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Tooth extractions can result in alveolar bone dimensional changes, necessitating additional bone grafting for implant placement. Alveolar ridge preservation (ARP) aims to counteract postextraction changes. This case series evaluates the bone regenerative properties of a freeze-dried bone allograft (FDBA) and the clinical outcomes of implants in grafted extraction sites. A total of 33 patients were enrolled, undergoing single/multiple tooth extractions followed by ARP. Biopsy samples were harvested during implant placement for histologic and histomorphometric analysis. Clinical outcomes included marginal bone loss and pink esthetic score (PES). Twenty-five patients completed the study. FDBA-augmented sockets exhibited new bone formation adjacent to graft particles. Implants (n = 25) showed 100% survival and success rates at 1 and 2 years. PES improved significantly over time (P < .001), while marginal bone loss did not significantly differ at 1 and 2 years (P = .096). Specimens showed trabecular bone, residual FDBA particles, and marrow spaces. High magnification revealed immature bone and woven bone bridges around graft particles. No inflammatory cells were observed. This case series provides valuable insights into ARP performed with FDBA (as implants were placed after 3 months of healing without any additional bone augmentation), the histologic outcomes were favorable, and implants were successful after a 2-year follow-up period. [ABSTRACT FROM AUTHOR]

A total of 57 interproximal restorations invading the supracrestal tissue attachment were evaluated in terms of crestal bone loss over a mean period of 15 years (10 to 23 years). The distance from the cavity margin to the bone was measured at T0 (after the restoration; baseline) and controlled using radiographs and a measurable landmark. The mean vertical bone loss was 0.46 mm, with a 96.49% survival rate. Smoking habits (P = .02) and tooth type (P = .03) significantly affected bone loss. The proposed technique could help the clinician in adopting a minimally invasive approach in the treatment of heavily compromised teeth. Future research with rigorous study designs would be interesting to guide the clinical decision-making. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of implant placement at different time intervals on the esthetic and clinical outcomes in the esthetic zone. Materials and Methods: A literature screening was conducted in PubMed (MEDLINE), ScienceDirect, and Cochrane databases. Relevant articles were included according to selection criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was collected from studies published from 2017 to 2022 in English. Results: Nine articles were included, in which a total of 495 implants were placed; 250 of the implants were immediate, 109 were early, and 136 were delayed. Immediate implant placement (IIP) showed no statistically significant difference in Pink Esthetic Score (PES) compared with delayed implant placement (DIP). IIP showed significantly higher PES in comparison with early implant placement (EIP) (mean difference [MD] = -0.76; 95% CI = -1.50 to -0.02; P = .04). The probing depth (PD) was considerably greater for immediate implants than for delayed implants (MD = -0.62; 95% CI = -1.05 to -0.18; P = .005), and the Plaque Index (PI) was statistically greater for early implants compared with immediate implants (MD = 0.15; 95% CI = 0.11 to 0.19; P < .00001). All other soft tissue outcomes showed equal results. The marginal bone loss (MBL) was statistically higher in early implants compared with immediate implants (MD = 0.09; 95% CI = 0.02 to 0.16; P = .02). Conclusions: IIP had significantly superior PES, MBL, and PI results when compared with EIP. The PD was significantly higher for immediate implants compared with delayed implants. All other outcomes showed no significant difference between the three implant groups. It is important to highlight the limitations of this review such as the small number of studies included and the few reports on esthetic indices. [ABSTRACT FROM AUTHOR]

