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Objective: To investigate demographic/cinical variables associated to dual diagnosis and the psychological reaction of dual-diagnosis patients to COVID-19 pandemic., Methods: Information was collected at the Addiction Service of Monza, Italy. The Impact of Event Scale-Revised (IES-R), a self-report questionnaire measuring the subjective response to a traumatic event, was administered. Univariate analyses and binary logistic regression were performed. IES-R scores were compared between groups defined by qualitative variables through one-way analyses of variance (ANOVA)., Results: 118 outpatients were included, 48.3% with dual diagnosis. Alcohol use disorder and being female were associated to dual diagnosis. IES-R scores were significantly higher in the dual-diagnosis group, especially for personality disorders (PDs). IES-R scores were higher in patients taking treatment for substance use disorder (SUD)., Conclusions: Females and alcohol abusers were at-risk subjects for dual diagnosis. Patients with SUD and PDs may benefit from additional support, especially when traumatic life events occur., Trial Registration: ClinicalTrials.gov Identifier: NCT04694482.

Purposes: The aim of the present clinical and radiologic retrospective study was to evaluate alveolar bone remodeling, in terms of alveolar width and peri‑implant bone level, two years after immediate implant positioning (with two different collar lengths, 0.8 mm and 2.0 mm) and loading of preformed healing cap. The Null hypothesis, H0 is: there was no difference between the two groups of implants., Methods: Patients suffering from single-tooth edentulous areas in premolar, cuspid, and incisive areas were treated with fresh-socket implants and immediate preformed anatomical healing caps. Each final crown restoration was fabricated 3 months later. Primary outcomes (related to loss of the alveolar width and peri‑implant bone level) and secondary outcomes (testing adverse events, and measuring implant/prosthesis survival) were acquired and analyzed., Results: A two-year retrospective analysis was conducted on 31 patients (19 female and 12 male), who underwent dental implant placement with implants having two different lengths of the collar: group A, 0.8 mm, and group B, 2.0 mm. As for the width of the alveolar crest, there was a negligible loss (less than half a millimeter) reported for both the groups, anyway reaching a statistical significance. Preoperative alveolar widths (9.50±0.67 mm and 9.45±0.90 mm, respectively for groups A and B) were different from the two-year alveolar widths (9.20±0.74 mm and 8.93±0.99 mm, respectively for groups A and B) with p-values ≤ 0.0049. When the marginal bone loss was assessed, significant differences were registered between the two procedure groups (-1.42±0.34 mm for group A and -0.11±0.15 mm for group B with a p-value < 0.0001)., Conclusions: The proper design of a healing abutment was very important to preserve the emergence profile immediately after extraction and implant placement. The length of the implant collar used with an immediate healing abutment appeared to affect the preservation of the alveolar crest with predictable final results., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

The analysis aimed to compare two different single-tooth extraction surgical approaches in anterior maxillary areas of the ankylosed teeth: less traumatic magneto-electrical (mag) versus conventional tooth extraction (con) in minimizing the adverse effects on post-extractive sockets. Parameters of clinical interest such as intra-surgical fracture of the buccal bone plate, presence of postoperative inflammation, and application of stitches were acquired from medical records. The data were subjected to Pearson's χ 2 analysis or to Fisher's exact test with significance at 0.05. Sixty-six hopeless maxillary permanent ankylotic teeth were extracted in the same number of patients. In the mag group 2 incisors suffered a fracture. Two patients out of 40 had signs and symptoms of inflammation that resolved completely within 3 days. In the con group 18 out of 26 patients suffered from buccal alveolar fracture. Six of these patients experienced signs of inflamed tissue. The two groups showed significant differences with p-values ≤0.0009 with regards to fracture (2/38 vs. 18/8) and tissue inflammation variables (2/38 vs. 10/16). A significantly different distribution about the presence of sutures was registered between the mag (4/36) and the con (18/8) group with a p-value <0.0001. Mag group seemed to have reduced frequency of fractured and infected post-extractive sites., Competing Interests: Declaration of competing interest None., (Copyright © 2023. Published by Elsevier Ltd.)

