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Objectives: To evaluate the 10-year outcomes of a regenerative surgical treatment of single peri-implantitis intrabony defects, by means of deproteinized bovine bone mineral with 10% collagen (DBBMC)., Material and Methods: The original population consisted of 26 patients with one crater-like defect, around either SLA or TPS dental implants, with a probing depth ≥6 mm and no implant mobility. After debridement and surface decontamination, the defects were filled with DBBMC. Subsequently, patients were placed in an individualized supportive peri-implant/periodontal therapy (SPT) program., Results: Fourteen patients (eight SLA and six TPS) reached the 10-year examination. The overall implant survival rate was 67%, 80% for the SLA, and 55% for the TPS implants. During SPT, five patients were lost to follow-up, eight patients needed additional antibiotic and/or surgical therapy, and seven patients had the implant removed. PD was reduced from 6.6 ± 1.3 to 3.2 ± 0.7 mm in SLA and from 7.2 ± 1.5 to 3.4 ± 0.6 mm in TPS. BOP decreased from 75.0 ± 31.2% to 7.5 ± 12.1% (SLA) and from 90.0 ± 12.9% to 30.0 ± 19.7% (TPS). Treatment success was found in 5 of the 12 SLA (42%) and in 4 of the 14 TPS (29%)., Conclusions: The proposed reconstructive treatment, followed by SPT, was able to maintain in function the majority of SLA implants, although the overall treatment success was limited and many of TPS implants were removed. Therefore, the decision to treat implants affected by peri-implantitis should be based on several factors, including surface characteristics., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: The aim of this research was to investigate the clinical conditions around dental implants placed in the posterior mandible of healthy or moderately periodontally compromised patients, in relation to the presence or not of keratinized mucosa (KT)., Materials and Methods: One hundred and twenty-eight patients who needed an implant in the posterior mandible were consecutively enrolled in a private specialist practice. Only one implant per patient was examined originally placed either within KT or alveolar (AM) mucosa. At 10 years, clinical and radiographic measures were recorded by a calibrated operator. The number of sites treated according to therapy modalities C and D (antibiotics and/or surgery) during the 10 years was also registered., Results: Ninety-eight patients completed the 10-year study. The absence of KT was associated with higher plaque accumulation, greater soft-tissue recession (REC), and a higher number of sites that required additional surgical and/or antibiotic treatment. Patient-reported outcomes regarding maintenance procedures presented major differences between the groups. In 11 of the 35 AM cases, additional free gingival graft (FGG) was successfully employed to reduce discomfort and to facilitate optimal plaque control., Conclusion: Implants that are not surrounded by KT are more prone to plaque accumulation and REC, even in patients exercising sufficient oral hygiene and receiving adequate supporting periodontal therapy (SPT). In selected cases, particularly in the edentulous posterior mandible, where ridge resorption leads to reduced vestibular depth and lack of KT, additional FGG can be beneficial to facilitate proper oral hygiene procedures., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: The aim of this study was to compare the long-term outcomes of sandblasted and acid-etched (SLA) implants in patients previously treated for periodontitis and in periodontally healthy patients (PHP)., Material and Methods: One hundred and forty-nine partially edentulous patients were consecutively enrolled in private specialist practice and divided into three groups according to their periodontal condition: PHP, moderately periodontally compromised patients (PCP) and severely PCP. Implants were placed to support fixed prostheses, after successful completion of initial periodontal therapy. At the end of active periodontal treatment (APT), patients were asked to follow an individualized supportive periodontal therapy (SPT) program. Diagnosis and treatment of peri-implant biological complications were performed according to cumulative interceptive supportive therapy (CIST). At 10 years, clinical and radiographic measures were recorded by two calibrated operators, blind to the initial patient classification, on 123 patients, as 26 were lost to follow up. The number of sites treated according to therapy modalities C and D (antibiotics and/or surgery) during the 10 years was registered., Results: Six implants were removed for biological complications. The implant survival rate was 100% for PHP, 96.9% for moderate PCP and 97.1% for severe PCP. Antibiotic and/or surgical therapy was performed in 18.8% of cases in