Occurrence, associated factors and soft tissue reconstructive therapy for buccal soft tissue dehiscence at dental implants: Consensus report of group 3 of the DGI/SEPA/Osteology Workshop.

OBJECTIVES: To systematically assess the literature and report on (1) the frequency of occurrence of buccal soft tissue dehiscence (BSTD) at implants, (2) factors associated with the occurrence of BSTD and (3) treatment outcomes of reconstructive therapy for the coverage of BSTD. MATERIALS AND METHODS: Two systematic reviews addressing focused questions related to implant BSTD occurrence, associated factors and the treatment outcomes of BSTD coverage served as the basis for group discussions and the consensus statements. The main findings of the systematic reviews, consensus statements and implications for clinical practice and for future research were formulated within group 3 and were further discussed and reached final approval within the plenary session. RESULTS: Buccally positioned implants were the factor most strongly associated with the risk of occurrence of BSTD, followed by thin tissue phenotype. At immediate implants, it was identified that the use of a connective tissue graft (CTG) may act as a protective factor for BSTD. Coverage of BSTD may be achieved with a combination of a coronally advanced flap (CAF) and a connective tissue graft, with or without prosthesis modification/removal, although feasibility of the procedure depends upon multiple local and patient-related factors. Soft tissue substitutes showed limited BSTD coverage. CONCLUSION: Correct three-dimensional (3D) positioning of the implant is of utmost relevance to prevent the occurrence of BSTD. If present, BSTD may be covered by CAF +CTG, however the evidence comes from a low number of observational studies. Therefore, future research is needed for the development of further evidence-based clinical recommendations.

Evidence of re-osseointegration after electrolytic cleaning and regenerative therapy of peri-implantitis in humans: a case report with four implants.

OBJECTIVE: To evaluate re-osseointegration after electrolytic cleaning and regenerative therapy of dental implants with peri-implantitis in humans. MATERIAL AND METHODS: Four dental implants that developed peri-implantitis underwent electrolytic cleaning followed by regenerative therapy with guided bone regeneration. All four implants developed recurrent peri-implantitis and were therefore explanted 6 to 13 months later. Radiographic bone level, probing depth, and bleeding on probing were determined at the time of surgery, 6 months later, and before implant retrieval. The peri-implant tissues were histologically and histomorphometrically analyzed. RESULTS: All four implants demonstrated radiographic and histological bone gain, reduced probing depth, and bleeding on probing. Radiographic bone gain was 5.8 mm mesially and 4.8 mm distally for implant #1, 3.3 mm and 2.3 mm for implant #2, 3.1 mm and 0.5 mm for implant #3, and 3.5 mm and 2.8 mm for implant #4. The histometric mean and maximum vertical bone gain for implant #1 to #4 was 1.65 mm and 2.54 mm, 3.04 mm and 3.47 mm, 0.43 mm and 1.27 mm, and 4.16 mm and 5.22 mm, respectively. The percentage of re-osseointegration for implant #1 to #4 was 21.0%, 36.9%, 5.7%, and 39.0%, respectively. In one implant, the newly formed bone was deposited directly onto calculus on the implant surface. CONCLUSIONS: We found that (1) re-osseointegration is possible on a formerly contaminated implant surface and (2) the electrolytic cleaning process seems to be effective enough at sites with calculus residues. CLINICAL RELEVANCE: Since re-osseointegration can be achieved by electrolytic cleaning, this decontamination technique may be considered as a future treatment concept.

Comparison of decontamination efficacy of two electrolyte cleaning methods to diode laser, plasma, and air-abrasive devices.

