluate the vertical socket walls changes, and the peri-implant marginal bone remodelling, and clinicallly the soft tissues conditions around the non-submerged single implants placed into the inter radicular septum of mandibular molar sockets, associated with a collagen membrane, after 3 years of loading. MATERIAL AND METHODS: Thirty patients underwent to placement of a non-submerged implants with a laser-microtextured collar into the inter radicular septum of mandibular molar fresh extraction sockets. A collagen membrane and the mucoperiosteal flap were adapted around the neck of the implants, leaving the laser-microtextured collar to heal in a transmucosal fashion. RESULTS: At the end of the follow-up period, no statistical differences were found for each radiographic measurements used for the examination of extraction sockets vertical bone changes. Compared to implants placement, at the end of the 3-year follow-up, the vertical radiographic mesial and distal peri-implant marginal bone levels showed a statistically significant gain of 0.9 (SD 0.5), and 1.0 mm (SD 0.6), respectively (P=0.037). CONCLUSIONS: In mandibular fresh extraction sockets, the method of GBR around transmucosal implants with laser-microtextured surface placed into the interadicular septum may be used successfully to counteract the ridge remodelling. Key words:Non-submerged implants, GBR, laser-microtextured collar.