Purpose: To explore the effect of adding an allogeneic soft tissue graft at the time of single implant placement using a fully digital workflow for implant placement and restoration without making either analog or digital impressions. Materials and Methods: A prospective randomized clinical study was performed enrolling 39 participants requiring single-tooth implants. The patients were randomized into one of two groups: (1) the graft group, which received an allogeneic dermal graft at the time of implant placement (n = 19), or (2) the nongraft group (n = 20). A fully digital surgical and restorative protocol was implemented for both groups. Intraoral scans were taken before implant placement (T0), at the time of final crown delivery (T1), and 1 year after placement (T2). Intraoral scans were aligned using Geomagic Control X 2020 software, and linear and volumetric changes in buccal tissues were measured at T0, T1, and T2. Implant survival, probing depths (PDs), and complications were recorded. Participants were asked to complete an Oral Health Impact Profile (OHIP)-14 survey at T0 and T2. Marginal bone levels were measured at T0 and T2 on periapical radiographs. Results: Overall, 39 participants completed surgery and restoration in the incisor, canine, premolar, and molar sites. Two early failures were recorded in central incisor positions (95% survival). Crown delivery without complication from the digital workflow (impressionless) was achieved for 36 out of 39 cases (92%), and implant depth control was the main challenge. At 1 year, 37 participants attended the follow-up appointment. Both groups showed gain in buccal tissue thickness without significant differences between the two groups for both linear and volumetric measurements (P > .05). Soft tissue grafting was associated with minimal added morbidity. The interproximal marginal bone changes were recorded as follows: -0.16 mm mesial and -0.12 mm distal for the graft group and -0.01 mm mesial and -0.11 mm distal for the nongraft group (P = .07 for mesial and .83 for distal). The OHIP score was significantly reduced at T2 compared to T0 (P = .003) for the entire cohort. Conclusions: Augmentation of the alveolar mucosa on the buccal aspect of single-tooth implants is associated with clinically favorable outcomes. A fully digital workflow has been validated to permit crown delivery on CAD/CAM abutments without implant impressions. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to evaluate the efficacy of alveolar ridge preservation (ARP) therapy 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 regression models were conducted to investigate the individual effect of demographic and clinical variables. Ninety -six subjects (USH = 49; ARP = 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 reduction 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 thickness (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 (+1.3 mm) and by a factor of 1.6 for the distal site (+0.9 mm). This study demonstrated that ARP therapy largely attenuates interproximal soft tissue dimensional reduction after maxillary single-tooth extraction compared to USH. [ABSTRACT FROM AUTHOR]

This study compared the survival, marginal bone loss (MBL), and prosthetic complications of 4.5-mm extra-short implants and longer implants splinted to the short implants via the restoration. A retrospective controlled cohort study was performed. The 4.5-mm extra-short group (study group; SG) included 48 consecutively placed implants. The control group (CG) included 48 implants splinted to the extra-short implants. The same surgical team treated the 39 included patients, and all implants were restored with a screw-retained fixed restoration and intermediate abutments. Immediate and conventionally loaded implants were included. All implants were in function during the follow-up period (14 ± 3.4 and 17 ± 13 months for SG and CG, respectively). No differences in technical complications were observed between the groups (one and two cases of screw loosening for SG and CG, respectively; two provisional prosthesis fractures for SG; P = .310). Marginal bone stability was similar for SG and CG at the mesial level (-0.01 ± 0.28 mm for SG vs -0.18 ± 0.72 mm for CG; P = .270) and at the distal level (0.02 ± 0.39 mm for SG vs -0.18 ± 0.68 mm for CG; P = .076). The same good clinical performance could be observed for 4.5-mm implants and longer implants under the same prosthesis. [ABSTRACT FROM AUTHOR]

Objective: Periodontal disease is caused by subgingival bacteria that adversely affect the host immune system and create and maintain unmitigated inflammation in gingival and periodontal tissues. The condition is also linked to systemic conditions including cardiovascular disease, diabetes, and arthritis. Periodontitis elevates the bacterial load and spreads systemic inflammation through infection and inflammation. The main radiographic sign of periodontitis is marginal bone loss. Risk factors, including medications, smoking, age, and sex, are known to influence periodontal health. However, there is little information about the impact of systemic conditions and medications on tooth wear. The aim of the present study was to assess the association between systemic conditions and medications and radiographic signs of tooth wear and marginal bone loss. Method and materials: This retrospective analysis was conducted on a group of 2,223 consecutive patients who came for dental treatment in the clinics of a large Health Maintenance Organization in Israel. Data available for the study included details of concomitant systemic diseases and medication and fullmouth radiographic surveys. Odds ratio and logistic regression analysis were used to detect associations between systemic conditions and medication, and marginal bone loss and tooth wear. Results: The results indicated an elevated odds ratio for tooth wear associated with age, sex, and smoking across all age groups. Among young patients, those using proton pump inhibitors and psychiatric medications had an elevated risk of tooth wear. Age, smoking, and diabetes conditions were associated with an increased odds ratio for marginal bone loss in all age groups. Psychiatric medications and sex elevated the odds ratio for marginal bone loss only among older patients. Conclusion: The results highlight the significant impact of age, sex, and smoking on tooth wear, and extend these risks to alveolar bone loss when combined with diabetes and psychiatric conditions. [ABSTRACT FROM AUTHOR]