OBJECTIVE: To compare the in vitro decontamination efficacy of two electrolytic cleaning methods to diode laser, plasma, and air-abrasive devices. MATERIAL AND METHODS: Sixty sandblasted large-grit acid-etched (SLA) implants were incubated with 2 ml of human saliva and Tryptic Soy Broth solution under continuous shaking for 14 days. Implants were then randomly assigned to one untreated control group (n = 10) and 5 different decontamination modalities: air-abrasive powder (n = 10), diode laser (n = 10), plasma cleaning (n = 10), and two electrolytic test protocols using either potassium iodide (KI) (n = 10) or sodium formate (CHNaO2) (n = 10) solution. Implants were stained for dead and alive bacteria in two standardized measurement areas, observed at fluorescent microscope, and analyzed for color intensity. RESULTS: All disinfecting treatment modalities significantly reduced the stained area compared to the untreated control group for both measurement areas (p < 0.001). Among test interventions, electrolytic KI and CHNaO2 treatments were equally effective, and each one significantly reduced the stained area compared to any other treatment modality (p < 0.001). Efficacy of electrolytic protocols was not affected by the angulation of examined surfaces [surface angulation 0° vs. 60° (staining %): electrolytic cleaning-KI 0.03 ± 0.04 vs. 0.09 ± 0.10; electrolytic cleaning-CHNaO2 0.01 ± 0.01 vs. 0.06 ± 0.08; (p > 0.05)], while air abrasion [surface angulation 0° vs. 60° (staining %): 2.66 ± 0.83 vs. 42.12 ± 3.46 (p < 0.001)] and plasma cleaning [surface angulation 0° vs. 60° (staining %): 33.25 ± 3.01 vs. 39.16 ± 3.15 (p < 0.001)] were. CONCLUSIONS: Within the limitations of the present in vitro study, electrolytic decontamination with KI and CHNaO2 was significantly more effective in reducing bacterial stained surface of rough titanium implants than air-abrasive powder, diode laser, and plasma cleaning, regardless of the accessibility of the contaminated implant location. CLINICAL RELEVANCE: Complete bacterial elimination (residual bacteria < 1%) was achieved only for the electrolytic cleaning approaches, irrespectively of the favorable or unfavorable access to implant surface.

Photo-activated implants: a triple-blinded, split-mouth, randomized controlled clinical trial on the resistance to removal torque at various healing intervals.

OBJECTIVES: Hydrophilic implant surfaces promote faster osseointegration of dental implants with a higher bone-implant contact (BIC) rate. Animal and in vitro studies proved that ultraviolet (UV) irradiation of titanium implants regains hydrophilicity. Clinical impact is still unclear. The objective of this RCT was to assess the removal torque (RT) required to unfix a surface-treated implant (test group) versus the original surface implant (control group) performed at various points in time. The null hypothesis stated that test and control implants will show the same deliberation force at specific time points. MATERIAL AND METHODS: One hundred eighty partially edentulous patients were randomly assigned to six groups. In single-stage surgery, each patient received one test and one control implant. In total, 180 test and 180 control implants were placed epicrestally. Test implants received a surface treatment with UV irradiation prior to insertion, in order to reduce carbon and enhance hydrophilicity and thus wettability. Maximum RT values for test and control implants were recorded with a torque measuring device at implant placement (T1), after 1 (group 1), 2 (group 2), 3 (group 3), 4 (group 4), 6 (group 5) (T2), and 8 weeks (group 6) of healing. Subsequently, implants were returned to their original position for the continuation of the healing process. RESULTS: No implant was lost. Age, gender, smoking, implant position, and bone quality could be excluded as confounding factors because of the lack of statistical significance. At T2, RT values were higher for test implants compared with those for control implants, being statistically significant in groups 2, 3, 4, and 6 (p < 0.05). CONCLUSIONS: Our data support rejection of the null hypothesis. CLINICAL RELEVANCE: Photo-activation of the surface of titanium implants leads to higher resistance to RT forces compared with that of non-treated implants, indicating improved healing and implant stability especially in the early healing phase.

A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant.

