The Long-Term Esthetic and Radiographic Outcome of Implants Placed in the Anterior Maxilla after Ridge Preservation, Combining Bovine Xenograft with Collagen Matrix.

The objective of the study was to evaluate the long-term esthetic and radiographic results of implants placed in the anterior maxilla after ridge preservation, combining bovine xenograft with collagen matrix. Fifteen patients who required a single tooth extraction because of fracture, root resorption, or extended caries were included in the study. After extraction, all sites were grafted using Deproteinized Bovine Bone Mineral (DBBM) with collagen and covered by a resorbable collagen matrix (CM). Five months after socket grafting, implants were successfully installed. The implant diameter range was between 3.8 and 4.2 mm. All patients were monitored for over 7 years, both clinically and radiographically. Three independent observers evaluated the long-term esthetic outcome, employing the Pink Esthetic Score (PES) technique. Over a period exceeding seven years, a 100% survival rate was observed for all 15 implants, with minimal marginal bone loss. The mean PES was 11.40 (±1.44) at the first assessment and 11.38 (±1.63) at the second assessment. The difference was not statistically significant (p = 0.978), and the scores of PES measurements indicated excellent esthetic results even after seven years. Based on these preliminary results, it seems that placing collagen bovine bone in a fresh extraction socket, covered with a collagen matrix, can preserve the alveolar ridge and provide long-term stable esthetic results.

Association between defect morphology and healing of intrabony defects treated with minimally invasive non-surgical therapy: A pilot exploratory analysis of two cohorts.

OBJECTIVE: The aim of this study was to explore the associations between defect morphology (defined by clinical and radiographic parameters) and the healing of periodontal intrabony defects treated with minimally invasive non-surgical therapy (MINST). BACKGROUND DATA: MINST has shown to result in favorable clinical and radiographic improvements in intrabony defects. However, it is not clear which types of intrabony defects are most suitable for this treatment. METHODS: Clinical and radiographic analyses were carried out in a total of 71 intrabony defects treated with MINST belonging to two previously published studies. Baseline defect characteristics were analyzed and related to clinical and radiographic outcomes at 12 months post-MINST with or without adjunctive enamel matrix derivative. RESULTS: No associations were detected between defect depth, angle and predicted number of walls and clinical and radiographic healing 12 months post-MINST. CONCLUSIONS: No evidence emerged for associations between defect characteristics and healing following MINST. These data seem to suggest that factors other than defect morphology may influence treatment response to MINST.

Prevalence and risk indicators of peri-implantitis: a university based cross-sectional study.

OBJECTIVES: To assess the prevalence of peri-implantitis and identify risk and protective indicators of peri-implantitis in a population that underwent implant therapy in a university dental clinic. METHOD AND MATERIALS: Randomly selected patients from a postgraduate university dental clinic were invited to participate. Clinical and radiographic examinations were recorded. Peri-implantitis was defined as the presence of bleeding and/or suppuration on probing, probing depths of ≥ 6 mm, and bone loss ≥ 3 mm. Patient-, implant-, and bone- related factors were recorded and analyzed using a multivariate logistic regression analysis. RESULTS: A total of 355 dental implants placed in 108 patients and exhibiting at least 1 year loading time were included. The prevalence of peri-implantitis was 21.3% at patient-level, while 10.7% at implant-level. Simultaneous guided bone regeneration (OR 2.76, 95% CI 1.07-7.12, P = .035), recurrent periodontitis (OR 3.11, 95% CI 1.02-9.45, P = .045) and significant medical history (OR 2.86, 95% CI 1.08-7.59, P = .034) were identified as risk indicators for peri-implantitis. The mean peri-implant bone loss was estimated to be 2.18 ± 1.57 mm for the total number of implants, whereas implants diagnosed with peri-implantitis demonstrated 4.42 ± 1.12 mm in a time period between 12 to 177 months. CONCLUSION: Within the limitations of the study, the prevalence of peri-implantitis in a cohort receiving dental implant therapy at a university dental clinic was 10.7% at implant level and 21.3% at patient level. Patient-reported systemic comorbidities and recurrent periodontitis as well as implants placed in ridge augmented sites were associated with greater risk of peri-implantitis.

Surgical Treatment of Peri-Implantitis Using a Combined Nd: YAG and Er: YAG Laser Approach: Investigation of Clinical and Bone Loss Biomarkers.

