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Objectives: The purpose of the present survey is to give an update of European experts' opinion on infection control and prevention in dentistry during second wave of pandemic. The secondary aim was to analyze how experts' opinion changed in the light of the new scientific evidence since the first wave., Material & Methods: An anonymous online 14-item questionnaire was sent to a total of 27 leading academic experts in Oral (and Maxillofacial) Surgery from different European countries, who had completed a previous survey in April-May 2020. The questionnaire covered the topics of dental setting safety, personal protective equipment (PPE), and patient-related measures to minimize transmission risk. Data collection took place in November-February 2020/21., Results: 26 experts participated in the follow-up survey. The overall transmission risk in dental settings was scored significantly lower compared to the initial survey (p < .05), though the risk associated with aerosol-generating procedures (AGP) was still considered to be high. Maximum PPE was less frequently recommended for non-AGP (p < .05), whereas the majority of experts still recommended FFP2/FFP3 masks (80.8%), face shields or goggles (88.5%), gowns (61.5%), and caps (57.7%) for AGP. Most of the experts also found mouth rinse relevant (73.1%) and reported to be using it prior to treatment (76.9%). No uniform opinion was found regarding the relevance of COVID-19 testing of staff and patients., Conclusion: With the continuation of dental care provision, transmission risk has been scored lower compared to the first wave of pandemic. However, high risk is still assumed for AGP, and maximum PPE remained advised for the respective treatments., (© 2021 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.)

Objectives: Implantoplasty (IP) is a treatment option for peri-implantitis. Mechanical concerns were raised on fracture resistance of implants subjected to this procedure. This study aimed to compare two methods of IP in terms of implant wear and fracture resistance, and of surface topography., Material and Methods: Eighteen cylindrical screw-shaped dental implants (4 mm diameter, 13 mm length) with an external hexagonal connection were used. IP was performed on the first 6-mm implant surface with a sequence of burs or diamond sonic tips, both followed by an Arkansas finishing. IP duration and implant weight variation were recorded. Micro-computed tomography (micro-CT) was used to evaluate material loss. Implant fracture resistance was assessed by static compression test. Surface topography analysis was performed with a stylus profilometer. Scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) was applied for implant surface morphology and elemental characterization., Results: Micro-CT showed less material loss in sonic compared to burs. No statistically significant difference was found between the mean fracture resistance values reached in bur and sonic, both followed by Arkansas, and with respect to control. IP performed with burs led to a smoother surface compared to sonic. Equivalent final surface roughness was found after Arkansas in both IP procedures. SEM-EDS showed a deburring effect associated to sonic and revealed carbon and aluminum peaks attributable to contamination with sonic diamond tips and Arkansas bur, respectively., Conclusions: IP with sonic diamond tips was found to be more conservative in terms of structure loss. This could have a clinical relevance in case of narrow-diameter implants., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: The current COVID-19 outbreak in conjunction with the need to provide safe dental treatments and the limited knowledge on the efficacy of protective measures has posed dentists into a challenging situation. Therefore, the present article aimed at collecting experiences and recommendations of frontline clinical experts on critical aspects of dental treatment provision during pandemic., Material & Methods: From a total of 32 European countries, one leading academic expert in Oral and Maxillofacial Surgery or Oral Surgery per country was asked to participate in an anonymous online 10-item survey on COVID-19 covering the topics of safety of dental settings, personal protective equipment (PPE), and patient-related measures to reduce transmission risk. Data collection took place from April 12th to May 22nd, 2020., Results: A total of 27 experts from different European countries completed the survey. The transmission risk of SARS-CoV-2 in dental settings for aerosol-generating procedures was considered high by all experts except two. For aerosol-free and aerosol-generating procedures, more than 80% of the experts recommended face protection and caps for every single treatment. For aerosol-generating procedures, additional measures (FFP2/FFP3 masks and gowns) were suggested by the vast majority of the experts. To reduce transmission risk, all experts recommended limiting aerosol-generating procedures and reducing the number of patients in waiting areas as well as hand hygiene for the patients., Conclusion: The limitation of aerosol-generating procedures along with the usage of adequate personal protection equipment was considered to be crucial to protect dental healthcare providers and patients, thus reducing the transmission risk of COVID-19., (© 2020 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.)

