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Periodontitis is a chronic infectious disease driven by dysbiosis, an imbalance between commensal bacteria and the host organism. Periodontitis is a leading cause of tooth loss in adults and occurs in about 50% of the US population. In addition to the clinical challenges associated with treating periodontitis, the progression and chronic nature of this disease seriously affect human health. Emerging evidence suggests that periodontitis is associated with mechanisms beyond bacteria-induced protein and tissue degradation. Here, we hypothesize that bacteria are able to induce epigenetic modifications in oral epithelial cells mediated by histone modifications. In this study, we found that dysbiosis in vivo led to epigenetic modifications, including acetylation of histones and downregulation of DNA methyltransferase 1. In addition, in vitro exposure of oral epithelial cells to lipopolysaccharides resulted in histone modifications, activation of transcriptional coactivators, such as p300/CBP, and accumulation of nuclear factor-κB (NF-κB). Given that oral epithelial cells are the first line of defense for the periodontium against bacteria, we also evaluated whether activation of pathogen recognition receptors induced histone modifications. We found that activation of the Toll-like receptors 1, 2, and 4 and the nucleotide-binding oligomerization domain protein 1 induced histone acetylation in oral epithelial cells. Our findings corroborate the emerging concept that epigenetic modifications play a role in the development of periodontitis. [ABSTRACT FROM AUTHOR]

This PRISMA-compliant systematic review aimed to investigate the effect of supportive peri- implant care (SPIC) on peri-implant tissue health and disease recurrence following the non surgical and surgical treatment of peri-implant diseases. The protocol of this review was registered in PROSPERO (CRD42023468656). A literature search was conducted to identify investigations that fulfilled a set of pre-defined eligibility criteria based on the PICO question: what is the effect of SPIC upon peri-implant tissue stability following non-surgical and surgical interventions for the treatment of peri-implant diseases in adult human subjects? Data on SPIC (protocol, frequency, and compliance), clinical and radiographic outcomes, and other variables of interest were extracted and subsequently categorized and analyzed. A total of 8 studies, with 288 patients and 512 implants previously diagnosed with peri-implantitis were included. No studies including peri-implant mucositis fit the eligibility criteria. Clinical and radiographic outcomes were similar independently of specific SPIC features. Nevertheless, a 3-month recall interval was generally associated with a slightly lower percentage of disease recurrence. The absence of disease recurrence at the final follow-up period (mean of 58.7±25.7 months) ranged between 23.3% and 90.3%. However, when the most favorable definition of disease recurrence reported in the selected studies was used, mean disease recurrence was 28.5% at baseline, considered 1 year after treatment for this investigation, and increased to 47.2% after 2 years of follow-up. In conclusion, regardless of the SPIC interval and protocol, disease recurrence tends to increase over time after the treatment of peri-implantitis, occasionally requiring additional interventions.

Dental implant surfaces and their unique properties can interact with the surrounding oral tissues through epigenetic cues. The present scoping review provides current perspectives on surface modifications of dental implants, their impact on the osseointegration process, and the interaction between implant surface properties and epigenetics, also in peri-implant diseases. Findings of this review demonstrate the impact of innovative surface treatments on the epigenetic mechanisms of cells, showing promising results in the early stages of osseointegration. Dental implant surfaces with properties of hydrophilicity, nanotexturization, multifunctional coatings, and incorporated drug-release systems have demonstrated favorable outcomes for early bone adhesion, increased antibacterial features, and improved osseointegration. The interaction between modified surface morphologies, different chemical surface energies, and/or release of molecules within the oral tissues has been shown to influence epigenetic mechanisms of the surrounding tissues caused by a physical-chemical interaction. Epigenetic changes around dental implants in the state of health and disease are different. In conclusion, emerging approaches in surface modifications for dental implants functionalized with epigenetics have great potential with a significant impact on modulating bone healing during osseointegration., (© 2024 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd.)

