Five decades of research on immediate implant therapy: A modern bibliometric network analysis via Altmetric and level of evidence mapping.

AIM: To conduct a bibliometric network analysis to explore the research landscape of immediate implant placement (IIP) and provide insights into its trends and contributors. MATERIALS AND METHODS: The Scopus database was utilized as the bibliographic source, and a search strategy was implemented to identify relevant research articles. Various bibliometric parameters were extracted, including publication year, journal, authors, citations, and funding. The analysis involved examining authorship patterns, international collaborations, level of evidence, Altmetric data, and funding analysis. RESULTS: We identified a steady annual growth rate of 6.49% in IIP research. The top three countries contributing to research output were the USA, Italy, and China. Prolific authors were identified based on publication and citation metrics. International collaborations among different countries were observed. The level of evidence analysis revealed that over 30% of the articles fell into higher levels of evidence (levels 1 and 2). Altmetric data analysis indicated no significant correlations between citation counts and Altmetric Attention Score (AAS), and conversely a significant association with Mendeley readers count. Funding and open access did not significantly impact the bibliometric indices of the papers. CONCLUSIONS: The focus of research on IIP has been evolving as indicated by an exponential growth rate in this study. Only approximately 16% of the articles fit into level 1 evidence, therefore, emphasizing on higher quality level research study shortage in this field. Modern indices can be used as new bibliometric indicators as they also cover social media and online attention scores.

Vertical Ridge Augmentation Using Collagen Membrane and Tenting Screws in the Esthetic Zone: A Case Series.

Successful rehabilitation of severely atrophic, short-span edentulous ridges in esthetic regions can seldom be done without some form of vertical ridge augmentation (VRA). The best available evidence shows that guided bone regeneration procedures may present a very predictable option with reduced potential for complications compared to alternative options. The present case series presents a novel technique to achieve predictable VRA with a low complication rate using tenting screws and cross-linked resorbable membranes. A total of 10 patients (5 men, 5 women) with severe vertical defects in the esthetic zone participated in this study. Following a mean healing time of 9.3 months, the mean defect resolution was 80%, with a mean vertical bone gain of 6.2 ± 1.61 mm. Only one case presented with reduced defect resolution (50%); however, the bone gain for this case was 6 mm.

Orthodontic tooth extrusion to regenerate missing papilla adjacent to maxillary anterior single implants: A 2- to 7-year retrospective study.

INTRODUCTION: Regeneration of the missing papilla adjacent to single implants in the esthetic zone has always been challenging, despite advances in vertical hard and soft tissue regeneration. Orthodontic tooth extrusion has been shown to effectively gain alveolar bone and gingival tissue. This retrospective study evaluated the effectiveness of orthodontic tooth extrusion on regenerating missing papilla between existing maxillary anterior single implant and its adjacent tooth. METHODS: Patients who underwent orthodontic tooth extrusion to regenerate missing papilla adjacent to a single implant in the esthetic zone were included in this study. The gingival phenotype, orthodontic extrusion movement, proximal bone level, dento-implant papilla level, facial gingival level, mucogingival junction level, and keratinized tissue width, of the extruded tooth were recorded at pre-orthodontic extrusion (T0 ), post-orthodontic extrusion and retention (T1 ), and latest follow-up (T2 ). RESULTS: A total of 17 maxillary single tooth had orthodontic tooth extrusion to regenerate missing papilla adjacent to 14 maxillary anterior single implants in 14 patients. After a mean follow-up time of 48.4 months, implant success rate was 100% (14/14), with none of the orthodontically extruded teeth being extracted. After a mean extrusion and retention period of 14.3 months, a mean orthodontic extrusion movement of 4.62 ± 0.78 mm was noted with a mean proximal bone level gain of 3.54 ± 0.61 mm (77.0% efficacy), dento-implant papilla level gain of 3.98 ± 0.81 mm (86.8% efficacy), and facial gingival tissue gain of 4.27 mm ± 0.55 mm (93.4% efficacy). A mean keratinized tissue width gain of 4.17 ± 0.49 mm with minimal mean mucogingival junction level change of 0.10 ± 0.30 mm were observed. The efficacy of orthodontic eruption movement on dento-implant papilla gain was less in the thin (80.5%) phenotype group when compared with that in the thick (91.5%) phenotype group. CONCLUSIONS: Within the confines of this study, orthodontic extrusion is an effective, noninvasive method in regenerating mid-term stable proximal bone and papilla adjacent to maxillary anterior single implants. CLINICAL SIGNIFICANCE: This retrospective study presents a mid-term result on orthodontic extrusion as a mean to regenerate dento-implant papilla defect. The extended retention period following orthodontic extrusion showed stable and efficacious proximal bone and papilla gain.