Purpose: To assess the complications, satisfaction, and quality of life of patients rehabilitated with delayed and immediate loading of single crowns. Materials and Methods: An electronic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase databases up to February 2023. Only prospective studies and randomized and nonrandomized clinical trials comparing immediate and delayed loading were included. For the quantitative analysis, dichotomous and consistent variables were evaluated with a 95% confidence interval. Results: A total of 20 studies were evaluated. No statistically significant difference was observed between protocols: satisfaction (I²: 0%; P = .42), quality of life (I²: 0 %; P = .05), biologic complications (I²: 9%; P = .17), mechanical complications (I²: 58%; P = .84), and survival rate (I²: 0%; P = .38). The subgroup analysis showed significant differences only for marginal bone loss (MBL) when immediate implants were placed in the mandible (I²: 15%; P = .01) and posterior zone (I²: 0%; P = .001). Conclusions: Complications and patient-centered outcomes for immediate single-implant crowns were comparable to delayed loading. Scientific evidence showed no significant difference between loading protocols for survival rates. Note that several factors could interfere with the complication events, implant failures, and MBL. The subgroup analysis showed that only immediate implants placed in the posterior mandible had a higher and statistically significant mean MBL. [ABSTRACT FROM AUTHOR]

Purpose: To assess the healing process of the extraction socket and the dimensional changes that occur after alveolar ridge preservation utilizing a polylactide-co-glycolide scaffold (PLGA). Materials and Methods: The present study involved the extraction of 28 teeth from 14 patients. The total number of sockets was 28, which were divided into two groups consisting of 14 test sockets and 14 control sockets. The study group (SG) was subjected to socket preservation with a PLGA scaffold while the control group (CG) was left for spontaneous healing. The dimensions were measured before and after operation at 1, 3, and 5 mm below the alveolar crest horizontally and the height of buccolingual bone vertically. Results: According to the histologic analyses, the PLGA scaffold was resorbed within 4 months. CBCT imaging revealed a decrease in the horizontal crest dimension at three distinct coronoapical levels in SG, measuring 2.05 ± 1.05 mm at -1 mm, 1.51 ± 0.89 mm at -3 mm, and 0.92 ± 0.7 mm at -5 mm. CG showed readings of 1.22 ± 1 at -1 mm, 0.92 ± 0.67 at -3 mm, and 0.73 ± 0.69 at -5 mm. In comparison to CG, SG showed a significant reduction in horizontal losses at -1 mm. Vertical crest dimensions decreased by 1.64 ± 1.11 mm for the buccal bone height and by 1.56 ± 1.08 mm for lingual bone height in SG; in CG, the buccal and lingual bone height had mean values of 2.08 ± 1.44 mm and 1.73 ± 1.27 mm, respectively. There was no statistically significant difference observed in the vertical losses between the groups. Conclusions: Following a period of 4 months, the PLGA scaffold was completely resorbed. Based on CBCT measurements, horizontal resorption was lower than CG at -1 mm coronally. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether genetic variations in cytokine genes involved in the pathogenesis of peri-implantitis are associated with the occurrence of peri-implantitis, an issue that remains controversial and may vary according to the population evaluated. Materials and Methods: A cross-sectional analytical study was carried out on 102 Caucasian Portuguese individuals who were divided into two groups: (1) 43 individuals with peri-implantitis and (2) 59 individuals with good peri-implant health. Samples from the buccal mucosa were obtained, and genetic analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A and IL-1B and PCR for IL-1RN. Results: The IL-1A-889 C/T polymorphism presented with a higher prevalence of the less common allele (T allele) in patients with peri-implantitis (27.9%) than in healthy patients (16.9%), but without statistical significance (P = .060). For the IL-1B+3954 C/T and IL-1RN (variable number of tandem repeats [VNTR]) polymorphisms, analysis revealed that the allele and genotype frequencies did not differ significantly between groups. There was a significant association between a history of periodontitis and peri-implantitis (P = .020). Conclusions: The evaluated genetic polymorphisms had no influence on the occurrence of peri-implantitis in the study population. Further research into genetic variations in different populations is needed to elucidate the role of genetic factors in the onset and progression of peri-implant disease. [ABSTRACT FROM AUTHOR]