Introduction: The present study aimed to examine the middle-term effects of transcrestal double-sinus elevation (TSFE) versus alveolar/palatal split expansion technique (APS) and simultaneous implant placement in the augmented sinus., Null Hypothesis: there were no differences between groups., Material & Methods: Magnetoelectric device was used for bone augmentation and expansion techniques in long-standing edentulous patients with a deficiency in vertical height in the posterior maxilla (3mm to 4mm residual bone height): TSFE group, or two-stage process with a first transcrestal sinus floor augmentation and a second sinus floor elevation with immediate implant placement; APS group, or "dual split and dislocation" of the two cortical bony plates towards the sinus and palatal side. Volumetric and linear analyses were performed on the superimposed preoperative and postoperative 3-year computed tomography scans. The level of significance was set at 0.05., Results: Thirty patients were selected for the present analysis. For both groups significant differences were found in the volume outcomes between baseline and 3-year follow-up, showing a gain of about +0.28±0.06cm 3 for the TSFE group, and +0.43±0.12cm 3 for the APS group, with p-values < 0.0001. However, an effective increase of the volume of the alveolar crest was registered just in the APS group (+0.22±0.09cm 3 ). A significant increase in bone width was found in the APS group (+1.45±0.56mm with p-value < 0.0001); on the contrary, a slight width reduction of the alveolar crest was observed in the TSFE group (-0.63±0.21mm)., Discussion: TSFE procedure seemed to not affect the shape of the alveolar crest. APS procedures led to a higher increase of the volume available for dental implant placement and could be used in horizontal bone defects too., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Purposes: To investigate the amount of first-year peri‑implant bone loss and the development of the papillae when delayed dental implants loaded with anatomic cover screw and those underwent conventional healing protocol were compared., Methods: Edentulous healed sites had undergone delayed implants placement. In the anatomical cap group, patients were treated with a guided tissue healing, tooth-like cross-linkable acrylic resin caps had been immediately screwed on dental implants. The marginal loss of the alveolar bone height 1 year after surgery and Jemt's papillae index were obtained. Non-parametric statistics were performed with a level of significance of 1% RESULTS: Forty patients were included in the present retrospective analysis. After a follow-up of 1 year, none of the 40 included implants showed a failure. The Jemt's papilla index was 1.76±0.44 and 1.34±0.50 respectively for guided tissue healing and conventional healing group, without any significant difference. Within the first year of survey a bone loss of -1.27±0.26 mm for conventional healing treatment showed a statistically significant difference (p-value<0.0001) when it was compared to the negligible of the other group (-0.06±0.31 mm)., Conclusions: A guided healing procedure with preformed caps seemed to give better outcomes regarding marginal bone loss and papilla index than those of conventional abutments., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Aim: To determine the 3-year clinical and dimensional change of the soft tissue following implant placement in healed sites before and after loading with either customized or conventional healing abutments., Materials and Methods: Premolar/molar implants were immediately loaded with either provisional and customized abutments without finishing lines according to principles of the Biologically Oriented Preparation Technique (BOPT), test group, or conventional healing abutments, control group. Three months later, the definitive crowns were fabricated. Primary outcomes (changes in the soft tissue) and secondary outcomes (adverse events) had been registered., Result: Fifty out of 87 subjects originally included were finally selected for this retrospective analysis: 23 in the test and 27 in the control group. During the first days after surgery 2 adverse events of mucositis, one for each group, occurred. A Few technical complications such as unscrewing 4 screw-retained crowns were recorded. A significant increase in the alveolar width was observed in both groups (test &#61; &#43;2.5±0.5mm, and control &#61; &#43;1.0±0.9mm). The widths appeared to not be merely changed from 3 months to 3 years in both groups. There were no significant differences regarding the width of the keratinized mucosa measured at baseline and after follow-up. Jemt papilla index showed a higher increase in the test group compared with that of the control group., Conclusion: Within 3 years of the follow-up period, peri-implant soft tissue outcomes of single, immediately loaded implants with customized healing abutments showed better results in terms of thickness and width when they were compared with those of the conventional group. Side effects count (mucositis and dehiscence) appeared to be very similar between the two groups. In addition, customized healing abutments led to significant augmentation of the alveolar width more than twice that registered in the conventional group.