Facial Contour Preservation of Anterior Immediate Single-Tooth Replacement With the Socket Shield Technique Versus Connective Tissue Graft: A Case Report.

The socket shield technique and subepithelial connective tissue graft following immediate implant placement with provisionalization had been advocated for peri-implant facial contour and gingival architecture preservation. This case report used three-dimensional volumetric analysis to longitudinally assess the peri-implant facial contour change before and after these procedures. The results demonstrated comparable and acceptable preservation of peri-implant facial contour between the two procedures after 2 years of function.

Effects of cyclic loading on loss of abutment screw torque of angled screw channel single implant crowns on narrow diameter implants.

STATEMENT OF PROBLEM: Screw access channels that emerge on the facial aspect of anterior screw-retained implant crowns can compromise esthetics. Recently, angled screw channels (ASCs) have been developed that can alter screw access channel angulations to improve esthetics. While ASCs can be used on narrow-diameter implants, information is limited on the loss of abutment screw torque on narrow-diameter implants with ASCs. PURPOSE: The purpose of this in vitro study was to compare the loss of abutment screw torque after thermocycling and the cyclic loading of ASCs from 3 different companies connected to narrow-diameter implants. MATERIAL AND METHODS: A total of 40 narrow-diameter implants (NobelReplace Conical Connection 3.5×11.5 mm) were mounted individually in acrylic resin blocks and divided equally into 4 groups. The first group, NB-0 (Control), consisted of screw-retained zirconia crowns fabricated on ASCs at 0-degree angulation (n=10). The other 3 groups consisted of a total of 30 screw-retained zirconia crowns fabricated on ASCs at 20-degree angulation: NB-20 (Angulated Screw Channel Solutions), ATL-20 (Atlantis Custom Base Solution with angulated screw access), and DA-20 (Dynamic TiBase). Each crown was secured on the mounted implant with its corresponding titanium base insert and screw and then tightened to the manufacturer's recommended torque with a digital torque gauge. The initial reverse torque value (RTVI) was obtained and recorded at baseline. Subsequently, a new set of screws were tightened to recommended values, and each specimen underwent thermocycling and then cyclic loading at 0 to 100 N at 10 Hz for 1 million cycles to simulate 1year of functional loading. After cyclic loading, the final reverse torque values (RTVF) were recorded and compared with the RTVI to evaluate the percentage torque loss (PTLF). Statistical analysis was performed using the Kruskal-Wallis analysis, Rank base analysis of covariance (ANCOVA), and the Tukey HSD post hoc comparisons (α=.05). RESULTS: Significant differences were found for the PTLF among all groups after cyclic loading (P<.001). The PTLF in ATL-20 (51.4%) was significantly higher than in NB-0 (22.2%) (P<.001) and NB-20 (29.2%) (P=.010). No significant difference was found in the PTLF among other groups (P>.05). CONCLUSIONS: The abutment screw torque loss after cyclic loading of the ASCs on narrow diameter implants among the 4 groups did not perform comparably. The largest percentage torque loss was recorded for the ATL-20 group. The NB-20 group demonstrated the lowest percentage torque loss. DA-20 showed percentage torque loss less than ATL-20; however, its RTVF was the lowest.