Purpose: To analyze the influence of abutment height (AH) on marginal bone loss (MBL)., Materials and Methods: A literature search was performed for human studies (RCTs, prospective and retrospective cohorts) reporting on AH and MBL. The data obtained-including clinical outcomes, treatment covariates, and patient characteristics-were analyzed. Meta-regression was performed on the effect size of the differences between the shorter and larger AHs on the MBL of each study. The estimation was done using the restricted maximum likelihood method., Results: The initial screening and full-text analysis resulted in 7,936 and 46 articles, respectively. Finally, 14 articles were included in the systematic review, reporting a total of 1,606 implants. An overall high-to-moderate risk of bias was determined among the included investigations. Meta-regression analysis revealed that AH had a significant effect on MBL (b = -1.630, P < .003), demonstrating that longer abutments were correlated with less MBL. No effects were observed for the study type (P = .607), the number of stages (P = .510), or the elapsed time (P = .491)., Conclusions: The height of the abutment has a significant impact on MBL. As such, increased AH is related to less MBL. Nevertheless, the role of confounding variables remains to be studied and determined.

Introduction: The present investigation compared the stability and volumetric changes of two different grafting material used for lateral window sinus floor augmentation (LWSFA)., Methods: Sixteen patients with a total 20 maxillary sinuses in need of LWSFA were included in the present study. The sinuses were grafted with either 100% anorganic bovine bone mineral (ABBM) alone (Group 1) or a mixture (0.8:1 ratio) of ABBM and mineralized cortical allograft (MCA) (Group 2). Cone beam computer tomography (CBCT) was obtained pre-operatively, and at 2-weeks, and 6-months after LWSFA to perform linear measurements including lateral window dimensions, sinus anatomy, residual bone height/thickness (RBH/RBT), and Schneiderian membrane thickness (SMT), among others. Three-dimensional segmentation analysis was used to evaluate changes of bone graft volume/height (GV/GH)., Results: A total of 10 sinuses per group were included in the analysis. No statistically significant difference was found in between groups regarding mean reduction of GV (Group 1: 14.87% ± 16.60%, Group 2: 18.06% ± 9.81%, p = 0.33). Among the linear measurements, only SMT revealed a significant increase after 2-weeks more pronounce in Group 1 (8.70 mm) when compared with Group 2 (5.70 mm) with plausible effect upon LWSFA outcomes. Sinus width showed weak positive correlation with GH reduction after 6 months., Conclusion: This study demonstrated that both ABBM alone and ABBM + MCA represent suitable alternatives for LWSFA with adequate graft stability as they revealed similar volumetric and linear dimensional changes 6 months postoperatively., (© 2023 Wiley Periodicals LLC.)

The primary aim of this study was to evaluate the efficacy of alveolar ridge preservation (ARP) ther- apy compared with unassisted socket healing (USH) in attenuating interproximal soft tissue atrophy. Adult patients who underwent maxillary single-tooth extraction with or without ARP therapy were included. Surface scans were obtained and CBCT was performed to digitally assess interproximal soft tissue height changes and measure facial bone thickness (FBT), respectively. Logistic regres- sion models were conducted to investigate the individual effect of demographic and clinical vari- ables. Ninety-six subjects (USH &#61; 49; ARP &#61; 47) constituted the study population. Linear soft tissue assessments revealed a significant reduction of the interproximal soft tissue over time within and between groups (P < .0001). ARP therapy significantly attenuated interproximal soft tissue height re- duction compared to USH: -2.0 ± 0.9 mm mesially for USH vs -1.0 ± 0.5 mm mesially for ARP; -1.9 ± 0.7 mm distally for USH vs -1.1 ± 0.5 mm distally for ARP (P < .0001). Thin (≤ 1 mm) facial bone thick- ness (FBT) upon extraction was associated with greater interproximal soft tissue atrophy compared to thick FBT (> 1 mm), independent of the treatment received (P < .0001). Nevertheless, ARP therapy resulted in better preservation of interproximal soft tissue height, especially in thin bone phenotype, by a factor of 2 for the mesial site (&#43;1.3 mm) and by a factor of 1.6 for the distal site (&#43;0.9 mm). This study demonstrated that ARP therapy largely attenuates interproximal soft tissue dimensional re- duction after maxillary single-tooth extraction compared to USH.

