Platform-switched implants vs platform-matched implants placed in different implant-abutment interface positions: A prospective randomized clinical and microbiological study.

BACKGROUND: Placement of the implant-abutment interface (IAI) away from the bone crest has been suggested to have positive impacts on maintenance of peri-implant tissues. PURPOSE: To assess the effects of platform-switched and platform-matched implants, taking into consideration the IAI at different positions relative to the bone crest, on clinical, radiographic, and microbiological outcomes during 12 months following functional loading. MATERIALS AND METHODS: The present prospective randomized study was performed upon 70 patients. Group I (n = 23) implants presenting a platform-switched implant-abutment connection design was inserted 1 mm subcrestally. Group II (n = 22) implants with similar properties were inserted crestally. Group III (n = 25) implants presenting a platform-matched approach with an internal hexagon connection design was inserted crestally. The periodontal parameters were assessed at baseline, and 3, 6, and 12 months postloading. Radiographic marginal bone level (MBL) changes were analyzed at the 12-month follow-up. The amount of DNA copies of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Provetalla intermedia and total bacterial mean load in peri-implant sulcus fluid (PISF) were assessed at the same periods. RESULTS: There were no significant differences among the groups with respect to the periodontal parameters for all time periods. At 12-month follow-up, the MBL changes were 0.16 ± 0.29 mm and 0.17 ± 0.23 mm for group I, 0.15 ± 0.25 mm and 0.17 ± 0.26 mm for group II, 0.17 ± 0.26 mm and for group III in mesial and distal sites, respectively. The mean total bacterial load was found significantly higher for group III compared to the other groups in the three interval times (P < .05). CONCLUSION: Implants restored with platform-switching and platform-matching performed equally regarding clinical and radiographic outcomes. Platform-matched implants inserted at the crestal level presented higher the mean bacterial total load in PISF.

Could drug burden be associated with severe periodontitis in patients receiving haemodialysis?

BACKGROUND: Periodontitis increases the risk of cardiovascular disease in the general population by triggering systemic inflammation. AIM: To investigate the relationship between systemic inflammation and periodontitis, and clarify any association between severe periodontitis and the medications used by patients receiving haemodialysis. DESIGN: A cross-sectional study. PARTICIPANTS: The study was undertaken with 56 patients receiving haemodialysis. MEASUREMENTS: Demographic and laboratory data and prescribed drugs regularly used by patients were recorded from hospital records. During the dialysis session, a validated Xerostomia Inventory score was completed. A complete dental/periodontal examination was also undertaken on all patients by the same periodontist. RESULTS: In the study population, stage I periodontitis was determined in 41%, stage II periodontitis in 17%, stage III periodontitis in 21%, and stage IV periodontitis in 21%. Male gender, hypertension, coronary artery disease, ß antagonists, calcium channel blockers, sodium polystyrene sulphonate, teeth brushing less than twice a day and high sensitive C-reactive protein > 8 mg/l were significantly associated with severe periodontitis. CONCLUSION: Drugs, including ß antagonists, calcium channel blockers, polystyrene sulphonate, co-morbid conditions and poor or insufficient oral care could facilitate an increase in the severity of periodontitis in patients receiving haemodialysis. Severe periodontitis also seems to be associated with cardiovascular disease and inflammation in patients with chronic renal disease.

A Technique for Restoring Severely Resorbed Edentulous Mandible with a Computer-aided Design and Computer-aided Manufacturing Surgical Guide and an Implant-supported Fixed Dental Prosthesis in Two Days.

AIM: The aim of this report is to describe a technique, in which a severely resorbed edentulous mandible was restored with computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guide and an implant-supported fixed dental prosthesis in two days. BACKGROUND: The quality of life of edentulous patients is generally restricted due to functional and psychosocial problems associated with complete dentures. These issues become worse over time due to ongoing bone resorption. Implant-supported prostheses have been utilized to overcome these problems. CASE DESCRIPTION: A 79-year-old patient with a severely resorbed edentulous maxilla and mandible presented to our clinic. After the cone beam computed tomography (CBCT) scans were performed, five implants were virtually placed via a 3-dimensional software. Then, a CAD/CAM surgical guide was fabricated with a stereolithographic method. Her mandible was restored with five implants by using the CAD/CAM surgical guide and the implant-supported prosthesis with CAD/CAM titanium framework in 2 days. CONCLUSION: The severely resorbed edentulous mandible was successfully restored with five dental implants, and the implant-supported fixed dental prosthesis via the CAD/CAM milled titanium framework. CLINICAL SIGNIFICANCE: The technique using software and hardware portrayed in this report may be a feasible option to restore similar patients if it is executed by trained restorative dentists adhering to strict guidelines.