Inter-implant Papilla Changes Following Anterior Immediate Tooth Replacement with Socket Shields: A 1- to 10-Year Retrospective Study.

This retrospective study investigates the efficacy of the socket shield (SS) in preserving inter-implant papilla and bone in anterior adjacent implant sites. Clinical and radiographic records of 23 patients were evaluated. A total of 31 implants were placed immediately into extraction sockets with SS, resulting in 26 inter-implant sites, and 7 implants were placed without SS. After a mean follow-up of 41.5 months (range: 12 to 124 months), 30/31 (96.8%) implants with SS and 7/7 (100%) implants without SS were clinically successful. The mean changes in inter-implant papilla and bone heights were -0.40 mm and -0.46 mm, respectively. The effects of implant placement timing and the socket shield number, shape, and crestal level on inter-implant tissue height changes were found to be insignificant (P > .05). Supracrestal shield level (31.6% vs 16.6% in equicrestal), U-shape shield (41.2% vs 7.1% in C-shape), and shield-to-implant contact (40.0% vs 12.5% in no contact) were associated with increased occurrence of exposures. The application of SS in adjacent anterior implant situations is a viable treatment option for maintaining inter-implant papilla.

Facial Mucosal Level Change Following Maxillary Anterior Single Immediate Tooth Replacement in Extraction Sockets With Facial Bone Wall Defects: A 4- to 15-Year Retrospective Study.

An intact extraction socket has been considered a prerequisite for an immediate implant placement and provisionalization (IIPP) procedure. Recent studies, however, have shown successful outcomes when IIPP was performed in sockets with a facial bone wall defect. This retrospective study evaluated the facial implant mucosal stability following IIPP in extraction sockets with a facial bone wall defect in the esthetic zone. The study included 16 cases in 16 patients who received maxillary anterior single IIPP with contour bone graft (C-BG) and contour connective tissue graft (C-CTG) in compromised extraction sockets (V- or U-shaped defect). After a mean follow-up of 6 years, the implant success rate was 100% (16/16). Minimal and non-statistically significant changes were noted in the facial implant mucosal and marginal bone level. Statistically significant changes were observed in facial implant mucosal thickness gain (2.5 mm [1.8 mm to 3.5 mm]) and midfacial bone sounding reduction (6 mm). Within the confines of this study, IIPP with simultaneous C-BG and C-CTG in fresh extraction sockets exhibiting a V- or U-shaped facial bone wall defect can lead to long-term successful outcomes in terms of mucosal stability, contour bone gain, and marginal bone level stability.

Hard- and Soft-Tissue Reconstruction in the Anterior Maxilla for Esthetic Implant Therapy.

Implant rehabilitation in the esthetic zone is often challenged by vertical bone defects and soft-tissue deformities. This article describes a combined hard- and soft-tissue restorative approach that involves staged guided bone regeneration, implant placement, and two soft-tissue augmentation procedures to achieve optimal esthetic outcomes at multiple implant sites in the anterior zone. The staged bone augmentation procedure, performed with a mixture of autogenous and xenogeneic bone graft and a nonresorbable membrane, allowed for the placement of three implants in ideal positions after 9 months. Further soft-tissue augmentation involved the use of multiple connective tissue grafts (CTGs) stabilized on the occlusal aspect of the implants and between the implants to enhance peri-implant papillae (ie, the "iceberg" CTG approach). Then, a second soft-tissue grafting procedure was executed to reposition the mucogingival junction and re-establish an adequate amount of keratinized mucosa at the implant sites. The article highlights the importance of performing both hard- and soft-tissue augmentation for implant therapy in the esthetic zone.

Frequency of screw-retained angulated screw channel single crown following immediate implant placement and provisionalization in the esthetic zone: A cone beam computed tomography study.