The current study aimed to investigate the effect of the combined Nd-Er: YAG laser on the surgical treatment of peri-implantitis by evaluating clinical markers and biomarkers of bone loss (RANKL/OPG). Twenty (20) patients having at least 1 implant diagnosed with peri-implantitis were randomly assigned to two groups for surgical treatment. In the test group (n = 10), Er: YAG laser was used for granulation tissue removal and implant surface decontamination, while Nd: YAG laser was employed for deep tissue decontamination and biomodulation. In the control group (n = 10), an access flap was applied, and mechanical instrumentation of the implant surface was performed by using titanium curettes. The following clinical parameters were evaluated at baseline and six months after treatment: Full-mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Probing Attachment Levels (PAL), recession (REC), and Bleeding on probing (BoP). Peri-implant crevicular fluid (PICF) was collected at baseline and six months for the evaluation of soluble RANKL and OPG utilizing enzyme-linked immunosorbent assay (ELISA). Baseline clinical values were similar for both groups, with no statistical differences between them. The study results indicated statistically significant improvements in the clinical parameters during the 6-month observation period in both groups. More specifically, PPD, PAL, and REC were improved in the test and control groups with no differences in the between-groups comparisons. However, a greater reduction in the BoP-positive sites was noted for the laser group (Mean change 22.05 ± 33.92 vs. 55.00 ± 30.48, p = 0.037). The baseline and six-month comparisons of sRANKL and OPG revealed no statistically significant differences between the two groups. The combined Nd: YAG-Er: YAG laser surgical therapy of peri-implantitis seemed to lead to more favorable improvements in regard to bleeding on probing six months after treatment compared to the conventional mechanical decontamination of the implant surface. None of the methods was found superior in the modification of bone loss biomarkers (RANKL, OPG) six months after treatment.

Minimally Invasive Non-Surgical Technique in the Treatment of Intrabony Defects-A Narrative Review.

Intrabony defects occur frequently in periodontitis and represent sites that, if left untreated, are at increased risk for disease progression. Although resective or repair procedures have been used to treat intrabony defects, aiming at their elimination, the treatment of choice is surgical periodontal regeneration. The development of periodontal regeneration in the last 30 years has followed two distinctive, though totally different, paths. The interest of researchers has so far focused on regenerative materials and products on one side, and on novel surgical approaches on the other side. In the area of materials and products, three different regenerative concepts have been explored namely, barrier membranes, bone grafts, and wound healing modifiers/biologics, plus many combinations of the aforementioned. In the area of surgical approaches, clinical innovation in flap design and handling, as well as minimally invasive approaches, has radically changed regenerative surgery. Recently, a minimally invasive non-surgical technique (MINST) for the treatment of intrabony defects was proposed. Initial clinical trials indicated comparable results to the surgical minimally invasive techniques in both clinical and radiographic outcomes. These results support the efficacy of this treatment approach. The aim of this review is to present the evidence on the application of minimally invasive non-surgical techniques and their efficacy in the treatment of intrabony defects.

A novel biofilm removal approach (Guided Biofilm Therapy) utilizing erythritol air-polishing and ultrasonic piezo instrumentation: A randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of biofilm removal of a treatment protocol combining an air-abrasive device using erythritol powder (AIRFLOW®) and an ultrasonic piezon instrumentation (Guided Biofilm Therapy/GBT) compared with the conventional mechanical approach (Scaling and Root Planing/SRP) during supportive periodontal treatment (SPT). MATERIALS AND METHODS: Fifty patients, scheduled for supportive periodontal treatment at the Department of Preventive Dentistry, Periodontology and Implant Biology of the Aristotle University of Thessaloniki were randomly assigned to either a GBT (group A: 24 participants) or a SRP (Group B: 26 participants) treatment protocol. Therapeutic interventions and clinical measurements were performed at baseline and repeated at 6 weeks. Oral hygiene instructions were reinforced at each visit. A questionnaire was handed to the participants for evaluation of patient perception of both utilized approaches. RESULTS: At 6 weeks, the two groups showed statistically significant reduction in plaque score and in gingival bleeding index compared with baseline. GBT required approximately 15% less chair-time than SRP with a mean difference of 5.1 min, which was statically significant (p = 0.049). Patient perception was more favourable for GBT than SRP. CONCLUSIONS: Biofilm removal using erythritol AIRFLOW® and ultrasonic piezo-electric instruments (GBT) can be considered equally efficient compared with the conventional SRP. Moreover, GBT seemed to require shorter treatment time and to exhibit a more favourable patient perception than the conventional approach.

