Role of implant loading time in the prevention of marginal bone loss after implant-supported restorations: A targeted review.

The implant-supported restoration of missing teeth is a recognized method of treatment that ensures a functional, esthetic and durable effect, along with patient satisfaction. However, the preferable time of dental implant loading is under debate. Currently, 3 protocols are used: immediate loading; early loading; and conventional (late) loading. Immediate loading provides benefits such as short treatment time, the elimination of the second surgery required for later loading protocols, the protection of the gingival papilla, an immediate esthetic effect, and high patient satisfaction. This review aimed to summarize the evidence on the impact of loading time on marginal bone loss (MBL) around dental implants, which is considered a useful measure of implantological treatment effects. A literature search was conducted based on the PubMed/MEDLINE database. The search focused on studies providing the MBL values by protocol. Out of the 1,366 hits received in the initial search, 10 studies were included in the qualitative analysis. At 12 months, the MBL range was 0.17-1.86 mm in patients undergoing the immediate protocol, 0.14-1.22 mm in patients undergoing the early protocol, and 0.44-0.91 mm in patients undergoing the late protocol. The studies were heterogeneous, but no significant differences in the occurrence of MBL were reported between the immediately and early loaded implants as compared with the conventionally loaded ones. Further studies are needed to determine other factors that might be related to the type of protocol, important for optimal patient treatment.

Aesthetic Outcomes of Early Occlusal Loaded SLA Dental Implants with Hydroxyl Ion Modified Surface-A 12 Months Prospective Study.

BACKGROUND: Many efforts have been made recently to arrange a newer, more hydrophilic and more osteoconductive implant surface. One of the possible options in this matter is modification with hydroxyl ion. MATERIALS AND METHODS: Forty implants with the diameters 3.5 and 4.0 mm were inserted as a single missing tooth restoration protocol in the frontal aspect of the maxilla. All implants were loaded early in a 4 week period. Prior to and during the surgery, the following indices were considered: height of keratinized tissue, the thickness of soft tissue, and the initial level of bone tissue. After 12 months, the implant and the tissues in its direct vicinity were evaluated once more with the following indices: marginal bone loss (MBL), height of keratinized tissue (HKT), probing pocket depth (PPD), pink and white aesthetics scores (PES, WES), as well as pain sensations combined with the procedure (VAS). All results were related to the diameter of the implant and thickness of periodontal biotype. RESULTS: High aesthetic outcomes were reported regardless of soft tissue thickness and implant diameter. The VAS score was higher for the 4.0 implant group, and the thickness of soft tissue had no influence on VAS. In case of implantation in thin or soft tissue, higher MBL levels were reported (0.26 mm), while in case of a thick phenotype, MBL was 0.06 mm. CONCLUSIONS: Hydrophilic surface implants can be used for a protocol of early functional occlusal loading. The initial thickness of soft tissue does not influence aesthetic outcomes and does not raise pain perception, although it may elevate crestal bone resorption.

Prospective evaluation of vitamin D levels in dental treated patients: A screening study.

BACKGROUND: The available epidemiological data indicates the existence of numerous tooth deficiencies and periodontopathies in the Polish population. Successful surgical treatment is dependent upon multiple factors, including bone quality, which is affected by vitamin D - one of the regulators of calcium (Ca) and phosphorus (P) metabolism. OBJECTIVES: The aim of this study was to conduct a prospective evaluation of the levels of vitamin D among patients receiving dental treatment for various reasons (conservative, surgical or prosthodontic treatment). MATERIAL AND METHODS: The study involved 60 patients, who, for various reasons, were admitted for dental treatment for over a 1-week period in the summer season. A thorough interview together with a periodontological examination consisting of probing depth (PD) and clinical attachment level (CAL) measurements, were conducted. A total of 2 mL of blood was collected from each patient to determine the concentrations of vitamin D, parathyroid hormone (PTH), Ca, magnesium (Mg), and P in the blood with the use of mass spectrometry. RESULTS: Among the 60 patients enrolled in the study, 53 (88.3%) showed vitamin D deficiency and 18 (30%) showed a concentration below 17.8 ng/mL, which is an independent general mortality factor. The difference in the level of vitamin D between group A (without periodontitis) and group B (with periodontitis) was not statistically significant (p = 0.076), but a tendency for lower vitamin D levels in people with periodontitis was observed. We also observed a tendency for periodontal disease to occur more often with extreme vitamin D deficiency (<15 ng/mL) (p = 0.730). CONCLUSIONS: Low levels of vitamin D are present in a large proportion of dental patients, and an increase in the incidence of periodontal disease is likely associated with a decrease in the level of vitamin D.

Short Implants and Conventional Implants in The Residual Maxillary Alveolar Ridge: A 36-Month Follow-Up Observation.