Objectives: The purpose of this prospective, single-center randomized pilot study was to histologically evaluate and compare vital bone development in premolar and molar-extraction sites grafted with two different bovine-derived xenografts. The secondary outcome of interest was implant survival in the grafted sites., Materials and Methods: Adult patients in need of at least two tooth extractions were enrolled. A paired design was used; each patient received at least one of each type of graft at different sites. Each extraction site was randomized to one of two xenograft treatment groups. A resorbable membrane was always placed, and primary intention soft tissue closure was achieved. Four months later, implants were placed and a trephine drill was used to remove bone cores for histologic and histomorphometric analysis., Results: Sixteen patients with 40 extraction sites were enrolled; 20 sites were grafted with one type of xenograft and 20 with another. Mean patient age was 53.5 years, and 65% of patients were male. Evaluation of bone core samples taken from grafted sites showed no significant difference in the mean value of percentage of new bone formation between the different grafted sites (33.4% and 32.4%, p = .76). Cumulative implant survival was 97.5% at the 24-month follow-up visit., Conclusion: Within the limitations of this pilot study, no statistically significant differences in new bone growth between sites grafted with two different types of xenograft were found. Both graft materials promoted the formation of new bone and provided osseous support for implant placement after socket grafting., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To evaluate the influence on osseointegration of Deproteinized bovine bone mineral (DBBM) particles used to fill defects of at least 1 mm around implants having no primary contact with bone., Material and Methods: Premolars and first molars were extracted bilaterally from the mandible of six Labrador dogs. After 3 months of healing, mucoperiosteal full-thickness flaps were elevated, and one recipient site was prepared in the molar region of each hemi-mandible to place implants. These were installed with a deliberate circumferential and periapical space to the bone walls of 1.2 mm. All implants were stabilized with passive fixation plates to maintain the implants in situ and without any contact with the implant bed. The control sites were left to be filled with coagulum, while at the test sites, the residual gap was filled with DBBM. After 3 months of submerged healing, the animals were sacrificed. Ground sections were prepared and analyzed histomorphometrically., Results: Mineralized bone-to-implant contact was 4.0% and 3.9% for control and test sites, respectively. The width of the residual defects was 0.48 mm and 0.88 mm at the control and test sites, respectively. The percentage of implant surface covered by a layer of dense connective tissue of 0.12 mm of width on average was 84.9% and 88.5% at the control and test sites, respectively., Conclusion: A minor and not predictable degree of contact or distance osteogenesis was obtained on the implant surface when primary contact of the implant surface with the implant bed had deliberately been avoided. DBBM grafting of the artificial gap did not favor osseointegration. Neither did it enhance the ability to bridge the gap with newly formed bone in an artificial defect wider than 1 mm., (© 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.)

Aim: To evaluate the influence of implant positioning into extraction sockets on bone formation at buccal alveolar dehiscence defects., Material and Methods: In six Labrador dogs the pulp tissue of the mesial roots of (4) P(4) was removed and the root canals were filled. Flaps were elevated bilaterally, the premolars hemi-sectioned and the distal roots removed. The implants were placed in contact with either the buccal (test site) or with the lingual (control site) bony wall of the extraction sockets. Healing abutments were affixed and triangular buccal bony dehiscence defects, about 2.7 mm deep and 3.5 mm wide, were then prepared. No regenerative procedures were done and a non-submerged healing was allowed. After 4 months of healing, block sections of the implant sites were obtained for histological processing and peri-implant tissue assessment., Results: After 4 months of healing, the bony crest and the coronal border of osseointegration at the test sites were located 1.71 ± 1.20 and 2.50 ± 1.21 mm apically to the implant shoulder, respectively. At the control sites, the corresponding values were 0.68 ± 0.63 and 1.69 ± 0.99 mm, respectively. The differences between test and control reached statistical significance (P < 0.05). Residual marginal bone defects were found both at the test and control sites. A statistically significant difference between test and control sites was only found at the lingual aspects (depth 2.09 ± 1.01 and 1.01 ± 0.48 mm, respectively). Similar heights of the buccal biological width were observed at both sites (about 5.1 mm)., Conclusions: The placement of implants in a lingual position of the extraction sockets allowed a higher degree of bone formation at buccal alveolar dehiscence defects compared with a buccal positioning., (© 2012 John Wiley & Sons A/S.)