Enamel matrix derivative as an adjunct to minimally invasive non-surgical treatment of intrabony defects: A randomized clinical trial.

AIM: To compare the efficacy of minimally invasive non-surgical technique (MINST) with or without enamel matrix derivative (EMD) in the treatment of intrabony defects ≤7 mm. MATERIALS AND METHODS: Thirty-six patients were randomly assigned to the two groups. The control group received MINST, while the experimental MINST+EMD. Clinical measurements were recorded at baseline and at 6 and 12 months, and radiographic measurements were made at baseline and 12 months. RESULTS: All subjects completed the study, 18 in each group. Significant improvements were observed in both groups at 12 months (p < .001) with no differences in mean PD reduction (4.0 ± 1.4 vs. 4.2 ± 1.7 mm), CAL gain (3.5 ± 1.4 vs. 3.4 ± 1.6 mm), and defect resolution (1.9 ± 1.1 vs. 1.8 ± 0.9 mm) for the MINST and the MINST+EMD groups, respectively (p > .05). A trend for greater pocket closure (PD ≤4 mm and no BoP) was achieved with the application of EMD (77.8% vs. 55.6% sites), particularly for sites with baseline PD ≤8 mm (92.3% vs. 69.2% sites), accompanied by an increased number of successful composite outcome results (61.1% vs. 44.4% sites). CONCLUSIONS: MINST demonstrates significant improvements 12 months after treatment of intrabony defects ≤7 mm. The additional application of EMD does not further improve the mean clinical or radiographic outcomes. This study is registered in ClinicalTrials.gov (NCT03622255).

Prevalance and clinical characteristics of gingival recession in Greek young adults: A cross-sectional study.

OBJECTIVE: The current cross-sectional study aimed to investigate the prevalence of gingival recession (REC) in a sample of young individuals. In addition, the association with several risk factors was examined. MATERIALS & METHODS: A 104 subjects, aged 18-30 years old, were randomly enrolled in the study. Participants were requested to fill in a simple structured questionnaire in order to provide information on dental hygiene habits, educational level, smoking and history of orthodontic treatment. Afterwards, all the included individuals were subjected to a thorough clinical periodontal examination including gingival recession (REC), gingival biotype, plaque levels and gingival bleeding index (GBI) assessment. RESULTS: The mean prevalence of REC in the studied population surpassed 50% with an equal distribution among females and males. The most common teeth associated with REC were the lower left canine and left 1st premolar. Among the examined variables, only the bleeding index was found to be associated with the presence of REC. CONCLUSIONS: Gingival recession was a prevalent condition among young individuals. Gingival inflammation was found to be the most significant factor affecting the incidence of REC.

Is There an Association between the Gingival Phenotype and the Width of Keratinized Gingiva? A Systematic Review.

The concept of gingival phenotype and width of keratinized gingiva influencing the diagnosis and treatment in the periodontal scenario is relatively new. Soft and hard tissue dimensions of oral tissues are considered essential parameters in daily clinical practice. Factors such as the biotype category and the width of the keratinized gingiva help dentists seek the perfect therapy plan for each patient to achieve long-term stability of periodontal health. Several methods have been proposed to categorize phenotypes and each phenotype is characterized by various clinical characteristics. This review aims to discuss the possible association between the gingival phenotype and the width of keratinized gingiva along with the results appeared. After a rigorous search in major electronic databases, the results of the included studies indicated that the width of keratinized gingiva seems to be associated with the periodontal phenotype, with thick biotypes being characterized by a more pronounced keratinized gingival width. However, the heterogeneity of the included studies did not allow to make a conclusion about a direct relationship.

Detrusor Overactivity May Be a Prognostic Factor for Better Response to Combination Therapy Over Monotherapy in Male Patients With Benign Prostatic Enlargement and Storage Lower Urinary Tract Symptoms.