PHP, in 52.2% of cases in moderate PCP and in 66.7% cases in severe PCP, with a statistically significant differences between PHP and both PCP groups. At 10 years, the percentage of implants, with at least one site that presented a PD ≥ 6 mm, was, respectively, 0% for PHP, 9.4% for moderate PCP and 10.8% for severe PCP, with a statistically significant difference between PHP and both PCP groups., Conclusions: This study shows that SLA implants, placed under a strict periodontal control, offer predictable long-term results. Nevertheless, patients with a history of periodontitis, who did not fully adhere to the SPT, presented a statistically significant higher number of sites that required additional surgical and/or antibiotic treatment. Therefore, patients should be informed, from the beginning, of the value of the SPT in enhancing long-term outcomes of implant therapy, particularly those affected by periodontitis., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: The aim of this study was to compare long-term outcomes of implants placed both in patients treated for periodontitis and in periodontally healthy patients (PHP)., Material and Methods: One hundred and twelve partially edentulous patients were consecutively enrolled in private specialist practice and divided into three groups according to their initial periodontal condition: PHP, moderately periodontally compromised patients (PCP) and severely PCP. Implants were placed to support fixed prostheses, after successful completion of initial periodontal therapy [full-mouth plaque score (FMPS) <25%, full-mouth bleeding score (FMBS) <25%]. At the end of active periodontal treatment (APT), patients were asked to follow an individualized supportive periodontal therapy (SPT) program. Diagnosis and treatment of peri-implant biological complications was performed according to cumulative interceptive supportive therapy. At 10 years, clinical measures were recorded by two calibrated operators, blinded to the initial patient classification, on 101 patients, as 11 were lost to follow-up. The number of sites treated according to therapy modalities C and D (antibiotics and/or surgery) during the 10 years was registered., Results: Eighteen implants were removed for biological complications. Antibiotic and/or surgical therapy was performed in 10.7% of cases in PHP, in 27% of cases in moderate PCP and in 47.2% cases in severe PCP, with a statistically significant differences between PHP and severe PCP (P = 0.002). At the final examination, the percentage of implants, with at least one site which presented a PD ≥6 mm, was respectively 1.7% for PHP, 15.9% for moderate PCP and 27.2% for severe PCP, with a statistically significant difference between PHP and moderate PCP (P = 0.005) and PHP and severe PCP (P = 0.0001)., Conclusion: Patients with a history of periodontitis presented a statistically significant higher number of sites which required additional treatment. Therefore, patients with a history of periodontitis should be informed that they are more at risk for peri-implant disease. This underlines the value of the SPT in enhancing long-term outcomes of implant therapy, particularly in subjects affected by periodontitis. Therefore, the approach for multiple preventive dental extractions and implant placement, based on the assumption the implants perform better than teeth, should be followed with extreme caution., (© 2011 John Wiley & Sons A/S.)

Objectives: The aim of this prospective study was to evaluate a regenerative surgical treatment modality for peri-implantitis lesions on two different implant surfaces., Materials and Methods: Twenty-six patients with one crater-like defect, around either TPS (Control) or SLA (Test) dental implants, with a probing depth (PD) ≥6 mm and no implant mobility, were included. The implant surface was mechanically debrided and treated using a 24% EDTA gel and a 1% chlorhexidine gel. The bone defect was filled with a bovine-derived xenograft (BDX) and the flap was sutured around the non-submerged implant., Results: One-year follow-up demonstrated clinical and radiographic improvements. PDs were significantly reduced by 2.1±1.2 mm in the Control implants and by 3.4±1.7 mm in the Test implants. Complete defect fill was never found around Controls, while it occurred in three out of 12 Test implants. Bleeding on probing decreased from 91.1±12.4% (Control) and 75.0±30.2% (Test) to 57.1±38.5% (p=0.004) and 14.6±16.7% (p=0.003), respectively. Several deep pockets (≥6 mm) were still present after surgical therapy around Controls., Conclusions: Surface characteristics may have an impact on the clinical outcome following surgical debridement, disinfection of the contaminated surfaces and grafting with BDX. Complete fill of the bony defect seems not to be a predictable result., (© 2011 John Wiley & Sons A/S.)