OBJECTIVE: The purpose of this cone beam computed tomography (CBCT) study was to determine the frequency percentage of screw-retained crown using angulated screw channel (ASC) abutment for single immediate implant placement and provisionalization (IIPP) in the esthetic zone. METHODS: The CBCT images of 200 patients without disease and without metal restorations in maxillary anterior teeth were evaluated. The mid-sagittal-sectional CBCT images of maxillary anterior teeth (#6-#11) were created in an implant planning software, screen-captured, and transferred to a presentation program. Template of tapered implants with diameter of 3.5 mm (for central and lateral incisors) and 4.3 mm (for central incisors and canines) and lengths of 13, 15, and 18 mm were applied to the sagittal images to identify the IIPP cases. To qualify for IIPP, the implant must engage >35% bone with at least 1 mm of surrounding bone and no perforations. The IIPP cases were further divided into straight screw channel (IIPPSSC) abutment or 25-degree angulated screw channel abutment (IIPPASC), based upon its restorability. The frequency percentages of possible IIPP, IIPPSSC, and IIPPASC were reported and compared among all maxillary anterior teeth. RESULTS: A total of 1200 maxillary anterior teeth sagittal images from 200 patients (88 male and 112 female) with a mean age of 51.3 years (range 20-83 years) were evaluated in this study. The overall frequency percentages of IIPP, IIPPSSC, and IIPPASC possibility were 84% (74%-92%), 14% (10%-24%), and 75% (66%-87%), respectively. CONCLUSION: Within the limitations of this CBCT study, 90% of single IIPP in the esthetic zone can be restored with screw-retained crown when utilizing ASC. In addition, the possibility of using a screw-retained restoration following IIPP increases about five times with ASC abutment compared to the SSC abutment.

Facial implant gingival level and thickness changes following maxillary anterior immediate tooth replacement with scarf-connective tissue graft: A 4-13-year retrospective study.

OBJECTIVE: A scarf-shaped connective tissue graft can be placed at the facial and proximal aspect of the peri-implant soft tissue zone during immediate implant placement and provisionalization (IIPP) procedures in the esthetic zone to optimize implant esthetics without the need of flap reflection. This retrospective study evaluated soft tissue stability after scarf-connective tissue graft (S-CTG) in conjunction with IIPP procedures in the esthetic zone. MATERIALS AND METHODS: Patients who received IIPP with S-CTG with a minimum 1-year follow-up were evaluated. Mid-facial gingival level (MFGL) change and mid-facial gingival thickness (MFGT) change were measured and compared at the pre-op (T0), IIPP + S-CTG surgery (T1), follow up appointment with MFGT measurement (T2), and latest follow-up appointment (T3). Implant success rate and graft necrosis were also recorded. RESULTS: A total of 22 IIPP and S-CTG procedures in 20 patients were evaluated in the study. After a mean follow-up of 8.2 years (3.9-13.4) (T3), all implants remained osseointegrated (22/22 [100%]), with statistically insignificant mean midfacial gingival level change of -0.19 mm (-1.5 to 0.8). Statistically significant difference in midfacial gingival thickness (MFGT) was noted (2.5 mm [1.8-3.5 mm]) after a mean follow-up time (T2) of 2.3 years (1-8.6) when compared with MFGT at baseline (1.1 mm [0.6-1.3 mm]) (T1). Necrosis of S-CTG during initial healing phase was noted in 9% (2/22) of the sites. CONCLUSIONS: Within the confines of this study, scarf-connective tissue graft at time of immediate implant placement and provisionalization can thicken the gingiva and maintain the gingival level at the critical soft tissue zone. CLINICAL SIGNIFICANCE: Managing the soft tissue zone is as important as that of the hard tissue zone for peri-implant esthetics. Connective tissue graft is one of the methods that can enhance the final esthetic outcomes. This retrospective study has demonstrated that Scarf-CTG technique is an effective treatment modality to maintain soft tissue stability.