PURPOSE: Several trials have shown that in men with overactive bladder (OAB) and benign prostate enlargement (BPE), the combination of an α-blocker with an anticholinergic is superior to α-blocker monotherapy. The purpose of this study is to explore whether urodynamic detrusor overactivity (DO) affects clinical outcomes in men with BPE and OAB. METHODS: This is a post hoc analysis of a prospective, randomized trial, designed to evaluate the changes of morphometric parameters of the prostate following monotherapy or combination therapy in men with BPE-OAB. The initial study recruited men aged ≥50 years, with BPE and predominantly storage lower urinary tract symptoms (LUTS). Patients were randomized to receive tamsulosin monotherapy or a combination of tamsulosin and solifenacin for 26 weeks. All participants completed a 3-day bladder diary and the International Prostate Symptom Score (IPSS), and then underwent pressure-flow and ultrasonographic studies. Data were stratified and analysed based on the urodynamic observation of DO at baseline (DO vs. non-DO). The primary endpoint was the mean change in urgency episodes from baseline. Secondary outcomes were the changes in nocturia, total IPSS, and urodynamic parameters. RESULTS: Sixty-nine men were initially randomized, but only 60 men were included in this analysis. Urgency episodes significantly improved in men with DO who received combination therapy compared to the DO monotherapy subgroup (P=0.04) or to the non-DO combination treatment subgroup (P=0.038). Nocturia also improved in the DO combination treatment subgroup as compared to the non-DO combination subgroup (P=0.037). The 24-hour frequency and total IPSS significantly improved from baseline without significant differences among the subgroups. CONCLUSION: The present study suggests that baseline DO could be a prognostic factor for a better response to combination therapy over monotherapy in men with BPE and storage LUTS.

Evaluation of a Double Layer Technique to Enhance Bone Formation in Atrophic Alveolar Ridge: Histologic Results of a Pilot Study.

The atrophic alveolar ridge has been a challenge in implant dentistry; various techniques using the principle of guided bone regeneration (GBR) have been applied in the past 2 decades.The aim of this study was to introduce and evaluate-clinically, histologically, and radiographically-a novel technique of regenerating a new bone in the atrophic alveolar ridge, which is based on the GBR principles, the double layer technique (DLT). Six patients with partially edentulous jaws with a residual bone width less than or equal to 4 mm in the maxilla were subjected to GBR. The sites were grafted using a DLT. At first, sites were grafted with allogenic bone and then a second layer of deproteinized bovine bone was placed. Next, grafted sites were covered with a resorbable membrane tucked with 2 titanium pins. Cone-beam computed tomography scans were obtained before and 5 months after DLT. In the latter case and during implant site preparation, trephine biopsies were obtained and processed for histologic and histomorphometric evaluation. In all cases, implants were successfully installed and primary stability was established. Implant diameter ranged from 3.8 to 4.1 mm. In all cases, radiographic findings showed increased alveolar ridge width before and after surgery. The new tissues consisted mostly of a variable amount of new trabecular bone, some loose connective tissue, blood vessels, and occasional inflammatory cells. All 15 implants placed had 100% survival rate after a 5-year follow-up. On the basis of these preliminary results, it seems that the double layer GBR technique may achieve satisfactory results from a clinical, radiographic, and histologic perspective favoring placement of dental implants in the atrophic maxillary alveolar ridge.

Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population-A Prospective Cohort Study.

While periodontitis deteriorates patients' quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients' perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters.

The application of antimicrobial photodynamic therapy (aPDT, 670 nm) and diode laser (940 nm) as adjunctive approach in the conventional cause-related treatment of chronic periodontal disease: a randomized controlled split-mouth clinical trial.

OBJECTIVES: The aim of the present randomized controlled split-mouth clinical trial is to evaluate the effectiveness of the adjunctive use of photodynamic low-level laser therapy (670 nm), applying methylene blue as photosensitizer, and the effectiveness of a diode laser (940 nm) compared with conventional non-surgical mechanical treatment in a group of patients with chronic periodontal disease. MATERIALS AND METHODS: Twenty-one patients with moderate to severe periodontal disease with presence of 3 or more quadrants, each containing at least three sites with periodontal pocket depth (PPD) of ≥ 5 mm, were included in the study. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (control group), SRP with diode laser (diode group), and SRP with photodynamic therapy (photodynamic group). RESULTS: All treatment modalities in this study lead to statistically significant improvements in the evaluated clinical parameters at 3 months and 6 months compared with baseline. There was no statistically significant difference regarding PD and BOP between groups. There was only a tendency for greater reduction of PD in the diode group for deep pockets at 3 months, but not statistically significant. CONCLUSIONS: After 6 months of evaluation, the high intensity diode laser and the antimicrobial photodynamic therapy have not shown any additional benefits to the conventional periodontal treatment. CLINICAL RELEVANCE: The diode or photodynamic laser therapy in conjunction with conventional SRP does not seem to be superior in reducing probing depth and bleeding on probing than SRP alone 6 months after treatment. More studies are necessary to prove the actual need of these types of lasers in the periodontal clinical practice.