OBJECTIVE: This multicenter prospective non-interventional study evaluated the success and survival of the CONELOG implants inserted according to the standard protocol with one- or two-step surgery in daily practice three years after loading. Changes of soft tissue and bone level over time, esthetical outcome, and patient satisfaction were assessed. MATERIALS AND METHODS: The study included patients in six centers. The implants were used in accordance with standard practice of each particular center, and the use was documented systematically. Failure rate, implant success, bone level changes, different clinical parameters, and patients' satisfaction were assessed. RESULTS: In total, 130 dental implants were placed in 94 patients (64 female, 30 male). Mean age of patients was 50.4 ± 13.7. At 3-year post-loading, 108 implants in 78 patients were available for evaluation. Success and survival rate were 98.4% after placement and 100% 36 months post-loading. Bone loss from surgery to loading was 0.52 ± 0.55 mm. From loading to 36 months post-loading, the bone level change remained stable. Patient assessments were performed for function, ability to chew, speech, esthetics, and general satisfaction. Patients were very satisfied (82.3%) or satisfied (16.1%). None of the patients was dissatisfied. CONCLUSION: The 3-year results of this non-interventional multicenter study indicate that the CONELOG implants are reliable and effective over the course of the observation while used in standard conditions of daily environment and confirm the results obtained in controlled clinical trials. CLINICAL RELEVANCE: Performance of CONELOG implants under daily routine is similar to controlled clinical trials.

Allogeneic bone block for challenging augmentation-a clinical, histological, and histomorphometrical investigation of tissue reaction and new bone formation.

OBJECTIVES: The aim of the present study was the histological investigation of an allogeneic spongious bone block for horizontal and vertical ridge augmentation in humans. The amount of new bone, soft tissue, and residual bone substitute were histomorphometrically assessed after a mean healing period of 6 months. MATERIALS AND METHODS: Fourteen patients received augmentation with an allogeneic spongious bone block (Tutobone®, Tutogen Medical, Neunkirchen, Germany). After 6 months of healing, 28 implants were placed with simultaneous harvesting of bone biopsies for histological and histomorphometrical analysis. Moreover, samples from the bone blocks were collected as blanks and analyzed histologically. The formation of new bone, connective tissue, and remaining bone substitute material as well as vascularization and formation of multinucleated giant cells (MNCGs) within the augmentation bed were analyzed. RESULTS: New bone formation could be observed primarily in close proximity to the bone block. Histomorphometrical analyses showed 18.65 ± 12.20% newly formed bone, 25.93 ± 12.36% allogeneic spongious bone block, and 53.45 ± 10.34% connective tissue. MNCGs were observed on the biomaterial surface. Furthermore, organic residues were evident, as donor-related cellular remnants within the osteocyte lacunae were found in the blank bone blocks and in the analyzed biopsies. CONCLUSION: Despite the presence of donor-related organic remnants, the bone block shows the ability to serve as a scaffold for new bone formation. Within the limits of the present study, the detect organic remnants seemed not to affect the bone formation or influence the host in the long term. CLINICAL RELEVANCE: Clinicians have to make a conscious choice of the applied biomaterials with regard to their components and structure to support tissue regeneration and maintain patient safety.

The influence of various rehydration protocols on biomechanical properties of different acellular tissue matrices.

OBJECTIVES: This study evaluated the influence of different rehydration media and time periods on biomechanical and structural properties of different acellular collagen matrices (ACMs). MATERIALS AND METHODS: Specimens of three ACMs (mucoderm®, Mucograft®, Dynamatrix®) were rehydrated in saline solution (SS) or human blood for different time periods (5-60 min). ACMs under dry condition served as controls. Biomechanical properties of the ACMs after different rehydration periods were determined by means of tensile testing. ACMs' properties were further characterized using Fourier-transform-infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). RESULTS: At dry conditions, mucoderm® presented the highest tensile strength (TS) and Dynamatrix® showed the maximum elastic modulus (EM; p each ≤0.036). Rehydration in SS and blood resulted in significant TS changes of mucoderm® (p each ≤0.05). Concering EM, mucograft® showed significantly decreased values after rehydration in SS compared to Dynamatrix® and mucoderm® after 10 min (p each ≤0.024). mucoderm® hydrated for 5 min in blood displayed nearly double TS and a significantly increased EM after 60 min (p = 0.043) compared to rehydration in SS. TS and EM values of Dynamatrix® and Mucograft® were not altered following rehydration in blood versus SS (p each ≥0.053). FTIR analysis confirmed the recovery of the graft protein backbone with increased rehydration in all samples. DSC measurements revealed that tissue hydration decreased thermal stability of the investigated ACMs. CONCLUSION: Our findings demonstrated that the rehydration protocol affects the biomechanical properties of ACMs. CLINICAL RELEVANCE: Clinicians should be aware of altered handling and mechanical properties of ACMs following different rehydration protocols.