Artificial intelligence models for diagnosing gingivitis and periodontal disease: A systematic review.

STATEMENT OF PROBLEM: Artificial intelligence (AI) models have been developed for periodontal applications, including diagnosing gingivitis and periodontal disease, but their accuracy and maturity of the technology remain unclear. PURPOSE: The purpose of this systematic review was to evaluate the performance of the AI models for detecting dental plaque and diagnosing gingivitis and periodontal disease. MATERIAL AND METHODS: A review was performed in 4 databases: MEDLINE/PubMed, World of Science, Cochrane, and Scopus. A manual search was also conducted. Studies were classified into 4 groups: detecting dental plaque, diagnosis of gingivitis, diagnosis of periodontal disease from intraoral images, and diagnosis of alveolar bone loss from periapical, bitewing, and panoramic radiographs. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. RESULTS: Twenty-four articles were included: 2 studies developed AI models for detecting plaque, resulting in accuracy ranging from 73.6% to 99%; 7 studies assessed the ability to diagnose gingivitis from intraoral photographs reporting an accuracy between 74% and 78.20%; 1 study used fluorescent intraoral images to diagnose gingivitis reporting 67.7% to 73.72% accuracy; 3 studies assessed the ability to diagnose periodontal disease from intraoral photographs with an accuracy between 47% and 81%, and 11 studies evaluated the performance of AI models for detecting alveolar bone loss from radiographic images reporting an accuracy between 73.4% and 99%. CONCLUSIONS: AI models for periodontology applications are still in development but might provide a powerful diagnostic tool.

Abutment screw torque changes with straight and angled screw-access channels.

STATEMENT OF PROBLEM: Angle-correcting options allow the use of screw-retained implant prostheses in situations where an implant has been placed with a facial inclination. However, manufacturers have different recommended torque values, and it is unclear whether the performance of these designs is equivalent to that of the traditional screw-retained crowns (SRCs) when subjected to cyclic loading forces. PURPOSE: The purpose of this in vitro study was to compare torque differences between conventional straight-line screw access and angulated access SRCs before and after simulated functional loading. MATERIAL AND METHODS: Five groups consisting of 10 SRCs and implants were formed: Nobel Biocare zirconia crowns with 20-degree access channels (NB-20); Dynamic Abutment Solution zirconia crowns (DA-20) with 20-degree access channels; Core3dcentre angle correction zirconia crowns with 20-degree access channels (C3D-20); Nobel Biocare zirconia crowns with 0-degree access channels (NB-0); and gold alloy crowns cast to Nobel Biocare Gold-Adapt abutments (GA-0). Each specimen underwent thermocycling before cyclic loading. A preload torque based on the manufacturer's recommendation was applied to each crown placed on an implant. Reverse torque measurements were obtained for each specimen before cyclic loading. Each implant-abutment assembly was then cyclic loaded at 0 to 100 N at 10 Hz for 1 million cycles. Reverse torque measurements were obtained after cyclic loading and the percentage difference calculated. RESULTS: No significant percentage torque loss differences were observed between the 0-degree and 20-degree SRCs after cyclic loading. No significant differences were seen among the angulated access channel crowns. DA-20 and C3D-20 specimens had significantly higher torque loss compared with the NB-0 group. The C3D-20 group reported the largest percentage torque loss (34.5%) among the angulated access screw channel groups. The GA-0 group reported the largest percentage torque loss of all the groups (35.9%). No crown mobility or other complications were observed in any of the groups after cyclic loading. CONCLUSIONS: Angulated access channel crowns performed comparably with conventional straight-line screw access SRCs with regard to percentage torque values after cyclic loading. Angulated access channel crowns with lower manufacturer recommended torque values had higher percentage torque differences.