BACKGROUND Short dental implants are considered an alternative method of treatment to the maxillary sinus elevation and bone augmentation procedure at the sites of a reduced alveolar ridge height. The aim of the study was to determine the most effective therapeutic approach for a single tooth replacement in a reduced maxillary alveolar crest. MATERIAL AND METHODS We enrolled 30 partially edentulous patients having a residual crestal height of 6 mm and a minimal width of the alveolar ridge of 6-7 mm: 15 patients received regular dental implants (OsseoSpeed™ L11 Ø4 mm and L13 Ø4 mm) and the implantation was preceded by the sinus lift procedure from a lateral window approach with the application of a xenogeneic bone graft, whereas the remaining 15 patients received short implants (OsseoSpeed™ L6 mm Ø4 mm) without the sinus lift and augmentation procedure. All implants were loaded with single non-splinted crowns. Radiological examination (CBCT, RVG) was performed before the surgery and after 36 months. Primary and secondary stabilization with Osstell ISQ® and Periotest® were assessed. RESULTS Good results in primary and secondary stability were achieved in both systems. The marginal bone level (MBL) loss was low (0.22±0.46 mm and 0.34±0.24 mm, for short and conventional implants, respectively). No significant difference in MBL between groups was found. CONCLUSIONS Short implants can be successfully used to support single crowns in the lateral part of the maxilla.

The Influence of the Crown-Implant Ratio on the Crestal Bone Level and Implant Secondary Stability: 36-Month Clinical Study.

INTRODUCTION: When the era of dental implantology began, the pioneers defined some gold standards used in dental prosthetics treatment for implant-supported restorations. Referring to traditional prosthetics, it was taken for granted that the length of an implant placed in the alveolar bone (the equivalent of the root) should exceed the length of the superstructure. AIM OF THE STUDY: The aim of the study was to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and the loss of the surrounding marginal bone and whether short implants can be used instead of sinus augmentation procedures. MATERIAL AND METHODS: The patients participating in the study (n = 30) had one single tooth implant, a short (OsseoSpeed™ L6 Ø4 mm, Implants) or a regular implant (OsseoSpeed L11 and L13 Ø4 mm, DENTSPLY Implants), placed in the maxilla. The evaluation was based on clinical and radiological examination. The crown-to-implant ratio was determined by dividing the length of the crown together with the abutment by the length of the implant placed crestally. Mean crown-to-implant ratios were calculated separately for each group and its correlation with the MBL (marginal bone loss) and stability was assessed. The authors compared the correlation between the C/I ratio values, MBL, and secondary implant stability. RESULTS: Positive results in terms of primary and secondary stability were achieved with both (short and conventional) implants. The MBL was low for short and conventional implants being 0.34 ± 0.24 mm and 0.22 ± 0.46 mm, respectively. No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the marginal bone loss. CONCLUSIONS: Short implants can be successfully used to support single crowns. The study has revealed no significant differences in the clinical performance of prosthetic restorations supported by short implants. Clinical trial registration number is NCT03471000.

The role of vitamin D in the human body with a special emphasis on dental issues: Literature review.

The aim of the study was to review the current literature on the role of vitamin D in dentistry. The term vitamin D is defined as a group of compounds which are cholesterol derivatives with a similar chemical structure. It is produced in the human body and passes through many stages of synthesis. Vitamin D affects our body through the immune, muscular, nervous, and cardiovascular systems. It is also relevant in dentistry and in the carbohydrate metabolism. Nowadays, vitamin D deficiency levels are high in both the Polish and the world population as a whole. This is due to many factors: latitude, diseases and lifestyle. The data shows that over 90% of people of color (black, Latino, Asian, etc.) and nearly 3/4 of whites living in the United States suffer from a shortage of 25-hydroxycholecalciferol (25(OH) vitamin D). Meanwhile, studies performed in Poland report that a concentration of vitamin D <20 ng/mL (50 nmol/mL) occurs in 70% of the population. Preliminary reports suggest that vitamin D, through the maintenance of normal bone metabolism, as well as its antibacterial and anti-inflammatory activity, modulates periodontal disease. A normal level of vitamin D is important in the treatment of periodontitis. More and more studies are focusing on the problem of vitamin D deficiency and its role in the human body. It is very important to maintain normal levels of vitamin D in the blood and supplement it in the case of shortfalls.

Comparative evaluation of the effectiveness of the implantation in the lateral part of the mandible between short tissue level (TE) and bone level (BL) implant systems.

Short dental implants can be an alternative method of treatment to a vertical bone augmentation procedure at sites of reduced alveolar height. However, for successful treatment, an implant system that causes a minimal marginal bone loss (MBL) should be taken into consideration. The aim of the study has been to evaluate implantation effectiveness for bone level and tissue level short implants provided in lateral aspects of partially edentulous mandible and limited alveolar ridge height. The MBL and primary as well as secondary implant stability were determined in the study. Patients were randomly divided into two groups according to the method of treatment provided. Sixteen short Bone Level Implants (OsseoSpeed TX, Astra tech) and 16 short Tissue Level Implants (RN SLActive®, Straumann) were successfully placed in the edentulous part of the mandible. The determination of the marginal bone level was based on radiographic evaluation after 12 and 36 weeks. Implant stability was measured immediately after insertion and after 12 weeks. The marginal bone level of Bone Level Implants was significantly lower compared to Tissue Level Implants. Furthermore, the Bone Level Implants had greater primary and secondary stability in comparison with Tissue Level Implants (Primary: 77.8 ISQ versus 66.5 ISQ; Secondary: 78.9 ISQ versus 73.9 ISQ, respectively). Since short Bone Level Implants showed a significantly decreased MBL 12 and 36 weeks after implantation as well as better results for the primary stability compared to Tissue Level Implants, they should preferentially be used for this mentioned indication.