Bone level alterations at implants placed in the posterior segments of the dentition: outcome of submerged/non-submerged healing. A 5-year multicenter, randomized, controlled clinical trial.

OBJECTIVE: To determine if longitudinal bone level change at Astra Tech implants placed in the posterior part of the dentition was influenced by the healing conditions provided following implant placement, i.e., submerged or non-submerged healing. MATERIAL AND METHODS: Eighty-four patients and 115 fixed partial dentures (FPDs or cases) entered the study. The cases were randomized into two implant installation groups: initially non-submerged (group A) or initially submerged (group B) implants. Three hundred and twenty-four implants were installed (group A=153; group B=171): 145 in the maxilla and 179 in the mandible. Radiographs from the implant sites were obtained at FPD insertion (baseline) and subsequently every 12 months. In the radiographs, the position of the marginal bone at the mesial and distal aspects of the implants was determined and the radiographic (Rx) bone level change over time was calculated. RESULTS: Seven implants failed to integrate (four in group A and three in group B). During the 5 years of monitoring, three implants had to be removed and 35 implants were lost to follow-up. The Rx bone level alteration that occurred during year 1 was 0.02+/-0.38 mm in group A and 0.17+/-0.51 mm in group B. During the subsequent 4 years there was some further Rx bone loss in group B (0.02+/-0.62 mm), while in group A there was some gain of bone (0.07+/-0.5 mm). CONCLUSION: The peri-implant bone level change and number of biological complications that took place during the 5 years was small and unrelated to the surgical protocol used for implant placement.

Periodontal disease and coronary heart disease: an epidemiological and microbiological study.

AIMS: This is an investigation on the association between periodontal disease and an increased risk of coronary heart disease; the main hypothesis is that periodontal infections may increase the systemic inflammatory burden of the host above a threshold that may favour the atherogenic processes. MATERIALS AND METHODS: Case-control study with 27 cases, cardiologically affected, and 15 healthy controls. Patients underwent a complete periodontal probing. Periodontal conditions were compared between cases and controls to assess the mentioned association and to search for periodontal conditions related to the increased coronary risk. The presence and prevalence of periodontal pathogens was assessed in crevicular fluid samples. RESULTS: The overall periodontal conditions resulted worse in the test group. In particular periodontal conditions such as the presence of deep pockets (probing depth >6 mm) and the loss of more than 12 teeth might represent indicators of a strongly increased risk of cardiological disease and microbiological investigations confirmed these findings; Prevotella gingivalis was the most common bacteria. CONCLUSION: This study supports the existence of an epidemiologic association between periodontal disease and coronary heart disease and confirms previous data present in the literature. Two periodontal parameters, deep pockets and number of missing teeth, seem to be important risk factors for cardiovascular diseases.

1.3 Development of professional competences.

Competency-based education, introduced approximately 10 years ago, has become the preferred method and generally the accepted norm for delivering and assessing the outcomes of undergraduate (European) or predoctoral (North America) dental education in many parts of the world. As a philosophical approach, the competency statements drive national agencies in external programme review and at the institutional level in the definition of curriculum development, student assessment and programme evaluation. It would be presumptuous of this group to prescribe competences for various parts of the world; the application of this approach on a global basis may define what is the absolute minimum knowledge base and behavioural standard expected of a 'dentist' in the health care setting, while respecting local limitations and values. The review of documents and distillation of recommendations is presented as a reference and consideration for dental undergraduate programmes and their administration.