A two-year prospective study to compare the peri-implant parameters of posterior implant-supported single crowns with and without mesial proximal contact loss.

Background/purpose: Interproximal contact loss may lead to food impaction and result in subsequently periodontal complications. The purpose of this prospective study was to investigate the peri-implant parameters of posterior implant-supported single crowns (SCs) with and without mesial proximal contact loss after 2 years of follow-up. Material and methods: Twenty-six patients with a total of 40 posterior implant-supported SCs with mesial adjacent natural teeth were observed for 24 months after crown insertion. The mesial proximal contacts were assessed by dental floss, then were classified as tight, weak, and open contacts. The following peri-implant parameters were evaluated, including modified plaque index (MPI), modified gingival index (MGI), and probing depth (PD) were conducted at six sites per tooth (mesiofacail, midfacial, distofacial, mesiolingual, mid-lingual and distolingual) in the 6-, 12-, 18- and 24-month following visits. Furthermore, radiographs were taken regularly in 12- and 24-month recall sections for measuring the marginal bone loss (MBL). Results: At 12-month observation, the incidence rates of weak and open contacts were 22.5 % and 12.5 %; whereas after 24 months of clinical service, the rates came up with 12.9 % and 25.6 %, respectively. No significant differences were found between the tight, weak, and open contact groups in the parameters of MPI, MGI, or PD (P > 0.05) at 12- and 24-month follow-up. None of the mean differences of the peri-implant parameters: MPI, MGI, PD and MBL had significant differences between the tight, weak, and open contact groups after 1 and 2 years of clinical service (P > 0.05). Conclusion: The presence of open, weak, and tight mesial proximal contacts had no significant effects on the peri-implant tissue conditions.

Peri-implant parameters and bone metabolic markers among water-pipe users treated with photodynamic therapy.

AIM: The study aimed to evaluate the efficacy of Mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of peri­implantitis among waterpipe smokers (WPS) and non-smokers with peri­implantitis MATERIAL AND METHODS: Participants were stratified into two groups. Group 1: Subjects who smoked water pipes for the last 2 years with peri­implant disease were treated with aPDT adjunct to MD and group 2: Participants who did not use water pipes in the last 2 years but have periimplantitis (controls) were treated with MD only. Participants were scrutinized with peri­implantitis (PI) in one dental implant at least based on the inclusion and exclusion criteria. Using structured questionnaire information was gathered from participants. All participants underwent mechanical debridement (MD). Participants of WPS underwent antimicrobial photodynamic therapy (aPDT). Peri implant inflammatory parameters (PI, BI, PD, and CBL) were assessed in all participant at baseline, 3 months and 6 months follow-up. Periimplant sulcular fluid was collected for assessment of bone metabolic biomarkers RANK-L and OPG. For immunological and clinical peri­implant parameters analysis of variance (ANOVA) and Kruskal-Wallis test were used. For multiple comparisons, Bonferroni post hoc test was deployed. RESULTS: Clinical periodontal parameters at baseline were significantly different in the control group PI (49.8 ± 10.5), BI(46.8 ± 7.7), and PD (5.0 ± 1.8) compared to WPS PI (56.1 ± 12.0), BI (40.9 ± 8.3), and PD (5.6 ± 1.5) (p < 0.05). At 3 months follow-up after PDT, PI (19.1 ± 7.7) and PD (3.9 ± 1.4) were significantly lower in the control group compared to WPS group PI (23.5 ± 8.4) and PD (4.5 ± 1.2) (p < 0.05). Whereas, BI of control (16.3 ± 6.8) and WPS group (17.1 ± 5.3) at 3 months follow-up was comparable (p > 0.05). At six months follow up following PDT, PI (15.7 ± 5.5) and PD (3.4 ± 1.2) was significantly lower in the control group compared to participants with water piped users PI (18.6 ± 7.4) and PD (3.9 ± 1.3) (p < 0.05). No significant difference was noted in BI in both groups (p > 0.05). Participants treated with PDT adjunct to MD demonstrated significantly reduced mean RANK-L levels at both 3 and 6 months (p<0.05). CONCLUSION: aPDT adjunctive to MD improved periodontal parameters i.e., plaque index, pocket depth, and crestal bone loss along with metabolic marker RANK-L in water pipe smokers compared to non piped smokers.

Impact of hyperglycemia on the rate of implant failure and peri-implant parameters in patients with type 2 diabetes mellitus: Systematic review and meta-analysis.