Vertical ridge augmentation using the modified shell technique--a case report.

PURPOSE: Vertical defects of the alveolar crest limit implant placements. Accordingly, hard tissue grafting is essential in a separate procedure before implant placement; however, the outcome of vertical bone augmentation is unpredictable. MATERIALS AND METHODS: This case report describes a new approach to vertical hard tissue grafting using the modified autogenous shell technique. With the help of a bone mill, the bone graft was trimmed to a shell with a thickness of less than 1 mm and seeded to rebuild the vertical dimension of the alveolar ridge. The shell was fixated with titanium microscrews, and the vertical distance between the shell and the residual bone was filled with autogenous particulate bone. RESULTS: Wound healing was uneventful. Corticalization was observed across the bone chips, and there was only a small vertical resorption of the shell. Two implants could be inserted above the alveolar nerve into the augmented bone. CONCLUSION: The modified shell technique showed promising results for the reconstruction of vertical bone defects. This technique could decrease the need for bone grafts taken from the iliac crest.

Retrospective analysis of augmentation procedures with umbrella screws, a novel tenting technique: a consecutive case series in 279 patients.

OBJECTIVES: The consecutive case series accesses the results and experiences of ridge augmentation using an umbrella screw tenting technique. METHOD AND MATERIALS: In total, 279 patients were treated between 26 May 2015 and 16 June 2021, including horizontal and vertical ridge defects. Sex, age, smoking behavior, jaw, graft material, soft tissue thickness, extent of horizontal/vertical augmentation, resorption rate, and occurrence of early/late exposure were evaluated. Bone gain was determined by resorption at the screw head. Only cases without premature screw removal were evaluated metrically (n = 201). All other augmentations were evaluated according to whether implantation was possible with or without further augmentation (n = 27). A target performance index was calculated, which should enable evidence-based comparability of different augmentation methods in future. RESULTS: In total, 54 wound dehiscences (39 early, 15 late exposures) occurred, which corresponds to 24.08% of the augmented sites; 42 umbrella screws were removed prematurely. In all cases an implantation was possible at the desired position afterwards. Cases with a vertical augmentation component showed a higher prevalence of exposure (early, P = .000; late, P = .024). The extent of the vertical augmentation was only relevant for early exposure (P = .048). Mean bone gain of 4.23 ± 1.69 mm horizontally and 4.11 ± 1.99 mm vertically could be achieved. Regression analysis showed that there was no limit in horizontal/vertical direction. Mean percentage target performance index was 75.90 ± 20.54 for vertical and 82.25 ± 16.67 for horizontal portions. CONCLUSION: The umbrella technique is an effective augmentation method, which can be applied to any defect morphology.

The Impact of Implant Abutment Angle and Height on Peri-implant Tissue Health: Retrospective Analyses from a Randomized Controlled Clinical Trial.