The aim of this morphometric study was to precisely determine the 3D characteristics of the root complex of the posterior dentition. Extracted and well-preserved permanent posterior teeth were included in this analysis and grouped based on tooth type and arch location. All teeth were digitally scanned. Morphologic and dimensional features of the root complex were assessed, including length and surface area of the root trunk and individual roots, width of root concavities (RC), and furcation entrance, when present. A total of 240 posterior teeth comprised the study sample. The root complex of multirooted maxillary first premolars presented with a long root trunk (10.49 mm), representing 65.52% of the surface area, and two short roots comprising the remaining 34.8% of the surface area. Root trunks of mandibular molars were an average of 0.8 mm shorter than their maxillary counterparts. Class III furcation involvement is expected in all maxillary and mandibular molars, as well as multirooted maxillary first premolars, after 4.80 mm and 10.49 mm of clinical attachment loss, respectively. RCs were a common finding among the evaluated dentitions. The root complex morphology varies among the maxillary and mandibular posterior dentition. RCs are highly prevalent in both maxillary and mandibular dentition. The findings derived from this study can be utilized in daily clinical practice for the adequate management of posterior dentition and serve as a reference for future investigations in dental anatomy and digital technology. Also, these findings can guide the industry into creating and redefining tools that adequately adapt to the anatomical characteristics and variations of the specific tooth type.

The aim of this PRISMA-compliant systematic review was to analyze the evidence pertaining to disease resolution after treatment of peri-implant diseases (PROSPERO: CRD42022306999) with the following PICO question: what is the rate of disease resolution following non-surgical and surgical therapy for peri-implant diseases in adult human subjects? A literature search to identify studies that fulfilled a pre-established eligibility criteria was conducted. Data on primary therapeutic outcomes, including treatment success, rate of disease resolution and/or recurrence, as well as a variety of secondary outcomes was extracted and categorized. Fifty-five articles were included. Few studies investigated the efficacy of different non-surgical and surgical therapies to treat peri-implant diseases using a set of pre-defined criteria and with follow-up periods of at least one year. The definition of treatment success and outcomes of disease resolution differed considerably among the included studies. Treatment of peri-implant mucositis was most commonly reported to be successful in arresting disease progression for ≤60% of the cases, whereas most studies on peri-implantitis treatment reported disease resolution occurring in <50% of the fixtures. In conclusion, disease resolution is generally unpredictable and infrequently achieved after the treatment of peri-implant diseases. A great variety of definitions have been used to define treatment success. Notably, percentages of treatment success and disease resolution were generally underreported. The use of standardized parameters to evaluate disease resolution should be considered an integral component in future clinical studies.

Introduction: Deep margin elevation (DME) is an emerging technique attempting to minimize the need for surgical procedures (i.e., crown lengthening [CL]), deliver indirect restorations in one clinical session and reduce overall treatment time. The present study evaluated the impact of DME upon periodontal measurements based exclusively on human studies., Methods: A literature search was performed by two independent reviewers in several databases including PubMed, EMBASE, and Cochrane Central up to March 2022. This review searched for randomized human trials, cohort (prospective/ retrospective) and/or case series studies using DME, reporting periodontal (i.e. marginal bone levels [MBL], probing depths [PD], bleeding on probing [BoP], recession [REC], clinical attachment level [CAL]), and the type of approach (non-surgical or surgical) with at least ⟩3 months of post-operative outcomes., Results: None of the included studies reported MBL, REC or CAL, and thus, results were limited to PD and BoP. BoP was increased when the distance between restorative margin and alveolar bone was approximately ⟨2mm. Non-surgical and surgical DME approaches led to different outcomes in PD (0.26±0.77mm vs -0.39±0.85mm) and BoP (31.50% vs -22.33%)., Conclusions: Limited findings of the present systematic review can be drawn and thus, the impact of DME upon the periodontium remains inconclusive., (Copyright© 2023 Dennis Barber Ltd.)