BACKGROUND: The impact of hyperglycemia on dental implant therapy remains unclear. In this systematic review and meta-analysis, the authors compared the rates of implant failure and peri-implant bleeding on probing (BOP), probing depth (PD), and peri-implant bone loss (PIBL) among patients with type 2 diabetes mellitus and nondiabetic patients. The authors performed subgroup analyses based on glycemic level to evaluate whether patients with higher glycemic levels were more prone to peri-implant inflammation. TYPE OF STUDIES REVIEWED: The authors searched 4 databases for original clinical studies. Studies in which the researchers provided information on the rate of implant failure or peri-implant parameters were included. RESULTS: Nine clinical studies were identified on the basis of the inclusion criteria. No significant differences were found in rates of implant failure (P = .46) and PD (P = .1) between diabetic and nondiabetic patients. Significant differences in BOP (P < .00001) and PIBL (P = .02), favoring nondiabetic patients, were observed. Results of subgroup analyses indicated that the increase in glycemic level did not significantly influence BOP, PD, and PIBL values among diabetic patients. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Patients with type 2 diabetes mellitus seem to be able to achieve a rate of implant survival similar to that of healthy patients. Regarding peri-implant parameters, BOP and PIBL were higher in patients with type 2 diabetes mellitus, indicating that hyperglycemia is an important risk factor for peri-implant inflammation. No association was found between peri-implant parameters and glycemic level among patients with type 2 diabetes mellitus, providing oral hygiene was strictly maintained.

Mandibular Overdentures Supported by Two vs Four Endosteal Implants: A Retrospective Cohort Study.

AIM: Documentation of marginal bone resorption caused by implant-supported mandibular overdentures is scarce. This study sought to evaluate marginal bone resorption, survival rate, patient satisfaction, peri-implant soft tissue status, and prosthetic aftercare of mandibular overdentures supported by two vs four implants. MATERIALS AND METHODS: This retrospective cohort study evaluated 92 edentulous patients presented to the Implant Center of Tehran University of Medical Sciences; out of which, 46 patients received overdentures supported by two Implantium implants (group A), while the remaining 46 received overdentures supported by four Implantium implants (group B). Standard radiographic indices were assessed following the delivery of overdenture and after 2 years of functional loading. Clinical evaluation was performed after 2 years of function. Data were analyzed using the t test (for continuous variables) and the Mann-Whitney test (for ordinal variables). RESULTS: In group A, two implants were lost in one patient. The groups were not significantly different in terms of clinical or radiographic parameters (p > 0.05). Patient satisfaction and prosthetic aftercare were not significantly different in groups A and B (p > 0.05). CONCLUSIONS: During the 2-year evaluation period, the clinical and radiographic parameters were the same in patients who received overdentures supported by two or four implants. CLINICAL SIGNIFICANCE: Successful results may be obtained by the use of mandibular overdentures supported by two or four implants.

Comparison of clinical and radiographic peri-implant parameters among obese and non-obese patients: A 5-year study.

BACKGROUND: It is postulated that peri-implant parameters are worse in obese individuals as compared to nonobese. OBJECTIVE: The aim of the present 5-year longitudinal study was to analyze and compare the changes in clinical and radiographic peri-implant parameters among obese and non-obese patients. MATERIALS AND METHODS: Twenty patients with body mass index ≥ 27.5 kg/m2 and 18 non-obese controls were included. All patients were indicated for single tooth maxillary or mandibular molar replacement with the adjacent teeth intact. Peri-implant clinical (plaque index [PI], bleeding on probing [BOP], probing depth [PD]) and radiographic (marginal bone loss [MBL]) parameters were measured at 12, 24, and 60 months of follow-up. RESULTS: All peri-implant parameters showed statistically significant difference between obese and non-obese individuals. Obese group recorded significant higher BOP, PD, and MBL at different observation times. Probing depth and MBL increased significantly with advance of time in both groups. After 60 months of follow-up period, greater PI and BOP was observed in obese patients (P < 0.01). At 60 months follow-up period, obese patients showed significant increased PD (3.69 mm) as compared to non-obese individuals (2.46 mm). Marginal bone loss in non-obese individuals varied from 0.30 mm after 12 months, reaching 0.55 mm after 60 months of follow-up period, while in obese patients MBL values went from 0.36 mm after 12 months to 0.91 mm at 60 months follow-up (P < 0.01). CONCLUSIONS: Patients with obesity are at risk of increased localized peri-implant soft and hard tissue inflammation. It is recommended that clinicians should educate obese patients about risk of increased peri-implant tissue inflammation and susceptibility to bone loss and stipulate stringent oral hygiene care for ideal peri-implant health.

Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3-year follow-up results.

