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Aim: To answer the following PECO question: "In systemically healthy human subjects (P), which are the differences between peri‐implantitis (E) and peri‐implant health/mucositis (C) in terms of bacterial presence/count (O)?" Materials and Methods: Cross‐sectional studies fulfilling specific inclusion criteria established to answer the PECO question were included. Two review authors independently searched for studies, screened the titles and abstracts, did full‐text analysis, extracted the data from the included reports, and performed the risk of bias assessment through an adaptation of the Newcastle/Ottawa tool for cross‐sectional studies and of the JBI critical appraisal checklist. In case of disagreement, a third reviewer author took the final decision. Study results were summarized using random effects meta‐analyses. Results: A total of 12 studies were included, involving 1233 participants and 1513 implants. Peri‐implantitis was associated with the presence of S. epidermidis (Odds ratio, OR = 10.28 [95% Confidence interval, CI: 1.26–83.98]), F. nucleatum (OR = 7.83 [95% CI: 2.24–27.36]), T. denticola (OR = 6.11 [95% CI: 2.72–13.76]), T. forsythia (OR = 4.25 [95% CI: 1.71–10.57]), P. intermedia (OR = 3.79 [95% CI: 1.07–13.35]), and P. gingivalis (OR = 2.46 [95% CI: 1.21–5.00]). Conversely, the presence of A. actinomycetemcomitans (OR = 3.82 [95% CI: 0.59–24.68]), S. aureus (OR = 1.05 [95% CI: 0.06–17.08]), and C. rectus (OR = 1.48 [95% CI: 0.69–3.17]) was not associated with peri‐implantitis. Conclusions: Peri‐implantitis is associated with the presence of S. epidermidis and specific periodontopathogens (P. gingivalis, T. forsythia, T. denticola, F. nucleatum, and P. intermedia). (CRD42021254589) [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of implantoplasty (IP) is to remove titanium implant layers that have been contaminated and to smoothen the implant surfaces so they retain less plaque. However, existing IP methods are very invasive and reduce implant wall thickness. Aim: To investigate the suitability of novel sonic tips in IP and to compare this novel protocol with conventional abrasive procedures. Materials and Methods: Thirty dental implants (Ø 4.1 mm, 10 mm length) were distributed in three groups and investigated according to the protocol of Sivolella et al., with modifications to the instrument's feed rate, the applied contact force, and the speed of implant rotations per minute. The upper third of the implant was processed with a diamond‐coated bur (BUR) or novel non‐diamond‐coated sonic tips (AIRSCALER). After standardized IP, the surfaces were analyzed by tactile profilometry and scanning electron microscopy (SEM). Changes in implant weight, implant material loss, and implant fracture strength were assessed. Results: The mean roughness (Ra, Sa), implant material loss, and change in implant weight were significantly lower in the AIRSCALER group than in the BUR group, whereas the mean compression resistance values were significantly higher in the AIRSCALER group than in the BUR group. Conclusions: IP with uncoated sonic tips smoothes the surfaces and reduces structural loss of the implant in the area of microthreads. This new IP method could be of great clinical importance, especially for implants with microthreads and reduced diameter or wall thickness. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate several mechanical and chemical decontamination methods associated with a newly introduced biofilm matrix disruption strategy for biofilm cleaning and preservation of implant surface features. Materials and Methods: Titanium (Ti) discs were obtained by additive manufacturing. Polymicrobial biofilm‐covered Ti disc surfaces were decontaminated with mechanical [Ti curette, Teflon curette, Ti brush, water–air jet device, and Er:YAG laser] or chemical [iodopovidone (PVPI) 0.2% to disrupt the extracellular matrix, along with amoxicillin; minocycline; tetracycline; H2O2 3%; chlorhexidine 0.2%; NaOCl 0.95%; hydrocarbon‐oxo‐borate‐based antiseptic] protocols. The optimal in vitro mechanical/chemical protocol was then tested in combination using an in vivo biofilm model with intra‐oral devices. Results: Er:YAG laser treatment displayed optimum