PURPOSE: To examine the influence of abutment emergence angle and abutment height on marginal peri-implant bone stability in patients not considered susceptible to peri-implantitis. Furthermore, it was analyzed whether titanium-base (Ti-base) abutments lead to wider abutment emergence angles compared to one-piece abutments. MATERIALS AND METHODS: A total of 48 abutments (ie, 24 Ti-base and 24 one-piece abutments in 24 patients) were evaluated at abutment installation, after 1 year, and thereafter on a yearly basis for up to 5 years. Clinical and radiographic outcome variables were assessed. RESULTS: With regard to peri-implant marginal bone stability, only moderately negative, albeit significant, correlations were found on the mesial sides of the one-piece abutments after 4 and 5 years for an abutment emergence angle > 30 degrees. No statistically significant negative correlations were found for distances of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level for either Ti-base or for one-piece abutments. Furthermore, abutments bonded to Ti-bases were not associated with larger emergence angles than one-piece abutments. CONCLUSIONS: For patients at low risk of developing peri-implantitis, it can be concluded that neither a larger abutment emergence angle (> 30 degrees) nor a distance of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level are associated with marginal peri-implant bone loss. Furthermore, abutments bonded to Ti-bases are not associated with wider emergence angles than one-piece abutments.

Clinical study evaluating the discrepancy of two different impression techniques of four implants in an edentulous jaw.

OBJECTIVES: Precise implant-supported prosthodontics requires accurate impressions. Many in vitro studies comparing different implant impression techniques were performed. The purpose of this in vivo study was to compare the discrepancy of two different impression techniques of implants clinically. MATERIAL AND METHODS: Four implants were inserted nearly bilateral in ten edentulous jaws. From each jaw, two different impressions (A, transfer; B, splinted pick-up) were taken. Respectively two stone casts of each jaw were produced and scan bodies were mounted on the lab analogues to digitize the casts. One scan body of the digitized casts was each superimposed and the deviations of the remaining three scan bodies were measured three dimensionally. The fit of the suprareconstructions was evaluated clinically on both casts and in the mouth. RESULTS: The mean discrepancy of scan body 2 was 192 µm (±96), 282 µm (±97) for scan body 3, and 366 µm (±114) for scan body 4. The discrepancies between two scan bodies were statistically significant (p ≤ 0.010; ANOVA test). Comparing the data with the span between the scan bodies, a linear regression line could be drawn to show the dependency between the misfit and the length of the span. Clinically, the fit on the cast produced by the splinted pick-up technique was favorable. CONCLUSIONS: The discrepancy between the splinted pick-up impression technique and the transfer technique were in a range with clinical influence. CLINICAL RELEVANCE: For better accuracy of implant-supported prosthodontics, the splinted pick-up technique should be used for impressions of four implants evenly spread in edentulous jaws.

Ridge augmentation using customized allogenic bone blocks: proof of concept and histological findings.

AIM: To evaluate handling and healing patterns of customized allogenic bone blocks for vertical and horizontal alveolar defect augmentation. MATERIALS AND METHODS: In 2 patients, 3 combined horizontal and vertical post-foraminal mandibular defects were grafted using computer-aided design (CAD) trimmed individual block grafts, 3D-designed on preoperative computed tomography scans. After a healing period of 6 months, graft resorption was measured and bone trephines were taken in progress of implant bed preparation. Four months later, implants were restored with single crowns. Moreover, clinical and radiological implant parameters were assessed 6 and 12 months after restorative rehabilitation. RESULTS: Uneventful healing was observed in 2 of the 3 cases. A partial exposure of 1 block after 8 weeks could be successfully treated by block reduction and application of a soft tissue graft. Histological evaluation revealed predictable bone formation within all augmented areas, and both patient satisfaction and long-term stability parameters were considered excellent. CONCLUSIONS: It was concluded that the application of individual CAD allografts supports bone formation at deficient sites with reduced patient morbidity, decreased surgery time, and high patient acceptance.

The impact of implant abutment angle and height on peri-implant tissue health: Retrospective analyses from a randomized, controlled, clinical trial.