The purpose of this study was to evaluate the long-term clinical outcomes around implants placed in sites previously augmented with demineralized bovine bone mineral with 10% collagen (Bio-Oss Collagen, Geistlich). In this prospective study, 36 consecutive, healthy patients, in need of a single-tooth extraction (incisors, canines, and premolars) and implant replacement, were included. After tooth extraction, Bio-Oss Collagen was inserted in the socket and covered either with a double layer of collagen membrane (test) or with a few drops of a flowable polylactide polymer (control). Following a healing period of 4 to 6 months, a single nonsubmerged implant surgery was performed. After cementation of a single ceramic crown, patients were asked to follow an individualized supportive periodontal therapy program. Clinical and radiographic data were obtained after prosthesis delivery (baseline) and at the 10-year follow-up visit. At the 10‑year examination, two patients were lost to follow-up. All implants demonstrated healthy peri-implant soft tissues as documented by standard parameters (full-mouth plaque score, full-mouth bleeding score, local bleeding on probing) in both groups. Mean soft tissue recession (REC) was 0.39 ± 0.54 mm for the test group and 0.50 ± 0.33 mm for the control, with no significant difference between the two groups. The results of this prospective study confirmed the long-term stability of the peri-implant marginal soft tissues supported by regenerated bone by means of the described technique using Bio-Oss Collagen. If the patient is properly followed throughout time, the risk for mucosal recession is low, with < 1 mm of mean REC after 10 years. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to report the 5-year outcomes of a coverage procedure of shallow maxillary soft tissue dehiscences, around single tissue-level implants.Material and methods: The original population consisted of 16 patients presenting a single maxillary buccal implant soft tissue recession. A connective tissue graft, taken from the maxillary tuberosity, was inserted underneath a split-thickness envelope flap. After treatment, patients received individually tailored supportive periodontal therapy (SPT).Results: Two patients were lost to follow-up, while one implant was removed due to peri-implantitis, before the final examination. At 5 years, complete implant soft tissue coverage was depicted in 8 out of 13 cases (62%). Mean soft tissue dehiscence coverage was 86%. Patients' esthetic evaluation showed the persistency of high VAS scores.Conclusions: Treatment of buccal soft tissue dehiscence around single implant, followed by regular supportive therapy, resulted in good esthetic and functional results in the majority of patients.Clinical relevance: Within the limits of this study, the positive results suggest that the proposed technique may be a reliable option in selected cases. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the long-term clinical results around non-submerged implants placed after vertical alveolar ridge augmentation. Material and methods The original population consisted of two groups of partially edentulous patients (Clinical Oral Implants Research, 15, 2004, 73; Clinical Oral Implants Research, 18, 2007, 286), receiving a total of 82 implants, after a vertical bone augmentation of at least 4 mm. Following cementation of the fixed dental prostheses, patients were asked to follow an individualized supportive periodontal therapy ( SPT) program for an appropriate clinical and radiographic follow-up. Results At the 10-year examination, seven of the 41 patients were lost to follow-up. During SPT, additional antibiotic and/or surgical therapy was necessary in 18 implants, and four of these implants were removed for biological complications. The overall implant survival rate was 94.1%. The mean interproximal bone loss ( BL) was 0.58 ± 0.57 mm. Conclusions The results of this study confirmed that implants, placed after vertical augmentation and followed by an adequate SPT, offer predictable long-term results. Nevertheless, patients whose bone atrophy was consequence of a previous history of periodontitis presented a statistically significant greater BL. [ABSTRACT FROM AUTHOR]

Aim To evaluate the efficacy of a reconstructive surgical procedure in single peri-implantitis infrabony defects. Methods Seventy-five patients with one peri-implantitis crater-like lesion with pocket depth ( PD) ≥ 6 mm, were included. Each defect was assigned to one characteristic class, by an independent examiner. After implant decontamination, defects were filled with deproteinized bovine bone mineral with 10% collagen. Results At 1-year follow-up, four patients were lost and six implants removed. Treatment success, PD ≤5 mm and absence of suppuration/bleeding on probing ( BOP), was obtained in 37 (52.1%) of the 71 implants examined. PD was significantly reduced by 2.92 ± 1.73 mm ( p < 0.0001). BOP decreased from 71.5 ± 34.4% to 18.3 ± 28.6% ( p < 0.0001). The mean number of deep pockets (≥6 mm) decreased from 3.00 ± 0.93 to 0.85 ± 1.35 ( p < 0.0001). Conclusions These results confirm the possibility to successfully treat peri-implantitis lesions. There is lack of evidence of whether or not the resolution of the peri-implant disease is associated with the defect configuration. Due to the fact that complete resolution does not seem a predictable outcome, the clinical decision on whether implants should be treated should be based on several patient related elements. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the outcome of a soft tissue dehiscence coverage technique, at single non-submerged implant sites, presenting shallow isolated buccal mucosal recession. Material and Methods Sixteen patients were included in this prospective study. A connective tissue graft ( CTG) was harvested from the maxillary tuberosity. The donor soft tissue was de-epithelialized and trimmed with a mucotome for an optimal adaptation to the collar of the implant. Results Surgery and healing proceeded with no complications and minimal post-operative discomfort. One-year follow-up demonstrated clinical and esthetic improvements. Treatment resulted in 89.6 ± 13.1% mean coverage, and complete implant soft tissue coverage was achieved in nine of 16 cases, corresponding to a 56.3%. The VAS esthetic analysis showed a significant improvement from 3.6 ± 0.2 to 8.5 ± 0.3. Conclusions These positive preliminary results suggest that, by means of the surgical technique presented, buccal soft tissue dehiscences around single implants can be successfully treated. Additional Randomized controlled trials (RCTs) should be encouraged to assess the most effective variation to the technique in the various clinical situations and around implants of different designs. [ABSTRACT FROM AUTHOR]