surface cleaning by biofilm removal with minimal deleterious damage to the surface, smaller Ti release, good corrosion stability, and improved fibroblast readhesion. NaOCl 0.95% was the most promising agent to reduce in vitro and in vivo biofilms and was even more effective when associated with PVPI 0.2% as a pre‐treatment to disrupt the biofilm matrix. The combination of Er:YAG laser followed by PVPI 0.2% plus NaOCl 0.95% promoted efficient decontamination of rough Ti surfaces by disrupting the biofilm matrix and killing remnants of in vivo biofilms formed in the mouth (the only protocol to lead to ~99% biofilm eradication). Conclusion: Er:YAG laser + PVPI 0.2% + NaOCl 0.95% can be a reliable decontamination protocol for Ti surfaces, eliminating microbial biofilms without damaging the implant surface. [ABSTRACT FROM AUTHOR]

The goal of this extension study was to compare the 10‐year outcome of 3.3 mm diameter titanium–zirconium (TiZr) or grade IV titanium (Ti) implants in mandibular implant‐overdentures. Materials and Methods: This study is the 10‐year follow‐up from a randomised, controlled, double‐blind, split‐mouth multicentre clinical trial. Patients with edentulous mandibles had received two implants in the interforaminal region (bone‐level, diameter 3.3 mm, microrough surface), one of TiZr (test) and one of Ti (control). Implant survival and success, plaque and sulcus bleeding indices, probing pocket depth, gingival margin, clinical attachment level and radiographic crestal bone levels were evaluated. Results: Fifty of 91 patients with implants were available for the 10‐year examination and 36 patients were valid for the intent‐to‐treat (ITT) analysis. The implant success rate was calculated as 94.6% and 91.9% for the TiZr implants and the Ti implants respectively. Four implants were lost (TiZr = 1; Ti = 3) in the entire study period. Kaplan–Meier survival analyses estimated 10‐ year implant survival rate for TiZr to 98.9% and Ti 95.8%.The mean of total and functional crestal bone loss was 1.49 mm (±1.37 mm) and 0.82 mm (±1.09 mm) in the TiZr group and 1.56 mm (±1.34 mm) and 0.85 mm (±1.16 mm) in the Ti group. Conclusions: This split‐mouth design RCT on mandibular implant‐overdentures evidenced, bearing in mind its follow‐up time‐related reduced cohort size, high 10‐year implant success‐ and survival rates. These results confirm TiZr as well‐suited implant material for realising small‐diameter implants. Registered on www.clinicaltrials.gov: NCT01878331. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the risk of less than 2 mm keratinized mucosa (KM) width occurrence after free epithelialized graft (FEG) and keratinized mucosa shifting (KMS) procedures using survival analysis. In addition, KM dimensional changes were evaluated. Materials and Methods: This study included 76 implants in 36 patients with insufficient KM (<2 mm). The implants underwent either FEG or KMS procedures. The mid‐buccal KM width was measured from surgery to the end of a one 13‐year follow‐up period. Results: Mean follow‐up durations were 9.2 ± 3.9 years for FEG and 6.3 ± 4.2 years for KMS. Two implants in FEG and nine implants in KMS exhibited a KM width of less than 2 mm during follow‐up. The hazard ratios for KMS compared to FEG were 6.48 (crude) and 6.54 (adjusted), both statistically significant (p <.05). The incidence rate of KMS (4.06%) was higher than that of FEG (0.63%), with an average incidence time of 3.38 years for KMS and 8.82 years for FEG post‐surgery. FEG showed a significant shrinkage within 6 months (33% ± 22%), whereas KMS demonstrated a gradual decrease over 13 years (34% ± 25%). FEG exhibited significantly greater width change than KMS during a 5‐year follow‐up (p <.05). Conclusions: FEG and KMS enhanced PIKM but exhibited different long‐term reduction patterns. FEG demonstrated rapid shrinkage, while KMS displayed gradual and continuous reduction. Moreover, KMS presented a higher risk and incidence of KM width less than 2 mm compared to FEG. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of implantoplasty (IP) on maximum implant failure strength of narrow diameter implants of different type/design and material, with simulated advanced bone loss. Materials and Methods: Narrow, parallel‐walled implants (3.3 mm in diameter × 10 mm long) with an internal connection of different type/design [bone level (BL), tissue level (TL)] and material [Titanium grade IV (Ti), Titanium‐Zirconium alloy (TiZr)] from one specific manufacturer were used. Half of the implants were subjected to IP in their coronal 5 mm; the remaining were used as controls (seven implants per group). Dynamic loading prior to maximum load strength testing was included. Results: During dynamic loading, the fracture rate of BL implants was low and independent of IP, while that of TL implants increased significantly with IP compared with controls (p =.001). Maximum implant failure strength reduction (in %) due to IP, was 1.3%–25.4%; TiZr BL implants were least affected. Implants subjected to IP compared to those without IP as well as TL implants compared to BL implants showed a significantly lower maximum implant failure strength (p <.002); implant material was not significant (p =.845). Conclusions: Based on data from implants of one specific manufacturer, IP has a significant negative impact on the fracture strength of narrow implants suffering from advanced peri‐implantitis. TL implants have been more severely affected compared to BL implants and presented an increased risk for failure during normal chewing forces. In addition, this negative impact of IP on TL implants was independent of the implant material (i.e., Ti or TiZr). Clinical Relevance: Narrow single TL implants with advanced horizontal bone loss (e.g., 5 mm), when subjected to IP, appear to have an increased fracture risk during normal function. [ABSTRACT FROM AUTHOR]

Objective: To investigate the 3‐year implant‐related outcomes following alveolar ridge preservation in periodontally compromised molar sockets. Material and methods: Thirty implants were placed in 26 patients following either ridge preservation (test, n = 16) or natural healing (control, n = 14) at deficient molar extraction sites after a 6‐month healing period. The need for additional augmentation procedures at implant placement was recorded. Patients were assessed for 3 years following a definitive restoration. Patient information being collected included modified plaque index, the modified sulcus bleeding index, the peri‐implant probing depth clinically, and alterations of marginal bone level (MBL) radiographically. Results: There was a 100% survival rate of implants in both groups after 3‐year follow‐up. During implant placement operation, 35.7% in the control group and 6.3% in the test group required additional augmentation procedures. No statistically significant differences were determined for peri‐implant parameters and marginal bone levels between the two groups. The overall mean difference of MBL was 0.072 mm (95% CI [−0.279, 0.423]) during the 3 years of follow‐up. The success rate was 81.2% in the test and 78.6% in the control group. Conclusions: Implants placed into periodontally compromised molar‐extracted sites after ridge augmentation resulted in comparable outcomes to implant placement at naturally healed sites after 3‐year functional loading. (Chinese Clinical Trial Registry ChiCTR‐ONN‐16009433). [ABSTRACT FROM AUTHOR]

Objectives: Retrospectively evaluate the association of periodontal treatment outcomes and the prevalence of peri‐implant diseases around tissue‐level implants. Materials and Methods: Eighty‐six patients with 260 tissue‐level implants attending supporting periodontal and implant therapy for more than 3 years were evaluated. Clinical and radiographic periodontal and implant data were recorded at initial examination (T0), before implant placement (T1) and at final re‐examination (T2). Two definitions of peri‐implantitis severity, PIBE and PIKA, were used corresponding to the presence of periodontal pocket ≥5 mm or ≥6 mm with bleeding on probing or suppuration and radiographic signs of a bone level ≥2 mm, or ≥3 mm during implant follow‐up, respectively. Analyses were performed at patient level. Results: The mean implant follow‐up per patient was 9.4 years and 38.0% of patients had implant for at least 10 years. Two implants were lost due to peri‐implantitis. The prevalence of patients with PIKA and PIBE was 15.1% and 12.8%, respectively. Residual periodontal pockets, clinical attachment loss and bone loss/age at T2 were more pronounced in patients with PIKA and PIBE. Cox regression analysis adjusted with the number of implants per patient showed that residual pockets at T1 were independently associated with PIKA and PIBE. Initial diagnosis of severe periodontitis was associated with PIBE incidence. Conclusions: The present study showed that periodontal conditions before implant placement are a risk indicator for peri‐implantitis incidence. During implant follow‐up, the severity of periodontal status appeared to be a reliable indicator of patient susceptibility to peri‐implantitis. [ABSTRACT FROM AUTHOR]