OBJECTIVE: To compare the clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: Forty-five male patients with T2DM (Group-1) and 42 male non-diabetic controls (Group-2) who had undergone implant therapy in the posterior mandible were included. Depending upon the length of the implant, patients were divided into two subgroups: (a) patients with short implants (6-8 mm long) and (b) patients with long implants (11 mm long). Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were measured at 18 and 36 months of follow-up in both groups. Hemoglobin A1c (HbA1c) levels were measured at baseline and after 18 and 36 months of follow-up in both groups. P-values less than 0.05 were considered statistically significant. RESULTS: The mean age of patients in groups 1 and 2 was 42.5 and 40.6 years, respectively. The mean HbA1c levels at baseline among patients in groups 1 and 2 were 7.7% and 4.5%, respectively. At 18 and 36 months of follow-up, the mean HbA1c levels among patients in groups 1 and 2 were 6.6% and 4.5% and 6.5% and 4.4%, respectively. The mean duration of T2DM among patients that received short and long implants was 4.3 years and 4.1 years, respectively. There was no significant difference in PI, BOP, PD and CBL around implants placed in both groups at 18 and 36 months of follow-up. Success rate of short and long dental implants was 100% in both groups. CONCLUSION: Short implants can demonstrate clinical and radiographic stability in a manner similar to conventional long implants in patients with and without T2DM. The role of oral hygiene and glycemic maintenance in this scenario cannot be disregarded.

Comparison of clinical and radiographic status of platform-switched implants placed in patients with and without type 2 diabetes mellitus: a 24-month follow-up longitudinal study.

OBJECTIVE: The purpose of the present 24-month follow-up longitudinal study was to compare the clinical and radiographic status of platform-switched implants placed in patients with and without type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: In total, 45 male non-smokers were included. In Group-1, there were 23 patients with T2DM, and patients in Group-2 comprised of 22 self-reported non-diabetic controls. Under local anesthesia, platform-switched implants were placed in the mandible. Peri-implant bleeding on probing (BOP), probing depth (PD), marginal bone loss (MBL) and hemoglobin A1c (HbA1c) levels were measured at 12 and 24 months of follow-up. Participants were also enrolled in a biannual oral hygiene maintenance program. RESULTS: The mean age of participants in groups 1 and 2 were 42.4 years (40-46 years) and 41.8 years (39-44 years), respectively. In Group-1, the mean duration of T2DM was 14.5 ± 0.7 months. At 12 and 24 months of follow-up, there was no significant difference in the mean HbA1c levels among patients in groups 1 and 2. At 12 and 24 months of follow-up, there was no significant difference in peri-implant BOP, PD and MBL in both groups. CONCLUSIONS: Platform-switched implants can remain clinically and radiographically stable in patients with T2DM in a manner similar to non-diabetic individuals. However, it is emphasized that bone loss around implants is influenced by several factors (such as oral hygiene status, glycemic control and tobacco smoking) and not merely platform switching.

Comparison of clinical and radiographic status around immediately loaded versus conventional loaded implants placed in patients with type 2 diabetes: 12- and 24-month follow-up results.

There are no studies that have compared the clinical and radiographic status around immediately loaded (IL) and conventional loaded (CL) implants placed in patients with type 2 diabetes mellitus (T2DM). The aim was to compare the clinical and radiographic status around IL and CL implants placed in T2DM patients. One hundred and eight diabetic patients [55 with IL implants (Group 1) and 53 with CL implants (Group 2)] were included in this cross-sectional study. All implants were placed in healed sites in the maxillary and mandibular premolar and molar regions and supported single restorations. All patients underwent full mouth mechanical debridement biannually. Haemoglobin A1c (HbA1c) levels, clinical [bleeding on probing (BOP) and probing depth (PD) ≥ 4 mm] and radiographic [crestal bone loss (CBL)] peri-implant parameters were measured for both groups at 12- and 24-month follow-up. Group comparisons were performed using the Mann-Whitney U-test (P < 0·05). The mean age and duration of T2DM in groups 1 and 2 were 50·6 ± 2·2 and 51·8 ± 1·7 years, and 9·2 ± 2·4 and 8·5 ± 0·4 years, respectively. At 12- and 24-month follow-up, the mean HbA1c levels in groups 1 and 2 were 5·4% (4·8-5·5%) and 5·1% (4·7-5·4%) and 5·1% (4·7-5·2%) and 4·9% (4·5-5·2%), respectively. At 12- and 24-month follow-up, there was no statistically significant difference in peri-implant BOP, PD and CBL in both groups. It was concluded that clinical and radiographic status is comparable around IL and CL implants placed in patients with T2DM. The contribution of careful case selection, oral hygiene maintenance and glycaemic control is emphasised.