This study aimed to calculate the 3-year dimensional change in crestal bone width when dental implants placed in postextraction sockets underwent two alternative techniques for alveolar preservation. Fresh sockets that had undergone immediate implant placement were categorized into one of two groups depending on the procedure type. For the xenogeneic biomaterial grafted (BG) group, the gaps between the metallic implant surfaces and the bony walls were filled with corticocancellous porcine bone; in the anatomical cap group, in which patients were treated with guided tissue healing (GTH), cross-linkable acrylic resin caps were immediately screwed on the implants. Absolute measurements of the alveolar width were performed on 3D images acquired before tooth extraction (thereby ensuring correct surgical treatment) and 3 years after surgery. Nonparametric statistics were performed, with the level of significance set at 1%. The results of 46 implants (placed in 36 patients) were analyzed, and 100% survival rates were reported for both groups at 3 years postsurgery. Minor swelling of treated areas was observed the first few days of healing, but neither mucositides, dehiscence events, nor suppurations occurred. At 3 years postsurgery, loss in alveolar ridge width was higher for the BG group (-1.1 ± 0.6 mm) than for the GTH group (0.0 ± 0.3 mm); moreover, these changes were significantly different (P < .0001). This clinical and radiographic data analysis suggests that the implant sites that received a xenogeneic filling material were less effective in maintaining the preoperative alveolar bone width than sites that underwent GTH with immediate implants and anatomical tooth-shaped caps.

Purpose: To examine the short-term outcomes of maxillary sinus augmentations consisting of laterally and apically displacing the palatal wall through a transcrestal approach., Materials and Methods: The maxillary sinus floor was fractured in its palatal aspect by allowing a displacement in the buccal and apical direction with a magnetoelectric system. A medial displacement of the alveolar crest in its palatal bony plate was performed at the same time. Crestal bone change was investigated using superimposed preoperative and postsurgical computed tomography scans. Clinical and radiologic outcomes over 1 year were evaluated., Results: A total of 18 implants were selected for retrospective volumetric and linear analyses. Sinus floor and alveolar bone augmentation surgery led to a significant increase in the bone volume (P = .0002) from 0.134 ± 0.060 cm 3 to 0.639 ± 0.166 cm 3 , with an overall gain of +0.504 ± 0.139 cm 3 . No part of the implant apices appeared to protrude into the maxillary sinus at the 1-year follow-up. The width of the alveolar crest changed from 5.1 ± 0.5 mm to 6.5 ± 0.7 mm, with a significant increase of +1.4 ± 0.6 mm registered at 1 year. However, a marginal bone loss of 1.0 ± 0.8 mm was observed. When tooth positions were investigated, no significant differences between the two groups (premolars versus molars) were found., Conclusion: Significant and effective bone gains allowed proper placement of the dental implants but with a minimal loss of peri-implant bone volume.

The present study evaluated the 2-year changes in soft tissue width after implant placement in healed sites, using two different methodologies to obtain tissue healing: preformed and anatomical abutment caps for customized healing (test) vs conventional healing abutments (control). The null hypothesis was that there would be no difference between the test group and the control group. Patients who suffered from a single-tooth edentulous area in the premolar/molar region were included. Both the standard abutments and the preformed and anatomical abutment caps were immediately screwed on the implants. The final crown restoration was fabricated 3 months later. Primary outcomes (changes in the alveolar soft tissue ridge) and secondary outcomes (testing adverse events and measuring implant/prosthesis survival) were evaluated. Thirty-nine patients (24 women) with a mean age of 57.7 ± 7.1 years (range: 42.6 to 72.8 years) were included. Alveolar widths in both groups showed significant increases from baseline to the 3-month follow-up, with augmentations of 3.6 ± 0.7 mm for the test group and 1.1 ± 0.9 mm for the control group. The gain in soft tissue appeared to be statistically different between the two groups (P < .0001). Contrarily, any subsequent change in width from 3 months to 2 years was negligible and insignificant (< 0.33 mm for both groups). The technique described in the present study encourages the potential for alternative healing based on the guided soft tissue concept, as it either eliminated the need for second-stage surgery or it reduced step-by-step peri-implant soft tissue conditioning, obtaining a tissue contour immediately very similar to that of a final prosthesis.