Facial Gingival Changes With and Without Socket Gap Grafting Following Single Maxillary Anterior Immediate Tooth Replacement: One-Year Results.

This 1-year prospective study evaluated horizontal and vertical facial gingival tissue changes after immediate implant placement and provisionalization (IIPP) with and without bone graft in the implant-socket gap (ISG). During IIPP, 10 patients received bone graft material in the ISG (G group), while the other 10 patients did not (NG group). The implants were evaluated for implant stability quotient (ISQ), modified plaque index (mPI), modified bleeding index (mBI), marginal bone level (MBL), facial gingival level (FGL), and facial gingival profile (FGP) changes. The mean ISQ value at 9-month follow-up was statistically significantly greater than on the day of implant surgery (P < .05). The mPI and mBI scores demonstrated that patients were able to maintain a good level of hygiene. There were no statistically significant differences in the mean MBL changes between the G and NG groups (P > .05). There were statistically significant differences in FGL changes between the G (-0.77 mm) and NG (-1.35 mm) groups (P = .035). There were no statistically significant differences in FGP changes between the G and NG groups (P > .05). However, statistically significant differences were noted in FGP change between the 3-12 and 0-12 month intervals in both groups (P < .05). Within the limitations of this study, although no significant differences were noted in FGP changes between groups, G group experienced significantly less FGL changes than NG group. Bone graft material placement into ISG seems to be advantageous for tissue preservation during IIPP. However, future long-term studies, with larger sample size, are needed to validate the efficacy of such procedure.

The significance of surgically modifying soft tissue phenotype around fixed dental prostheses: An American Academy of Periodontology best evidence review.

BACKGROUND: This systematic review endeavored to investigate the effect of soft tissue phenotype modification therapy (PhMT-s) at sites with a tooth or an implant supported fixed dental prosthesis. METHODS: A comprehensive literature search was conducted by two independent examiners to identify relevant studies reporting differences in clinical, esthetic, or radiographic outcomes of interest between sites underwent PhMT-s and sites that remained untreated. Risk of bias assessment was calculated for all included studies. Meta-analyses involving endpoints of interest were performed when feasible. RESULTS: No controlled studies pertaining to tooth sites were identified. A total of six articles reporting on the outcomes of buccal soft tissue phenotype modification around implants were selected, of which, five were included in the meta-analyses. Quantitative analyses showed a weighted mean difference (WMD) of 0.98 mm (95% CI = 0.25 to 1.72 mm, P = 0.009) for change of tissue thickness; a WMD of -4.87% (95% CI = -34.27 to 24.53%, P = 0.75) for bleeding on probing (BOP); a WMD of 0.36 mm (95% CI = 0.12 to 0.59 mm, P = 0.003) for mucosal recession (MR); a WMD of 0.13 mm (95% CI = -0.11 to 0.36 mm, P = 0.30 for probing depth (PD); a WMD of 1.08 (95% CI = -0.39 to 2.55, P = 0.15) for pink esthetic score (PES), and a WMD of 0.40 mm (95% CI = -0.34 to 1.14 mm, P = 0.28) for marginal bone loss (MBL). CONCLUSIONS: Surgical modification of peri-implant soft tissue phenotype via PhMT-s may decrease the amount of MR. Future clinical trials are needed to warrant the clinical benefits of modifying soft tissue phenotype around tooth-supported restorations.

Residual root preparation for socket-shield procedures: a facial window approach.

Two common complications that occur following immediate implant placement and provisionalization procedures in the anterior maxilla are changes to the facial periimplant soft tissue levels and the facial contours. To counteract these changes, different techniques and treatments have been recommended. The recently introduced socket-shield technique (SST) appears to be a viable treatment option for stabilizing the facial osseous and gingival architecture; however, preparation of the root fragment can present challenges. This article describes a surgical approach designed to facilitate preparation of the facial root fragment.

