Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Five-Year Retrospective Study.

Recent short-term studies suggested the use of short and ultra-short implants in association with a modified osteotome sinus floor elevation (internal sinus lift) technique for the treatment of edentulous resorbed posterior maxilla. The aim of this retrospective study was to investigate this hypothesis in locking-taper implants with a mid-term follow-up of 5 years. Overall, 155 implants (32, 100, and 23 of, respectively, 5.0 mm, 6.0 mm, and 8.0 mm length) were positioned in the atrophic upper maxilla of 79 patients, and 151 implants were loaded with single crowns. Overall implant survival after 5 years was 94.84%. Implant survival for each length group was 93.75%, 94%, and 100% for 5.0, 6.0, and 8.0 mm length, respectively. Preoperative residual crestal bone height of 4.45 (1.3) mm increased to 9.25 (2.13) mm after implant placement and settled at 6.35 (1.73) mm after loading and at 5.25 (1.68) mm at follow-up. Elevation of the Schneiderian membrane was 4.8 (2.46) mm after implant placement, 3.06 (1.3) mm after loading, and 1.46 (1.06) mm at follow-up. Mean variations of peri-implant crestal bone loss and first bone-to-implant contact point were, respectively, -0.36 (1.3) mm and -0.62 (1.15) mm. It can be confirmed that internal sinus lift procedure revealed stable bone gain and negligible resorption at mid-term follow-up for atrophic upper crests with reduced height.

Survival rates of ultra-short (<6 mm) compared with short locking-taper implants supporting single crowns in posterior areas: A 5-year retrospective study.

BACKGROUND: Short and ultra-short implants represent a predictable treatment, in terms of implant survival, with patients presenting insufficient available bone volumes. Moreover, single crown restorations represent a gold standard in terms of oral hygiene. PURPOSE: The aim of this retrospective study was to evaluate implant survival, marginal bone loss, and peri-implant complications in 333 locking-taper short and ultra-short implants. MATERIALS AND METHODS: Implants were placed in the maxillary and mandibular posterior regions of 142 patients. Clinical and radiographic examinations were performed at 5-year recall appointments. RESULTS: All implants placed consisted of 8.0-, 6.0-, and 5.0-mm length, 38.14%, 34.53%, and 27.33%, respectively. Three hundred thirty-two implants (one early failure) were rehabilitated with single crowns in 141 patients. In 45.48% of the implants the crown-to-implant ratio was ≥2, with a mean value of 1.94. Overall implant-based survival after 5 years of follow-up was 96.10%: 96.85%, 95.65%, and 95.60% for 8.0-, 6.0-, and 5.0-mm length implants, respectively (p = 0.82). Overall patient-based survival was 91.55%. Regarding crestal bone level variations, average crestal bone loss and apical shift of the "first bone-to-implant contact point" position were 0.69 and 0.01 mm, respectively. Setting the threshold for excessive bone loss at 1 mm, during the time interval from loading to follow-up, 28 implants experienced loss of supporting bone greater than 1 mm: 19 of them (67.85%) were surgically treated with a codified surgical regenerative protocol. After 60 months, a peri-implantitis prevalence of 5.94% was reported, with an overall implant success of 94.06%: 95.93%, 92.73%, and 93.10% for 8.0-, 6.0-, and 5.0-mm length implants, respectively (p = 0.55). CONCLUSION: Long-term outcomes suggest that short and ultra-short locking-taper implants can be successfully restored with single crowns in the posterior area of the maxilla and mandible.

Assessment of Oral Conditions in Individuals Treated with Methadone: A Research Report.

PURPOSE: Oral health is essential in everyone's daily life, and becomes particularly important for those individuals who have been previously drug addicted. The aim of this study was to assess oral health in patients almost at the end of a methadone-detoxification process due to heroin dependency, identifying their treatment needs. MATERIALS AND METHODS: Seventeen patients, aged between 22 and 51 years, were admitted to the University Hospital of Verona after at least 6 months of being drug-free, except for standard methadone therapy (20 mg/day). Data concerning medical history, social status, drugs and nutritional habits were collected. Restorative conditions and periodontal status were evaluated clinically and radiographically. RESULTS: The duration of illicit drug consumption ranged from 2 to 20 years; methadone treatment duration ranged from 1 to 17 months. A total of 392 teeth were evaluated: 2 patients were diagnosed with periodontitis, whereas dental caries was widespread, affecting most frequently interproximal surfaces of the anterior teeth. Some 185 teeth needed restorations, 15 decayed teeth endodontic treatments, 21 teeth extraction, and 84 teeth were suitable for prosthetic rehabilitations. Caries and periodontal indexes were analysed according to years of heroin consumption (HYC) and months of methadone therapy (MMT), without any statistical differences (p > 0.05) found for both phases. Social and individual factors were investigated in relation with the indexes: no correlations were demonstrated. Regarding irregular food ingestion during HYC, a statistically significant difference (p < 0.05) between the full-mouth visible bleeding on probing index (FM-VBOP) and diet was found. CONCLUSION: A large carbohydrate intake consequent to methadone therapy increased caries prevalence, despite a more regular diet.