Background: The present retrospective analysis aimed to compare two different single tooth extraction surgical approaches in both premolar and molar areas: less traumatic magneto-electrical versus conventional tooth extraction in minimizing the edentulous ridge volume loss., Methods: In the present retrospective control trial, 48 patients who underwent one-tooth extraction, were allocated either to control (28 sites treated with conventional tooth extraction procedures) or test group (20 subjects treated with less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric roots subluxation). Intraoperatively (during tooth extraction surgery just after the subsequent filling of the alveolar socket with the sterile fast re-absorbable gelatin sponge), and then four months later, contours of the sockets were acquired through a laser intra-oral scanner. The digitally superimposed models were converted to dicom (Digital Imaging and Communications in Medicine) format first, then volumetric and area evaluations were performed with a DentaScan tool package. Non-parametric tests were applied with a level of significance set at p < 0.01., Results: significant reductions of anatomical features were observed four months later in all the groups ( p -values < 0.001) with volume losses leading to a final alveolar ridge volume of 0.87 ± 0.34 cm 3 for atraumatic extractions and 0.66 ± 0.19 cm 3 for conventional extractions. No significant differences were registered for outcomes related to the basal surface variables. When just molar tooth were considered, the outcomes relating to volume loss between baseline and four months (ΔV) and its percentage (ΔV%) showed a better behavior in the less traumatic procedure (ΔV = -0.30 ± 0.10 cm 3 and ΔV% = -22.3 ± 8.4%) compared to the conventional extractions (ΔV = -0.59 ± 0.10 cm 3 and ΔV% = -44.3 ± 5.8%) with p -values < 0.0001., Conclusions: at four months, the less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric root subluxation seemed to be able to better preserve the volume of the alveolar crest (reduction close to 22% with less traumatic extraction in molar sites) when compared to subjects treated with the conventional tooth extraction techniques.

SARS-CoV-2 infection causes a pulmonary disease (COVID-19) which spread worldwide generating fear, anxiety, depression in the general population as well as among subjects affected by mental disorders. Little is known about which different psychopathological changes the pandemic caused among individuals affected by different psychiatric disorders, which represents the aim of the present study. Specific psychometric scales were administered at three time points: T0 as outbreak of pandemic, T1 as lockdown period, T2 as reopening. Descriptive analyses and linear regression models were performed. A total of 166 outpatients were included. Overall, psychometric scores showed a significant worsening at T1 with a mild improvement at T2. Only psychopathology in schizophrenia (SKZ) patients and obsessive-compulsive (OC) symptoms did not significantly improve at T2. Subjects affected by personality disorders (PDs) resulted to be more compromised in terms of general psychopathology than depressed and anxiety/OC ones, and showed more severe anxiety symptoms than SKZ patients. In conclusion, subjects affected by PDs require specific clinical attention during COVID-19 pandemic. Moreover, the worsening of SKZ and OC symptoms should be strictly monitored by clinicians, as these aspects did not improve with the end of lockdown measures. Further studies on larger samples are needed to confirm our results. ClinicalTrials.gov Identifier: NCT04694482., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The FIBRONET study was an observational study of patients with idiopathic pulmonary fibrosis (IPF) in Italy., Objectives: In this post hoc descriptive analysis, we describe changes in lung function, anxiety/depression, coughing, exacerbations, and adverse events (AEs) in patients receiving nintedanib treatment., Methods: Patients with IPF from 20 centers in Italy, aged ≥40 years who received nintedanib for ≥7 months, were followed up for 12 months from study enrollment, attending clinic visits every 3 months. Outcomes included change in forced vital capacity (FVC)% predicted from baseline to 12 months, anxiety/depression measured by the Hospital Anxiety and Depression Scale (HADS), and the proportion of patients with cough, AEs, and exacerbations., Results: In total, 52 patients received nintedanib (mean duration of 11.6 months). Ten patients had dose reductions from 150 mg to 100 mg twice daily, due to AEs. FVC% predicted was unchanged in the overall nintedanib population (78.7% at baseline; 79.8% at 12 months) and those with a reduced dose (77.7% at baseline; 81.0% at 12 months). HADS score was low at baseline and throughout the study. The proportion of patients with cough decreased from 50.0% to 21.2% over 12 months. Two patients experienced exacerbations, 2 patients discontinued treatment, and 27 (51.9%) reported AEs. The most common AE was diarrhea (34.6%)., Conclusions: In patients with IPF who received nintedanib in the FIBRONET study, FVC% predicted was stable over 12 months, and the proportion of patients with cough decreased. The safety profile was consistent with the known safety profile for nintedanib in IPF., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