PURPOSE: Implant abutment design may influence the predisposition of peri-implant sites to develop peri-implant inflammation, especially peri-implantitis. Therefore, the objectives of the current study were to examine the influence of (1) abutment emergence angle and, (2) abutment height on marginal periimplant bone stability in patients not considered susceptible to peri-implantitis. Furthermore, it was analyzed (3) whether Ti-Base abutments lead to wider abutment emergence angles as compared to onepiece abutments. MATERIALS AND METHODS: 48 abutments (i.e., 24 Ti-base- and 24 one-piece abutments in 24 patients) have been at abutment installation, after one year, and thereafter on a yearly basis for up to five years. Clinical and radiographic outcome variables were assessed. RESULTS: With regard to peri-implant marginal bone stability, (1) only moderately negative, albeit significant, correlations were found on the mesial sides of the one-piece abutments after 4 and 5 years for an abutment emergence angle >30° and no statistically significant negative correlations were found between a distance of less than or equal to versus more than 1.5 mm between the restoration margin and the crestal peri-implant bone level, neither for Ti-Base nor for one-piece abutments. Furthermore, (3) abutments bonded to Ti-bases are not associated with larger emergence angles than one-piece abutments. CONCLUSION: For patients at low risk of developing peri-implantitis it can be concluded, that neither (1) a larger abutment emergence angle (>30°) nor (2) a distance of less than or equal to 1.5 mm between the restoration margin and the crestal peri-implant bone level are per se associated with marginal periimplant bone loss. Furthermore, (3) abutments bonded to Ti-bases are not as such associated with wider emergence angles than one-piece abutments. Int J Prosthodont 2023. doi: 10.11607/ijp.8138.

Long-term effects of titanium-base abutments on peri-implant health: A 5-year randomised controlled trial.

PURPOSE: Titanium bases are used frequently in daily practice for bonding to CAD/CAM abutments or crowns. Due to intimate contact between the adhesive gap of the titanium-base abutment and the peri-implant bone, the physical and chemical characteristics of the bonding material, or the gap itself, may affect peri-implant inflammatory reactions. The present study therefore aimed to examine the long-term effects of individualised abutments bonded to titanium bases on peri-implant health. MATERIALS AND METHODS: A total of 24 patients, each with one test and one control abutment, participated in the present prospective, single-blind, randomised controlled clinical trial. The test abutments were CAD/CAM titanium abutments bonded to titanium bases. As the control abutments were individualised, one-piece CAD/CAM titanium abutments were used. Clinical and radiographic parameters were assessed at abutment insertion and then on a yearly basis over the following 5 years. RESULTS: No significant differences in marginal bone level were observed between the titanium-base and one-piece abutments at any of the follow-up time points; however, when intragroup marginal bone levels were compared to the baseline values, significant differences were found at several follow-up time points. Intergroup differences were only found to be significant for pocket depth at the 4- (P = 0.006) and 5-year follow-ups (P = 0.024), favouring titanium-base abutments. CONCLUSIONS: Within the limitations of the present study, it appears that the peri-implant tissues of this specific patient cohort responded to titanium-base abutments in a rather similar manner to one-piece abutments over a 5-year period; however, no definitive conclusions can be drawn due to the low power of the present study.

Correction: Ratka et al. The Effect of In Vitro Electrolytic Cleaning on Biofilm-Contaminated Implant Surfaces. J. Clin. Med. 2019, 8, 1397.

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

Treatment of gingival recession in the anterior mandible using the tunnel technique and a combination epithelialized-subepithelial connective tissue graft-a case series.

Covering exposed roots becomes more and more difficult as the gingiva becomes thinner and the vestibule becomes more shallow. Also, the outcome becomes less predictable. In addition, where there is high frenal attachment or muscle pull, such as the mentalis muscle in the mandibular anterior region, secondary retraction of a coronally advanced flap will likely occur. Therefore, a transplanted connective tissue graft may not completely cover the recession. This case series presents a technique where the roots are covered with a combination epithelialized-subepithelial connective tissue graft. The epithelialized portions of the graft are positioned directly over the exposed roots to aid in resistance to the environment of the mouth, and there is no displacement of the mucogingival junction or flattening of the vestibule.