Immediate placement and provisionalization of maxillary anterior single implant with guided bone regeneration, connective tissue graft, and coronally positioned flap procedures.

Immediate implant placement and provisionalization in the esthetic zone have been documented with success. The benefit of immediate implant placement and provisionalization is the preservation of papillary mucosa. However, in cases with osseous defects presenting on the facial bony plate, immediate implant placement procedures have resulted in facial gingival recession. Subepithelial connective tissue grafts for immediate implant placement and provisionalization procedures have been reported with a good esthetic outcome. Biotype conversion around implants with subepithelial connective tissue grafts have been advocated, and the resulting tissues appear to be more resistant to recession. The dimensions of peri-implant mucosa in a thick biotype were significantly greater than in a thin biotype. Connective tissue graft with coronally positioned flap procedures on natural teeth has also been documented with success. This article describes a technique combining immediate implant placement, provisionalization, guided bone regeneration (GBR), connective tissue graft, and a coronally positioned flap in order to achieve more stable peri-implant tissue in facial osseous defect situations.

Accuracy of computer-guided surgery: A comparison of operator experience.

STATEMENT OF PROBLEM: Even though high-precision technologies have been used in computer-guided implant surgery, studies have shown that linear and angular deviations between the planned and placed implants can be expected. PURPOSE: The purpose of this study was to evaluate the effect of operator experience on the accuracy of implant placement with a computer-guided surgery protocol. MATERIAL AND METHODS: Ten surgically experienced and 10 surgically inexperienced operators participated in this study. Each operator placed 1 dental implant (Replace Select) on the partially edentulous mandibular model that had been planned with software by following a computer-guided surgery (NobelGuide) protocol. Three-dimensional information of the planned and placed implants were then superimposed. The horizontal and vertical linear deviations at both the apex and platform levels and the angular deviation were measured and compared between the experienced and inexperienced groups with the independent t test with Bonferroni adjustment (α=.01). The magnitude and direction of the horizontal deviations were also measured and recorded. RESULTS: No significant differences were found in the angular and linear deviations between the 2 groups (P>.01). Although not statistically significant (P>.01), the amount of vertical deviation in the coronal direction of the implants placed by the inexperienced operators was about twice that placed by the experienced operators. Overall, buccal apical deviations were most frequent and of the highest magnitude. CONCLUSIONS: When a computer-guided protocol was used, the accuracy of the vertical dimension (depth of implant placement) was most influenced by the operator's level of experience.

Marginal bone response of implants with platform switching and non-platform switching abutments in posterior healed sites: a 1-year prospective study.

OBJECTIVES: This 1-year prospective study evaluated the implant success rate and marginal bone response of non-submerged implants with platform and non-platform switching abutments in posterior healed sites. MATERIAL AND METHODS: Nineteen patients (9 male, 10 female) with posterior partially edentulous spaces, between the ages of 23 and 76 (mean = 55.4 years), were included in this study. A total of 30 implants (15 implants restored with platform switching [PS] abutments [control] and 15 implants restored with non-platform switching [NPS] abutments [test]) were assigned between two groups using a randomization procedure. The definitive abutments with conical connections were placed at the time of surgery, and the definitive restorations were placed at 3 months. All patients were evaluated clinically and radiographically using standardized radiographs at time of implant placement (0), 3, 6 and 12 months after implant placement. Data were analyzed using Friedman test with post hoc pairwise comparisons, Mann-Whitney U-test, and Pearson's chi-square test at the significance level of α = 0.05. RESULTS: At 12 months, all 30 implants remained osseointegrated corresponding to a 100% success rate. The overall mean marginal bone level change at 12 months was -0.04 ± 0.08 mm for PS group and -0.19 ± 0.16 mm for NPS group. Statistically significant difference in the marginal bone level change was observed between groups at 0 to 12 months and 3 to 12 months (P < 0.05). CONCLUSIONS: This 1-year randomized control study suggests that when a conical implant-abutment connection is present, similar peri-implant tissue responses can be achieved with platform switching and non-platform switching abutments.