Diverse surgical approaches, such as resective, reconstructive, and combined therapy, have been proposed for peri-implantitis treatment. A resective surgical approach with an adjunctive modified implantoplasty refers to the modification of the implant body into a constricted area to mimic a "waist" silhouette. This modified technique forms an adequate concave smooth area that may favor the outcomes of resective surgical therapy for soft tissue adaptation, biofilm control, and possible peri-implant bone gain over the long term. The present case series aimed to exhibit the long-term clinical and radiographic outcomes of resective surgery with adjunctive implantoplasty over a 6- to 11-year follow-up. Four patients presenting four implants (one per patient) diagnosed with peri-implantitis (according to an established case definition) were included in the present case series. Patients underwent resective surgery, a modified implantoplasty approach, and implant surface decontamination. After surgical therapy, clinical and radiographic outcomes such as bleeding on probing (BoP), suppuration on probing (SoP), probing depth (PD), marginal recession (MR), modified plaque index (mPI), and marginal bone levels (MBLs) were recorded over a long-term follow-up period. Over the 6- to 11-year follow-up, mean BoP, PD, and SoP scores amounted to 17% ± 24%, 3.2 ± 0.66 mm, and 0%, respectively. Mean BoP, PD, and SoP scores were reduced by 67% ± 24%, 2.5 ± 1.26 mm, and 100%, respectively. Radiographic analysis revealed a mean radiographic bone gain of 3.1 ± 1.84 mm. Peri-implant marginal bone loss surface area decreased by 5.7 ± 3.77 mm2 over the long-term follow-up. Resective therapy with adjunctive implantoplasty promoted favorable clinical and radiographic outcomes at treated peri-implantitis sites over a long-term period. [ABSTRACT FROM AUTHOR]

Surface contaminants on customized implant abutments could trigger an inflammatory response in the peri-implant tissues. The aim of this randomized controlled study was to assess the radiographic bone changes around implants restored with customized, platform-switched abutments, with and without autoclave treatment, 12 months after definitive restoration. Dental implants were placed 1 mm subcrestally in 64 systemically healthy patients (mean age: 63.3 ± 10.0 years; 31 patients had a history of periodontitis) to replace single or multiple missing teeth. According to a randomization list, abutments were subjected to steam and autoclave sterilization (43 implants, test group) or steam cleaning alone (44 implants, control group). Periapical standardized radiographs were taken at implant placement, prosthetic abutment connection, and 12 months after definitive cement-retained restoration. All implants were clinically stable without any sign of infection at the 12-month follow-up. An average marginal bone loss of 0.25 ± 0.19 mm was found in the test group compared to 0.35 ± 0.23 mm in the control group (no statistically significant difference), while the percentage of bleeding sites was significantly higher in the control group (8.7% ± 13.1% vs 19.1% ± 19.8%; P = .035). Autoclave treatment of customized abutments seems to reduce the inflammatory response around subcrestally placed implants. [ABSTRACT FROM AUTHOR]