Purpose: This study aimed to test the effectiveness and reliability of the alveolar ridge-splitting technique in atrophic posterior arches, investigating the middle-term volumetric and clinical outcomes., Materials and Methods: Atrophic alveolar ridges in the maxillary and mandibular posterior areas were treated with the alveolar ridge-splitting/expansion technique (ARST), immediate implant placement, collagen sponges covering the defect, and healing by secondary intention. Areas were rehabilitated by fixed dental prostheses supported by dental implants. Changes in volume and width of the alveolar ridge were retrospectively calculated by comparing the x-ray tomography scans obtained before and 5 years after surgery. Report of failure in the case sheets was taken into account. Cross-sectional images were also used to assess the thickness of the labial alveolar plates at the implant shoulder. Nonparametric analyses of variance with post hoc and pair-comparison tests were performed with a level of significance of .05., Results: A total of 38 patients were retrospectively selected (23 women and 15 men). Six patients underwent ARST surgeries in both the maxilla and the mandible and were excluded from statistical analysis. Differences between 16 maxillae and 16 mandibles and between 12 single crowns and 20 fixed partial dentures (FPDs) were searched. Episodes of minor swelling occurred within the first 2 days after surgery. Neither mucositis nor flap dehiscence had been registered. The mean values of buccal cortical thickness were 2.46 ± 0.49 mm and 1.15 ± 0.33 mm, respectively, in the maxillary and mandibular areas. After 5 years of survey, maxillary increases in alveolar ridge width and volume were +4.4 ± 0.4 mm and +295 ± 45 mm 3 , respectively, whereas the same outcome variables (+3.5 ± 0.7 mm and +217 ± 53 mm 3 ) measured in the mandible appeared to be significantly smaller than those in the maxilla (P < .0001). One maxillary single implant failed. Cumulative survival rates at 5 years were 100% for mandibles and 95.5% (95% CI: 86.8% to 100%) for maxillae., Conclusion: Posterior areas of the maxilla displayed a higher increase in alveolar width and volume than mandibular areas, and even if it would be premature to draw survival conclusions at this stage without any statistical support, a lower cumulative survival rate was reported for the maxillary single implants.

Purpose: This study aimed to report a practicable and noninvasive two-stage technique for sinus elevation and delayed implant insertion in the augmented site with residual bone height down to 3 mm or even lower., Materials and Methods: The surgical technique employed a two-stage process for rehabilitation of posterior maxillary single-tooth edentulous areas, involving, in the first step, transcrestal maxillary sinus floor augmentation with a collagen sponge to fill the intrabony cavity resulting from the detachment of the sinus membrane; the second step consisted of another indirect sinus floor elevation using magnetoelectric surgery with immediate implant placement and no grafting material. Changes in bone height were evaluated by a comparison of the computed tomography scans acquired before treatment and after surgery (at 3 months and 5 years of the survey). Statistically significant differences between the times and the tooth sites were evaluated by nonparametric statistics (matched and independent), with P < .01., Results: Forty patients were retrospectively selected. The preoperative height of the available alveolar bone was 2.9 ± 0.6 mm. A significant increase in bone height (P < .01) was found for both the first and the second surgery (3.1 ± 0.6 mm and 4.4 ± 0.6 mm, respectively). The overall bone height was measured at 3 years after the first surgery (10.3 ± 0.6 mm). Measurements of the bone height ranked for tooth positions showed no significant difference between premolars and molars. None of the selected patients registered an implant failure., Conclusion: Two-stage osteotome-mediated sinus elevation appeared to be a predictable technique that enabled practitioners to increase the bone height and to obtain successful outcomes even if the amount of bone was approximately 3 mm in height.