Inflammatory effects of individualized abutments bonded onto titanium base on peri-implant tissue health: A randomized controlled clinical trial.

BACKGROUND: In implant prosthodontics, computer-assisted design and computer-assisted manufacturing (CAD/CAM) zirconia abutments bonded onto titanium bases are frequently used in prosthetic dentistry. Unpolymerized monomer of the bonding material or the adhesive gap itself may have a negative effect on peri-implant tissue health. However, evidence addressing this problem is not available. PURPOSE: The aim of the current trial was to study inflammatory effects of individualized abutments bonded onto titanium bases. MATERIAL AND METHOD: A total of 24 patients with one test abutment and one control abutment each participated in this prospective, double-blind, randomized controlled clinical trial. Thereby, test abutments were CAD/CAM titanium abutments bonded onto titanium abutments (Ti-Base). As control abutments individualized, one-piece CAD/CAM titanium abutments were used. At abutment installation as well as 6 and 12 months thereafter bone level changes, clinical parameters as well as Il-1ß levels were assessed. RESULTS: Neither for bone level or clinical parameters nor for Il-1ß levels, significant differences between test and control abutments could be found. However, in both groups Il-1ß levels were significantly elevated at both the 6 and 12 months follow-up compared to baseline. CONCLUSION: Within the limits of this RCT, it can be concluded that effects on the inflammatory state of peri-implant tissues do not differ between individualized abutments bonded onto Ti-Bases and individualized one-piece abutments.

Treatment of Periimplantitis with Electrolytic Cleaning versus Mechanical and Electrolytic Cleaning: 18-Month Results from a Randomized Controlled Clinical Trial.

Aim of the study: This RCT assesses patients' 18-month clinical outcomes after the regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and an electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration, and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), and 6 (T2) and 12 (T3) months after the replacement of the restoration. Results: The mean PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 were 100%, BoP decreased at T2 to 36.8% and at T3 to 35.3%. Suppuration was found to be at a level of 10.6% at T2 and 11.8% at T3. The radiologic bone level measured from the implant shoulder to the first visible bone to the implant contact was 4.9 ± 1.9 mm at mesial sites and 4.4 ± 2.2 mm at distal sites at T0 and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and the improvement of clinical parameters were demonstrated 18 months after therapy.

Is Complete Re-Osseointegration of an Infected Dental Implant Possible? Histologic Results of a Dog Study: A Short Communication.

Complete reosseointegration after treatment of periimplantitis was never published yet. This short scientific communication reports about results of a randomized controlled preclinical study. An electrolytic approach was compared to a classical modality (ablative, cotton pellets soaked with sodium chloride solution and H2O2. For electrolytic cleaning a complete reosseointegration was achieved in several cases serving as a proof of concept.

Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.

BACKGROUND: The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-year post-loading; survival analysis (Kaplan-Meier), changes of soft tissue, and bone level over time, as well as patient satisfaction were evaluated. RESULTS: In total, 130 dental implants were placed in 94 patients (64 female, 30 male). Mean age of patients was 50.4 ± 13.7. At 5-year post-loading, 104 implants in 76 patients were available for evaluation. The cumulative implant survival rate was 96.6%. After an initial bone remodeling process post-surgery (bone loss of - 0.52 ± 0.55 mm), the bone level change remained clinically stable from loading to 5-year post-loading (- 0.09 ± 0.43 mm). Patient satisfaction surveyed by questionnaire (comfort, ability to chew and taste, esthetics, general satisfaction) steadily increased towards the end. At the last study follow-up, all the patients rated their general satisfaction as either very satisfied (87.5%) or satisfied (12.5%). CONCLUSION: The study implants have shown to be highly effective with reliable peri-implant tissue stability over the 5 to 7 years of observation for both single tooth restorations and fixed partial dentures while used in standard conditions in daily dental practice. The results obtained are comparable with those obtained in controlled clinical trials.