Subtle errors of bladder wall thickness measurement have a significant impact on the calculation of ultrasound-estimated bladder weight. A pilot study.

AIMS: Ultrasound-estimated bladder weight (UEBW), is an emerging diagnostic tool, which has been used in both males and females with lower urinary tract dysfunction. The currently acknowledged UEBW calculation methods rely on the accurate measurement of bladder wall thickness (BWT). We aim to identify if subtle errors in BWT measurement have a significant impact on UEBW calculations. MATERIALS AND METHODS: Twenty patients were randomly selected from an overactive bladder patient cohort. The primary endpoint was to identify the range of false BWT measurements outside which significant changes in UEBW calculation occur. We used the Kojima method and a semi-automatic 3-D model that is based on Chalana's principle. Measurements were performed using the correct BWT and a series of faulty calculations from +0.5 mm to -0.5 mm using steps of 0.05 mm from true BWT. The effect of a fixed 0.5 mm BWT error was checked in bladder volumes above and below 250 ml and in three UEBW groups (<35 gr; 36-50 gr; >51gr). RESULTS: BWT measurement errors above 0.25 mm cause statistically significant changes in UEWB calculation when a 3-D model is used and errors above 0.15 mm when Kojima's method is used. At a fixed BWT error of 0.5 mm and bladder volume <250 ml, there is a 23.76% deviation from true UEBW, while at volumes >250 ml the deviation is 32.72%. The deviation is inversely proportional to the UEBW result, and heavier bladders deviate less. CONCLUSIONS: UEBW is a promising diagnostic tool, but small errors in BWT measurement might cause significant deviation from the true values. A 3-D calculation model appears to minimize such risks.

Combination of solifenacin with tamsulosin reduces prostate volume and vascularity as opposed to tamsulosin monotherapy in patients with benign prostate enlargement and overactive bladder symptoms: Results from a randomized pilot study.

OBJECTIVES: To identify the potential influence of antimuscarinics on morphometric parameters of the prostate in patients with benign prostatic enlargement and overactive bladder. METHODS: Non-neurological patients with prostate volume >30 mL, predominately storage lower urinary tract symptoms, three or more urgency episodes per 24 h, maximum flow rate ≥10 mL/s and post-void residual ≤100 mL were recruited for this study. They were randomized to receive either tamsulosin or tamsulosin + solifenacin. Patients were submitted to transrectal and transvesical ultrasonography, pressure-flow study and prostate-specific antigen test, and completed the International Prostate Symptom Score, bladder diary and overactive bladder questionnaire at induction and at 6 months. End-study changes in morphometric prostate parameters (total prostate and adenoma volumes, prostate vascularity), as measured by transrectal ultrasound, were the principal outcomes. RESULTS: A reduction in total prostate volume (mean -9.5%) was noted in the combination group, as opposed to an increase in the monotherapy group (+9.2%; P < 0.001). Similar changes were reflected in adenoma volume (monotherapy +17.4% vs combination -12.5%, P = 0.001) and in prostate vascularity (monotherapy +149.3% vs combination -19.8%, P = 0.001). Both treatment regimens improved the International Prostate Symptom Score (P = 0.001); monotherapy improved the voiding subscale (P = 0.01) more, whereas combination therapy improved the storage subscale (P = 0.024). Cystometric capacity improved in the combination group (P < 0.001). Post-void residual was increased in the combination group (+34.79%), as opposed to a decrease in the monotherapy group (-17.05%; P = 0.001). CONCLUSIONS: The results of this pilot study suggest that solifenacin might affect morphometric properties of the prostate, decreasing total prostate and adenoma volume, as well as vascularity. A molecular effect of antimuscarinics on the prostate, in parallel with their expected bladder effect, warrants further investigation.

Comparison of enamel matrix derivative (Emdogain) and subepithelial connective tissue graft for root coverage in patients with multiple gingival recession defects: A randomized controlled clinical study.

