Marginal changes at bone-level implants supporting dental prostheses with or without intermediate standardised abutments after 36 months: Randomised controlled clinical trial.

OBJECTIVE: The objective of this study is to evaluate the changes at marginal bone level at implants restored with screw-retained prosthesis connected directly to the implants or with an intermediate abutment, after 3-year follow-up. MATERIAL AND METHODS: Thirty-six partially edentulous patients received 72 implants. Each patient received 2 implants and a 2-4-unit screw-retained implant-prosthesis. The test group implants received a screw-retained prosthesis connected directly to the implant shoulder, the control group prosthesis were connected through a 3-mm standardised intermediate abutment. Clinical and radiological data were recorded at baseline and at 6-, 12-, and 36-month follow-up. RESULTS: At 36 months, the mean marginal bone loss was 0.13 ± 0.18 mm for the control group and 0.20 ± 0.24 for the test group, with no significant differences between groups (p > .05). Clinical variables (Probing Pocket Depth, Bleeding on Probing and Plaque Index) at 36 months also showed no significant difference between groups. Minor complications frequency was 6.7% in the control group and 5.3% in test group. None of the groups suffered from mayor complications. Patient Reported Outcomes (PROs) showed a General Satisfaction mean score in the control group of 9.40 (SD 0.82) and 9.37 (SD 1.06) in the test group with no significant differences between groups. CONCLUSIONS: Bone-level implants restored with screw-retained partial prostheses with or without intermediate abutments showed similar radiographic and clinical outcomes after 3 years.

Marginal changes at bone-level implants supporting fixed screw-retained partial implant prostheses with or without intermediate standardised abutments: 1-year results of a randomised controlled clinical trial.

OBJECTIVE: To compare marginal changes at bone-level implants restored with screw-retained implant prosthesis with or without intermediate standardised abutments, after 1 year of follow-up. MATERIALS AND METHODS: Thirty-six partially edentulous patients received 72 implants. Each patient received 2 implants and a 2- to 4-unit screw-retained implant-prosthesis. The test group received implants consisting of a screw-retained prosthesis connected directly to the implant shoulder, while the prostheses in the control group were connected through a 3-mm standardised intermediate abutment. Clinical and radiological data were recorded at baseline and at 3, 6 and 12 months in follow-up visits. RESULTS: At 12 months, the marginal bone loss was 0.17 ± 0.24 mm for the test group (19 patients) and 0.09 ± 0.15 mm for the control group (17 patients), with no statistically significant differences (p > .05). The mean probing pocket depth was 2.96 mm ± 0.46 for the test group and 2.86 ± 0.62 mm for the control group. The test and control groups showed bleeding on probing levels of 18.86 ± 14.12% and 13.73 ± 17.66%, respectively. All patients scored below 25% on the plaque index levels. CONCLUSIONS: Restoration of bone-level implants with fixed screw-retained partial prostheses with or without intermediate abutments presented similar radiographic and clinical outcomes after 1 year.

Clinical and esthetic outcomes of immediate implant placement compared to alveolar ridge preservation: a systematic review and meta-analysis.

AIM: The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP) in terms of clinical, esthetic, and patient-reported outcomes. METHODS: A manual and electronic search (National Library of Medicine) was performed for controlled clinical trials, with at least 12 months of follow-up. Primary outcome variable was implant survival and secondary outcomes were marginal bone level (MBL) (change), pink esthetic score (PES), mid-facial mucosal level (change), papilla index score, complications, and patient-reported outcomes. RESULTS: A total of 10 publications were included (7 randomized clinical trials and 3 controlled clinical trials). The results from the meta-analyses showed that survival rate was significantly lower in the IIP group compared to ARP group [RR = 0.33; 95% CI (0.14; 0.78); p = 0.01]. No significant differences between the two groups were observed regarding radiographic MBL, PES scores, or mid-facial mucosal level (p > 0.05). CONCLUSION: The results from this systematic review and meta-analysis showed that IIP had lower survival rates and similar esthetic results when compared to ARP. CLINICAL RELEVANCE: Clinicians should weigh the benefits and disadvantages of each intervention to select the optimal timing of implant placement.