Background: The present study is designed to compare the outcomes of two sinus augmentation procedures: distal displacement of the anterior wall versus standard sinus lifting and grafting with a lateral window approach., Methods: In the displacement group, a localized surgical fracture of the sinus floor achieved through an electromagnetic device results in the distal displacement of the anterior wall. In the filling group, sinus lifting (with lateral access) and grafting with particulate xenogeneic bone substitute was performed. Bone volume beneath the maxillary sinus was investigated with computerized tomography after baseline and postoperative data superimposition. Clinical and radiological outcomes over three years had been evaluated., Results: Forty-three dental implants were selected. The two sinus lift procedures significantly increased the bone volume ( p -value ≤ 0.0017) in the displacement group from 1.17 ± 0.34 to 1.53 ± 0.39 cc, with a final bone gain of +0.36 ± 0.17 cc, and in the filling group from 1.24 ± 0.41 to 1.94 ± 0.68 cc, with a bone augmentation of +0.71 ± 0.31 cc. No events of dental implant bulging into the maxillary sinus occurred. Two implants failed early on in the filling group, attesting the 3-year survival rate of 92.6% (CI95%: 82.7-100%). Marginal bone loss at the distal aspect was 1.66 ± 0.72 and 1.25 ± 0.78 mm, respectively, for the displacement and filling groups, with a significant difference ( p -value = 0.0497)., Conclusion: Results showed a significant and effective bone gain around dental implants at a 3-year survey for both sinus augmented by backward displacement of the anterior wall (+34%) and sinus lifting and grafting with a lateral window approach (+57%).

Background : To investigate the middle-term effect on bone remodeling of different timings for different implant placement (immediate versus delayed). Methods : Patients with an anterior maxillary failing tooth were treated by single-crown supported by dental implant. Subjects were retrospectively analyzed for 3 years and assigned to one of two predictor groups: nine immediate versus 10 delayed implant placement (1-2 months after tooth extraction). The crestal bone loss around dental implants was measured with the cone beam computerized tomography by fusing pre-operative and post-operative data. Results: The percentage of volume loss registered at 1-year follow-up (%ΔV) was of 7.5% for the immediate group, which was significantly lower ( p -values ≤ 0.0002) than the loss of 24.2% for the delayed group. At 3 years, there was a significant difference ( p -values = 0.0291) between the two groups, respectively, with a volume loss of 14.6% and 27.1%. When different times were compared, the percentage of the volume loss for the immediate group was different ( p -value = 0.0366) between the first and third year (7.5% and 14.6%, respectively). For the delayed group, no significant difference was registered between the 1- and 3-year follow-up. Conclusions : The bone loss around dental implant-supported single-crown with different timing of insertion appeared higher for the delayed group than the immediate group.

Purpose: The purpose of this study was to compare success and outcomes among implants positioned either in grafted or ungrafted alveoli during 10 years of follow-up., Materials and Methods: This retrospective analysis was conducted on data of subjects who underwent tooth extraction and alveolar ridge preservation. Sites, one per patient, were ranked into three groups: postextraction ungrafted alveoli, and postextraction grafted alveoli with either synthetic magnesium-enriched hydroxyapatite or porcine bone. An absorbable collagen sheet was used to completely cover all the sockets. A secondary intention healing was sought for all procedures. Data regarding implant survival and marginal bone loss around implants were gathered until the 10-year follow up. Pairwise comparisons were performed with nonparametric tests, and statistical significance was set at .01., Results: Sixty-three subjects were included: 42 implants (19 and 23 in the magnesium-enriched hydroxyapatite and porcine bone groups, respectively) placed in grafted sites and 21 in nongrafted sites. The success rate of the grafted groups was 88.1% (CI: 78.3% to 97.9%) at the 10-year follow-up. On the other hand, in the ungrafted group, the overall success rate was 85.7% (CI: 70.8% to 100%). Peri-implant marginal bone loss at the 10-year follow-up for the magnesium-enriched hydroxyapatite group was 1.2 (0.7) mm, while for the porcine bone group, it was close to 0. The behavior of the ungrafted group appeared to be significantly different compared with both grafted groups; however, marginal bone levels ranging from 0.1 to 0.4 mm were observed from 3 to 10 years., Conclusion: A difference in terms of long-term success rates between grafted and ungrafted sites was not revealed. Bone loss was significantly higher in the magnesium-enriched hydroxyapatite grafted group compared with those in the other groups (without or with other bone substitute material).

Background: Subjects with intellectual disability (ID) are vulnerable to experience psychiatric disorders. The present authors performed a systematic review and meta-analysis to estimate the prevalence of co-occurring psychiatric disorders, excluding co-occurring autism spectrum disorders, in subjects with intellectual disability., Method: The present authors performed a random-effects meta-analysis of the prevalence of psychiatric disorders in adults and adolescents with intellectual disability., Results: Twenty-two studies were included. The pooled prevalence of any co-occurring psychiatric disorders in intellectual disability was 33.6% (95% CI: 25.2%-43.1%) with high heterogeneity but no publication bias. Prevalence was lower in population-based studies, in studies that used ICD criteria for the psychopathology and in studies with low risk of bias. The prevalence was higher in mild, moderate and severe intellectual disability than in profound intellectual disability., Conclusions: Psychiatric disorders are common in subjects with intellectual disability, and the present authors found that clinical and methodological moderators affect the pooled prevalence., (© 2019 John Wiley & Sons Ltd.)