Effects of connective tissue grafting on the facial gingival level following single immediate implant placement and provisionalization in the esthetic zone: a 1-year randomized controlled prospective study.

PURPOSE: This 1-year randomized controlled prospective study evaluated the implant success rate and peri-implant tissue response following single immediate implant placement and provisionalization (IIPP) with and without subepithelial connective tissue graft (SCTG) in the esthetic zone. MATERIALS AND METHODS: Implants were placed either IIPP with SCTG (test group) or IIPP without SCTG (control group). The implants were evaluated both clinically and radiographically before surgery, immediately after implant placement, and 3, 6, and 12 months after implant placement. Data were analyzed using Friedman, Wilcoxon signed-rank, and Mann-Whitney U tests at the significance level of α = .05. RESULTS: Twenty implants (10 test, 10 control) were placed in 20 patients (7 men, 13 women) between the ages of 27 and 87 (mean age, 52.6 years). At 1 year, all implants remained osseointegrated, with overall mean marginal bone changes of -0.01 mm and -0.14 mm for the test and control groups, respectively. Mean facial gingival level change was significantly more pronounced in the control group (-0.70 mm) than in the test group (-0.25 mm). The modified Plaque Index scores showed that patients were able to maintain a good level of hygiene throughout the study. At 1 year, the Papilla Index indicated that more than 50% papilla fill was observed in 75% of the test sites and 80% of the control sites. CONCLUSIONS: Within the limitations of this study, SCTG was shown to be beneficial in maintaining facial gingival level when performed in conjunction with IIPP procedures.

Restauração provisória imediata sobre implantes de 3 mm de diâmetro, repondo incisivos superiores e inferiores unitários ausentes: estudo prospectivo de um ano / Immediate provisionalization of 3 mm-diameter implants replacing single missing maxillary and mandibular incisors: 1-year prospective study

Propósito: este estudo prospectivo de um ano avaliou a taxa de sucesso do implante e a resposta tecidual peri-implantar dos implantes estreitos (3 mm) que receberam restaurações imediatas em sítios dos incisivos superiores e inferiores. Material e Métodos: as restaurações provisórias imediatas foram colocadas em pacientes que preencheram os critérios de inclusão/exclusão. O sucesso do implante, o nível ósseo marginal (MBL), a mudança no nível ósseo marginal (MBLC), o valor do Periotest (PTV), o índice de placa modificado, o índice de sangramento modificado e o escore de papila (PIS) foram avaliados imediatamente após a colocação do implante, três, seis e 12 meses após a cirurgia. Todas as complicações cirúrgicas e protéticas foram registradas. Os dados foram analisados estatisticamente com nível de significância de 5%. Resultados: 17 implantes receberam restaurações provisórias imediatas em 13 pacientes com perdas nos incisivos laterais superiores e/ou incisivos inferiores. As taxas de sucesso do implante após um ano foram de 100% (17/17). Os valores médios MBL no início, três, seis, e 12 meses foram -0,03 ± 0,06 mm, -0,28 ± 0,35 mm, -0,28 ± 0,32 mm e -0,38 ± 0,36 mm, respectivamente. O valor médio MBLC do zero aos 12 meses foi -0,35 ± 0,35 mm. O valor PTV médio aos três meses (-2,65) foi significativamente menor do que no período inicial (1,59). Nenhuma diferença significativa nos índices de placa ou sangramento foi observada ao longo do tempo. Um aumento leve, mas significativo, no PIS, ao longo do tempo, indicou que as papilas peri-implantares permaneceram estáveis e bem mantidas. Todas as complicações foram relacionadas à prótese (sete restaurações provisórias fraturadas, duas restaurações com soltura, três parafusos de pilares com afrouxamento) e ocorreram nos primeiros três meses após a cirurgia.