This case series investigated the effect of a combination therapy utilizing connective tissue graft (CTG) in the treatment of periodontal regeneration of mandibular Class III/IV furcation involvement (FI). Six patients diagnosed with periodontitis stage III or IV (grade A to C), presenting with Class III or IV FI, were treated with fibroblast growth factor-2 and carbonate apatite in combination with CTG. The following clinical parameters were evaluated at baseline and after 6, 12, and 18 months: periodontal probing depth, clinical attachment level, furcation invasion, radiographic vertical defect depth, and gingival phenotype. Significant improvements in clinical parameters were observed in all treated FI sites. Four Class III defects and one Class IV defect obtained complete closure, and one Class IV defect was improved to Class I. This case series showed the potential of administering combination regenerative therapy for changing the prognosis of hopeless teeth with severe furcation defects. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients. Method and materials: Following PRISMA guidelines, health science librarians completed literature searches from inception to 17 March 2023 in seven databases. There were 15,686 items exported to EndNote from Embase.com, CINAHL (EBSCO), Cochrane Library, Ovid MEDLINE-ALL, PubMed, Scopus, and Web of Science. Hand-searching added four more articles. After deduplication, 6,756 items were screened for eligibility. Twenty-nine studies were assessed by full text, of which ten studies, involving 424 subjects, were included in the review. Risk of bias assessment was conducted using the Cochrane risk-of-bias tool and the Newcastle-Ottawa scale. A meta-analysis was performed to synthesize and analyze the collective data from the selected studies. Results: The included studies used diverse methodologies, implant systems, and loading protocols. Most studies reported no significant difference in marginal bone loss between ball and locator attachments. The meta-analysis revealed high heterogeneity. Conclusion: The results of this systematic review suggest that ball and locator attachments exhibit similar performance in terms of marginal bone loss in implant-retained overdentures. However, the limited number, risk of bias, and heterogeneity of studies highlight the need for standardized research designs and larger sample sizes in future investigations to draw more definitive conclusions. [ABSTRACT FROM AUTHOR]

Purpose: To determine the relationship between bone loss that occurs during the peri-implantitis process and variations in implant stability using resonance frequency analysis (RFA) measurement methods. Materials and Methods: Forty selftapping implants were placed in cow ribs, and study scenarios were established according to the affected implant side and bone loss depth (n = 10 implants per group): Case 1 = bone loss on one side (vestibular); Case 2 = bone loss on two opposite sides (buccal and lingual); Case 3 = bone loss on two adjacent sides (buccal and mesial); and Case 4 = foursided bone loss (circumferential). For each group of 10 implants, first a bone loss of 0 mm was evaluated, then 4-mm defects (simulating 1/3 of bone loss) were created and evaluated, and finally 8-mm defects (simulating 2/3 of bone loss) were created and evaluated. Osteotomy measurements were made with a periodontal probe. For each implant, RFA was measured by the same operator using the Beacon system (Osstell). Results: The initial implant stability quotient (ISQ) values of the 40 implants exceeded 70, reflecting an average of 73 in the buccolingual (VL) and 74.8 in the mesiodistal (MD) directions. ISQ measurements in the 10 implants in which bone dehiscence was performed on the vestibular aspect reflected a decrease in ISQ values as bone loss increased. When generating bone loss in two opposite sides (buccal and lingual), a greater decrease in ISQ values was observed when 2/3 of the implant were affected. The average VL ISQ measurement was less than 70 when at sites with 2/3 of bone loss. Conclusions: When bone loss occurs on only one side of the implant, the ISQ values decrease, but the implant maintains good stability. The same occurs when two opposite sides of the implant are affected, as the unaffected side has the least decrease in ISQ value. [ABSTRACT FROM AUTHOR]

Purpose: This prospective study evaluated the marginal bone level and periodontal parameters 6 years after placement of a convergent transmucosal neck implant. Materials and Methods: In total, 71 implants were placed in 60 patients. Of these, 52 implants were placed with a flapless technique and with the convergent neck exposed by 1 mm (early and delayed placement), while 19 implants were placed immediately after extraction (immediate placement). At least 3 months after insertion, customized abutments were applied and provisional resin crowns were cemented, while being careful to prevent any tissue compression. After 3 weeks, definitive metal-ceramic crowns were designed with the finish line at the soft tissue level and free from any compression. The implant survival rate at 6 years, marginal bone level changes (ΔMBL, mm), and Pink Esthetic Score (PES) were evaluated. Gingival phenotype was determined before the implant surgeries (thin/thick). A three-level hierarchical model was examined with a random intercept and random slope on follow-up time at the patient level and a random intercept at the implant level. Results: In all, 57 patients with 67 implants reached the 6-year point; 3 patients (5.0%) dropped out. The implant survival rate was 100%. ΔMBL from baseline to 24 months was 0.58 mm (95% CI: 0.48, 0.68), while ΔMBL from 24 to 72 months was 0.33 mm (95% CI: 0.19, 0.47). PES improved steadily from 6 to 48 months (+0.96; 95% CI: 0.71, 1.20), with overall stability at 72 months. No correlation between MBL and PES was observed. A significant association was found between thick gingival phenotype and less MBL variation. Greater implant diameter offered more MBL stability after 3 years but resulted in lower PES values. Conclusions: The use of convergent transmucosal neck implants placed with a flapless transmucosal approach with the crown margin positioned at the gingival level preserved marginal bone and guided gingival morphology for up to 72 months. The gingival phenotype was the parameter that most affected the soft and hard tissues. In the long term, implant placement timing was not related to MBL. [ABSTRACT FROM AUTHOR]