Aim: To evaluate the healing outcomes in non-molar post-extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM-C) as a function of time., Materials and Methods: Patients in need of non-molar tooth extraction were randomly allocated into one of three groups according to the total healing time (A-3 months; B-6 months; C-9 months). The effect of alveolar ridge preservation (ARP) therapy via socket filling using DBBM-C and socket sealing with a porcine collagen matrix (CM) was assessed based on a panel of clinical, digital, histomorphometric, implant-related, and patient-reported outcomes., Results: A total of 42 patients completed the study (n = 14 in each group). Histomorphometric analysis of bone core biopsies obtained at the time of implant placement showed a continuous increase in the proportion of mineralized tissue with respect to non-mineralized tissue, and a decrease in the proportion of remaining xenograft material over time. All volumetric bone and soft tissue contour assessments revealed a dimensional reduction of the alveolar ridge overtime affecting mainly the facial aspect. Linear regression analyses indicated that baseline buccal bone thickness is a strong predictor of bone and soft tissue modelling. Ancillary bone augmentation at the time of implant placement was needed in 16.7% of the sites (A:2; B:1; C:4). Patient-reported discomfort and wound healing index scores progressively decreased over time and was similar across groups., Conclusions: Healing time influences the proportion of tissue compartments in non-molar post-extraction sites filled with DBBM-C and sealed with a CM. A variable degree of alveolar ridge atrophy, affecting mainly the facial aspect, occurs even after performing ARP therapy. These changes are more pronounced in sites exhibiting thin facial bone (≤1 mm) at baseline (Clinicaltrials.gov NCT03659617)., (© 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

Objective: This review aims to present the current understanding of endotoxin tolerance (ET) in chronic inflammatory diseases and explores the potential connection with periodontitis., Summary: Subsequent exposure to lipopolysaccharides (LPS) triggers ET, a phenomenon regulated by different mechanisms and pathways, including toll-like receptors (TLRs), nuclear factor kappa-light-chain enhancer of activated B-cells (NFκB), apoptosis of immune cells, epigenetics, and microRNAs (miRNAs). These mechanisms interconnect ET with chronic inflammatory diseases including periodontitis. While the direct correlation between ET and periodontal destruction has not been fully elucidated, emerging reports point towards the potential tolerization of human periodontal ligament cells (hPDLCs) and gingival tissues with a significant reduction of TLR levels., Conclusions: There is a potential link between ET and periodontal diseases. Future studies should explore the crucial role of ET in the pathogenesis of periodontal diseases, as evidence of a tolerized oral mucosa may represent an intrinsic mechanism capable of regulating the oral immune response. A clear understanding of this host immune regulatory mechanism might lead to effective and more predictable therapeutic strategies to treat chronic inflammatory diseases and periodontitis., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: To evaluate the impact of implant surface characteristics on the initiation, progression and treatment outcomes of peri-implantitis based exclusively on in vivo investigations., Materials and Methods: A literature search was conducted by two independent reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify animal studies comparing at least two different implant surfaces affected by experimental peri-implantitis, with distinct characteristics and with or without subsequent surgical treatment that aims to arrest disease progression. The parameters evaluated included both radiographic (e.g., marginal bone level) and clinical (e.g., probing depth, bleeding on probing) aspects to determine changes in disease progression and treatment outcomes., Results: No statistically significant differences were found among the different implant surfaces during the initiation of peri-implantitis. On the other hand, the progression and treatment outcomes of peri-implantitis displayed statistically significant differences among the different implant systems, with turned surfaces reporting less bone loss during the progression period and greater bone gain after treatment., Conclusions: Implant surface characteristics play a critical role in the progression and treatment outcomes of peri-implantitis. Turned implant surfaces demonstrated the least amount of bone loss after ligature removal and recorded the most favourable treatment outcomes.

Background: The aim of this 1-year prospective clinical trial was to compare clinical parameters and marginal bone levels (MBLs) around tissue level implants with a partially smooth collar between patients with thin (≤2 mm) and thick (>2 mm) vertical mucosal phenotypes., Methods: Thirty patients needing a single dental implant were recruited and allocated to thin (n = 14) or thick (n = 16) phenotype groups. Post-restoration, clinical (probing depth, recession, width of keratinized mucosa, bleeding on probing, suppuration, implant mobility, plaque index, and gingival index) and radiographic bone level measurements were recorded at different timepoints for 1 year., Results: Twenty-six patients (13 per group) completed the 1-year examination. No implants were lost (100% survival rate). There were no significant differences (P >0.05) between thin and thick vertical mucosal phenotypes for any clinical parameter or for the radiographic MBL., Conclusions: Tissue level implants at 1 year of function placed in thin vertical mucosa achieved similar clinical parameters and radiographic MBLs as those in thick tissue. The formation of the peri-implant supracrestal tissue height plays a key role in MBL than mucosal thickness in tissue level implant., (© 2020 American Academy of Periodontology.)