Titanium vs ceramic single dental implants in the anterior maxilla: A 12-month randomized clinical trial.

OBJECTIVE: The aim of this randomized clinical trial was to compare ceramic and titanium implants with respect to the esthetic and clinical parameters, and patient-reported outcome measures (PROMs). MATERIAL AND METHODS: Thirty patients received thirty implants (8-12 mm in length, 3.3 mm diameter, and a tissue level design) to replace single teeth in the anterior maxilla. Patients were randomly allocated to receive a ceramic or a titanium implant. Esthetic, clinical parameters, and PROMs were evaluated 18 months after surgery. RESULTS: At 12 months post-final loading, there were no significant differences between groups with respect to esthetics. Mean Index Crown Aesthetic score was 6.31 (95% C.I. 4.59-8.04) and 6.07 (95% C.I. 4.21-7.93) for ceramic and titanium implants, respectively. The pink esthetic score (PES) was 7.81 (95% C.I. 6.90-8.73) for ceramic implants and 7.86 (95% C.I. 7.11-8.60) for titanium implants, with no significant differences between groups. No statistically significant differences were found for any of the other clinical parameters and PROMs. CONCLUSIONS: Monotype ceramic implants have proven to be a good treatment option in the upper anterior sector, showing favorable esthetic results, being comparable to titanium implants. This clinical trial has been registered in clinical trials with the identifier CI_RCT_US16 and registration number NCT04707677. A retrospective registration of the clinical trial was carried out since registration was not mandatory on the date the study began.

Subepithelial connective tissue graft in combination with a coronally advanced flap for the treatment of Miller Class II and III gingival recessions in mandibular incisors: a case series.

Limited evidence is available regarding the effect of the subepithelial connective tissue graft (SCTG) on root coverage in the mandibular anterior region. A technique is described using an SCTG with a coronally advanced flap (CAF) for the treatment of Miller Class II and III gingival recessions in mandibular central incisors. Fourteen Miller Class II and III recessions were treated in 10 patients using an SCTG with a CAF. After a mean follow-up of 11.7 months, 90.22% ± 12.36% root coverage was achieved. There were no statistically significant differences in root coverage for Miller Class II and III recession defects. Complete root coverage was achieved at five (71.42%) Miller Class II sites compared with three (42.85%) Class III defects. These results suggest that the combination of an SCTG and CAF is an effective technique to obtain root coverage in mandibular incisors with Class II and III recession defects, with excellent patient satisfaction regarding the esthetic appearance of the treated teeth.

Vertical and horizontal ridge alterations after tooth extraction in the dog: flap vs. flapless surgery.

OBJECTIVE: To compare ridge alterations after flap and flapless tooth extraction in the vertical and horizontal dimension in the dog model. MATERIAL AND METHODS: This study was carried out on five Beagle dogs. Four extractions were performed in the lower jaw of each dog (two per side. Pm3, Pm4). At the time of tooth extraction, flap surgery was performed on one side (control group). On the contra-lateral side, a flapless extraction was performed (test group). Mesial sockets were left untreated on both sides. After 3 months of healing, the dogs were sacrificed and prepared for histological analysis. RESULTS: Ten samples were evaluated on each group. The vertical difference in height between the buccal and lingual crest was 1.48 mm for the flap, and 1.22 mm for the flapless group. The horizontal dimension of the ridge was 4.41 mm (at 1 mm from the crest), 5.72 mm (at 3 mm from the crest) and 6.67 mm (at 5 mm form the crest) in the flap group. In the flapless group, the measurements were 4.5, 5.58 mm and 6.44 at 1, 3 and 5 mm from the crest, respectively. CONCLUSION: Evaluating ridge alterations in the vertical and horizontal dimension after 3 months of healing following tooth extraction, results for the flap and the flapless group were very similar.