[show abstract][hide abstract] ABSTRACT: Aim: Limited data exist on the longitudinal crestal bone changes around teeth compared to implants in partially edentulous patients. This study sought to compare the 10-year radiographic crestal bone changes (BL) around teeth and implants in periodontally compromised (PCP) and periodontally healthy patients (PHP). Materials and methods: A total of 120 patients were evaluated for the radiographic crestal bone level (BL) around dental implants and adjacent teeth at time of implant crown insertion and at the 10-year follow-up. Sixty patients had a previous history of periodontitis (PCP) and the remaining 60 were periodontally healthy. In each category (PCP and PHP), two different implant systems were used. The mean BL at implant and at the adjacent tooth at the interproximal area was calculated subtracting the radiographic crestal bone level at time of crown cementation from the radiographic crestal bone level at the 10-year follow-up. Results: At 10 years post-therapy, the survival rate ranged from 80% to 95% for subgroups for implants, whereas it was 100% for the adjacent teeth. In all the 8 different patient categories evaluated, teeth demonstrated a significantly more stable radiographic bone level as compared to adjacent dental implants (teeth BL 0.44±0.23 mm, Implant BL 2.28±0.72 mm (p<0.05)). Radiographic bone level changes around teeth seemed not be influenced by the presence or not of an advanced bone loss (≥3mm) at the adjacent implants. Conclusions: Natural teeth yielded better long-term results with respect to survival rate and marginal bone level changes as compared to dental implants. Moreover, these findings also extend to teeth with an initial reduced periodontal attachment level (CAL), provided adequate periodontal treatment and maintenance are performed. As a consequence, the decision of tooth extraction due to periodontal reasons in favor of a dental implant should be carefully considered in partially edentulous patients.
Journal of Periodontology 11/2013; · 2.40 Impact Factor
[show abstract][hide abstract] ABSTRACT: To assess soft and hard tissues healing at immediate transmucosal implants placed into maxillary molar region with collagen membranes uncovered.
Twenty subjects received 20 immediate transmucosal implants placed in maxillary molar extraction sockets. Periimplant marginal defects were treated according to the principles of guided bone regeneration by means of deproteinized bovine bone mineral particles in conjunction with collagen membrane. Flaps were repositioned and sutured, allowing nonsubmerged, transmucosal soft tissues healing. The collagen membranes adapted around implant neck were uncovered.
No implants were lost during the 1-year observation period yielding a survival rate of 100%. No postsurgical wound healing complications were observed. No degranulation of grafting material was reported.
The results of this 12-month prospective study showed that the exposure of collagen membrane at time of the flap suturing does not represent a limitation for the soft and hard tissues healing at immediate transmucosal implants placed into maxillary molar extraction sites.
[show abstract][hide abstract] ABSTRACT: The purpose of this report is to present the clinical outcomes and patients' satisfaction of full-mouth rehabilitation using computer-aided flapless implant placement and immediate loading of a prefabricated prosthesis.
The study included 30 consecutive fully edentulous patients who received 312 implants. Mandible and maxilla were treated in the same surgical session with computer-guided flapless approach using the NobelGuide protocol. Prefabricated screw-retained fixed prostheses were inserted at the end of surgery. Clinical and radiographic evaluations were assessed at 6, 12, and 36 months. At baseline and 6 months after surgery, patients answered Oral Health Impact Profile in Edentulous Adults questionnaire to assess satisfaction.
The implant survival rate was 97.9%, whereas the average marginal bone loss was 1.9 ± 1.3 mm after 3 years. At 6 months, patients showed significantly greater satisfaction with their fixed rehabilitation when compared with conventional dentures.
The results of this study confirm that rehabilitation with a prefabricated fixed prosthesis supported by implants placed with NobelGuide protocol is a viable and predictable treatment and increases patients' satisfaction and improves oral health-related quality of life.
[show abstract][hide abstract] ABSTRACT: Objectives
The aim of this study was to evaluate the efficacy of two alcohol-free, 0.2% chlorhexidine mouthwashes, with and without antidiscoloration systems, following nonsurgical periodontal therapy.Materials and methodsThirty patients suffering from chronic generalized periodontitis were randomly divided into two groups. After completion of root scaling and planing, the patients in the test group were instructed to use the alcohol-free 0.2% chlorhexidine mouthwash containing an antidiscoloration system, while those of the control group were treated with alcohol-free 0.2% chlorhexidine mouthwash alone.ResultsThe mouthwash used in the test group caused less discoloration than the one used by controls.Conclusions
Treatment for 2 weeks with alcohol-free 0.2% chlorhexidine mouthwash containing an antidiscoloration system allows good control of mucobacterial plaque without causing tooth discoloration.
[show abstract][hide abstract] ABSTRACT: To evaluate the clinical and radiographic changes at implants in posterior maxillary and mandibular areas supporting single-unit crowns (SCs) and fixed dental prostheses (FDPs) with one mesial or distal cantilever extension after an observation period of at least 3 years.
Seventeen subjects with 19 implant-supported SCs and 21 subjects with 21 implant-supported FDPs fulfilled the inclusion criteria. All FDPs were supported by two implants and had a span of 3-4 units. All reconstructions were incorporated in the posterior maxilla or mandible. The mesial and distal radiographic marginal bone loss from baseline (i.e. delivery of the reconstruction) to the follow-up examination was averaged and compared between SCs supporting one cantilever extension with that of implants supporting FDPs adjacent to or distant from the cantilever extension. Changes in mean pocket probing depth (PPD) were calculated and compared between the three groups.
