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Objectives: The aim of this study was to evaluate the systemic effect of non‐surgical peri‐implantitis treatment (NSPIT) with or without the administration of systemic metronidazole. Methods: In this secondary analysis from a previously published clinical trial (NCT03564301), peri‐implantitis patients were randomized into two groups: test, receiving NSPIT plus 500 mg of oral systemic metronidazole three times a day for 7 days (n = 10); and control group, receiving NSPIT plus placebo (n = 11). Serum samples were obtained at baseline, 3 and 6 months after therapy to determine levels of inflammatory biomarkers, lipid fractions and complete blood counts. Results: Both treatment modalities produced improvements in clinical and radiographic parameters. After 6 months from NSPIT, a substantial reduction in C‐reactive protein (6.9 mg/dL; 95% CI: 3.7 to 9.9, p <.001) and low‐density lipoprotein cholesterol (21.8 mg/dL; 95% CI: −6.9 to 50.5, p =.013) as well as a modest increase in neutrophils counts (0.4 × 103/μL; 95% CI: −0.4 to 1.1, p =.010) was observed in the control group while the test group showed a significant reduction of TNF‐α (110.1; 95% CI: 38.9 to 181.4, p =.004). Conclusions: NSPIT showed a short‐term beneficial systemic effect regardless of adjunctive use of systemic metronidazole. [ABSTRACT FROM AUTHOR]

The prevalence of infraocclusion and/or loss of interproximal contact areas with implant-supported restorations is high, and replacement of these prostheses has been advocated for the treatment of mild or moderate infraocclusion; however, replacement is complicated if the manufacturer of the implant is unknown. A technique is presented for correcting the infraocclusion of posterior prostheses that are directly connected to the implant. Advantages include possibly preventing marginal bone loss secondary to the removal and reconnection of the prosthetic attachments and reducing the number of appointments. [ABSTRACT FROM AUTHOR]

Purpose: To show the clinical and radiographic results of intrabony peri-implantitis lesions treated nonsurgically with adjunctive systemic metronidazole with a mean follow-up of 50 months. Materials and Methods: Subjects diagnosed with peri-implantitis (probing depth ≥ 5 mm with concomitant bleeding on probing and/or suppuration) with radiographic evidence of intrabony defects > 2 mm were included in this study. Implants affected received one session of nonsurgical mechanical debridement with ultrasonic and steel curettes. Systemic metronidazole was immediately prescribed for 7 days. Clinical and radiographic variables were registered at baseline and at the end of follow-up. Results: Eighteen patients and 25 implants were included in this investigation. At baseline, the mean radiographic bone level and intrabony component were 4.52 ± 2.14 mm and 3.93 ± 1.51 mm, respectively. After a mean follow-up of 54 (range: 12 to 108) months, the mean radiographic bone level reduction was 2.6 ± 0.21 mm, and the intrabony component reduction was 2.85 ± 0.37 mm (P < .05). A mean probing depth reduction of 4.66 ± 1.33 mm was observed (P < .05). Conclusion: Within the limits of this study, nonsurgical treatment of peri-implantitis with the adjunctive administration of systemic metronidazole has shown potential effectiveness in terms of probing depth and radiographic defect reduction after a mean follow-up of 54 months. [ABSTRACT FROM AUTHOR]

Introduction: Vestibuloplasty is a mucogingival procedure that aims to increase the vestibule and the amount of keratinized tissue (KT) around teeth and dental implants. Currently, the gold standard in this procedure is still represented by free gingival grafts (FGGs); however, they require a second surgical site, which means more morbidity for the patient and a higher risk of surgical complications, as well as surgical time and chromatic alteration of the recipient area. Case Presentation: This is a description of the vestibuloplasty technique with platelet‐rich fibrin (PRF) in a 35‐year‐old female patient with a thin gingival phenotype and no medical history of interest. The reason for consultation was tooth sensitivity during brushing and the presence of recessions in the fifth sextant. Conclusions: The use of PRF as a graft biomaterial in vestibuloplasty is a valid and effective option as an alternative to secondary epithelialization of the surgical site, as well as to FGGs, with acceptable results in terms of KT gain and root coverage, and with minimal postoperative discomfort. Key points: Why is this case new information? The use of PRF is an interesting option as an alternative to second‐intention healing, as FGGs in vestibuloplasty. What are the keys to successful management of this case? The most important part of the membranes is the part that was in close relation to the erythrocyte fraction in the blood collection tube, so this part must be oriented toward the recipient bed.A minimum of four membranes should be obtained, overlapping one on top of the other. What are the primary limitations to success in this case? The stability of the PRF. [ABSTRACT FROM AUTHOR]