Objective: The aim of this cross-sectional study was to determine the clinical outcome and patient satisfaction in subjects treated with mandibular overdentures supported by two implants., Material and Methods: One hundred and fifty-nine patients, who received restorative therapy in the edentulous mandible consisting of a bar-retained overdenture supported by two osseointegrated implants in a private clinic in Italy, were recalled for a clinical and radiographic examination. One hundred and forty-one subjects with 280 implants attended the examination. The average follow-up time was 3.9 years. The radiographic examination included assessments of the distance between the implant margin and the most coronal position of bone-to-implant contact at the mesial and distal aspects of each implant. A questionnaire regarding comfort, satisfaction with the treatment, aesthetics, speaking capacity and efficiency in chewing was obtained from each subject. Biological and technical complications were recorded and the number of visits due to complications between the delivery of the prostheses and the re-examination was determined., Results: The results from the examination revealed that the number of lost implants was small and the average marginal bone level around the implants was 0.67 mm apical of the implant margin. The most frequently observed complication was hyperplasia of the mucosal tissue under the bar construction. Few patients experienced loosening of retention. The vast majority of patients reported to be satisfied in relation to the restorative therapy from both functional and aesthetic points of view., Conclusion: Patients with edentulous mandibles may be successfully rehabilitated by means of two implants supporting a bar-retained overdenture., (© 2011 John Wiley & Sons A/S.)

Aim: To evaluate the healing at implants with a moderately rough surface placed and stabilized in recipient sites of dimensions deeper and larger than that of the implants to avoid any contact between parent bone and the implant., Material & Methods: In six Labrador dogs, premolars and first molars were extracted bilaterally in the mandible. After 3 months of healing, mucoperiosteal full-thickness flaps were elevated and the premolar area of the alveolar bony crest was selected. Three recipient sites were prepared to place three implants. One implant was used as control. The other two were placed in recipient sites which left a circumferentially and periapical prepared defect of 0.7 mm (small) and 1.2 mm (large), respectively. All implants were stabilized with passive fixation plates to maintain the implants stable and without any contact with the implant bed. After 3 months of submerged healing, the animals were sacrificed. Ground sections were prepared and analyzed histomorphometrically., Results: The BIC% was 5.3% and 0.3% for implants placed in small and large defect sites, respectively, whereas it was 46.1% for control implants. The differences were statistically significant. The width of the residual defects was 0.4 and 0.5 mm at the small and large defects, respectively. An approximately 0.09 mm layer of dense connective tissue (DCT) rich in fibers and fibroblast-like cells was observed adherent to the implant surfaces. The percentage of implant surface covered by DCT was 92.8% and 95.6% at the small and large defects, respectively., Conclusion: Osseointegration was observed at the test sites, and the dimensions of the defects influenced the outcomes. However, the degree of osseointegration at both small and large defects was very low compared with the control sites., (© 2012 John Wiley & Sons A/S.)

Aim: To evaluate the effect of implant length (6 mm vs.11 mm) on osseointegration (bone-to-implant contact) of implants installed into sockets immediately after tooth extraction., Material and Methods: In six Labrador dogs, the pulp tissue of the mesial roots of (3) P(3) was removed and the root canals were filled. Flaps were elevated bilaterally, the premolars hemi-sectioned and the distal roots removed. Recipient sites were prepared in the distal alveolus and a 6 mm or an 11 mm long implant was installed at the test and control sites, respectively. Non-submerged healing was allowed. After 4 months of healing, block sections of the implant sites were obtained for histological processing and peri-implant tissue assessment., Results: No statistically significant differences were found between test and control sites both for hard and soft tissue parameters. The bone-to-implant contact evaluated at the apical region of the implants was similar as well. Although not statistically significant, the location of the top of the bony crest at the buccal aspect was more apical in relation to the implant shoulder at the test compared with the control sites (2.0 ± 1.4 and 1.2 ± 1.1 mm, respectively)., Conclusions: Shorter implants (6 mm) present with equal osseointegration than do longer implants (11 mm)., (© 2012 John Wiley & Sons A/S.)