Objectives: The mechanisms involved in the initiation and progression of peri-implantitis lesions are poorly understood. It was the aim to determine the content and activation status of macrophages present in human peri-implantitis lesions and compare the current findings with the macrophage polarization associated with periodontitis lesions., Material and Methods: A total of 14 patients were studied in this investigation. Seven were soft tissue biopsies from dental implants affected by peri-implantitis that required explantation. Seven biopsies were from chronic periodontal disease. Immunofluorescence stains were performed using biomarkers to identify macrophages (CD68 + ) undergoing M1 polarization (iNOS + ) and M2 polarization (CD206 + ), along with Hoechst 33,342 to identify DNA content. All samples were stained and photographed, and double-positive cells for CD68 and iNOS or CD68 and CD206 were quantified., Results: All peri-implantitis biopsies examined revealed a mixed population of macrophages undergoing M1 polarization and M2 polarization. Further analysis demonstrated the co-expression of iNOS and CD206, which indicates the presence of a heterogenic immune response on peri-implantitis lesions. Macrophage polarization in peri-implantitis lesions presents a distinct pattern than in periodontitis. We observed a significant increase in the population of M1 macrophages on peri-implantitis samples compared to periodontal disease samples., Conclusion: Our results demonstrate that peri-implantitis has higher numbers of macrophages displaying a distinct macrophage M1 polarization signature compared to periodontitis lesions. This pattern may explain, in part, the distinct nature of peri-implantitis progression vs. periodontitis in humans., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Tooth mobility assessment is subjective and current techniques require the translation of a continuous variable to a categorical variable based on the perception of the examiner. The aim of this study was to evaluate the reliability of a novel technique to assess tooth mobility., Methods: Three experienced periodontists were asked to push tooth #16 into a buccal position to in a typodont model with different mobility (M1-M2). Tooth position was obtained using an intraoral scanner and files were compared in metrology software. Mobility was calculated at three reference points at the cervical (C), middle (M), and occlusal (O) regions of the buccal surface of the tooth to determine the linear deviation in the three axes (x, y, and z). Reliability was determined by intraclass-correlation coefficient, differences between M1 and M2 determined by t test, and the analysis of variance (ANOVA) was used to compare the data at the C-M-O regions., Results: Excellent reliability was assessed by Cronbach alpha >0.9 on the x-y-z axes for both mobility tested, except for M1-C X (0.85), M1-M Y (0.89), and M2-M Z (0.89). The correlation between the examiners demonstrated excellent (˃0.90) or good (0.75˃ x ˂0.90) consistency, except for M1-C Y (0.73; examiner 1 to 2) and M1-M X (0.69; examiners 1 to 3). Significant changes were detected in all axes at the three reference points comparing M1 and M2, and a similar proportional change was observed between O-M-C reference points for M1 and M2., Conclusion: A novel technique to assess tooth mobility based on intraoral scanner measurements provided reliable data in an in vitro experiment., (© 2019 American Academy of Periodontology.)

Purpose: To evaluate topographic changes and effectiveness of mechanical instrumentation upon machined (MA) and roughened (RG) surfaces of dental implants., Materials and Methods: The coronal one-third of seven RG and seven MA implants was coated with a mixture of cyanoacrylate and toluidine blue dye to resemble calculus. Implants were cleaned with three curettes (SS: stainless steel, PT: plastic, TI: titanium), two ultrasonic tips (UM: metal tip, UP: plastic tip), a titanium brush (TB), and an air-polishing device (AA) until visibly clean. Additionally, a simulation of 1- and 5-year supportive peri-implant therapy (SPT) was performed on 14 implants using the aforementioned instruments with 20 strokes/40 s (T 1 ) or 100 strokes/200 s (T 5 ). Each implant was evaluated using stereomicroscopy, atomic force microscopy, and scanning electron microscopy., Results: UM was the most effective instrument, with 0% average percentage of residual artificial calculus (RAC), followed by TB (2.89%) and UP (4.90%). SS was more effective than TI (15.43% vs 20.12% RAC, respectively), while PT failed to remove any deposit (100% RAC). AA completely removed deposits on RG surfaces but not MA surfaces (26.61% RAC). Noticeable topographic changes were observed between both implant surfaces. RG surfaces became less rough, whereas MA surfaces became rougher at both T 1 and T 5 with the exception of AA. Plastic- and titanium-like remnants were noted after debridement with PT, SS, and TI, respectively., Conclusion: Artificial calculus removal by mechanical instrumentation, with the exception of PT, was proven to be clinically effective. All instruments induced minor to major topographic changes upon dental implant surfaces. AA did not remarkably change MA and RG surfaces at both micrometer and nanometer levels. Findings from this study may impact the selection of instruments or devices used during SPT protocols.