Aim: To evaluate width loss of the alveolar ridge three years after implant placement in a fresh extraction socket following two different tissue healing methodologies: conventional healing procedure vs CAD/CAM technology for a customized healing abutment., Materials and Methods: Post-extraction sockets underwent immediate dental implant placement without the voids being filled between the implant surface and the socket wall. Samples (one implant per patient) were retrospectively enrolled in each group according to the type of healing procedure: implants in the conventional group underwent standard closed healing with a cover screw, while in the customized group the healing abutment was immediately screwed onto the head of the implant, mimicking the look of the extracted tooth fabricated by CAD/CAM technology. The width of the alveolar ridge was measured on 3D radiographs at baseline (before surgery) and three years postsurgery. Nonparametric statistics were performed with a significance level of 0.01., Results: A total of 54 dental implants were selected. An implant survival rate of 100% was reported for all implants after 36 months. Three years after implant placement, loss in bone width was registered for both the conventional and customized groups, being 2.2 (1.1) and 0.2 (0.7) mm, respectively. Changes in the customized group were significantly lower than in the conventional group. Significant differences were again found between the groups for each of the tooth sites. Loss of bone width appeared negligible (from incisor to premolar), with values ranging between 0.2 and 0.4 mm in the customized group, whereas in the conventional group all tooth sites underwent wide shrinkage (with a bone loss ranging from 1.6 to 3.0 mm)., Conclusion: The CAD/CAM procedure might provide the following advantages: 1) Stabilization of the gingival setting and bone volume in a fresh socket implant; 2) Maintaining the same emergence profile of teeth for restorative crowns, avoiding laboratory approximation of the emergence profile of the definitive restoration; and 3) Optimal prosthetic-surgical planning and minimally invasive extraction to preserve the integrity of the supporting tissue.

Purpose: To measure the volume effect on maintaining a sealing around immediately rehabilitated dental implants in a comparison between customized and conventional provisional crowns at a 3-year follow-up., Materials and Methods: A single crown supported by a dental implant was used as a rehabilitation strategy for a failing tooth. The primary predictor was the type of immediate restoration with custom or conventional provisional crowns; a secondary predictor was tooth position: incisor, canine, or premolar. In order to accurately measure the width between buccal and palatal plates at the alveolar margin in a comparison between preoperative (before tooth extraction) and postoperative (at the 3-year follow-up) radiographs, two cone beam computed tomography (CBCT) scans were three-dimensionally analyzed and superimposed., Results: Seventy-six patients, rehabilitated with single implants, were selected (31 implants belonging to the custom group and 45 to the conventional group). In patients treated with conventional restorations, a significant shrinkage (-0.6 ± 1.2 mm with P = .002) was registered. On the other hand, the bone change registered for the custom restoration group appeared negligible, with a nonsignificant and slight increase in width (+0.2 ± 0.7 mm). When the subgroups regarding the implant sites were investigated, the decrease in width was very limited for the canine tooth in the custom group (-0.3 ± 0.2 mm), whereas the shrinkage at the canine in the standard group appeared to be significantly higher (-1.5 ± 0.7 mm with P = .0001)., Conclusion: An anatomically contoured provisional restoration may provide a strategy to stimulate peri-implant soft tissue healing, minimize loss of buccal bone plate at the marginal level, and maintain pristine volume in the alveolar bone better than noncustomized restorations.