Purpose: The structural and compositional similarities between dentin and alveolar bone form the basis for utilizing dentin for bone regeneration. Various authors have recommended using treated mineralized, partially demineralized, or demineralized dentin grafts instead of xenografts because of their comparable clinical and radiographic results and lower costs. The current study therefore compared the effect of untreated mineralized dentin grafts (UMDGs) versus xenografts in vertical and horizontal augmentation around dental implants that were immediately placed in the mandibular anterior region. Materials and Methods: A total of 56 patients who required immediate dental implant placement in the mandibular anterior region were randomly allocated to group I (study), where ground dentin was washed with normal saline and placed around the dental implants, or group II (control), where a xenograft was used. The primary implant stability was measured at the time of implant placement. Secondary implant stability, plaque index (PI), bleeding index (BI), probing depth (PD), and keratinized mucosa width (KMW) were assessed at baseline (time of definitive abutment and provisional crown placement) and then at 3, 6, and 12 months. Pain and the number of analgesics consumed were assessed daily during the first postoperative week. Marginal bone loss (MBL) and radiodensity were assessed radiographically. Results: There were no significant differences between the groups in terms of postoperative pain, the number of analgesic tablets consumed, peri-implant mucositis, or peri-implantitis. Both groups showed comparable results for the PI, BI, and PD. Moreover, there was no statistical difference between the groups with regard to primary implant stability and secondary implant stability at baseline and 12 months. Group I showed significantly lower secondary implant stability after loading at 3 and 6 months and significantly greater bone loss and lower bone density before exposure. KMW and MBL after exposure were significantly higher in group I at all time points. Conclusions: Although UMDGs showed similar clinical results to xenografts, including primary and secondary implant stability, they had higher resorption rates than xenografts. Therefore, treatment of the dentin graft is required. Thus, the authors do not recommend using UMDGs. [ABSTRACT FROM AUTHOR]

The management of marked horizontal bone atrophy represents a critical challenge for traditional implantology procedures. For this purpose, clinicians have developed several protocols and procedures to allow the most suitable and accurate surgical and prosthetic implant rehabilitation. Despite the development of guided bone regeneration methods and the use of small-diameter implants, the rehabilitation of thin bone areas is a clinical dilemma for the medium- and long-term survival of implant-prosthetic therapies. This clinical case evaluates the use of wedge-shaped implants for the full-arch rehabilitation of an atrophic maxilla with a thin ridge. This treatment choice allowed a minimally invasive rehabilitation, avoiding regenerative bone surgery, while respecting biologic and prosthetic limits. Furthermore, evaluation of the implant stability quotient and marginal bone loss values during the first year of follow-up allowed analysis of the behavior of this rehabilitation in fullarch maxillary cases. [ABSTRACT FROM AUTHOR]