Aim: To explore the M1/M2 status of macrophage polarization from healthy, gingivitis, and periodontitis patient samples., Materials and Methods: Gingival biopsies were collected from 42 individuals (14 gingivitis, 18 periodontitis, and 10 healthy samples) receiving periodontal therapy. Histomorphology analysis was performed with haematoxylin and eosin staining. Immunofluorescence was performed using a combination of CD68 (macrophages), iNOS (M1), and CD206 (M2) in order to acquire changes in macrophage polarization at a single-cell resolution. Macrophages were quantified under microscopy using narrow wavelength filters to detect Alexa 488, Alexa 568, Alexa 633 fluorophores, and Hoechst 33342 to identify cellular DNA content., Results: Gingivitis and periodontitis samples showed higher levels of macrophages compared with healthy samples. Unexpectedly, periodontitis samples displayed lower levels of macrophages dispersed in the stromal tissues compared with gingivitis samples; however, it remained higher than healthy tissues. The polarization of macrophages appears to be reduced in periodontitis and showed similar levels to those observed in healthy tissues., Conclusions: Our study found that gingivitis and periodontitis differ from each other by the levels of macrophage infiltrate, but not by changes in macrophage polarization., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Nonsurgical and surgical management of periimplant mucositis and periimplantitis have shown promising results in arresting periimplant marginal bone loss (MBL) and preventing implant loss. However, management of periimplant diseases still remains unpredictable for full reconstruction of lost tissues and completely arrests disease progression. The present study proposes a decision tree that compiles both clinical and radiographic presentation of failing implants to aid in the decision making for their management., Materials and Methods: An extensive literature review was performed using 3 electronic databases (PubMed, Ovid MEDLINE, and Cochrane Central) on the most recent treatment modalities for the management of periimplant diseases., Discussion: Evidence-based treatment suggestions were primarily derived from periimplant defect morphology, presence, and severity of periimplant MBL. More evidence is required supporting soft-tissue augmentation for the treatment of periimplant diseases., Conclusion: Management of periimplant diseases can include lasers, mechanical instrumentation, chemical detoxification, and antimicrobial agents for nonsurgical approaches. On the other hand, removal of failing implants, resective surgery, guided bone regeneration, and soft-tissue grafting are presented as valid options for the surgical treatment of periimplantitis.

The aim of the present study was to perform a software-assisted radiographic assessment of the effect of platform-switching on marginal bone loss (MBL) around dental implants. Forty patients requiring a dental implant in non-grafted partially edentulous mandibles were enrolled and categorized into implants receiving a platform-matched abutment (control group) or implants with a platform-switched abutment (test group). Standardized digital periapical radiographs were taken at the time of implant placement (T0), at implant loading (T1) and 1-year after functional loading (T2). Software-assisted radiographic assessment of the MBL horizontal, vertical and area changes was performed and compared between time intervals (T1-T0, T2-T1 and T2-T0). Mean radiographic horizontal MBL (hMBL) and vertical MBL (vMBL) from implant placement to 1-year after implant loading (T2-T0) were significantly increased around platform-matched when compared to platform-switched abutments (1.04 mm vs 0.84 mm, p<0.05) and (0.99 mm vs 0.82 mm, p<0.05), respectively. Additionally, bone loss area (BLa) was greater (0.77 mm2 vs 0.63 mm2; p<0.05) for platform-matched compared to platform-switched abutments. Platform-switching has a positive impact upon the amount of bone modeling after loading implants with internal hexagon connection.