Purpose: The purpose of this study was to assess the effect of different loading protocols (immediate or delayed) on bone volume remodeling of an immediate implant-supported single crown in the maxilla with a follow-up from 2 to 3 years., Materials and Methods: Patients presenting a failing tooth have been rehabilitated with implant-supported single crowns. Data of patients with a survey from 2 to 3 years after baseline surgery were retrospectively acquired. One implant per patient was randomly selected during data analysis and assigned to one of two predictor groups: the loading protocol, 9 immediate vs 13 delayed loading; and tooth position, 9 incisors vs 9 canines. Cumulative survival rates were recorded; loss of crestal bone volume was assessed with cone beam computed tomography (CBCT) by means of software that superimposed the preoperative and postoperative CBCT scan data (Matrix Laboratory) and by destascan software., Results: Twenty-two patients were enrolled. No postoperative complications or implant failures were recorded. Bone volume loss from the 2- to 3-year follow-up period ranged between 19.1% and 22.0%, without significant differences between the two loading protocols. Irrespective of the tooth site, intragroup analyses revealed the presence of significant differences between preoperative and postoperative time evaluations for all the analyzed groups and subgroups. Volumes at baseline (ranging between 0.546 cc and 0.553 cc) recorded significant loss of approximately 110 mm 3 (P values ≤ .0001) for both loading protocols. The volume at the postoperative evaluation ranged between 0.428 cc and 0.442 cc. Considering tooth site in the analysis, the subgroups showed similar behaviors at the crestal bone level. However, bone loss at the apex of the implant appeared to be lower for incisors than canines., Conclusion: This study attested that the loss of crestal bone around an immediate implant-supported single crown depended on neither the loading protocol nor the tooth site.

The aim of the present study was to consider the long-term midfacial mucosal outcome around final prosthetic restorations on dental implants placed and loaded immediately after tooth extractions. A total of 42 patients requiring tooth extractions were recruited, and 142 teeth were extracted. Based on the amount of keratinized mucosa (KM), implants were categorized into group A (KM ≥ 2 mm; n = 61) or group B (KM < 2 mm; n = 62). In both groups, all patients received temporary prosthetic restorations immediately after the surgical procedure. Baseline levels were measured at placement of the final prosthetic restoration and patients were followed for 8 years. After the 8-year follow-up, a survival rate of 98.37% was reported. Two implants were lost due to peri-implantitis after 6 and 7 years of function, respectively. Peri-implantitis occurred at 9 implants (3 from group A and 6 from group B) in 8 patients (7.32%). At the 8-year follow-up for group A, an increase in midfacial tissue level of 0.14 ± 0.13 mm (screwed restorations) and 0.16 ± 0.09 mm (cemented restorations) was measured. For group B, a decrease in midfacial tissue level of 0.15 ± 0.09 mm (screwed restorations) and 0.17 ± 0.12 mm (cemented restorations) was reported. Statistically significant differences between groups were measured at 2, 5, and 8 years of follow-up (P < .01). The results demonstrated that the presence of KM is significantly associated with less mucosal inflammation and less gingival recession, regardless of the type of prosthetic restoration (screwed vs cemented).

Objectives: The purpose of this study was to evaluate a nonsurgical approach toward peri-implantitis by means of mechanical debridement and local detoxification leaving granulation tissue into the peri-implant pockets., Materials and Methods: An analysis was performed on the outcomes of 2 nonsurgical protocols: mechanical debridement plus chemical detoxification with 0.2% chlorhexidine and chlortetracycline hydrochloride (test), and mechanical debridement alone (control). Measures were collected at baseline, 3, 24, and 36 months after treatment., Results: Seventy-five implants with peri-implantitis were included. At a 36-month evaluation, mean pocket probing depth was 3.15 ± 0.32 mm for the test group and 5.97 ± 0.90 mm for the control group, the difference being significant. An improvement of marginal bone level was recorded for the test group, whether the control group showed a further marginal bone loss. Treatment success was 100% in the test group and 31.4% in the control group., Conclusion: Nonsurgical implant debridement alone seemed not efficient in the treatment of peri-implantitis. Further longitudinal studies are required to evaluate the efficacy of mechanical debridement with chemical detoxification and removal of granulation tissues against mechanical debridement with chemical detoxification alone.

The aim of this study was to compare midfacial soft tissue assessment and horizontal width changes of fresh socket implants in immediate and delayed prosthetic restorations. Patients requiring extractions in the maxillary esthetic zone were recruited. In one group, 30 implants were placed using an immediate loading approach; in the second group, 30 implants were loaded after a period of 3 months. At the 4-year follow-up, statistically significant differences (P < .001) were found. Immediate implants restored on the day of surgery demonstrated more stable midfacial soft tissue levels and bone volume maintenance than delayed implants.