In this 3-year follow-up study, peri-implant bone loss at bone-level implants was evaluated with two definitive abutment heights: 1 mm and 2.5 mm. Peri-implant bone loss was defined as the distance between the implant shoulder and the first bone-to-implant contact from the time of loading to the 36-month follow-up, estimated using periapical radiographs. The bone loss was increased at the time of follow-up, to 1.30 mm (95% confidence interval [CI]: 0.70–1.89 mm; SD = 1.89) and 0.33 mm (95% CI: 0.11–0.55; SD = 0.59) at 36 months in short and long abutments, respectively. Placement of short abutments induced higher peri-implant bone loss at bone-level implants during a peri-implant recall program. [ABSTRACT FROM AUTHOR]

Aim: To study clinical, radiographic, and microbiological outcomes after non‐surgical therapy of peri‐implantitis with or without adjunctive systemic metronidazole. Materials and Methods: A randomized placebo‐controlled clinical trial was carried out in 32 subjects (62 implants) diagnosed with peri‐implantitis. Implants received a mechanical non‐surgical debridement session and systemic metronidazole or placebo. Clinical, radiographic, and microbiological outcomes were evaluated at baseline, 3, 6, and 12 months. Results: After 12 months, the test treatment resulted in significantly greater PPD reduction (2.53 vs. 1.02 mm) and CAL gain (2.14 vs. 0.53 mm) (p value <.05) in comparison with placebo. The test treatment also resulted in additional radiographic bone gain (2.33 vs. 1.13 mm) compared with placebo (p value <.05). There was a significantly greater decrease in Porphyromonas gingivalis, Tannerella forsythia, and Campylobacter rectus counts compared with the control group (p value <.05). At the end of follow‐up, 56.3% of patients met the success criteria in the test group and 25% in the control group. Conclusions: The use of systemic metronidazole as an adjunct to non‐surgical treatment of peri‐implantitis resulted in significant additional improvements in clinical, radiographic, and microbiological parameters after 12 months of follow‐up. This study is registered in ClinicalTrials.gov (NCT03564301). [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of different screening protocols for undiagnosed hyperglycaemia in a Research Network of Dental Clinics coordinated by the Spanish Society of Periodontology (SEPA). Material and Methods: A total of 1143 patients were included in the study. Participants filled a questionnaire considering diabetes risk factors (FINDRISC) and received a periodontal screening examination. Patients with a slightly elevated score according to the Findrisc (≥7), received a point‐of‐care HbA1c and were eventually referred to their physician for confirmatory diagnosis. Receiver Operating Characteristic (ROC) curves were used to assess the performance of various predictive models with confirmed hyperglycaemia as outcome. Results: From this population, 97 (8.5%) were finally diagnosed of diabetes (n = 28; 2.5%) or prediabetes (n = 69; 6.0%). When only including the results from the FINDRISC questionnaire, the model reported an area under the curve (AUC) of 0.866 (95% confidence interval ‐ CI [0.833; 0.900]). This model significantly improved when a basic periodontal examination (EPB Code; AUC = 0.876; 95% CI [0.845: 0.906]; p =.042) or a point‐of‐care HbA1c were added (AUC = 0.961; 95% CI [0.941; 0.980]; p <.001). Conclusions: The tested protocol, combining the FINDRISC questionnaire and a point‐of‐care HbA1c, showed to be feasible when carried out in a dental clinic setting and was efficient to identify subjects with undiagnosed diabetes or prediabetes. [ABSTRACT FROM AUTHOR]