Objective: To assess clinical and patient‐reported outcomes of implant‐prosthetic rehabilitations in patients with a history of head–neck cancer (HNC), treated with tumor resection without (TR) or with adjuvant radiotherapy (TR/RT). A healthy cohort rehabilitated with the same reconstructive protocols served as control group (C). Materials and Methods: A total of 28 women and 29 men were considered in the present retrospective study. Participants received 322 implants, finally supporting 79 prosthetic reconstructions. Primary outcome was the assessment of implant and prosthetic survival rates. Furthermore peri‐implant soft tissue parameters (attached peri‐implant mucosa, AM; modified bleeding and plaque indices, mBI/mPI; probing depth, PD) and prosthetic technical complications were documented. Patient‐reported outcome measures (PROMs) by means of visual analog scales (VAS) and the Oral Health Impact Profile German 14 form (OHIP G14) were collected. For statistical purposes Chi‐square and Mann–Whitney‐U‐Test were adapted. Results: After a mean follow‐up of 81.2 ± 50.3 months, implant survival rate was 98.1% (HNC‐TR), 98.2% (HNC‐TR/RT) and 100.0% (C), respectively (four implants failed in the HNC groups). HNC‐TR/RT showed significant higher mPI and mBI compared to C. Within HNC‐TR/RT, vestibuloplasty significantly reduced mBI and PD values. No failures occurred at the prosthetic level. Overall, higher VAS scores were reported for bar‐ compared with Locator‐retained prostheses. Furthermore, increased OHIP G14 values resulted for HNC‐TR/RT. Conclusions: High survival rates on implant and prosthetic level were observed. The use of soft tissue grafts resulted in stabilization of the peri‐implant mucosa in irradiated patients. In terms of retention and chewing ability, participants preferred bars over Locator attachments. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The aim of this systematic review was to investigate the tooth–implant papilla formation in correlation with the distance between the interproximal bone level and the prosthetic contact point. Material and Methods: A comprehensive search of the current literature (01/01/2000–01/01/2017) was performed to identify human trials that included 10 patients or more, with at least 12 months follow‐up, in need of the replacement of one single tooth in the anterior maxillary region with an implant‐supported single crown. To meet the inclusion criteria, studies had to provide both radiographic and clinical data regarding the distance between the interproximal bone level and the prosthetic contact point. Results: The search yielded 136 records. After evaluation of abstracts and full texts, 12 papers were included in the final review, even though various reference points, for the comparison between the vertical distance and the papilla height, were used. The vertical distance between the interproximal bone level and prosthetic contact point ranged between 2 and 11 mm, and the partial or complete papilla fill (Jemt's score 2–3) ranged between 56.5% and 100% of cases. Conclusion: There is limited evidence that the vertical distance from the base of the interproximal contact point to the crestal bone level seems to affect the interproximal papilla height; that is, the lower is the distance the higher is the percentage of papilla fill. Complete embrasure fill between an implant restoration and the adjacent tooth seems to be correlated with the integrity of the periodontal ligament of the tooth. To reduce the risk of aesthetic failures, interproximal probing on the adjacent teeth should be encouraged before implant placement. [ABSTRACT FROM AUTHOR]