Objectives: The aim of the present investigation was to determine the profile of peri-implant crevicular fluid (PICF) biomarkers combined with microbial profiles from implants with healthy peri-implant tissues and peri-implantitis to assess real-time disease activity., Material and Methods: Sixty-eight patients were included in this cross-sectional study. They were divided into two groups: 34 patients with at least one healthy implant (control) and 34 with at least one peri-implantitis affected implant (test). Total DNA content and qPCR analysis for periodontal bacteria obtained from subgingival plaque samples (Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) and a PICF analysis for IL-1β, VEGF, MMP-8, TIMP-2, and OPG were performed. The individual and combined diagnostic ability of each biomarker for peri-implantitis and target bacterial species were analyzed., Results: The mean concentration of IL-1β (44.6 vs. 135.8 pg/ml; P < 0.001), TIMP-2 (5488.3 vs. 9771.8 pg/ml; P = 0.001), VEGF (59.1 vs. 129.0 pg/ml; P = 0.012), and OPG (66.5 vs. 111.7 pg/ml; P = 0.050) was increased in the peri-implantitis patients. The mean expression of MMP-8 (6029.2 vs. 5943.1 pg/ml; P = 0.454) and did not reveal a meaningful difference among groups. Total bacterial DNA of selected microorganisms was associated with a threefold or greater increase in peri-implantitis although no statistical significant difference. The ability to diagnose diseased sites was enhanced by T. denticola combined with IL-1β, VEGF, and TIMP-2 PICF levels., Conclusion: The present data suggest that the increased levels of the selected PICF-derived biomarkers of periodontal tissue inflammation, matrix degradation/regulation, and alveolar bone turnover/resorption combined with site-specific microbial profiles may be associated with peri-implantitis and could have potential as predictors of peri-implant diseases., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: Given that the nature and presence of voids present within grafted sinuses following maxillary sinus elevation procedures were not known, nor was the contribution of these factors to implant success, the purpose of this study was to investigate these parameters and their relationship to implant success., Materials and Methods: This study evaluated data from 25 subjects who had a lateral window maxillary sinus augmentation procedure. Cone-beam computed tomography (CBCT) was performed at baseline and 4 months after surgery. CBCT images were used to evaluate grafted sites prior to implant placement. Using CBCT images, three examiners independently measured bone-grafted areas (BG), void areas (V), and percentage of void areas (V%) from six different sections within grafted sites. The six sections were defined as a cross-sectional (CS) midpoint, CS mesial point, CS distal point, horizontal section (HS) low point, HS midpoint, and HS high point. Implant success was also determined., Results: The calculated V% (V/BG) for the CS midpoint, CS mesial point, CS distal point, HS low point, HS midpoint, and HS high point were 5.30 ± 6.67%, 5.79 ± 8.51%, 6.67 ± 7.12%, 2.07 ± 2.56%, 5.30 ± 6.62%, and 4.92 ± 5.17% respectively. Implant success after 6 months of follow-up approximated 100%., Conclusions: Although voids within grafts varied in terms of distribution and size, the V% within the HS low point were significantly smaller compared to those within the CS midpoint and CS distal point, which had the most intra-subject V%. Thus, more attention should be given to the distal aspect of the sinus when compacting graft materials in the lateral wall sinus augmentation procedure. Implant success was not influenced by the existence of voids as implant success remained high., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: The aim of this cone beam computed tomography (CBCT) study was to investigate the incidence of fenestration and associated risk factors with virtual placement of an implant in the maxillary incisor region., Materials and Methods: Edentulous ridges missing a maxillary central or lateral incisor and amenable for single implant placement were included. Root-form implants (4×12 mm and 3.5×12 mm for the central and lateral incisors, respectively) were placed virtually in the edentulous space following the axis of the ipsilateral crown. Buccolingually, the implants were placed in the ideal prosthetic cingulum position. The angles of the ridge (RA) and implants (IA) in relation to the hard palate and the incidence of fenestration were recorded., Results: A total of 48 CBCT scans were analyzed. The mean RA and IA were 124.32 degrees and 110.91 degrees, respectively. Nine cases resulted in fenestration, equivalent to 18.75% of the total cases. The discrepancy between the RA and IA was statistically significantly larger in the fenestration sites (19.93 degrees) than in the nonfenestration sites (13.05 degrees). The concavity depth of the alveolar ridge was statistically significantly higher in the fenestration sites (4.79 mm) than in the nonfenestration sites (3.40 mm)., Conclusion: Within the limitations of this study, it can be concluded that the occurrence of fenestration is common (approximately 20%) if an implant is placed in the cingulum position with the axis following that of its restoration.