OBJECTIVE: The purpose of the present study was to compare the clinical efficiency of enamel matrix derivative (EMD) placed under a coronally advanced flap (CAF; test group), to a connective tissue graft (CTG) placed under a CAF (control group), in patients with multiple recession defects. METHOD AND MATERIALS: Twelve patients with multiple Miller's Class I or II gingival recessions in contralateral quadrants of the maxilla were selected. The primary outcome variable was the change in depth of the buccal recession (REC), at 6 months (T6) after surgery. The secondary outcome parameters included the clinical attachment level (CAL), the probing pocket depth (PPD), and the width of keratinized gingiva (WKT) apical to the recession. Recession defects were randomly divided to the test or control group by using a computer-generated randomization list. Data were analyzed within the frame of Mixed Linear Models with the ANOVA method. RESULTS: There were no statistically significantly differences observed between test and control groups in regards with the depth of buccal recession with a mean REC of 1.82 mm (CTG) and 1.72 mm (EMD) respectively. Similarly the mean PPD value was 1.3 mm for both groups at T6, while the respective value for CAL was 1.7 mm (EMD) and 1.8 mm (CTG). Statistically significant differences were observed only for the WKT, which were 3.0 mm and 3.6 mm for the test and control groups respectively (P < .001) at T6. CONCLUSION: The use of EMD in conjunction with a CAF resulted in similar results as compared to the CTG plus CAF.

Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis.

OBJECTIVE: To investigate the outcomes of implant therapy in partially dentate patients treated for aggressive periodontitis (GAgP) in comparison to periodontally healthy (HP) and patients treated for chronic periodontitis (CP) utilizing radiographic and clinical parameters. MATERIAL AND METHODS: An electronic search of databases, supplemented by hand searching, was conducted to identify relevant clinical studies. Sequential screenings at the title, abstract and full-text levels were performed independently and in duplicate. A random effects meta-analysis was conducted and bias corrected bootstrap 95 % confidence intervals were estimated for group comparisons. RESULTS: The search strategy revealed a total of 899 results. After title screening, abstract scanning, and full-text reading, seven articles fulfilled the inclusion criteria. The 3-year survival rate for CP and HP patients was 100 % while in GAgP subjects, the respective value was 97.98 %; this difference being statistically significant. The 3-year mean marginal bone loss (MBL) was 1.07 mm for the GAgP group, 0.47 mm for the CP group, and 0.69 mm for the HP group. A significant difference between the GAgP and CP groups was identified (p < 0.05). The weighted mean differences of MBL concerning the above groups were also calculated and examined for statistical significance in both 1 and 3 years. CONCLUSIONS: The 3-year survival rate and peri-implant marginal bone loss was found statistically significantly lower in GAgP subjects (SR 97.98 % vs 100 %) in comparison to HP and CP individuals. CLINICAL RELEVANCE: The outcome of implant therapy in terms of survival rate and marginal bone loss is considered very important for the clinician in decision making when placing implants in patients with a history of aggressive periodontitis.

Diagnosis and treatment of ankyloglossia: A narrative review and a report of three cases.

BACKGROUND: Ankyloglossia or tongue-tie is a congenital oral anomaly with short, tight, and thick lingual frenulum. It may be asymptomatic or can cause movement limitations of the tongue, speech and articulation difficulties, breastfeeding difficulties in neonates, as well as periodontal and malocclusion problems. The etiopathogenesis of ankyloglossia is unknown; it can occur either as a sole anomaly in the vast majority or in association with other craniofacial anomalies. OBJECTIVES: The aims of this paper were (1) to provide a comprehensive review on the criteria for clinical assessment and diagnosis, etiology and inheritance, and the therapeutic options of ankyloglossia; and (2) to demonstrate the treatment of ankyloglossia by means of frenuloplasty in three cases. REVIEW: The available evidence from the literature indicates that among neonates, children, and adults the prevalence of ankyloglossia is low and in some cases remains undiagnosed. The early clinical assessment, diagnosis, and treatment are beneficial for the patients and their mothers. CONCLUSIONS: Frenuloplasty is a safe, quick, effective, and economical method and for this reason the parents should not hesitate towards frenulum release. More clinical studies are needed to confirm the benefits of the surgical interventions and to compare the results with those obtained using nonsurgical therapy or with untreated cases.