The mean observation period was 78.2 ± 34.5 months for SCs supported by one implant and 67.8 ± 29.8 months for FDPs supported by two implants. No implant loss occurred, yielding a 100% survival rate. At baseline, the mean radiographic bone levels ± SD were 2.6 ± 0.3 mm for implants supporting SCs, 2.6 ± 0.3 mm for implants of FDPs adjacent to the cantilever extension, and 2.4 ± 0.5 mm for implants of FDPs distant from the cantilever extension. At follow-up, the corresponding mean bone levels ± SD were 2.7 ± 0.4, 2.7 ± 0.5, and 2.8 ± 0.5 mm, respectively. No statistically significant differences (P > 0.05) were observed comparing the mean marginal bone loss between the three groups. Moreover, mean changes in PPD between baseline and follow-up were not statistically significantly different (P > 0.05) between the three groups.
The presence of one mesial or distal cantilever extension in the posterior maxilla or mandible does not jeopardize the marginal bone levels of implants supporting SCs or short-span FDPs after a mean observation period of at least 5 years.
Clinical Oral Implants Research 01/2012; 23(5):550-5. · 3.43 Impact Factor
[show abstract][hide abstract] ABSTRACT: The purpose of this study is to compare the healing of deep, non-contained intrabony defects (i.e., with a ≥80% 1-wall component and a residual 2- to 3-wall component in the most apical part) treated with either an enamel matrix derivative (EMD) or guided tissue regeneration (GTR) after 12 months.
In this randomized, controlled clinical trial, 40 subjects with 40 defects affecting single-rooted teeth were treated. The defects were treated with EMD alone or with a non-resorbable titanium-reinforced membrane. No grafting materials were used. At baseline and after 12 months, clinical parameters including probing depths (PDs) and clinical attachment levels (CAL) were recorded. The difference in CAL gain was the primary outcome.
At baseline, the intrabony component of the defects amounted to 8.5 ± 2.2 mm at EMD-treated sites and 8.6 ± 1.7 mm at GTR-treated sites (P = 0.47). The mean CAL gain at sites treated with GTR was significantly greater (P <0.001) than that at sites treated with EMD (4.1 ± 1.4 mm versus 2.4 ± 2.2 mm, respectively). GTR therapy, compared to EMD application alone, significantly (P = 0.01) increased the probability of CAL gain ≥4 mm (79.2% versus 11.3%, respectively) and significantly (P = 0.01) decreased the probability of residual PDs ≥6 mm (3% versus 79.3%, respectively).
Although the outcomes of open-flap debridement alone were not investigated, the application of EMD alone appeared to yield less PD reduction and CAL gain compared to GTR therapy in the treatment of deep, non-contained intrabony defects.
Journal of Periodontology 01/2011; 82(1):62-71. · 2.40 Impact Factor
[show abstract][hide abstract] ABSTRACT: To assess dimensional ridge alterations following immediate implant placement in molar extraction sites.
Twelve subjects received 12 immediate transmucosal implants in molar extraction sites. Peri-implant defects were treated according to the principles of Guided Bone Regeneration by means of a deproteinized bone substitute and a bioresorbable collagen membrane. Changes in vertical (IS-BD, CREST-BD) and horizontal distances (EC-I, IC-I) of alveolar bony walls to the bottom of the defects (BD) and to the implant surfaces (I) were compared between implant placement and surgical re-entry at 6 months.
The implant survival rate at 6 months was 100%. Statistically significant differences (P<0.01) were observed in the mean changes in vertical distances IS-BD and CREST-BD between baseline and re-entry. At re-entry, all peri-implant marginal defects assessed from the internal socket wall to the implant surface (IC-I) were healed. The residual combined thickness of the buccal wall with the newly formed peri-implant bone at sites with an initial thickness of 1 mm was statistically significantly smaller (P<0.05) compared with that of sites with an initial buccal thickness of 2 mm (2.50 +/- 0.76 vs. 4+/-0 mm).
The marginal defects around immediate implants placed in molar extraction sites were completely filled after 6 months of healing through de novo bone formation. Bone resorption was observed from the external aspects of the buccal and oral socket walls. Dimensional changes of the external socket walls were mostly pronounced at the buccal aspects.
Clinical Oral Implants Research 08/2009; 20(10):1092-8. · 3.43 Impact Factor
[show abstract][hide abstract] ABSTRACT: To assess soft tissues healing at immediate transmucosal implants placed into molar extraction sites with buccal self-contained dehiscences.
For this 12-month controlled clinical trial, 15 subjects received immediate transmucosal tapered-effect (TE) implants placed in molar extraction sockets displaying a buccal bone dehiscence (test sites) with a height and a width of > or =3 mm, respectively. Peri-implant marginal defects were treated according to the principles of Guided Bone Regeneration (GBR) by means of deproteinized bovine bone mineral particles in conjunction with a bioresorbable collagen membrane. Fifteen subjects received implants in healed molar sites (control sites) with intact buccal alveolar walls following tooth extraction. In total, 30 TE implants with an endosseous diameter of 4.8 mm and a shoulder diameter of 6.5 mm were used. Flaps were repositioned and sutured, allowing non-submerged, transmucosal soft tissues healing. At the 12-month follow-up, pocket probing depths (PPD) and clinical attachment levels (CAL) were compared between implants placed in the test and the control sites, respectively.
All subjects completed the 12-month follow-up period. All implants healed uneventfully, yielding a survival rate of 100%. After 12 months, statistically significantly higher (P<0.05) PPD and CAL values were recorded around implants placed in the test sites compared with those placed in the control sites.
The findings of this controlled clinical trial showed that healing following immediate transmucosal implant installation in molar extraction sites with wide and shallow buccal dehiscences yielded less favorable outcomes compared with those of implants placed in healed sites, and resulted in lack of 'complete' osseointegration.
Clinical Oral Implants Research 02/2009; 20(5):482-8. · 3.43 Impact Factor