This study assessed the effects of buccal contour augmentation for periodontally compromised teeth with horizontal bone loss. A total of 30 subjects were divided into Group A or Group B (n = 15 subjects per group). Group A received open-flap debridement (OFD) with buccal contour augmentation using deproteinized bovine bone mineral (DBBM), jointly referred to as contour augmentation for periodontal defects (CAPD; test group). Group B received only OFD (control group). Bleeding on probing (BOP), clinical attachment level (CAL), probing depth (PD), gingival recession (GR), keratinized mucosa width (WKM), keratinized mucosa thickness (TKM), and labial cortical plate thickness were compared at baseline and 1 year. BOP, CAL, PD, and GR did not show significant differences. TKM increased by 1.76 mm for Group A but decreased by 1 mm for Group B. WKM increased from 2.86 ± 0.4 mm to 3.6 ± 0.71 mm (P < .001) and from 2.93 ± 0.32 mm to 3 ± 0.7 mm (P = 0.5) for Groups A and B, respectively, which showed statistical significance. Labial cortical plate thickness increased from 0.94 ± 0.3 mm to 1.95 ± 0.54 mm (P < .001) for Group A but decreased from 0.87 ± 0.45 mm to 0.68 ± 0.31 mm for Group B. Visual analog scale scores for pain perception showed no difference between the two groups. CAPD for periodontally compromised teeth improves WKM and TKM. Long-term analyses are needed to determine its benefits in daily clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis. Method and materials: Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement. Results: Mean radiographic bone level gain was significant, with 2.13 ± 1.64 mm at T1 and 3.02 ± 2.00 mm at T2. Mean probing pocket depth was significantly reduced from 5.40 ± 1.80 mm at baseline to 3.78 ± 1.73 mm at T1, and remained stable with 3.73 ± 1.70 mm at T2. Pocket closure (≤ 4 mm probing pocket depth) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%. Conclusion: Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive orthodontic therapy with clear aligners can lead to favorable results. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study analyzed radiographic bone levels of 10,871 dental implants in a cohort of 4,247 patients over a 22-year period. The objectives of the study were to assess and explore risk factors associated with the radiographic bone level of dental implants. Method and materials: A longitudinal observational cohort study based on data collected from 1995 to 2019 was conducted on implants placed by a single periodontist. Inclusion criteria included both partially and fully edentulous sites. Exclusion criteria were patients who were considered ASA 3 or greater. Information on medical and dental status prior to implant placement such as diabetes and smoking were included in the analysis. Implant factors such as the implant characteristics (length and diameter) and surgical site were recorded. The outcome assessed was the prevalence of bone loss around implants and any associative factors related to the bone loss. Results: Overall, dental implants lost an average of 0.05 ± 0.38 mm of bone 2 to 3 years after placement and 0.21 ± 0.64 mm 8 years after placement. The soft tissue condition was evaluated using the Implant Mucosal Index (IMI), and bone loss around dental implants was significantly higher when bleeding on probing was multi-point and moderate, multi-point and profuse, and when infection with suppuration was recorded. The mean difference in bone level between smokers and nonsmokers was 0.26 mm (P < .01) over a 4-year period. A mean difference of 0.10 mm (P = .04) in bone loss over 4 years was found between those with an autoimmune disease compared to those without. The diameter of the implant and immediate loading of the dental implant did not influence the radiographic bone levels over time. Conclusions: This large dataset of dental implants highlights predictive risk factors for bone loss around dental implants and the impact these risk factors have on the implant bone level. Consideration of these risk factors by both the dental team and the patient prior to dental implant placement will promote success of the treatment. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovary syndrome (PCOS) is widely reported among young females, and anti-androgens are used for treating hirsutism and acne in these patients. The protective effects of myo-inositol, oral contraceptives, and insulin sensitizers have been reported on the periodontium and high-sensitivity C-reactive protein (hsCRP) levels in PCOS females. However, cyproterone acetate/ethinyl estradiol (CPA/EE) has not yet been studied. This cross-sectional study explores the periodontal status and systemic inflammation in PCOS women on CPA/EE drug combination compared to females not on medication. Method and materials: A total of 150 participants were enrolled into three groups: 50 newly diagnosed PCOS females not on medication (N-PCOS); 50 PCOS females consuming CPA/EE combination for the last 6 months (PCOS+CPA/EE); and 50 systemically healthy females (control group). Anthropometric, biochemical, periodontal parameters, and health-related quality of life questionnaires were recorded. Results: N-PCOS and PCOS+CPA/EE groups showed a nonsignificant difference in hsCRP levels, Gingival Index, bleeding on probing, waist circumference, and waist-hip ratio (P > .05). Gingival thickness and keratinized tissue width were significantly greater in the PCOS+CPA/EE than the N-PCOS group (P = .05); however, these were comparable with the control group (P > .05). Regression analysis showed significant association of bleeding on probing with Gingival Index, clinical attachment level, and hsCRP (P = .05). Conclusions: CPA/EE combination does not influence the periodontal and systemic inflammatory status in PCOS females, as similar levels of local and systemic inflammation were observed in CPA/EE consumers compared with PCOS females not on medication. However, it might play a role in increasing gingival thickness and keratinized tissue width in these patients. [ABSTRACT FROM AUTHOR]